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Logan C, Singh M, Fox N, Brown G, Krishna S, Gordon K, Macallan D, Bicanic T. Chromoblastomycosis treated with posaconazole and adjunctive imiquimod: lending innate immunity a helping hand. Open Forum Infect Dis 2023; 10:ofad124. [PMID: 37035498 PMCID: PMC10077821 DOI: 10.1093/ofid/ofad124] [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] [Received: 12/07/2022] [Accepted: 03/13/2023] [Indexed: 03/16/2023] Open
Abstract
Abstract
Chromoblastomycosis (CBM) is a difficult-to-treat, chronic fungal infection of the skin and subcutaneous tissue. The evidence base for treatment is scarce, with no standardised therapeutic approach. Chronicity of CBM infection is postulated to be due in part to a failure of host cell-mediated immunity to generate a proinflammatory response sufficient for fungal clearance. We present a case of a chronic chromoblastomycosis lesion of the hand present for nearly four decades, previously refractory to itraconazole monotherapy, that was successfully treated with a combination of posaconazole and adjunctive immunotherapy with topical Imiquimod, a toll-like receptor 7 agonist. Serial biopsies and images demonstrate the clinical and histopathological improvement of the lesion. Randomised trials of antifungal therapy with adjunctive imiquimod are warranted to determine whether a combination of antifungal and host-directed therapy improves outcomes for this neglected tropical mycosis.
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Affiliation(s)
- C Logan
- Clinical Infection Unit, St George’s University Hospitals NHS Foundation Trust , Blackshaw Road, London , United Kingdom
- Institute of Infection & Immunity, St Georges University London , Cranmer Terrace, London , United Kingdom
| | - M Singh
- Department of Cellular Pathology, St George’s University Hospitals NHS Foundation Trust , Blackshaw Road, London , United Kingdom
| | - N Fox
- Department of Dermatology, St George’s University Hospitals NHS Foundation Trust , London , United Kingdom
| | - G Brown
- MRC Centre for Medical Mycology, University of Exeter, Geoffrey Pope Building , Stocker Road, Exeter, EX4 4QD , UK
| | - S Krishna
- Department of Dermatology, St George’s University Hospitals NHS Foundation Trust , London , United Kingdom
| | - K Gordon
- Department of Dermatology, St George’s University Hospitals NHS Foundation Trust , London , United Kingdom
| | - D Macallan
- Clinical Infection Unit, St George’s University Hospitals NHS Foundation Trust , Blackshaw Road, London , United Kingdom
- Institute of Infection & Immunity, St Georges University London , Cranmer Terrace, London , United Kingdom
| | - T Bicanic
- Clinical Infection Unit, St George’s University Hospitals NHS Foundation Trust , Blackshaw Road, London , United Kingdom
- Institute of Infection & Immunity, St Georges University London , Cranmer Terrace, London , United Kingdom
- MRC Centre for Medical Mycology, University of Exeter, Geoffrey Pope Building , Stocker Road, Exeter, EX4 4QD , UK
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Yamazaki T, Gunderson AJ, Gilchrist M, Whiteford M, Kiely MX, Hayman A, O'Brien D, Ahmad R, Manchio JV, Fox N, McCarty K, Phillips M, Brosnan E, Vaccaro G, Li R, Simon M, Bernstein E, McCormick M, Yamasaki L, Wu Y, Drokin A, Carnahan T, To Y, Redmond WL, Lee B, Louie J, Hansen E, Solhjem MC, Cramer J, Urba WJ, Gough MJ, Crittenden MR, Young KH. Galunisertib plus neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer: a single-arm, phase 2 trial. Lancet Oncol 2022; 23:1189-1200. [DOI: 10.1016/s1470-2045(22)00446-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/17/2022] [Accepted: 06/28/2022] [Indexed: 02/08/2023]
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Ward R, Fox N, Natkunarajah J. Scurvy: a forgotten cause of purpuric rash. Clin Exp Dermatol 2021; 46:956-957. [PMID: 33655521 DOI: 10.1111/ced.14628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/26/2021] [Accepted: 02/26/2021] [Indexed: 11/29/2022]
Affiliation(s)
- R Ward
- Dermatology Department, Kingston Hospital, Galsworthy Road, Kingston upon Thames, UK
| | - N Fox
- Dermatology Department, Kingston Hospital, Galsworthy Road, Kingston upon Thames, UK
| | - J Natkunarajah
- Dermatology Department, Kingston Hospital, Galsworthy Road, Kingston upon Thames, UK
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Affiliation(s)
- M I Malik
- Department of Internal Medicine, Piedmont Athens Regional Medical Center, 1199 Prince Avenue, Suite 70, Athens, GA 30606, USA
| | - N Fox
- Athens Pulmonary & Sleep Medicine and Piedmont Athens Regional Medical Center, 3320 Old Jefferson Rd # 200a, Athens, GA 30607, USA
- Address correspondence to N. Fox, Athens Pulmonary & Sleep Medicine, 3320 Old Jefferson Rd # 200a, Athens, GA 30607, USA.
