1
|
Berlin M, Cantley J, Bookbinder M, Bortolon E, Broccatelli F, Cadelina G, Chan EW, Chen H, Chen X, Cheng Y, Cheung TK, Davenport K, DiNicola D, Gordon D, Hamman BD, Harbin A, Haskell R, He M, Hole AJ, Januario T, Kerry PS, Koenig SG, Li L, Merchant M, Pérez-Dorado I, Pizzano J, Quinn C, Rose CM, Rousseau E, Soto L, Staben LR, Sun H, Tian Q, Wang J, Wang W, Ye CS, Ye X, Zhang P, Zhou Y, Yauch R, Dragovich PS. PROTACs Targeting BRM (SMARCA2) Afford Selective In Vivo Degradation over BRG1 (SMARCA4) and Are Active in BRG1 Mutant Xenograft Tumor Models. J Med Chem 2024; 67:1262-1313. [PMID: 38180485 DOI: 10.1021/acs.jmedchem.3c01781] [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] [Indexed: 01/06/2024]
Abstract
The identification of VHL-binding proteolysis targeting chimeras (PROTACs) that potently degrade the BRM protein (also known as SMARCA2) in SW1573 cell-based experiments is described. These molecules exhibit between 10- and 100-fold degradation selectivity for BRM over the closely related paralog protein BRG1 (SMARCA4). They also selectively impair the proliferation of the H1944 "BRG1-mutant" NSCLC cell line, which lacks functional BRG1 protein and is thus highly dependent on BRM for growth, relative to the wild-type Calu6 line. In vivo experiments performed with a subset of compounds identified PROTACs that potently and selectively degraded BRM in the Calu6 and/or the HCC2302 BRG1 mutant NSCLC xenograft models and also afforded antitumor efficacy in the latter system. Subsequent PK/PD analysis established a need to achieve strong BRM degradation (>95%) in order to trigger meaningful antitumor activity in vivo. Intratumor quantitation of mRNA associated with two genes whose transcription was controlled by BRM (PLAU and KRT80) also supported this conclusion.
Collapse
Affiliation(s)
- Michael Berlin
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Jennifer Cantley
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Mark Bookbinder
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Elizabeth Bortolon
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Fabio Broccatelli
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Greg Cadelina
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Emily W Chan
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Huifen Chen
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Xin Chen
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Yunxing Cheng
- Pharmaron Beijing, Co. Ltd., 6 Tai He Road, BDA, Beijing 100176, P. R. China
| | - Tommy K Cheung
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Kim Davenport
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Dean DiNicola
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Debbie Gordon
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Brian D Hamman
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Alicia Harbin
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Roy Haskell
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Mingtao He
- Pharmaron Beijing, Co. Ltd., 6 Tai He Road, BDA, Beijing 100176, P. R. China
| | - Alison J Hole
- Evotec (U.K.) Ltd., 95 Park Drive, Milton Park, Abingdon, Oxfordshire OX14 4RY, U.K
| | - Thomas Januario
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Philip S Kerry
- Evotec (U.K.) Ltd., 95 Park Drive, Milton Park, Abingdon, Oxfordshire OX14 4RY, U.K
| | - Stefan G Koenig
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Limei Li
- Pharmaron Beijing, Co. Ltd., 6 Tai He Road, BDA, Beijing 100176, P. R. China
| | - Mark Merchant
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | | | - Jennifer Pizzano
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Connor Quinn
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Christopher M Rose
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Emma Rousseau
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Leofal Soto
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Leanna R Staben
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Hongming Sun
- Pharmaron Beijing, Co. Ltd., 6 Tai He Road, BDA, Beijing 100176, P. R. China
| | - Qingping Tian
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Jing Wang
- Arvinas LLC, 5 Science Park, New Haven, Connecticut 06511, United States
| | - Weifeng Wang
- Pharmaron Beijing, Co. Ltd., 6 Tai He Road, BDA, Beijing 100176, P. R. China
| | - Crystal S Ye
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Xiaofen Ye
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Penghong Zhang
- Pharmaron Beijing, Co. Ltd., 6 Tai He Road, BDA, Beijing 100176, P. R. China
| | - Yuhui Zhou
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Robert Yauch
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Peter S Dragovich
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| |
Collapse
|
2
|
Taylor AM, Williams BR, Giordanetto F, Kelley EH, Lescarbeau A, Shortsleeves K, Tang Y, Walters WP, Arrazate A, Bowman C, Brophy E, Chan EW, Deshmukh G, Greisman JB, Hunsaker TL, Kipp DR, Saenz Lopez-Larrocha P, Maddalo D, Martin IJ, Maragakis P, Merchant M, Murcko M, Nisonoff H, Nguyen V, Nguyen V, Orozco O, Owen C, Pierce L, Schmidt M, Shaw DE, Smith S, Therrien E, Tran JC, Watters J, Waters NJ, Wilbur J, Willmore L. Identification of GDC-1971 (RLY-1971), a SHP2 Inhibitor Designed for the Treatment of Solid Tumors. J Med Chem 2023; 66:13384-13399. [PMID: 37774359 DOI: 10.1021/acs.jmedchem.3c00483] [Citation(s) in RCA: 3] [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: 10/01/2023]
Abstract
Protein tyrosine phosphatase SHP2 mediates RAS-driven MAPK signaling and has emerged in recent years as a target of interest in oncology, both for treating with a single agent and in combination with a KRAS inhibitor. We were drawn to the pharmacological potential of SHP2 inhibition, especially following the initial observation that drug-like compounds could bind an allosteric site and enforce a closed, inactive state of the enzyme. Here, we describe the identification and characterization of GDC-1971 (formerly RLY-1971), a SHP2 inhibitor currently in clinical trials in combination with KRAS G12C inhibitor divarasib (GDC-6036) for the treatment of solid tumors driven by a KRAS G12C mutation.
Collapse
Affiliation(s)
- Alexander M Taylor
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Bret R Williams
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Fabrizio Giordanetto
- D. E. Shaw Research, 120 W. 45th St., 39th Fl., New York, New York 10036, United States
| | - Elizabeth H Kelley
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - André Lescarbeau
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Kelley Shortsleeves
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Yong Tang
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - W Patrick Walters
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Alfonso Arrazate
- Genentech, Inc., 1 DNA Way Mailstop 258A, South San Francisco, California 94080-4990, United States
| | - Christine Bowman
- Genentech, Inc., 1 DNA Way Mailstop 258A, South San Francisco, California 94080-4990, United States
| | - Erin Brophy
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Emily W Chan
- Genentech, Inc., 1 DNA Way Mailstop 258A, South San Francisco, California 94080-4990, United States
| | - Gauri Deshmukh
- Genentech, Inc., 1 DNA Way Mailstop 258A, South San Francisco, California 94080-4990, United States
| | - Jack B Greisman
- D. E. Shaw Research, 120 W. 45th St., 39th Fl., New York, New York 10036, United States
| | - Thomas L Hunsaker
- Genentech, Inc., 1 DNA Way Mailstop 258A, South San Francisco, California 94080-4990, United States
| | - D Randal Kipp
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | | | - Danilo Maddalo
- Genentech, Inc., 1 DNA Way Mailstop 258A, South San Francisco, California 94080-4990, United States
| | - Iain J Martin
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Paul Maragakis
- D. E. Shaw Research, 120 W. 45th St., 39th Fl., New York, New York 10036, United States
| | - Mark Merchant
- Genentech, Inc., 1 DNA Way Mailstop 258A, South San Francisco, California 94080-4990, United States
| | - Mark Murcko
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Hunter Nisonoff
- D. E. Shaw Research, 120 W. 45th St., 39th Fl., New York, New York 10036, United States
| | - Vi Nguyen
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Vy Nguyen
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Olivia Orozco
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Christopher Owen
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Levi Pierce
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Molly Schmidt
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - David E Shaw
- D. E. Shaw Research, 120 W. 45th St., 39th Fl., New York, New York 10036, United States
- Department of Biochemistry and Molecular Biophysics, Columbia University, 701 West 168th St., New York, New York 10032, United States
| | - Sherri Smith
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Eric Therrien
- Schrödinger, Inc., 1540 Broadway, 24th Floor, New York, New York 10036, United States
| | - John C Tran
- Genentech, Inc., 1 DNA Way Mailstop 258A, South San Francisco, California 94080-4990, United States
| | - Jim Watters
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Nigel J Waters
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Jeremy Wilbur
- Relay Therapeutics, Inc., 399 Binney St., Cambridge,, Massachusetts 02139, United States
| | - Lindsay Willmore
- D. E. Shaw Research, 120 W. 45th St., 39th Fl., New York, New York 10036, United States
| |
Collapse
|
3
|
Gao L, Man KKC, Tse ML, Chow ATY, Wong KHTW, Chan EW, Chui CSL, Coghill D, Hon KL, Ip P, Wong ICK. Descriptive analysis of poisoning cases involving attention deficit hyperactivity disorder medications in Hong Kong. Hong Kong Med J 2023. [PMID: 37303104 DOI: 10.12809/hkmj219624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Abstract
INTRODUCTION The number of poisoning cases involving attention deficit hyperactivity disorder (ADHD) medications has reportedly risen with their increased use. However, there is limited relevant evidence from Asia. We analysed the characteristics of poisoning events involving these medications in Hong Kong. METHODS We retrieved data regarding ADHD medication-related poisoning cases from the Hong Kong Poison Information Centre and conducted a descriptive analysis of the demographic information and poisoning information including sources of cases, exposure reason, exposure location, and outcome. The HKPIC data were linked with the Hospital Authority Clinical Data Analysis and Reporting System (CDARS) via de-identified Accident and Emergency numbers of public hospitals to investigate clinical characteristics. We also retrieved ADHD medication prescription records from the CDARS, then compared trends between poisoning cases and ADHD medication use. RESULTS We identified 72 poisoning cases involving ADHD medications between 2009 and 2019, of which approximately 70% occurred in the affected individual's residence; most were intentional poisoning events (65.3%). No statistically significant association was observed between ADHD medication prescription trends and poisoning events involving ADHD medications. Of the 66 cases (91.7%) successfully linked to CDARS, 40 (60.6%) occurred in individuals with ADHD (median age: 14 years); 26 (39.4%) occurred in individuals who lacked ADHD (median age: 33 years) but displayed higher rates of other mental disorders including depression and anxiety. CONCLUSION No significant correlation was evident between ADHD medication prescriptions and poisoning events involving ADHD medications. However, medication management and caregiver education must be emphasised to prevent potential poisoning events.
