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Chen YL, Chen CY, Lai KH, Chang YC, Hwang TL. Anti-inflammatory and antiviral activities of flavone C-glycosides of Lophatherum gracile for COVID-19. J Funct Foods 2023; 101:105407. [PMID: 36627926 DOI: 10.1016/j.jff.2023.105407] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/28/2022] [Accepted: 01/03/2023] [Indexed: 01/07/2023] Open
Abstract
Lophatherum gracile (L. gracile) has long been used as a functional food and herbal medicine. Previous studies have demonstrated that extracts of L. gracile attenuate inflammatory response and inhibit SARS-CoV-2 replication; however, the underlying active constituents have yet to be identified. This study investigated the bioactive components of L. gracile. Flavone C-glycosides of L. gracile were found to dominate both anti-inflammatory and antiviral effects. A simple chromatography-based method was developed to obtain flavone C-glycoside-enriched extract (FlavoLG) from L. gracile. FlavoLG and its major flavone C-glycoside isoorientin were shown to restrict respiratory bursts and the formation of neutrophil extracellular traps in activated human neutrophils. FlavoLG and isoorientin were also shown to inhibit SARS-CoV-2 pseudovirus infection by interfering with the binding of the SARS-CoV-2 spike on ACE2. These results provide scientific evidence indicating the efficacy of L. gracile as a potential supplement for treating neutrophil-associated COVID-19.
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Key Words
- ACE2, angiotensin-converting enzyme 2
- CB, cytochalasin B
- COVID-19
- COVID-19, coronavirus disease 2019
- DMSO, dimethyl sulfoxide
- Flavone C-glycosides
- HBSS, Hank’s balanced salt solution
- HPLC, high-performance liquid chromatography
- IC50, half-maximal inhibitory concentration
- LDH, lactate dehydrogenase
- LG, Lophatherum gracile
- Lophatherum gracile
- MRM, multiple reaction monitoring
- NETs, neutrophil extracellular traps
- Neutrophils
- O2•−, superoxide
- RBD, receptor-binding domain
- ROS, reactive oxygen species
- SARS-CoV-2
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- UPLC, ultra-performance liquid chromatography
- fMLF, N-formyl-methionyl-leucyl-phenylalanine
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Keijzer K, Niezink AG, de Boer JW, van Doesum JA, Noordzij W, van Meerten T, van Dijk LV. Semi-automated 18F-FDG PET segmentation methods for tumor volume determination in Non-Hodgkin lymphoma patients: a literature review, implementation and multi-threshold evaluation. Comput Struct Biotechnol J 2023; 21:1102-1114. [PMID: 36789266 PMCID: PMC9900370 DOI: 10.1016/j.csbj.2023.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 01/21/2023] Open
Abstract
In the treatment of Non-Hodgkin lymphoma (NHL), multiple therapeutic options are available. Improving outcome predictions are essential to optimize treatment. The metabolic active tumor volume (MATV) has shown to be a prognostic factor in NHL. It is usually retrieved using semi-automated thresholding methods based on standardized uptake values (SUV), calculated from 18F-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) images. However, there is currently no consensus method for NHL. The aim of this study was to review literature on different segmentation methods used, and to evaluate selected methods by using an in house created software tool. A software tool, MUltiple SUV Threshold (MUST)-segmenter was developed where tumor locations are identified by placing seed-points on the PET images, followed by subsequent region growing. Based on a literature review, 9 SUV thresholding methods were selected and MATVs were extracted. The MUST-segmenter was utilized in a cohort of 68 patients with NHL. Differences in MATVs were assessed with paired t-tests, and correlations and distributions figures. High variability and significant differences between the MATVs based on different segmentation methods (p < 0.05) were observed in the NHL patients. Median MATVs ranged from 35 to 211 cc. No consensus for determining MATV is available based on the literature. Using the MUST-segmenter with 9 selected SUV thresholding methods, we demonstrated a large and significant variation in MATVs. Identifying the most optimal segmentation method for patients with NHL is essential to further improve predictions of toxicity, response, and treatment outcomes, which can be facilitated by the MUST-segmenter.
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Key Words
- 18F-FDG PET
- AT, adaptive thresholding methods
- CAR, chimeric antigen receptor
- CT, computed tomography
- DICOM, Digital Imaging and Communications in Medicine
- DLBCL, Diffuse large B-cell lymphoma
- EANM, European Association of Nuclear Medicine
- EARL, EANM Research Ltd.
- FDG, fluorodeoxyglucose
- HL, Hodgkin lymphoma
- IMG, robustness across image reconstruction methods
- IQR, interquartile range
- LBCL, Large B-cell lymphoma
- LDH, lactate dehydrogenase
- MAN, clinician based evaluation using manual segmentations
- MATV, Metabolic active tumor volume
- MIP, Maximum Intensity Projection
- MUST, Multiple SUV Thresholding
- Metabolic tumor volume
- NHL, Non-Hodgkin lymphoma
- Non-Hodgkin lymphoma
- OBS, robustness across observers
- OS, overall survival
- PD-L1, programmed cell death ligand-1
- PET segmentation
- PET, positron emission tomography
- PFS, progression free survival
- PROG, progression vs non-progression
- PTCL, Peripheral T-cell lymphoma
- PTLD, Post-transplant lymphoproliferative disorder
- QS, quality scores
- SOFT, robustness across software
- SUV thresholding
- SUV, standardized uptake value
- Segmentation software
- TCL, T-cell lymphoma
- UMCG, University Medical Center Groningen
- VOI, volume of interest
- cc, cubic centimeter
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Affiliation(s)
- Kylie Keijzer
- Department of Hematology, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands,Department of Radiation Oncology, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Anne G.H. Niezink
- Department of Radiation Oncology, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Janneke W. de Boer
- Department of Hematology, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Jaap A. van Doesum
- Department of Hematology, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Walter Noordzij
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Tom van Meerten
- Department of Hematology, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Lisanne V. van Dijk
- Department of Radiation Oncology, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands,Corresponding author.
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Bodensohn R, Werner S, Reis J, Pazos Escudero M, Kaempfel AL, Hadi I, Forbrig R, Manapov F, Corradini S, Belka C, Theurich S, Heinzerling L, Schlaak M, Niyazi M. Stereotactic radiosurgery and combined immune checkpoint therapy with ipilimumab and nivolumab in patients with melanoma brain metastases: A retrospective monocentric toxicity analysis. Clin Transl Radiat Oncol 2023; 39:100573. [PMID: 36655118 PMCID: PMC9841023 DOI: 10.1016/j.ctro.2022.100573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 01/06/2023] Open
Abstract
Purpose and objective Adding stereotactic radiosurgery (SRS) to combined immune checkpoint therapy with ipilimumab and nivolumab (IPI + NIVO) has led to promising results for patients with melanoma brain metastases (MBM). This study retrospectively analyzes the toxicity profile depending on the timing of SRS with regard to IPI + NIVO. Materials and methods For this study, the clinical database was searched for all patients with MBM who were treated with SRS and IPI + NIVO. The patients were separated into three groups: group A completed IPI + NIVO (usually up to four cycles) >14 days before SRS, in group B IPI + NIVO was initiated>14 days after SRS, and group C received SRS concurrently to IPI + NIVO. Treatment related toxicity was obtained from clinical and neuroradiological records. Analyses were performed using the Fisher-Yates-test. Results 31 patients were assessed including six (19.4 %), seven (22.6 %) and 18 (58.1 %) patients, in groups A, B and C, respectively. Baseline prognostic markers between groups were balanced. In total, five (16.1 %) patients experienced neurological grade 3 toxicities related to SRS. All of these five patients were in group C, which was near-significantly correlated with a risk for grade 3 toxicities (p = 0.058). Post-hoc analyses showed that a maximum time period of seven days between SRS and IPI + NIVO was significantly correlated with grade 3 toxicity (p = 0.048). Conclusion Application of SRS to IPI + NIVO within a seven-day span was related to higher toxicity rates in this retrospective analysis. After previous studies focused on immune checkpoint monotherapies with SRS and declared it as safe, this study indicates that concomitant application of IPI + NIVO and SRS might increase side effects. Prospective validation is warranted to corroborate these findings.
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Key Words
- AE, Adverse events
- CTCAE, Common Terminology Criteria for Adverse Events
- Checkpoint inhibition
- GPA, graded prognostic assessment
- IPI, ipilimumab
- Intracranial hemorrhage
- Ipilimumab
- LDH, lactate dehydrogenase
- MBM, Melanoma brain metastases
- MRI, magnet resonance imaging
- NIVO, nivolumab
- Nivolumab
- OS, overall survival
- PFS, progression-free survival
- RN, radiation necrosis
- Radiation necrosis
- SRS, Stereotactic radiosurgery
- SRT, Stereotactic radiotherapy
- Side effects
- Stereotactic radiosurgery
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Affiliation(s)
- Raphael Bodensohn
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Simone Werner
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Jonas Reis
- Institute of Neuroradiology, University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Montserrat Pazos Escudero
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Anna-Lena Kaempfel
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Indrawati Hadi
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Robert Forbrig
- Institute of Neuroradiology, University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Farkhad Manapov
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Claus Belka
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany,German Cancer Consortium (DKTK), Partner Site, Munich, Germany
| | - Sebastian Theurich
- Department of Medicine III, University Hospital, LMU Munich, Ziemssenstraße 1, 80336 Munich, Germany
| | - Lucie Heinzerling
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Frauenlobstraße 9-11, 80337 Munich, Germany,Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Ulmenweg 18, 91052 Erlangen, Germany
| | - Max Schlaak
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117 Berlin, Germany
| | - Maximilian Niyazi
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany,German Cancer Consortium (DKTK), Partner Site, Munich, Germany,Corresponding author at: Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
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Tanaka Y, Takahashi K, Hattori N, Yokoyama H, Yamaguchi K, Shibui Y, Kawaguchi S, Shimazaki T, Nakai K, Kusuhara H, Saito Y. The influence of serial 50 μL microsampling on rats administered azathioprine, the immunosuppressive drug. Toxicol Rep 2023; 10:334-340. [PMID: 36923445 PMCID: PMC10008918 DOI: 10.1016/j.toxrep.2023.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/20/2023] [Accepted: 02/28/2023] [Indexed: 03/05/2023] Open
Abstract
According to the ICH S3A Q&A, microsampling is applicable to pharmaceutical drugs and toxicological analysis. Few studies have reported the effect of microsampling on the toxicity of immunotoxicological drugs. The aim of this multicenter study was to evaluate the toxicological effects of serial microsampling on rats treated with azathioprine as a model drug with immunotoxic effects. Fifty microliters of blood were collected from the jugular vein of Sprague-Dawley rats at six time points from day 1 to 2 and 7 time points from day 27 to 28. The study was performed at three organizations independently. The microsampling effect on clinical signs, body weights, food consumption, hematological parameters, biochemical parameters, urinary parameters, organ weights, and tissue pathology was evaluated. Azathioprine-induced changes were observed in certain hematological and biochemical parameters and thymus weight and pathology. Microsampling produced minimal or no effects on almost all parameters; however, at 2 organizations, azathioprine-induced changes were apparently masked for two leukocytic, one coagulation, and two biochemical parameters. In conclusion, azathioprine toxicity could be assessed appropriately as overall profiles even with blood microsampling. However, microsampling may influence azathioprine-induced changes in certain parameters, especially leukocytic parameters, and its usage should be carefully considered.
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Key Words
- A/G, albumin/globulin
- ALP, alkaline phosphatase
- ALT, alanine transaminase
- APTT, activated partial thromboplastin time
- AST, aspartate transaminase
- Azathioprine
- BUN, blood urea nitrogen
- CPK, creatine phosphokinase
- Ca, calcium
- Cl, chloride
- Cre, creatinine
- GLDH, glutamate dehydrogenase
- Hematological parameter
- ICH, International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
- Jugular vein
- K, potassium
- LDH, lactate dehydrogenase
- MCH, mean corpuscular hemoglobin
- MCHC, mean corpuscular hemoglobin concentration
- MCV, mean corpuscular volume
- Microsampling
- Na, sodium
- P, inorganic phosphorus
- PT, prothrombin time
- RBC, red blood cell
- Rat
- TK, toxicokinetics
- Toxicokinetics
- WBC, leukocyte/white blood cell
- γGT, γ-glutamyltranspeptidase
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Affiliation(s)
- Yoichi Tanaka
- Division of Medicinal Safety Science, National Institute of Health Sciences, 3-25-26, Tonomachi, Kawasaki-ku, Kasasaki-shi, Kanagawa, Japan
| | - Kazuaki Takahashi
- LSIM Safety Institute Corporation., 14-1 Sunayama, Kamisu-shi, Ibaraki, Japan
| | - Norimichi Hattori
- Ajinomoto Fine-Techno Co., Inc., 1-1, Suzuki-cho, Kawasaki-ku, Kwasaki-shi, Kanagawa, Japan
| | - Hideaki Yokoyama
- Japan Tobacco Inc., 1-13-2, Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Koki Yamaguchi
- Japan Tobacco Inc., 1-13-2, Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Yusuke Shibui
- Ajinomoto Fine-Techno Co., Inc., 1-1, Suzuki-cho, Kawasaki-ku, Kwasaki-shi, Kanagawa, Japan
| | - Sayaka Kawaguchi
- Ajinomoto Fine-Techno Co., Inc., 1-1, Suzuki-cho, Kawasaki-ku, Kwasaki-shi, Kanagawa, Japan
| | - Taishi Shimazaki
- Japan Tobacco Inc., 1-13-2, Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Keiko Nakai
- LSIM Safety Institute Corporation., 14-1 Sunayama, Kamisu-shi, Ibaraki, Japan
| | - Hiroyuki Kusuhara
- Laboratory of Molecular Pharmacokinetics, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yoshiro Saito
- Division of Medicinal Safety Science, National Institute of Health Sciences, 3-25-26, Tonomachi, Kawasaki-ku, Kasasaki-shi, Kanagawa, Japan
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Vasbinder A, Chen Y, Procureur A, Gradone A, Azam TU, Perry D, Shadid H, Anderson E, Catalan T, Blakely P, Nelapudi N, Fardous M, Bretagne MC, Adie SK, Pogue KT, Leja M, Yentz S, Schneider B, Fecher LA, Lao CD, Salem JE, Hayek SS. Biomarker Trends, Incidence, and Outcomes of Immune Checkpoint Inhibitor-Induced Myocarditis. JACC CardioOncol 2022; 4:689-700. [PMID: 36636441 PMCID: PMC9830199 DOI: 10.1016/j.jaccao.2022.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 12/24/2022] Open
Abstract
Background Myocarditis is a dreaded and unpredictable complication of immune checkpoint inhibitors (ICI). We sought to determine whether routinely measured biomarkers could be helpful in monitoring for ICI myocarditis. Objectives The authors examined biomarker trends of patients on ICI and their association with the incidence of ICI myocarditis and outcomes. Methods We conducted an observational cohort study of adults who received at least one dose of ICI at Michigan Medicine between June 2014 and December 2021 and underwent systematic serial testing for aspartate aminotransferase (AST) and alanine aminotransferase (ALT), creatine phosphokinase (CPK), and lactate dehydrogenase during ICI therapy. Results Among 2,606 patients (mean age 64 ± 13 years; 60.7% men), 27 (1.0%) were diagnosed with ICI myocarditis. At diagnosis, patients with myocarditis had an elevated high-sensitivity troponin T (100%), ALT (88.9%), AST (85.2%), CPK (88.9%), and lactate dehydrogenase (92.6%). Findings were confirmed in an independent cohort of 30 patients with biopsy-confirmed ICI myocarditis. A total of 95% of patients with ICI myocarditis had elevations in at least 3 biomarkers compared with 5% of patients without myocarditis. Among the noncardiac biomarkers, only CPK was associated (per 100% increase) with the development of myocarditis (HR: 1.83; 95% CI: 1.59-2.10) and all-cause mortality (HR: 1.10; 95% CI: 1.01-1.20) in multivariable analysis. Elevations in CPK had a sensitivity of 99% and specificity of 23% for identifying myocarditis. Conclusions ICI myocarditis is associated with changes in AST, ALT, and CPK. An increase in noncardiac biomarkers during ICI treatment, notably CPK, should prompt further evaluation for ICI myocarditis.
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Affiliation(s)
- Alexi Vasbinder
- Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - YeeAnn Chen
- Department of Clinical Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
| | - Adrien Procureur
- Department of Pharmacology and Clinical Investigation Centre, Pitié-Salpêtrière Hospital, Sorbonne Universite, Paris, France
| | - Allison Gradone
- Rogel Cancer Center, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Tariq U. Azam
- Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Daniel Perry
- Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Husam Shadid
- Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Elizabeth Anderson
- Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Tonimarie Catalan
- Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Pennelope Blakely
- Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Namratha Nelapudi
- Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Mohamad Fardous
- Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Marie C. Bretagne
- Department of Pharmacology and Clinical Investigation Centre, Pitié-Salpêtrière Hospital, Sorbonne Universite, Paris, France
| | - Sarah K. Adie
- Department of Clinical Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
| | - Kristen T. Pogue
- Department of Clinical Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
| | - Monika Leja
- Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Sarah Yentz
- Rogel Cancer Center, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Bryan Schneider
- Rogel Cancer Center, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Leslie A. Fecher
- Rogel Cancer Center, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Christopher D. Lao
- Rogel Cancer Center, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Joe-Elie Salem
- Department of Pharmacology and Clinical Investigation Centre, Pitié-Salpêtrière Hospital, Sorbonne Universite, Paris, France
| | - Salim S. Hayek
- Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA,Address for correspondence: Dr Salim Hayek, Department of Medicine, Division of Cardiology, University of Michigan Frankel Cardiovascular Center, 1500 East Medical Center Drive, CVC #2709, Ann Arbor, Michigan 48109, USA. @salimhayek
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Santopolo G, Clemente A, González-Freire M, Russell SM, Vaquer A, Barón E, Aranda M, Socias A, Del Castillo A, Borges M, de la Rica R. Plasma-induced nanoparticle aggregation for stratifying COVID-19 patients according to disease severity. Sens Actuators B Chem 2022; 373:132638. [PMID: 36124254 PMCID: PMC9476366 DOI: 10.1016/j.snb.2022.132638] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/06/2022] [Indexed: 06/15/2023]
Abstract
Stratifying patients according to disease severity has been a major hurdle during the COVID-19 pandemic. This usually requires evaluating the levels of several biomarkers, which may be cumbersome when rapid decisions are required. In this manuscript we show that a single nanoparticle aggregation test can be used to distinguish patients that require intensive care from those that have already been discharged from the intensive care unit (ICU). It consists of diluting a platelet-free plasma sample and then adding gold nanoparticles. The nanoparticles aggregate to a larger extent when the samples are obtained from a patient in the ICU. This changes the color of the colloidal suspension, which can be evaluated by measuring the pixel intensity of a photograph. Although the exact factor or combination of factors behind the different aggregation behavior is unknown, control experiments demonstrate that the presence of proteins in the samples is crucial for the test to work. Principal component analysis demonstrates that the test result is highly correlated to biomarkers of prognosis and inflammation that are commonly used to evaluate the severity of COVID-19 patients. The results shown here pave the way to develop nanoparticle aggregation assays that classify COVID-19 patients according to disease severity, which could be useful to de-escalate care safely and make a better use of hospital resources.
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Key Words
- AST, aspartate aminotransferaseALT, alanine aminotransferase
- Alb, albumin
- C1.75, protein concentration 1.75 × 10-4 g·dL-1
- CPImin, protein concentration at PImin
- CRP, C-reactive protein
- Colorimetric
- Creat, creatinine
- D-D, D-dimer
- Ferr, ferritin
- GGT, gamma-glutamyl transferase
- Glu, glucose
- Gold
- Hb, hemoglobin
- ICU, intensive care unit
- INR, international normalized ratio (prothrombin time)
- LDH, lactate dehydrogenase
- LSPR, localized surface plasmon resonance
- MCV, mean corpuscular volume
- MPV, mean platelet volume
- Mono, monocytes
- NIR, near-infrared
- NLR, neutrophil-to-lymphocyte ratio
- NTA, nanoparticle tracking analysis
- PDW, platelet distribution width
- PI, pixel intensity
- PI1.75, pixel intensity at C1.75
- PIdil, pixel intensity at plasma dilution 1:31250
- PImin, minimum value of pixel intensity
- PLR, platelet-to-lymphocyte ratio
- Plasmonic
- RBC, red blood cells
- RDW, red cell distribution width
- SARS-CoV-2
- Sepsis
- TG, triglycerides
- TotProt, total protein concentration
- WBC, white blood cells
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Affiliation(s)
- Giulia Santopolo
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- University of the Balearic Islands (UIB), Chemistry Department, 07122 Palma, Spain
| | - Antonio Clemente
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Marta González-Freire
- Translational Research In Aging and Longevity (TRIAL) group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Steven M Russell
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Andreu Vaquer
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- University of the Balearic Islands (UIB), Chemistry Department, 07122 Palma, Spain
| | - Enrique Barón
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - María Aranda
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, 07198 Palma, Spain
| | - Antonia Socias
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, 07198 Palma, Spain
| | - Alberto Del Castillo
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, 07198 Palma, Spain
| | - Marcio Borges
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, 07198 Palma, Spain
| | - Roberto de la Rica
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), 28029 Madrid, Spain
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Okuno T, Nakashima K, Mitarai Y, Kataoka M, Tobita H, Nagase M, Isobe T, Tsubata Y. Immune checkpoint inhibitor (ICI)-induced hepatitis diagnosed by liver biopsy followed by ICI-free chemotherapy leading to therapeutic effect: A case of lung cancer treatment. Respir Med Case Rep 2022; 40:101753. [PMID: 36217354 PMCID: PMC9547299 DOI: 10.1016/j.rmcr.2022.101753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 09/28/2022] [Accepted: 10/03/2022] [Indexed: 11/11/2022] Open
Abstract
In recent years, the combination of platinum-based chemotherapy and immune checkpoint inhibitors (ICIs) has become the standard treatment for patients with lung cancer. Hepatitis is one of the common toxicities following ICI/chemotherapy. When drug-induced hepatitis occurs, the suspected drug must be discontinued. Since it may be difficult to determine the exact drug causing the hepatitis, liver biopsy may help identify this. We report the case of a patient diagnosed with immune-related adverse event hepatitis from liver biopsy and clinical course. A 45-year-old man with lung adenocarcinoma (stage IV, cT4N3M1c) negative for driver gene mutation was treated with carboplatin (CBDCA), pemetrexed (PEM), and pembrolizumab. Elevated blood aspartate aminotransferase and alanine aminotransferase levels after chemotherapy indicated hepatitis induced by cytotoxic anticancer agents and ICIs. As autoimmune hepatitis was also suspected, liver biopsy was performed and the findings suggested ICI-induced hepatitis. Pembrolizumab was discontinued and CBDCA/PEM was resumed, following which, the primary lesion shrank. When drug-induced hepatitis is suspected, clinicians should actively perform liver biopsy to confirm the diagnosis, so that appropriate therapeutic regimen can be administered.