| | - A Chopra
- Division of Pulmonary and Critical Care, Albany Medical College, Albany, NY, USA
| | - H Y Hughes
- Division of Infectious Disease Medical University of South Carolina and Ralph H. Johnson VA Medical Center. Charleston, SC
| | - R Washburn
- Division of Infectious Disease Medical University of South Carolina and Ralph H. Johnson VA Medical Center. Charleston, SC
| | - J T Huggins
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina and Ralph H. Johnson VA Medical Center, 171 Ashley Avenue, Charleston, SC 29425, USA
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Gunderson AJ, Yamazaki T, McCarty K, Fox N, Phillips M, Alice A, Blair T, Whiteford M, O'Brien D, Ahmad R, Kiely MX, Hayman A, Crocenzi T, Gough MJ, Crittenden MR, Young KH. TGFβ suppresses CD8 + T cell expression of CXCR3 and tumor trafficking. Nat Commun 2020; 11:1749. [PMID: 32273499 PMCID: PMC7145847 DOI: 10.1038/s41467-020-15404-8] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 03/10/2020] [Indexed: 12/14/2022] Open
Abstract
Transforming growth factor beta (TGFβ) is a multipotent immunosuppressive cytokine. TGFβ excludes immune cells from tumors, and TGFβ inhibition improves the efficacy of cytotoxic and immune therapies. Using preclinical colorectal cancer models in cell type-conditional TGFβ receptor I (ALK5) knockout mice, we interrogate this mechanism. Tumor growth delay and radiation response are unchanged in animals with Treg or macrophage-specific ALK5 deletion. However, CD8αCre-ALK5flox/flox (ALK5ΔCD8) mice reject tumors in high proportions, dependent on CD8+ T cells. ALK5ΔCD8 mice have more tumor-infiltrating effector CD8+ T cells, with more cytotoxic capacity. ALK5-deficient CD8+ T cells exhibit increased CXCR3 expression and enhanced migration towards CXCL10. TGFβ reduces CXCR3 expression, and increases binding of Smad2 to the CXCR3 promoter. In vivo CXCR3 blockade partially abrogates the survival advantage of an ALK5ΔCD8 host. These data demonstrate a mechanism of TGFβ immunosuppression through inhibition of CXCR3 in CD8+ T cells, thereby limiting their trafficking into tumors.
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Affiliation(s)
- Andrew J Gunderson
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA
| | - Tomoko Yamazaki
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA
| | - Kayla McCarty
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA
| | - Nathaniel Fox
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA
| | - Michaela Phillips
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA
| | - Alejandro Alice
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA
| | - Tiffany Blair
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA
| | - Mark Whiteford
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA
- The Oregon Clinic, Colon and Rectal Surgery Division, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA
| | - David O'Brien
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA
- The Oregon Clinic, Colon and Rectal Surgery Division, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA
| | - Rehan Ahmad
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA
- The Oregon Clinic, Colon and Rectal Surgery Division, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA
| | - Maria X Kiely
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA
- The Oregon Clinic, Colon and Rectal Surgery Division, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA
| | - Amanda Hayman
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA
- The Oregon Clinic, Colon and Rectal Surgery Division, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA
| | - Todd Crocenzi
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA
| | - Michael J Gough
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA
| | - Marka R Crittenden
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA
- The Oregon Clinic, Radiation Oncology Division, 4805 NE Glisan St, G level, Portland, OR, 97213, USA
| | - Kristina H Young
- Earle A. Chiles Research Institute, Providence Cancer Institute, 4805 NE Glisan St, Portland, OR, 97213, USA.
