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Mandapathil M, Beier UH, Graefe H, Kröger B, Hedderich J, Maune S, Meyer JE. Differential chemokine expression patterns in tonsillar disease. ACTA ACUST UNITED AC 2019; 38:316-322. [PMID: 30197422 PMCID: PMC6146581 DOI: 10.14639/0392-100x-1743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 09/06/2017] [Indexed: 12/18/2022]
Abstract
Expression profiles of CXC- and CC-chemokines in various forms of tonsillar disease were studied to evaluate whether certain chemokines play a predominant role in a specific subset of tonsillar disease. Total RNA was isolated from 89 biopsies (21 hyperplastic palatine tonsils, 25 adenoids, 16 chronic inflammatory palatine tonsils and 27 chronic inflammatory palatine tonsils with histological prove of acute inflammation), reverse transcribed and subjected to PCR amplifying IL-8, Gro-alpha, eotaxin-1, eotaxin-2, MCP-3, MCP-4 and RANTES. 2% agarose gel electrophoresis revealed a predominance of IL-8 in the chronic inflammatory palatine tonsil group compared to tonsillar hyperplasia. Furthermore, eotaxin-2 was strongly overexpressed in adenoid samples compared to chronic inflammatory specimens. Our data suggest that the majority of diseases related to adenoid formation are mediated via an eotaxin-2 expression, whereas chronic inflammatory tonsillitis is associated with IL-8 upregulation. These data imply that adenoids are related to a Th-2, and chronic inflammatory tonsillitis to a Th-1 based immune response.
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Affiliation(s)
- M Mandapathil
- Department of Otorhinolaryngology, Head and Neck Surgery, Asklepios St. Georg, Hamburg, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, University of Marburg, Germany
| | - U H Beier
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, PA, USA
| | - H Graefe
- Department of Otorhinolaryngology, Head and Neck Surgery, Asklepios St. Georg, Hamburg, Germany
| | - B Kröger
- Department of Otorhinolaryngology, University of Bremen, Bremen, Germany
| | - J Hedderich
- Institute of Medical Informatics and Statistics, University of Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - S Maune
- Department of Otorhinolaryngology, Head and Neck Surgery, Kliniken Köln, Cologne, Germany
| | - J E Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, Asklepios St. Georg, Hamburg, Germany
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Walliczek-Dworschak U, Diogo I, Strack L, Mandapathil M, Teymoortash A, Werner J, Güldner C. Indications of cone beam CT in head and neck imaging in children. Acta Otorhinolaryngol Ital 2017; 37:270-275. [PMID: 28872156 PMCID: PMC5584097 DOI: 10.14639/0392-100x-1219] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 09/21/2016] [Indexed: 11/23/2022]
Abstract
For imaging of bony structures, especially for the anterior and lateral skull base in ORL medicine, cone beam computed tomography (CBCT) is an increasingly used alternative to CT, with a lower exposition to plain radiography that makes its use for imaging, particularly in children, very interesting. The aim of this study was to analyse possible indications and settings for CBCT in children and compare them to those of adults. A total of 554 patients (age range 0-18 years, mean age 10.36 years), who underwent CBCT between 01/2004-06/2013 in the ENT department at the university clinic of Marburg were enrolled in this retrospective analysis to evaluate technical parameters and indications. Data on CBCT of all children were compared with previously published data collected from 1730 adults who were diagnosed with the help of CBCT in the ENT department at the university clinic of Marburg, during the years 2012-2013. The most frequent indications of CBCT in children vs. adults were in the anterior skull base region: mid-facial trauma (60.4%) vs. chronic rhinosinusitis (54.8%), disturbed nasal breathing (13.9% vs. 13.0%) and chronic rhinosinusitis (12%) vs. mid-facial trauma (10.8%). For the lateral skull base the main indications were cholesteatoma (20.3%) vs. position control of cochlear implant (CI) electrode (31.2%), chronic otorrhoea (17.5%) vs. cholesteatoma (20.9%), and position control of CI electrode (11.8%) vs. chronic otitis media mesotympanalis (6.8%). CBCT is a suitable imaging modality for bony structures in adults and children. Settings mainly depend on the region of interest. One aim should also be to reduce exposure to radiation in both adults and children.