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Key Words
- AIH, autoimmune hepatitis
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- CBDCA, carboplatin
- CT, computed tomography
- CTCAE, Common Terminology for Adverse Events
- Hepatitis
- ICI, immune checkpoint inhibitor
- Immune checkpoint inhibitor
- Immune-related adverse events
- LDH, lactate dehydrogenase
- Liver biopsy
- Non-small cell lung cancer
- PEM, pemetrexed
- PSL, prednisolone
- irAE, immune-related adverse event
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Affiliation(s)
- Takae Okuno
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
| | - Kazuhisa Nakashima
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
| | - Yuki Mitarai
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
| | - Masatoshi Kataoka
- Department of Gastroenterology and Hepatology, Shimane University Faculty of Medicine, Japan
| | - Hiroshi Tobita
- Department of Gastroenterology and Hepatology, Shimane University Faculty of Medicine, Japan
| | - Mamiko Nagase
- Department of Organ Pathology, Shimane University Faculty of Medicine, Japan
| | - Takeshi Isobe
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
| | - Yukari Tsubata
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan,Corresponding author. Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine 89-1 Enya-cho, Izumo, Shimane 693-8501, Japan.
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Magalingam KB, Somanath SD, Haleagrahara N, Selvaduray KR, Radhakrishnan AK. Unravelling the neuroprotective mechanisms of carotenes in differentiated human neural cells: Biochemical and proteomic approaches. Food Chem (Oxf) 2022; 4:100088. [PMID: 35415676 DOI: 10.1016/j.fochms.2022.100088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/08/2022] [Accepted: 02/11/2022] [Indexed: 12/20/2022]
Abstract
Total mixed carotenes (TMC) protect differentiated human neural cells against 6-hydroxydopamine-induced toxicity. TMC elevated the antioxidant enzymes activities and suppressed generation of reactive oxygen species. TMC augmented the dopamine and tyrosine hydroxylase levels. TMC exerted differential protein expression in human neural cells.
Carotenoids, fat-soluble pigments found ubiquitously in plants and fruits, have been reported to exert significant neuroprotective effects against free radicals. However, the neuroprotective effects of total mixed carotenes complex (TMC) derived from virgin crude palm oil have not been studied extensively. Therefore, the present study was designed to establish the neuroprotective role of TMC on differentiated human neural cells against 6-hydroxydopamine (6-OHDA)-induced cytotoxicity. The human neural cells were differentiated using retinoic acid for six days. Then, the differentiated neural cells were pre-treated for 24 hr with TMC before exposure to 6-OHDA. TMC pre-treated neurons showed significant alleviation of 6-OHDA-induced cytotoxicity as evidenced by enhanced activity of the superoxide dismutase (SOD) and catalase (CAT) enzymes. Furthermore, TMC elevated the levels of intra-neuronal dopamine and tyrosine hydroxylase (TH) in differentiated neural cells. The 6-OHDA induced overexpression of α-synuclein was significantly hindered in neural cells pre-treated with TMC. In proteomic analysis, TMC altered the expression of ribosomal proteins, α/β isotypes of tubulins, protein disulphide isomerases (PDI) and heat shock proteins (HSP) in differentiated human neural cells. The natural palm phytonutrient TMC is a potent antioxidant with significant neuroprotective effects against free radical-induced oxidative stress.
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Key Words
- 6-OHDA, 6-hydroxydopamine
- 6-hydroxydopamine
- AD, Alzheimer’s disease
- BCM, beta-carotene-15,15′-monooxygenase
- CAT, catalase
- DRD2, dopamine receptor D2
- Dopamine
- ER, endoplasmic reticulum
- GO, gene ontology
- HSP, Heat shock protein
- HSPA9, Heat shock protein family A (HSP70) member 9
- HSPD1, Heat shock protein family D (HSP60) member 1
- KEGG, Kyoto Encyclopedia of Genes and Genomes
- LC-MS/MS, liquid chromatography-double mass spectrometry
- LDH, lactate dehydrogenase
- MCODE, minimal common oncology data elements
- MS, mass spectrometry
- Mixed carotene
- PD, Parkinson's disease
- PDI, protein disulphide isomerases
- PHB2, prohibitin 2
- PPI, protein–protein interaction
- RAN, Ras-related nuclear protein
- ROS, reactive oxygen species
- RPs, ribosomal proteins
- SH-SY5Y neuroblastoma cells
- SOD, superoxide dismutase
- TH, tyrosine hydroxylase
- TMC, total mixed carotene complex
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Bawua SA, Ichihara K, Keatley R, Arko-Mensah J, Ayeh-Kumi PF, Erasmus R, Fobil J. Derivation of sex and age-specific reference intervals for clinical chemistry analytes in healthy Ghanaian adults. Clin Chem Lab Med 2022; 60:1426-1439. [PMID: 35786502 DOI: 10.1515/cclm-2022-0293] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 03/25/2022] [Accepted: 06/13/2022] [Indexed: 11/15/2022]
Abstract
OBJECTVIES This study is aimed at establishing reference intervals (RIs) of 40 chemistry and immunochemistry analytes for Ghanaian adults based on internationally harmonized protocol by IFCC Committee on Reference Intervals and Decision Limits (C-RIDL). METHODS A total of 501 healthy volunteers aged ≥18 years were recruited from the northern and southern regions of Ghana. Blood samples were analyzed with Beckman-Coulter AU480 and Centaur-XP/Siemen auto-analyzers. Sources of variations of reference values (RVs) were evaluated by multiple regression analysis (MRA). The need for partitioning RVs by sex and age was guided by the SD ratio (SDR). The RI for each analyte was derived using parametric method with application of the latent abnormal values exclusion (LAVE) method. RESULTS Using SDR≥0.4 as threshold, RVs were partitioned by sex for most enzymes, creatinine, uric acid (UA), bilirubin, immunoglobulin-M. MRA revealed age and body mass index (BMI) as major source of variations of many analytes. LAVE lowered the upper limits of RIs for alanine/aspartate aminotransferase, γ-glutamyl transaminase and lipids. Exclusion of individuals with BMI≥30 further lowered the RIs for lipids and CRP. After standardization based on value-assigned serum panel provided by C-RIDL, Ghanaian RIs were found higher for creatine kinase, amylase, and lower for albumin and urea compared to other collaborating countries. CONCLUSIONS The LAVE effect on many clinical chemistry RIs supports the need for the secondary exclusion for reliable derivation of RIs. The differences in Ghanaian RIs compared to other countries underscore the importance of country specific-RIs for improved clinical decision making.
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Key Words
- AG, anion gap
- ALP, alkaline phosphatase
- ALT, alanine aminotransferase
- AMY, amylase
- AST, aspartate aminotransferase
- Alb, albumin
- BD, Becton Dickinson
- BMI, body mass index
- BR, bias ratio
- C-RIDL, Committee on Reference Intervals and Decision Limits
- C3, complement component 3
- C4, complement component 4
- CDL, clinical decision limit
- CI, confidence interval
- CK, creatine kinase
- CRP, C-reactive protein
- CV(b), CV of the regression slope b
- Ca, calcium
- Cl, chloride
- Cre, creatinine
- DBil, direct bilirubin
- F, female
- GGT, gamma-glutamyl transferase
- Glb, globulin
- Glu, glucose
- HDL-CHDL-C, high-density lipoprotein cholesterol
- HbA1c, hemoglobin A1c
- IFCC, International Federation of Clinical Chemistry and Laboratory Medicine
- IP, inorganic phosphate
- IgA, immunoglobulin A
- IgG, immunoglobulin G
- IgM, immunoglobulin M
- K, potassium
- LAVE, latent abnormal values exclusion
- LDH, lactate dehydrogenase
- LDL-C, low-density lipoprotein cholesterol
- LL, lower limit
- M, male
- MF, male + female
- MRA, multiple regression analysis
- Mg, magnesium
- NP, non-parametric
- Na, sodium
- P, parametric
- RI, reference interval
- RV, reference values
- SDR, standard deviation ratio
- SV, sources of variation
- TBil, total bilirubin
- TC, total cholesterol
- TCO2, total carbon dioxide
- TG, triglycerides
- TP, total protein
- UA, uric acid
- UL, upper limit
- between-country differences
- bias ratio
- eGFR, estimated glomerular filtration rate
- ethnicity
- latent abnormal values exclusion method
- multiple regression analysis
- nonparametric method
- parametric method
- rp, standardized partial correlation coefficient
- standard deviation ratio
- standardization
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Affiliation(s)
- Serwaa Akoto Bawua
- Department of Biological, Environmental & Occupational Health Sciences, University of Ghana School of Public Health, Accra, Ghana
| | - Kiyoshi Ichihara
- Faculty of Health Sciences, Department of Clinical Laboratory Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | | | - John Arko-Mensah
- Department of Biological, Environmental & Occupational Health Sciences, University of Ghana School of Public Health, Accra, Ghana
| | - Patrick F Ayeh-Kumi
- Department of Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Ghana
| | - Rajiv Erasmus
- University of Stellenbosch, Division of Chemical Pathology, Tygerberg, Cape Town, South Africa
| | - Julius Fobil
- Department of Biological, Environmental & Occupational Health Sciences, University of Ghana School of Public Health, Accra, Ghana
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Du D, Liu C, Qin M, Zhang X, Xi T, Yuan S, Hao H, Xiong J. Metabolic dysregulation and emerging therapeutical targets for hepatocellular carcinoma. Acta Pharm Sin B 2022; 12:558-580. [PMID: 35256934 PMCID: PMC8897153 DOI: 10.1016/j.apsb.2021.09.019] [Citation(s) in RCA: 169] [Impact Index Per Article: 84.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 12/12/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is an aggressive human cancer with increasing incidence worldwide. Multiple efforts have been made to explore pharmaceutical therapies to treat HCC, such as targeted tyrosine kinase inhibitors, immune based therapies and combination of chemotherapy. However, limitations exist in current strategies including chemoresistance for instance. Tumor initiation and progression is driven by reprogramming of metabolism, in particular during HCC development. Recently, metabolic associated fatty liver disease (MAFLD), a reappraisal of new nomenclature for non-alcoholic fatty liver disease (NAFLD), indicates growing appreciation of metabolism in the pathogenesis of liver disease, including HCC, thereby suggesting new strategies by targeting abnormal metabolism for HCC treatment. In this review, we introduce directions by highlighting the metabolic targets in glucose, fatty acid, amino acid and glutamine metabolism, which are suitable for HCC pharmaceutical intervention. We also summarize and discuss current pharmaceutical agents and studies targeting deregulated metabolism during HCC treatment. Furthermore, opportunities and challenges in the discovery and development of HCC therapy targeting metabolism are discussed.
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Key Words
- 1,3-BPG, 1,3-bisphosphoglycerate
- 2-DG, 2-deoxy-d-glucose
- 3-BrPA, 3-bromopyruvic acid
- ACC, acetyl-CoA carboxylase
- ACLY, adenosine triphosphate (ATP) citrate lyase
- ACS, acyl-CoA synthease
- AKT, protein kinase B
- AML, acute myeloblastic leukemia
- AMPK, adenosine mono-phosphate-activated protein kinase
- ASS1, argininosuccinate synthase 1
- ATGL, adipose triacylglycerol lipase
- CANA, canagliflozin
- CPT, carnitine palmitoyl-transferase
- CYP4, cytochrome P450s (CYPs) 4 family
- Cancer therapy
- DNL, de novo lipogenesis
- EMT, epithelial-to-mesenchymal transition
- ER, endoplasmic reticulum
- ERK, extracellular-signal regulated kinase
- FABP1, fatty acid binding protein 1
- FASN, fatty acid synthase
- FBP1, fructose-1,6-bisphosphatase 1
- FFA, free fatty acid
- Fatty acid β-oxidation
- G6PD, glucose-6-phosphate dehydrogenase
- GAPDH, glyceraldehyde-3-phosphate dehydrogenase
- GLS1, renal-type glutaminase
- GLS2, liver-type glutaminase
- GLUT1, glucose transporter 1
- GOT1, glutamate oxaloacetate transaminase 1
- Glutamine metabolism
- Glycolysis
- HCC, hepatocellular carcinoma
- HIF-1α, hypoxia-inducible factor-1 alpha
- HK, hexokinase
- HMGCR, 3-hydroxy-3-methylglutaryl-CoA reductase
- HSCs, hepatic stellate cells
- Hepatocellular carcinoma
- IDH2, isocitrate dehydrogenase 2
- LCAD, long-chain acyl-CoA dehydrogenase
- LDH, lactate dehydrogenase
- LPL, lipid lipase
- LXR, liver X receptor
- MAFLD, metabolic associated fatty liver disease
- MAGL, monoacyglycerol lipase
- MCAD, medium-chain acyl-CoA dehydrogenase
- MEs, malic enzymes
- MMP9, matrix metallopeptidase 9
- Metabolic dysregulation
- NADPH, nicotinamide adenine nucleotide phosphate
- NAFLD, non-alcoholic fatty liver disease
- NASH, non-alcoholic steatohepatitis
- OTC, ornithine transcarbamylase
- PCK1, phosphoenolpyruvate carboxykinase 1
- PFK1, phosphofructokinase 1
- PGAM1, phosphoglycerate mutase 1
- PGK1, phosphoglycerate kinase 1
- PI3K, phosphoinositide 3-kinase
- PKM2, pyruvate kinase M2
- PPARα, peroxisome proliferator-activated receptor alpha
- PPP, pentose phosphate pathway
- Pentose phosphate pathway
- ROS, reactive oxygen species
- SCD1, stearoyl-CoA-desaturase 1
- SGLT2, sodium-glucose cotransporter 2
- SLC1A5/ASCT2, solute carrier family 1 member 5/alanine serine cysteine preferring transporter 2
- SLC7A5/LAT1, solute carrier family 7 member 5/L-type amino acid transporter 1
- SREBP1, sterol regulatory element-binding protein 1
- TAGs, triacylglycerols
- TCA cycle, tricarboxylic acid cycle
- TKIs, tyrosine kinase inhibitors
- TKT, transketolase
- Tricarboxylic acid cycle
- VEGFR, vascular endothelial growth factor receptor
- WD-fed MC4R-KO, Western diet (WD)-fed melanocortin 4 receptor-deficient (MC4R-KO)
- WNT, wingless-type MMTV integration site family
- mIDH, mutant IDH
- mTOR, mammalian target of rapamycin
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Affiliation(s)
- Danyu Du
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| | - Chan Liu
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| | - Mengyao Qin
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| | - Xiao Zhang
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| | - Tao Xi
- Research Center of Biotechnology, School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, China
| | - Shengtao Yuan
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing 210009, China
| | - Haiping Hao
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 210009, China
- Key Laboratory of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University, Nanjing 210009, China
- Corresponding authors.
| | - Jing Xiong
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
- Corresponding authors.
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Ma X, Yang S, Zhang T, Wang S, Yang Q, Xiao Y, Shi X, Xue P, Kang Y, Liu G, Sun ZJ, Xu Z. Bioresponsive immune-booster-based prodrug nanogel for cancer immunotherapy. Acta Pharm Sin B 2022; 12:451-466. [PMID: 35127398 PMCID: PMC8800001 DOI: 10.1016/j.apsb.2021.05.016] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/28/2021] [Accepted: 04/25/2021] [Indexed: 12/24/2022] Open
Abstract
The combination of chemotherapy and immunotherapy motivates a potent immune system by triggering immunogenic cell death (ICD), showing great potential in inhibiting tumor growth and improving the immunosuppressive tumor microenvironment (ITM). However, the therapeutic effectiveness has been restricted by inferior drug bioavailability. Herein, we reported a universal bioresponsive doxorubicin (DOX)-based nanogel to achieve tumor-specific co-delivery of drugs. DOX-based mannose nanogels (DM NGs) was designed and choosed as an example to elucidate the mechanism of combined chemo-immunotherapy. As expected, the DM NGs exhibited prominent micellar stability, selective drug release and prolonged survival time, benefited from the enhanced tumor permeability and prolonged blood circulation. We discovered that the DOX delivered by DM NGs could induce powerful anti-tumor immune response facilitated by promoting ICD. Meanwhile, the released mannose from DM NGs was proved as a powerful and synergetic treatment for breast cancer in vitro and in vivo, via damaging the glucose metabolism in glycolysis and the tricarboxylic acid cycle. Overall, the regulation of tumor microenvironment with DOX-based nanogel is expected to be an effectual candidate strategy to overcome the current limitations of ICD-based immunotherapy, offering a paradigm for the exploitation of immunomodulatory nanomedicines.
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Key Words
- 5-ALA, 5-aminolevulinic acid
- 5-FU, 5-fluorouracil
- ALKP, alkaline phosphatase
- ALT, alanine aminotransferase
- APCs, antigen-presenting cells
- AST, aminotransferase
- ATP, adenosine triphosphate
- AUC, area under curves
- Bioresponsive
- CLSM, confocal laser scanning microscope
- CPT-11, irinotecan
- CRE, creatinine
- CRT, calreticulin
- Ce6, chlorin e6
- Chemotherapy
- DAMPs, damage-associated molecular patterns
- DCs, dendritic cells
- DDSs, drug delivery systems
- DLN, draining lymph nodes
- DM NGs, doxorubicin-based mannose nanogel
- DOC, docetaxel
- DOX, doxorubicin
- DTT, d,l-dithiothreitol
- Doxorubicin
- FCM, flow cytometry
- FDA, Fluorescein diacetate
- GEM, gemcitabine
- GSH, glutathione
- H&E, hematoxylin-eosin
- HCPT, 10-hydroxy camptothecin
- HCT, hematocrit
- HGB, hemoglobin concentration
- HMGB1, high migrating group box 1
- ICB, immune checkpoint blockade
- ICD, immunogenic cell death
- ICG, indocyanine Green
- IHC, immunohistochemistry
- ITM, immunosuppressive tumor microenvironment
- Immunogenic cell death
- Immunotherapy
- LDH, lactate dehydrogenase
- LYM, lymphocyte ratio
- MAN, mannose
- MCHC, mean corpuscular hemoglobin concentration
- MCSs, multicellular spheroids
- MFI, mean fluorescence intensity
- MPV, mean platelet volume
- Mannose
- NGs, nanogels
- Nanogel
- OXA, oxaliplatin
- P18, purpurin 18
- PDI, polydispersity index
- PLT, platelets
- PTX, paclitaxel
- Prodrug
- RBC, red blood cell count
- RDW, variation coefficient of red blood cell distribution width
- TAAs, tumor-associated antigens
- TAM, tumor-associated macrophages
- TGF-β, transforming growth factor-β
- TMA, tissue microarrays
- TME, tumor microenvironment
- Urea, urea nitrogen
- WBC, white blood cell count
- irAEs, immune-related adverse events
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Affiliation(s)
- Xianbin Ma
- Key Laboratory of Luminescence Analysis and Molecular Sensing (Southwest University), Ministry of Education, School of Materials and Energy & Chongqing Engineering Research Center for Micro-Nano Biomedical Materials and Devices, Southwest University, Chongqing 400715, China
| | - Shaochen Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Tian Zhang
- Key Laboratory of Luminescence Analysis and Molecular Sensing (Southwest University), Ministry of Education, School of Materials and Energy & Chongqing Engineering Research Center for Micro-Nano Biomedical Materials and Devices, Southwest University, Chongqing 400715, China
| | - Shuo Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Qichao Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Yao Xiao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Xiaoxiao Shi
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Peng Xue
- Key Laboratory of Luminescence Analysis and Molecular Sensing (Southwest University), Ministry of Education, School of Materials and Energy & Chongqing Engineering Research Center for Micro-Nano Biomedical Materials and Devices, Southwest University, Chongqing 400715, China
| | - Yuejun Kang
- Key Laboratory of Luminescence Analysis and Molecular Sensing (Southwest University), Ministry of Education, School of Materials and Energy & Chongqing Engineering Research Center for Micro-Nano Biomedical Materials and Devices, Southwest University, Chongqing 400715, China
| | - Gang Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, China
- Corresponding authors. Tel./fax: +86 23 68253792 (Zhigang Xu); +86 27 87686108 (Zhijun Sun); +86 592 2880648 (Gang Liu).
| | - Zhi-Jun Sun
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China
- Corresponding authors. Tel./fax: +86 23 68253792 (Zhigang Xu); +86 27 87686108 (Zhijun Sun); +86 592 2880648 (Gang Liu).
| | - Zhigang Xu
- Key Laboratory of Luminescence Analysis and Molecular Sensing (Southwest University), Ministry of Education, School of Materials and Energy & Chongqing Engineering Research Center for Micro-Nano Biomedical Materials and Devices, Southwest University, Chongqing 400715, China
- Corresponding authors. Tel./fax: +86 23 68253792 (Zhigang Xu); +86 27 87686108 (Zhijun Sun); +86 592 2880648 (Gang Liu).