- The Oregon Clinic, Radiation Oncology Division, 4805 NE Glisan St, G level, Portland, OR, 97213, USA.
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Cummings J, Fox N, Vellas B, Aisen P, Shan G. Biomarker and Clinical Trial Design Support for Disease-Modifying Therapies: Report of a Survey of the EU/US: Alzheimer's Disease Task Force. J Prev Alzheimers Dis 2019; 5:103-109. [PMID: 29616703 DOI: 10.14283/jpad.2018.13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Disease-modifying therapies are urgently needed for the treatment of Alzheimer's disease (AD). The European Union/United States (EU/US) Task Force represents a broad range of stakeholders including biopharma industry personnel, academicians, and regulatory authorities. OBJECTIVES The EU/US Task Force represents a community of knowledgeable individuals who can inform views of evidence supporting disease modification and the development of disease-modifying therapies (DMTs). We queried their attitudes toward clinical trial design and biomarkers in support of DMTs. DESIGN/SETTING/PARTICIANTS A survey of members of the EU/US Alzheimer's Disease Task Force was conducted. Ninety-three members (87%) responded. The details were analyzed to understand what clinical trial design and biomarker data support disease modification. MEASUREMENTS/RESULTS/CONCLUSIONS Task Force members favored the parallel group design compared to delayed start or staggered withdrawal clinical trial designs to support disease modification. Amyloid biomarkers were regarded as providing mild support for disease modification while tau biomarkers were regarded as providing moderate support. Combinations of biomarkers, particularly combinations of tau and neurodegeneration, were regarded as providing moderate to marked support for disease modification and combinations of all three classes of biomarkers were regarded by a majority as providing marked support for disease modification. Task Force members considered that evidence derived from clinical trials and biomarkers supports clinical meaningfulness of an intervention, and when combined with a single clinical trial outcome, nearly all regarded the clinical trial design or biomarker evidence as supportive of disease modification. A minority considered biomarker evidence by itself as indicative of disease modification in prevention trials. Levels of evidence (A,B,C) were constructed based on these observations. CONCLUSION The survey indicates the view of knowledgeable stakeholders regarding evidence derived from clinical trial design and biomarkers in support of disease modification. Results of this survey can assist in designing clinical trials of DMTs.
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Affiliation(s)
- J Cummings
- Jeffrey Cummings, MD, ScD, Cleveland Clinic Lou Ruvo Center for Brain Health, 888 W Bonneville Ave, Las Vegas, NV, 89106, USA, T: 702.483.6029, F: 702.722.6584,
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7
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Peres B, Allen AH, Fox N, Laher I, Almeida F, Jen R, Ayas N. Obstructive sleep apnea (OSA) as a predictor of oxidative stress. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Beaudin A, Skomro R, Ayas N, Raneri J, Nocon A, Fox N, Ahmed S, Hanly P. Prevalence of patients at risk for progression of chronic kidney disease in a sleep clinic cohort with obstructive sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sullivan JV, Frew Q, Fox N, Dziewulski P. Letter to the editors in response to the article: Facial restoration by transplantation, B. Kolar, B Pomahac. The surgeon 16 (2018) 245-249. Surgeon 2019; 17:190-191. [PMID: 30772181 DOI: 10.1016/j.surge.2018.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 12/01/2018] [Indexed: 11/28/2022]
Affiliation(s)
- J V Sullivan
- The St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Mid Essex Hospitals Trust, Chelmsford, Essex, UK.
