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Mohamad MA, Ahmad Asnawi AW, Suhiman MS, Sathar J, Hayati AR, Abdul Rahim NS, Masri MA, Abdul Hamid N, Nurul Farihah S, Mohamad Nor N, Nur Fariha MM. Placenta microRNA profile of patient with Obstetric Antiphospholipid Syndrome. Malays J Pathol 2023; 45:425-440. [PMID: 38155384] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
The onset of obstetric antiphospholipid syndrome (APS) occurs when antiphospholipid antibodies act upon the placenta. During pregnancy, APS exhibits traits such as vascular thrombosis, inflammation, and hindered trophoblast implantation. The involvement of microRNA expression has been proposed as a genetic factor contributing to the syndrome's development. MicroRNAs play a role in regulating gene expression in various cellular processes, including the formation of placental tissue. Therefore, additional research is needed to explore the control of placental miRNA in APS. In this study, we aimed to profile miRNA expressions from placenta tissue of patients with APS. Differentially expressed miRNAs were determined for its targeted genes and pathways. Agilent microarray platform was used to measure placental microRNA expressions between normal placental tissue and those obtained from patients with APS. Differentially expressed miRNAs were detected using GeneSpring GX software 14.2 and sequences were mapped using TargetScan software to generate the predicted target genes. Pathway analysis for the genes was then performed on PANTHER and REACTOME software. Selected miRNAs and their associated genes of interest were validated using qPCR. Microarray findings revealed, 9 downregulated and 21 upregulated miRNAs expressed in placenta of patients with APS. Quantitative expressions of 3 selected miRNAs were in agreement with the microarray findings, however only miR-525-5p expression was statistically significant. Pathway analysis revealed that the targeted genes of differentially expressed miRNAs were involved in several hypothesised signalling pathways such as the vascular endothelial (VE) growth factor (VEGF) and inflammatory pathways. VE-cadherin, ras homolog member A (RHOA) and tyrosine kinase receptor (KIT) showed significant downregulation while Retinoblastoma gene (RET), Dual specificity protein phosphatase 10 (DUSP10) and B-lymphocyte kinase (BLK) genes were significantly upregulated. These preliminary findings suggest the involvement of miRNAs and identified novel associated genes involvement in the mechanism of obstetric APS, particularly through the alteration of vascular-associated regulators and the inflammatory signalling cascade.
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Affiliation(s)
- M A Mohamad
- Universiti Sains Islam Malaysia, Faculty of Medicine and Health Sciences, Negeri Sembilan, Malaysia
| | - A W Ahmad Asnawi
- Universiti Sains Islam Malaysia, Faculty of Medicine and Health Sciences, Negeri Sembilan, Malaysia
| | - M S Suhiman
- Universiti Sains Islam Malaysia, Faculty of Medicine and Health Sciences, Negeri Sembilan, Malaysia
| | - J Sathar
- Hospital Ampang, Department of Haematology, Malaysia
| | - A R Hayati
- Universiti Sains Islam Malaysia, Faculty of Medicine and Health Sciences, Negeri Sembilan, Malaysia
| | - N S Abdul Rahim
- Universiti Sains Islam Malaysia, Faculty of Medicine and Health Sciences, Negeri Sembilan, Malaysia
| | - M A Masri
- Universiti Sains Islam Malaysia, Faculty of Medicine and Health Sciences, Negeri Sembilan, Malaysia
| | - N Abdul Hamid
- Universiti Sains Islam Malaysia, Faculty of Medicine and Health Sciences, Negeri Sembilan, Malaysia
| | - S Nurul Farihah
- Universiti Sains Islam Malaysia, Faculty of Medicine and Health Sciences, Negeri Sembilan, Malaysia
| | - N Mohamad Nor
- Universiti Sains Islam Malaysia, Faculty of Medicine and Health Sciences, Negeri Sembilan, Malaysia
| | - M M Nur Fariha
- Universiti Sains Islam Malaysia, Faculty of Medicine and Health Sciences, Negeri Sembilan, Malaysia.
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Venkatesan S, Myles PR, Leonardi-Bee J, Muthuri SG, Al Masri M, Andrews N, Bantar C, Dubnov-Raz G, Gérardin P, Koay ESC, Loh TP, Memish Z, Miller E, Oliva ME, Rath BA, Schweiger B, Tang JW, Tran D, Vidmar T, Waight PA, Nguyen-Van-Tam JS. Impact of Outpatient Neuraminidase Inhibitor Treatment in Patients Infected With Influenza A(H1N1)pdm09 at High Risk of Hospitalization: An Individual Participant Data Metaanalysis. Clin Infect Dis 2018; 64:1328-1334. [PMID: 28199524 PMCID: PMC5411393 DOI: 10.1093/cid/cix127] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 02/10/2017] [Indexed: 12/05/2022] Open
Abstract
Background. While evidence exists to support the effectiveness of neuraminidase inhibitors (NAIs) in reducing mortality when given to hospitalized patients with A(H1N1)pdm09 virus infection, the impact of outpatient treatment on hospitalization has not been clearly established. We investigated the impact of outpatient NAI treatment on subsequent hospitalization in patients with A(H1N1)pdm09 virus infection. Methods. We assembled general community and outpatient data from 9 clinical centers in different countries collected between January 2009 and December 2010. We standardized data from each study center to create a pooled dataset and then used mixed-effects logistic regression modeling to determine the effect of NAI treatment on hospitalization. We adjusted for NAI treatment propensity and preadmission antibiotic use, including “study center” as a random intercept to account for differences in baseline hospitalization rate between centers. Results. We included 3376 patients with influenza A(H1N1)pdm09, of whom 3085 (91.4%) had laboratory-confirmed infection. Eight hundred seventy-three patients (25.8%) received outpatient or community-based NAI treatment, 928 of 2395 (38.8%) with available data had dyspnea or respiratory distress, and hospitalizations occurred in 1705 (50.5%). After adjustment for preadmission antibiotics and NAI treatment propensity, preadmission NAI treatment was associated with decreased odds of hospital admission compared to no NAI treatment (adjusted odds ratio, 0.24; 95% confidence interval, 0.20–0.30). Conclusions. In a population with confirmed or suspected A(H1N1)pdm09 and at high risk of hospitalization, outpatient or community-based NAI treatment significantly reduced the likelihood of requiring hospital admission. These data suggest that community patients with severe influenza should receive NAI treatment.