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Larionova R, Byvaltsev K, Kravtsova О, Takha E, Petrov S, Kazarian G, Valeeva A, Shuralev E, Mukminov M, Renaudineau Y, Arleevskaya M. SARS-Cov2 acute and post-active infection in the context of autoimmune and chronic inflammatory diseases. J Transl Autoimmun 2022; 5:100154. [PMID: 35434592 PMCID: PMC9005220 DOI: 10.1016/j.jtauto.2022.100154] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 03/31/2022] [Indexed: 12/11/2022] Open
Abstract
The clinical and immunological spectrum of acute and post-active COVID-19 syndrome overlaps with criteria used to characterize autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Indeed, following SARS-Cov2 infection, the innate immune response is altered with an initial delayed production of interferon type I (IFN-I), while the NF-kappa B and inflammasome pathways are activated. In lung and digestive tissues, an alternative and extrafollicular immune response against SARS-Cov2 takes place with, consequently, an altered humoral and memory T cell response leading to breakdown of tolerance with the emergence of autoantibodies. However, the risk of developing severe COVID-19 among SLE and RA patients did not exceed the general population except in those having pre-existing neutralizing autoantibodies against IFN-I. Treatment discontinuation rather than COVID-19 infection or vaccination increases the risk of developing flares. Last but not least, a limited number of case reports of individuals having developed SLE or RA following COVID-19 infection/vaccination have been reported. Altogether, the SARS-Cov2 pandemic represents an unique opportunity to investigate the dangerous interplay between the immune response against infectious agents and autoimmunity, and to better understand the triggering role of infection as a risk factor in autoimmune and chronic inflammatory disease development.
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Key Words
- ACE2, angiotensin converting enzyme 2
- ACPA, anti-cyclic citrullinated peptide autoAb
- ANA, antinuclear autoAb
- AutoAb, autoantibodies
- BAFF/BlySS, B-cell-activating factor/B lymphocyte stimulator
- CCL, chemokine ligand
- COVID-19, coronavirus disease 2019
- DMARDs, disease-modifying anti-rheumatic drugs
- E, envelope
- HEp-2, human epithelioma cell line 2
- IFN-I, interferon type I
- IFNAR, IFN-alpha receptors
- IL, interleukin
- IRF, interferon regulatory factor
- ISGs, IFN-stimulated genes
- ITP, immune-thrombocytopenic purpura
- Ig, immunoglobulin
- Infection
- Inflammation
- Jak, Janus kinase
- LDH, lactate dehydrogenase
- M, membrane
- MDA-5, melanoma differentiation-associated protein
- MERS-Cov, Middle East respiratory syndrome coronavirus
- MIS-C, multisystem inflammatory syndrome in children
- N, nucleocapsid
- NET, nuclear extracellular traps
- NF-κB, nuclear factor-kappa B
- NK, natural killer
- NLRP3, NOD-like receptor family
- Rheumatoid arthritis
- Risk factors
- SARS-Cov2
- Systemic lupus erythematosus
- T cell receptor, TLR
- Toll-like receptor, TMPRSS2
- aPL, antiphospholipid
- mAb, monoclonal Ab
- open reading frame, PACS
- pathogen-associated molecular patterns, pDC
- pattern recognition receptors, RA
- peptidylarginine deiminase 4, PAMPs
- plasmacytoid dendritic cells, PMN
- polymorphonuclear leukocytes, PRRs
- post-active COVID-19 syndrome, PAD-4
- primary Sjögren's syndrome, SLE
- pyrin domain containing 3, ORF
- reactive oxygen species, rt-PCR
- receptor binding domain, RF
- regulatory T cells, VDJ
- retinoic acid-inducible gene I, ROS
- reverse transcription polymerase chain reaction, S
- rheumatoid arthritis, RBD
- rheumatoid factor, RIG-I
- severe acute respiratory coronavirus 2, SjS
- signal transducer and activator of transcription, TCR
- single-stranded ribonucleic acid, STAT
- spike, SAD
- systemic autoimmune disease, SARS-Cov2
- systemic lupus erythematosus, SSc
- systemic sclerosis, ssRNA
- transmembrane serine protease 2, TNF
- tumor necrosis factor, Treg
- variable, diversity and joining Ig genes
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Affiliation(s)
- Regina Larionova
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
| | - K Byvaltsev
- Institute of Fundamental Medicine, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Оlga Kravtsova
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Elena Takha
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
| | - Sergei Petrov
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Environmental Sciences, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Gevorg Kazarian
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
| | - Anna Valeeva
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
| | - Eduard Shuralev
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Environmental Sciences, Kazan (Volga Region) Federal University, Kazan, Russia
- Kazan State Academy of Veterinary Medicine Named After N.E. Bauman, Kazan, Russia
| | - Malik Mukminov
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Environmental Sciences, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Yves Renaudineau
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Laboratory of Immunology, CHU Purpan Toulouse, INSERM U1291, CNRS U5051, University Toulouse III, Toulouse, France
| | - Marina Arleevskaya
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
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13
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Bovard D, van der Toorn M, Schlage WK, Constant S, Renggli K, Peitsch MC, Hoeng J. Iota-carrageenan extracted from red algae is a potent inhibitor of SARS-CoV-2 infection in reconstituted human airway epithelia. Biochem Biophys Rep 2021; 29:101187. [PMID: 34931176 PMCID: PMC8673819 DOI: 10.1016/j.bbrep.2021.101187] [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] [Received: 11/15/2021] [Revised: 12/09/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Iota-carrageenan (IC) nasal spray, a medical device approved for treating respiratory viral infections, has previously been shown to inhibit the ability of a variety of respiratory viruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), to enter and replicate in the cell by interfering with the virus binding to the cell surface. The aim of this study was to further investigate the efficacy and safety of IC in SARS-CoV-2 infection in advanced in vitro models of the human respiratory epithelium, the primary target and entry port for SARS-CoV-2. We extended the in vitro safety assessment of nebulized IC in a 3-dimensional model of reconstituted human bronchial epithelium, and we demonstrated the efficacy of IC in protecting reconstituted nasal epithelium against viral infection and replication of a patient-derived SARS-CoV-2 strain. The results obtained from these two advanced models of human respiratory tract epithelia confirm previous findings from in vitro SARS-CoV-2 infection assays and demonstrate that topically applied IC can effectively prevent SARS-CoV-2 infection and replication. Moreover, the absence of toxicity and functional and structural impairment of the mucociliary epithelium demonstrates that the nebulized IC is well tolerated. IC had a potent antiviral effect in SARS-CoV-2 infected organotypic nasal epithelial cultures. Topical application (nasal drops) was non-toxic at anti-virally efficient doses. Aerosolized IC had no adverse effects on reconstituted human bronchial epithelium.
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Key Words
- 3D, 3-dimensional
- AE, after exposure
- ALI, air–liquid interface
- Air–liquid interface
- BE, before exposure
- Bronchial epithelium
- CBF, ciliary beating frequency
- COVID-19
- COVID19, Coronavirus disease 2019
- DMMB, Dimethylmethylene blue
- IC, Iota-carrageenan
- Iota-carrageenan
- LDH, lactate dehydrogenase
- MOI, multiplicity of infection
- NHBE, normal human bronchial epithelial
- Nasal epithelium
- Nasal spray
- PBS, phosphate-buffered saline
- SARS-CoV-2
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- SSPL, spike-pseudotyped lentivirus
- TEER, transepithelial electrical resistance
- hACE2, human angiotensin I-converting enzyme 2
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Affiliation(s)
- David Bovard
- PMI R&D, Philip Morris Products S.A, Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Marco van der Toorn
- PMI R&D, Philip Morris Products S.A, Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Walter K Schlage
- Biology Consultant, Max-Baermann-Str. 21, 51429, Bergisch Gladbach, Germany
| | - Samuel Constant
- Epithelix Sarl, 18 Chemin des Aulx, Plan-les-Ouates, 1228, Geneva, Switzerland
| | - Kasper Renggli
- PMI R&D, Philip Morris Products S.A, Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Manuel C Peitsch
- PMI R&D, Philip Morris Products S.A, Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Julia Hoeng
- PMI R&D, Philip Morris Products S.A, Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
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14
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Harding AL, Murdoch C, Danby S, Hasan MZ, Nakanishi H, Furuno T, Hadad S, Turner R, Colley HE. Determination of Chemical Irritation Potential Using a Defined Gene Signature Set on Tissue-Engineered Human Skin Equivalents. JID Innov 2021; 1:100011. [PMID: 34909715 PMCID: PMC8659397 DOI: 10.1016/j.xjidi.2021.100011] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 12/03/2022] Open
Abstract
There are no physical or visual manifestations that define skin sensitivity or irritation; a subjective diagnosis is made on the basis of the evaluation of clinical presentations, including burning, prickling, erythema, and itching. Adverse skin reaction in response to topically applied products is common and can limit the use of dermatological or cosmetic products. The purpose of this study was to evaluate the use of human skin equivalents based on immortalized skin keratinocytes and evaluate the potential of a 22-gene panel in combination with multivariate analysis to discriminate between chemicals known to act as irritants and those that do not. Test compounds were applied topically to full-thickness human skin equivalent or human ex vivo skin and gene signatures determined for known irritants and nonirritants. Principle component analysis showed the discriminatory potential of the 22-gene panel. Linear discrimination analysis, performed to further refine the gene set for a more high-throughput analysis, identified a putative seven-gene panel (IL-6, PTGS2, ATF3, TRPV3, MAP3K8, HMGB2, and matrix metalloproteinase gene MMP-3) that could distinguish potential irritants from nonirritants. These data offer promise as an in vitro prediction tool, although analysis of a large chemical test set is required to further evaluate the system.
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Key Words
- CA, cinnamaldehyde
- CAP, capsaicin
- CON, control
- Co-DEA, cocamide diethanolamine
- Co-MEA, cocamide monoethanolamine
- H2O, water
- HDF, human dermal fibroblast
- HSE, human skin equivalent
- KC, keratinocyte
- LA, lactic acid
- LDA, linear discrimination analysis
- LDH, lactate dehydrogenase
- MMP, matrix metalloproteinase
- MP, methylparaben
- N-LA, neutralized lactic acid
- PCA, principal component analysis
- TEER, transepithelial electrical resistance
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Affiliation(s)
- Amy L. Harding
- The School of Clinical Dentistry, The University of Sheffield, Sheffield, United Kingdom
| | - Craig Murdoch
- The School of Clinical Dentistry, The University of Sheffield, Sheffield, United Kingdom
- Correspondence: Craig Murdoch, The School of Clinical Dentistry, The University of Sheffield, 19 Claremont Crescent, Sheffield, S10 2TA, United Kingdom.
| | - Simon Danby
- Sheffield Dermatology Research, Department of Infection, Immunity and Cardiovascular Disease, The Medical School, The University of Sheffield, Sheffield, United Kingdom
| | - Md Zobaer Hasan
- Safety Design Centre, Rohto Pharmaceutical Co, Ltd, Kyoto, Japan
| | | | - Tetsuo Furuno
- Safety Design Centre, Rohto Pharmaceutical Co, Ltd, Kyoto, Japan
| | - Sirwan Hadad
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Robert Turner
- Research Software Engineering Sheffield, The University of Sheffield, Sheffield, United Kingdom
| | - Helen E. Colley
- The School of Clinical Dentistry, The University of Sheffield, Sheffield, United Kingdom
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15
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Kamata M, Tada Y. A Literature Review of Real-World Effectiveness and Safety of Dupilumab for Atopic Dermatitis. JID Innov 2021; 1:100042. [PMID: 34909737 PMCID: PMC8659403 DOI: 10.1016/j.xjidi.2021.100042] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/01/2021] [Accepted: 07/14/2021] [Indexed: 02/08/2023] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease with pruritus, characterized by recurrent eczema with exacerbations and remissions. AD impairs patients’ QOL and places a heavy burden on patients. Recently, dupilumab, an anti–IL-4Rα antibody, was approved for the treatment of patients with moderate-to-severe AD who are refractory to topical agents and/or conventional systemic therapy. Clinical trials of dupilumab for AD demonstrated high efficacy and tolerable safety profiles. Furthermore, real-world evidence of dupilumab for AD is accumulating. Most of these data show favorable effectiveness and safety profile; however, they also clarified issues, including conjunctivitis and facial redness. There are still a certain number of patients with significant failure. In this article, we review real-world evidence of dupilumab for AD, identify concerns specific to dupilumab, and discuss unmet needs and issues to be addressed in the future.
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Key Words
- AA, alopecia areata
- AD, atopic dermatitis
- CsA, cyclosporin A
- EASI, Eczema Area and Severity Index
- HSV, herpes simplex virus
- IGA, Investigator’s Global Assessment
- LDH, lactate dehydrogenase
- TCS, topical corticosteroid
- Th, T helper type
- q2w, every other week
- qw, weekly
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Affiliation(s)
- Masahiro Kamata
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Yayoi Tada
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
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16
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Shimoda M, Tanaka Y, Kokutou H, Furuuchi K, Osawa T, Morimoto K, Yano R, Yoshimori K, Ohta K. Actinomyces meyeri pleural infection that was difficult to treat due to delayed culture: A case report and literature review of 28 cases. Respir Med Case Rep 2021; 34:101530. [PMID: 34745867 DOI: 10.1016/j.rmcr.2021.101530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/15/2021] [Accepted: 10/19/2021] [Indexed: 11/24/2022] Open
Abstract
An eighty-three-year-old man suffered from cough, right chest pain, and progressive dyspnea for sixteen days. He had hypoxemia, high white blood cells and C-reactive protein, and moderate right-sided pleural effusion on radiographic imaging. A pleural fluid examination revealed exudate. He was diagnosed with pleural infection and treated with intravenous ampicillin/sulbactam. On the second day of hospitalization, the treatment was changed to levofloxacin and clindamycin due to drug eruption. He improved gradually and was prescribed only oral levofloxacin on the eighteenth day of hospitalization. However, improvements in inflammation and imaging findings were poor. Actinomyces meyeri resistant to fluoroquinolones was cultured from a pleural effusion sample on the twenty-sixth day of hospitalization. The treatment was changed to oral clindamycin, and his medical condition subsequently improved. We reviewed twenty-eight patients with Actinomyces pleural infection and thirty-eight patients with other pleural infection phenotypes from our hospital and published case reports. Actinomyces pleural infection is a long-term process and results in a large amount of pleural effusion compared to other pleural infection phenotypes. These results might be related to the fact that Actinomyces is a slow-growing organism.
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17
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Wu X, Liu L, Zheng Q, Hao H, Ye H, Li P, Yang H. Protocatechuic aldehyde protects cardiomycoytes against ischemic injury via regulation of nuclear pyruvate kinase M2. Acta Pharm Sin B 2021; 11:3553-66. [PMID: 34900536 DOI: 10.1016/j.apsb.2021.03.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/14/2021] [Accepted: 02/10/2021] [Indexed: 12/12/2022] Open
Abstract
Rescuing cells from stress damage emerges a potential therapeutic strategy to combat myocardial infarction. Protocatechuic aldehyde (PCA) is a major phenolic acid in Chinese herb Danshen (Salvia miltiorrhiza root). This study investigated whether PCA regulated nuclear pyruvate kinase isoform M2 (PKM2) function to protect cardiomyocytes. In rats subjected to isoprenaline, PCA attenuated heart injury and protected cardiomyocytes from apoptosis. Through DARTS and CETSA assays, we identified that PCA bound and promoted PKM2 nuclear translocation in cardiomyocytes exposed to oxygen/glucose deprivation (OGD). In the nucleus, PCA increased the binding of PKM2 to β-catenin via preserving PKM2 acetylation, and the complex, in cooperation with T-cell factor 4 (TCF4), was required for transcriptional induction of genes encoding anti-apoptotic proteins, contributing to rescuing cardiomyocyte survival. In addition, PCA ameliorated mitochondrial dysfunction and prevented mitochondrial apoptosis dependent on PKM2. Consistently, PCA increased the binding of PKM2 to β-catenin, improved heart contractive function, normalized heart structure and attenuated oxidative damage in mice subjected to artery ligation, but the protective effects were lost in Pkm2-deficient heart. Together, we showed that PCA regulated nuclear PKM2 function to rescue cardiomyocyte survival via β-catenin/TCF4 signaling cascade, suggesting the potential of pharmacological intervention of PKM2 shuttle to protect the heart.
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Key Words
- Apoptosis
- CETSA, cellular thermal shift assay
- CK-MB, creatine kinase isoenzyme-MB
- DARTS, drug affinity responsive target stability
- Heart ischemia
- ISO, isoprenaline
- LDH, lactate dehydrogenase
- Mitochondrial damage
- Myocardial infarction
- NRVMs, neonatal rat ventricular myocytes
- Nuclear translocation
- OGD, oxygen and glucose deprivation
- PCA, protocatechuic aldehyde
- PKM2
- PKM2, pyruvate kinase isoform M2
- Protocatechuic aldehyde
- ROS, reactive oxygen species
- TCF4
- TCF4, T-cell factor 4
- TUNEL, deoxynucleotidyl transferase-mediated dUTP nick end-labeling
- shRNA, short hairpin RNA
- β-Catenin
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18
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Akamo AJ, Akinloye DI, Ugbaja RN, Adeleye OO, Dosumu OA, Eteng OE, Antiya MC, Amah G, Ajayi OA, Faseun SO. Naringin prevents cyclophosphamide-induced erythrocytotoxicity in rats by abrogating oxidative stress. Toxicol Rep 2021; 8:1803-1813. [PMID: 34760624 PMCID: PMC8567332 DOI: 10.1016/j.toxrep.2021.10.011] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 09/30/2021] [Accepted: 10/24/2021] [Indexed: 01/02/2023] Open
Abstract
Earlier reports have shown that Cyclophosphamide (CYCP), an anti-malignant drug, elicited cytotoxicity; and that naringin has several beneficial potentials against oxidative stress and dyslipidaemias. We investigated the influence of naringin on free radical scavenging, cellular integrity, cellular ATP, antioxidants, oxidative stress, and lipid profiles in the CYCP-induced erythrocytotoxicity rat model. Rats were pretreated orally by gavage for fourteen consecutive days with three doses (50, 100, and 200 mg/kg) naringin before single CYCP (200 mg/kg, i.p.) administration. Afterwards, the rats were sacrificed. Naringin concentrations required for 50 % scavenging hydrogen peroxide and nitric oxide radical were 0.27 mg/mL and 0.28 mg/mL, respectively. Naringin pretreatment significantly (p < 0.05) protected erythrocytes plasma membrane architecture and integrity by abolishing CYCP-induced decrease in the activity of erythrocyte LDH (a marker of ATP). Pretreatment with naringin remarkably (p < 0.05) reversed CYCP-induced decreases in the erythrocytes glutathione levels, activities of glutathione-S-transferase, catalase, glutathione peroxidase, and glutathione reductase; attenuated CYCP-mediated increases in erythrocytes levels of malondialdehyde, nitric oxide, and major lipids (cholesterol, triacylglycerol, phospholipids, and non-esterified fatty acids). Taken together, different acute pretreatment doses of naringin might avert CYCP-mediated erythrocytes dysfunctions via its antioxidant, free-radical scavenging, and anti-dyslipidaemia properties.