Collapse
Affiliation(s)
- L Gao
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - K K C Man
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Centre for Medicines Optimisation Research and Education, Research Department of Policy and Practice, University College London School of Pharmacy, London, United Kingdom
| | - M L Tse
- Hong Kong Poison Information Centre, United Christian Hospital, Hong Kong SAR, China
| | - A T Y Chow
- Hong Kong Poison Information Centre, United Christian Hospital, Hong Kong SAR, China
| | - K H T W Wong
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - E W Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - C S L Chui
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - D Coghill
- Department of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - K L Hon
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - P Ip
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - I C K Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Centre for Medicines Optimisation Research and Education, Research Department of Policy and Practice, University College London School of Pharmacy, London, United Kingdom
| |
Collapse
|
4
|
Meng L, Chan EW, Ng C, Aimi J, Tran JC, Oh AJ, Merchant M, Purkey HE, Heffron TP, Kaur S, Xu K, Shi Z, He J. Assessment of KRAS G12C Target Engagement by a Covalent Inhibitor in Tumor Biopsies Using an Ultra-Sensitive Immunoaffinity 2D-LC-MS/MS Approach. Anal Chem 2022; 94:12927-12933. [PMID: 36083155 DOI: 10.1021/acs.analchem.2c03146] [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: 11/28/2022]
Abstract
KRAS is one of the most frequently mutated oncogenes, with KRAS G12C recently becoming an actionable target for small molecule intervention. GDC-6036 is an investigational KRAS G12C inhibitor that acts by irreversibly binding to the switch II pocket of KRAS G12C when in the inactive GDP-bound state, thereby blocking GTP binding and activation. Assessing target engagement is an essential component of clinical drug development, helping to demonstrate mechanistic activity, guide dose selection, understand pharmacodynamics as it relates to clinical response, and explore resistance. Here, we report the development of an ultra-sensitive approach for assessing KRAS G12C engagement. Immunoaffinity enrichment with a commercially available anti-RAS antibody was combined with a targeted 2D-LC-MS/MS technique to quantify both free and GDC-6036-bound KRAS G12C proteins. A KRAS G12C-positive non-small cell lung cancer xenograft model was dosed with GDC-6036 to assess the feasibility of this assay for analyzing small core needle biopsies. As predicted, dose-dependent KRAS G12C engagement was observed. To date, a sensitivity of 0.08 fmol/μg of total protein has been achieved for both free and GDC-6036-bound KRAS G12C with as little as 4 μg of total protein extracted from human tumor samples. This sub-fmol/μg level of sensitivity provides a powerful potential approach to assess covalent inhibitor target engagement at the site of action using core needle tumor biopsies from clinical studies.
Collapse
Affiliation(s)
- Lingyao Meng
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Emily W Chan
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Carl Ng
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Junko Aimi
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - John C Tran
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Angela J Oh
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Mark Merchant
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Hans E Purkey
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Timothy P Heffron
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Surinder Kaur
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Keyang Xu
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Zhen Shi
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Jintang He
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| |
Collapse
|
5
|
Chan EW, Chaulk RC, Cheng Y, Shin J. No decrease in incidence of arthroscopic meniscectomy in a Canadian province. Knee Surg Sports Traumatol Arthrosc 2021; 29:4223-4231. [PMID: 33745007 DOI: 10.1007/s00167-021-06534-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/09/2021] [Indexed: 01/05/2023]
Abstract
PURPOSE Arthroscopic meniscectomy (APM) is the most common procedure in orthopedic surgery, despite increasing evidence questioning its benefit over conservative management for treatment of degenerative meniscal tears. The purpose of this study is to determine the epidemiology and trends of APM in Saskatchewan, a Canadian province, over a 20 year period. METHODS Physician billing codes were used to identify patients who underwent APM in Saskatchewan between January 1, 1998 and December 31, 2017. Records were obtained from eHealth Saskatchewan, a provincial health database. Data was analyzed for overall incidence and age-specific trends of APM. RESULTS A total of 35,099 APMs were performed during the study period. The population of Saskatchewan ranged from 992,314 to 1,150,782 (median 1,017,368) during this time interval, with 81 orthopedic surgeons performing APM. Overall incidence rate of APM did not change significantly over time. No decrease was observed in patients presumed to have degenerative tears (≥ 50 years). The number of meniscectomies in patients ≥ 50 years was significantly greater during the second decade of study compared to the first (OR 1.48, p < 0.01). Conversely, the increase in incidence rate among older patients was not statistically significant (R2 = 0.125, n.s.). CONCLUSION Overall incidence rate of APM in Saskatchewan has not decreased during the last 20 years. Furthermore, APM frequency increased over time for individuals ≥ 50 years. Several regional factors may have contributed to these findings, including the large proportion of Saskatchewan residents engaged in physically demanding work and barriers to accessing physiotherapy services. Given recent evidence disputing the benefit of APM over conservative measures, this study highlights the need for improved dissemination of evidence, as well as the importance of an individualized treatment plan to address patient-specific factors. LEVEL OF EVIDENCE Level IV.
Collapse
Affiliation(s)
- Emily W Chan
- Department of Surgery, University of Saskatchewan College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada. .,Division of Orthopedic Surgery, University of Saskatchewan College of Medicine, Saskatoon, Canada.
| | - Richard C Chaulk
- Department of Surgery, University of Saskatchewan College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Yanzhao Cheng
- Department of Surgery, University of Saskatchewan College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Jason Shin
- Department of Surgery, University of Saskatchewan College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada.,Division of Orthopedic Surgery, University of Saskatchewan College of Medicine, Saskatoon, Canada.,Dr. F. H. Wigmore Regional Hospital, Moose Jaw, Canada
| |
Collapse
|
6
|
Shahid SM, Flores-Sánchez BC, Chan EW, Anguita R, Ahmed SN, Wickham L, Charteris DG. Scleral-fixated intraocular lens implants-evolution of surgical techniques and future developments. Eye (Lond) 2021; 35:2930-2961. [PMID: 34117388 PMCID: PMC8526814 DOI: 10.1038/s41433-021-01571-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 04/07/2021] [Accepted: 04/21/2021] [Indexed: 11/08/2022] Open
Abstract
Varied options are available for the implantation of secondary intraocular lens implants in the absence of zonular or capsular support. Loss of the capsule can occur in the context of complicated cataract surgery, trauma or inherited conditions such as Marfan syndrome or pseudoexfoliation. Approaches to overcome this include optical measures such as the use of spectacles or contact lenses, and surgical therapy incorporating the use of anterior chamber, iris-fixated or scleral-fixated lenses. Surgical techniques to implant scleral-fixated lenses have undergone various modifications, since the first publication of sutured intrascleral fixation described in the 1980s. However, despite the advances in surgical techniques, studies are limited either by their retrospective nature, small sample size and most importantly small duration of follow-up. This comprehensive review aims to amalgamate the evolution of various surgical techniques with regards to intrascleral lens fixation and suggests areas for future development.
Collapse
Affiliation(s)
- S M Shahid
- Vitreoretinal Service, Moorfields Eye Hospital, London, UK.
| | | | - E W Chan
- Vitreoretinal Service, Moorfields Eye Hospital, London, UK
| | - R Anguita
- Vitreoretinal Service, Moorfields Eye Hospital, London, UK
| | - S N Ahmed
- Ophthalmology Department, Northampton General Hospital, Cliftonville, Northampton, UK
| | - L Wickham
- Vitreoretinal Service, Moorfields Eye Hospital, London, UK
| | - D G Charteris
- Vitreoretinal Service, Moorfields Eye Hospital, London, UK
- UCL Institute of Ophthalmology, London, UK
| |
Collapse
|
7
|
Leung TYM, Chan AYL, Chan EW, Chan VKY, Chui CSL, Cowling BJ, Gao L, Ge MQ, Hung IFN, Ip MSM, Ip P, Lau KK, Lau CS, Lau LKW, Leung WK, Li X, Luo H, Man KKC, Ng VWS, Siu CW, Wan EYF, Wing YK, Wong CSM, Wong KHT, Wong ICK. Short- and potential long-term adverse health outcomes of COVID-19: a rapid review. Emerg Microbes Infect 2020; 9:2190-2199. [PMID: 32940572 PMCID: PMC7586446 DOI: 10.1080/22221751.2020.1825914] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has resulted in millions of patients
infected worldwide and indirectly affecting even more individuals through disruption of
daily living. Long-term adverse outcomes have been reported with similar diseases from
other coronaviruses, namely Middle East Respiratory Syndrome (MERS) and Severe Acute
Respiratory Syndrome (SARS). Emerging evidence suggests that COVID-19 adversely affects
different systems in the human body. This review summarizes the current evidence on the
short-term adverse health outcomes and assesses the risk of potential long-term adverse
outcomes of COVID-19. Major adverse outcomes were found to affect different body systems:
immune system (including but not limited to Guillain-Barré syndrome and paediatric
inflammatory multisystem syndrome), respiratory system (lung fibrosis and pulmonary
thromboembolism), cardiovascular system (cardiomyopathy and coagulopathy), neurological
system (sensory dysfunction and stroke), as well as cutaneous and gastrointestinal
manifestations, impaired hepatic and renal function. Mental health in patients with
COVID-19 was also found to be adversely affected. The burden of caring for COVID-19
survivors is likely to be huge. Therefore, it is important for policy makers to develop
comprehensive strategies in providing resources and capacity in the healthcare system.
Future epidemiological studies are needed to further investigate the long-term impact on
COVID-19 survivors.
Collapse
Affiliation(s)
- T Y M Leung
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - A Y L Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - E W Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - V K Y Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - C S L Chui
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Department of Social Work and Social Administration, Faculty of Social Science, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - B J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - L Gao
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - M Q Ge
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - I F N Hung
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - M S M Ip
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - P Ip
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - K K Lau
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - C S Lau
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - L K W Lau
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - W K Leung
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - X Li
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - H Luo
- Department of Social Work and Social Administration, Faculty of Social Science, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Department of Computer Science, Faculty of Engineering, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - K K C Man
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
| | - V W S Ng
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - C W Siu
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - E Y F Wan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Department of Family Medicine and Primary Care, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Y K Wing
- Department of Psychiatry, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - C S M Wong
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Department of Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - K H T Wong
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - I C K Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
| |
Collapse
|
8
|
Chotai S, Chan EW, Ladner TR, Hale AT, Gannon SR, Shannon CN, Bonfield CM, Naftel RP, Wellons JC. Timing of syrinx reduction and stabilization after posterior fossa decompression for pediatric Chiari malformation type I. J Neurosurg Pediatr 2020; 26:193-199. [PMID: 32330878 DOI: 10.3171/2020.2.peds19366] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 02/18/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to determine the timeline of syrinx regression and to identify factors mitigating syrinx resolution in pediatric patients with Chiari malformation type I (CM-I) undergoing posterior fossa decompression (PFD). METHODS The authors conducted a retrospective review of records from pediatric patients (< 18 years old) undergoing PFD for the treatment of CM-I/syringomyelia (SM) between 1998 and 2015. Patient demographic, clinical, radiological, and surgical variables were collected and analyzed. Radiological information was reviewed at 4 time points: 1) pre-PFD, 2) within 6 months post-PFD, 3) within 12 months post-PFD, and 4) at maximum available follow-up. Syrinx regression was defined as ≥ 50% decrease in the maximal anteroposterior syrinx diameter (MSD). The time to syrinx regression was determined using Kaplan-Meier analysis. Multivariate analysis was conducted using a Cox proportional hazards model to determine the association between preoperative, clinical, and surgery-related factors and syrinx regression. RESULTS The authors identified 85 patients with CM-I/SM who underwent PFD. Within 3 months post-PFD, the mean MSD regressed from 8.1 ± 3.4 mm (preoperatively) to 5.6 ± 2.9 mm within 3 months post-PFD. Seventy patients (82.4%) achieved ≥ 50% regression in MSD. The median time to ≥ 50% regression in MSD was 8 months (95% CI 4.2-11.8 months). Using a risk-adjusted multivariable Cox proportional hazards model, the patients who underwent tonsil coagulation (n = 20) had a higher likelihood of achieving ≥ 50% syrinx regression in a shorter time (HR 2.86, 95% CI 1.2-6.9; p = 0.02). Thirty-six (75%) of 45 patients had improvement in headache at 2.9 months (IQR 1.5-4.4 months). CONCLUSIONS The maximum reduction in syrinx size can be expected within 3 months after PFD for patients with CM-I and a syrinx; however, the syringes continue to regress over time. Tonsil coagulation was associated with early syrinx regression in this cohort. However, the role of surgical maneuvers such as tonsil coagulation and arachnoid veil identification and sectioning in the overall role of CM-I surgery remains unclear.