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Affiliation(s)
- Sudhir Venkatesan
- Division of Epidemiology and Public Health, University of Nottingham, and
| | - Puja R Myles
- Division of Epidemiology and Public Health, University of Nottingham, and
| | - Jo Leonardi-Bee
- Division of Epidemiology and Public Health, University of Nottingham, and
| | - Stella G Muthuri
- MRC Unit for Lifelong Health and Ageing, University College London, United Kingdom
| | | | | | - Carlos Bantar
- Department of Infection Control, Hospital San Martín de Paraná, Entre Ríos, Argentina
| | - Gal Dubnov-Raz
- Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel
| | - Patrick Gérardin
- Pôle Femme Mère Enfant, Centre Hospitalier Universitaire de la Réunion.,Institut National de la Santé et de la Recherche Médical (INSERM) Centre for Clinical Investigation (CIC1410), Centre Hospitalier Universitaire de la Réunion, Saint Pierre.,Unité Mixte 134 PIMIT "Processus Infectieux en Milieu Insulaire Tropical" (Centre National de la Recherche Scientifique 9192, INSERM U1187, Institut Recherche et Développement 249), Université de la Réunion, CYROI "Cyclotron Réunion-océan Indien", Sainte Clotilde, Reunion
| | - Evelyn S C Koay
- Molecular Diagnostic Centre, Department of Laboratory Medicine National University Hospital, and.,Department of Pathology, National University of Singapore
| | - Tze Ping Loh
- Molecular Diagnostic Centre, Department of Laboratory Medicine National University Hospital, and
| | - Ziad Memish
- Ministry of Health, Riyadh, Kingdom of Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | | | - Maria E Oliva
- Department of Infection Control, Hospital San Martín de Paraná, Entre Ríos, Argentina
| | - Barbara A Rath
- Department of Pediatrics, Charité University Medical Center, and
| | - Brunhilde Schweiger
- National Reference Centre Influenza at Robert Koch Institute, Berlin, Germany
| | - Julian W Tang
- Molecular Diagnostic Centre, Department of Laboratory Medicine National University Hospital, and.,University Hospitals Leicester, and.,Department of Infection, Immunity and Inflammation, University of Leicester, United Kingdom
| | - Dat Tran
- Division of Infectious Diseases, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Canada
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3
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Assiri A, Abedi GR, Al Masri M, Bin Saeed A, Gerber SI, Watson JT. Middle East Respiratory Syndrome Coronavirus Infection During Pregnancy: A Report of 5 Cases From Saudi Arabia. Clin Infect Dis 2016; 63:951-3. [PMID: 27358348 PMCID: PMC5812010 DOI: 10.1093/cid/ciw412] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 06/13/2016] [Indexed: 12/24/2022] Open
Abstract
Little is known about the effects of Middle East respiratory syndrome coronavirus (MERS-CoV) during pregnancy. In Saudi Arabia, 5 cases of MERS-CoV infection among pregnant women were reviewed, and all cases resulted in adverse outcomes. MERS-CoV infection during pregnancy may be associated with maternal and perinatal disease and death.
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Affiliation(s)
| | - Glen R Abedi
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Susan I Gerber
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John T Watson
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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4
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Hall AJ, Tokars JI, Badreddine SA, Saad ZB, Furukawa E, Al Masri M, Haynes LM, Gerber SI, Kuhar DT, Miao C, Trivedi SU, Pallansch MA, Hajjeh R, Memish ZA. Health care worker contact with MERS patient, Saudi Arabia. Emerg Infect Dis 2015; 20:2148-51. [PMID: 25418612 PMCID: PMC4257796 DOI: 10.3201/eid2012.141211] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
To investigate potential transmission of Middle East respiratory syndrome coronavirus (MERS-CoV) to health care workers in a hospital, we serologically tested hospital contacts of the index case-patient in Saudi Arabia, 4 months after his death. None of the 48 contacts showed evidence of MERS-CoV infection.