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Affiliation(s)
| | | | | | | | | | | | - C. Güldner
- Department of ORL, Head and Neck Surgery, UKGM, Marburg, Germany
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Güldner C, Orth A, Dworschak P, Diogo I, Mandapathil M, Teymoortash A, Walliczek-Dworschak U. Evaluation of different time schedules in training with the Da Vinci simulator. Surg Endosc 2017; 31:4118-4125. [PMID: 28281118 DOI: 10.1007/s00464-017-5460-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 02/03/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND This prospective study analyzed the effect of different time schedules in training on the main performance outcomes: overall score, time to complete, and economy of motion. METHODS The study was performed on the da Vinci Skills Simulator from December 2014 to April 2016. Forty robotic novices were randomized into two groups of 20 participants, which trained in the same three exercises but with different intervals between their training sessions. Each group performed training in Peg Board 1 in their first week, Match Board 2 in their second week, and Ring and Rail 2 in their third week. On their last day, Needle Targeting and Energy Dissection 2, for which no previous training had been received, were performed. Regarding the different training intervals, group 1 trained each exercise six times in a row once a week. Group 2 performed their training once a day for 5 days. Technical performance parameters were recorded by the Mimics simulator software for further analysis. In addition, the participants were asked to fill out a questionnaire concerning the robotics training. RESULTS Group 2 performed significantly better compared to group 1 in the main metrics in the more advanced exercises. For the easier exercises, the training frequency did not lead to significant differences in performance outcome. A significant skills gain was seen between the first and last training sessions for all exercises in both groups. CONCLUSIONS Performance in the final exercise NT was significantly better in group 2 than group 1. Regarding ED 2, no difference was found between the two groups. As the training of group 2 led to significantly better outcomes, we suggest that, especially for advanced exercises, it seems to be more favorable to perform training every day for a short period than to train once a week six times in a row.
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Affiliation(s)
- C Güldner
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Marburg, University of Gießen and Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - A Orth
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Marburg, University of Gießen and Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - P Dworschak
- Center of Orthopedics and Traumatology, University Hospital of Marburg, University of Gießen and Marburg, Marburg, Germany
| | - I Diogo
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Marburg, University of Gießen and Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - M Mandapathil
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Marburg, University of Gießen and Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - A Teymoortash
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Marburg, University of Gießen and Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - U Walliczek-Dworschak
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Marburg, University of Gießen and Marburg, Baldingerstraße, 35043, Marburg, Germany.
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Walliczek-Dworschak U, Schmitt M, Dworschak P, Diogo I, Ecke A, Mandapathil M, Teymoortash A, Güldner C. The effect of different training exercises on the performance outcome on the da Vinci Skills Simulator. Surg Endosc 2016; 31:2397-2405. [DOI: 10.1007/s00464-016-5240-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 09/06/2016] [Indexed: 10/21/2022]
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Walliczek-Dworschak U, Mandapathil M, Förtsch A, Teymoortash A, Dworschak P, Werner JA, Güldner C. Structured training on the da Vinci Skills Simulator leads to improvement in technical performance of robotic novices. Clin Otolaryngol 2016; 42:71-80. [PMID: 27133186 DOI: 10.1111/coa.12666] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND The increasing use of minimally invasive techniques such as robotic-assisted devices raises the question of how to acquire robotic surgery skills. The da Vinci Skills Simulator has been demonstrated to be an effective training tool in previous reports. To date, little data are available on how to acquire proficiency through simulator training. We investigated the outcome of a structured training programme for robotic surgical skills by robotic novices. METHODS This prospective study was conducted from January to December 2013 using the da Vinci Skills Simulator. Twenty participants, all robotic novices, were enrolled in a 4-week training curriculum. After a brief introduction to the simulator system, three consecutive repetitions of five selected exercises (Match Board 1, 2, 3 and Ring and Rail 1, 2) were performed in a defined order on days 1, 8, 15 and 22. On day 22, one repetition of a previously unpractised more advanced module (Needle Targeting) was also performed. After completion of each study day, the overall performance, time to completion, economy in motion, instrument collisions, excessive instrument force, instruments out of view, master workspace range and number of drops were analysed. RESULTS Comparing the first and final repetition, overall score and time needed to complete all exercises, economy of motion and instrument collisions were significantly improved in nearly all exercises. Regarding the new exercise, a positive training effect could be demonstrated. While its overall entry score was significantly higher, the time to completion and economy of motion were significantly lower than the scores on the first repetition of the previous 5 exercises. CONCLUSIONS It could be shown that training on the da Vinci Skills Simulator led to an improvement in technical performance of robotic novices. With regard to a new exercise, the training had a positive effect on the technical performance.