Collapse
Affiliation(s)
- Silky Chotai
- 1Department of Neurosurgery, Vanderbilt University Medical Center.,2Surgical Outcomes Center for Kids (SOCKs), Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Emily W Chan
- 2Surgical Outcomes Center for Kids (SOCKs), Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Travis R Ladner
- 2Surgical Outcomes Center for Kids (SOCKs), Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee.,3Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York; and
| | - Andrew T Hale
- 2Surgical Outcomes Center for Kids (SOCKs), Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Stephen R Gannon
- 2Surgical Outcomes Center for Kids (SOCKs), Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Chevis N Shannon
- 1Department of Neurosurgery, Vanderbilt University Medical Center.,2Surgical Outcomes Center for Kids (SOCKs), Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee.,4Division of Pediatric Neurosurgery, Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Christopher M Bonfield
- 1Department of Neurosurgery, Vanderbilt University Medical Center.,2Surgical Outcomes Center for Kids (SOCKs), Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee.,4Division of Pediatric Neurosurgery, Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Robert P Naftel
- 1Department of Neurosurgery, Vanderbilt University Medical Center.,2Surgical Outcomes Center for Kids (SOCKs), Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee.,4Division of Pediatric Neurosurgery, Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee
| | - John C Wellons
- 1Department of Neurosurgery, Vanderbilt University Medical Center.,2Surgical Outcomes Center for Kids (SOCKs), Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee.,4Division of Pediatric Neurosurgery, Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee
| |
Collapse
|
9
|
Abblitt WP, Chan EW, Shinar AA. Risk of Periprosthetic Joint Infection in Patients With Multiple Arthroplasties. J Arthroplasty 2018; 33:840-843. [PMID: 29129616 DOI: 10.1016/j.arth.2017.10.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 10/04/2017] [Accepted: 10/15/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Risk of subsequent periprosthetic joint infection (PJI) in a second prosthetic joint following initial PJI has been shown to be 19%-20%. We sought to identify (1) the risk of developing a second PJI for our patients with multiple prosthetic joints and (2) the effect of bacteremia on development of a subsequent PJI. METHODS We retrospectively reviewed all patients treated surgically for PJI by a single surgeon from 2003 to 2014. Time between initial and subsequent infection, bacteremia, and risk factors for PJI were identified. RESULTS Of 167 patients treated for PJI, 76 had multiple prosthetic joints. Thirteen percent (10/76) developed a PJI in a second location. Excluding simultaneous infections, the rate was 8.3% (6/72), despite having a 57% incidence of immunosuppression, diabetes, renal failure, smoking, or steroid use. Average follow-up for patients with 1 PJI was 4.6 years (range 0.03-13.6). Seventy percent (7/10) of patients with multiple infections were bacteremic at the time of initial infection compared to 18.1% (12/66) of patients with a single infection (P = .0004). Excluding the 4 simultaneous infections (all bacteremic), the risk of developing an infection in a second joint was 20% if bacteremic and 5.2% if not bacteremic. CONCLUSION Our study identified the risk of developing a subsequent PJI to be one half of previous studies. Bacteremia at the time of PJI is an important factor for developing subsequent PJI. Multiple prosthetic joints may be less hazardous than previously thought for patients with PJI suggesting that suppressive antibiotics may only be necessary in cases with bacteremia.
Collapse
Affiliation(s)
- W Parker Abblitt
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Medical Center East, Nashville, Tennessee
| | - Emily W Chan
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Medical Center East, Nashville, Tennessee
| | - Andrew A Shinar
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Medical Center East, Nashville, Tennessee
| |
Collapse
|
10
|
Chotai S, Guidry BS, Chan EW, Sborov KD, Gannon S, Shannon C, Bonfield CM, Wellons JC, Naftel RP. Unplanned readmission within 90 days after pediatric neurosurgery. J Neurosurg Pediatr 2017; 20:542-548. [PMID: 29027867 DOI: 10.3171/2017.6.peds17117] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Readmission and return to operating room after surgery are increasingly being used as a proxy for quality of care. Nearly 60% of these readmissions are unplanned, which translates into billions of dollars in health care costs. The authors set out to analyze the incidence of readmission at their center, to define causes of unplanned readmission, and to determine the preoperative and surgical variables associated with readmissions following pediatric neurosurgery. METHODS A total of 536 children who underwent operations for neurosurgical diagnoses between 2012 and 2015 and who were later readmitted were included in the final analysis. Unplanned readmissions were defined to have occurred as a result of complications within 90 days after index surgery. Patient records were retrospectively reviewed to determine the primary diagnosis, surgery indication, and cause of readmission and return to operating room. The cost for index hospitalization, readmission episode, and total cost were derived based on the charges obtained from administrative data. Bivariate and multivariable analyses were conducted. RESULTS Of 536 patients readmitted in total, 17.9% (n = 96) were readmitted within 90 days. Of the overall readmissions, 11.9% (n = 64) were readmitted within 30 days, and 5.97% (n = 32) were readmitted between 31 and 90 days. The median duration between discharge and readmission was 20 days (first quartile [Q1]: 9 days, third quartile [Q3]: 36 days). The most common reason for readmission was shunt related (8.2%, n = 44), followed by wound infection (4.7%, n = 25). In the risk-adjusted multivariable logistic regression model for total 90-day readmission, patients with the following characteristics: younger age (p = 0.001, OR 0.886, 95% CI 0.824-0.952); "other" (nonwhite, nonblack) race (p = 0.024, OR 5.49, 95% CI 1.246-24.2); and those born preterm (p = 0.032, OR 2.1, 95% CI 1.1-4.12) had higher odds of being readmitted within 90 days after discharge. The total median cost for patients undergoing surgery in this study cohort was $11,520 (Q1: $7103, Q3: $19,264). For the patients who were readmitted, the median cost for a readmission episode was $8981 (Q1: $5051, Q3: $18,713). CONCLUSIONS Unplanned 90-day readmissions in pediatric neurosurgery are primarily due to CSF-related complications. Patients with the following characteristics: young age at presentation; "other" race; and children born preterm have a higher likelihood of being readmitted within 90 days after surgery. The median cost was > $8000, which suggests that the readmission episode can be as expensive as the index hospitalization. Clearly, readmission reduction has the potential for significant cost savings in pediatric neurosurgery. Future efforts, such as targeted education related to complication signs, should be considered in the attempt to reduce unplanned events. Given the single-center, retrospective study design, the results of this study are primarily applicable to this population and cannot necessarily be generalized to other institutions without further study.
Collapse
|
11
|
Nasr A, Sullivan KJ, Chan EW, Wong CA, Benchimol EI. Validation of algorithms to determine incidence of Hirschsprung disease in Ontario, Canada: a population-based study using health administrative data. Clin Epidemiol 2017; 9:579-590. [PMID: 29180902 PMCID: PMC5695258 DOI: 10.2147/clep.s148890] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective Incidence rates of Hirschsprung disease (HD) vary by geographical region, yet no recent population-based estimate exists for Canada. The objective of our study was to validate and use health administrative data from Ontario, Canada to describe trends in incidence of HD between 1991 and 2013. Study design To identify children with HD we tested algorithms consisting of a combination of diagnostic, procedural, and intervention codes against the reference standard of abstracted clinical charts from a tertiary pediatric hospital. The algorithm with the highest positive predictive value (PPV) that could maintain high sensitivity was applied to health administrative data from April 31, 1991 to March 31, 2014 (fiscal years 1991–2013) to determine annual incidence. Temporal trends were evaluated using Poisson regression, controlling for sex as a covariate. Results The selected algorithm was highly sensitive (93.5%) and specific (>99.9%) with excellent predictive abilities (PPV 89.6% and negative predictive value >99.9%). Using the algorithm, a total of 679 patients diagnosed with HD were identified in Ontario between 1991 and 2013. The overall incidence during this time was 2.05 per 10,000 live births (or 1 in 4,868 live births). The incidence did not change significantly over time (odds ratio 0.998, 95% confidence interval 0.983–1.013, p = 0.80). Conclusion Ontario health administrative data can be used to accurately identify cases of HD and describe trends in incidence. There has not been a significant change in HD incidence over time in Ontario between 1991 and 2013.
Collapse
Affiliation(s)
- Ahmed Nasr
- Department of Pediatric Surgery, Children's Hospital of Eastern Ontario.,Faculty of Medicine, University of Ottawa
| | | | - Emily W Chan
- Department of Pediatric Surgery, Children's Hospital of Eastern Ontario
| | - Coralie A Wong
- Institute for Clinical Evaluative Science (ICES University of Ottawa)
| | - Eric I Benchimol
- Faculty of Medicine, University of Ottawa.,Institute for Clinical Evaluative Science (ICES University of Ottawa).,CHEO Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
12
|
Lau WCY, Li X, Wong ICK, Man KKC, Lip GYH, Leung WK, Siu CW, Chan EW. Bleeding-related hospital admissions and 30-day readmissions in patients with non-valvular atrial fibrillation treated with dabigatran versus warfarin. J Thromb Haemost 2017; 15:1923-1933. [PMID: 28748652 DOI: 10.1111/jth.13780] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 04/11/2017] [Indexed: 12/14/2022]
Abstract
Essentials Bleeding is a common cause of hospital admission and readmission in oral anticoagulant users. Patients with dabigatran and warfarin were included to assess hospital admission risk. Dabigatran users had a higher risk of 30-day readmission with bleeding than warfarin users. Close monitoring following hospital discharge for dabigatran-related bleeding is warranted. SUMMARY Background Reducing 30-day hospital readmission is a policy priority worldwide. Warfarin-related bleeding is among the most common cause of hospital admissions as a result of adverse drug events. Compared with warfarin, dabigatran achieves a full anticoagulation effect more quickly following its initiation; hence it may lead to early-onset bleeds. Objectives To compare the incidence of bleeding-related hospital admissions and 30-day readmissions with dabigatran vs. warfarin in patients with non-valvular atrial fibrillation (NVAF). Methods This was a retrospective cohort study using a population-wide database managed by the Hong Kong Hospital Authority. Patients newly diagnosed with NVAF from 2010 through to 2014 and prescribed dabigatran or warfarin were 1:1 matched by propensity score. The incidence rate of hospital admission with bleeding (a composite of gastrointestinal bleeding, intracranial hemorrhage and bleeding at other sites) was assessed. Results Among the 51 946 patients with NVAF, 8309 users of dabigatran or warfarin were identified, with 5160 patients matched by propensity score. The incidence of first hospitalized bleeding did not differ significantly between groups (incidence rate ratio, 0.92; 95% confidence interval [CI], 0.66-1.28). Among patients who were continuously prescribed their initial anticoagulants upon discharge, dabigatran use was associated with a higher risk of 30-day readmission with bleeding over warfarin (adjusted hazard ratio, 2.87; 95%CI, 1.10-7.43). Conclusion When compared with warfarin, dabigatran was associated with a comparable incidence of first hospital admission but a higher risk of 30-day redmission with respect to bleeding. Close early monitoring of patients initiated on dabigatran following hospital discharge for bleeding is warranted.