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Key Words
- AP-1, activator protein 1
- ATP, adenosine triphosphate
- Antioxidants
- BHT, butylated hydroxytoluene
- C31H28N2Na4O13S, xylenol tetrasodium
- C5FeN6Na2O, sodium nitroprusside
- CAT, catalase
- CDNB, 1-chloro-2,4-dinitrobenzene
- CYCP, cyclophosphamide
- Cu(NO3)2.3H2O, copper II nitrate
- Cyclophosphamide
- DNA, deoxyribonucleic acid
- DTNB, 5,5ˈ-dithiobis(2-nitrobenzoic acid)
- Erythrocytotoxicity
- FeSO4.7H2O, Iron (II) sulfate heptahydrate
- G6PDH, glucose-6-phosphate dehydrogenase
- GSH, reduced glutathione
- GSPx, glutathione peroxidase
- GSR, glutathione reductase
- GSSG, oxidized glutathione
- GST, glutathione-S-transferase
- H2O2, hydrogen peroxide
- H3PO3, phosphoric acid
- HO•, hydroxyl radical
- HSCs, hepatic stellate cells
- K2HPO4, dipotassium hydrogen phosphate
- KCl, potassium chloride
- LDH, lactate dehydrogenase
- Lipid profile
- MAPKs, mitogen-activated protein kinases
- MDA, malondialdehyde
- MMP, matrix metalloprotease
- NAD+, nicotinamide adenine dinucleotide
- NADH, nicotinamide adenine dinucleotide reduced
- NADPH, nicotinamide adenine dinucleotide phosphate reduced
- NF-κB, nuclear factor kappa B
- NH4OH, ammonium hydroxide
- NO, nitric oxide
- NO2−, nitrite
- NO3−, nitrate
- NOAEL, no-observed-adverse-effect level
- Na2HPO4, disodium hydrogen phosphate
- NaH2PO4, sodium dihydrogen phosphate
- Naringin
- Nrf2, nuclear factor-erythroid factor 2-related factor 2
- O2HbFe2+, oxyhemoglobin
- O2•–, superoxide radical
- OONO−, peroxynitrite radical
- Oxidative stress
- PBS, phosphate-buffered saline
- PUFA, Polyunsaturated fatty acids
- R-Smad, Smad activated receptor
- RNS, reactive nitrogen species
- ROS, reactive oxygen species
- SOD, superoxide dismutase
- TBA, 2-thiobarbituric acid
- TBARS, thiobarbituric acid reactive substances
- TGF-β, transforming growth factor-β
- TLR, toll-like receptor
- TROOH, total hydroperoxide
- VLDL, very low density lipoprotein
- eNOS, endothelial nitric oxide synthase
- i.p., intraperitoneally
- mRNA, messenger ribonucleic acid
- metHb, methemoglobin
- α-SMA, alpha smooth muscle actin
- •NO, nitric oxide radical
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Affiliation(s)
- Adio J. Akamo
- Department of Biochemistry, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Dorcas I. Akinloye
- Department of Biochemistry, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Regina N. Ugbaja
- Department of Biochemistry, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Oluwagbemiga O. Adeleye
- Department of Animal Production and Health, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Oluwatosin A. Dosumu
- Department of Biochemistry, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Ofem E. Eteng
- Department of Biochemistry, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Moses C. Antiya
- Department of Biochemistry, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Gogonte Amah
- Department of Biochemistry, Benjamin Carson (SRN) School of Medicine, Babcock University, Ilisan, Ogun State, Nigeria
| | - Oluwafunke A. Ajayi
- Department of Biochemistry, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Samuel O. Faseun
- Department of Biochemistry, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
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19
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Slostad JA, Liu MC, Allred JB, Erickson LA, Rumilla KM, Block MS, Keppen M, King D, Markovic SN, McWilliams RR. BRAF V600 Mutation Detection in Plasma Cell-Free DNA: NCCTG N0879 (Alliance). Mayo Clin Proc Innov Qual Outcomes 2021; 5:1012-1020. [PMID: 34703985 PMCID: PMC8526905 DOI: 10.1016/j.mayocpiqo.2021.05.003] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To evaluate the prognostic significance of detectable circulating cell-free DNA (cfDNA) BRAF V600E/K mutations in patients with advanced melanoma enrolled in a clinical trial without BRAF-targeted therapy. PATIENTS AND METHODS BRAF V600E/K mutation status was determined on archived tissue and pretreatment stored plasma from 149 patients with unresectable stage IV melanoma who were enrolled between May 5, 2010 and May 2, 2014 in the North Central Cancer Treatment Group/Alliance N0879 randomized phase 2 clinical trial. Results were reported as presence or absence of cfDNA BRAF V600E/K detection of assay vs tissue. Progression-free survival (PFS) and overall survival (OS) were assessed for patients with and without detectable BRAF mutation. RESULTS In total, 63 of 149 (42.3%) patients had BRAF V600E/K results for tissue and blood, and 20 of 63 (31.7%) patients had tissue-diagnosed mutant BRAF. Of these, 11 of 20 (55.0%) patients had detectable plasma cfDNA BRAF. Among patients with tissue-mutant BRAF V600E/K, PFS and OS were shorter for those with corresponding cfDNA mutations (PFS, 5.8 vs 12.0 months; P=.051; OS, 9.2 vs 27.1 months; P=.054). Our assay demonstrated sensitivity of 55% (95% CI, 0.322 to 0.768), specificity of 97.7% (95% CI, 0.932 to 1.000), positive predictive value of 91.7% (95% CI, 0.760 to 1.000), and negative predictive value of 82.4% (95% CI, 0.719 to 0.928). CONCLUSION In advanced melanoma, detectable cfDNA BRAF V600E/K mutation is present in about half the patients with stage IV with BRAF-mutant melanoma tumor tissue and appears to confer a poorer prognosis when detectable. Given the poorer prognosis, cfDNA can be used to risk-stratify patients with metastatic melanoma in practice or clinical trials.Trial Registration: clinicaltrials.gov Identifier: NCT00976573.
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Key Words
- FFPE, formalin-fixed paraffin-embedded
- HR, hazard ratio
- LDH, lactate dehydrogenase
- MAPK, mitogen-activated protein kinase
- NA, not available
- NCCTG, North Central Cancer Treatment Group
- NPV, negative predictive value
- OS, overall survival
- PFS, progression-free survival
- PPV, positive predictive value
- cfDNA, cell-free DNA
- ddPCR, digital droplet polymerase chain reaction
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Affiliation(s)
- Jessica A. Slostad
- Division of Hematology-Oncology, Rush University Medical Center, Chicago, IL
| | - Minetta C. Liu
- Division of Medical Oncology, Mayo Clinic, Rochester, MN
- Department of Laboratory Medicine and Pathology, Clinical Genomics, Mayo Clinic, Rochester, MN
| | - Jacob B. Allred
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN
| | | | - Kandelaria M. Rumilla
- Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
- Sanford USD Medical Center-Sioux Falls, Sioux Falls, SD
| | | | | | | | | | - Robert R. McWilliams
- Division of Medical Oncology, Mayo Clinic, Rochester, MN
- Correspondence: Address to Robert R. McWilliams, MD, Mayo Clinic, 200 First St SW, Rochester, MN 55905. @JessSlostadMD
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Affiliation(s)
- Hasina Maredia
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Antonio Cozzio
- Department of Dermatology, St. Gallen Hospital, St. Gallen, Switzerland
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zürich Skin Cancer Center and University Zürich, Zürich, Switzerland
| | - Egle Ramelyte
- Department of Dermatology, University Hospital Zürich Skin Cancer Center and University Zürich, Zürich, Switzerland
| | - Ellen J Kim
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sima Rozati
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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21
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Mouhoub B, Bensalah M, Berhili A, Azghar A, El Malki J, El Mezgueldi I, Nassiri O, Slaoui M, Miri A, Rochdi C, Benajiba N, Seddik R. Visceral leishmaniasis associated with macrophage activation syndrome: Case report and literature review. IDCases 2021; 26:e01247. [PMID: 34430207 PMCID: PMC8371194 DOI: 10.1016/j.idcr.2021.e01247] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/06/2021] [Accepted: 08/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background The combination of visceral leishmaniasis (VL) and macrophage activation syndrome (MAS) makes the diagnosis difficult due to their similar clinical presentation, with a poor prognosis especially since the treatment is still poorly codified. We report the case of a 17-month-old female patient from Berkane, presenting for a 3 months history of anarchic fever with anemic syndrome made up of pallor and hemorrhagic syndrome made up of epistaxis. Physical examination revealed a temperature of 39 ° C, lower limbsedema, paleness of skin and mucous membranes, gingival petechiae, bleached hair, and hepatosplenomegaly. Case presentation The complete blood count showed pancytopenia with deep aregenerative normochromic normocytic anemia at 3 g/dL, leukocytes were at 4860/mm 3 with neutropenia at 680/mm 3 and thrombocytopenia at 12.000/mm3, the blood smear was without abnormality. These anomalies were associated with a hypoalbunemia, hypertriglyceridemia, hyperferritinemia, lactate dehydrogenase (LDH) level was at 337 IU/L, low prothrombin time (PT) at 56 % and fibrinogen level at 1 g/L. The direct Coombs test was positive. Examination of the myelogram revealed the presence of leishmania bodies and figures of hemophagocytosis. A diagnosis of visceral leishmaniasis associated with MAS was made. The patient was put on liposomal amphotericin B and corticosteroid therapy with good clinical and biological evolution and good therapeutic tolerance. Conclusion The association of VL and MAS remains rare and should be evoked even in non-endemic areas since late diagnosis worsens the prognosis and may even be responsible for the death of patients despite an aggressive treatment.
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Affiliation(s)
- Boutaina Mouhoub
- Central Laboratory, University Hospital Center Mohamed VI Oujda, Morocco.,Faculty of Medicine and Pharmacy Oujda, Mohammed First University Oujda, Morocco
| | - Mohammed Bensalah
- Central Laboratory, University Hospital Center Mohamed VI Oujda, Morocco.,Faculty of Medicine and Pharmacy Oujda, Mohammed First University Oujda, Morocco
| | - Abdelilah Berhili
- Central Laboratory, University Hospital Center Mohamed VI Oujda, Morocco
| | - Ali Azghar
- Central Laboratory, University Hospital Center Mohamed VI Oujda, Morocco.,Faculty of Medicine and Pharmacy Oujda, Mohammed First University Oujda, Morocco
| | - Jalila El Malki
- Central Laboratory, University Hospital Center Mohamed VI Oujda, Morocco.,Faculty of Medicine and Pharmacy Oujda, Mohammed First University Oujda, Morocco
| | - Imane El Mezgueldi
- Central Laboratory, University Hospital Center Mohamed VI Oujda, Morocco.,Faculty of Medicine and Pharmacy Oujda, Mohammed First University Oujda, Morocco
| | - Oumaima Nassiri
- Central Laboratory, University Hospital Center Mohamed VI Oujda, Morocco.,Faculty of Medicine and Pharmacy Oujda, Mohammed First University Oujda, Morocco
| | - Mounia Slaoui
- Central Laboratory, University Hospital Center Mohamed VI Oujda, Morocco
| | - Achraf Miri
- Central Laboratory, University Hospital Center Mohamed VI Oujda, Morocco.,Faculty of Medicine and Pharmacy Oujda, Mohammed First University Oujda, Morocco
| | - Chaymae Rochdi
- Central Laboratory, University Hospital Center Mohamed VI Oujda, Morocco
| | - Noufissa Benajiba
- Faculty of Medicine and Pharmacy Oujda, Mohammed First University Oujda, Morocco.,Pediatric Service, University Hospital Center Mohamed VI Oujda, Morocco
| | - Rachid Seddik
- Central Laboratory, University Hospital Center Mohamed VI Oujda, Morocco.,Faculty of Medicine and Pharmacy Oujda, Mohammed First University Oujda, Morocco
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Maestro S, Weber ND, Zabaleta N, Aldabe R, Gonzalez-Aseguinolaza G. Novel vectors and approaches for gene therapy in liver diseases. JHEP Rep 2021; 3:100300. [PMID: 34159305 PMCID: PMC8203845 DOI: 10.1016/j.jhepr.2021.100300] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [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: 01/21/2021] [Revised: 03/23/2021] [Accepted: 04/18/2021] [Indexed: 12/13/2022] Open
Abstract
Gene therapy is becoming an increasingly valuable tool to treat many genetic diseases with no or limited treatment options. This is the case for hundreds of monogenic metabolic disorders of hepatic origin, for which liver transplantation remains the only cure. Furthermore, the liver contains 10-15% of the body's total blood volume, making it ideal for use as a factory to secrete proteins into the circulation. In recent decades, an expanding toolbox has become available for liver-directed gene delivery. Although viral vectors have long been the preferred approach to target hepatocytes, an increasing number of non-viral vectors are emerging as highly efficient vehicles for the delivery of genetic material. Herein, we review advances in gene delivery vectors targeting the liver and more specifically hepatocytes, covering strategies based on gene addition and gene editing, as well as the exciting results obtained with the use of RNA as a therapeutic molecule. Moreover, we will briefly summarise some of the limitations of current liver-directed gene therapy approaches and potential ways of overcoming them.
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Key Words
- AAT, α1-antitrypsin
- AAV, adeno-associated virus
- AHP, acute hepatic porphyrias
- AIP, acute intermittent porphyria
- ALAS1, aminolevulic synthase 1
- APCs, antigen-presenting cells
- ASGCT, American Society of Gene and Cell Therapy
- ASGPR, asialoglycoprotein receptor
- ASOs, antisense oligonucleotides
- Ad, adenovirus
- CBS, cystathionine β-synthase
- CN, Crigel-Najjar
- CRISPR, clustered regularly interspaced short palindromic repeats
- CRISPR/Cas9, CRISPR associated protein 9
- DSBs, double-strand breaks
- ERT, enzyme replacement therapy
- FH, familial hypercholesterolemia
- FSP27, fat-specific protein 27
- GO, glycolate oxidase
- GSD1a, glycogen storage disorder 1a
- GT, gene therapy
- GUSB, β-glucuronidase
- GalNAc, N-acetyl-D-galactosamine
- HDAd, helper-dependent adenovirus
- HDR, homology-directed repair
- HT, hereditary tyrosinemia
- HemA/B, haemophilia A/B
- IDS, iduronate 2-sulfatase
- IDUA, α-L-iduronidase
- IMLD, inherited metabolic liver diseases
- ITR, inverted terminal repetition
- LDH, lactate dehydrogenase
- LDLR, low-density lipoprotein receptor
- LNP, Lipid nanoparticles
- LTR, long terminal repeat
- LV, lentivirus
- MMA, methylmalonic acidemia
- MPR, metabolic pathway reprograming
- MPS type I, MPSI
- MPS type VII, MPSVII
- MPS, mucopolysaccharidosis
- NASH, non-alcoholic steatohepatitis
- NHEJ, non-homologous end joining
- NHPs, non-human primates
- Non-viral vectors
- OLT, orthotopic liver transplantation
- OTC, ornithine transcarbamylase
- PA, propionic acidemia
- PB, piggyBac
- PCSK9, proprotein convertase subtilisin/kexin type 9
- PEG, polyethylene glycol
- PEI, polyethyleneimine
- PFIC3, progressive familial cholestasis type 3
- PH1, Primary hyperoxaluria type 1
- PKU, phenylketonuria
- RV, retrovirus
- S/MAR, scaffold matrix attachment regions
- SB, Sleeping Beauty
- SRT, substrate reduction therapy
- STK25, serine/threonine protein kinase 25
- TALEN, transcription activator-like effector nucleases
- TTR, transthyretin
- UCD, urea cycle disorders
- VLDLR, very-low-density lipoprotein receptor
- WD, Wilson’s disease
- ZFN, zinc finger nucleases
- apoB/E, apolipoprotein B/E
- dCas9, dead Cas9
- efficacy
- gene addition
- gene editing
- gene silencing
- hepatocytes
- immune response
- lncRNA, long non-coding RNA
- miRNAs, microRNAs
- siRNA, small-interfering RNA
- toxicity
- viral vectors
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Affiliation(s)
- Sheila Maestro
- Gene Therapy Area, Foundation for Applied Medical Research, University of Navarra, IdisNA, Pamplona, Spain
| | | | - Nerea Zabaleta
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass Eye and Ear, Boston, MA, USA
| | - Rafael Aldabe
- Gene Therapy Area, Foundation for Applied Medical Research, University of Navarra, IdisNA, Pamplona, Spain
- Corresponding authors. Address: CIMA, Universidad de Navarra. Av. Pio XII 55 31008 Pamplona. Spain
| | - Gloria Gonzalez-Aseguinolaza
- Gene Therapy Area, Foundation for Applied Medical Research, University of Navarra, IdisNA, Pamplona, Spain
- Vivet Therapeutics, Pamplona, Spain
- Corresponding authors. Address: CIMA, Universidad de Navarra. Av. Pio XII 55 31008 Pamplona. Spain
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23
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Kaur S, Hussain S, Kolhe K, Kumar G, Tripathi DM, Tomar A, Kale P, Narayanan A, Bihari C, Bajpai M, Maiwall R, Gupta E, Sarin SK. Elevated plasma ICAM1 levels predict 28-day mortality in cirrhotic patients with COVID-19 or bacterial sepsis. JHEP Rep 2021; 3:100303. [PMID: 33997748 PMCID: PMC8106200 DOI: 10.1016/j.jhepr.2021.100303] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 02/01/2021] [Revised: 04/01/2021] [Accepted: 04/24/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND & AIMS Endothelial injury and dysfunction play a detrimental role in the pathogenesis of infections. Endothelium-related molecules have been reported as potential diagnostic and/or prognostic biomarkers of infection. The prognostic value of these biomarkers in patients with cirrhosis and infections remains elusive. METHODS In this study, we investigated the performance of key soluble endothelial injury biomarkers, including intercellular adhesion molecule 1 (ICAM1), von Willebrand factor (vWF), vascular endothelial growth factor receptor 1 (VEGFR1), and angiopoietin 1 and 2 (Ang1, 2) as mortality predictors in patients with cirrhosis and severe COVID-19 or bacterial sepsis. RESULTS A total of 66 hospitalized patients (admitted to the COVID-19 ward or liver intensive care unit [ICU]) were included. Twenty-two patients had COVID-19 alone, while 20 patients had cirrhosis plus COVID-19. Twenty-four patients had cirrhosis plus bacterial sepsis. Among patients with cirrhosis, the most common aetiology of liver disease was alcohol. ICAM1 was increased (p = 0.003) while VEGFR1 (p <0.0001) and Ang1 (p <0.0001) were reduced in patients with COVID-19 and cirrhosis, compared to patients with COVID-19 alone. Endothelial biomarker levels did not differ significantly between patients with cirrhosis and severe COVID-19 or bacterial sepsis in the ICU. In these patients, ICAM1 levels significantly and independently predicted mortality (hazard ratio 3.24; 95% CI 1.19-8.86) along with model for end-stage liver disease (MELD) score, renal and coagulation failures. The AUC for ICAM1 was 0.74, MELD was 0.60 and combined ICAM1 and MELD was 0.70. ICAM1 also positively correlated with the composite organ failure scores recorded 3-5 days post ICU admission (CLIF-OF and SOFA) in this subgroup of patients. CONCLUSION The study indicates that in patients with cirrhosis, elevated plasma ICAM1 serves as an independent predictor of severe COVID-19- or sepsis-associated 28-day mortality. LAY SUMMARY Bacterial sepsis and COVID-19 lead to increased mortality in patients with cirrhosis. In this study, we demonstrate that high plasma levels of ICAM1, an endothelial injury biomarker, is one of the important factors predicting mortality in critically ill cirrhotic patients with severe COVID-19 or bacterial sepsis.
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Key Words
- ACLF, acute-on-chronic liver failure
- AST, aspartate aminotransferase
- Ang1, angiopoietin 1
- Ang2, angiopoietin 2
- Biomarkers
- CCI, Charlson comorbidity index
- COVID-19
- Endothelial Injury
- HR, hazard ratio
- ICAM1, intercellular adhesion molecule 1
- ICU, intensive care unit
- LDH, lactate dehydrogenase
- Liver Cirrhosis
- MELD, model for end-stage liver disease
- NLR, neutrophil to lymphocyte ratio
- PCT, procalcitonin
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- SOFA, sequential organ failure assessment
- Sepsis
- VEGFR1, vascular endothelial growth factor receptor 1
- vWF, von Willebrand factor
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Affiliation(s)
- Savneet Kaur
- Department of Molecular and Cellular Medicine, Institute of liver and biliary Sciences, New Delhi, India
| | - Sadam Hussain
- Department of Molecular and Cellular Medicine, Institute of liver and biliary Sciences, New Delhi, India
| | - Kailash Kolhe
- Department of Molecular and Cellular Medicine, Institute of liver and biliary Sciences, New Delhi, India
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India
| | - Guresh Kumar
- Department of Molecular and Cellular Medicine, Institute of liver and biliary Sciences, New Delhi, India
- Department of Research and Biostatistics, Institute of liver and biliary Sciences, New Delhi, India
| | - Dinesh M. Tripathi
- Department of Molecular and Cellular Medicine, Institute of liver and biliary Sciences, New Delhi, India
| | - Arvind Tomar
- Department of Pulmonary Medicine, Institute of liver and biliary Sciences, New Delhi, India
| | - Pratibha Kale
- Department of Microbiology, Institute of liver and biliary Sciences, New Delhi, India
| | - Ashad Narayanan
- Department of Emergency, Institute of liver and biliary Sciences, New Delhi, India
| | - Chaggan Bihari
- Department of Pathology, Institute of liver and biliary Sciences, New Delhi, India
| | - Meenu Bajpai
- Department of Transfusion Medicine, Institute of liver and biliary Sciences, New Delhi, India
| | - Rakhi Maiwall
- Department of Hepatology, Institute of liver and biliary Sciences, New Delhi, India
| | - Ekta Gupta
- Department of Virology, Institute of liver and biliary Sciences, New Delhi, India
| | - Shiv K. Sarin
- Department of Hepatology, Institute of liver and biliary Sciences, New Delhi, India
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24
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Kuwano A, Tanaka M, Suzuki H, Kurokawa M, Imoto K, Tashiro S, Goya T, Kohjima M, Kato M, Ogawa Y. Upregulated expression of hypoxia reactive genes in peripheral blood mononuclear cells from chronic liver disease patients. Biochem Biophys Rep 2021; 27:101068. [PMID: 34307908 PMCID: PMC8283323 DOI: 10.1016/j.bbrep.2021.101068] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 03/30/2021] [Accepted: 06/28/2021] [Indexed: 12/26/2022] Open
Abstract
Liver fibrosis induces intrahepatic microcirculation disorder and hypoxic stress. Hypoxic stress has the potential for an increase in the possibility of more liver fibrosis and carcinogenesis. Liver biopsy is a standard method that evaluates of intrahepatic hypoxia, however, is invasive and has a risk of bleeding as a complication. Here, we investigated the hypoxia reactive gene expressions in peripheral blood mononuclear cells (PBMC) from chronic liver disease patients to evaluate intrahepatic hypoxia in a non-invasive manner. The subjects enrolled for this study were composed of 20 healthy volunteers (HV) and 48 patients with chronic liver disease (CLD). CLD patients contained 24 patients with chronic hepatitis(CH)and 24 patients with liver cirrhosis (LC). PBMC were isolated from heparinized peripheral blood samples. We measured the transcriptional expression of hypoxia reactive genes and inflammatory cytokines by quantitative RT-PCR. mRNA expression of adrenomedullin (AM), vascular endothelial growth factor A (VEGFA) superoxide dismutase (SOD), glutathione peroxidase (GPx) (p < 0.05), Interleukin-6 (IL-6), transforming growth factor-beta (TGF-β) and heme oxygenase-1 (HO-1) in CLD group were significantly higher than HV. AM mRNA expression is correlated with serum lactate dehydrogenase (LDH), serum albumin (Alb), IL6, and SOD mRNA expression. The hypoxia reactive gene expression in PBMCs from CLD patients was more upregulated than HV. Especially, angiogenic genes were notably upregulated and correlated with liver fibrosis. Here, we suggest that mRNA expression of AM in PBMCs could be the biomarker of intrahepatic hypoxia. The hypoxia reactive genes in PBMC were elevated in patients with chronic liver disease. •Angiogenic genes were upregulated and correlated with liver fibrosis in patients with chronic liver disease. •Adrenomedullin mRNA expression in PBMC was correlated with liver function. •mRNA expression of adrenomedullin in PBMC could be the biomarker of intrahepatic hypoxia.