| | - Q Frew
- The St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Mid Essex Hospitals Trust, Chelmsford, Essex, UK
| | - N Fox
- The St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Mid Essex Hospitals Trust, Chelmsford, Essex, UK
| | - P Dziewulski
- The St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Mid Essex Hospitals Trust, Chelmsford, Essex, UK
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Andorn A, Haight B, Greenwald M, Zhao Y, Fox N, Heidbreder C, Learned S. 49 Higher Abstinence Rates With Greater Buprenorphine Exposure Among Patients Who Inject Opioids. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.054] [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: 10/28/2022]
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11
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Aisen P, Touchon J, Amariglio R, Andrieu S, Bateman R, Breitner J, Donohue M, Dunn B, Doody R, Fox N, Gauthier S, Grundman M, Hendrix S, Ho C, Isaac M, Raman R, Rosenberg P, Schindler R, Schneider L, Sperling R, Tariot P, Welsh-Bohmer K, Weiner M, Vellas B. EU/US/CTAD Task Force: Lessons Learned from Recent and Current Alzheimer's Prevention Trials. J Prev Alzheimers Dis 2018; 4:116-124. [PMID: 29186281 DOI: 10.14283/jpad.2017.13] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
At a meeting of the EU/US/Clinical Trials in Alzheimer's Disease (CTAD) Task Force in December 2016, an international group of investigators from industry, academia, and regulatory agencies reviewed lessons learned from ongoing and planned prevention trials, which will help guide future clinical trials of AD treatments, particularly in the pre-clinical space. The Task Force discussed challenges that need to be addressed across all aspects of clinical trials, calling for innovation in recruitment and retention, infrastructure development, and the selection of outcome measures. While cognitive change provides a marker of disease progression across the disease continuum, there remains a need to identify the optimal assessment tools that provide clinically meaningful endpoints. Patient- and informant-reported assessments of cognition and function may be useful but present additional challenges. Imaging and other biomarkers are also essential to maximize the efficiency of and the information learned from clinical trials.
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Affiliation(s)
- P Aisen
- PPaul Aisen, Alzheimer's Therapeutic Research Institute (ATRI), Keck School of Medicine, University of Southern California, San Diego, CA, USA,
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Gowing S, King K, Strike G, Fox N. 25IMPROVING MEDICINES MANAGEMENT IN INPATIENTS WITH PARKINSON'S DISEASE: INTRODUCING THE OPTIMAL CALCULATOR. Age Ageing 2017. [DOI: 10.1093/ageing/afx115.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fox N, Tuck J, Chandler J, Greenwood S, May P, Porter K, Sargeant S. 74ADVANCED NURSE PRACTITIONER-LED AMBULATORY CARE FOR OLDER PEOPLE: SAFE AND EFFECTIVE. Age Ageing 2017. [DOI: 10.1093/ageing/afx055.74] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hirsch Allen A, Urbanetto Peres B, Fox N, vanEeden S, Ayas N. 0452 THE INTERACTION BETWEEN OBSTRUCTIVE SLEEP APNEA (OSA) AND OBESITY ON SERUM LEVELS OF INFLAMMATORY ADHESION MOLECULES. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Laratta C, Carlsten C, Brauer M, Hirsch Allen A, Fox N, Peres BU, Ayas N. 0434 THE ASSOCIATION OF TRAFFIC-RELATED AIR POLLUTION WITH SLEEP APNEA AND INFLAMMATORY BIOMARKERS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.433] [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] [Indexed: 11/12/2022] Open
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Abstract
BACKGROUND Disease-modifying therapies (DMTs) are urgently needed to treat the growing number of individuals with Alzheimer's disease (AD) or at immanent risk for AD. A definition of DMT is required to facilitate the process of DMT drug development. PROCESS This is a review of the state of the science with regard to definition and development of DMTs. RESULTS A DMT is as an intervention that produces an enduring change in the clinical progression of AD by interfering in the underlying pathophysiological mechanisms of the disease process that lead to cell death. Demonstration of DMT efficacy is garnered through clinical trial designs and biomarkers. Evidence of disease modification in the drug development process is based on trial designs such as staggered start and delayed withdrawal showing an enduring effect on disease course or on combined clinical outcomes and correlated biomarker evidence of an effect on the underlying pathophysiological processes of the disease. Analytic approaches such as showing change in slope of cognitive decline, increasing drug-placebo difference over time, and delay of disease milestones are not conclusive by themselves but support the presence of a disease modifying effect. Neuroprotection is a related concept whose demonstration depends on substantiating disease modification. No single type of evidence in itself is sufficient to prove disease modification - consistency, robustness, and variety of sources of data will all contribute to convincing stakeholders that an agent is a DMT. CONCLUSION DMT is defined by its enduring effect on processes leading to cell death. A variety of types of data can be used to support the hypothesis that disease modification has occurred.