Collapse
Affiliation(s)
- W C Y Lau
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - X Li
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - I C K Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
| | - K K C Man
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - G Y H Lip
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
- Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - W K Leung
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - C W Siu
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - E W Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| |
Collapse
|
13
|
Chan EW, Gannon SR, Shannon CN, Martus JE, Mencio GA, Bonfield CM. The impact of curve severity on obstetric complications and regional anesthesia utilization in pregnant patients with adolescent idiopathic scoliosis: a preliminary analysis. Neurosurg Focus 2017; 43:E4. [DOI: 10.3171/2017.7.focus17321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVEAdolescent idiopathic scoliosis (AIS), the most common type of scoliosis, often presents immediately prior to a woman’s childbearing years; however, research investigating the impact of AIS on women’s health, particularly pregnancy delivery outcomes, is sparse, with existing literature reporting mixed findings. Similarly limited are studies examining the change in scoliotic curve during or after pregnancy. Therefore, this study aims to determine 1) the impact of scoliotic curvature on obstetric complications (preterm births, induction of labor, and urgent/emergency caesarean section delivery), 2) regional anesthetic decision making and success during delivery for these patients, and 3) the effect of pregnancy on curve progression.METHODSRecords of all pregnant patients diagnosed with AIS at the authors’ institution who delivered between January 2002 and September 2016 were retrospectively reviewed. Demographic information, pre- and postpartum radiographic Cobb angles, and clinical data for each pregnancy and delivery were recorded and analyzed. The Wilcoxon rank-sum test and the Wilcoxon signed-rank test were used for statistical analyses.RESULTSFifty-nine patients (84 deliveries) were included; 14 patients had undergone prior posterior spinal fusion. The median age at AIS diagnosis was 15.2 years, and the median age at delivery was 21.8 years. Overall, the median major Cobb angle prior to the first pregnancy was 25° (IQR 15°–40°). Most births were by spontaneous vaginal delivery (n = 45; 54%); elective caesarean section was performed in 17 deliveries (20%). Obstetric complications included preterm birth (n = 18; 21.4%), induction of labor (n = 20; 23.8%), and urgent/emergency caesarean section (n = 12; 14.0%); none were associated with severity of scoliosis curve or prior spinal fusion. Attempts at spinal anesthesia were successful 99% of the time (70/71 deliveries), even among the patients who had undergone prior spinal fusion (n = 13). There were only 3 instances of provider refusal to administer spinal anesthesia. In the subset of 11 patients who underwent postpartum scoliosis radiography, there was no statistically significant change in curve magnitude either during or immediately after pregnancy.CONCLUSIONSThe results of this study suggest that there was no effect of the severity of scoliosis on delivery complications or regional anesthetic decision making in pregnant patients with AIS. Moreover, scoliosis was not observed to progress significantly during or immediately after pregnancy. Larger prospective studies are needed to further investigate these outcomes, the findings of which can guide the prenatal education and counseling of pregnant patients with AIS.
Collapse
Affiliation(s)
- Emily W. Chan
- 1Surgical Outcomes Center for Kids, and
- 2Vanderbilt University School of Medicine, Nashville, Tennessee
| | | | | | | | | | - Christopher M. Bonfield
- 1Surgical Outcomes Center for Kids, and
- 4Neurological Surgery, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville; and
| |
Collapse
|
14
|
Romero FA, Murray J, Lai KW, Tsui V, Albrecht BK, An L, Beresini MH, de Leon Boenig G, Bronner SM, Chan EW, Chen KX, Chen Z, Choo EF, Clagg K, Clark K, Crawford TD, Cyr P, de Almeida Nagata D, Gascoigne KE, Grogan JL, Hatzivassiliou G, Huang W, Hunsaker TL, Kaufman S, Koenig SG, Li R, Li Y, Liang X, Liao J, Liu W, Ly J, Maher J, Masui C, Merchant M, Ran Y, Taylor AM, Wai J, Wang F, Wei X, Yu D, Zhu BY, Zhu X, Magnuson S. GNE-781, A Highly Advanced Potent and Selective Bromodomain Inhibitor of Cyclic Adenosine Monophosphate Response Element Binding Protein, Binding Protein (CBP). J Med Chem 2017; 60:9162-9183. [PMID: 28892380 DOI: 10.1021/acs.jmedchem.7b00796] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Inhibition of the bromodomain of the transcriptional regulator CBP/P300 is an especially interesting new therapeutic approach in oncology. We recently disclosed in vivo chemical tool 1 (GNE-272) for the bromodomain of CBP that was moderately potent and selective over BRD4(1). In pursuit of a more potent and selective CBP inhibitor, we used structure-based design. Constraining the aniline of 1 into a tetrahydroquinoline motif maintained potency and increased selectivity 2-fold. Structure-activity relationship studies coupled with further structure-based design targeting the LPF shelf, BC loop, and KAc regions allowed us to significantly increase potency and selectivity, resulting in the identification of non-CNS penetrant 19 (GNE-781, TR-FRET IC50 = 0.94 nM, BRET IC50 = 6.2 nM; BRD4(1) IC50 = 5100 nΜ) that maintained good in vivo PK properties in multiple species. Compound 19 displays antitumor activity in an AML tumor model and was also shown to decrease Foxp3 transcript levels in a dose dependent manner.
Collapse
Affiliation(s)
- F Anthony Romero
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Jeremy Murray
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Kwong Wah Lai
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Vickie Tsui
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Brian K Albrecht
- Constellation Pharmaceuticals, Inc. , 215 First Street, Suite 200, Cambridge, Massachusetts 02142, United States
| | - Le An
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Maureen H Beresini
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | | | - Sarah M Bronner
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Emily W Chan
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Kevin X Chen
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Zhongguo Chen
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Edna F Choo
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Kyle Clagg
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Kevin Clark
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Terry D Crawford
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Patrick Cyr
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | | | - Karen E Gascoigne
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Jane L Grogan
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | | | - Wei Huang
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Thomas L Hunsaker
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Susan Kaufman
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Stefan G Koenig
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Ruina Li
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Yingjie Li
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Xiaorong Liang
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Jiangpeng Liao
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Wenfeng Liu
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Justin Ly
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Jonathan Maher
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Colin Masui
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Mark Merchant
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Yingqing Ran
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Alexander M Taylor
- Constellation Pharmaceuticals, Inc. , 215 First Street, Suite 200, Cambridge, Massachusetts 02142, United States
| | - John Wai
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Fei Wang
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Xiaocang Wei
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Dong Yu
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Bing-Yan Zhu
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| | - Xiaoyu Zhu
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Steven Magnuson
- Genentech, Inc. , 1 DNA Way, South San Francisco, California 94080, United States
| |
Collapse
|
15
|
Shiller AM, Chan EW, Joung DJ, Redmond MC, Kessler JD. Light rare earth element depletion during Deepwater Horizon blowout methanotrophy. Sci Rep 2017; 7:10389. [PMID: 28871146 PMCID: PMC5583346 DOI: 10.1038/s41598-017-11060-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [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: 05/19/2017] [Accepted: 08/17/2017] [Indexed: 11/30/2022] Open
Abstract
Rare earth elements have generally not been thought to have a biological role. However, recent work has demonstrated that the light REEs (LREEs: La, Ce, Pr, and Nd) are essential for at least some methanotrophs, being co-factors in the XoxF type of methanol dehydrogenase (MDH). We show here that dissolved LREEs were significantly removed in a submerged plume of methane-rich water during the Deepwater Horizon (DWH) well blowout. Furthermore, incubation experiments conducted with naturally methane-enriched waters from hydrocarbon seeps in the vicinity of the DWH wellhead also showed LREE removal concurrent with methane consumption. Metagenomic sequencing of incubation samples revealed that LREE-containing MDHs were present. Our field and laboratory observations provide further insight into the biochemical pathways of methanotrophy during the DWH blowout. Additionally, our results are the first observations of direct biological alteration of REE distributions in oceanic systems. In view of the ubiquity of LREE-containing MDHs in oceanic systems, our results suggest that biological uptake of LREEs is an overlooked aspect of the oceanic geochemistry of this group of elements previously thought to be biologically inactive and an unresolved factor in the flux of methane, a potent greenhouse gas, from the ocean.
Collapse
Affiliation(s)
- A M Shiller
- Center for Trace Analysis, University of Southern Mississippi, Stennis Space Center, Mississippi, 39529, United States.
| | - E W Chan
- Earth and Environmental Sciences, University of Rochester, Rochester, NY, 14627, USA
| | - D J Joung
- Center for Trace Analysis, University of Southern Mississippi, Stennis Space Center, Mississippi, 39529, United States
| | - M C Redmond
- Department of Biological Sciences, University of North Carolina at Charlotte, Charlotte, NC, 28223, USA
| | - J D Kessler
- Earth and Environmental Sciences, University of Rochester, Rochester, NY, 14627, USA
| |
Collapse
|
16
|
Chung AY, Anand S, Wong IC, Tan KC, Wong CF, Chui WC, Chan EW. Improving medication safety and diabetes management in Hong Kong: a multidisciplinary approach. Hong Kong Med J 2017; 23:158-67. [PMID: 28302923 DOI: 10.12809/hkmj165014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Patients with diabetes often require complex medication regimens. The positive impact of pharmacists on improving diabetes management or its co-morbidities has been recognised worldwide. This study aimed to characterise drug-related problems among diabetic patients in Hong Kong and their clinical significance, and to explore the role of pharmacists in the multidisciplinary diabetes management team by evaluating the outcome of their clinical interventions. METHODS An observational study was conducted at the Diabetes Clinic of a public hospital in Hong Kong from October 2012 to March 2014. Following weekly screening, and prior to the doctor's consultation, selected high-risk patients were interviewed by a pharmacist for medication reconciliation and review. Drug-related problems were identified and documented by the pharmacist who presented clinical recommendations to doctors to optimise a patient's drug regimen and resolve or prevent potential drug-related problems. RESULTS A total of 522 patients were analysed and 417 drug-related problems were identified. The incidence of patients with drug-related problems was 62.8% with a mean of 0.9 (standard deviation, 0.6) drug-related problems per patient. The most common categories of drug-related problems were associated with dosing (43.9%), drug choice (17.3%), and non-allergic adverse reactions (15.6%). Drugs most frequently involved targeted the endocrine or cardiovascular system. The majority (71.9%) of drug-related problems were of moderate clinical significance and 28.1% were considered minor problems. Drug-related problems were totally solved (50.1%) and partially solved (11.0%) by doctors' acceptance of pharmacist recommendations, or received acknowledgement from doctors (5.5%). CONCLUSIONS Pharmacists, in collaboration with the multidisciplinary team, demonstrated a positive impact by identifying, resolving, and preventing drug-related problems in patients with diabetes. Further plans for sustaining pharmacy service in the Diabetes Clinic would enable further studies to explore the long-term impact of pharmacists in improving patients' clinical outcomes in diabetes management.