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5
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Benkouiten S, Charrel R, Belhouchat K, Drali T, Nougairede A, Salez N, Memish ZA, Al Masri M, Fournier PE, Raoult D, Brouqui P, Parola P, Gautret P. Respiratory viruses and bacteria among pilgrims during the 2013 Hajj. Emerg Infect Dis 2015; 20:1821-7. [PMID: 25341199 PMCID: PMC4214309 DOI: 10.3201/eid2011.140600] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The most common pathogens detected were coronaviruses, rhinoviruses, influenza viruses, and Streptococcus pneumoniae. Pilgrims returning from the Hajj might contribute to international spreading of respiratory pathogens. Nasal and throat swab specimens were obtained from 129 pilgrims in 2013 before they departed from France and before they left Saudi Arabia, and tested by PCR for respiratory viruses and bacteria. Overall, 21.5% and 38.8% of pre-Hajj and post-Hajj specimens, respectively, were positive for ≥1 virus (p = 0.003). One third (29.8%) of the participants acquired ≥1 virus, particularly rhinovirus (14.0%), coronavirus E229 (12.4%), and influenza A(H3N2) virus (6.2%) while in Saudi Arabia. None of the participants were positive for the Middle East respiratory syndrome coronavirus. In addition, 50.0% and 62.0% of pre-Hajj and post-Hajj specimens, respectively, were positive for Streptococcus pneumoniae (p = 0.053). One third (36.3%) of the participants had acquired S. pneumoniae during their stay. Our results confirm high acquisition rates of rhinovirus and S. pneumoniae in pilgrims and highlight the acquisition of coronavirus E229.
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Gautret P, Charrel R, Benkouiten S, Belhouchat K, Nougairede A, Drali T, Salez N, Memish ZA, Al Masri M, Lagier JC, Million M, Raoult D, Brouqui P, Parola P. Lack of MERS coronavirus but prevalence of influenza virus in French pilgrims after 2013 Hajj. Emerg Infect Dis 2014; 20:728-30. [PMID: 24656283 PMCID: PMC3966380 DOI: 10.3201/eid2004.131708] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Memish ZA, Alsahly A, Masri MA, Heil GL, Anderson BD, Peiris M, Khan SU, Gray GC. Sparse evidence of MERS-CoV infection among animal workers living in Southern Saudi Arabia during 2012. Influenza Other Respir Viruses 2014; 9:64-7. [PMID: 25470665 PMCID: PMC4353318 DOI: 10.1111/irv.12287] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2014] [Indexed: 01/24/2023] Open
Abstract
Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging viral pathogen that primarily causes respiratory illness. We conducted a seroprevalence study of banked human serum samples collected in 2012 from Southern Saudi Arabia. Sera from 300 animal workers (17% with daily camel exposure) and 50 non-animal-exposed controls were examined for serological evidence of MERS-CoV infection by a pseudoparticle MERS-CoV spike protein neutralization assay. None of the sera reproducibly neutralized the MERS-CoV-pseudotyped lentiviral vector. These data suggest that serological evidence of zoonotic transmission of MERS-CoV was not common among animal workers in Southern Saudi Arabia during July 2012.
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Affiliation(s)
- Ziad A Memish
- Ministry of Health, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, KSA
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8
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Benkouiten S, Gautret P, Belhouchat K, Drali T, Nougairede A, Salez N, Memish ZA, Al Masri M, Raoult D, Brouqui P, Parola P, Charrel RN. Comparison of nasal swabs with throat swabs for the detection of respiratory viruses by real-time reverse transcriptase PCR in adult Hajj pilgrims. J Infect 2014; 70:207-10. [PMID: 25193499 PMCID: PMC7127672 DOI: 10.1016/j.jinf.2014.08.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 08/26/2014] [Indexed: 01/15/2023]
Affiliation(s)
- Samir Benkouiten
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005 Marseille, France; Institut Hospitalo-Universitaire Méditerranée Infection, 13005 Marseille, France
| | - Philippe Gautret
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005 Marseille, France; Institut Hospitalo-Universitaire Méditerranée Infection, 13005 Marseille, France.
| | - Khadidja Belhouchat
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005 Marseille, France
| | - Tassadit Drali
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005 Marseille, France
| | - Antoine Nougairede
- Institut Hospitalo-Universitaire Méditerranée Infection, 13005 Marseille, France; Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 Emergence des Pathologies Virales, 13385, Marseille, France
| | - Nicolas Salez
- Institut Hospitalo-Universitaire Méditerranée Infection, 13005 Marseille, France; Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 Emergence des Pathologies Virales, 13385, Marseille, France
| | - Ziad A Memish
- Public Health Directorate, Saudi Ministry of Health, WHO Collaborating Center for Mass Gathering Medicine, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Malak Al Masri
- Public Health Directorate, Saudi Ministry of Health, WHO Collaborating Center for Mass Gathering Medicine, Riyadh, Saudi Arabia
| | - Didier Raoult
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005 Marseille, France; Institut Hospitalo-Universitaire Méditerranée Infection, 13005 Marseille, France
| | - Philippe Brouqui
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005 Marseille, France; Institut Hospitalo-Universitaire Méditerranée Infection, 13005 Marseille, France
| | - Philippe Parola
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005 Marseille, France; Institut Hospitalo-Universitaire Méditerranée Infection, 13005 Marseille, France
| | - Rémi N Charrel
- Institut Hospitalo-Universitaire Méditerranée Infection, 13005 Marseille, France; Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 Emergence des Pathologies Virales, 13385, Marseille, France
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9
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Benkouiten S, Gautret P, Belhouchat K, Drali T, Salez N, Memish ZA, Al Masri M, Fournier PE, Brouqui P. Acquisition of Streptococcus pneumoniae carriage in pilgrims during the 2012 Hajj. Clin Infect Dis 2013; 58:e106-9. [PMID: 24248810 DOI: 10.1093/cid/cit749] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [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: 01/11/2023] Open
Abstract
To investigate the nasal carriage of some respiratory bacterial pathogens that are responsible for infections associated with person-to-person transmission, we conducted a cohort survey of pilgrims departing to Mecca for the 2012 Hajj season. In this report, we demonstrate the acquisition of Streptococcus pneumoniae nasal carriage in returning Hajj pilgrims.
