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Mahony T, Wang C, Coilparampil A, Kong A, Patterson-Norrie T, Villarosa A, George A, Yaacoub A. Dental clinicians' perceptions on the use of tele-dentistry consultations during COVID-19 within public dental clinics in Sydney, Australia. Aust Dent J 2023; 68:282-293. [PMID: 37694508 DOI: 10.1111/adj.12979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Although well accepted by clinicians and patients, teledentistry is not currently a widely used model of care within Australian public oral health services. This qualitative study aimed to review and evaluate dental clinicians' perceptions, by determining the acceptability and appropriateness of teledentistry as a model of care. METHODS A purposive sample of 12 public dental practitioners employed by a Local Health District in Sydney, and who had participated in teledentistry consultations, were recruited to participate in focus groups. Focus group discussions were transcribed verbatim and subjected to thematic analysis. RESULTS Teledentistry was a novel concept for most participants and was well accepted. Participants valued the use of a standardized consultation template as well as effective communication with other dental clinicians to support the practice of teledentistry. However, many found attempting contact with patients over the telephone difficult as well as the perceived patient frustration with the administration process and technological difficulties experienced. CONCLUSION Teledentistry has the potential for growth and expansion in the public health system. From the opinions in this study, the authors propose further research is needed into the efficacy of teledentistry to assist with the development of a model of care that would be beneficial for dental clinicians and their patients. © 2023 Australian Dental Association.
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Affiliation(s)
- T Mahony
- Oral Health Services, Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
| | - C Wang
- Oral Health Services, Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
| | - A Coilparampil
- Oral Health Services, Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
| | - A Kong
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - T Patterson-Norrie
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - A Villarosa
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - A George
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Surry Hills, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
| | - A Yaacoub
- Oral Health Services, Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Surry Hills, New South Wales, Australia
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Bhullar A, Nahmias J, Kong A, Swentek L, Chin T, Schellenberg M, Grigorian A. Cocaine use in trauma: the vices-paradox revisited. Surgery 2023; 174:1056-1062. [PMID: 37495463 DOI: 10.1016/j.surg.2023.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/02/2023] [Accepted: 06/18/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND The "vices-paradox" describes the paradoxical association between illicit substance use and decreased mortality risk in trauma patients. Cocaine's vasoconstrictive effects may decrease hemorrhage but also increase the risk of thromboembolic complications. To clarify the effects of cocaine use on trauma patients, we compared the risk of mortality and thromboembolic complications in patients screening positive for cocaine with those screening negative. METHODS We searched the Trauma Quality Improvement Program database to identify patients 18 years and over who had presented with a drug and alcohol screen on admission between 2017 and 2019. After excluding all patients who had tested positive for alcohol and substances other than cocaine, we then compared the clinical outcomes of patients who were positive and negative for cocaine use. RESULTS Of the 312,553 patients identified, 11,942 (3.82%) had tested positive for cocaine. Cocaine users were significantly more likely to present with stab (8.0% vs 3.1%) or gunshot wounds (8.0% vs 3.0%) but had lower rates of mortality (3.6% vs 4.7%), myocardial infarction (0.1% vs 0.2%,) and cerebrovascular accident (0.3% vs 0.4%,). After controlling for covariates, the risk of death, myocardial infarction, and cerebrovascular accident did not significantly differ between cocaine and non-cocaine users. CONCLUSION Trauma patients positive for cocaine have similar risks of death and thromboembolic complications and so have a similar prognosis to patients negative for all drugs or alcohol, indicating that the "vices-paradox" does not apply to cocaine use. However, these patients more commonly present after penetrating trauma, suggesting cocaine use in hazardous environments.
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Affiliation(s)
- A Bhullar
- Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, Orange, CA
| | - J Nahmias
- Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, Orange, CA
| | - A Kong
- Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, Orange, CA
| | - L Swentek
- Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, Orange, CA
| | - T Chin
- Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, Orange, CA
| | - M Schellenberg
- Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, Orange, CA
| | - A Grigorian
- Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, Orange, CA.
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Deng S, Xie R, Kong A, Luo Y, Li J, Chen M, Wang X, Gong H, Wang L, Fan X, Pan Q, Li D. Early-life stress contributes to depression-like behaviors in a two-hit mouse model. Behav Brain Res 2023; 452:114563. [PMID: 37406776 DOI: 10.1016/j.bbr.2023.114563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/23/2023] [Accepted: 07/01/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Depression is a common psychological disorder with pathogenesis involving genetic and environmental interactions. Early life stress can adversely affect physical and emotional development and dramatically increase the risk for the development of depression and anxiety disorders. METHODS To examine potential early life stress driving risk for anxiety and depression, we used a two-hit developmental stress model,injecting poly(I: C) into neonatal mice on P2-P6 followed by peripubertal unpredictable stress in adolescence. RESULTS Our study shows that early-life and adolescent stress leads to anxiety and depression-related behavioral phenotypes in male mice. Early-life stress exacerbated depression-like behavior in mice following peripubertal unpredictable stress. We confirmed that early life stress might be involved in the decreased neuronal activity in the medial prefrontal cortex (mPFC) and might be involved in shaping behavioral phenotypes of animals. We found that increased microglia and neuroinflammation in the mPFC of two-hit mice and early life stress further boost microglia activation and inflammatory factors in the mPFC region of mice following adolescent stress. LIMITATIONS The specific neural circuits and mechanisms by which microglia regulate depression-like behaviors require further investigation. CONCLUSIONS Our findings provide a novel insight into developmental risk factors and biological mechanisms in depression and anxiety disorders.
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Affiliation(s)
- Shilong Deng
- Department of Physiology, School of Basic Medical Sciences, Southwest Medical University, Luzhou 646000, China; Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing 400038, China
| | - Ruxin Xie
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing 400038, China
| | - Anqi Kong
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing 400038, China
| | - Yi Luo
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing 400038, China
| | - Jianghui Li
- Department of Physiology, School of Basic Medical Sciences, Southwest Medical University, Luzhou 646000, China
| | - Mei Chen
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing 400038, China
| | - Xiaqing Wang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing 400038, China
| | - Hong Gong
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing 400038, China
| | - Lian Wang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing 400038, China
| | - Xiaotang Fan
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing 400038, China.
| | - Qiangwen Pan
- Department of Physiology, School of Basic Medical Sciences, Southwest Medical University, Luzhou 646000, China.
| | - Dabing Li
- Department of Physiology, School of Basic Medical Sciences, Southwest Medical University, Luzhou 646000, China.
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Xia M, Yan R, Wang W, Kong A, Zhang M, Miao Z, Ge W, Wan B, Xu X. The Tet2–Upf1 complex modulates mRNA stability under stress conditions. Front Genet 2023; 14:1158954. [PMID: 37091805 PMCID: PMC10117899 DOI: 10.3389/fgene.2023.1158954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 03/27/2023] [Indexed: 04/09/2023] Open
Abstract
Introduction: Environmental stress promotes epigenetic alterations that impact gene expression and subsequently participate in the pathological processes of the disorder. Among epigenetic regulations, ten–eleven Translocation (Tet) enzymes oxidize 5-methylcytosine (5mC) to 5-hydroxymethylcytosine (5hmC) in DNA and RNA and function as critical players in the pathogenesis of diseases. Our previous results showed that chronic stress increases the expression of cytoplasmic Tet2 in the hippocampus of mice exposed to chronic mild stress (CMS). Whether the cytoplasmic Tet2 alters RNA 5hmC modification in chronic stress-related processes remains largely unknown.Methods: To explore the role of cytoplasmic Tet2 under CMS conditions, we established CMS mice model and detected the expression of RNA 5hmC by dot blot. We verified the interaction of Tet2 and its interacting protein by co-immunoprecipitation combined with mass spectrometry and screened downstream target genes by cluster analysis of Tet2 and upstream frameshift 1 (Upf1) interacting RNA. The expression of protein was detected by Western blot and the expression of the screened target genes was detected by qRT-PCR.Results: In this study, we found that increased cytoplasmic Tet2 expression under CMS conditions leads to increase in total RNA 5hmC modification. Tet2 interacted with the key non-sense-mediated mRNA decay (NMD) factor Upf1, regulated the stability of stress-related genes such as Unc5b mRNA, and might thereby affect neurodevelopment.Discussion: In summary, this study revealed that Tet2-mediated RNA 5hmC modification is involved in stress-related mRNA stability regulation and may serve as a potential therapeutic target for chronic stress-related diseases such as depression.
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Affiliation(s)
- Meiling Xia
- Departments of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Rui Yan
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Wenjuan Wang
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Anqi Kong
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Meng Zhang
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Zhigang Miao
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Wei Ge
- Institute of Neuroscience, Soochow University, Suzhou, China
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- *Correspondence: Wei Ge, ; Bo Wan, ; Xingshun Xu,
| | - Bo Wan
- Institute of Neuroscience, Soochow University, Suzhou, China
- *Correspondence: Wei Ge, ; Bo Wan, ; Xingshun Xu,
| | - Xingshun Xu
- Departments of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Neuroscience, Soochow University, Suzhou, China
- *Correspondence: Wei Ge, ; Bo Wan, ; Xingshun Xu,
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Tan HS, Plichta JK, Kong A, Tan CW, Hwang S, Sultana R, Wright MC, Sia ATH, Sng BL, Habib AS. Risk factors for persistent pain after breast cancer surgery: a multicentre prospective cohort study. Anaesthesia 2023; 78:432-441. [PMID: 36639918 DOI: 10.1111/anae.15958] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2022] [Indexed: 01/15/2023]
Abstract
Identifying factors associated with persistent pain after breast cancer surgery may facilitate risk stratification and individualised management. Single-population studies have limited generalisability as socio-economic and genetic factors contribute to persistent pain development. Therefore, this prospective multicentre cohort study aimed to develop a predictive model from a sample of Asian and American women. We enrolled women undergoing elective breast cancer surgery at KK Women's and Children's Hospital and Duke University Medical Center. Pre-operative patient and clinical characteristics and EQ-5D-3L health status were recorded. Pain catastrophising scale; central sensitisation inventory; coping strategies questionnaire-revised; brief symptom inventory-18; perceived stress scale; mechanical temporal summation; and pressure-pain threshold assessments were performed. Persistent pain was defined as pain score ≥ 3 or pain affecting activities of daily living 4 months after surgery. Univariate associations were generated using generalised estimating equations. Enrolment site was forced into the multivariable model, and risk factors with p < 0.2 in univariate analyses were considered for backwards selection. Of 210 patients, 135 (64.3%) developed persistent pain. The multivariable model attained AUC = 0.807, with five independent associations: age (OR 0.85 95%CI 0.74-0.98 per 5 years); diabetes (OR 4.68, 95%CI 1.03-21.22); pre-operative pain score at sites other than the breast (OR 1.48, 95%CI 1.11-1.96); previous mastitis (OR 4.90, 95%CI 1.31-18.34); and perceived stress scale (OR 1.35, 95%CI 1.01-1.80 per 5 points), after adjusting for: enrolment site; pre-operative pain score at the breast; pre-operative overall pain score at rest; postoperative non-steroidal anti-inflammatory drug use; and pain catastrophising scale. Future research should validate this model and evaluate pre-emptive interventions to reduce persistent pain risk.