Collapse
Affiliation(s)
- A Ys Chung
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - S Anand
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - I Ck Wong
- Research Department of Practice and Policy, School of Pharmacy, University College London, United Kingdom
| | - K Cb Tan
- Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong
| | - C Ff Wong
- Department of Pharmacy, Queen Mary Hospital, Pokfulam, Hong Kong
| | - W Cm Chui
- Department of Pharmacy, Queen Mary Hospital, Pokfulam, Hong Kong
| | - E W Chan
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| |
Collapse
|
17
|
Wise ES, Gadomski SP, Ilg AM, Bermudez C, Chan EW, Izmaylov ML, Gridley SJ, Kaczmarek JV, Melancon NT, Ahmad S, Hocking KM, Diaz JJ, Kavic SM. Independent Preoperative Predictors of Prolonged Length of Stay after Laparoscopic Appendectomy in Patients over 30 Years of Age: Experience from a Single Institution. Am Surg 2016. [DOI: 10.1177/000313481608201124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Prompt discharge after laparoscopic appendectomy (LA) is a marker of quality of care, fiscally desirable and feasible in select patients. Patients over 30 comprise a more heterogeneous cohort known to experience worse outcomes after LA. We aimed to identify easily available preoperative risk factors portending a postoperative length of stay ≥2 days among patients above age 30. In this investigation, 296 included patients from a single institution who underwent LA for acute appendicitis from 2010 to 2014 were retrospectively reviewed for preoperative demographics, laboratory studies, comorbidities, presentation characteristics, radiographic finding, and other rationally selected factors for association with postoperative length of stay ≥2 days. Bivariate and multivariate analysis was conducted to determine independent risk factors, which were subsequently modeled via receiver-operating characteristic curve generation and Kaplan-Meier analysis. “Classic” presentation [odds ratio (OR) = 0.5, P = .02], elevated red cell distribution width (RDW; OR = 1.5/% increase, P = 0.004) as well as evidence of rupture on CT (OR = 6.9, P < 0.001) were independently associated with postoperative length of stay ≥ 2 days. Modeling length of stay using these factors generated an area under the curve of 0.713 ± 0.037. Kaplan-Meier analysis of “classic” presentation, elevated RDW, and evidence of rupture on CT through the fifth postoperative day generated log-rank P values of 0.02, 0.05, and ≤ 0.001, respectively. In summary, lack of “classic” presentation, elevated RDW, and CT evidence of rupture are novel risk factors for prolonged postoperative length of stay in LA patients over 30. These findings may help target patients most appropriate for prompt discharge.
Collapse
Affiliation(s)
- Eric S. Wise
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland
| | | | - Annette M. Ilg
- Vanderbilt University School of Medicine, Nashville Tennessee; and
| | - Camilo Bermudez
- Vanderbilt University School of Medicine, Nashville Tennessee; and
| | - Emily W. Chan
- Vanderbilt University School of Medicine, Nashville Tennessee; and
| | | | | | | | | | - Sarwat Ahmad
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland
| | - Kyle M. Hocking
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Jose J. Diaz
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland
| | - Stephen M. Kavic
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland
| |
Collapse
|
18
|
Man KKC, Coghill D, Chan EW, Lau WCY, Hollis C, Liddle E, Banaschewski T, McCarthy S, Neubert A, Sayal K, Ip P, Wong ICK. Methylphenidate and the risk of psychotic disorders and hallucinations in children and adolescents in a large health system. Transl Psychiatry 2016; 6:e956. [PMID: 27845780 PMCID: PMC5314128 DOI: 10.1038/tp.2016.216] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 08/07/2016] [Accepted: 08/24/2016] [Indexed: 12/11/2022] Open
Abstract
Previous studies have suggested that risk of psychotic events may be increased in children exposed to methylphenidate (MPH). However, this risk has not been fully examined, and the possibility of confounding factors has not been excluded. Patients aged 6-19 years who received at least one MPH prescription were identified using Hong Kong population-based electronic medical records on the Clinical Data Analysis and Reporting System (2001-2014). Using the self-controlled case series design, relative incidence of psychotic events was calculated comparing periods when patients were exposed to MPH with non-exposed periods. Of 20,586 patients prescribed MPH, 103 had an incident psychotic event; 72 (69.9%) were male and 31 (30.1%) female. The mean age at commencement of observation was 6.95 years and the mean follow-up per participant was 10.16 years. On average, each participant was exposed to MPH for 2.17 years. The overall incidence of psychotic events during the MPH exposure period was 6.14 per 10,000 patient-years. No increased risk was found during MPH-exposed compared with non-exposed periods (incidence rate ratio (IRR) 1.02 (0.53-1.97)). However, an increased risk was found during the pre-exposure period (IRR 4.64 (2.17-9.92)). Results were consistent across all sensitivity analyses. This study does not support the hypothesis that MPH increases risk of incident psychotic events. It does indicate an increased risk of psychotic events before the first prescription of MPH, which may be because of an association between psychotic events and the behavioural and attentional symptoms that led to psychiatric assessment and initiation of MPH treatment.
Collapse
Affiliation(s)
- K K C Man
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China,Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - D Coghill
- Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK,Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - E W Chan
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - W C Y Lau
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - C Hollis
- CANDAL (Centre for ADHD and Neuro-developmental Disorders across the Lifespan), Institute of Mental Health, Nottingham, UK,Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - E Liddle
- CANDAL (Centre for ADHD and Neuro-developmental Disorders across the Lifespan), Institute of Mental Health, Nottingham, UK,Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - T Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - S McCarthy
- School of Pharmacy, University College Cork, Cork, Ireland
| | - A Neubert
- Department of Paediatrics and Adolescents Medicine, University Hospital Erlangen, Erlangen, Germany
| | - K Sayal
- CANDAL (Centre for ADHD and Neuro-developmental Disorders across the Lifespan), Institute of Mental Health, Nottingham, UK,Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - P Ip
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - I C K Wong
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China,Centre for Paediatric Pharmacy Research, Research Department of Practice and Policy, UCL School of Pharmacy, London, UK,Centre for Paediatric Pharmacy Research, Research Department of Practice and Policy, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK. E-mail:
| |
Collapse
|
19
|
Wise ES, Gadomski SP, Ilg AM, Bermudez C, Chan EW, Izmaylov ML, Gridley SJ, Kaczmarek JV, Melancon SNT, Ahmad S, Hocking KM, Diaz JJ, Kavic SM. Independent Preoperative Predictors of Prolonged Length of Stay after Laparoscopic Appendectomy in Patients Over 30 Years of Age: Experience from a Single Institution. Am Surg 2016; 82:1092-1097. [PMID: 28206936] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Prompt discharge after laparoscopic appendectomy (LA) is a marker of quality of care, fiscally desirable and feasible in select patients. Patients over 30 comprise a more heterogeneous cohort known to experience worse outcomes after LA. We aimed to identify easily available preoperative risk factors portending a postoperative length of stay ≥2 days among patients above age 30. In this investigation, 296 included patients from a single institution who underwent LA for acute appendicitis from 2010 to 2014 were retrospectively reviewed for preoperative demographics, laboratory studies, comorbidities, presentation characteristics, radiographic finding, and other rationally selected factors for association with postoperative length of stay ≥2 days. Bivariate and multivariate analysis was conducted to determine independent risk factors, which were subsequently modeled via receiver-operating characteristic curve generation and Kaplan-Meier analysis. "Classic" presentation [odds ratio (OR) = 0.5, P = .02], elevated red cell distribution width (RDW; OR = 1.5/% increase, P = 0.004) as well as evidence of rupture on CT (OR = 6.9, P < 0.001) were independently associated with postoperative length of stay ≥ 2 days. Modeling length of stay using these factors generated an area under the curve of 0.713 ± 0.037. Kaplan-Meier analysis of "classic" presentation, elevated RDW, and evidence of rupture on CT through the fifth postoperative day generated log-rank P values of 0.02, 0.05, and ≤ 0.001, respectively. In summary, lack of "classic" presentation, elevated RDW, and CT evidence of rupture are novel risk factors for prolonged postoperative length of stay in LA patients over 30. These findings may help target patients most appropriate for prompt discharge.
Collapse
Affiliation(s)
- Eric S Wise
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Crawford TD, Romero FA, Lai KW, Tsui V, Taylor AM, de Leon Boenig G, Noland CL, Murray J, Ly J, Choo EF, Hunsaker TL, Chan EW, Merchant M, Kharbanda S, Gascoigne KE, Kaufman S, Beresini MH, Liao J, Liu W, Chen KX, Chen Z, Conery AR, Côté A, Jayaram H, Jiang Y, Kiefer JR, Kleinheinz T, Li Y, Maher J, Pardo E, Poy F, Spillane KL, Wang F, Wang J, Wei X, Xu Z, Xu Z, Yen I, Zawadzke L, Zhu X, Bellon S, Cummings R, Cochran AG, Albrecht BK, Magnuson S. Discovery of a Potent and Selective in Vivo Probe (GNE-272) for the Bromodomains of CBP/EP300. J Med Chem 2016; 59:10549-10563. [PMID: 27682507 DOI: 10.1021/acs.jmedchem.6b01022] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The single bromodomain of the closely related transcriptional regulators CBP/EP300 is a target of much recent interest in cancer and immune system regulation. A co-crystal structure of a ligand-efficient screening hit and the CBP bromodomain guided initial design targeting the LPF shelf, ZA loop, and acetylated lysine binding regions. Structure-activity relationship studies allowed us to identify a more potent analogue. Optimization of permeability and microsomal stability and subsequent improvement of mouse hepatocyte stability afforded 59 (GNE-272, TR-FRET IC50 = 0.02 μM, BRET IC50 = 0.41 μM, BRD4(1) IC50 = 13 μM) that retained the best balance of cell potency, selectivity, and in vivo PK. Compound 59 showed a marked antiproliferative effect in hematologic cancer cell lines and modulates MYC expression in vivo that corresponds with antitumor activity in an AML tumor model.