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Affiliation(s)
- J Cummings
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - N Fox
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, United Kingdom
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Lindsay MR, Anderson C, Fox N, Scofield G, Allen J, Anderson E, Bueter L, Poudel S, Sutherland K, Munson-McGee JH, Van Nostrand JD, Zhou J, Spear JR, Baxter BK, Lageson DR, Boyd ES. Microbialite response to an anthropogenic salinity gradient in Great Salt Lake, Utah. Geobiology 2017; 15:131-145. [PMID: 27418462 DOI: 10.1111/gbi.12201] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 06/10/2016] [Indexed: 06/06/2023]
Abstract
A railroad causeway across Great Salt Lake, Utah (GSL), has restricted water flow since its construction in 1959, resulting in a more saline North Arm (NA; 24%-31% salinity) and a less saline South Arm (SA; 11%-14% salinity). Here, we characterized microbial carbonates collected from the SA and the NA to evaluate the effect of increased salinity on community composition and abundance and to determine whether the communities present in the NA are still actively precipitating carbonate or if they are remnant features from prior to causeway construction. SSU rRNA gene abundances associated with the NA microbialite were three orders of magnitude lower than those associated with the SA microbialite, indicating that the latter community is more productive. SSU rRNA gene sequencing and functional gene microarray analyses indicated that SA and NA microbialite communities are distinct. In particular, abundant sequences affiliated with photoautotrophic taxa including cyanobacteria and diatoms that may drive carbonate precipitation and thus still actively form microbialites were identified in the SA microbialite; sequences affiliated with photoautotrophic taxa were in low abundance in the NA microbialite. SA and NA microbialites comprise smooth prismatic aragonite crystals. However, the SA microbialite also contained micritic aragonite, which can be formed as a result of biological activity. Collectively, these observations suggest that NA microbialites are likely to be remnant features from prior to causeway construction and indicate a strong decrease in the ability of NA microbialite communities to actively precipitate carbonate minerals. Moreover, the results suggest a role for cyanobacteria and diatoms in carbonate precipitation and microbialite formation in the SA of GSL.
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Affiliation(s)
- M R Lindsay
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
| | - C Anderson
- Department of Earth Sciences, Montana State University, Bozeman, MT, USA
| | - N Fox
- Department of Earth Sciences, Montana State University, Bozeman, MT, USA
| | - G Scofield
- Department of Earth Sciences, Montana State University, Bozeman, MT, USA
| | - J Allen
- Department of Earth Sciences, Montana State University, Bozeman, MT, USA
| | - E Anderson
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
| | - L Bueter
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
| | - S Poudel
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
| | - K Sutherland
- Department of Earth Sciences, Montana State University, Bozeman, MT, USA
| | - J H Munson-McGee
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
| | - J D Van Nostrand
- Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, USA
| | - J Zhou
- Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, USA
- State Key Joint Laboratory of Environment Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, China
- Earth Science Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - J R Spear
- Department of Civil and Environmental Engineering, Colorado School of Mines, Golden, CO, USA
- NASA Astrobiology Institute, Mountain View, CA, USA
| | - B K Baxter
- Department of Biology, Westminster College, Salt Lake City, UT, USA
| | - D R Lageson
- Department of Earth Sciences, Montana State University, Bozeman, MT, USA
| | - E S Boyd
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
- NASA Astrobiology Institute, Mountain View, CA, USA
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Bale SD, Goetz K, Harvey PR, Turin P, Bonnell JW, de Wit TD, Ergun RE, MacDowall RJ, Pulupa M, Andre M, Bolton M, Bougeret JL, Bowen TA, Burgess D, Cattell CA, Chandran BDG, Chaston CC, Chen CHK, Choi MK, Connerney JE, Cranmer S, Diaz-Aguado M, Donakowski W, Drake JF, Farrell WM, Fergeau P, Fermin J, Fischer J, Fox N, Glaser D, Goldstein M, Gordon D, Hanson E, Harris SE, Hayes LM, Hinze JJ, Hollweg JV, Horbury TS, Howard RA, Hoxie V, Jannet G, Karlsson M, Kasper JC, Kellogg PJ, Kien M, Klimchuk JA, Krasnoselskikh VV, Krucker S, Lynch JJ, Maksimovic M, Malaspina DM, Marker S, Martin P, Martinez-Oliveros J, McCauley J, McComas DJ, McDonald T, Meyer-Vernet N, Moncuquet M, Monson SJ, Mozer FS, Murphy SD, Odom J, Oliverson R, Olson J, Parker EN, Pankow D, Phan T, Quataert E, Quinn T, Ruplin SW, Salem C, Seitz D, Sheppard DA, Siy A, Stevens K, Summers D, Szabo A, Timofeeva M, Vaivads A, Velli M, Yehle A, Werthimer D, Wygant JR. The FIELDS Instrument Suite for Solar Probe Plus: Measuring the Coronal Plasma and Magnetic Field, Plasma Waves and Turbulence, and Radio Signatures of Solar Transients. Space Sci Rev 2016; 204:49-82. [PMID: 29755144 PMCID: PMC5942226 DOI: 10.1007/s11214-016-0244-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