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Affiliation(s)
- Samir Benkouiten
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095
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10
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Masri MA, Rizk S, Attia MLE, Barbouch H, Rost M. Bioavailability of a New Generic Formulation of Mycophenolate Mofetil MMF 500 Versus CellCept in Healthy Adult Volunteers. Transplant Proc 2007; 39:1233-6. [PMID: 17524942 DOI: 10.1016/j.transproceed.2007.03.055] [Citation(s) in RCA: 9] [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
Several studies have revealed a decreased incidence of early graft rejection with the use of mycophenate mofetil (MMF). The cost of the drug is, however, prohibitive especially in developing countries with limited resources. We compared the pharmacokinetic profile of a new MMF generic formulation (MMF 500 batch number: 06T3001; Medis Tunis) with those of Cellcept, (batch number: M1427; Hoffmann La Roche, Switzerland) in healthy volunteers. The study was double-blinded to investigator and volunteers. It had a balanced randomized, two-treatment, two-period, two-sequence, single-dose, crossover, comparative oral bioavailability design in adult healthy human volunteers. The study was designed, performed, and monitored by CRO Transmedical s.a.l International (Beirut, Lebanon) in accordance with the Basic Principals defined in the US 21 CFR Part 312.20, and the principals enunciated in the World Medical Association Declaration of Helsinki. We included nonsmoking healthy volunteers between the ages of 22 and 45 years. The subjects were admitted to the hospital one night prior to blood sampling. After volunteers received the same dinner, they were fasted overnight and for 2 hours postdosing. At 8 am each person received a single oral dose of 500 mg of either formulation. Blood samples were collected to construct the pharmacokinetic profiles as follows: 0, 0.15, 0.30, 0.45 minutes and 1, 1.15, 1.30, 2, 4, 6, 10, 12, and 24 hours. Water and food intake were the same for all volunteers during the whole study period. Following an 8-day washout period, the subjects were crossed over. Plasma mycophenolic acid concentrations were determined using a high-performance liquid chromatography validated enzyme-linked immunosorbent assay-based method (TransMedical, Beirut Lebanon). Physical examinations, hematology, urinanalysis, serum chemistry tests, and liver enzymes were performed at screening and at the end of each period. Subjects were monitored for safety and adverse events throughout the study by two physicians (one from the hospital and one from TransMedical). The Cmax, Tmax, and AUC for MMF 500 were 10.14 ng/mL, 51.82 minutes, and 18.33 ng/mL/h vs 10.94 ng/mL, 49.09 minutes, and 17.46 ng/mL/h for CellCept, respectively. The 90% confidence intervals (LSM) of Cmax, Tmax, and AUC for MMF 500 were 92.7%, 105.6%, and 105%, respectively, which is within the Food and Drug Administration (FDA)-assigned range for immunosuppressive drugs (90% to 111%). These results indicated that the products are equivalent and switchable according to FDA rulings.
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Affiliation(s)
- M A Masri
- TransMedical Drug Evaluation Center, Beirut, Lebanon
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11
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Barbari AG, Stephan AG, Masri MA. Calcineurin inhibitor-free protocols: risks and benefits. Saudi J Kidney Dis Transpl 2007; 18:1-23. [PMID: 17237886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
The nephrotoxic and extra-renal adverse effects associated with calcineurin inhibitor (CNI) therapies appear to have a negative impact on long-term graft survival. Several CNI minimization protocols have been recently studied. These protocols involve either early CNI avoidance or CNI withdrawal. CNI withdrawal strategies are associated with a significant improvement in renal function and graft survival on both a short and long-term basis. Delayed and progressive withdrawal appears to be safer. Maintaining a high mycophenolate mofetil (MMF) or sirolimus (SIR) exposure minimizes the risk of acute rejection. CNI avoidance regimens using maintenance mono-therapy or combination therapies without induction appear to be immunologically risky and unsafe. In contrast, the combination of SIR + MMF with induction therapy reduces markedly the incidence of acute rejection and chronic allograft nephropathy (CAN). Two year patient and graft survival levels were comparable. CAN as well as the incidence and the risk for cancer in addition to blood pressure profiles and uric acid levels were overall lower in the SIR-based treatment. In contrast, hyperlipidemia, delayed wound healing, lymphocele, arthralgias, thrombocytopenia and study protocol deviations were reported more frequently in the SIR-maintenance protocols. Longer-term follow-ups are definitely needed to determine whether these avoidance strategies will result in a significant improvement in long-term patient and graft survival. Outcome differences among various protocols within the same CNI elimination strategy are probably related to study design, patient selection criteria, immunosuppression monitoring methods, indications for graft biopsies, environmental, and both genetic and ethnic factors. All monitoring techniques are unreliable short of a graft biopsy. Preliminary results on drug lymphocyte binding may offer new guidelines for tailoring immunosuppression. Whether these protocols based on SIR or SIR + MMF can also be extended to high risk patients is currently unknown. These encouraging results allow speculation but with caution that the use of the combination of non-nephrotoxic immunosuppression such as SIR and MMF, might change dramatically the natural course of CAN and may influence long-term patient survival.