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Affiliation(s)
- H S Tan
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Duke-NUS Medical School, Singapore
| | - J K Plichta
- Division of Surgical Oncology, Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - A Kong
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Duke-NUS Medical School, Singapore
| | - C W Tan
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Duke-NUS Medical School, Singapore
| | - S Hwang
- Division of Surgical Oncology, Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - R Sultana
- Centre for Quantitative Medicine, Singapore
| | - M C Wright
- Division of Women's Anesthesia, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - A T H Sia
- KK Women's and Children's Hospital, Duke-NUS Medical School, Singapore
| | - B L Sng
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Duke-NUS Medical School, Singapore
| | - A S Habib
- Division of Women's Anesthesia, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
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Kong A, Liu T, Deng S, Xu S, Luo Y, Li J, Du Z, Wang L, Xu X, Fan X. Novel antidepressant-like properties of the fullerenol in an LPS-induced depressive mouse model. Int Immunopharmacol 2023; 116:109792. [PMID: 36738679 DOI: 10.1016/j.intimp.2023.109792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 01/12/2023] [Accepted: 01/24/2023] [Indexed: 02/05/2023]
Abstract
Depression is a common mental disease and is highly prevalent in populations. Dysregulated neuroinflammation and concomitant-activated microglia are involved in the pathogenesis of depression. Experimental evidence has indicated that fullerenol exerts anti-neuroinflammation and protective effects against neurological diseases. Here, we evaluated fullerenol's effects against lipopolysaccharide (LPS)-induced mouse depressive-like behaviors. Fullerenol treatment produced an antidepressant-like effect, as indicated by preventing the LPS-induced reduction in the sucrose preference and shortening the immobility durations in both the tail suspension test and the forced swim test. We found that fullerenol treatment mitigated LPS-induced hippocampal microglia activation and released proinflammatory cytokines. Meanwhile, fullerenol promoted hippocampus neurogenesis, evidenced by increased DCX-positive cells in LPS-treated mice. Hippocampal RNA-Seq analysis revealed proinflammatory cytokine and neurogenesis involved in fullerenol's antidepressant-like effects. Our data indicate that fullerenol exerts antidepressant effects, which might be due to beneficial functions in reducing neuroinflammatory processes and promoting neurogenesis in the hippocampus.
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Affiliation(s)
- Anqi Kong
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China; Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China; Institute of Neuroscience, Soochow University, Suzhou 215123, People's Republic of China
| | - Tianyao Liu
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China
| | - Shilong Deng
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China
| | - Shiyao Xu
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China; Institute of Neuroscience, Soochow University, Suzhou 215123, People's Republic of China
| | - Yi Luo
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China
| | - Jianghui Li
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China
| | - Zhulin Du
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China
| | - Liuyongwei Wang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China
| | - Xingshun Xu
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China; Institute of Neuroscience, Soochow University, Suzhou 215123, People's Republic of China.
| | - Xiaotang Fan
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China.
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Adjogatse D, Petkar I, Reis Ferreira M, Kong A, Lei M, Thomas C, Barrington SF, Dudau C, Touska P, Guerrero Urbano T, Connor SEJ. The Impact of Interactive MRI-Based Radiologist Review on Radiotherapy Target Volume Delineation in Head and Neck Cancer. AJNR Am J Neuroradiol 2023; 44:192-198. [PMID: 36702503 PMCID: PMC9891322 DOI: 10.3174/ajnr.a7773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/31/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND PURPOSE Peer review of head and neck cancer radiation therapy target volumes by radiologists was introduced in our center to optimize target volume delineation. Our aim was to assess the impact of MR imaging-based radiologist peer review of head and neck radiation therapy gross tumor and nodal volumes, through qualitative and quantitative analysis. MATERIALS AND METHODS Cases undergoing radical radiation therapy with a coregistered MR imaging, between April 2019 and March 2020, were reviewed. The frequency and nature of volume changes were documented, with major changes classified as per the guidance of The Royal College of Radiologists. Volumetric alignment was assessed using the Dice similarity coefficient, Jaccard index, and Hausdorff distance. RESULTS Fifty cases were reviewed between April 2019 and March 2020. The median age was 59 years (range, 29-83 years), and 72% were men. Seventy-six percent of gross tumor volumes and 41.5% of gross nodal volumes were altered, with 54.8% of gross tumor volume and 66.6% of gross nodal volume alterations classified as "major." Undercontouring of soft-tissue involvement and unidentified lymph nodes were predominant reasons for change. Radiologist review significantly altered the size of both the gross tumor volume (P = .034) and clinical target tumor volume (P = .003), but not gross nodal volume or clinical target nodal volume. The median conformity and surface distance metrics were the following: gross tumor volume Dice similarity coefficient = 0.93 (range, 0.82-0.96), Jaccard index = 0.87 (range, 0.7-0.94), Hausdorff distance = 7.45 mm (range, 5.6-11.7 mm); and gross nodular tumor volume Dice similarity coefficient = 0.95 (0.91-0.97), Jaccard index = 0.91 (0.83-0.95), and Hausdorff distance = 20.7 mm (range, 12.6-41.6). Conformity improved on gross tumor volume-to-clinical target tumor volume expansion (Dice similarity coefficient = 0.93 versus 0.95, P = .003). CONCLUSIONS MR imaging-based radiologist review resulted in major changes to most radiotherapy target volumes and significant changes in volume size of both gross tumor volume and clinical target tumor volume, suggesting that this is a fundamental step in the radiotherapy workflow of patients with head and neck cancer.
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Affiliation(s)
- D Adjogatse
- From the Departments of Oncology (D.A., I.P., M.R.F., A.K., M.L., T.G.U.)
- School of Biomedical Engineering and Imaging Sciences (D.A., C.T., S.E.J.C.)
| | - I Petkar
- From the Departments of Oncology (D.A., I.P., M.R.F., A.K., M.L., T.G.U.)
| | - M Reis Ferreira
- From the Departments of Oncology (D.A., I.P., M.R.F., A.K., M.L., T.G.U.)
| | - A Kong
- From the Departments of Oncology (D.A., I.P., M.R.F., A.K., M.L., T.G.U.)
| | - M Lei
- From the Departments of Oncology (D.A., I.P., M.R.F., A.K., M.L., T.G.U.)
| | - C Thomas
- Medical Physics (C.T.)
- School of Biomedical Engineering and Imaging Sciences (D.A., C.T., S.E.J.C.)
| | - S F Barrington
- King's College London and Guy's and St Thomas' PET Centre (S.F.B.), School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, UK
| | - C Dudau
- Radiology (C.D., P.T., S.E.J.C.), Guy's and St Thomas' National Health Service Foundation Trust, London, UK
- Department of Neurororadiology (C.D., S.E.J.C.), King's College Hospital, London, UK
| | - P Touska
- Radiology (C.D., P.T., S.E.J.C.), Guy's and St Thomas' National Health Service Foundation Trust, London, UK
| | - T Guerrero Urbano
- From the Departments of Oncology (D.A., I.P., M.R.F., A.K., M.L., T.G.U.)
- Faculty of Dentistry, Oral and Craniofacial Sciences (T.G.U.), King's College London, London, UK
| | - S E J Connor
- Radiology (C.D., P.T., S.E.J.C.), Guy's and St Thomas' National Health Service Foundation Trust, London, UK
- School of Biomedical Engineering and Imaging Sciences (D.A., C.T., S.E.J.C.)
- Department of Neurororadiology (C.D., S.E.J.C.), King's College Hospital, London, UK
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Gu J, Kong A, Guo C, Liu J, Li K, Ren Z, Zhou Y, Tang M, Shi H. Cadmium perturbed lipid profile and induced liver dysfunction in mice through phosphatidylcholine remodeling and promoting arachidonic acid synthesis and metabolism. Ecotoxicol Environ Saf 2022; 247:114254. [PMID: 36334344 DOI: 10.1016/j.ecoenv.2022.114254] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/23/2022] [Accepted: 10/29/2022] [Indexed: 06/16/2023]
Abstract
Cadmium ion (Cd2+) exposure has been reported to associate with the prevalence of dyslipidemia, and contribute to the initiation and progression of nonalcoholic fatty liver disease (NAFLD). However, Cd2+ exposure perturbed specific metabolic pathways and underlying mechanisms are still unclear. In the present study, through lipidomics analyses of differential metabolites in serum between the Cd2+-exposed mice and the control group, 179 differential metabolites were identified, among which phosphatidylcholines (PCs) accounted for 49 % metabolites. Moreover, the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment assay indicates that PCs participate in the metabolic pathways, including the Arachidonic Acid (AA) metabolism, which also could be potential NAFLD biomarkers. Moreover, in vivo and in vitro results suggested that Cd2+ exposure induced PC synthesis and remodeling, and increased AA level by promoting fatty acid desaturase 1 (FADS1) to catalyze synthesis process instead of cytosolic phospholipase A2 (cPLA2) mediated release pathway. Inhibition of FADS1 by T3364366 could reverse Cd-induced AA, prostaglandin E2 (PGE2) and triglyceride (TAG) levels, and it also reduce cisplatin resistance in HepG2 cells. This study provides new evidence of Cd2+-induced dyslipidemia and reveals underlying molecular mechanism involved in liver dysfunction of Cd2+ exposure.
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Affiliation(s)
- Jie Gu
- School of Life Sciences, Jiangsu University, Zhenjiang 212000, China
| | - Anqi Kong
- School of Life Sciences, Jiangsu University, Zhenjiang 212000, China
| | - Chuanzhi Guo
- School of Life Sciences, Jiangsu University, Zhenjiang 212000, China
| | - Junlin Liu
- School of Life Sciences, Jiangsu University, Zhenjiang 212000, China
| | - Kongdong Li
- School of Life Sciences, Jiangsu University, Zhenjiang 212000, China
| | - Zhen Ren
- School of Life Sciences, Jiangsu University, Zhenjiang 212000, China
| | - Yang Zhou
- School of Life Sciences, Jiangsu University, Zhenjiang 212000, China
| | - Min Tang
- School of Life Sciences, Jiangsu University, Zhenjiang 212000, China
| | - Haifeng Shi
- School of Life Sciences, Jiangsu University, Zhenjiang 212000, China; School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212000, China.