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Affiliation(s)
- U Walliczek-Dworschak
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Marburg, University of Giessen and Marburg, Marburg, Germany
| | - M Mandapathil
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Marburg, University of Giessen and Marburg, Marburg, Germany
| | - A Förtsch
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Marburg, University of Giessen and Marburg, Marburg, Germany
| | - A Teymoortash
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Marburg, University of Giessen and Marburg, Marburg, Germany
| | - P Dworschak
- Center of Orthopedics and Traumatology, University Hospital of Marburg, University of Giessen and Marburg, Marburg, Germany
| | - J A Werner
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Marburg, University of Giessen and Marburg, Marburg, Germany
| | - C Güldner
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Marburg, University of Giessen and Marburg, Marburg, Germany
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Schuler PJ, Saze Z, Hong CS, Muller L, Gillespie DG, Cheng D, Harasymczuk M, Mandapathil M, Lang S, Jackson EK, Whiteside TL. Human CD4+ CD39+ regulatory T cells produce adenosine upon co-expression of surface CD73 or contact with CD73+ exosomes or CD73+ cells. Clin Exp Immunol 2014; 177:531-43. [PMID: 24749746 DOI: 10.1111/cei.12354] [Citation(s) in RCA: 189] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2014] [Indexed: 12/18/2022] Open
Abstract
While murine CD4(+) CD39(+) regulatory T cells (T(reg)) co-express CD73 and hydrolyze exogenous (e) adenosine triphosphate (ATP) to immunosuppressive adenosine (ADO), surface co-expression of CD73 on human circulating CD4(+) CD39(+) T(reg) is rare. Therefore, the ability of human T(reg) to produce and utilize ADO for suppression remains unclear. Using mass spectrometry, we measured nucleoside production by subsets of human CD4(+) CD39(+) and CD4(+) CD39(-)CD73(+) T cells or CD19(+) B cells isolated from blood of 30 volunteers and 14 cancer patients. CD39 and CD73 expression was evaluated by flow cytometry, Western blots, confocal microscopy or reverse transcription-polymerase chain reaction (RT-PCR). Circulating CD4(+) CD39(+) T(reg) which hydrolyzed eATP to 5'-AMP contained few intracytoplasmic granules and had low CD73 mRNA levels. Only ∼1% of these T(reg) were CD39(+) CD73(+) . In contrast, CD4(+) CD39(neg) CD73(+) T cells contained numerous CD73(+) granules in the cytoplasm and strongly expressed surface CD73. In vitro-generated T(reg) (Tr1) and most B cells were CD39(+) CD73(+) . All these CD73(+) T cell subsets and B cells hydrolyzed 5'-AMP to ADO. Exosomes isolated from plasma of normal control (NC) or cancer patients carried enzymatically active CD39 and CD73(+) and, when supplied with eATP, hydrolyzed it to ADO. Only CD4(+) CD39(+) T(reg) co-incubated with CD4(+) CD73(+) T cells, B cells or CD39(+) CD73(+) exosomes produced ADO. Thus, contact with membrane-tethered CD73 was sufficient for ADO production by CD4(+) CD39(+) T(reg). In microenvironments containing CD4(+) CD73(+) T cells, B cells or CD39(+) CD73(+) exosomes, CD73 is readily available to CD4(+) CD39(+) CD73(neg) T(reg) for the production of immunosuppressive ADO.
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Affiliation(s)
- P J Schuler
- University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA; Department of Otolaryngology, University of Ulm, Ulm, Germany
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Teymoortash A, Mandapathil M, Hoch S. Indications for reconstruction of mucosal defects in oropharyngeal cancer using a supraclavicular island flap. Int J Oral Maxillofac Surg 2014; 43:1054-8. [DOI: 10.1016/j.ijom.2014.04.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 02/16/2014] [Accepted: 04/17/2014] [Indexed: 10/25/2022]
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Greve J, Schuler PJ, Mandapathil M, Dominas N, Veit J, Bas M, Lehnerdt G, Hoffmann TK. [Penetrating injuries of the head and neck region - a potentially life threatening situation]. Laryngorhinootologie 2014; 93:671-6. [PMID: 24978127 DOI: 10.1055/s-0034-1376974] [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: 10/25/2022]
Abstract
UNLABELLED Penetrating Injuries of the Head and Neck Region - A Potentially Life Threatening Situation Background: Cuts, stabs and gunshot wounds in the head and neck region are potentially life-threatening because of the high risk of vascular lesions. A consistent emergency management is usually based on an operative exploration of the wound with effective reconstruction of viable structures. PATIENTS AND METHODS Various penetrating injuries of the head and neck region are described in 11 cases with respect of age, gender, course of events of injury, type of injury, involved structures, diagnostic and operative procedures and outcome and compared with current literature and guidelines. RESULTS In 10 of 11 patients, in the context of an interdisciplinary emergency room management, CT angiography was performed following clinical examination. A surgical exploration and wound treatment was performed in 9 of these patients. The common carotid artery, the external carotid artery and large venous blood vessels of the neck were injured in 2 cases respectively. None of the patients deceased or suffered permanent damage. CONCLUSION The outcome of deep head and neck lesions with relevant vascular trauma is determined by a rapid and interdisciplinary approach. A rapid, systematic and interdisciplinary approach in specialized trauma centers has a significant role in ensuring that patients with penetrating wounds in the head and neck -region rarely die due to their serious injury or their consequences.