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Key Words
- AM, Adrenomedullin
- ANGPTL4, Angiopoietin-like 4
- Adrenomedullin
- CH, chronic hepatitis
- CLD, chronic liver disease
- Chronic liver disease
- GPx, glutathione peroxidase
- HCC, hepatocellular carcinoma
- HCV, hepatitis C virus
- HIF, hypoxia inducible factor
- HO-1, heme oxygenase -1
- HV, healthy volunteers
- IL-6, Interleukin-6
- Intrahepatic hypoxia
- LC, liver cirrhosis
- LDH, lactate dehydrogenase
- MCP-1, Monocyte chemoattractant protein-1
- PBMC, Peripheral blood mononuclear cells
- PT, prothrombin time
- Peripheral blood mononuclear cells
- ROS, reactive oxygen species
- SOD, Superoxide dismutase
- TGF-β, transforming growth factor-beta
- TNF-α, Tumor Necrosis Factor-α
- VEGF, vascular endothelial growth factor
- VEGFA, vascular endothelial growth factor A
- VEGFR2, vascular endothelial growth factor receptor 2
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Affiliation(s)
- Akifumi Kuwano
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.,Department of Hepatology, Iizuka Hospital, 3-83 Yoshio-machi, Iizuka, Fukuoka, 820-8505, Japan
| | - Masatake Tanaka
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hideo Suzuki
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Miho Kurokawa
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koji Imoto
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Shigeki Tashiro
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Takeshi Goya
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Motoyuki Kohjima
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Masaki Kato
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yoshihiro Ogawa
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.,CREST, Japan Agency for Medical Research and Development, 1-7-1 Otemachi, Chiyoda-ku, Tokyo, 100-0004, Japan
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25
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Nishino T, Shimbo M, Endo F, Kawamori J, Kanomata N, Hattori K. Prostate cancer featuring a unique progression pattern: A case of prominent direct perineal invasion without definite metastasis. Urol Case Rep 2021; 39:101779. [PMID: 34345591 PMCID: PMC8319353 DOI: 10.1016/j.eucr.2021.101779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/08/2021] [Accepted: 07/13/2021] [Indexed: 12/02/2022] Open
Abstract
Locally advanced prostate cancer can extend into the pelvis, and can also invade the bladder and rectum. We encountered a patient with prostate cancer that exhibited severe local invasion, protruding into the perineum. Distant metastasis was absent, despite the large tumor size. The tumor bled and caused difficulty sitting and standing, compromising the patient's quality of life. Total pelvic exenteration and chemotherapy were considered, but the patient's general condition rendered these therapies inappropriate. However, of the limited treatment options available given the patient's condition, palliative irradiation of the protruding region proved effective. Prostate cancer invaded the perineum without distant metastasis. Radiation therapy shrank the tumor; hormonal therapy was ineffective. Tumor progression was rapid and the prognosis was poor.
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Affiliation(s)
- Takato Nishino
- Department of Urology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Masaki Shimbo
- Department of Urology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Fumiyasu Endo
- Department of Urology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Jiro Kawamori
- Department of Radiation Oncology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Naoki Kanomata
- Department of Pathology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Kazunori Hattori
- Department of Urology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
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26
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Lin Y, Yuan J, Long Q, Hu J, Deng H, Zhao Z, Chen J, Lu M, Huang A. Patients with SARS-CoV-2 and HBV co-infection are at risk of greater liver injury. Genes Dis 2021; 8:484-492. [PMID: 33225036 PMCID: PMC7672332 DOI: 10.1016/j.gendis.2020.11.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023] Open
Abstract
To date, it remains unclear if severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-infection exacerbates liver injury in patients with chronic hepatitis B virus (HBV) infection. In this study, we present a retrospective study of 133 hospitalized confirmed mild coronavirus disease 2019 (COVID-19) cases, including 116 patients with COVID-19 with negative serum hepatitis B antigen and 17 HBV inactive carriers with COVID-19. We found that there were no significant differences for the discharge rate or duration of hospitalization between the two groups. However, inactive HBV carriers with SARS-CoV-2 co-infection are at a higher risk of abnormal liver function tests. The enhanced liver injury induced by SARS-CoV-2 and HBV co-infection was identified as the hepatocyte type rather than the cholangiocyte type. Moreover, the inflammatory response, including abnormal lactate dehydrogenase, D-dimer and interleukin-6 production, may contribute to this injury following SARS-CoV-2 co-infection. Collectively, SARS-CoV-2 and HBV co-infection exacerbates liver function of the patients with COVID-19.
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Key Words
- ALP, alkaline phosphatase
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- Abnormal liver function
- COVID-19
- COVID-19, coronavirus disease 2019
- GGT, gamma-glutamyltransferase
- HBV
- HBV, hepatitis B virus
- IQR, interquartile range
- Inactive HBV carriers
- LDH, lactate dehydrogenase
- Liver injury
- SARS-CoV-2
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- TBIL, total bilirubin
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Affiliation(s)
- Yong Lin
- Key Laboratory of Molecular Biology of Infectious Diseases (Chinese Ministry of Education), Chongqing Medical University, Chongqing, 400016, PR China
| | - Jun Yuan
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, PR China
| | - Quanxin Long
- Key Laboratory of Molecular Biology of Infectious Diseases (Chinese Ministry of Education), Chongqing Medical University, Chongqing, 400016, PR China
| | - Jieli Hu
- Key Laboratory of Molecular Biology of Infectious Diseases (Chinese Ministry of Education), Chongqing Medical University, Chongqing, 400016, PR China
| | - Haijun Deng
- Key Laboratory of Molecular Biology of Infectious Diseases (Chinese Ministry of Education), Chongqing Medical University, Chongqing, 400016, PR China
| | - Zhenyu Zhao
- Key Laboratory of Molecular Biology of Infectious Diseases (Chinese Ministry of Education), Chongqing Medical University, Chongqing, 400016, PR China
| | - Juan Chen
- Key Laboratory of Molecular Biology of Infectious Diseases (Chinese Ministry of Education), Chongqing Medical University, Chongqing, 400016, PR China
| | - Mengji Lu
- Institute for Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, 45122, Germany
| | - Ailong Huang
- Key Laboratory of Molecular Biology of Infectious Diseases (Chinese Ministry of Education), Chongqing Medical University, Chongqing, 400016, PR China
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27
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Yu L, Wang Z, Mo Z, Zou B, Yang Y, Sun R, Ma W, Yu M, Zhang S, Yu Z. Synergetic delivery of triptolide and Ce6 with light-activatable liposomes for efficient hepatocellular carcinoma therapy. Acta Pharm Sin B 2021; 11:2004-2015. [PMID: 34386334 PMCID: PMC8343191 DOI: 10.1016/j.apsb.2021.02.001] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/11/2020] [Accepted: 01/10/2021] [Indexed: 12/12/2022] Open
Abstract
Hepatocellular carcinoma (HCC) has been known as the second common leading cancer worldwide, as it responds poorly to both chemotherapy and medication. Triptolide (TP), a diterpenoid triepoxide, is a promising treatment agent for its effective anticancer effect on multiple cancers including HCC. However, its clinical application has been limited owing to its severe systemic toxicities, low solubility, and fast elimination in the body. Therefore, to overcome the above obstacles, photo-activatable liposomes (LP) integrated with both photosensitizer Ce6 and chemotherapeutic drug TP (TP/Ce6-LP) was designed in the pursuit of controlled drug release and synergetic photodynamic therapy in HCC therapy. The TP encapsulated in liposomes accumulated to the tumor site due to the enhanced permeability and retention (EPR) effect. Under laser irradiation, the photosensitizer Ce6 generated reactive oxygen species (ROS) and further oxidized the unsaturated phospholipids. In this way, the liposomes were destroyed to release TP. TP/Ce6-LP with NIR laser irradiation (TP/Ce6-LP+L) showed the best anti-tumor effect both in vitro and in vivo on a patient derived tumor xenograft of HCC (PDXHCC). TP/Ce6-LP significantly reduced the side effects of TP. Furthermore, TP/Ce6-LP+L induced apoptosis through a caspase-3/PARP signaling pathway. Overall, TP/Ce6-LP+L is a novel potential treatment option in halting HCC progression with attenuated toxicity.
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Key Words
- ALT, liver-related alanine aminotransferase
- AST, aspartate aminotransferase
- BCA, bicinchoninic acid
- BUN, blood urea nitrogen
- CK, creatine kinase
- CK-MB, creatine kinase-MB
- CLSM, confocal laser scanning microscopy
- Ce6
- Chol, cholesterol
- Cr, creatinine
- DEE, drug encapsulation efficiency
- DLC, drug loading content
- DLS, dynamic light scattering
- DSPG, distearoyl phosphatidylglycerole
- Dox, doxorubicin
- EPR, enhanced permeability and retention
- FBS, fetal bovine serum
- FCM, flow cytometry
- HCC, hepatocellular carcinoma
- Hepatocellular carcinoma
- LDH, lactate dehydrogenase
- LP, liposomes
- NIR, near-infrared
- PDT, photodynamic therapy
- PDX model
- PDX, patient-derived xenograft
- PDXHCC, patient derived tumor xenograft of HCC
- PI, propidium iodide
- Photo-activatable liposomes
- Photosensitizer
- Process of photodynamic therapy
- Pt, platinum
- ROS, reactive oxygen species
- So, sorafenib
- Synergetic delivery
- TEM, transmission electron microscope
- TP, triptolide
- TP/Ce6-LP, liposomes integrated with both photosensitizer Ce6 and chemotherapeutic drug TP
- TUNEL, dT-mediated dUTP Nick-End Labeling
- Triptolide
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Affiliation(s)
- Ling Yu
- Department of Traditional Chinese Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhenjie Wang
- The People's Hospital of Gaozhou, Maoming 525200, China
| | - Zhuomao Mo
- Department of Traditional Chinese Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Binhua Zou
- School of Pharmaceutical Sciences, Guangdong Provincial Key Laboratory of New Drug Screening, Southern Medical University, Guangzhou 510515, China
| | - Yuanyuan Yang
- School of Pharmaceutical Sciences, Guangdong Provincial Key Laboratory of New Drug Screening, Southern Medical University, Guangzhou 510515, China
| | - Rui Sun
- School of Pharmaceutical Sciences, Guangdong Provincial Key Laboratory of New Drug Screening, Southern Medical University, Guangzhou 510515, China
| | - Wen Ma
- School of Pharmaceutical Sciences, Guangdong Provincial Key Laboratory of New Drug Screening, Southern Medical University, Guangzhou 510515, China
| | - Meng Yu
- School of Pharmaceutical Sciences, Guangdong Provincial Key Laboratory of New Drug Screening, Southern Medical University, Guangzhou 510515, China
- Corresponding authors.
| | - Shijun Zhang
- Department of Traditional Chinese Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
- Corresponding authors.
| | - Zhiqiang Yu
- School of Pharmaceutical Sciences, Guangdong Provincial Key Laboratory of New Drug Screening, Southern Medical University, Guangzhou 510515, China
- Corresponding authors.
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28
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Zhou K, Sun Y, Li L, Zang Z, Wang J, Li J, Liang J, Zhang F, Zhang Q, Ge W, Chen H, Sun X, Yue L, Wu X, Shen B, Xu J, Zhu H, Chen S, Yang H, Huang S, Peng M, Lv D, Zhang C, Zhao H, Hong L, Zhou Z, Chen H, Dong X, Tu C, Li M, Zhu Y, Chen B, Li SZ, Guo T. Eleven routine clinical features predict COVID-19 severity uncovered by machine learning of longitudinal measurements. Comput Struct Biotechnol J 2021; 19:3640-3649. [PMID: 34188785 PMCID: PMC8225590 DOI: 10.1016/j.csbj.2021.06.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/13/2021] [Accepted: 06/15/2021] [Indexed: 01/08/2023] Open
Abstract
Severity prediction of COVID-19 remains one of the major clinical challenges for the ongoing pandemic. Here, we have recruited a 144 COVID-19 patient cohort, resulting in a data matrix containing 3,065 readings for 124 types of measurements over 52 days. A machine learning model was established to predict the disease progression based on the cohort consisting of training, validation, and internal test sets. A panel of eleven routine clinical factors constructed a classifier for COVID-19 severity prediction, achieving accuracy of over 98% in the discovery set. Validation of the model in an independent cohort containing 25 patients achieved accuracy of 80%. The overall sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 0.70, 0.99, 0.93, and 0.93, respectively. Our model captured predictive dynamics of lactate dehydrogenase (LDH) and creatine kinase (CK) while their levels were in the normal range. This model is accessible at https://www.guomics.com/covidAI/ for research purpose.
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Key Words
- ABG, arterial blood gas
- APTT, activated partial thromboplastin time
- AST, aspartate aminotransferase
- AUC, area under the curve
- BASO#, basophil counts
- CFDA, China Food and Drug Administration
- CK, creatine kinase
- COVID-19
- CRP, C-reactive protein
- CT, computed tomography
- ESR, erythrocyte sedimentation rate
- GA, genetic algorithm
- GGT, gamma glutamyl transpeptidase
- HIS, hospital information system
- LAC, lactate
- LDH, lactate dehydrogenase
- LOESS, locally estimated scatterplot smoothing
- LOS, length of stay
- Longitudinal dynamics
- Machine learning
- Mg, magnesium
- NETs, neutrophil extracellular traps
- NPV, negative predictive value
- PCT, procalcitonin
- PPV, positive predictive value
- ROC, receiver operating characteristics
- RT-PCR, reverse transcriptase -polymerase chain reaction
- Routine clinical test
- SARS-CoV-2
- SHAP, SHapley Additive exPlanations
- SVM, support vector machine
- SaO2, oxygen saturation
- Severity prediction
- TT, thrombin time
- eGFR, estimated glomerular filtration rate
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Affiliation(s)
- Kai Zhou
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Yaoting Sun
- Key Laboratory of Structural Biology of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, Zhejiang Province, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou 310024, Zhejiang Province, China
| | - Lu Li
- Key Laboratory of Structural Biology of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, Zhejiang Province, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou 310024, Zhejiang Province, China
| | - Zelin Zang
- School of Engineering, Westlake University, Hangzhou 310024, Zhejiang Province, China
| | - Jing Wang
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Jun Li
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Junbo Liang
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Fangfei Zhang
- Key Laboratory of Structural Biology of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, Zhejiang Province, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou 310024, Zhejiang Province, China
| | - Qiushi Zhang
- Westlake Omics (Hangzhou) Biotechnology Co., Ltd., Hangzhou 310024, Zhejiang Province, China
| | - Weigang Ge
- Westlake Omics (Hangzhou) Biotechnology Co., Ltd., Hangzhou 310024, Zhejiang Province, China
| | - Hao Chen
- Westlake Omics (Hangzhou) Biotechnology Co., Ltd., Hangzhou 310024, Zhejiang Province, China
| | - Xindong Sun
- Key Laboratory of Structural Biology of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, Zhejiang Province, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou 310024, Zhejiang Province, China
| | - Liang Yue
- Key Laboratory of Structural Biology of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, Zhejiang Province, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou 310024, Zhejiang Province, China
| | - Xiaomai Wu
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Bo Shen
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Jiaqin Xu
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Hongguo Zhu
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Shiyong Chen
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Hai Yang
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Shigao Huang
- Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 999078 Macau SAR, China
| | - Minfei Peng
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Dongqing Lv
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Chao Zhang
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Haihong Zhao
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Luxiao Hong
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Zhehan Zhou
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Haixiao Chen
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Xuejun Dong
- Shaoxing People's Hospital, Shaoxing Hospital, Zhejiang University School of Medicine, Shaoxing 312000, Zhejiang Province, China
| | - Chunyu Tu
- Shaoxing People's Hospital, Shaoxing Hospital, Zhejiang University School of Medicine, Shaoxing 312000, Zhejiang Province, China
| | - Minghui Li
- Shaoxing People's Hospital, Shaoxing Hospital, Zhejiang University School of Medicine, Shaoxing 312000, Zhejiang Province, China
| | - Yi Zhu
- Key Laboratory of Structural Biology of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, Zhejiang Province, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou 310024, Zhejiang Province, China
| | - Baofu Chen
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Stan Z. Li
- School of Engineering, Westlake University, Hangzhou 310024, Zhejiang Province, China
| | - Tiannan Guo
- Key Laboratory of Structural Biology of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, Zhejiang Province, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou 310024, Zhejiang Province, China
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Masotta NE, Martinez-Perafan F, Carballo MA, Gorzalczany SB, Rojas AM, Tripodi VP. Genotoxic risk in humans and acute toxicity in rats of a novel oral high-dose coenzyme Q10 oleogel. Toxicol Rep 2021; 8:1229-1239. [PMID: 34195014 PMCID: PMC8233171 DOI: 10.1016/j.toxrep.2021.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 03/23/2021] [Accepted: 06/14/2021] [Indexed: 11/30/2022] Open
Abstract
An oral high-dose CoQ10 oleogel was assessed in its genotoxicity and acute toxicity. There was no genotoxic risk associated with the use of CoQ10 oleogel in volunteers. Biochemical parameters remained within reference values after oleogel treatment. No signs of toxicity or mortality were observed in the rats exposed to the oleogel. The novel high-dose CoQ10 oleogel formulation designed is safe for oral consumption.
Coenzyme Q10 (CoQ10) supplementation has demonstrated to be safe and effective in primary and secondary CoQ10 deficiencies. Previously, we have designed a high-dose CoQ10 oleogel (1 g/disk) with excipients used in quantities that do not represent any toxic risk. However, it was necessary to demonstrate their safety in the final formulation. Following this purpose, an acute toxicity study of the oleogel in rats was performed. Furthermore, the genotoxic risk was evaluated in human volunteers after CoQ10 supplementation with oleogel and compared to the solid form (1 g/three 00-size-capsules). In addition, the general health status and possible biochemical changes of the participants were determined using serum parameters. Results suggested the absence of adverse effects caused by the interaction of the components in the oleogel formulation. Therefore, we conclude that the designed novel high-dose CoQ10 oleogel was safe for oral consumption.
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Key Words
- ALKP, alkaline phosphatase
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- CBMNcyt, cytokinesis-block micronucleus cytome
- CoQ10, coenzyme Q10
- EC, ethylcellulose
- GGT, gamma-glutamyl transferase
- Genotoxicity
- High-dose coenzyme Q10 oleogel
- LDH, lactate dehydrogenase
- MCT, Medium-chain Triglycerides
- MNi, micronuclei
- Micronucleus cytome assay
- NBUDs, nuclear buds
- NPBs, nucleoplasmic bridges
- Rat acute toxicity
- Serum biochemical parameters
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Affiliation(s)
- Natalia Ehrenhaus Masotta
- Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de Industrias, ITAPROQ (CONICET-UBA), Int. Güiraldes 2620, Ciudad Universitaria, C1428BGA, Buenos Aires, Argentina.,CONICET, Argentina
| | - Fabian Martinez-Perafan
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Departamento de Bioquímica Clínica, CIGETOX (Citogenética Humana y Genética Toxicológica), C1113AAD, Buenos Aires, Argentina
| | - Marta Ana Carballo
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Departamento de Bioquímica Clínica, CIGETOX (Citogenética Humana y Genética Toxicológica), C1113AAD, Buenos Aires, Argentina
| | - Susana Beatriz Gorzalczany
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Farmacología, C1113AAD, Buenos Aires, Argentina
| | - Ana M Rojas
- Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de Industrias, ITAPROQ (CONICET-UBA), Int. Güiraldes 2620, Ciudad Universitaria, C1428BGA, Buenos Aires, Argentina.,CONICET, Argentina
| | - Valeria P Tripodi
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Tecnología Farmacéutica, Junín 954, C1113AAD, Buenos Aires, Argentina.,CONICET, Argentina
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30
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Hennon TR, Yu KOA, Penque MD, Abdul-Aziz R, Chang AC, McGreevy MB, Pastore JV, Prout AJ, Schaefer BA, Alibrahim OS, Gomez-Duarte OG, Hicar MD. COVID-19 associated Multisystem Inflammatory Syndrome in Children (MIS-C) guidelines; revisiting the Western New York approach as the pandemic evolves. Prog Pediatr Cardiol 2021; 62:101407. [PMID: 34121829 PMCID: PMC8179839 DOI: 10.1016/j.ppedcard.2021.101407] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 06/02/2021] [Indexed: 02/06/2023]
Abstract
Multisystem inflammatory syndrome of children (MIS-C) continues to be a highly concerning diagnosis in those recently infected with SARS-CoV-2. The diagnosis of MIS-C cases will likely become even more challenging as vaccine uptake and natural immunity in previously infected persons leads to lower circulating rates of SARS-CoV-2 infection and will make cases sporadic. Febrile children presenting with cardiac dysfunction, symptoms overlapping Kawasaki disease or significant gastrointestinal complaints warrant a thorough screen in emergency departments, urgent care centers, and outpatient pediatric or family medicine practices. An increased index of suspicion and discussion regarding higher level of care (transferring to pediatric tertiary care centers or to intensive care) continues to be recommended. Herein we outline a broad approach with a multidisciplinary team for those meeting the case definition and believe such an approach is crucial for successful outcomes.