Collapse
Affiliation(s)
- Terry D Crawford
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - F Anthony Romero
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Kwong Wah Lai
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Vickie Tsui
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Alexander M Taylor
- Constellation Pharmaceuticals, Inc. 215 First Street, Suite 200, Cambridge, Massachusetts 02142, United States
| | | | - Cameron L Noland
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Jeremy Murray
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Justin Ly
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Edna F Choo
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Thomas L Hunsaker
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Emily W Chan
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Mark Merchant
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Samir Kharbanda
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Karen E Gascoigne
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Susan Kaufman
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Maureen H Beresini
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Jiangpeng Liao
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Wenfeng Liu
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Kevin X Chen
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Zhongguo Chen
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Andrew R Conery
- Constellation Pharmaceuticals, Inc. 215 First Street, Suite 200, Cambridge, Massachusetts 02142, United States
| | - Alexandre Côté
- Constellation Pharmaceuticals, Inc. 215 First Street, Suite 200, Cambridge, Massachusetts 02142, United States
| | - Hariharan Jayaram
- Constellation Pharmaceuticals, Inc. 215 First Street, Suite 200, Cambridge, Massachusetts 02142, United States
| | - Ying Jiang
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - James R Kiefer
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Tracy Kleinheinz
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Yingjie Li
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Jonathan Maher
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Eneida Pardo
- Constellation Pharmaceuticals, Inc. 215 First Street, Suite 200, Cambridge, Massachusetts 02142, United States
| | - Florence Poy
- Constellation Pharmaceuticals, Inc. 215 First Street, Suite 200, Cambridge, Massachusetts 02142, United States
| | - Kerry L Spillane
- Constellation Pharmaceuticals, Inc. 215 First Street, Suite 200, Cambridge, Massachusetts 02142, United States
| | - Fei Wang
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Jian Wang
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Xiaocang Wei
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Zhaowu Xu
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Zhongya Xu
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Ivana Yen
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Laura Zawadzke
- Constellation Pharmaceuticals, Inc. 215 First Street, Suite 200, Cambridge, Massachusetts 02142, United States
| | - Xiaoyu Zhu
- Wuxi Apptec Co., Ltd. , 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, People's Republic of China
| | - Steven Bellon
- Constellation Pharmaceuticals, Inc. 215 First Street, Suite 200, Cambridge, Massachusetts 02142, United States
| | - Richard Cummings
- Constellation Pharmaceuticals, Inc. 215 First Street, Suite 200, Cambridge, Massachusetts 02142, United States
| | - Andrea G Cochran
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| | - Brian K Albrecht
- Constellation Pharmaceuticals, Inc. 215 First Street, Suite 200, Cambridge, Massachusetts 02142, United States
| | - Steven Magnuson
- Genentech, Inc. 1 DNA Way, South San Francisco, California 94080, United States
| |
Collapse
|
21
|
Chu SY, Pong EWK, Rashid R, Chen H, Chan EW, Phung S, Endo NA, Ardila MC, Bonzon C, Leung IWL, Muchhal US, Moore GL, Bernett MJ, Desjarlais JR, Szymkowski DE. Abstract 5000: Immunotherapy with anti-PSMA x anti-CD3 bispecific antibody stimulates potent killing of a human prostate cancer cell line and target-mediated T cell activation in monkeys: A potential therapy for prostate cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-5000] [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
PSMA (Prostate-Specific Membrane Antigen) is a promising therapeutic target in prostate cancer. Exploiting the high and selective expression of PSMA in the prostate, capromab and J591 antibodies are used as imaging or therapeutic agents, and antibody-toxin conjugates such as MLN2704 are being developed. Such antibodies do not stimulate T cell-mediated killing of prostate cancer cells; however, promising clinical data with T cell-recruiting bispecific agents and chimeric antigen receptor (CAR) T cells have created new immunotherapy paradigms that may also have potential in prostate cancer.
We designed long-acting humanized bispecific antibodies that coengage PSMA+ cells and CD3+ T cells to stimulate redirected T cell-mediated cytotoxicity (RTCC) of prostate cancer cells. Unlike other bispecific formats, our antibodies possess an Fc domain and form stable heterodimers that are easily manufactured. Binding to Fcγ receptors was also abolished (reducing the potential for nonselective T cell activation), yet binding to human FcRn was preserved to maintain long serum half-life.
We screened several anti-PSMA x anti-CD3 bispecific antibodies in vitro, and selected XmAb14484 based on its potent (< 1ng/ml) stimulation of human T cell killing of the LNCaP prostate tumor cell line. RTCC activity required PSMA binding, because a non-specific control (XENP13245, anti-RSV x anti-CD3) was inactive. XmAb14484 crossreacts with monkey but not mouse targets; therefore, we evaluated its effects in cynomolgus monkeys. Peripheral blood cells do not express PSMA, so we were unable to monitor target cell depletion. However, T cell engagement of target cells induces distinct effects on peripheral T cells, which can be used as surrogate markers for activity in the prostate. After treatment with 0.03 mg/kg XmAb14484, CD4+ and CD8+ T cells were rapidly activated (quantified by CD69 upregulation) and redistributed from the periphery. Serum cytokines including IL-6 and TNF were also strongly induced. T cell and cytokine responses returned to baseline within 2-3 days. In marked contrast, a 100-fold higher dose (3 mg/kg) of the anti-RSV x anti-CD3 control antibody induced minimal effects, demonstrating that PSMA+ target cells are required for T cell activation by XmAb14484.
In summary, the pharmacologic activities of XmAb14484 on human cells and in monkeys support its clinical assessment in prostate cancer. We also demonstrate that T cell effects readily measured in peripheral blood (T cell redistribution, activation and cytokine induction) are useful surrogate markers of target-specific engagement.
Citation Format: Seung Y. Chu, Erik W. K. Pong, Rumana Rashid, Hsing Chen, Emily W. Chan, Sheryl Phung, Nancy A. Endo, Maria C. Ardila, Christine Bonzon, Irene W. L. Leung, Umesh S. Muchhal, Gregory L. Moore, Matthew J. Bernett, John R. Desjarlais, David E. Szymkowski. Immunotherapy with anti-PSMA x anti-CD3 bispecific antibody stimulates potent killing of a human prostate cancer cell line and target-mediated T cell activation in monkeys: A potential therapy for prostate cancer. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 5000.
Collapse
|
22
|
He Y, Chan EW, Leung WK, Anand S, Wong ICK. Systematic review with meta-analysis: the association between the use of calcium channel blockers and gastrointestinal bleeding. Aliment Pharmacol Ther 2015; 41:1246-55. [PMID: 25898902 DOI: 10.1111/apt.13211] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 02/17/2015] [Accepted: 04/01/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND Due to their potential anti-platelet effect, it is suggested that calcium channel blockers (CCBs) are associated with gastrointestinal bleeding (GIB). However, results from previous studies are conflicting. AIM To conduct a systematic review and meta-analysis of randomised controlled trials (RCTs) and observational studies to clarify the association between CCBs and GIB. METHODS We conducted a systematic search of PubMed, EMBASE, Cochrane library and Trial Register databases up to January 2015. Studies that evaluated exposure to CCBs reporting GIB outcomes were included in the meta-analysis. The inverse variance method with random effects model was used to calculate the pooled estimates. RESULTS Seventeen studies (four RCTs, eleven case-control and two cohort studies) were included in the meta-analysis. The summary risk ratio (RR) for GIB was 1.17 (95% CI 1.01-1.36) for CCB users vs. non-users. Subgroup analysis showed that CCB use was associated with a moderately higher risk of lower GIB (RR = 1.83, 95% CI 1.17-2.84) but not upper GIB. However, data from four RCTs did not support association between CCBs and GIB (RR = 0.93, 95% CI 0.82-1.05). Subgroup analyses further showed that the increased risk of GIB among CCB users was only observed in studies that failed to adjust for prior history of GIB (RR = 1.67, 95% CI 1.34-2.08) or use of anti-ulcer drugs (RR = 1.40, 95% CI 1.19-1.65). CONCLUSION Our meta-analysis showed a marginal association between calcium channel blocker use and the risk of gastrointestinal bleeding. This association is of dubious clinical significance, as the effects of different comparators or adjustment for confounding factors render this association nonsignificant.
Collapse
Affiliation(s)
- Y He
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, The University of Hong Kong, Hong Kong
| | - E W Chan
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, The University of Hong Kong, Hong Kong
| | - W K Leung
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - S Anand
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, The University of Hong Kong, Hong Kong
| | - I C K Wong
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, The University of Hong Kong, Hong Kong
| |
Collapse
|
23
|
Chan EW, He Y, Chui CSL, Wong AYS, Lau WCY, Wong ICK. Efficacy and safety of lorcaserin in obese adults: a meta-analysis of 1-year randomized controlled trials (RCTs) and narrative review on short-term RCTs. Obes Rev 2013; 14:383-92. [PMID: 23331711 DOI: 10.1111/obr.12015] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 11/29/2012] [Accepted: 12/10/2012] [Indexed: 01/14/2023]
Abstract
Lorcaserin is a new anti-obesity drug recently approved by US Food and Drug Administration. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the association of lorcaserin therapy with weight loss and adverse events in obese adults (18-65 years old). Weight loss of 3.23 kg (95% confidence interval [CI]: 2.70, 3.75) and body mass index reduction of 1.16 kg m⁻² (95% CI: 0.98, 1.34) was observed compared with placebo in RCTs of 1 year duration. The use of lorcaserin for 8 and 12 weeks reduced weight of 1.60 kg (95% CI: 0.34, 2.86) and 2.9 kg (95% CI: 2.2, 3.5), respectively. In comparison to placebo, lorcaserin decreased waist circumference, blood pressure, total cholesterol, low-density lipoprotein-cholesterol and triglycerides, however did not statistically affect heart rate or high-density lipoprotein-cholesterol. Headache, nausea and dizziness were found to be significantly higher in the patients receiving lorcaserin than patients receiving placebo, whereas diarrhoea is no more likely than in patients receiving placebo. In conclusion, lorcaserin achieves modest weight loss and appears to be well tolerated. Clinical and pharmacovigilance studies with longer study duration are needed to inform of the long-term efficacy and safety of lorcaserin.
Collapse
Affiliation(s)
- E W Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | | | | | | | | | | |
Collapse
|
24
|
Au Eong KG, Chan EW, Luo N, Wong SH, Tan NWH, Lim TH, Wagle AM. Validity of EuroQOL-5D, time trade-off, and standard gamble for age-related macular degeneration in the Singapore population. Eye (Lond) 2012; 26:379-88. [PMID: 22222257 PMCID: PMC3298978 DOI: 10.1038/eye.2011.218] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Accepted: 07/05/2011] [Indexed: 10/14/2022] Open
Abstract
BACKGROUND/AIMS Utility values of age-related macular degeneration (AMD) in Asian patients are unknown. This study aims to assess utility values and construct validity of the EuroQOL-5D (EQ-5D), time trade-off (TTO), and standard gamble (SG) instruments in the Singapore multi-ethnic AMD population. METHODS Cross-sectional, two-centre, institution-based study. Visual acuity (VA), clinical AMD severity, and utility scores on the EQ-5D, TTO, and SG were obtained from 338 AMD patients. VA was analysed in terms of the better-seeing eye (BEVA), worse-seeing eye (WEVA), and weighted average of both eyes (WVA). We evaluated SG on the perfect health-death (SG(death)) and binocular perfect vision-binocular blindness (SG(blindness)) scales. Construct validity was determined by testing a priorihypotheses relating the EQ-5D, TTO, and SG utility scores to VA and clinical AMD severity. RESULTS The mean utilities on the EQ-5D, TTO, SG(death), and SG(blindness) were 0.89, 0.81, 0.86, and 0.90, respectively. EQ-5D scores correlated weakly with BEVA, WEVA, and WVA (Pearson's correlation coefficients -0.291, -0.247, and -0.305 respectively, P<0.001 for all). SG(death) and SG(blindness) demonstrated no correlation with BEVA, WEVA, or WVA (Pearson's correlation coefficients, range -0.06 to -0.125). TTO showed weak association only with WEVA and WVA (correlation coefficients -0.237, -0.228, P<0.0001), but not with BEVA (correlation coefficient -0.161). Clinical AMD severity correlated with EQ-5D and SG(death), but not with TTO and SG(blindness) (P=0.004, 0.002, 0.235, and 0.069, respectively). CONCLUSIONS AMD has a negative impact on utilities, although utility scores were high compared with Western cohorts. EQ-5D, TTO, and SG showed suboptimal construct validity, suggesting that health status utilities may not be sufficiently robust for cost-utility analyses in this population.