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Pascal L, Guerrero Urbano T, Petkar I, Reis Ferreira M, Kong A, Van Hemelrijck M, Lei M. Assessment of Optimal Time Points for Collection of Patient Reported Outcome Measures for Patients Undergoing Radical Radiotherapy for Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Shaaban A, Badr N, Zaakouk M, Kearns D, Kong A. Comparison of ER, PR, HER2 and Ki67 expression by MammaTyper® RT-qPCR and immunohistochemistry (IHC) on needle core biopsies of breast cancer. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01587-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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11
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Noid G, Currey A, Tai A, Kelly T, Jorns J, Bovi J, Kong A, Wadhwa A, Bergom C, Li A. Treatment Response Assessment Using Daily Dual-Energy CT during Pre-Operative Radiation Therapy for Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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12
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Dunton J, Lord R, Lee K, Doughty C, Bogotto A, O'Neill N, Kong A, Reis Ferreira M, Guerrero Urbano T, Petkar I, Lei M. Adherence to Swallow Exercises during (Chemo)Radiotherapy for Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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13
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Adjogatse D, Petkar I, Ferreira MR, Kong A, Lei M, Thomas C, Dudau C, Touska P, Barrington S, Urbano TG, Connor S. The Impact of Real-Time MRI Radiology-Based Peer Review on Head and Neck Radiotherapy Target Volume Delineation. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Chu E, Cheung K, Wu W, Cheung K, Lee J, Ma O, Kong A. 143P Evaluate the use of the residual liquid of Pap test for human papillomavirus (HPV) screening. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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15
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Ma Y, Liu T, Li X, Kong A, Xiao R, Xie R, Gao J, Wang Z, Cai Y, Zou J, Yang L, Wang L, Zhao J, Xu H, Margaret W, Xu X, Gustafsson JA, Fan X. Estrogen receptor β deficiency impairs gut microbiota: a possible mechanism of IBD-induced anxiety-like behavior. Microbiome 2022; 10:160. [PMID: 36175956 PMCID: PMC9520828 DOI: 10.1186/s40168-022-01356-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 08/24/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Although the lack of estrogen receptor β (ERβ) is a risk factor for the development of inflammatory bowel disease (IBD) and psychiatric disorders, the underlying cellular and molecular mechanisms are not fully understood. Herein, we revealed the role of gut microbiota in the development of IBD and related anxiety-like behavior in ERβ-deficient mice. RESULTS In response to dextran sodium sulfate (DSS) insult, the ERβ knockout mice displayed significant shift in α and β diversity in the fecal microbiota composition and demonstrated worsening of colitis and anxiety-like behaviors. In addition, DSS-induced colitis also induced hypothalamic-pituitary-adrenal (HPA) axis hyperactivity in ERβ-deficient mice, which was associated with colitis and anxiety-like behaviors. In addition, RNA sequencing data suggested that ErbB4 might be the target of ERβ that is involved in regulating the HPA axis hyperactivity caused by DSS insult. Gut microbiota remodeling by co-housing showed that both the colitis and anxiety-like behaviors were aggravated in co-housed wild-type mice compared to single-housed wild-type mice. These findings suggest that gut microbiota play a critical role in mediating colitis disease activity and anxiety-like behaviors via aberrant neural processing within the gut-brain axis. CONCLUSIONS ERβ has the potential to inhibit colitis development and anxiety-like behaviors via remodeling of the gut microbiota, which suggests that ERβ is a promising therapeutic target for the treatment of IBD and related anxiety-like behaviors. Video Abstract.
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Affiliation(s)
- Yuanyuan Ma
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Tianyao Liu
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Xin Li
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Anqi Kong
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Rui Xiao
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Ruxin Xie
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Junwei Gao
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Zhongke Wang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Yun Cai
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Jiao Zou
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Ling Yang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Lian Wang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Jinghui Zhao
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Haiwei Xu
- Southwest Eye Hospital, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Warner Margaret
- Center for Innovative Medicine, Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden
| | - Xingshun Xu
- Institute of Neuroscience, Soochow University, Suzhou, China.
| | - Jan-Ake Gustafsson
- Center for Innovative Medicine, Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden.
- Center for Nuclear Receptors and Cell Signaling, University of Houston, Houston, USA.
| | - Xiaotang Fan
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China.
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16
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Kong A, Chiu G, Shah S, Bolodeoku J, Casey C, Massey O, Patel A, Black C. 682P Patient characteristics and treatment patterns of newly diagnosed locally advanced head and neck squamous cell carcinoma (LA HNSCC): A retrospective cohort analysis of real-world data in England. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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17
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Ning B, Guo C, Kong A, Li K, Xie Y, Shi H, Gu J. Calcium Signaling Mediates Cell Death and Crosstalk with Autophagy in Kidney Disease. Cells 2021; 10:cells10113204. [PMID: 34831428 PMCID: PMC8622220 DOI: 10.3390/cells10113204] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/09/2021] [Accepted: 11/13/2021] [Indexed: 12/15/2022] Open
Abstract
The kidney is an important organ for the maintenance of Ca2+ homeostasis in the body. However, disruption of Ca2+ homeostasis will cause a series of kidney diseases, such as acute kidney injury (AKI), chronic kidney disease (CKD), renal ischemia/reperfusion (I/R) injury, autosomal dominant polycystic kidney disease (ADPKD), podocytopathy, and diabetic nephropathy. During the progression of kidney disease, Ca2+ signaling plays key roles in various cell activities such as necrosis, apoptosis, eryptosis and autophagy. Importantly, there are complex Ca2+ flux networks between the endoplasmic reticulum (ER), mitochondria and lysosomes which regulate intracellular Ca2+ signaling in renal cells and contribute to kidney disease. In addition, Ca2+ signaling also links the crosstalk between various cell deaths and autophagy under the stress of heavy metals or high glucose. In this regard, we present a review of Ca2+ signaling in cell death and crosstalk with autophagy and its potential as a therapeutic target for the development of new and efficient drugs against kidney diseases.
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Affiliation(s)
- Bo Ning
- School of Life Sciences, Jiangsu University, Zhenjiang 212013, China; (B.N.); (C.G.); (A.K.); (K.L.); (H.S.)
| | - Chuanzhi Guo
- School of Life Sciences, Jiangsu University, Zhenjiang 212013, China; (B.N.); (C.G.); (A.K.); (K.L.); (H.S.)
| | - Anqi Kong
- School of Life Sciences, Jiangsu University, Zhenjiang 212013, China; (B.N.); (C.G.); (A.K.); (K.L.); (H.S.)
| | - Kongdong Li
- School of Life Sciences, Jiangsu University, Zhenjiang 212013, China; (B.N.); (C.G.); (A.K.); (K.L.); (H.S.)
| | - Yimin Xie
- Affiliated Hospital of Jiangsu University—Yixing Hospital, Yixing 214200, China;
| | - Haifeng Shi
- School of Life Sciences, Jiangsu University, Zhenjiang 212013, China; (B.N.); (C.G.); (A.K.); (K.L.); (H.S.)
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Jie Gu
- School of Life Sciences, Jiangsu University, Zhenjiang 212013, China; (B.N.); (C.G.); (A.K.); (K.L.); (H.S.)
- Correspondence: ; Tel.: +86-0511-88791923
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18
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Kong A, Zhang Y, Ning B, Li K, Ren Z, Dai S, Chen D, Zhou Y, Gu J, Shi H. Cadmium induces triglyceride levels via microsomal triglyceride transfer protein (MTTP) accumulation caused by lysosomal deacidification regulated by endoplasmic reticulum (ER) Ca 2+ homeostasis. Chem Biol Interact 2021; 348:109649. [PMID: 34516972 DOI: 10.1016/j.cbi.2021.109649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/29/2021] [Accepted: 09/09/2021] [Indexed: 01/11/2023]
Abstract
Cadmium (Cd) exposure induced lipid metabolic disorder with changes in lipid composition, as well as triglyceride (TG) levels. Liver is the main organ maintaining body TG level and previous studies suggested that Cd exposure might increase TG synthesis but reduce TG uptake in liver. However, the effects of Cd exposure on TG secretion from liver and underlying mechanism are still unclear. In the present study, the data revealed that Cd exposure increased TG levels in the HepG2 cells and the cultured medium by increasing the expression of microsomal triglyceride transfer protein (MTTP), which was abrogated by siRNA knockdown of MTTP. MTTP was synergistically accumulated after Cd exposure or treated with proteasome inhibitor MG132 and lysosome inhibitor chloroquine (CQ), which suggested the Cd increased MTTP protein stability by inhibiting both the proteasome and the lysosomal protein degradation pathways. In addition, our results demonstrated that Cd exposure inhibited the lysosomal acidic degradation pathway through disrupting endoplastic reticulum (ER) Ca2+ homeostasis. Cd-induced MTTP protein and TG levels were significantly reduced by pretreatments of BAPTA/AM chelation of intracellular Ca2+, 2-APB inhibition of ER Ca2+ release channel inositol 1,4,5-trisphosphate receptor (IP3R) and CDN1163 activation of ER Ca2+ reuptake pump sarcoplasmic reticulum Ca2+-ATPase (SERCA). These results suggest that Cd-induced ER Ca2+ release impaired the lysosomal acidity, which associated with MTTP protein accumulation and contributed to increased TG levels.
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Affiliation(s)
- Anqi Kong
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu, 212013, China
| | - Yao Zhang
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu, 212013, China
| | - Bo Ning
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu, 212013, China
| | - Kongdong Li
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu, 212013, China
| | - Zhen Ren
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu, 212013, China
| | - Shuya Dai
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu, 212013, China
| | - Dongfeng Chen
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu, 212013, China
| | - Yang Zhou
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu, 212013, China
| | - Jie Gu
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu, 212013, China.
| | - Haifeng Shi
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu, 212013, China; School of Food and Biological Engineering, Zhenjiang, Jiangsu, 212013, China.
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19
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Humbert-Vidan L, Patel V, Begum R, McGovern M, Eaton D, Kong A, Petkar I, Reis Ferreira M, Lei M, King A, Guerrero Urbano T. PH-0387 Mandible osteoradionecrosis: a dosimetric study. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07318-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Zhang Y, Li K, Kong A, Zhou Y, Chen D, Gu J, Shi H. Dysregulation of autophagy acts as a pathogenic mechanism of non-alcoholic fatty liver disease (NAFLD) induced by common environmental pollutants. Ecotoxicol Environ Saf 2021; 217:112256. [PMID: 33901779 DOI: 10.1016/j.ecoenv.2021.112256] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 06/12/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) has been the most common chronic liver disease in the world, including the developing countries. NAFLD is metabolic disease with significant lipid deposition in the hepatocytes of the liver, which is usually associated with oxidative stress, inflammation and fibrogenesis, and insulin resistance. Progressive NAFLD can develop into non-alcoholic steatohepatitis (NASH) or hepatocellular carcinoma. The current evidence proposes that environmental pollutants promote development and progression of NAFLD, and autophagy plays a vital role but is multifactorial affected in NAFLD. In this review, we analyzed on the regulations of common environmental pollutants on autophagy in NAFLD. To clarify the involved roles of autophagy, we discussed the dysregulation of autophagy by environmental pollutants in adipose tissue and gut, and their interactions with liver, as well as epigenetic regulation on autophagy by environmental pollutants. Furthermore, protective roles of potential therapeutic treatments on the multiple-hits of autophagy in NAFLD were descripted.