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Barbari AG, Masri MA, Stephan AG, El Ghoul B, Rizk S, Mourad N, Kamel GS, Kilani HE, Karam AS. Cyclosporine lymphocyte maximum level monitoring in de novo kidney transplant patients: a prospective study. EXP CLIN TRANSPLANT 2006; 4:400-5. [PMID: 16827634] [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: 05/10/2023]
Abstract
OBJECTIVES To determine prospectively the temporal variations of cyclosporine-A lymphocyte maximum level, whole blood maximum concentration, and total lymphocyte count in patients with de novo kidney transplantation. MATERIALS AND METHODS Lymphocyte maximum level, whole blood maximum concentration, and total lymphocyte count were prospectively measured in 35 patients at 1, 2, and 3 months after kidney transplantation. Two groups--a biopsy-proven acute rejection group (REJ+) and a rejection-free group (REJ-)--were compared. RESULTS Both groups had similar lymphocyte maximum levels, whole blood maximum concentrations, and total lymphocyte counts at the first month after transplantation. REJ+ patients had significantly lower lymphocyte maximum levels at 2 and 3 months (59+/-34 and 33+/-9 pg/Lc) and higher total lymphocyte counts (0.00204+/-0.00078x10(9)/L and 0.00203+/-0.00022x10(9)/L) when compared with their REJ- counterparts (87+/-56 and 63+/-30 pg/Lc, P<.05 and P<.007) and (0.00137+/-0.00074x10(9)/L and 0.0015+/-0.0006x10(9)/L, P<.02 and P<.003) respectively. Whole blood maximum concentrations were significantly higher in patients in the REJ+ group (2050+/-623 vs 1414+/-536 ng/mL, P<.02) at 2 months. At 3 months, the 2 groups were comparable (1158+/-340 vs 1365+/-525 ng/mL, P=NS). CONCLUSIONS These results suggest that acute rejection is associated with a relatively low cyclosporine- A lymphocyte maximum level and high total lymphocyte count in the early posttransplant period. Cyclosporine-A whole blood maximum concentration failed to correlate with clinical outcome. Cyclosporine-A lymphocyte maximum level seems to offer a more reliable alternative than does whole blood maximum concentration for cyclosporine-A monitoring in patients with kidney transplantation.
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Affiliation(s)
- A G Barbari
- Nephrology and Transplantation Unit, Rizk Hospital, Beirut, Lebanon.
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13
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Masri MA, Haberal M, Rizvi A, Stephan A, Bilgin N, Naqvi A, Barbari A, Kamel G, Zafar N, Emiroğlu R, Colak T, Manzoor K, Matha V, Kamarad V, Rost M, Rizk S, Hazime A, Perlik F. Switchability of neoral and equoral according to Food and Drug Administration rules and regulations. Transplant Proc 2006; 37:2988-93. [PMID: 16213282 DOI: 10.1016/j.transproceed.2005.07.055] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [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: 10/25/2022]
Abstract
According to the US Food and Drug Administration (FDA), if a drug product contains a drug substance that is chemically identical and is delivered to the site of action at the same rate and extent as another drug product, then it is equivalent and can be substituted (switchable) for that drug product. Methods used to define bioequivalence as stated by the FDA rules (FDA 21 CFR 320, 24) are (1) pharmacokinetic (PK) studies in healthy volunteers, (2) comparative clinical trials, and (3) pharmacodynamic (PD) studies (bioactivity). We evaluated the switchability of Equoral (IVAX-USA) with Neoral (Novartis Switzerland using all FDA rules. In a single oral dose, we undertook a comparative bioavailability study of Equoral (IVAX, USA) Neoral (Novartis, USA), and Neoral (Novartis UK). The pharmacokinetics of Equoral and Neoral were determined with blood levels at 0, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 30, 36, 42, and 48 hours. The area under curve (AUC), AUC extrapolated to infinity (AUC0-inf), rate of absorption (Tmax), extent of absorption (Cmax), half time (t1/2) of Equoral and Neoral were all within the 90% confidence interval of 80% to 125% boundaries. A comparative multinational multicenter clinical trial in stable renal transplant patients included 70 patients (22 women and 48 men) of mean age of 33 years (range, 26 to 43) was performed in Turkey, Lebanon, and Pakistan. In this study the ratios of LSM and the 90% confidence intervals for the Nontransformed/Parameters (AUC0-t, AUCinf, Tmax, and Cmax) of Equoral and Neoral SGC were 98% and 95%, respectively, which are within the 80% to 125% FDA acceptance range. For immunosuppressive drugs, the site of action is the lymphocyte and the measurable response is the decrease in lymphocyte count caused by the relative concentration of the drug in the lymphocyte. In a controlled switch, fixed-dose study, both Equoral and Neoral achieved the same concentration in the lymphocytes and caused the same degree of lymphocyte count reduction. The results of the testing (bioavailability-bioequivalence, clinical studies, and pharmacodynamic-bioactivity) required by FDA for interchangeability ("switchability") of immunosuppressive agents suggests that Neoral and Equoral are switchable.