Collapse
Affiliation(s)
- K G Au Eong
- Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore.
| | | | | | | | | | | | | |
Collapse
|
25
|
Holland SJ, Powell MJ, Franci C, Chan EW, Friera AM, Atchison RE, McLaughlin J, Swift SE, Pali ES, Yam G, Wong S, Lasaga J, Shen MR, Yu S, Xu W, Hitoshi Y, Bogenberger J, Nör JE, Payan DG, Lorens JB. Multiple roles for the receptor tyrosine kinase axl in tumor formation. Cancer Res 2005; 65:9294-303. [PMID: 16230391 DOI: 10.1158/0008-5472.can-05-0993] [Citation(s) in RCA: 153] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
A focus of contemporary cancer therapeutic development is the targeting of both the transformed cell and the supporting cellular microenvironment. Cell migration is a fundamental cellular behavior required for the complex interplay between multiple cell types necessary for tumor development. We therefore developed a novel retroviral-based screening technology in primary human endothelial cells to discover genes that control cell migration. We identified the receptor tyrosine kinase Axl as a novel regulator of endothelial cell haptotactic migration towards the matrix factor vitronectin. Using small interfering RNA-mediated silencing and overexpression of wild-type or mutated receptor proteins, we show that Axl is a key regulator of multiple angiogenic behaviors including endothelial cell migration, proliferation, and tube formation in vitro. Moreover, using sustained, retrovirally delivered short hairpin RNA (shRNA) Axl knockdown, we show that Axl is necessary for in vivo angiogenesis in a mouse model. Furthermore, we show that Axl is also required for human breast carcinoma cells to form a tumor in vivo. These findings indicate that Axl regulates processes vital for both neovascularization and tumorigenesis. Disruption of Axl signaling using a small-molecule inhibitor will hence simultaneously affect both the tumor and stromal cell compartments and thus represents a unique approach for cancer therapeutic development.
Collapse
MESH Headings
- Animals
- Breast Neoplasms/blood supply
- Breast Neoplasms/enzymology
- Cell Growth Processes/physiology
- Cell Line, Tumor
- Cell Movement/genetics
- Cell Transformation, Neoplastic/metabolism
- Cells, Cultured
- Chemotaxis/drug effects
- Chemotaxis/physiology
- Coculture Techniques
- Endothelial Cells/cytology
- Endothelial Cells/enzymology
- Humans
- Mice
- Mice, SCID
- Neovascularization, Pathologic/enzymology
- Neovascularization, Pathologic/genetics
- Neovascularization, Physiologic/genetics
- Neovascularization, Physiologic/physiology
- Oncogene Proteins/antagonists & inhibitors
- Oncogene Proteins/biosynthesis
- Oncogene Proteins/genetics
- Oncogene Proteins/physiology
- Proto-Oncogene Proteins
- RNA, Small Interfering/genetics
- Receptor Protein-Tyrosine Kinases/antagonists & inhibitors
- Receptor Protein-Tyrosine Kinases/biosynthesis
- Receptor Protein-Tyrosine Kinases/genetics
- Receptor Protein-Tyrosine Kinases/physiology
- Signal Transduction
- Transfection
- Transplantation, Heterologous
- Vitronectin/pharmacology
- Axl Receptor Tyrosine Kinase
Collapse
Affiliation(s)
- Sacha J Holland
- Rigel, Inc., South San Francisco, California and University of Michigan School of Dentistry, Ann Arbor, MI, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Abstract
A total of 88 salmonella isolates (72 clinical isolates for which the ciprofloxacin MIC was >0.06 microg/ml, 15 isolates for which the ciprofloxacin MIC was < or =0.06 microg/ml, and Salmonella enterica serotype Typhimurium ATCC 13311) were studied for the presence of genetic alterations in four quinolone resistance genes, gyrA, gyrB, parC, and parE, by multiplex PCR amplimer conformation analysis. The genetic alterations were confirmed by direct nucleotide sequencing. A considerable number of strains had a mutation in parC, the first to be reported in salmonellae. Seven of the isolates sensitive to 0.06 micro g of ciprofloxacin per ml had a novel mutation at codon 57 of parC (Tyr57-->Ser) which was also found in 29 isolates for which ciprofloxacin MICs were >0.06 micro g/ml. Thirty-two isolates had a single gyrA mutation (Ser83-->Phe, Ser83-->Tyr, Asp87-->Asn, Asp87-->Tyr, or Asp87-->Gly), 34 had both a gyrA mutation and a parC mutation (29 isolates with a parC mutation of Tyr57-->Ser and 5 isolates with a parC mutation of Ser80-->Arg). Six isolates which were isolated recently (from 1998 to 2001) were resistant to 4 micro g of ciprofloxacin per ml. Two of these isolates had double gyrA mutations (Ser83-->Phe and Asp87-->Asn) and a parC mutation (Ser80-->Arg) (MICs, 8 to 32 microg/ml), and four of these isolates had double gyrA mutations (Ser83-->Phe and Asp87-->Gly), one parC mutation (Ser80-->Arg), and one parE mutation (Ser458-->Pro) (MICs, 16 to 64 micro g/ml). All six of these isolates and those with a Ser80-->Arg parC mutation were S. enterica serotype Typhimurium. One S. enterica serotype Typhi isolate harbored a single gyrA mutation (Ser83-->Phe), and an S. enterica serotype Paratyphi A isolate harbored a gyrA mutation (Ser83-->Tyr) and a parC mutation (Tyr57-->Ser); both of these isolates had decreased susceptibilities to the fluoroquinolones. The MICs of ciprofloxacin, levofloxacin, and sparfloxacin were in general the lowest of those of the six fluoroquinolones tested. Isolates with a single gyrA mutation were less resistant to fluoroquinolones than those with an additional parC mutation (Tyr57-->Ser or Ser80-->Arg), while those with double gyrA mutations were more resistant.
Collapse
Affiliation(s)
- J M Ling
- Department of Microbiology, The Chinese University of Hong Kong, The Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China.
| | | | | | | |
Collapse
|
27
|
Abstract
This study was initiated throughout Hong Kong, to reveal the characteristics of community-acquired infections. All specimens collected by general practitioners from infected patients were followed prospectively, and those that were culture-positive were analysed. Four thousand seven hundred and forty-one specimens were collected from 3977 patients by 89 doctors from July 2000 to October 2001. The most common specimens were throat swabs (33%), urine (26%) and sputa (16%). The average culture-positive rate was 28%. The most common organisms were Escherichia coli (18%), beta-haemolytic streptococci (15%) and Staphylococcus aureus (12%). Fluoroquinolone resistance was relatively high (up to 35%) in organisms commonly causing urinary tract infection (E. coli, Proteus and Morganella). Although none of the pneumococci was resistant to penicillin 1 mg/L, the proportion with intermediate resistance (0.1-1 mg/L) was alarming (81%). There were three strains of methicillin-resistant S. aureus. A decrease in ampicillin resistance but a high prevalence of macrolide resistance were noted in Haemophilus influenzae. All Neisseria gonorrhoeae isolates were resistant to penicillin, up to 79% to the fluoroquinolones, 15% to spectinomycin, but all were susceptible to ceftriaxone. Respiratory pathogens (Streptococcus pneumoniae, beta-haemolytic streptococci and H. influenzae) were relatively susceptible to the newer fluoroquinolones (0-2%, 0.5-6% and 2% resistant, respectively) or third-generation cephalosporins (0-2% resistant). The distribution of organisms and their antibiotic resistance varied over time. Thus frequent surveillance is needed to provide information on the drugs of choice for different infections.
Collapse
Affiliation(s)
- J M Ling
- Department of Microbiology, The Chinese University of Hong Kong, The Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China.
| | | | | | | |
Collapse
|
28
|
Chan EW, Cheng SC, Sin FW, Xie Y. Triptolide induced cytotoxic effects on human promyelocytic leukemia, T cell lymphoma and human hepatocellular carcinoma cell lines. Toxicol Lett 2001; 122:81-7. [PMID: 11397559 DOI: 10.1016/s0378-4274(01)00353-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Triptolide, a traditional Chinese medicine, has been reported to be effective in the treatment of auto-immune diseases, and it can also induce anti-neoplastic activity on several human tumor cell lines. This study investigates the cytotoxic function and the functional mechanism of triptolide on tumor cells. Promyelocytic leukemia, (HL-60), T cell lymphoma (Jurkat), and human hepatocelluar carcinoma (SMMC-7721) cells were subjected to triptolide treatment, and cell growth inhibition was examined by XTT cell viability assay. Cell death mechanism (apoptosis) was confirmed through DNA fragmentation and DAPI staining. Triptolide inhibited 50% of cell growth (IC(50)) on HL-60 cells at 7.5 nM, Jurkat cells at 27.5 nM and SMMC cells at 32 nM. Characteristic apoptotic features including internucleosomal DNA fragmentation and chromatin condensation were observed in triptolide treated cells. Data from the study indicates that triptolide could induce apoptosis in human tumor cell lines and it may be applicable as a potential chemotherapeutic agent for cancer treatment.
Collapse
Affiliation(s)
- E W Chan
- Department of Biology, The Hong Kong University of Science and Technology, Clearwater Bay, Kowloon, Hong Kong ROC
| | | | | | | |
Collapse
|
29
|
Abstract
OBJECTIVES We aimed to study the antimicrobial susceptibilities and molecular epidemiology of Salmonella enterica serotype Derby, a unique and common salmonella serotype in Hong Kong. METHODS Salmonella Derby strains isolated from stools of patients in a large general hospital in Hong Kong from 1989 to 1994 and from food samples isolated in the Public Health Laboratory were randomly selected and investigated for the antimicrobial susceptibilities by determining the minimal inhibitory concentrations of 19 antimicrobial agents and their relatedness using plasmid analysis, ribotyping, pulsed-field gel electrophoresis (PFGE) and total DNA fingerprinting. RESULTS About 50% of the 127 isolates studied were susceptible to all the 19 antibiotics tested, although resistance to tetracycline (49%) and sulfamethoxazole (38%) was high. Only 12% did not harbour any detectable plasmids, while the rest contained plasmids in 51 profiles. There were two predominant clones, one comprising of 35% of isolates that could not be pulsotyped because discrete bands were not discernible after PFGE and another comprising 34% of isolates that could be pulsotyped. The remaining 31% belonged to a variety of types. CONCLUSIONS Approximately 70% of S. Derby belonging to two clones were endemic in the community, while the remaining isolates belonged to a variety of types which were probably a result of sporadic infection. The sources of human infections were foods, since most isolates from foods also belonged to the two endemic clones. Typing of S. Derby isolates from other sources such as animals or the environment would help elucidate how foods were contaminated. PFGE might not be universally applicable to all salmonella strains.