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Affiliation(s)
- Yao Zhang
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu 212000, China
| | - Kongdong Li
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu 212000, China
| | - Anqi Kong
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu 212000, China
| | - Yang Zhou
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu 212000, China
| | - Dongfeng Chen
- Department of Rheumatology and Inflammation Research, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Jie Gu
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu 212000, China
| | - Haifeng Shi
- School of Life Sciences, Jiangsu University, Zhenjiang, Jiangsu 212000, China.
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21
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Wallis TJM, Heiden E, Horno J, Welham B, Burke H, Freeman A, Dexter L, Fazleen A, Kong A, McQuitty C, Watson M, Poole S, Brendish NJ, Clark TW, Wilkinson TMA, Jones MG, Marshall BG. Risk factors for persistent abnormality on chest radiographs at 12-weeks post hospitalisation with PCR confirmed COVID-19. Respir Res 2021; 22:157. [PMID: 34020644 PMCID: PMC8139368 DOI: 10.1186/s12931-021-01750-8] [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: 01/04/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
Background The long-term consequences of COVID-19 remain unclear. There is concern a proportion of patients will progress to develop pulmonary fibrosis. We aimed to assess the temporal change in CXR infiltrates in a cohort of patients following hospitalisation for COVID-19.
Methods We conducted a single-centre prospective cohort study of patients admitted to University Hospital Southampton with confirmed SARS-CoV2 infection between 20th March and 3rd June 2020. Patients were approached for standard-of-care follow-up 12-weeks after hospitalisation. Inpatient and follow-up CXRs were scored by the assessing clinician for extent of pulmonary infiltrates; 0–4 per lung (Nil = 0, < 25% = 1, 25–50% = 2, 51–75% = 3, > 75% = 4).
Results 101 patients with paired CXRs were included. Demographics: 53% male with a median (IQR) age 53.0 (45–63) years and length of stay 9 (5–17.5) days. The median CXR follow-up interval was 82 (77–86) days with median baseline and follow-up CXR scores of 4.0 (3–5) and 0.0 (0–1) respectively. 32% of patients had persistent CXR abnormality at 12-weeks. In multivariate analysis length of stay (LOS), smoking-status and obesity were identified as independent risk factors for persistent CXR abnormality. Serum LDH was significantly higher at baseline and at follow-up in patients with CXR abnormalities compared to those with resolution. A 5-point composite risk score (1-point each; LOS ≥ 15 days, Level 2/3 admission, LDH > 750 U/L, obesity and smoking-status) strongly predicted risk of persistent radiograph abnormality (0.81). Conclusion Persistent CXR abnormality 12-weeks post COVID-19 was common in this cohort. LOS, obesity, increased serum LDH, and smoking-status were risk factors for radiograph abnormality. These findings require further prospective validation. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-021-01750-8.
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Affiliation(s)
- T J M Wallis
- Department of Respiratory Medicine and Southampton NIHR Biomedical Research Centre, University Hospital Southampton and School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK. .,NIHR Southampton Biomedical Research Centre Research Fellow, University of Southampton, MP218 D-Level South Academic Block University Hospital Southampton, Southampton, SO16 6YD, UK.
| | - E Heiden
- Department of Respiratory Medicine, University Hospital Southampton, Southampton, UK
| | - J Horno
- Department of Respiratory Medicine, University Hospital Southampton, Southampton, UK
| | - B Welham
- Department of Respiratory Medicine, University Hospital Southampton and School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - H Burke
- Department of Respiratory Medicine, University Hospital Southampton and School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - A Freeman
- Department of Respiratory Medicine, University Hospital Southampton and School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - L Dexter
- Department of Respiratory Medicine, University Hospital Southampton, Southampton, UK
| | - A Fazleen
- Department of Respiratory Medicine, University Hospital Southampton and School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - A Kong
- Department of Respiratory Medicine and Southampton NIHR Biomedical Research Centre, University Hospital Southampton and School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - C McQuitty
- Department of Respiratory Medicine and Southampton NIHR Biomedical Research Centre, University Hospital Southampton and School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - M Watson
- Department of Respiratory Medicine, University Hospital Southampton, Southampton, UK
| | - S Poole
- Department of Infection and Southampton NIHR Biomedical Research Centre, University Hospital Southampton and School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - N J Brendish
- Department of Infection, University Hospital Southampton and School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - T W Clark
- Department of Infection and Southampton NIHR Biomedical Research Centre, University Hospital Southampton and School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - T M A Wilkinson
- Department of Respiratory Medicine and Southampton NIHR Biomedical Research Centre, University Hospital Southampton and School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - M G Jones
- Department of Respiratory Medicine and Southampton NIHR Biomedical Research Centre, University Hospital Southampton and School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - B G Marshall
- Department of Respiratory Medicine and Southampton NIHR Biomedical Research Centre, University Hospital Southampton and School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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Chau SL, Wang MP, Wu Y, Cheung DYT, Kong A, Lai V, Lam TH, Ho SY. Polytobacco product use among current cigarette smokers in Hong Kong, China: results from population surveys (2015-17). BMC Public Health 2021; 21:307. [PMID: 33549071 PMCID: PMC7866759 DOI: 10.1186/s12889-021-10341-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 01/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Polytobacco product use is increasingly popular, but little is known about the prevalence, trend, and factors of such use particularly in non-western countries. METHOD A representative sample of 1139 current cigarette smokers aged 15+ (84.1% male) were telephone interviewed in Tobacco Control Policy-related Surveys in 2015-2017. Information collected included poly-tobacco use (PTU), smoking and socio-demographic characteristics. Associations of current PTU with related factors were analyzed using logistic regression with adjustment for confounders. Prevalence was weighted by age and sex of current cigarette users in the general population. RESULTS Eighty-four point one percent (95% CI 81.4-86.6%) were exclusive cigarette smokers. Fifteen point nine percent (13.4-18.6%) were current polytobacco product users, 12.3% (10.2-14.8%) used one tobacco product and 2.52% (1.59-3.97%) used two tobacco products in addition to cigarette. Cigarette use with cigar was more common (6.28%, 4.75-8.27%), and the least used product with cigarette was e-cigarette (1.05%, 0.44-2.50%). The changes in overall prevalence of PTU by number of products use varied in 3 years. Current PTU was associated with being male (AOR 2.01, 95% CI 1.12-3.61), younger age (AORs range from 1.34-4.65, P for trend < .001) and less ready to quit (2.08, 1.09-3.97). CONCLUSIONS Prevalence of PTU increased slowly by year, one tobacco product use with cigarette was more common. The most used tobacco product with cigarette was cigar. Being male, younger and less ready to quit were associated with current PTU.
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Affiliation(s)
- S L Chau
- School of Nursing, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
| | - M P Wang
- School of Nursing, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Y Wu
- School of Nursing, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
| | - D Y T Cheung
- School of Nursing, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
| | - A Kong
- Hong Kong Council on Smoking and Health, 183 Queen's Road East, Wanchai, Hong Kong
| | - V Lai
- Hong Kong Council on Smoking and Health, 183 Queen's Road East, Wanchai, Hong Kong
| | - T H Lam
- School of Public Health, University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong
| | - S Y Ho
- School of Public Health, University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong
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Phang R, Kong A, Lees J, Lim S. Modelling Diabetic Cardiomyopathy-Associated Dysfunction Using Human Induced Pluripotent Stem Cell-Derived Cardiovascular Cells. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Shi H, Sun X, Kong A, Ma H, Xie Y, Cheng D, Wong CKC, Zhou Y, Gu J. Cadmium induces epithelial-mesenchymal transition and migration of renal cancer cells by increasing PGE2 through a cAMP/PKA-COX2 dependent mechanism. Ecotoxicol Environ Saf 2021; 207:111480. [PMID: 33254385 DOI: 10.1016/j.ecoenv.2020.111480] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/07/2020] [Accepted: 10/09/2020] [Indexed: 06/12/2023]
Abstract
Environmental or occupational exposure of Cadmium (Cd) is concerned to be a threat to human health. The kidney is main target of Cd accumulation, which increases the risk of renal cell carcinoma (RCC). In addition, low content of Cd had been determined in kidney cancer, however, the roles of presence of Cd in renal tumors progression are still unclear. The present study is proposed to determine the effect of low-dose Cd exposure on the renal cancer cells and aimed to clarify the underlying mechanisms. The cell viability, cytotoxicity, and the migratory effect of low-dose Cd on the renal cancer cells were detected. Moreover, the roles of reactive oxygen species (ROS), Ca2+, and cyclic AMP (cAMP)/protein kinase A (PKA)-cyclooxygenase2 (COX2) signaling, as well as COX2 catalytic product prostaglandin E2 (PGE2) on cell migration and invasion were identified. Our results suggested that low dose Cd exposure promoted migration of renal cancer Caki-1 cells, which was not dependent on Cd-induced ROS and intracellular Ca2+ levels. Cd exposure induced cAMP/PKA-COX2, which mediated cell migration and invasion, and decreased expressions of epithelial-mesenchymal transition (EMT) marker, E-cadherin, but increased expressions of N-cadherin and Vimentin. Moreover, Cd-induced secretion of PGE2 feedback on activation of cAMP/PKA-COX2 signaling, also promoted EMT, migration and invasion of renal cancer Caki-1 cells. This study might contribute to understanding of the mechanism of Cd-induce progression of renal cancer and future studies on the prevention and therapy of renal cell carcinomas.
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Affiliation(s)
- Haifeng Shi
- School of Life Sciences, Jiangsu University, Jiangsu, Zhenjiang 212000, China
| | - Xi Sun
- School of Life Sciences, Jiangsu University, Jiangsu, Zhenjiang 212000, China
| | - Anqi Kong
- School of Life Sciences, Jiangsu University, Jiangsu, Zhenjiang 212000, China
| | - Haiyan Ma
- School of Life Sciences, Jiangsu University, Jiangsu, Zhenjiang 212000, China
| | - Yimin Xie
- Affiliated Hospital of Jiangsu University-Yixing Hospital, Jiangsu, Yixing 214200, China
| | - Dongrui Cheng
- General Hospital of Nanjing Military Region, East Zhongshan Road 305, Xuanwu District, Jiangsu, Nanjing 210002, China
| | | | - Yang Zhou
- School of Life Sciences, Jiangsu University, Jiangsu, Zhenjiang 212000, China
| | - Jie Gu
- School of Life Sciences, Jiangsu University, Jiangsu, Zhenjiang 212000, China.