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Barbari A, Stephan A, Masri MA, Kamel G, Karam A, Mourad N, Kilani H, El Ghoul B. Mycophenolic acid plasma trough level: correlation with clinical outcome. EXP CLIN TRANSPLANT 2005; 3:355-60. [PMID: 16417443] [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: 05/06/2023]
Abstract
OBJECTIVES Assess the relationship between clinical diagnosis, state of immunosuppression, mycophenolic acid (MPA) plasma trough levels (MPACmin), and mycophenolate mofetil (MMF) dosage in renal transplant recipients. MATERIALS AND METHODS MPACmin were determined in 30 kidney transplant patients, of whom 7 exhibited biopsy-proven acute rejection. The remaining 23 had normal graft function. Graft outcome, defined by clinical diagnosis and serum creatinine level, was compared according to MPACmin, MMF dosage, and total lymphocyte count (LC). RESULTS Patients with acute rejection had similar MPACmin (2.4 +/- 1.7 microg/mL), MMF dosages (1.7 +/- 0.5 g), and LCs (0.001165 +/- 0.0040 x 10(9)/L) when compared with normal patients (2.2 +/- 0.7 microg/mL, 1.7 +/- 0.4 g and 0.001160 +/- 0.00527 x 10(9)/L) respectively. Rejection rates were comparable irrespective of MPACmin)ranges and higher in those receiving the 1-g dose (30%) when compared with those receiving 1.5-g and 2-g doses (12.5% and 11.7%). No relationship was observed between MPACmin and MMF doses, and neither parameter correlated with LC. CONCLUSIONS These results suggest that MPACmin is a poor correlate of clinical outcome and state of immunosuppression. Although the usually recommended dosage of MMF (2 g) may be associated with acute rejection, low-dose MMF (1 g) seems to constitute a higher risk.
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Affiliation(s)
- A Barbari
- Nephrology and Transplantation Unit, Rizk Hospital, Ashrafieh, Beirut, Lebanon.
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Kremkova MM, Grachev AV, Aliavi BA, Iakubov MM, Masri MA. [A comparative assessment of valsartan and lisinopril effects on systolic and diastolic function of the left ventricular in patients with acute Q-infarction]. Kardiologiia 2005; 45:82-3. [PMID: 15821717] [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: 05/02/2023]
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Masri MA, Haberal M, Rizvi A, Stephan A, Bilgin N, Naqvi A, Barbari A, Kamel G, Zafar N, Emiroğlu R, Colak T, Manzoor K, Matha V, Kamarad V, Rizk S, Itany AR, Shehedeh I. The pharmacokinetics of equoral versus neoral in stable renal transplant patients: a multinational multicenter study. Transplant Proc 2004; 36:80-3. [PMID: 15013306 DOI: 10.1016/j.transproceed.2003.11.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [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: 11/25/2022]
Abstract
We studied the pharmacokinetics (PKs) of the new generic cyclosporine formulation, Equoral capsules, after the switch from original formulation Neoral capsules in stable renal transplant patients. The study was carried out in accordance with the basic principles defined in the US 21 CFR Part 312.20 and the principles of the Declaration of Helsinki. The study included clinically stable first renal transplant patients maintained on cyclosporine with no rejection episode during the past 6 months. Hematology, biochemistry, and urine chemistry were determined on day 7, and day 21. The patients were all switched to Neoral (lot number 416MFD0601) on day 0 when the first sparse sampling PK was performed. On day 14 a 12-hour PK profile included predose, 30 minutes; 1 hour; 1 hour 30 minutes; 2 hours; 3 hours; 4 hours; 5 hours; 6 hours; 8 hours; 10-hours and 12-hour samples. Cyclosporine levels were determined using a CYA kit (Abbott TDx). On day 15 the patients were switched from Neoral capsules to Equoral capsules (lot 5T111014) at an equivalent dosage (mg/mg). The second sparse sampling PK was performed on day 21 and a 12-hour PK was performed on day 28. On the morning of day 29 patients were switched from Equoral capsules to Neoral capsules at an equivalent dosage (mg/mg). Additional concentrations were measured on days -7, 18, and 35. Safety parameters were monitored at each visit. The pharmacokinetics of both formulations were equivalent. The mean AUC for Neoral and Equoral was 2856 and 2892, respectively. The ratios of LSM and the 90% confidence intervals for the in-transformed parameters (AUC o-t, AUC inf, and Cmax) of Equoral and Neoral SGC were 98% and 95%, respectively, suggesting that Equoral and Neoral SGC are bioequivalent.
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Abstract
Because several studies having revealed a relation between early graft rejection and long-term graft survival, potential benefits have been attributed to MMF. The cost of the drug is, however, prohibitive, which renders its long-term use in countries with limited income. We thus compared the pharmacokinetic profiles of a new MMF generic formulation (MM-Cept developed by Ivax CR) with those of Cellcept (Hoffman La Roche) in healthy volunteers. This open label, balanced randomized, two-treatment, two-period, two-sequence, single-dose, crossover, comparative oral bioavailability study was conducted in non-smoking adult male healthy volunteers between the ages of 18 and 45 years. The study was performed in accordance with the basic principles defined in the US 21 CFR Part 312.20 and the principles enunciated in the Declaration of Helsinki (World Medical Association Declaration of Helsinki). The subjects were given a single oral 1 g dose with a washout period of 10 days. Pharmacokinetic profiles included blood levels at 0, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 4, 6, 10, 12, 16, 20, 24, 30, 36, and 48 hours following each dose. The formulations were MMCept 500 mg tablets and Cellcept 500 mg tablets. Subjects were fasted overnight and for 4 hours postdosing. Mycophenolic acid (MPA) concentrations were determined using HPLC. Physical examinations, hematology, urinalysis, and serum chemistry tests including liver enzymes were performed at screening and at the end of the study. Subjects were monitored for safety and adverse events throughout the study. Both products showed similar bioavailability. The LSM were within the limits for FDA approval (80 to 125), suggesting that the two products are equivalent and switchable.