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Key Words
- AP, approved
- ASO, anti-streptolysin O
- BNP, brain-natriuretic peptide
- CDC, Center for Disease Control
- COVID-19
- COVID-19, coronavirus disease 2019
- CRP, C-reactive protein
- CXCL10, C-X-C-motif chemokine ligand 10
- DCBLD2, Discoidin, CUB and LCCL domain-containing protein 2
- E, envelope protein
- E.U., European Union
- ECMO, extracorporeal membrane oxygenation
- EKG, electrocardiogram
- EM, emergency use
- FDA, US Food and Drug Authority
- Fever
- GI, gastrointestinal
- IL, interleukin
- IVIG, intravenous immunoglobulin G
- Inflammation
- KD, Kawasaki disease
- LDH, lactate dehydrogenase
- LFTs, liver function tests
- M, membrane protein
- MIS-C
- MIS-C, Multisystem Inflammatory Syndrome in Children
- Mpred, methylprednisolone
- NP, Nucleoprotein
- PCR, polymerase chain reaction
- PT, prothrombin time
- PTT, partial thromboplastin time
- Pediatric
- RBD, receptor binding domain
- SARS-CoV-2
- TE, thromboembolic events
- TNF, tumor necrosis factor
- TWEAK, TNF-like weak inducer of apoptosis
- U.S., United States of America
- VA, veno-arterial
- VLPs, virus-like particles
- VTE, venous thromboembolic events
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Affiliation(s)
- Teresa R Hennon
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States of America.,John R. Oishei Children's Hospital, Buffalo, NY, United States of America
| | - Karl O A Yu
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States of America.,John R. Oishei Children's Hospital, Buffalo, NY, United States of America
| | - Michelle D Penque
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States of America.,John R. Oishei Children's Hospital, Buffalo, NY, United States of America
| | - Rabheh Abdul-Aziz
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States of America.,John R. Oishei Children's Hospital, Buffalo, NY, United States of America
| | - Arthur C Chang
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States of America.,John R. Oishei Children's Hospital, Buffalo, NY, United States of America
| | - Megan B McGreevy
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States of America.,John R. Oishei Children's Hospital, Buffalo, NY, United States of America
| | - John V Pastore
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States of America.,John R. Oishei Children's Hospital, Buffalo, NY, United States of America
| | - Andrew J Prout
- Wayne State University School of Medicine, Detroit, MI, United States of America.,Children's Hospital of Michigan, Detroit, MI, United States of America
| | - Beverly A Schaefer
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States of America.,John R. Oishei Children's Hospital, Buffalo, NY, United States of America
| | - Omar S Alibrahim
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States of America.,John R. Oishei Children's Hospital, Buffalo, NY, United States of America
| | - Oscar G Gomez-Duarte
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States of America.,John R. Oishei Children's Hospital, Buffalo, NY, United States of America
| | - Mark D Hicar
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States of America.,John R. Oishei Children's Hospital, Buffalo, NY, United States of America
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Rozenbaum D, Shreve J, Radakovich N, Duggal A, Jehi L, Nazha A. Personalized Prediction of Hospital Mortality in COVID-19-Positive Patients. Mayo Clin Proc Innov Qual Outcomes 2021; 5:795-801. [PMID: 34002167 PMCID: PMC8114764 DOI: 10.1016/j.mayocpiqo.2021.05.001] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective To develop predictive models for in-hospital mortality and length of stay (LOS) for coronavirus disease 2019 (COVID-19)–positive patients. Patients and Methods We performed a multicenter retrospective cohort study of hospitalized COVID-19–positive patients. A total of 764 patients admitted to 14 different hospitals within the Cleveland Clinic from March 9, 2020, to May 20, 2020, who had reverse transcriptase-polymerase chain reaction–proven coronavirus infection were included. We used LightGBM, a machine learning algorithm, to predict in-hospital mortality at different time points (after 7, 14, and 30 days of hospitalization) and in-hospital LOS. Our final cohort was composed of 764 patients admitted to 14 different hospitals within our system. Results The median LOS was 5 (range, 1-44) days for patients admitted to the regular nursing floor and 10 (range, 1-38) days for patients admitted to the intensive care unit. Patients who died during hospitalization were older, initially admitted to the intensive care unit, and more likely to be white and have worse organ dysfunction compared with patients who survived their hospitalization. Using the 10 most important variables only, the final model’s area under the receiver operating characteristics curve was 0.86 for 7-day, 0.88 for 14-day, and 0.85 for 30-day mortality in the validation cohort. Conclusion We developed a decision tool that can provide explainable and patient-specific prediction of in-hospital mortality and LOS for COVID-19–positive patients. The model can aid health care systems in bed allocation and distribution of vital resources.
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Key Words
- ANC, absolute neutrophil count
- AST, aspartate aminotransferase
- BMI, body mass index
- CK, creatinine kinase
- COVID-19, coronavirus disease 2019
- CRP, C-reactive protein
- CXR, chest radiograph
- D1, day 1
- ICU, intensive care unit
- INR, international normalized ratio
- LDH, lactate dehydrogenase
- LOS, length of stay
- LightGBM, Light Gradient Boosting Machine
- NC, nasal cannula
- Nan, missing value
- PTT, partial thromboplastin time
- Q, quartile
- ROC AUC, area under the receiver operating characteristics curve
- SHAP, SHapley Additive exPlanations
- SUN, serum urea nitrogen
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Affiliation(s)
- Daniel Rozenbaum
- Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH
| | - Jacob Shreve
- Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH
| | | | - Abhijit Duggal
- Department of Critical Care, Cleveland Clinic, Cleveland, OH
| | - Lara Jehi
- Neurological Institute and Lerner College of Medicine, Cleveland, OH
| | - Aziz Nazha
- Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH.,Lerner College of Medicine, Cleveland, OH.,Center for Clinical Artificial Intelligence, Cleveland Clinic, Cleveland, OH
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Ruan GJ, Gandhi S, Abeykoon JP, Schram S, Habermann TM, Sandefur BJ, Witzig TE. Elevated Serum Lactate in Patients With Lymphoma: It Is Not Always Infection. Mayo Clin Proc Innov Qual Outcomes 2021; 5:423-430. [PMID: 33997638 PMCID: PMC8105511 DOI: 10.1016/j.mayocpiqo.2021.01.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2023] Open
Abstract
OBJECTIVE To distinguish between sepsis only vs progressive lymphoma in patients with a history of lymphoma who present to the hospital with lactic acidosis. PATIENTS AND METHODS We identified patients with non-Hodgkin lymphoma (NHL) or Hodgkin lymphoma from January 2014 to December 2015. Patients were categorized into 2 groups: sepsis only or progressive lymphoma. Two-sided Wilcoxon rank sum test and χ1/Fisher exact test were used to compare the continuous and categorical variables, respectively. Kaplan-Meier analysis was used to estimate overall survival (OS). RESULTS A total of 51 patients were identified; 33 (65%) patients were categorized into the sepsis only group, and 18 (35%), into the progressive lymphoma group. Values for serum lactate dehydrogenase (LDH) drawn during hospitalization were statistically different between the sepsis only and progressive lymphoma groups (median, 262 vs 665 U/L; P=.005), respectively. The sensitivity and specificity of serum LDH level 2 or more times the upper limit of normal for progressive lymphoma were 56% (95% CI, 33% to 79%) and 85% (95% CI, 73% to 97%), respectively. Serum LDH level was independently predictive of inferior OS (hazard ratio, 27.8; 95% CI, 4.0 to 160.1; P<.001), while serum albumin level (hazard ratio, 0.05; 95% CI, 0.01 to 0.27; P<.001) was independently predictive of improved OS. CONCLUSION Serum LDH levels used in conjunction with serial serum lactate values may be reliable markers to differentiate patients with progressive lymphomatous disease from patients with lymphoma with sepsis only. The LDH levels should be obtained in all patients with lymphoma who present to the hospital with lactic acidosis.
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Key Words
- ATP, adenosine triphosphate
- CT, computed tomography
- CoA, coenzyme A
- DLBCL, diffuse large B-cell lymphoma
- GLUT, facilitative glucose transporter
- HR, hazard ratio
- IQR, interquartile range
- LDH, lactate dehydrogenase
- MCT, monocarboxylate transporter
- NAD, nicotinamide adenine dinucleotide
- NADH, nicotinamide adenine dinucleotide and hydrogen
- NHL, non-Hodgkin lymphoma
- O2, oxygen
- OS, overall survival
- TCA, tricarboxylic acid
- ULN, upper limit of normal
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Affiliation(s)
- Gordon J. Ruan
- Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | | | | | - Susan Schram
- Division of Hematology, Mayo Clinic, Rochester, MN
| | | | | | - Thomas E. Witzig
- Division of Hematology, Mayo Clinic, Rochester, MN
- Correspondence: Address to Thomas E. Witzig, MD, Division of Hematology, Mayo Clinic, 200 First St SW, Rochester, MN 55905
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33
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Saxena P, Saharan V, Baroliya PK, Gour VS, Rai MK, Harish. Mechanism of nanotoxicity in Chlorella vulgaris exposed to zinc and iron oxide. Toxicol Rep 2021; 8:724-731. [PMID: 33868956 PMCID: PMC8042424 DOI: 10.1016/j.toxrep.2021.03.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 02/03/2023] Open
Abstract
Growth kinetics of C. vulgaris is influenced by NPs exposure. NPs exposure influence proline, carotenoid, activity of SOD, CAT and LDH. NPs exposure disintegrate cellular membrane. Zinc and iron oxide NPs are more toxic to C. vulgaris compared to bulk counterpart.
Usage of nanoparticle in various products has increased tremendously in the recent past. Toxicity of these nanoparticles can have a huge impact on aquatic ecosystem. Algae are the ideal organism of the aquatic ecosystem to understand the toxicity impact of nanoparticles. The present study focuses on the toxicity evaluation of zinc oxide (ZnO) and iron oxide (Fe2O3) nanoparticles towards freshwater microalgae, Chlorella vulgaris. The dose dependent growth retardation in Chlorella vulgaris is observed under ZnO and Fe2O3 nanoparticles and nanoform attributed more toxicity than their bulk counterparts. The IC50 values of ZnO and Fe2O3 nanoparticles was reported at 0.258 mg L−1 and 12.99 mg L-1 whereas, for the bulk-form, it was 1.255 mgL-1 and 17.88 mg L−1, respectively. The significant decline in chlorophyll content and increase in proline content, activity of superoxide dismutase and catalase, indicated the stressful physiological state of microalgae. An increased lactate dehydrogenase level in treated samples suggested membrane disintegration by ZnO and Fe2O3 nanoparticles. Compound microscopy, scanning electron microscopy and transmission electron microscopy confirm cell entrapment, deposition of nanoparticles on the cell surface and disintegration of algal cell wall. Higher toxicity of nanoform in comparison to bulk chemistry is a point of concern.
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Key Words
- ANOVA, analysis of variance
- Algae
- Antioxidant
- Aquatic-ecosystem
- BG-11, blue green-11
- BSA, bovine serum albumin
- CAT, catalase
- CDH, central drug house
- DDW, double distilled water
- FTIR, fourier-transform infrared spectroscopy
- Fe2O3, ferric oxide
- IC50, half maximal inhibitory concentration
- JCPDS, Joint Committee on Powder Diffraction Standards
- LDH, lactate dehydrogenase
- MDA, malondialdehyde assay
- NADH, nicotinamide adenine dinucleotide (reduced form)
- NCBI, national center for biotechnology information
- NPs, nanoparticles
- Nanoparticles
- OD, optical density
- PBS, phosphate-buffered saline
- PDI, polydispersity index
- ROS, reactive oxygen species
- SD, standard deviation
- SEM, scanning electron microscopy
- SOD, superoxide dismutase
- Stress
- TEM, transmission electron microscopy
- UV, ultra violet
- XRD, X-ray diffraction
- ZnO, zinc oxide
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Affiliation(s)
- Pallavi Saxena
- Plant Biotechnology Laboratory, Department of Botany, Mohanlal Sukhadia University, Udaipur, 313 001, Rajasthan, India
| | - Vinod Saharan
- Department of Molecular Biology and Biotechnology, Rajasthan College of Agriculture, Maharana Pratap University of Agriculture and Technology, Udaipur, 313 001, Rajasthan, India
| | - Prabhat Kumar Baroliya
- Department of Chemistry, Mohanlal Sukhadia University, Udaipur, 313 001, Rajasthan, India
| | - Vinod Singh Gour
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India
| | - Manoj Kumar Rai
- Department of Environmental Science, Indira Gandhi National Tribal University, Amarkantak, Madhya Pradesh, 484887, India
| | - Harish
- Plant Biotechnology Laboratory, Department of Botany, Mohanlal Sukhadia University, Udaipur, 313 001, Rajasthan, India
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Singh D, Chaudhary D, Kumar V, Verma A. Amelioration of diethylnitrosamine (DEN) induced renal oxidative stress and inflammation by Carissa carandas embedded silver nanoparticles in rodents. Toxicol Rep 2021; 8:636-645. [PMID: 33850732 PMCID: PMC8039534 DOI: 10.1016/j.toxrep.2021.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 12/13/2022] Open
Abstract
Phytofabricated silver nanoparticles (CCAgNPs) were biosynthesized and characterized. CCAgNPs were evaluated against diethylnitrosamine induced renal cancer. Silver nanoparticles have an antioxidant property. Silver nanoparticles unveiled a therapeutic effect against renal cancer in vivo.
Introduction Inflammation and oxidative stress are the main factors ascribed with interruption in the process of renal tissue impairment. The toxicity of different types of nitrosamine is well recognized in animals and humans. Administration of the smallest quantities of diethylnitrosamine or dimethylnitrosamine either orally or parenterally results into renal damage. Therapeutic effects of phytofabricated silver nanoparticles of Carissa carandas aqueous extract has been scrutinised in current study for the assessment of renal cancer activity in animal model. Methodology Phytofabricated silver nanoparticles were characterized by using different instrumentation. Nephroprotective activity of silver nanoparticles at different doses was evaluated against N-diethylnitrosamine (200 mg/kg b.w., intraperitoneal) in animal model. Serum and renal homogenate were taken to evaluate the renal toxicity markers, oxidative stress, and antioxidant parameter, proinflammatory cytokines and histopathological study. Result Significant outcomes of silver nanoparticles in dose dependent manner down regulated the elevated serum marker, tumour marker enzymes and histopathology observation of repaired tissue assured the renal cancer activity in animals. In addition, profile of enzymatic and non-enzymatic antioxidant, proinflammatory cytokines and tumour promotion marker also favours the anticancer property of silver nanoparticles. Conclusion The data of current study reveals silver nanoparticles ameliorates renal oxidative stress and carcinogenesis which was induced by N-diethylnitrosamine and accredited to antioxidant and anticancer activities of phytofabricated nanoparticles by biological approach.
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Key Words
- ABTS, 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid
- AgNO3, silver nitrate
- AgNPs, silver nanoparticles
- BUN, blood urea nitrogen
- CC, carissa carandas
- CCAgNPs, silver nanoparticles of carissa carandas aqueous extract
- CDNB, 1-chloro-2,4-dinitrobenzene
- Carissa carandas embedded silver nanoparticles
- DEN, diethylnitrosamine
- DLS, dynamic light scattering
- DMN, dimethylnitrosamine
- DMSO, dimethyl sulphoxide
- FE-SEM, field emission scanning electron microscopy
- GGT, gamma glutamyl transpeptidase
- GGT, γ-glutamyl transpeptidase activity
- GPx, glutathione peroxidase
- GR, glutathione reductase activity
- GSH, glutathione
- GST, glutathione –S- Transferase
- H2O2, hydrogen peroxide
- IAEC, institutional animal ethical committee
- LDH, lactate dehydrogenase
- MDA, malondialdehyde
- NF-κB pathway
- NPs, nanoparticles
- ODC, ornithine decarboxylase
- ROS, reactive oxygen species
- Renal carcinoma
- SOD, superoxide dismutase
- XO, xanthine oxidase
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Affiliation(s)
- Deepika Singh
- Department of Pharmaceutical Sciences, Faculty of Health Sciences, Sam Higginbottom University of Agriculture, Technology & Sciences, Allahabad, Uttar Pradesh, 211007, India
| | - Deepak Chaudhary
- Department of Pharmaceutical Sciences, Mohanlal Sukhadia University, Udaipur, Rajasthan, India
| | - Vikas Kumar
- Department of Pharmaceutical Sciences, Faculty of Health Sciences, Sam Higginbottom University of Agriculture, Technology & Sciences, Allahabad, Uttar Pradesh, 211007, India
| | - Amita Verma
- Department of Pharmaceutical Sciences, Faculty of Health Sciences, Sam Higginbottom University of Agriculture, Technology & Sciences, Allahabad, Uttar Pradesh, 211007, India
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De Martin S, Gabbia D, Bogialli S, Biasioli F, Boschetti A, Gstir R, Rainer D, Cappellin L. Refill liquids for electronic cigarettes display peculiar toxicity on human endothelial cells. Toxicol Rep 2021; 8:456-462. [PMID: 33717998 PMCID: PMC7933715 DOI: 10.1016/j.toxrep.2021.02.021] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 02/07/2023] Open
Abstract
The electronic cigarettes mimic combustible cigarettes through a heating technology that vaporizes a refill liquid consisting of solvents, flavors, and nicotine. E-cigarettes are sometimes still used as a support for smoking cessation, even if in 2019 an acute lung injury outbreak occurred in the USA, affecting mainly adolescents and young adults, and was correlated to eCigs. Therefore, due to the lack of a definite knowledge about the mechanism(s) of refill liquid toxicity and considering that previous investigations gave controversial results, the aim of the present study was the cytotoxicity assessment of different refill liquids on human endothelial cells, evaluated by means of two different in vitro approaches, i.e. the resazurin and the LDH release assays. Our results clearly demonstrated that different refill liquids (6 samples) display different levels of cytotoxicity in our cellular model, although their cytotoxicity was always lower than that observed for the condensate obtained from traditional cigarettes (3 samples). These results suggest that accurate evaluations should be provided for refill liquids, in particular to correlate their toxicity to their chemical composition, with the final aim of obtaining useful information for the agencies involved in the regulation of their components.
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Affiliation(s)
- Sara De Martin
- Department of Pharmaceutical and Pharmacological Sciences, Università degli Studi di Padova, Padova, Italy
| | - Daniela Gabbia
- Department of Pharmaceutical and Pharmacological Sciences, Università degli Studi di Padova, Padova, Italy
| | - Sara Bogialli
- Department of Chemical Sciences, Università degli Studi di Padova, Padova, Italy
| | - Franco Biasioli
- Research and Innovation Centre, Fondazione Edmund Mach, S. Michele a/A, Italy
| | | | - Ronald Gstir
- Austrian Drug Screening Institute GmbH, Innsbruck, Austria
| | - Daniela Rainer
- Austrian Drug Screening Institute GmbH, Innsbruck, Austria
| | - Luca Cappellin
- Department of Chemical Sciences, Università degli Studi di Padova, Padova, Italy.,Research and Innovation Centre, Fondazione Edmund Mach, S. Michele a/A, Italy
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Naito K, Suzuki S, Ohwada C, Ishiwata K, Ruike Y, Ishida A, Deguchi-Horiuchi H, Fujimoto M, Koide H, Sakaida E, Horiguchi K, Iwadate Y, Tatsuno I, Inoshita N, Ikeda JI, Tanaka T, Yokote K. ICAM1-Negative Intravascular Large B-Cell Lymphoma of the Pituitary Gland: A Case Report and Literature Review. AACE Clin Case Rep 2021; 7:249-255. [PMID: 34307847 PMCID: PMC8282537 DOI: 10.1016/j.aace.2021.01.011] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/27/2021] [Indexed: 11/25/2022] Open
Abstract
Objective Intravascular large B-cell lymphoma (IVLBCL) is a rare and aggressive type of B-cell lymphoma with large cells growing within the lumen of blood vessels. Although previous reports revealed highly variable symptoms resulting from small-vessel occlusion by neoplastic cells in a variety of organs, there are few reports of IVLBCL with pituitary involvement. Method We present a case of IVLBCL with pituitary infiltration from our institution together with a literature review of similar cases to better understand this rare case of IVLBCL involving the pituitary gland. Results Our case and the pertinent literature demonstrated that IVLBCL with pituitary involvement predominantly occurred in women at a mean age of 64 years, and most of them showed panhypopituitarism that was reversible after standard therapy of rituximab-containing chemotherapy with intrathecal methotrexate. Notably, the pituitary biopsy in our case revealed that atypical large B-cells found within blood vessels and the pituitary gland were negative for intercellular adhesion molecule 1. Intercellular adhesion molecule 1-negative lymphoid cells may have contributed to panhypopituitarism by extravasation into the pituitary tissues, which do not have a blood-brain barrier and receive abundant blood flow. Conclusion IVLBCL of the pituitary gland is a rare lymphoma with nonspecific manifestations and a dismal prognosis. Recognition of the clinicopathological features is necessary for early clinical diagnosis and appropriate treatment.