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Galot R, Le Tourneau C, Guigay J, Licitra L, Tinhofer I, Kong A, Caballero C, Fortpied C, Bogaerts J, Govaerts AS, Staelens D, Raveloarivahy T, Rodegher L, Laes JF, Saada-Bouzid E, Machiels JP. Personalized biomarker-based treatment strategy for patients with squamous cell carcinoma of the head and neck: EORTC position and approach. Ann Oncol 2019; 29:2313-2327. [PMID: 30307465 DOI: 10.1093/annonc/mdy452] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The molecular landscape of squamous cell carcinoma of the head and the neck (SCCHN) has been characterized and actionable or targetable genomic alterations have been identified. However, targeted therapies have very limited activity in unselected SCCHN, and the current treatment strategy is still based on tumor location and disease stage and not on tumor biology. Trying to select upfront the patients who will benefit from a specific treatment might be a way to improve patients' outcome. With the objective of optimizing the activity of targeted therapies and immunotherapy, we have designed an umbrella biomarker-driven study dedicated to recurrent and/or metastatic SCCHN patients (EORTC-1559-HNCG, NCT03088059). In this article, we review not only the different trial designs for biomarker-driven studies with their respective advantages and opportunities but also the potential pitfalls that led to the design of the EORTC-1559-HNCG protocol. We also discuss the scientific and logistic challenges of biomarker-driven trials.
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Affiliation(s)
- R Galot
- Department of Medical Oncology, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, Belgium; Institute for Clinical and Experimental Research (POLE MIRO), Université Catholique de Louvain, Brussels, Belgium
| | - C Le Tourneau
- Department of Drug Development and Innovation, Institut Curie, Paris & Saint-Cloud, Paris, France; INSERM U900 Research Unit, Saint-Cloud, France; Versailles-Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux, France
| | - J Guigay
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - L Licitra
- Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS "Istituto Nazionale dei Tumori", Milan; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - I Tinhofer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin; Department of Radiooncology and Radiotherapy, Berlin Institute of Health, Berlin, Germany
| | - A Kong
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - C Caballero
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - C Fortpied
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - J Bogaerts
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - A-S Govaerts
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - D Staelens
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - T Raveloarivahy
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - L Rodegher
- European Organization of Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | | | - E Saada-Bouzid
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - J-P Machiels
- Department of Medical Oncology, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, Belgium; Institute for Clinical and Experimental Research (POLE MIRO), Université Catholique de Louvain, Brussels, Belgium.
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Desai N, Jorns J, Kelly T, Johnstone C, Bovi J, Shukla M, Wadhwa A, Kong A, Paulson E, Currey A, Bergom C. Correlation between Tumor-Infiltrating Lymphocytes and 21-Gene Recurrence Score in Patients Undergoing Pre-Operative Accelerated Partial-Breast Irradiation. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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27
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Desai N, Liang Y, Paulson E, Fitzgerald J, Jorns J, Bovi J, Kelly T, Wadhwa A, Li A, Kong A, Johnstone C, Shukla M, Bergom C, Currey A. Relationship of Radiomic Features and Tumor Response in Patients Undergoing Pre-Operative Accelerated Partial Breast Irradiation for Breast Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Affiliation(s)
- V Vigneswara
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - A Kong
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.
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Lau E, Salem A, Chan JCN, So WY, Kong A, Lamotte M, Luk A. Insulin glargine compared to neutral protamine Hagedorn (NPH) insulin in patients with type-2 diabetes uncontrolled with oral anti-diabetic agents alone in Hong Kong: a cost-effectiveness analysis. Cost Eff Resour Alloc 2019; 17:13. [PMID: 31303866 PMCID: PMC6604305 DOI: 10.1186/s12962-019-0180-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 09/28/2018] [Accepted: 06/21/2019] [Indexed: 12/20/2022] Open
Abstract
Background International guidelines recommend using basal insulin in patients with type-2 diabetes mellitus if glycaemic target cannot be attained on non-insulin anti-diabetic drugs. Available choices of basal insulin include intermediate-acting neutral protamine Hagedorn (NPH) insulin and long-acting insulin analogues like insulin glargine U100. Despite clear advantages of glargine U100, the existing practice in Hong Kong still favours NPH insulin due to lower immediate drug costs. Objectives The objective of this study was to assess the cost-effectiveness of insulin glargine U100 compared to NPH insulin in patients with type-2 diabetes uncontrolled with non-insulin anti-diabetic agents alone in Hong Kong. Methods The IQVIA™ Core Diabetes Model (CDM) v9.0 was used to conduct the cost-effectiveness analysis of glargine U100 versus NPH. Baseline characteristics were collected from the Hong Kong Diabetes Registry. Efficacy rates were extracted from a published study comparing glargine U100 and NPH in Asia, utilities from published literature, and costs constructed using the Hong Kong Hospital Authority (HA) Gazette (public healthcare setting). The primary outcome was an incremental cost-effectiveness ratio (ICER). Results Insulin glargine U100 resulted in an ICER of HKD 98,663 per Quality Adjusted Life Year (QALY) gained. The incremental gains in QALY and costs were 0.217 years and HKD 21,360 respectively. Results from scenario and probabilistic sensitivity analyses were consistent with that from base case analysis. Conclusion Insulin glargine U100 is a cost-effective treatment for patients with type 2 diabetes compared to NPH insulin in setting in Hong Kong. This was mainly driven by the significantly lower rates of hypoglycaemia of insulin glargine U100 than NPH insulin. Electronic supplementary material The online version of this article (10.1186/s12962-019-0180-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- E Lau
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR China
| | - A Salem
- IQVIA, Real World Evidence, Zaventem, Belgium
| | - J C N Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR China
| | - W Y So
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR China
| | - A Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR China
| | - M Lamotte
- IQVIA, Real World Evidence, Zaventem, Belgium
| | - A Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR China
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Mehanna H, Robinson M, Hartley A, Kong A, Foran B, Fulton-Lieuw T, Dalby M, Mistry P, Sen M, O’Toole L, Dunn J. OC-011 New insights from the De-ESCALate HPV trial. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30177-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Noid G, Schott D, Tai A, Currey A, Bergom C, Kelly T, Bovi J, Jorns J, Kong A, Liu Y, Li A. Enhancement of CT Based Treatment Response Detection for Breast Cancer Using Dual-Energy CT. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Garcia Foncillas J, Aftimos P, Barthelemy P, Bellmunt J, Berchem G, Camps C, de las Peñas R, Finzel A, Hervonen J, Joensuu T, Kong A, Mackay J, Mikropoulos C, Mokbel K, Mouysset JL, Perren TJ, Guitti G, Laes JF. Clinical utility of complex multi-platform profiling in metastatic cancer patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy294.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mehanna H, Kong A, Hartley A, Mistry P, Dalby M, Fulton-Lieuw T, Robinson M, Gray A, Foran B, Sen M, O'Toole L, Dyker K, Al Booz H, Moleron R, Brennan S, Aynsley E, Chan A, Srinivasan D, Buter J, Dunn J. Cetuximab versus cisplatin in patients with HPV-positive, low risk oropharyngeal cancer, receiving radical radiotherapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Blissitt J, Scalio R, Myers KB, Sweeney K, Kelly TR, Kong A, Chitambar C, Currey AD. Abstract P6-12-10: The importance of a survivorship coordinator role in the creation of survivorship care plans and maintaining compliance with new accreditation standards. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-12-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Froedtert Hospital and the Medical College of Wisconsin's Breast Care Center (F&MCWBCC), is a Commission on Cancer (CoC) and National Accreditation Program for Breast Centers (NAPBC) accredited facility providing care to over 500 patients a year. The F&MCWBCC recognized the importance of following the IOM survivorship recommendations and in 2014 began providing a survivorship care plan (SCP) to patients completing radiation therapy. In 2015, SCP standards for both CoC and NAPBC were established. A redesign of the process was necessary to meet these new requirements.
Methods: A review of accreditation standards was conducted along with an examination of staff availability. A collaborative team of content experts was gathered who worked with an informatics nurse to design content and a template in the EHR that met the elements outlined by the accreditation standards. Initially, treating physicians and advanced practice nurses were responsible for creating the SCP. However, these providers found it to be increasingly difficult to manage on top of their other responsibilities.
In May 2015, an experienced breast cancer technician was identified for the survivorship data coordinator role. The coordinator used available sources, patient lists and clinic schedules, to case find. She developed spreadsheets to assist in tracking patients and measuring compliance. The coordinator communicated with providers to alert them to populate and review the SCP and coordinated the survivorship appointment with the nurse.
Once the SCP is completed, a dedicated RN position is utilized for a survivorship visit with patients. During this visit, the RN reviews the care plan and provides education on follow up care guidelines and overall health and wellness concepts. Assessments for further supportive services are performed, and appropriate referrals made. The RN shares the SCP with the primary care provider. Results are tracked and reported to Cancer Service Line Leadership and the Breast Steering and Cancer Committees.
Results: During the implementation phase, completion of SCPs by physicians and advance practice nurses was inconsistent. Once the survivorship coordinator role was created and implemented, compliance with NAPBC standards improved as SCP delivery numbers increased 141%.
The survivorship coordinator improved delivery of SCPs. In 2014, 130 plans were delivered, and 185 in 2015. In 2016, 314 were delivered, achieving 100% compliance to the NAPBC survivorship standard.
Conclusion:Compliance with NAPBC and CoC standards to deliver SCPs to patients and primary care providers is labor intensive and requires a large number of resources. Use of a survivorship data coordinator has proven successful in determining and tracking eligible patients and ensuring timely delivery of SCPs to patients. The monitoring of new patients through this process has enabled this center to go from estimates of analytic cases, to a current real-time numbers. This is necessary to provide a comprehensive review of care and survivorship guidelines to cancer survivors and meeting accreditation standards. Further work is needed to assess the impact of the SCPs on patient outcomes and satisfaction.
Citation Format: Blissitt J, Scalio R, Myers KB, Sweeney K, Kelly TR, Kong A, Chitambar C, Currey AD. The importance of a survivorship coordinator role in the creation of survivorship care plans and maintaining compliance with new accreditation standards [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-12-10.