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Affiliation(s)
- M A Masri
- Transplant Unit, Rizk Hospital, Beirut, Lebanon.
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19
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Masri MA, Barbari A, Stephan A, Rizk S, Kamel G. Cytokine gene polymorphism in a Lebanese transplant population and its impact on graft acceptance: a single-center pilot study. Transplant Proc 2003; 35:251-2. [PMID: 12591385 DOI: 10.1016/s0041-1345(02)03925-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- M A Masri
- Transplant and Nephrology Unit, Rizk Hospital, Beirut, Lebanon
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22
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Affiliation(s)
- A Barbari
- Nephrology and Transplantation Unit, Rizk Hospital, Beirut, Lebanon.
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23
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Masri MA, Abdel Seed NM, Fahal AH, Romano M, Baralle F, El Hassam AM, Ibrahim ME. Minor role for BRCA2 (exon11) and p53 (exon 5-9) among Sudanese breast cancer patients. Breast Cancer Res Treat 2002; 71:145-7. [PMID: 11883440 DOI: 10.1023/a:1013807830329] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [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: 11/12/2022]
Abstract
A cohort of 20 breast cancer patients from the Sudan was tested for germ line and somatic mutation in their BRCA2 exon 11 as well as the main conserved area of the p53 tumor suppressor gene. The results indicate that both regions may play a limited role in the pathogenesis of breast cancer in those patients. The fact that there are no somatic mutations detected in p53 was particularly surprising as the expected rate for mutations in breast cancer is 30-50%.
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Affiliation(s)
- M A Masri
- Institute of Endemic Diseases, University of Khartoum, Sudan
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Barbari A, Stephan A, Masri MA, Joubran N, Dagher O, Kamel G. Donor specific transfusion in kidney transplantation: effect of different immunosuppressive protocols on graft outcome. Transplant Proc 2001; 33:2787-8. [PMID: 11498161 DOI: 10.1016/s0041-1345(01)02192-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- A Barbari
- Department ofNephrology and Transplantation, Rizk Hospital, Beirut, Lebanon
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Affiliation(s)
- A Stephan
- Department of Transplantation and Nephrology, Rizk Hospital, Beirut, Lebanon
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Barbari A, Masri MA, Stephan A, Mokhbat J, Kilani H, Rizk S, Kamel G, Joubran N. Cyclosporine lymphocyte versus whole blood pharmacokinetic monitoring: correlation with histological findings. Transplant Proc 2001; 33:2782-5. [PMID: 11498159 DOI: 10.1016/s0041-1345(01)02190-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- A Barbari
- Department of Transplantation and Nephrology, Rizk Hospital, Beirut, Lebanon
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27
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Affiliation(s)
- A Barbari
- Nephrology and Transplantation Unit at Rizk Hospital, Beirut, Lebanon
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28
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Affiliation(s)
- M A Masri
- Transplant Unit, Rizk Hospital, Beirut, Lebanon
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Masri MA, Barbari A, Stephan A, Kamel G, Aoun S, Rizk S, Karam A. Safe and cost effective conversion from Neoral to Consupren soft gelatin capsules in stable renal transplant patients: a 1-year study. Transplant Proc 1999; 31:3302-3. [PMID: 10616485 DOI: 10.1016/s0041-1345(99)00734-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- M A Masri
- Department of Transplantation and Immunology, Rizk Hospital, Beirut, Lebanon.
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30
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Affiliation(s)
- M A Masri
- Department of Immunology and Transplantation, Rizk Hospital, Beirut, Lebanon
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31
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Affiliation(s)
- A Stephan
- Transplantation and Nephrology Unit, Rizk Hospital, Beirut, Lebanon.