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Affiliation(s)
- J Greve
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Ulm, Ulm
| | - P J Schuler
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Ulm, Ulm
| | - M Mandapathil
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Giessen und Marburg, Standort Marburg, Marburg
| | - N Dominas
- Hals-, Nasen-, Ohrenklinik, Universitätsklinik Essen, Essen
| | - J Veit
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Ulm, Ulm
| | - M Bas
- Hals-Nasen-Ohren-Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, München
| | - G Lehnerdt
- Hals-, Nasen-, Ohrenklinik, Universitätsklinik Essen, Essen
| | - T K Hoffmann
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Ulm, Ulm
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Mattheis S, Mandapathil M, Rothmeier N, Lang S, Dominas N, Hoffmann T. Transorale Roboter-assistierte Chirurgie von Kopf-Hals-Tumoren: Eine Fallserie mit 17 Patienten. Laryngorhinootologie 2012; 91:768-73. [DOI: 10.1055/s-0032-1327663] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- S. Mattheis
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Essen, Essen
| | - M. Mandapathil
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Essen, Essen
| | - N. Rothmeier
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Essen, Essen
| | - S. Lang
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Essen, Essen
| | - N. Dominas
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Essen, Essen
| | - T. Hoffmann
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Essen, Essen
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Whiteside TL, Mandapathil M, Schuler P. The role of the adenosinergic pathway in immunosuppression mediated by human regulatory T cells (Treg). Curr Med Chem 2012; 18:5217-23. [PMID: 22087822 DOI: 10.2174/092986711798184334] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 10/01/2011] [Indexed: 12/30/2022]
Abstract
Tumor-induced dysfunction of immune cells is a common problem in cancer. Tumors induce immune suppression by many different mechanisms, including accumulation of regulatory T cells (Treg). Adaptive Treg (Tr1) generated in the tumor microenvironment express CD39 and CD73 ectonucleotidases, produce adenosine and are COX2+PGE2+. Adenosine and PGE2 produced by Tr1 or tumor cells bind to their respective receptors on the surface of T effector cells (Teff) and cooperate in up-regulating cytosolic 3'5'-cAMP levels utilizing adenylyl cyclase isoform 7 (AC-7). In Teff, increased cAMP mediates suppression of anti-tumor functions. Treg, in contrast to Teff, seem to require high cAMP levels for mediating suppression. This differential requirement of Treg and Teff for cAMP offers an opportunity for pharmacologic interventions using selected inhibitors of the adenosine/PGE2 pathways. Blocking of adenosine/PGE2 production by Tr1 or blocking binding of these factors to their receptors on T cells or inhibition of cAMP synthesis in Teff all represent novel therapeutic strategies that used in combination with conventional therapies could restore anti-tumor functions of Teff . At the same time, these inhibitors could disarm Tr1 cells by depriving them of the factors promoting their generation and activity or by down-regulating 3'5'-cAMP levels. Thus, the pharmacologic control of Treg-Teff interactions offers a novel strategy for restoration of anti-tumor Teff functions and silencing of Treg. Used in conjunction with anti-cancer drugs or with immune therapies, this strategy has a potential to improve therapeutic effects by preventing or reversing tumor-induced immune suppression.
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Affiliation(s)
- T L Whiteside
- University of Pittsburgh Cancer Institute, Research Pavilion at the Hillman Cancer Center, 5117 Centre Avenue, Suite 1.27, Pittsburgh, PA 15213-1863, USA.