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Affiliation(s)
- J Blissitt
- Froedtert Hospital, Milwaukee, WI; Medical College of Wisconsin, Milwaukee, WI
| | - R Scalio
- Froedtert Hospital, Milwaukee, WI; Medical College of Wisconsin, Milwaukee, WI
| | - KB Myers
- Froedtert Hospital, Milwaukee, WI; Medical College of Wisconsin, Milwaukee, WI
| | - K Sweeney
- Froedtert Hospital, Milwaukee, WI; Medical College of Wisconsin, Milwaukee, WI
| | - TR Kelly
- Froedtert Hospital, Milwaukee, WI; Medical College of Wisconsin, Milwaukee, WI
| | - A Kong
- Froedtert Hospital, Milwaukee, WI; Medical College of Wisconsin, Milwaukee, WI
| | - C Chitambar
- Froedtert Hospital, Milwaukee, WI; Medical College of Wisconsin, Milwaukee, WI
| | - AD Currey
- Froedtert Hospital, Milwaukee, WI; Medical College of Wisconsin, Milwaukee, WI
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Pistilli B, Pluard T, Urruticoechea A, Farci D, Kong A, Bachelot T, Chan S, Han HS, Jerusalem G, Urban P, Robinson D, Mouhaër SL, Tomaso ED, Massacesi C, Saura C. Phase II study of buparlisib (BKM120) and trastuzumab in patients with HER2+ locally advanced or metastatic breast cancer resistant to trastuzumab-based therapy. Breast Cancer Res Treat 2017; 168:357-364. [PMID: 29198055 DOI: 10.1007/s10549-017-4596-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 11/22/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE A Phase Ib study in patients with trastuzumab-resistant, human epidermal growth factor receptor-2- (HER2)-positive advanced breast cancer defined the recommended Phase II dose of buparlisib as 100 mg/day in combination with 2 mg/kg weekly trastuzumab, and reported preliminary signs of clinical activity. Here we present results from the Phase II portion. METHODS Patients with trastuzumab-resistant, HER2-positive advanced breast cancer received buparlisib plus trastuzumab. Study endpoints included safety/tolerability and antitumour activity. The study was extended to include a Phase Ib dose-escalation phase, in which patients with progressive brain metastases also received capecitabine. RESULTS In the Phase II portion, of 50 patients treated with buparlisib and trastuzumab, the most common (≥ 30%) all-grade adverse events (AEs) were diarrhoea (54%), nausea (48%), decreased appetite, increased alanine aminotransferase (36% each), increased aspartate aminotransferase (34%), fatigue, rash (32% each), cough and hyperglycemia (30% each). One (2%) patient achieved complete response and four (8%) patients had confirmed partial responses [PR; including two patients with phosphatidylinositol 3-kinase (PI3 K) pathway-activated tumours]. Overall response rate (ORR) was 10%: the primary endpoint (ORR ≥ 25%) was therefore not met. In the Phase Ib portion, all patients with measurable brain lesions at baseline showed tumour shrinkage to some degree; due to low enrollment, maximum tolerated dose of buparlisib in combination with trastuzumab and capecitabine was not determined. CONCLUSION Buparlisib plus trastuzumab, as a chemotherapy-free regimen, demonstrated an acceptable safety profile but limited efficacy in patients with heavily pretreated, trastuzumab-resistant HER2-positive breast cancer, and in patients with progressive brain metastases also receiving capecitabine.
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Affiliation(s)
- B Pistilli
- Breast Cancer Unit, Institut Gustave Roussy, 114 Rue Edouard-Vaillant, 94800, Villejuif, France. .,Macerata Hospital, Macerata, Italy.
| | - T Pluard
- Saint Luke's Health System, Kansas City, MO, USA
| | - A Urruticoechea
- Onkologikoa Foundation, San Sebastian, Spain.,Catalan Institute of Oncology, Barcelona, Spain
| | - D Farci
- Ospedale Oncologico, Cagliari, Italy
| | - A Kong
- University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,University of Oxford and Oxford University Hospitals NHS Trust, Oxford, UK
| | - T Bachelot
- Centre Léon Bérard et Inserm U1052, Lyon, France
| | - S Chan
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - H S Han
- Moffitt Cancer Center, Tampa, FL, USA
| | - G Jerusalem
- CHU Sart Tilman Liège and University of Liège, Liège, Belgium
| | - P Urban
- Novartis Pharma AG, Basel, Switzerland
| | - D Robinson
- Novartis Institutes for BioMedical Research, Cambridge, MA, USA
| | - S L Mouhaër
- Novartis Pharmaceuticals Corporation, Rueil-Malmaison, France
| | - E D Tomaso
- Novartis Institutes for BioMedical Research, Cambridge, MA, USA.,Syros Pharmaceuticals, Watertown, MA, USA
| | - C Massacesi
- Novartis Pharmaceuticals Corporation, Rueil-Malmaison, France
| | - C Saura
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Harrington K, Kong A, Mach N, Rordorf T, Corral J, Espeli V, Treichel S, Cheng J, Kim J, Chesney J. Early safety from phase 1b/3, multicenter, open-label, randomized trial of talimogene laherparepvec (T-VEC) + pembrolizumab (pembro) for recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN): MASTERKEY-232. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx374.061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Montoya A, Hernández-Totomoch O, Estrada-Torres A, Kong A, Caballero J. Traditional knowledge about mushrooms in a Nahua community in the state of Tlaxcala, México. Mycologia 2017. [DOI: 10.1080/15572536.2004.11833038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | | | - A. Kong
- Centro de Investigaciones en Ciencias Biológicas, Universidad Autónoma de Tlaxcala Km 10.5 Autopista San Martín Texmelucan-Tlaxcala, Ixtacuixtla, Tlaxcala, C.P. 90120, México
| | - J. Caballero
- Jardín Botánico, Instituto de Biología, Universidad Nacional Autónoma de México Apartado Postal 70-614, México, D.F. 04510, México
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Kong A, Mancheno DE, Boudet N, Delgado R, Andreansky ES, Blakey SB. Total synthesis of malagashanine: a chloroquine potentiating indole alkaloid with unusual stereochemistry. Chem Sci 2017; 8:697-700. [PMID: 28451219 PMCID: PMC5297967 DOI: 10.1039/c6sc03578g] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 09/11/2016] [Indexed: 11/21/2022] Open
Abstract
The first total synthesis of malagashanine, a chloroquine potentiating indole alkaloid, is presented. A highly stereoselective cascade annulation reaction was developed to generate the tetracyclic core of the Malagasy alkaloids. This chemistry is likely to be broadly applicable to the synthesis of other members of this stereochemically unique family of natural products.
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Affiliation(s)
- A Kong
- Department of Chemistry , Emory University , 1515 Dickey Drive , Atlanta , GA 30322 , USA .
| | - D E Mancheno
- Department of Chemistry , Emory University , 1515 Dickey Drive , Atlanta , GA 30322 , USA .
| | - N Boudet
- Department of Chemistry , Emory University , 1515 Dickey Drive , Atlanta , GA 30322 , USA .
| | - R Delgado
- Department of Chemistry , Emory University , 1515 Dickey Drive , Atlanta , GA 30322 , USA .
| | - E S Andreansky
- Department of Chemistry , Emory University , 1515 Dickey Drive , Atlanta , GA 30322 , USA .
| | - S B Blakey
- Department of Chemistry , Emory University , 1515 Dickey Drive , Atlanta , GA 30322 , USA .
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Li C, Han Z, Yu Y, Zhang Y, Dong B, Kong A, Shan Y. Efficient oxygen electroreduction over ordered mesoporous Co–N-doped carbon derived from cobalt porphyrin. RSC Adv 2016. [DOI: 10.1039/c5ra25862f] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
High-performance self-supported Co–N-doped carbon electrocatalyst for ORR with comparable activity to Pt/C in both acidic and alkaline media was prepared.
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Affiliation(s)
- C. Li
- School of Chemistry and Molecular Engineering
- East China Normal University
- Shanghai 200241
- P. R. China
| | - Z. Han
- School of Chemistry and Molecular Engineering
- East China Normal University
- Shanghai 200241
- P. R. China
| | - Y. Yu
- School of Chemistry and Molecular Engineering
- East China Normal University
- Shanghai 200241
- P. R. China
| | - Y. Zhang
- School of Chemistry and Molecular Engineering
- East China Normal University
- Shanghai 200241
- P. R. China
| | - B. Dong
- School of Chemistry and Molecular Engineering
- East China Normal University
- Shanghai 200241
- P. R. China
| | - A. Kong
- School of Chemistry and Molecular Engineering
- East China Normal University
- Shanghai 200241
- P. R. China
| | - Y. Shan
- School of Chemistry and Molecular Engineering
- East China Normal University
- Shanghai 200241
- P. R. China
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Jiao Y, Zhang J, Wang Y, Wing Y, Kong A. Associations of sleep duration with cardiac remolding in adolescents and young adults at risk of metabolic syndrome. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.1550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kong A, Tussing-Humphreys LM, Odoms-Young AM, Stolley MR, Fitzgibbon ML. Systematic review of behavioural interventions with culturally adapted strategies to improve diet and weight outcomes in African American women. Obes Rev 2014; 15 Suppl 4:62-92. [PMID: 25196407 PMCID: PMC4159728 DOI: 10.1111/obr.12203] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 06/09/2014] [Accepted: 06/10/2014] [Indexed: 01/28/2023]
Abstract
Behavioural interventions incorporating features that are culturally salient to African American women have emerged as one approach to address the high rates of obesity in this group. Yet, the systematic evaluation of this research is lacking. This review identified culturally adapted strategies reported in behavioural interventions using a prescribed framework and examined the effectiveness of these interventions for diet and weight outcomes among African American women. Publications from 1 January 1990 through 31 December 2012 were retrieved from four databases, yielding 28 interventions. Seventeen of 28 studies reported significant improvements in diet and/or weight change outcomes in treatment over comparison groups. The most commonly identified strategies reported were 'sociocultural' (reflecting a group's values and beliefs) and 'constituent involving' (drawing from a group's experiences). Studies with significant findings commonly reported constituent-involving strategies during the formative phases of the intervention. Involving constituents early on may uncover key attributes of a target group and contribute to a greater understanding of the heterogeneity that exists even within racial/ethnic groups. Available evidence does not, however, explain how culturally adapted strategies specifically influence outcomes. Greater attention to defining and measuring cultural variables and linking them to outcomes or related mediators are important next steps.
