Human cysteine dioxygenase type I (CDO-I; EC 1.13.11.20): 5' flanking region and intron-exon structure of the gene

AIM

The elucidation of the structure of the 5' flanking region and the exonic organisation of the human cysteine dioxygenase type I gene.

METHODS

Material for sequence studies was generated by polymerase chain reaction (PCR) methods using human genomic DNA, a cosmid clone containing the entire gene, and a commercial gene walking kit.

RESULTS AND CONCLUSIONS

The gene was found to be--12 kb in length and made up of five exons (418, 78, 155, 170, and 731 base pairs, respectively). The immediate 5' flanking region did not contain the canonical TATAA box. One DNA source (Clontech promoter finder kit) contained a liver specific nuclear factor response element approximately 550 base pairs from the transcription start site, whereas a second source did not. This and other cis acting factors in the 5' flanking region were identified by computer analysis. The physiological significance of such elements requires detailed experimental evaluation.

The structure of the human thyroxine binding globulin (TBG) gene

A portion of the human X-chromosome (> 5 kb) encoding the translated portion of the thyroxine-binding globulin (TBG) gene was sequenced. The primary templates for sequencing were isolated from a human X-chromosome library (two positive plaques from 400,000 screened initially with a TBG cDNA probe) or were produced by PCR amplification using leucocyte genomic DNA as the amplification template. Potential hormone response elements (HREs) were identified at either end of the gene. These HREs have sequences based on the consensus half-site of thyroid hormone response elements, although it is unclear whether the structures are functional HREs. Other potential regulatory elements also were identified towards the 3' end of the gene.

The effects of ethanol, 3,5,3'-triiodothyronine (T3) and oestradiol (E2) on thyroid hormone nuclear receptor expression in human hepatocyte primary cultures

The possibility that ethanol regulated the expression of thyroid hormone receptor mRNA levels was explored in a model involving human hepatocyte primary culture. Ethanol (20, 50 and 100 mM for 24 h was found to have no effect on the steady-state levels of either triiodothyronine (T3) receptor alpha 1 or alpha 2 mRNAs. In contrast both T3 (1, 10 and 100 nM) and oestradiol (0.1, 1 and 10 ng/ml) treatments affected either one or both of these mRNA levels in a complex manner, showing that the model was capable of responding to other stimuli. Triiodothyronine receptor beta 1 mRNA was not assayed. The hypermetabolic effects of long-term ethanol consumption in humans appears not to be due to the direct effect of ethanol on the regulation of these receptors.

Feasibility of implementing a rapid-learning methodology to inform radiotherapy treatments: key professional stakeholders' views

Objective

Pragmatic methodologies, often termed rapid-learning, are being pursued that can match the pace of innovation in radiotherapy and generate evidence from the real-world treatment setting. It is important to understand the feasibility of implementing such pragmatic approaches before their application in practice. This study investigated key professional stakeholders' perceptions and opinions of rapid-learning and real-world data (RWD).

Methods and analysis

Twenty-three interviews were conducted with key professional stakeholders based across five UK radiotherapy cancer centres. Centres varied in size and reflected different healthcare environments. Data were collected between December 2022 and May 2023, and analysed using inductive thematic analysis.

Results

Four themes were generated: (1) the alignment of rapid-learning methodologies with the reality of practice, (2) concerns related to the variability of RWD, (3) the maturity of data infrastructures and capacity for rapid-learning and (4) further support, education and evidence needed to convince stakeholders to adopt rapid-learning approaches.

Conclusion

The potential of rapid-learning to help address evidence gaps in radiotherapy development was positively received by different professional stakeholders. However, the effectiveness of rapid-learning was viewed as being highly dependent on the collection of quality data in the routine setting, while the variable set-up at different cancer centres is also likely to be a key challenge for potential implementation. Developing data infrastructures to improve data interoperability was considered crucial for rapid-learning implementation, along with method clarity, educational support and training for radiotherapy teams.

Exploring Consent to Use Real-World Data in Lung Cancer Radiotherapy: Decision of a Citizens' Jury for an 'Informed Opt-Out' Approach

An emerging approach to complement randomised controlled trial (RCT) data in the development of radiotherapy treatments is to use routinely collected 'real-world' data (RWD). RWD is the data collected as standard-of-care about all patients during their usual cancer care pathway. Given the nature of this data, important questions remain about the permissibility and acceptability of using RWD in routine practice. We involved and engaged with patients, carers and the public in a two-day citizens' jury to understand their views and obtain decisions regarding two key issues: (1) preferred approaches to consent for the use of RWD within the context of patients receiving radiotherapy for lung cancer in RAPID-RT and (2) how RWD use should be best communicated to patients. Individual views were polled using questionnaires at various stages of the jury, whilst group discussion activities prompted further dialogue about the rationale behind choices of consent. Key decisions obtained from the jury include: (1) an opt-out approach to consent for the use of RWD; (2) the opt-out approach to consent should be informed. Furthermore, it was advised that information and communication regarding the consent process and use of RWD should be accessible, clear and available in a variety of formats. It is important that the consent process for patient data use is underpinned by principles of autonomy and transparency with clear channels of communication between those asking for and giving consent. Moreover, the process of seeking consent from patients should be proportionate to the risks presented from their participation.