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Key Words
- ACTH, adrenocorticotropic hormone
- BAL, bronchoalveolar lavage fluid analysis
- CRH, corticotropin-releasing hormone
- FDG, 18F-fluorodeoxyglucose
- FSH, follicle-stimulating hormone
- GH, growth hormone
- GHRP2, growth hormone-releasing peptide 2
- ICAM1
- ICAM1, intercellular adhesion molecule 1
- IVLBCL, intravascular large B-cell lymphoma
- LDH, lactate dehydrogenase
- LH, luteinizing hormone
- LHRH, luteinizing hormone-releasing hormone
- MEAM, ranimustine, etoposide, cytarabine, and melphalan
- MTX, methotrexate
- R-CHOP, rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone
- R-hyper-CVAD/MA, rituximab plus hyper-fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with methotrexate and cytarabine
- TBLB, transbronchial lung biopsy
- TRH, thyrotropin-releasing hormone
- TSH, thyrotropin
- hypopituitarism
- intravascular
- large B-cell lymphoma
- pituitary
- sIL2R, soluble IL-2 receptor
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Affiliation(s)
- Kumiko Naito
- Department of Endocrinology, Hematology and Gerontology, Chiba University Hospital, Chiba, Japan.,Department of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Sawako Suzuki
- Department of Endocrinology, Hematology and Gerontology, Chiba University Hospital, Chiba, Japan.,Department of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Chikako Ohwada
- Department of Endocrinology, Hematology and Gerontology, Chiba University Hospital, Chiba, Japan.,Department of Hematology, Chiba University Hospital, Chiba, Japan
| | - Kazuki Ishiwata
- Department of Endocrinology, Hematology and Gerontology, Chiba University Hospital, Chiba, Japan.,Department of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Yutaro Ruike
- Department of Endocrinology, Hematology and Gerontology, Chiba University Hospital, Chiba, Japan.,Department of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Akiko Ishida
- Department of Endocrinology, Hematology and Gerontology, Chiba University Hospital, Chiba, Japan.,Department of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Hanna Deguchi-Horiuchi
- Department of Endocrinology, Hematology and Gerontology, Chiba University Hospital, Chiba, Japan.,Department of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Masanori Fujimoto
- Department of Endocrinology, Hematology and Gerontology, Chiba University Hospital, Chiba, Japan.,Department of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Hisashi Koide
- Department of Endocrinology, Hematology and Gerontology, Chiba University Hospital, Chiba, Japan.,Department of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - Emiko Sakaida
- Department of Endocrinology, Hematology and Gerontology, Chiba University Hospital, Chiba, Japan.,Department of Hematology, Chiba University Hospital, Chiba, Japan
| | - Kentaro Horiguchi
- Department of Neurological Surgery, Chiba University Hospital, Chiba, Japan
| | - Yasuo Iwadate
- Department of Neurological Surgery, Chiba University Hospital, Chiba, Japan
| | - Ichiro Tatsuno
- Center for Diabetes, Metabolism and Endocrinology, Toho University Sakura Medical Center, Chiba, Japan
| | - Naoko Inoshita
- Department of Pathological Diagnosis, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Jun-Ichiro Ikeda
- Department of Pathology, Chiba University Hospital, Chiba, Japan
| | - Tomoaki Tanaka
- Department of Molecular Diagnosis, Chiba University, Chiba, Japan
| | - Koutaro Yokote
- Department of Endocrinology, Hematology and Gerontology, Chiba University Hospital, Chiba, Japan.,Department of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
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Chaudhary R, Garg J, Houghton DE, Murad MH, Kondur A, Chaudhary R, Wysokinski WE, McBane RD. Thromboinflammatory Biomarkers in COVID-19: Systematic Review and Meta-analysis of 17,052 Patients. Mayo Clin Proc Innov Qual Outcomes 2021; 5:388-402. [PMID: 33585800 PMCID: PMC7869679 DOI: 10.1016/j.mayocpiqo.2021.01.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objective To evaluate differences in thromboinflammatory biomarkers between patients with severe coronavirus disease 2019 (COVID-19) infection/death and mild infection. Patients and Methods MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, EBSCO, Web of Science, and CINAHL databases were searched for studies comparing thromboinflammatory biomarkers in COVID-19 among patients with severe COVID-19 disease or death (severe/nonsurvivors) and those with nonsevere disease or survivors (nonsevere/survivors) from January 1, 2020, through July 11, 2020. Inclusion criteria were (1) hospitalized patients 18 years or older comparing severe/nonsurvivors vs nonsevere/survivors and (2) biomarkers of inflammation and/or thrombosis. A random-effects model was used to estimate the weighted mean difference (WMD) between the 2 groups of COVID-19 severity. Results We included 75 studies with 17,052 patients. The severe/nonsurvivor group was older, had a greater proportion of men, and had a higher prevalence of hypertension, diabetes, cardiac or cerebrovascular disease, chronic kidney disease, malignancy, and chronic obstructive pulmonary disease. Thromboinflammatory biomarkers were significantly higher in patients with severe disease, including D-dimer (WMD, 0.60; 95% CI, 0.49 to 0.71; I2=83.85%), fibrinogen (WMD, 0.42; 95% CI, 0.18 to 0.67; I2=61.88%; P<.001), C-reactive protein (CRP) (WMD, 35.74; 95% CI, 30.16 to 41.31; I2=85.27%), high-sensitivity CRP (WMD, 62.68; 95% CI, 45.27 to 80.09; I2=0%), interleukin 6 (WMD, 22.81; 95% CI, 17.90 to 27.72; I2=90.42%), and ferritin (WMD, 506.15; 95% CI, 356.24 to 656.06; I2=52.02%). Moderate to significant heterogeneity was observed for all parameters (I2 > 25%). Subanalysis based on disease severity, mortality, and geographic region of the studies revealed similar inferences. Conclusion Thromboinflammatory biomarkers (D-dimer, fibrinogen, CRP, high-sensitivity CRP, ferritin, and interleukin 6) and marker of end-organ damage (high-sensitivity troponin I) are associated with increased severity and mortality in COVID-19 infection.
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Affiliation(s)
- Rahul Chaudhary
- Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN.,Division of Cardiology, University of Pittsburgh Medical Center Heart and Vascular Institute, Pittsburgh, PA
| | - Jalaj Garg
- Division of Cardiology, Medical College of Wisconsin, Milwaukee
| | | | - M Hassan Murad
- Evidence-based Practice Center, Mayo Clinic, Rochester, MN
| | - Ashok Kondur
- Division of Cardiology, Garden City Hospital, Garden City, MI
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Dolivo D, Weathers P, Dominko T. Artemisinin and artemisinin derivatives as anti-fibrotic therapeutics. Acta Pharm Sin B 2021; 11:322-339. [PMID: 33643815 PMCID: PMC7893118 DOI: 10.1016/j.apsb.2020.09.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/18/2020] [Accepted: 08/21/2020] [Indexed: 12/18/2022] Open
Abstract
Fibrosis is a pathological reparative process that can occur in most organs and is responsible for nearly half of deaths in the developed world. Despite considerable research, few therapies have proven effective and been approved clinically for treatment of fibrosis. Artemisinin compounds are best known as antimalarial therapeutics, but they also demonstrate antiparasitic, antibacterial, anticancer, and anti-fibrotic effects. Here we summarize literature describing anti-fibrotic effects of artemisinin compounds in in vivo and in vitro models of tissue fibrosis, and we describe the likely mechanisms by which artemisinin compounds appear to inhibit cellular and tissue processes that lead to fibrosis. To consider alternative routes of administration of artemisinin for treatment of internal organ fibrosis, we also discuss the potential for more direct oral delivery of Artemisia plant material to enhance bioavailability and efficacy of artemisinin compared to administration of purified artemisinin drugs at comparable doses. It is our hope that greater understanding of the broad anti-fibrotic effects of artemisinin drugs will enable and promote their use as therapeutics for treatment of fibrotic diseases.
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Key Words
- ALP, alkaline phosphatase
- ALT, alanine aminotransferase
- AMPK, AMP-activated protein kinase
- ASP, aspartate aminotransferase
- Artemisia
- Artemisinin
- Artesunate
- BAD, BCL-2-associated agonist of cell death
- BDL, bile duct ligation
- BSA, bovine serum albumin
- BUN, blood urea nitrogen
- CCl4, carbon tetrachloride
- CTGF, connective tissue growth factor
- Col I, type I collagen
- DHA, dihydroartemisinin
- DLA, dried leaf Artemisia
- ECM, extracellular matrix
- EMT, epithelial-to-mesenchymal transition
- FLS, fibroblast-like synoviocyte
- Fibroblast
- Fibrosis
- HA, hyaluronic acid
- HSC, hepatic stellate cell
- HUVEC, human umbilical vein endothelial cell
- LAP, latency-associated peptide
- LDH, lactate dehydrogenase
- MAPK, mitogen-activated protein kinase
- MI, myocardial infarction
- MMP, matrix metalloproteinase
- Myofibroblast
- NAG, N-acetyl-β-d-glucosaminidase
- NICD, Notch intracellular domain
- PCNA, proliferating cell nuclear antigen
- PHN, passive heymann nephritis
- ROS, reactive oxygen species
- STZ, streptozotocin
- Scar
- TGF, β-transforming growth factor-β
- TGF-β
- TIMP, tissue inhibitor of metalloproteinase
- UUO, unilateral ureteral obstruction
- i.p., intraperitoneal
- mTOR, mechanistic target of rapamycin
- sCr, serum creatinine
- α-SMA, smooth muscle α-actin
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Simões JP, Alves Ferreira AR, Almeida PM, Trigueiros F, Braz A, Inácio JR, Medeiros FC, Braz S, Pais de Lacerda A. Organizing pneumonia and COVID-19: A report of two cases. Respir Med Case Rep 2021; 32:101359. [PMID: 33552895 PMCID: PMC7847533 DOI: 10.1016/j.rmcr.2021.101359] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/12/2021] [Accepted: 01/27/2021] [Indexed: 12/15/2022] Open
Abstract
Organizing pneumonia (OP) is a sub-acute process of pulmonary tissue repair secondary to lung injury, defined histopathologically by intra-alveolar buds of granulation tissue within the lumen of distal pulmonary airspaces. It can be either cryptogenic or secondary (SOP) to different clinical conditions, namely infections. Despite being nonspecific, its diagnosis can be made by the association of clinical and imaging criteria. We report two cases of OP associated to SARS-CoV-2 pneumonia, admitted at a Portuguese tertiary hospital unit dedicated to COVID-19. Both patients presented with severe respiratory failure with need of invasive mechanical ventilation. After initial recovery, there was worsening of dyspnea and hypoxemic respiratory failure with increase in inflammatory markers. Chest CT revealed an OP pattern. Other conditions such as superinfection, auto-immune disease and iatrogenic etiology, were excluded and corticotherapy at a dose of 1 mg/kg/day was administered. Chest CT follow up of both our patients showed complete resolution of OP pattern, with mild to moderate residual pulmonary fibrosis without honeycombing. There is no OP to SARS-CoV-2 case series yet published describing the progress of patients after corticotherapy, although the association between systemic corticosteroids and lower all-cause mortality in patients with COVID-19 has been recently established. It is possible that, as has been described with other viruses, OP secondary to SARS-CoV-2 represents an immunological process after initial infection, presenting with elevation of inflammatory markers and cytokines storm in the bloodstream and lung tissue, which may explain the favorable response to corticosteroids.
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Affiliation(s)
- Joana Paiva Simões
- Department of Internal Medicine II at Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, EPE, Portugal
| | - Ana Rita Alves Ferreira
- Department of Internal Medicine II at Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, EPE, Portugal
| | - Pedro Martins Almeida
- Department of Internal Medicine II at Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, EPE, Portugal
- Department of Hematology at Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, EPE, Portugal
| | - Frederico Trigueiros
- Department of Internal Medicine II at Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, EPE, Portugal
| | - Armando Braz
- Department of Internal Medicine II at Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, EPE, Portugal
| | - João Rodrigues Inácio
- Department of Medical Imaging at Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, EPE, Portugal
| | - Fábio Cota Medeiros
- Department of Infectious Diseases at Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, EPE, Portugal
- Institute of Microbiology, Institute of Environmental Health, Faculty of Medicine of Lisbon, Portugal
| | - Sandra Braz
- Department of Internal Medicine II at Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, EPE, Portugal
| | - António Pais de Lacerda
- Department of Internal Medicine II at Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, EPE, Portugal
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Shmueli H, Shah M, Ebinger JE, Nguyen LC, Chernomordik F, Flint N, Botting P, Siegel RJ. Left ventricular global longitudinal strain in identifying subclinical myocardial dysfunction among patients hospitalized with COVID-19. Int J Cardiol Heart Vasc 2021; 32:100719. [PMID: 33521240 PMCID: PMC7830223 DOI: 10.1016/j.ijcha.2021.100719] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/06/2021] [Accepted: 01/11/2021] [Indexed: 12/15/2022]
Abstract
Background The incidence of acute cardiac injury in COVID-19 patients is very often subclinical and can be detected by cardiac magnetic resonance imaging. The aim of this study was to assess if subclinical myocardial dysfunction could be identified using left ventricular global longitudinal strain (LV-GLS) in patients hospitalized with COVID-19. Methods We performed a search of COVID-19 patients admitted to our institution from January 1st, 2020 to June 8th, 2020, which revealed 589 patients (mean age = 66 ± 18, male = 56%). All available 60 transthoracic echocardiograms (TTE) were reviewed and off-line assessment of LV-GLS was performed in 40 studies that had sufficient quality images and the views required to calculate LV-GLS. We also analyzed electrocardiograms and laboratory findings including inflammatory markers, Troponin-I, and B-type natriuretic peptide (BNP). Results Of 589 patients admitted with COVID-19 during our study period, 60 (10.1%) underwent TTE during hospitalization. Findings consistent with overt myocardial involvement included reduced ejection fraction (23%), wall motion abnormalities (22%), low stroke volume (82%) and increased LV wall thickness (45%). LV-GLS analysis was available for 40 patients and was abnormal in 32 patients (80%). All patients with LV dysfunction had elevated cardiac enzymes and positive inflammatory biomarkers. Conclusions Subclinical myocardial dysfunction as measured via reduced LV-GLS is frequent, occurring in 80% of patients hospitalized with COVID-19, while prevalent LV function parameters such as reduced EF and wall motion abnormalities were less frequent findings. The mechanism of cardiac injury in COVID-19 infection is the subject of ongoing research.
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Key Words
- AV, atrioventricular
- BNP, B-type natriuretic peptide
- CMRI, cardiac magnetic resonance imaging
- COPD, chronic obstructive pulmonary disease
- COVID-19
- COVID-19, coronavirus disease 2019
- CRP, C-reactive protein
- ECG, electrocardiogram
- Echocardiography
- Global longitudinal strain
- HTN, hypertension
- ICU, intensive care unit
- IL-6, interleukin-6
- LA, left atrium
- LDH, lactate dehydrogenase
- LV, left ventricle
- LV-GLS, left ventricular global longitudinal strain
- LVEF, left ventricular ejection fraction
- LVOT, left ventricular outflow tract
- RV, right ventricle
- SARS, severe acute respiratory syndrome
- T2DM, type-2 diabetes mellitus
- TAPSE, tricuspid annular plane systolic excursion
- TTE, transthoracic echocardiogram
- VTI, velocity-time integral
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Affiliation(s)
- Hezzy Shmueli
- Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Maulin Shah
- Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Joseph E Ebinger
- Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Long-Co Nguyen
- Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Fernando Chernomordik
- Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA.,Pulmonary and Critical Care Medicine Division, Cedars Sinai Medical Center, Los Angeles, CA, USA.,Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nir Flint
- Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA.,Department of Cardiology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Patrick Botting
- Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Robert J Siegel
- Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
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Blaya D, Pose E, Coll M, Lozano JJ, Graupera I, Schierwagen R, Jansen C, Castro P, Fernandez S, Sidorova J, Vasa-Nicotera M, Solà E, Caballería J, Trebicka J, Ginès P, Sancho-Bru P. Profiling circulating microRNAs in patients with cirrhosis and acute-on-chronic liver failure. JHEP Rep 2021; 3:100233. [PMID: 33665588 DOI: 10.1016/j.jhepr.2021.100233] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 12/02/2020] [Accepted: 12/25/2020] [Indexed: 12/13/2022] Open
Abstract
Background & Aims MicroRNAs (miRNAs) circulate in several body fluids and can be useful biomarkers. The aim of this study was to identify blood-circulating miRNAs associated with cirrhosis progression and acute-on-chronic liver failure (ACLF). Methods Using high-throughput screening of 754 miRNAs, serum samples from 45 patients with compensated cirrhosis, decompensated cirrhosis, or ACLF were compared with those from healthy individuals (n = 15). miRNA levels were correlated with clinical parameters, organ failure, and disease progression and outcome. Dysregulated miRNAs were evaluated in portal and hepatic vein samples (n = 33), liver tissues (n = 17), and peripheral blood mononuclear cells (PBMCs) (n = 16). Results miRNA screening analysis revealed that circulating miRNAs are dysregulated in cirrhosis progression, with 51 miRNAs being differentially expressed among all groups of patients. Unsupervised clustering and principal component analysis indicated that the main differences in miRNA expression occurred at decompensation, showing similar levels in patients with decompensated cirrhosis and those with ACLF. Of 43 selected miRNAs examined for differences among groups, 10 were differentially expressed according to disease progression. Moreover, 20 circulating miRNAs were correlated with model for end-stage liver disease and Child-Pugh scores. Notably, 11 dysregulated miRNAs were associated with kidney or liver failure, encephalopathy, bacterial infection, and poor outcomes. The most severely dysregulated miRNAs (i.e. miR-146a-5p, miR-26a-5p, and miR-191-5p) were further evaluated in portal and hepatic vein blood and liver tissue, but showed no differences. However, PBMCs from patients with cirrhosis showed significant downregulation of miR-26 and miR-146a, suggesting a extrahepatic origin of some circulating miRNAs. Conclusions This study is a repository of circulating miRNA data following cirrhosis progression and ACLF. Circulating miRNAs were profoundly dysregulated during the progression of chronic liver disease, were associated with failure of several organs and could have prognostic utility. Lay summary Circulating miRNAs are small molecules in the blood that can be used to identify or predict a clinical condition. Our study aimed to identify miRNAs for use as biomarkers in patients with cirrhosis or acute-on-chronic liver failure. Several miRNAs were found to be dysregulated during the progression of disease, and some were also related to organ failure and disease-related outcomes. Circulating miRNAs are dysregulated with cirrhosis progression and in patients with ACLF. Patient decompensation is associated with important changes in the levels of circulating miRNAs. A total of 11 circulating miRNAs were identified as associated with organ failure and 7 with poor outcome. The miRNAs most dysregulated during cirrhosis progression were miR-146a, miR-26a, and miR-191. miR-146a was dysregulated in PBMCs of patients with decompensated cirrhosis vs. compensated cirrhosis.
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Key Words
- ACLF, acute-on-chronic liver failure
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- Biomarkers
- CXCL10, C-X-C motif chemokine ligand 10
- Chronic liver disease
- EF CLIF, European Foundation for the Study of Chronic Liver Failure
- FoxO, forkhead box O
- INR, International Normalised Ratio
- LDH, lactate dehydrogenase
- Liver decompensation
- MAPK, mitogen-activated protein kinase
- MELD, model for end-stage liver disease
- NASH, non-alcoholic steatohepatitis
- Non-coding RNAs
- PBMCs, peripheral blood mononuclear cells
- PCA, principal component analysis
- TGF, transforming growth factor
- TIPS, transjugular intrahepatic portosystemic shunt
- qPCR, quantitative PCR
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Elhence A, Aggarwal A, Goel A, Aggarwal M, Das P, Shalimar. Granulomatous Tubercular Hepatitis Presenting as Secondary Hemophagocytic Lymphohistiocytosis: A Case Report and Systematic Review of the Literature. J Clin Exp Hepatol 2021; 11:149-153. [PMID: 33679052 PMCID: PMC7897858 DOI: 10.1016/j.jceh.2020.05.007] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 05/14/2020] [Indexed: 12/12/2022] Open
Abstract
Hemophagocytic lymphohistiocytosis is a life-threatening disorder characterized by persistent pathologic activation of cytotoxic T lymphocytes, natural killer cells, and macrophages. We present details of a young patient who presented with high-grade fever, jaundice, and breathlessness. On investigations, he had hepatitis, anemia, neutropenia, and coagulopathy. He also had hypertriglyceridemia, hypofibrinogenemia, and hyperferritinemia. Bone marrow aspiration revealed histiocytosis, and transjugular liver biopsy revealed necrotizing granulomas positive for Mycobacterium tuberculosis on acid-fast bacilli staining. He was successfully managed with a combination of immunosuppressants and antitubercular therapy. Tuberculosis associated hemophagocytosis syndrome is rare and should be considered in patients with unexplained hemophagocytosis syndrome, especially in tuberculosis-endemic regions. Prompt recognition and treatment with antitubercular treatment and immunosuppressants are associated with good outcomes.
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Key Words
- ADA, adenosine deaminase
- AFB, acid-fast bacilli
- ALP, alkaline phosphatase
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- ATT, antitubercular therapy
- CAM, complementary and alternative medicine
- CMV, cytomegalovirus
- CRP, C-reactive protein
- CTL, cytotoxic T lymphocyte
- EBV, Epstein-Barr virus
- HIV, human immunodeficiency virus
- HLH
- HLH, hemophagocytic lymphohistiocytosis
- HSV, herpes simplex virus
- INR, international normalized ratio
- LDH, lactate dehydrogenase
- NK cell, natural killer cell
- PTH, parathyroid hormone
- PUO
- SAAG, serum-ascites albumin gradient
- TB-HLH, tuberculosis-associated hemophagocytic lymphohistiocytosis
- TJLB, transjugular liver biopsy
- hemophagocytic lymphohistiocytosis
- lymph node
- tuberculosis
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Affiliation(s)
- Anshuman Elhence
- Department of Gastroenetrology, All India Institute of Medical Sciences, New Delhi, India
| | - Abhinav Aggarwal
- Department of Medicine, University College of Medical Sciences, India
| | - Ashish Goel
- Department of Medicine, University College of Medical Sciences, India
| | - Mukul Aggarwal
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Prasenjit Das
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Shalimar
- Department of Gastroenetrology, All India Institute of Medical Sciences, New Delhi, India,Address for correspondence: Dr Shalimar, Additional Professor, Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.