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Radke P, Joost A, Kaiser A, Basler M, Mandapathil M, Weber C, Yla-Herttuala S, Ito W. 404 EVALUATION OF A DIABETIC RABBIT MODEL FOR IN-STENT RESTENOSIS. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70405-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Radke P, Joost A, Kaiser A, Mandapathil M, Basler M, Yla-Herttuala S, Weber C, Ito W. 377 EFFECTS OF TACROLIMUS-ELUTING STENTS IN A DIABETIC RABBIT MODEL OF IN-STENT RESTENOSIS. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70378-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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13
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Szajnik ME, Szczepanski MJ, Czystowska M, Elishaev E, Mandapathil M, Nowak-Markwitz E, Spaczynski M, Whiteside TL. Expression and signaling of Toll-like receptor 4 (TLR4) and MyD88 in ovarian carcinoma cells. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e16508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e16508 Background: TLR4, expressed by the cells of the immune system play a role in the protection of the host against pathogens. TLRs are also expressed on human cancer cells, but their role in tumor growth is unknown. The aim of this study was to correlate the presence of TLR4 and MyD88 expression with clinicopathologic outcome in patients with ovarian cancer and to analyze the consequences of signaling via the TLR4/MyD88 pathway in ovarian cancer cell lines. Methods: Tumor specimens from 41 patients with ovarian carcinoma were evaluated for TLR4 and MyD88 by immunohistochemistry and correlated with clinical and pathologic disease features. TLR4/MyD88 expression in OVCAR3, SKOV3, and A2780 was determined using RT-PCR, WB, and immunohistochemistry. NF-kB translocation to nucleus was measured by confocal microscopy. Culture supernatants were tested for levels of cytokines in Luminex-based assays. Proliferation of cancer cells was measured in the CFSE assays. Their sensitivity to paclitaxel (PLX) was measured by Annexin V binding. Western Blot analysis was used to measure activation of the PI3K/Akt, IRAK 1, IRAK 4, and TRIF. Results: In ovarian cancer patients TLR4 and MyD88 expression by the tumor was observed in 100% and 83% of tissues, respectively. The expression of MyD88 was associated with shorter progression-free survival (42 vs 31 months, p < 0.05). Ex vivo studies showed that TLR4 was expressed on OVCAR3, SKOV3, and A2780 cell lines, while A2780 did not expressed MyD88. In MyD88+ tumor cells, LPS increased proliferation (PI 17 vs 8, p < 0.05), activated NF-kB pathway and promoted cytokine production (IL-8, IL-6, RANTES, VEGF and MCP-1). LPS and PLX binding to TLR4 on MyD88+ cells induced activation of PI3K/Akt, IRAK4, and IRAK1, but decreased expression of pro-apoptotic TRIF. In contrast, in MyD88(-) cells LPS did not induce proliferation and neither LPS nor PLX induced secretion of pro-inflammatory cytokines. Further, no changes were noted in IRAK1 expression, but strong signal was observed for TRIF. TLR4+/MyD88+ tumor cells showed grater resistance to PLX. Conclusions: Our ex vivo studies elucidate the molecular mechanisms involved in TLR4/MyD88 signaling. Ligation via TLR4 leads to tumor growth, release of proinflammatory cytokines and induction of resistance to PLX-induced apoptosis. No significant financial relationships to disclose.
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Affiliation(s)
- M. E. Szajnik
- University of Pittsburgh, Pittsburgh, PA; Poznan University of Medical Sciences, Poznan, Poland
| | - M. J. Szczepanski
- University of Pittsburgh, Pittsburgh, PA; Poznan University of Medical Sciences, Poznan, Poland
| | - M. Czystowska
- University of Pittsburgh, Pittsburgh, PA; Poznan University of Medical Sciences, Poznan, Poland
| | - E. Elishaev
- University of Pittsburgh, Pittsburgh, PA; Poznan University of Medical Sciences, Poznan, Poland
| | - M. Mandapathil
- University of Pittsburgh, Pittsburgh, PA; Poznan University of Medical Sciences, Poznan, Poland
| | - E. Nowak-Markwitz
- University of Pittsburgh, Pittsburgh, PA; Poznan University of Medical Sciences, Poznan, Poland
| | - M. Spaczynski
- University of Pittsburgh, Pittsburgh, PA; Poznan University of Medical Sciences, Poznan, Poland
| | - T. L. Whiteside
- University of Pittsburgh, Pittsburgh, PA; Poznan University of Medical Sciences, Poznan, Poland
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