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Affiliation(s)
- A Kong
- Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA; University of Illinois Cancer Center, Chicago, IL, USA
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Albukhari A, Choudhry H, Haider S, Buffa F, Ahmed A, Kong A. 529: Identification of novel determinants of cetuximab-resistance in triple negative breast cancer. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50471-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Oddsson A, Kristinsson SY, Helgason H, Gudbjartsson DF, Masson G, Sigurdsson A, Jonasdottir A, Jonasdottir A, Steingrimsdottir H, Vidarsson B, Reykdal S, Eyjolfsson GI, Olafsson I, Onundarson PT, Runarsson G, Sigurdardottir O, Kong A, Rafnar T, Sulem P, Thorsteinsdottir U, Stefansson K. The germline sequence variant rs2736100_C in TERT associates with myeloproliferative neoplasms. Leukemia 2014; 28:1371-4. [PMID: 24476768 PMCID: PMC4051217 DOI: 10.1038/leu.2014.48] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- A Oddsson
- deCODE Genetics/Amgen Inc., Reykjavik, Iceland
| | - S Y Kristinsson
- 1] Faculty of Medicine, University of Iceland, Reykjavik, Iceland [2] Department of Hematology, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | - H Helgason
- 1] deCODE Genetics/Amgen Inc., Reykjavik, Iceland [2] School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | - G Masson
- deCODE Genetics/Amgen Inc., Reykjavik, Iceland
| | | | | | | | - H Steingrimsdottir
- Department of Hematology, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | - B Vidarsson
- Department of Hematology, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | - S Reykdal
- Department of Hematology, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | | | - I Olafsson
- Department of Clinical Biochemistry, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | - P T Onundarson
- 1] Faculty of Medicine, University of Iceland, Reykjavik, Iceland [2] Department of Hematology, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | - G Runarsson
- Department of Hematology, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | - O Sigurdardottir
- Department of Clinical Biochemistry, Akureyri Hospital, Akureyri, Iceland
| | - A Kong
- deCODE Genetics/Amgen Inc., Reykjavik, Iceland
| | - T Rafnar
- deCODE Genetics/Amgen Inc., Reykjavik, Iceland
| | - P Sulem
- deCODE Genetics/Amgen Inc., Reykjavik, Iceland
| | - U Thorsteinsdottir
- 1] deCODE Genetics/Amgen Inc., Reykjavik, Iceland [2] Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - K Stefansson
- 1] deCODE Genetics/Amgen Inc., Reykjavik, Iceland [2] Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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Hashimoto K, Roxanis I, Generali D, Andreis D, Strina C, Cappelletti M, Macaulay V, Kong A. Abstract P6-05-08: Nuclear HER3 localisation plays a role in trastuzumab resistance in HER2-positive breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p6-05-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: HER3 is known to locate in the nucleus. Unlike HER4, nuclear HER3 translocation has not been reported to be due to a proteolytic cleavage process by ADAM17 and gamma-secretase. The mechanisms of nuclear HER3 induction and its role in relation to trastuzumab treatment and resistance for HER2-positive breast cancer is unclear.
Methods: Using nuclear fractionation and confocal microscopy, nuclear HER3 localisation was investigated in response to trastuzumab with or without ADAM17 inhibitor and gamma-secretase inhibitor in a panel of HER2 expressing cell lines. We also correlated nuclear HER3 expression by immunohistochemistry with treatment response in patients who underwent window trastuzumab study as well as the survival outcome in a cohort of HER2-positive breast cancer patients using Kaplan–Meier survival curves with Log-rank test.
Results: HER3 ligand heregulin and trastuzumab was found to induce nuclear HER3 translocation in HER2-positive breast cancer cell lines, including SKBR3. Nuclear HER3 was also enriched in acquired trastuzumab resistant SKBR3 cells (SKBr3-TR). Trastuzumab treatment induced several HER3 fragments and HER3100kD was found to be responsible for nuclear HER3 enrichment by fractionation. This fragment was confirmed to be a specific band of HER3 as shown by HER3 knockdown. Nuclear HER3 was reduced by inhibiting either gamma-secretase or ADAM17 inhibitor. Gamma-secretase or ADAM17 inhibitor reduced HER3100kD in both SKBr3 and SKBr3-TR cells.
In HER2-positive breast cancer patients who underwent window trastuzumab study, baseline nuclear HER3 status was not a predictor of response for trastuzumab monotherapy at day 21. However, nuclear HER3 was enriched after trastuzumab treatment in a poor-responder patient. Total HER3 expression level in cytoplasm positively was correlated with poor response to trastuzumab monotherapy in HER2-positive patients (r = 0.67, p = 0.05). There was no statistically significant difference in disease-free survival between positive and negative nuclear HER3 expression but the number of patients was small (n = 87). Further validation to assess nuclear HER3 expression as a prognostic and predictive biomarker in HER2-positive breast cancer patients undergoing trastuzumab treatment will be assessed in randomized tumour samples from FinHER study.
Conclusion: Heregulin and trastuzumab treatment seems to induce nuclear HER3 translocation in some of the HER2 positive breast cancer cells. This may be due to proteolytic cleavage of HER3 as it is reduced by ADAM17 or gamma-secretase inhibitor. Enriched nuclear localisation of HER3 seems to be one possible mechanism of acquired resistance to trastuzumab in HER2-positive breast cancer.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-05-08.
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Affiliation(s)
- K Hashimoto
- Epidermal Growth Factor Receptors Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; IGF Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; Cellular Pathology, University of Oxford, Oxford, United Kingdom; Instituti Ospitalieri di Cremona, Cremona, Italy
| | - I Roxanis
- Epidermal Growth Factor Receptors Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; IGF Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; Cellular Pathology, University of Oxford, Oxford, United Kingdom; Instituti Ospitalieri di Cremona, Cremona, Italy
| | - D Generali
- Epidermal Growth Factor Receptors Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; IGF Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; Cellular Pathology, University of Oxford, Oxford, United Kingdom; Instituti Ospitalieri di Cremona, Cremona, Italy
| | - D Andreis
- Epidermal Growth Factor Receptors Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; IGF Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; Cellular Pathology, University of Oxford, Oxford, United Kingdom; Instituti Ospitalieri di Cremona, Cremona, Italy
| | - C Strina
- Epidermal Growth Factor Receptors Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; IGF Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; Cellular Pathology, University of Oxford, Oxford, United Kingdom; Instituti Ospitalieri di Cremona, Cremona, Italy
| | - M Cappelletti
- Epidermal Growth Factor Receptors Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; IGF Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; Cellular Pathology, University of Oxford, Oxford, United Kingdom; Instituti Ospitalieri di Cremona, Cremona, Italy
| | - V Macaulay
- Epidermal Growth Factor Receptors Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; IGF Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; Cellular Pathology, University of Oxford, Oxford, United Kingdom; Instituti Ospitalieri di Cremona, Cremona, Italy
| | - A Kong
- Epidermal Growth Factor Receptors Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; IGF Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom; Cellular Pathology, University of Oxford, Oxford, United Kingdom; Instituti Ospitalieri di Cremona, Cremona, Italy
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Awada A, Spector N, El-Hariry I, Rodriguez AA, Erban JK, Cortes J, Gomez H, Kong A, Hickish T, Fein L, Vahdat L, MacPherson I, Canon JL, Mansoor S, Giovanne A, McAdam K, Vukovic VM, Yalcin I, Bradley R, Proia D, Mano MS, Perez EA, Cameron DA. Abstract P2-16-23: The ENCHANT-1 trial (NCT01677455): An open label multicenter phase 2 proof of concept study evaluating first line ganetespib monotherapy in women with metastatic HER2 positive or triple negative breast cancer (TNBC). Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-16-23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Hsp90 is a molecular chaperone protein required for the stabilization and activation of many proteins, referred to as Hsp90 ‘clients’, such as HER2, HIF1-a, EGFR, ER, PI3K, AKT, P53 and VEGFR. The drug candidate, ganetespib is a novel triazolone inhibitor of Hsp90, with over 700 patients treated to date. Ganetespib has shown activity in preclinical models of HER2+, ER+/PR+ and TNBC. Early clinical trials documented ganetespib single agent activity in heavily pretreated HER2+ and TNBC patients. Ganetespib has been well tolerated in clinical trials with a favorable safety profile. This efficacy-screening study is designed to provide further evidence of ganetespib activity and identify potentially predictive biomarkers in metastatic breast cancer (BC).
Methods: The ENCHANT-1 Trial is an international, first-line 2-cohort Phase 2 study in BC patients: Cohort A, HER2 amplified (n = 35), and Cohort B, TNBC (n = 35). Patients who present with previously untreated metastatic disease are eligible for treatment with ganetespib at 150 mg/m2 twice weekly on 3 out of 4 wks, for a total of up to 12 wks. Primary endpoint: ORR assessed using RECIST1.1 criteria. Key secondary endpoints include metabolic response as assessed by PET/CT at wk 3 utilizing modified EORTC criteria. Disease progression (PD) at wk 3 by PET imaging indicates discontinuation of study therapy, and is performed to quickly offer patients with metabolic PD a standard of care treatment.
The study is designed as Simon 2-stage requiring at least one OR in 15 patients for the respective cohort to expand to 35 patients. A Steering Committee is established to oversee the overall study and review the interim results.
Results: The study was initiated in 23 centers globally. At the time of submission, a total of 17 patients had been enrolled; TNBC (n = 15) and HER2 (n = 2). Here we report the interim analysis in the TNBC cohort. The median age was 54 years (range 30 -77) with ECOG PS 0 (n = 7/15). Most patients (n = 9) presented with de novo metastatic disease. 5 patients were not evaluable for PET assessment (3 had not yet reached wk 3 and 2 withdrawn before wk 3 for clinical progression), and 9 patients were not evaluable for objective response at wk 6 (3 withdrawn before or at wk 3 for clinical progression and 6 had not yet reached wk 6 evaluation). In the 10 patients with evaluable PET imaging, 9 patients achieved metabolic (m) response (2 mPR, 4 mSD with dominant tumor shrinkage and 3 SD) and one patient with mPD. In the 6 patients evaluable for OR at wk 6, one patient achieved PR, 2 SD and 3 PD. Treatment with ganetespib was well tolerated; the most common AEs were mild or moderate diarrhea (8/15, 53%), fatigue (5/15, 33%), decreased appetite (4/15, 27%), insomnia (4/15, 27%), and nausea (4/15, 27%).
Conclusion: Ganetespib single agent was generally well tolerated and showed anti-tumor activity TNBC patients as early as 3 weeks following treatment. PET seems to be a good tool to screen antitumor activity of new agents in early settings rather that in heavily pretreated patients. The TNBC cohort has met the protocol criteria for proceeding to stage 2.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-16-23.
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Affiliation(s)
- A Awada
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - N Spector
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - I El-Hariry
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - AA Rodriguez
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - JK Erban
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - J Cortes
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - H Gomez
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - A Kong
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - T Hickish
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - L Fein
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - L Vahdat
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - I MacPherson
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - J-L Canon
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - S Mansoor
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - A Giovanne
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - K McAdam
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - VM Vukovic
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - I Yalcin
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - R Bradley
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - D Proia
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - MS Mano
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - EA Perez
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - DA Cameron
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
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Rack B, Messina C, Litiere S, Dittrich C, Mavroudis D, Kong A, Sotiriou C, Pierga JY, Piccart M, Ignatiadis M. Abstract OT1-3-02: The treat CTC trial – A new approach targeting circulating tumor cells (CTC) in early breast cancer (EBC). Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-ot1-3-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
The presence of CTC in metastatic BC is associated with an impaired prognosis. Recent data show a reduced disease-free survival and increased risk of death in the presence of CTC in EBC. Therefore, patients with persisting CTC after (neo)adjuvant chemotherapy might benefit from additional systemic treatment.