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Zhou Y, Fan X, Jiao T, Li W, Chen P, Jiang Y, Sun J, Chen Y, Chen P, Guan L, Wen Y, Huang M, Bi H. SIRT6 as a key event linking P53 and NRF2 counteracts APAP-induced hepatotoxicity through inhibiting oxidative stress and promoting hepatocyte proliferation. Acta Pharm Sin B 2021; 11:89-99. [PMID: 33532182 DOI: 10.1016/j.apsb.2020.06.016] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 01/10/2023] Open
Abstract
Acetaminophen (APAP) overdose is the leading cause of drug-induced liver injury, and its prognosis depends on the balance between hepatocyte death and regeneration. Sirtuin 6 (SIRT6) has been reported to protect against oxidative stress-associated DNA damage. But whether SIRT6 regulates APAP-induced hepatotoxicity remains unclear. In this study, the protein expression of nuclear and total SIRT6 was up-regulated in mice liver at 6 and 48 h following APAP treatment, respectively. Sirt6 knockdown in AML12 cells aggravated APAP-induced hepatocyte death and oxidative stress, inhibited cell viability and proliferation, and downregulated CCNA1, CCND1 and CKD4 protein levels. Sirt6 knockdown significantly prevented APAP-induced NRF2 activation, reduced the transcriptional activities of GSTμ and NQO1 and the mRNA levels of Nrf2, Ho-1, Gstα and Gstμ. Furthermore, SIRT6 showed potential protein interaction with NRF2 as evidenced by co-immunoprecipitation (Co-IP) assay. Additionally, the protective effect of P53 against APAP-induced hepatocytes injury was Sirt6-dependent. The Sirt6 mRNA was significantly down-regulated in P53 -/- mice. P53 activated the transcriptional activity of SIRT6 and exerted interaction with SIRT6. Our results demonstrate that SIRT6 protects against APAP hepatotoxicity through alleviating oxidative stress and promoting hepatocyte proliferation, and provide new insights in the function of SIRT6 as a crucial docking molecule linking P53 and NRF2.
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Key Words
- AAV, adeno-associated virus
- ALF, acute liver failure
- ALT, serum alanine aminotransferase
- APAP, acetaminophen
- ARE, antioxidant response element
- AST, aspartate aminotransferase
- Acetaminophen
- BCA, bicinchoninic acid
- BrdU, bromodeoxyuridine
- CCK-8, cell counting kit-8
- CCNA1, cyclin A1
- CCND1, cyclin D1
- CDK4, cyclin-dependent kinase 4
- CYP450, cytochromes P450
- Co-IP, co-immunoprecipitation
- DCF, dichlorofluorescein
- Dox, doxorubicin
- ECL, electrochemiluminescence
- GSH, glutathione
- GSTα, glutathianone S-transferase α
- GSTμ, glutathione S-transferase μ
- H&E, hematoxylin and eosin
- H3K56ac, histone H3 Nε-acetyl-lysines 56
- H3K9ac, histone H3 Nε-acetyl-lysines 9
- HO-1, heme oxygenase-1
- Hepatotoxicity
- KEAP1, Kelch-like ECH-associated protein 1
- LDH, lactate dehydrogenase
- NAPQI, N-acetyl p-benzoquinone imine
- NQO1, NAD(P)H quinone dehydrogenase 1
- NRF2
- NRF2, nuclear factor erythroid 2-related factor 2
- P53
- ROS, reactive oxygen species
- SIRT6
- SIRT6, sirtuin 6
- siRNA, small interfering RNA
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Leino V, Airaksinen R, Viluksela M, Vähäkangas K. Toxicity of colloidal silver products and their marketing claims in Finland. Toxicol Rep 2020; 8:106-113. [PMID: 33437653 PMCID: PMC7786010 DOI: 10.1016/j.toxrep.2020.12.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/21/2020] [Accepted: 12/21/2020] [Indexed: 01/30/2023] Open
Abstract
AIMS The aim was to investigate the marketing practices, beliefs and health claims regarding the use of colloidal silver in Finland. Silver nanoparticles (AgNPs) are potentially toxic due to their small size and Ag+-release capabilities, and the use of colloidal silver products containing AgNPs can cause a wide variety of adverse effects such as argyria. METHODS Contents of three company websites selling colloidal silver were reviewed, and the claims used in the marketing of colloidal silver were compared to the scientific information about silver. In Facebook posts and discussion about colloidal silver were analyzed. RESULTS In Finland, the marketing of colloidal silver products on websites selling the products did not follow the regulations of authorities; several scientifically unfounded claims about the efficacy and medical use of colloidal silver were found. After the Finnish Broadcasting Company (Yle) documentary and an intervention by authorities, contents of the websites were changed, but still questionable information and misleading claims could be found. In the analyzed Facebook groups attitudes towards medical use of colloidal silver were uncritically positive, internal use was highly promoted and the restrictions of use were considered unjustified. CONCLUSIONS The use of quackery products such as colloidal silver can be dangerous, and their use and marketing should be controlled and restricted.
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Key Words
- APTT, active partial thromboplastin time
- ATP, adenosine triphosphate
- AgNPs, silver nanoparticles
- Colloidal silver
- Evira, the finnish food safety authority
- Fimea, the finnish medicines agency
- LDH, lactate dehydrogenase
- NOAEL, no observable adverse effect level
- Pseudo-medicine
- Quackery
- ROS, reactive oxygen species
- RfD, reference dose
- Silver nanoparticles
- Social media
- THL, the finnish institute for health and welfare
- Tukes, the finnish safety and chemicals agency
- U.S. EPA, the environmental protection agency of the USA
- WHO, the World Health Organization
- Web-based advertising
- Yle, the finnish broadcasting company
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Affiliation(s)
- Veera Leino
- School of Pharmacy/Toxicology, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | | | - Matti Viluksela
- School of Pharmacy/Toxicology, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Kirsi Vähäkangas
- School of Pharmacy/Toxicology, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Vlachopoulos CV, Koutagiar IP, Georgakopoulos AT, Pouli AG, Sioni AΚ, Giannouli SΕ, Chondropoulos SD, Stergiou IΕ, Solomou EG, Terentes-Printzios DG, Karakitsios IG, Kafouris PP, Gaitanis A, Pianou NK, Petrocheilou A, Aggeli CI, Stroumpouli E, Marinakis TP, Voulgarelis M, Tousoulis DM, Anagnostopoulos CD. Lymphoma Severity and Type Are Associated With Aortic FDG Uptake by 18F-FDG PET/CT Imaging. JACC CardioOncol 2020; 2:758-770. [PMID: 34396292 PMCID: PMC8352324 DOI: 10.1016/j.jaccao.2020.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 12/27/2022]
Abstract
Background There is evidence that metabolic disease burden in lymphoma influences patient outcome. However, the impact of disease severity on the cardiovascular system is unknown. Objectives The aim of this study was to examine whether lymphoma is associated with arterial inflammation by investigating the relationship between disease metabolic burden and arterial fluorodeoxyglucose (FDG) uptake. Methods Sixty-two chemotherapy-naïve patients with active Hodgkin’s or non-Hodgkin’s lymphoma were matched (2:1) to individual control groups of lymphoma patients previously treated and free of active disease. All groups underwent 18F-FDG position emission tomography–computed tomography imaging. Disease severity was quantified by metabolic tumor volume (MTV) and total lesion glycolysis corresponding to standardized uptake values (SUVs) ≥41% or ≥2.5 of the maximum SUV within lymphoma regions, and aortic FDG uptake was quantified through the target-to-background ratio (TBR). Inflammatory and disease severity biomarkers were also measured. Results MTV and total lesion glycolysis measurements were significantly correlated with inflammatory and disease biomarkers. Aortic TBR was higher in patients with active non-Hodgkin’s lymphoma compared with control subjects (median difference 0.51; 95% confidence interval [CI]: 0.28 to 0.78; p < 0.001). Similarly, patients with active Hodgkin’s lymphoma had higher values of aortic TBR compared with control subjects (median difference 0.31; 95% CI: 0.15 to 0.49; p < 0.001). In addition, aortic TBR was modestly increased in patients with stage III to IV disease compared with those with stage I to II disease (median aortic TBR: 2.23 [interquartile range: 2.01 to 2.54] vs. 2.06 [interquartile range: 1.83 to 2.27; p = 0.050). In multivariable analysis, aortic FDG uptake and MTV≥2.5 values were independently associated (β = 0.425; 95% CI: 0.189 to 0.662; p = 0.001; R2 = 0.208), as were aortic FDG uptake and MTV≥41% (β = 0.407; 95% CI: 0.167 to 0.649, p = 0.001; R2 = 0.191). Conclusions Aortic wall FDG uptake is related with disease severity indicative of a possible vascular effect of lymphoma. This work highlights a new potential role of molecular imaging in cardio-oncology for evaluating disease severity and its consequences on the vasculature.
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Key Words
- 18F-FDG, 18F-fluorodeoxyglucose
- BMI, body mass index
- CI, confidence interval
- CT, computed tomography
- CVD, cardiovascular disease
- LDH, lactate dehydrogenase
- MTV, metabolic tumor burden
- PET, positron emission tomography
- SUV, standardized uptake value
- SUVmax, maximum standardized uptake value
- SUVmean, mean standardized uptake value
- TBR, target-to-background ratio
- TLG, total lesion glycolysis
- WBC, white blood cell count
- arterial inflammation
- hsCRP, high-sensitivity C-reactive protein
- lymphoma
- metabolic burden
- positron emission tomography
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Affiliation(s)
- Charalambos V Vlachopoulos
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Iosif P Koutagiar
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros T Georgakopoulos
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | | | | | - Stavroula Ε Giannouli
- 2nd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Ioanna Ε Stergiou
- Department of Pathophysiology, School of Medicine, University of Athens, Athens, Greece
| | - Eirini G Solomou
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios G Terentes-Printzios
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis G Karakitsios
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Pavlos P Kafouris
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece.,Department of Informatics and Telecommunications, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios Gaitanis
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Nikoletta K Pianou
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Aikaterini Petrocheilou
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantina I Aggeli
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Euaggelia Stroumpouli
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Michael Voulgarelis
- Department of Pathophysiology, School of Medicine, University of Athens, Athens, Greece
| | - Dimitrios M Tousoulis
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantinos D Anagnostopoulos
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece
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Zhou Y, Niu B, Wu B, Luo S, Fu J, Zhao Y, Quan G, Pan X, Wu C. A homogenous nanoporous pulmonary drug delivery system based on metal-organic frameworks with fine aerosolization performance and good compatibility. Acta Pharm Sin B 2020; 10:2404-2416. [PMID: 33354510 PMCID: PMC7745127 DOI: 10.1016/j.apsb.2020.07.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/24/2020] [Accepted: 06/19/2020] [Indexed: 12/21/2022] Open
Abstract
Pulmonary drug delivery has attracted increasing attention in biomedicine, and porous particles can effectively enhance the aerosolization performance and bioavailability of drugs. However, the existing methods for preparing porous particles using porogens have several drawbacks, such as the inhomogeneous and uncontrollable pores, drug leakage, and high risk of fragmentation. In this study, a series of cyclodextrin-based metal-organic framework (CD-MOF) particles containing homogenous nanopores were delicately engineered without porogens. Compared with commercial inhalation carrier, CD-MOF showed excellent aerosolization performance because of the homogenous nanoporous structure. The great biocompatibility of CD-MOF in pulmonary delivery was also confirmed by a series of experiments, including cytotoxicity assay, hemolysis ratio test, lung function evaluation, in vivo lung injury markers measurement, and histological analysis. The results of ex vivo fluorescence imaging showed the high deposition rate of CD-MOF in lungs. Therefore, all results demonstrated that CD-MOF was a promising carrier for pulmonary drug delivery. This study may throw light on the nanoporous particles for effective pulmonary administration.
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Key Words
- ANOVA, analysis of variance
- BALF, bronchoalveolar lavage fluid
- BET, Brunauer–Emmett–Teller
- CCK-8, cell counting kit-8
- CD-MOF, cyclodextrin-based metal-organic framework
- CD-MOF-K, ketoprofen-loaded cyclodextrin-based metal-organic framework
- CD-MOF-R, rhodamine B-loaded cyclodextrin-based metal-organic framework
- CF, commercial formulation
- CTAB, cetyl trimethyl ammonium bromide
- Cdyn, dynamic lung compliance
- DPPC, 1,2-dipalmitoyl-sn-glycero-3-phosphocholine
- FBS, fetal bovine serum
- FDA, U.S. Food and Drug Administration
- FPF, fine particle fraction
- GSD, geometric standard deviation
- HE, Hematoxylin-Eosin
- HPLC, high performance liquid chromatography
- Inhalable dry powder
- LDH, lactate dehydrogenase
- LPS, lipopolysaccharide
- MFI, mean fluorescence intensity
- MMAD, mean mass aerodynamic diameter
- MOF, metal-organic framework
- Metal-organic framework
- NGI, next generation pharmaceutical impactor
- Nanoporous particle
- PBS, phosphate buffered solution
- PVP, poly(vinyl pyrrolidone)
- PXRD, powder X-ray diffraction
- Pulmonary drug delivery
- Rl, lung resistance
- SD rat, Sprague–Dawley rat
- SEM, scanning electron microscopy
- SLF, simulated lung fluid
- γ-CD, γ-cyclodextrin
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Kamada T, Ishiguro H, Okada S, Takeuchi H, Takahashi J, Nakashima K, Nakaseko Y, Suzuki N, Ohdaira H, Suzuki Y. Pembrolizumab plus platinum-based chemotherapy for unfavorable cancer of unknown primary site: Case report. Ann Med Surg (Lond) 2020; 60:31-35. [PMID: 33101670 PMCID: PMC7578551 DOI: 10.1016/j.amsu.2020.10.024] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 10/10/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction We report a case of sustained complete response in unfavorable cancer of unknown primary site (CUP) successfully treated with chemotherapy combining pembrolizumab, pemetrexed and platinum. Case presentation A 66-year-old man was presented with weight loss and cough for 3 months. Contrast-enhanced computed tomography (CT) confirmed a mass in the superior anterior mediastinum and multiple enlarged mediastinal and axillary lymph nodes. Positron emission tomography-CT (PET-CT) showed abnormal uptake in the corresponding lesions. Histopathological analysis of the left axillary nodule revealed poorly differentiated adenocarcinoma. Immunohistochemistry showed the tumor cells were positive for cytokeratin 7 and thyroid transcription factor-1 and negative for cytokeratin 20. Thus, the patient was diagnosed as poorly differentiated adenocarcinoma of unknown primary, and treated as non-small-cell lung cancer. Additional genetic testing revealed the patient was negative for EGFR, ALK fluorescence in situ hybridization, ROS1, BRAF, and PD-L1 22C3 IHC with Tumor Proportion Score (TPS) was less than 1%. The patient received six cycles of pembrolizumab, platinum, and pemetrexed intravenously. Cisplatin was switched to carboplatin because of cisplatin nephrotoxicity in one course. PET-CT after six cycles showed all lesions disappeared; complete response was considered to have been achieved. Maintenance therapy of pembrolizumab and pemetrexed has been continued for 6 months after the induction therapies to prevent progressive disease. Complete response has been maintained. Discussion Chemotherapy with pembrolizumab, platinum and pemetrexed could be valuable for treating unfavorable CUP. Conclusion Chemotherapy with pembrolizumab, platinum, and pemetrexed helped achieved sustained complete response in a patient with unfavorable CUP.
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Key Words
- ALK, anaplastic lymphoma kinase
- CEA, carcinoembryonic antigen
- CK7, cytokeratin 7
- CR, complete response
- CT, computed tomography
- CUP, cancer of unknown primary site
- Cancer of unknown primary
- EGFR, epidermal growth factor receptor
- LDH, lactate dehydrogenase
- NCCN, National Comprehensive Cancer Network
- Non-small-cell lung cancer
- PD-L1, programmed death ligand 1
- PET, positron emission tomography
- Pembrolizumab
- Pemetrexed
- Platinum
- TTF-1, thyroid transcription factor-1
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Affiliation(s)
- Teppei Kamada
- Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara, Tochigi, 329-2763, Japan
| | - Hiroshi Ishiguro
- Department of Oncology, International University of Health and Welfare Narita Hospital, 852, Hatakeda, Narita, Chiba, 286-0124, Japan
| | - Shinya Okada
- Department of Pathology, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara, Tochigi, 329-2763, Japan
| | - Hideyuki Takeuchi
- Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara, Tochigi, 329-2763, Japan
| | - Junji Takahashi
- Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara, Tochigi, 329-2763, Japan
| | - Keigo Nakashima
- Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara, Tochigi, 329-2763, Japan
| | - Yuichi Nakaseko
- Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara, Tochigi, 329-2763, Japan
| | - Norihiko Suzuki
- Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara, Tochigi, 329-2763, Japan
| | - Hironori Ohdaira
- Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara, Tochigi, 329-2763, Japan
| | - Yutaka Suzuki
- Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara, Tochigi, 329-2763, Japan
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Balmforth D, Yates MT, Lau K, Hussain A, Lopez-Marco A, Edmondson S, Oo A, Uppal R. Cardiothoracic surgery in the midst of a pandemic: Operative outcomes and maintaining a coronavirus disease 2019 (COVID-19)-free environment. ACTA ACUST UNITED AC 2020; 4:107-114. [PMID: 34173548 PMCID: PMC7510586 DOI: 10.1016/j.xjon.2020.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 09/18/2020] [Indexed: 11/16/2022]
Abstract
Objective In the United Kingdom, the coronavirus disease 2019 (COVID-19) pandemic has led to the cessation of elective surgery. However, there remains a need to provide urgent and emergency cardiac and thoracic surgery as well as to continue time-critical thoracic cancer surgery. This study describes our early experience of implementing a protocol to safely deliver major cardiac and thoracic surgery in the midst of the pandemic. Methods Data on all patients undergoing cardiothoracic surgery at a single tertiary referral center in London were prospectively collated during the first 7 weeks of lockdown in the United Kingdom. A comprehensive protocol was implemented to maintain a COVID-19-free environment including the preoperative screening of all patients, the use of full personal protective equipment in areas with aerosol-generating procedures, and separate treatment pathways for patients with and without the virus. Results A total of 156 patients underwent major cardiac and thoracic surgery over the study period. Operative mortality was 9% in the cardiac patients and 1.4% in thoracic patients. The preoperative COVID-19 protocol implemented resulted in 18 patients testing positive for COVID-19 infection and 13 patients having their surgery delayed. No patients who were negative for COVID-19 infection on preoperative screening tested positive postoperatively. However, 1 thoracic patient tested positive on intraoperative bronchoalveolar lavage. Conclusions Our early experience demonstrates that it is possible to perform major cardiac and thoracic surgery with low operative mortality and zero development of postoperative COVID-19 infection.
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Affiliation(s)
- Damian Balmforth
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, United Kingdom.,Queen Mary University of London, London, United Kingdom
| | - Martin T Yates
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - Kelvin Lau
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - Azhar Hussain
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - Ana Lopez-Marco
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - Stephen Edmondson
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - Aung Oo
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, United Kingdom.,Queen Mary University of London, London, United Kingdom
| | - Rakesh Uppal
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, United Kingdom.,Queen Mary University of London, London, United Kingdom
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Cunha M, Pinho I, Lopes M, Trigueiros F, Braz S, Medeiros F. A case of corticosteroid-responsive SARS-CoV-2 related massive rhabdomyolysis. IDCases 2020; 22:e00946. [PMID: 32901220 PMCID: PMC7471856 DOI: 10.1016/j.idcr.2020.e00946] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 12/15/2022] Open
Abstract
SARS-CoV-2 infection may present with massive, non-ischemic rhabdomyolysis. COVID-19 related rhabdomyolysis may be a sign of an excessive inflammatory response. Corticosteroid use can resolve rhabdomyolysis without aggressive fluid replacement. Corticosteroid use may prevent progression of COVID-19 in select cases.
The 2019 coronavirus pandemic has united scientific and medical communities in a worldwide quest for understanding the pathophysiology of this rapidly spreading disease in order to develop effective treatments. We present a case of a 46-year-old woman with breast cancer who was found positive for SARS-CoV-2 in a screening test and developed massive rhabdomyolysis (creatinine kinase 87,456 U/liter) as well as new-onset lymphopenia and signs of lung disease starting on the 16th day of clinical surveillance, one month after the last administration of chemotherapy. Nasopharyngeal swab was still positive for SARS-CoV-2 RNA and serology revealed antibody response against the virus. Considering the possibility of a systemic inflammatory response in the setting of post-chemotherapy immune reconstitution, we avoided aggressive fluid administration and initiated treatment with methylprednisolone and hydroxychloroquine, resulting in rapid clearance of pulmonary infiltrates and creatinine kinase. Complete resolution after corticosteroid treatment may provide clinicians with a viable treatment option in similar situations and adds to the growing body of evidence pointing to dysregulated immune response as a major contributing factor to disease severity.
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Affiliation(s)
- Maria Cunha
- Department of Infectious Diseases at the Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Hospital De Santa Maria; Serviço De Doenças Infecciosas, Avenida Professor Egas Moniz 1649-035 Lisboa in Lisbon, Portugal
| | - Inês Pinho
- Department of Oncology at the Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Hospital De Santa Maria, Serviço De Oncologia, Avenida Professor Egas Moniz 1649-035, Lisboa in Lisbon, Portugal
| | - Marta Lopes
- Department of Internal Medicine at the Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Hospital De Santa Maria, Serviço De Medicina II, Avenida Professor Egas Moniz 1649-035 Lisboa in Lisbon, Portugal
| | - Frederico Trigueiros
- Department of Internal Medicine at the Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Hospital De Santa Maria, Serviço De Medicina II, Avenida Professor Egas Moniz 1649-035 Lisboa in Lisbon, Portugal
| | - Sandra Braz
- Department of Internal Medicine at the Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Hospital De Santa Maria, Serviço De Medicina II, Avenida Professor Egas Moniz 1649-035 Lisboa in Lisbon, Portugal
| | - Fábio Medeiros
- Department of Infectious Diseases at the Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Hospital De Santa Maria; Serviço De Doenças Infecciosas, Avenida Professor Egas Moniz 1649-035 Lisboa in Lisbon, Portugal
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