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Kamel G, Stephan A, Barbari A, Salme P, Zeineh S, Mokhbat J, Karam A, Ghobril R, Masri MA, Khoury-Barakat W. Transplantation at Rizk Hospital: 10 years' experience. Transplant Proc 1998; 30:3114-5. [PMID: 9838374 DOI: 10.1016/s0041-1345(98)00955-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- G Kamel
- Rizk Hospital, Beirut, Lebanon
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33
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Affiliation(s)
- M A Masri
- Department of Immunology and Transplantation, Rizk Hospital, Beirut, Lebanon
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34
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35
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Stephan A, Masri MA, Barbari A, Aoun S, Rizk S, Kamel G. A one-year comparative study of Neoral vs Consupren in de novo renal transplant patients. Transplant Proc 1998; 30:3533-4. [PMID: 9838547 DOI: 10.1016/s0041-1345(98)01125-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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36
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Barbari A, Stephan A, Kamel G, Kilany H, Masri MA. Experience with new cyclosporine formulations: Consupren and Neoral in renal transplant patients. Transplant Proc 1997; 29:2941-4. [PMID: 9365622 DOI: 10.1016/s0041-1345(97)00738-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- A Barbari
- Transplant Unit, Rizk Hospital, Beirut, Lebanon
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Masri MA, Stephan A, Barbari A, Rizk S, Karam A, Kamel G. A comparative study of HLA Allele frequency in Lebanese, Arabs, United Arab Emirates, and east Indian populations. Transplant Proc 1997; 29:2922-3. [PMID: 9365615 DOI: 10.1016/s0041-1345(97)00730-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M A Masri
- Immunology and Transplant Unit, Rizk Hospital, Beirut, Lebanon
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38
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Affiliation(s)
- M A Masri
- Transplant and Immunology Unit, Rizk Hospital, Beirut, Lebanon
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Masri MA, Stephan A, Barbari A, Kamel G, Kelany H, Karam A. Correlation between cyclosporine pharmacokinetics and immunologic parameters in dialyzed patients awaiting transplantation. Transplant Proc 1997; 29:2953-4. [PMID: 9365626 DOI: 10.1016/s0041-1345(97)00742-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M A Masri
- Transplant Unit, Rizk Hospital, Beirut, Lebanon
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40
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Kamel G, Stephan A, Masri MA, Barbari A, Kelany H, Younan F, Karam A. Donor-specific transfusion under the new cyclosporine A formulation Consupren versus azathioprine, Imuran. Transplant Proc 1997; 29:2960-1. [PMID: 9365629 DOI: 10.1016/s0041-1345(97)00745-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- G Kamel
- Transplant Unit, Rizk Hospital, Beirut, Lebanon
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41
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Masri MA, Barbari A, Stephan A, Kamel G, Frem G, Younan F, Rizk S, Moubarak R, Karam A. Cyclosporine pharmacokinetics in stable renal transplant patients: effect of formulation Sandimmun versus Consupren versus Neoral. Transplant Proc 1996; 28:1318-20. [PMID: 8658676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- M A Masri
- Transplant Unit, Rizk Hospital, Beirut, Lebanon
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42
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Stephan AG, Barbari A, Masri MA, Rizk S, Moubarak R, Frem GJ, Kamel G, Baracat-Khoury W, Karam A. Evaluation of the new cyclosporine formulation, Consupren, in renal transplant patients. Transplant Proc 1996; 28:1348-9. [PMID: 8658688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- A G Stephan
- Transplant Unit, Rizk Hospital, Beirut, Lebanon
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Masri MA. Comparative study of toxicity and efficacy of cyclosporine, cyclosporine G (OG37), FK 506, and rapamycin in BALB/c mice with fitted skin grafts. Transplant Proc 1995; 27:366. [PMID: 7533412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Masri MA, Shakuntala V, Shanwaz M, Zaher M, Dhawan I, Yasin I, Pingle A. Pharmacokinetics of cyclosporine in renal transplant patients on diltiazem. Transplant Proc 1994; 26:1921. [PMID: 8066626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- M A Masri
- Faculty of Medicine, Mafraq Hospital, Abu Dhabi, United Arab Emirates
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45
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Masri MA, Shakuntala V, Dhawan IK, Zahir M, Shanwaz M, Yasin I, Pingle A. Erythropoietin and plasmapheresis in the highly sensitized patient: results of a pilot study. Transplant Proc 1994; 26:1855. [PMID: 8066603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- M A Masri
- Faculty of Medicine, Mafraq Hospital, Abu Dhabi, United Arab Emirates
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Masri MA, Shakuntala RV, Dhawan IK, Zahir MB, Shanwaz M, Yassin I, Pingle A. Transplantation in the United Arab Emirates. Transplant Proc 1993; 25:2358. [PMID: 8516928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- M A Masri
- Emirates Institute for Medical Research, Faculty of Medicine, University of the UAE
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Masri MA, Shakuntala V, Dhawan IK, Zahir M, Shanwaz M, Hayes K, Pingle A. Cyclosporine monotherapy versus conventional therapy in the living-related renal transplant: a one center retrospective study. Transplant Proc 1993; 25:2248-9. [PMID: 8516889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- M A Masri
- Faculty of Medicine, Emirates Institute for Medical Research, University of the United Arab Emirates
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Pingle A, Shakuntala RV, Zahir MB, Shanawaz M, Masri MA, Hayes K, Daar AS, Dhawan IK. Factors responsible for elimination of potential kidney donors in a living-related donor kidney transplant program. Transplant Proc 1992; 24:1889-90. [PMID: 1412900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- A Pingle
- Nephrology Department, Abu Dhabi, United Arab Emirates
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Masri MA, Dhawan IK, Hayes K, Zahir M, Shanwaz M, Shakuntala S, Pingle A. The relevance of HLA A,B,C, matching on graft survival, patient survival, and graft function in living related renal transplant patients treated with cyclosporine. Transplant Proc 1992; 24:1676-7. [PMID: 1412793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- M A Masri
- Faculty of Medicine and Health Science, University of the UAE, Abu Dhabi
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Masri MA. Cyclosporine blood level monitoring by three specific methods; RIA H3, RIA I125, and fluorescence polarization: comparison of accuracy, cost, reproducibility and percent recovery. Transplant Proc 1992; 24:1716-7. [PMID: 1412807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- M A Masri
- Faculty of Medicine and Health Science, University of the United Arab Emirates, Abu Dhabi
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