Collapse
Affiliation(s)
- J M Ling
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | | |
Collapse
|
30
|
Wong HT, Cheng SC, Chan EW, Sheng ZT, Yan WY, Zheng ZX, Xie Y. Plasmids encoding foot-and-mouth disease virus VP1 epitopes elicited immune responses in mice and swine and protected swine against viral infection. Virology 2000; 278:27-35. [PMID: 11112477 DOI: 10.1006/viro.2000.0607] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
VP1 is a capsid protein of foot-and-mouth disease virus (FMDV) and contains epitopes of the virus. Plasmids encoding two VP1 epitopes (amino acid residues 141-160 and 200-213) and a host-self immunoglobulin molecule were constructed to produce a new type of FMD DNA vaccine. Two plasmids, namely, pCEIM and pCEIS, containing mouse immunoglobulin (IgG) or swine IgG were subjected to immunogenicity testing in mice and swine, respectively. In mice administrated pCEIM in the abdomen using a genegun, both FMDV-specific T-cell proliferation and neutralizing antibodies were detected. In swine immunized with pCEIS at the back of the ear, immune responses were achieved after the second administration. Swine showed a T-cell proliferative response with a stimulation index (SI) of up to 8.1 and a neutralizing antibody response that was able to protect suckling mice from 10(2) LD(50) (lethal dose 50) FMDV challenge. To compare the immunogenicity of the DNA-based vaccine candidate, versus the protein-based vaccine candidates, a second group of swine was immunized with the protein F1-scIgG, which was encoded by the plasmid pCEIS. Injection with F1-scIgG elicited a T-cell proliferative response of SI < 1.7 and a neutralizing antibody response that protected suckling mice from up to 10(5) LD(50) FMDV challenge. In the challenge test, three of three swine immunized with pCEIS were fully protected from FMDV challenge.
Collapse
Affiliation(s)
- H T Wong
- Department of Biology, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, China
| | | | | | | | | | | | | |
Collapse
|
31
|
Chan EW, Wong HT, Cheng SC, Yan WY, Zheng ZX, Sheng ZT, Zhu LQ, Xie Y. An immunoglobulin G based chimeric protein induced foot-and-mouth disease specific immune response in swine. Vaccine 2000; 19:538-46. [PMID: 11027819 DOI: 10.1016/s0264-410x(00)00186-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Epitopes containing the residues 141aa-160aa and 200aa-213aa from foot-and-mouth disease (FMD) serotype O1K HK type FMDV VP1 were joined to a swine immunoglobulin G single heavy chain constant region (scIgG), creating a novel chimeric protein, named F1-scIgG. In this study, inoculation with F1-scIgG induced both FMD virus-neutralizing antibody response and T cell response in swine. Antisera from these F1-scIgG-inoculated swine protected suckling mice against 1000 lethal dose 50 (1000LD(50)) FMD challenge. F1-scIgG-inoculated swine were also fully protected against 50LD(50) FMD virus challenge. The present study demonstrates the clear potential for viral epitopes linked with self-Ig in novel FMD vaccine design.
Collapse
Affiliation(s)
- E W Chan
- Department of Biology, Hong Kong University of Science and Technology, Clearwater Bay, Kowloon, Hong Kong
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Yousaf MN, Chan EW, Mrksich M. The Kinetic Order of an Interfacial Diels-Alder Reaction Depends on the Environment of the Immobilized Dienophile We are grateful for the support provided by the MRSEC (National Science Foundation, DMR-9808595) and DARPA. Angew Chem Int Ed Engl 2000; 39:1943-1946. [PMID: 10940989 DOI: 10.1002/1521-3773(20000602)39:11<1943::aid-anie1943>3.0.co;2-#] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- MN Yousaf
- Department of Chemistry The University of Chicago Chicago, IL 60637 (USA)
| | | | | |
Collapse
|
33
|
Abstract
OBJECTIVE Assessing the stability of cefazolin sodium in preservative-free and preservative-containing eye drops. METHOD Extemporaneous formulations of eye drops were prepared from a commercially-available parenteral product of cefazolin sodium: eye drops 'A' contained 50mg/ml of cefazolin sodium in 0.45% w/v sodium chloride solution, and eye drops 'B' contained 50 mg/ml, 0.005% w/v thiomersal and 1% w/v glycerol in water-for-injection. Cefazolin sodium concentrations in these eye drops were monitored by a stability-indicating HPLC assay method. Measurements of pH and osmolality, as well as tests for microbial contamination, were conducted. RESULTS The eye drops stored at 4 degrees C were stable for 42 days with minimal changes in pH and osmolality, but eye drops stored at room temperature were only stable for a few days with greater increments in pH and osmolality. None of the samples cultured had bacterial or fungal growth after 7 days of incubation. CONCLUSION Extemporaneously prepared formulations of cefazolin are unstable at room temperature and should be stored in a refrigerator.
Collapse
Affiliation(s)
- T H How
- National University Hospital, Singapore
| | | | | | | | | | | | | |
Collapse
|
34
|
Abstract
The stability of phenoxybenzamine hydrochloride in various oral liquids was studied. Phenoxybenzamine hydrochloride powder or capsules were combined with various vehicles to prepare 10-mL formulations with a drug concentration of 2 mg/mL and a 20-mL stock solution containing 10 mg/mL. All formulations were prepared in triplicate and stored at 4 degrees C. A 1.0-mL sample of each of the 2-mg/mL formulations was withdrawn on days 0, 1, 2, 3, and 4, and samples of selected formulations were taken on days 7 and 10. Samples of the stock solution were withdrawn on days 0, 2, 4, 7, 10, 14, and 30. All samples were analyzed by high-performance liquid chromatography. Phenoxybenzamine hydrochloride 2 mg/mL was stable for a longer time in 1% propylene glycol, 0.15% citric acid, and water than in a similar vehicle in which syrup was used in place of water. The concentrations of the drug in both the 10-mg/mL stock solution and stock solutions diluted to 2 mg/mL were > 90% of the initial drug concentration for 30 days. Phenoxybenzamine hydrochloride 2 mg/mL in 1% propylene glycol and 0.15% citric acid in distilled water was stable for 7 days at 4 degrees C. A stock solution of phenoxybenzamine hydrochloride 10 mg/mL in propylene glycol was stable for 30 days at 4 degrees C and, after dilution with 66.7% sucrose in distilled water to a concentration of 2 mg/mL, for up to one hour at 4 degrees C.
Collapse
Affiliation(s)
- L Y Lim
- Department of Pharmacy, National University of Singapore, Singapore
| | | | | | | | | | | |
Collapse
|
35
|
Chan EW, Lee CK, Dale PJ, Nortridge KR, Hom SS, Seed TM. Antiviral properties of polyinosinic acids containing thio and methyl substitutions. J Gen Virol 1981; 52:291-9. [PMID: 6169784 DOI: 10.1099/0022-1317-52-2-291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Polyinosinic acids containing methyl and sulphur substitutions are potent inhibitors of reverse transcriptase. Substitution of sulphur for oxygen at the 6 position produces significant effects on the properties of polyinosinic acid: the kinetics of inhibition change from competitive to mixed-type and the inhibition constant falls by three orders of magnitude. In contrast, 1-methyl substitution produces no such effects. Poly(1-methyl-6-thioinosinic acid) or poly(m1s6I) inhibits irreversibly, inhibiting all ten reverse transcriptases tested under a variety of assay conditions. In cell culture test systems, poly(m1s6I) is capable of blocking both infection by non-transforming viruses and transformation by a sarcoma virus. The presence of poly(m1s6I) in a preinfected culture results in the production of non-infectious virus particles lacking reverse transcriptase activity.
Collapse
|
36
|
Chan EW, Dale PJ, Greco IL, Rose JG, O'Connor TE. Effects of polyethylene glycol on reverse transcriptase and other polymerase activities. Biochim Biophys Acta 1980; 606:353-61. [PMID: 6153536 DOI: 10.1016/0005-2787(80)90045-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Polyethylene glycol enhances reverse transcription, augmenting both the rate and duration of polymerization. The effective mean molecular weight of polyethylene glycol is 6000 and the optimal concentration is 12% (w/w). Polyethylene glycol is effective on the reverse transcriptase reaction of all ten type B, C, and D viruses tested under a variety of exogenous, endogenous, and reconstitution assay systems, including the highly efficient conditions involving calf thymus DNA oligonucleotide primers. By three methods of synthesis, polyethylene glycol increased the yields of complementary [3H]DNA by a factor of 1.8--6.5. Polyethylene glycol does not alter the divalent cation requirements of the specificities of the enzyme. Complementary [3H]DNAs made in the presence of polyethylene glycol are indistinguishable in terms of size and sequence complementarity from those made in the absence of the polymer. The stimulatory effect was partly due to the ability of polyethylene glycol to stabilize reverse transcriptase. Preliminary tests indicate that polyethylene glycol also stimulates other nucleotide polymerases, such as the DNA-dependent DNA and RNA polymerases of Escherichia coli and the terminal transferase of calf thymus.
Collapse
|
37
|
|
38
|
Chan EW, Schiop-Stansly PE, O'Connor TE. Mammalian sarcoma-leukemia viruses. I. Infection of feline, bovine, and human cell cultures with Snyder-Theilen feline sarcoma virus. J Natl Cancer Inst 1974; 52:473-81. [PMID: 4361179 DOI: 10.1093/jnci/52.2.473] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
|
39
|
Chan EW, Schiop-Stansly PE, O'Connor TE. Rescue of cell-transforming virus from a non-virus-producing bovine cell culture transformed by feline sarcoma virus. J Natl Cancer Inst 1974; 52:469-72. [PMID: 4361178 DOI: 10.1093/jnci/52.2.469] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
|
40
|
Abstract
A microtissue culture method for the plaque assay of Herpesvirus saimiri has been developed. Virus titrations carried out in Microtest II tissue culture plates (Falcon) yielded reproducible results that agreed well with those obtained by employing macrocultures. The described method is quantitative, reproducible, economical, and suitable for routine assay of large numbers of virus samples.
Collapse
|
41
|
Chan EW, Ball JK. Polycyclic aromatic hydrocarbons. Covalent binding to DNA and effects on template function. Biochim Biophys Acta 1971; 238:46-9. [PMID: 4930634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
42
|
|