Recent data have reinforced the hypothesis that trastuzumab can eliminate tumor cells by antibody dependent cell cytotoxicity (ADCC) or other immune mechanisms. Preclinical data have provided evidence that the benefit of trastuzumab may be associated with targeting cancer stem cells in a HER2 independent model (Ithimakin et al Cancer Res 2013). Trastuzumab eliminated CTC, irrespective of the HER2 status of the primary tumor and of CTC and this was associated with reduced relapses(Georgoulias et al Ann Oncol 2012).
Trial Design:
Treat CTC trial is a multicenter European randomized phase II trial, sponsored by the EORTC and run under the BIG umbrella. It will assess the efficacy of trastuzumab in eliminating persisting CTC after the completion of (neo)adjuvant chemotherapy and surgery in patients with HER-2-negative EBC. Eligible patients will be randomized in a 1:1 ratio to either 6 cycles of trastuzumab or observation. Patients’ peripheral blood will be tested again for CTC after 18 weeks.
Main Eligibility criteria:
- Adequately excised HER2-negative EBC
- Evidence of CTC detection using the CellSearch technology after completion of (neo)adjuvant chemotherapy
- Completion of adjuvant chemotherapy for node-positive disease or neoadjuvant chemotherapy with residual invasive disease in breast or lymph nodes (no complete pathological response)
- Histological Grade > 1 and primary tumor size > 1 cm
Specific aims:
The primaryobjective of the trial is to evaluate whether trastuzumab decreases the detection rate of CTC in patients with HER2-negative EBC by comparing the trastuzumab treated arm to the observation arm. Furthermore, clinical outcomes as measured by Recurrence Free Interval (RFI), Invasive Disease Free Survival (IDFS), Disease Free Survival (DFS) and Overall Survival (OS)) between the trastuzumab and observation arms will be compared.
Present accrual and target accrual:
Treat CTC started patient screening in April 2013 in Belgium. It is estimated that 2175 women will be registered to include 174 patients eligible for randomization. Accrual is expected to be completed in 2 years.
Methods:
The primary test will be a one-sided test to compare the trastuzumab arm to the observation arm for the CTC detection rate at week 18 (superiority test). The comparison for the primary endpoint will be performed on the intention-to-treat population using a one-sided test with overall a of 0.1. The odds ratio and its confidence interval will be estimated using a logistic regression model. The comparison of RFI, IDFS, DFS and OS will be done using a two-sided test in a proportional hazards model for cause specific hazard, adjusted for the stratification factors.
Perspectives:
Given the prognostic relevance of CTC in BC, the Treat CTC trial will be the first multicenter, randomized trial in which CTC are used to guide treatment decisions in EBC. The results of this trial will help to clarify the clinical utility of CTCs in early disease.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr OT1-3-02.
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Affiliation(s)
- B Rack
- Ludwig-Maximilians-University, Munich, Germany; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Kaiser Franz Josef Spital, Vienna, Austria; University General Hospital Heraklion, Heraklion, Greece; Oxford University Hospitals NHS Trust - Churchill Hospital, Oxford, United Kingdom; Institut Curie, Paris, France; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - C Messina
- Ludwig-Maximilians-University, Munich, Germany; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Kaiser Franz Josef Spital, Vienna, Austria; University General Hospital Heraklion, Heraklion, Greece; Oxford University Hospitals NHS Trust - Churchill Hospital, Oxford, United Kingdom; Institut Curie, Paris, France; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - S Litiere
- Ludwig-Maximilians-University, Munich, Germany; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Kaiser Franz Josef Spital, Vienna, Austria; University General Hospital Heraklion, Heraklion, Greece; Oxford University Hospitals NHS Trust - Churchill Hospital, Oxford, United Kingdom; Institut Curie, Paris, France; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - C Dittrich
- Ludwig-Maximilians-University, Munich, Germany; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Kaiser Franz Josef Spital, Vienna, Austria; University General Hospital Heraklion, Heraklion, Greece; Oxford University Hospitals NHS Trust - Churchill Hospital, Oxford, United Kingdom; Institut Curie, Paris, France; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - D Mavroudis
- Ludwig-Maximilians-University, Munich, Germany; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Kaiser Franz Josef Spital, Vienna, Austria; University General Hospital Heraklion, Heraklion, Greece; Oxford University Hospitals NHS Trust - Churchill Hospital, Oxford, United Kingdom; Institut Curie, Paris, France; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - A Kong
- Ludwig-Maximilians-University, Munich, Germany; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Kaiser Franz Josef Spital, Vienna, Austria; University General Hospital Heraklion, Heraklion, Greece; Oxford University Hospitals NHS Trust - Churchill Hospital, Oxford, United Kingdom; Institut Curie, Paris, France; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - C Sotiriou
- Ludwig-Maximilians-University, Munich, Germany; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Kaiser Franz Josef Spital, Vienna, Austria; University General Hospital Heraklion, Heraklion, Greece; Oxford University Hospitals NHS Trust - Churchill Hospital, Oxford, United Kingdom; Institut Curie, Paris, France; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - J-Y Pierga
- Ludwig-Maximilians-University, Munich, Germany; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Kaiser Franz Josef Spital, Vienna, Austria; University General Hospital Heraklion, Heraklion, Greece; Oxford University Hospitals NHS Trust - Churchill Hospital, Oxford, United Kingdom; Institut Curie, Paris, France; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - M Piccart
- Ludwig-Maximilians-University, Munich, Germany; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Kaiser Franz Josef Spital, Vienna, Austria; University General Hospital Heraklion, Heraklion, Greece; Oxford University Hospitals NHS Trust - Churchill Hospital, Oxford, United Kingdom; Institut Curie, Paris, France; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - M Ignatiadis
- Ludwig-Maximilians-University, Munich, Germany; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Kaiser Franz Josef Spital, Vienna, Austria; University General Hospital Heraklion, Heraklion, Greece; Oxford University Hospitals NHS Trust - Churchill Hospital, Oxford, United Kingdom; Institut Curie, Paris, France; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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Affiliation(s)
| | - A Kong
- University of Central Florida
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Abbenhardt C, McTiernan A, Alfano CM, Wener MH, Campbell KL, Duggan C, Foster-Schubert KE, Kong A, Toriola AT, Potter JD, Mason C, Xiao L, Blackburn GL, Bain C, Ulrich CM. Effects of individual and combined dietary weight loss and exercise interventions in postmenopausal women on adiponectin and leptin levels. J Intern Med 2013; 274:163-75. [PMID: 23432360 PMCID: PMC3738194 DOI: 10.1111/joim.12062] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Excess body weight and a sedentary lifestyle are associated with the development of several diseases, including cardiovascular disease, diabetes and cancer in women. One proposed mechanism linking obesity to chronic diseases is an alteration in adipose-derived adiponectin and leptin levels. We investigated the effects of 12-month reduced calorie, weight loss and exercise interventions on adiponectin and leptin concentrations. METHODS Overweight/obese postmenopausal women (n = 439) were randomized as follows: (i) a reduced calorie, weight-loss diet (diet; N = 118), (ii) moderate-to-vigorous intensity aerobic exercise (exercise; N = 117), (iii) a combination of a reduced calorie, weight-loss diet and moderate-to-vigorous intensity aerobic exercise (diet + exercise; N = 117), and (iv) control (N = 87). The reduced calorie diet had a 10% weight-loss goal. The exercise intervention consisted of 45 min of moderate-to-vigorous aerobic activity 5 days per week. Adiponectin and leptin levels were measured at baseline and after 12 months of intervention using a radioimmunoassay. RESULTS Adiponectin increased by 9.5% in the diet group and 6.6% in the diet + exercise group (both P ≤ 0.0001 vs. control). Compared with controls, leptin decreased with all interventions (diet + exercise, -40.1%, P < 0.0001; diet, -27.1%, P < 0.0001; exercise, -12.7%, P = 0.005). The results were not influenced by the baseline body mass index (BMI). The degree of weight loss was inversely associated with concentrations of adiponectin (diet, P-trend = 0.0002; diet + exercise, P-trend = 0.0005) and directly associated with leptin (diet, P-trend < 0.0001; diet + exercise, P-trend < 0.0001). CONCLUSION Weight loss through diet or diet + exercise increased adiponectin concentrations. Leptin concentrations decreased in all of the intervention groups, but the greatest reduction occurred with diet + exercise. Weight loss and exercise exerted some beneficial effects on chronic diseases via effects on adiponectin and leptin.
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Affiliation(s)
- C Abbenhardt
- Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany
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Chen SH, Lei M, Xie XH, Zheng LZ, Yao D, Wang XL, Li W, Zhao Z, Kong A, Xiao DM, Wang DP, Pan XH, Wang YX, Qin L. PLGA/TCP composite scaffold incorporating bioactive phytomolecule icaritin for enhancement of bone defect repair in rabbits. Acta Biomater 2013; 9:6711-22. [PMID: 23376238 DOI: 10.1016/j.actbio.2013.01.024] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 01/22/2013] [Accepted: 01/23/2013] [Indexed: 12/18/2022]
Abstract
Bone defect repair is challenging in orthopaedic clinics. For treatment of large bone defects, bone grafting remains the method of choice for the majority of surgeons, as it fills spaces and provides support to enhance biological bone repair. As therapeutic agents are desirable for enhancing bone healing, this study was designed to develop such a bioactive composite scaffold (PLGA/TCP/ICT) made of polylactide-co-glycolide (PLGA) and tricalcium phosphate (TCP) as a basic carrier, incorporating a phytomolecule icaritin (ICT), i.e., a novel osteogenic exogenous growth factor. PLGA/TCP/ICT scaffolds were fabricated as PLGA/TCP (control group) and PLGA/TCP in tandem with low/mid/high-dose ICT (LICT/MICT/HICT groups, respectively). To evaluate the in vivo osteogenic and angiogenic potentials of these bioactive scaffolds with slow release of osteogenic ICT, the authors established a 12 mm ulnar bone defect model in rabbits. X-ray and high-resolution peripheral quantitative computed tomography results at weeks 2, 4 and 8 post-surgery showed more newly formed bone within bone defects implanted with PLGA/TCP/ICT scaffolds, especially PLGA/TCP/MICT scaffold. Histological results at weeks 4 and 8 also demonstrated more newly mineralized bone in PLGA/TCP/ICT groups, especially in the PLGA/TCP/MICT group, with correspondingly more new vessel ingrowth. These findings may form a good foundation for potential clinical validation of this innovative bioactive scaffold incorporated with the proper amount of osteopromotive phytomolecule ICT as a ready product for clinical applications.
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Affiliation(s)
- S-H Chen
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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Nafi SM, Kong A, Gijsen M, Kramer-Marek G, Capala J. 415 Investigating the Role of HER4 in Relation to Trastuzumab Treatment and Resistance in HER2 Positive Breast Cancer. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72213-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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