NASA's Solar Probe Plus (SPP) mission will make the first in situ measurements of the solar corona and the birthplace of the solar wind. The FIELDS instrument suite on SPP will make direct measurements of electric and magnetic fields, the properties of in situ plasma waves, electron density and temperature profiles, and interplanetary radio emissions, amongst other things. Here, we describe the scientific objectives targeted by the SPP/FIELDS instrument, the instrument design itself, and the instrument concept of operations and planned data products.
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Affiliation(s)
- S D Bale
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
- Physics Department, University of California, Berkeley, CA, USA
| | - K Goetz
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | - P R Harvey
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - P Turin
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J W Bonnell
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - T Dudok de Wit
- LPC2E, CNRS, 3A avenue de la Recherche Scientifique, Orléans, France
| | - R E Ergun
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - R J MacDowall
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - M Pulupa
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - M Andre
- Swedish Institute of Space Physics (IRF), Uppsala, Sweden
| | - M Bolton
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | | | - T A Bowen
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
- Physics Department, University of California, Berkeley, CA, USA
| | - D Burgess
- Astronomy Unit, Queen Mary, University of London, London, UK
| | - C A Cattell
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | - B D G Chandran
- Department of Physics, University of New Hampshire, Durham, NH, USA
| | - C C Chaston
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - C H K Chen
- Department of Physics, Imperial College, London, UK
| | - M K Choi
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - J E Connerney
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - S Cranmer
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - M Diaz-Aguado
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - W Donakowski
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J F Drake
- Department of Physics, University of Maryland, College Park, MD, USA
| | - W M Farrell
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - P Fergeau
- LPC2E, CNRS, 3A avenue de la Recherche Scientifique, Orléans, France
| | - J Fermin
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J Fischer
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - N Fox
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - D Glaser
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - M Goldstein
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - D Gordon
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - E Hanson
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
- Physics Department, University of California, Berkeley, CA, USA
| | - S E Harris
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - L M Hayes
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J J Hinze
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | - J V Hollweg
- Department of Physics, University of New Hampshire, Durham, NH, USA
| | - T S Horbury
- Department of Physics, Imperial College, London, UK
| | - R A Howard
- Space Science Division, Naval Research Laboratory, Washington, DC, USA
| | - V Hoxie
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - G Jannet
- LPC2E, CNRS, 3A avenue de la Recherche Scientifique, Orléans, France
| | - M Karlsson
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - J C Kasper
- University of Michigan, Ann Arbor, MI, USA
| | - P J Kellogg
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | - M Kien
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - J A Klimchuk
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | | | - S Krucker
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J J Lynch
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | | | - D M Malaspina
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - S Marker
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - P Martin
- LPC2E, CNRS, 3A avenue de la Recherche Scientifique, Orléans, France
| | | | - J McCauley
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - D J McComas
- Southwest Research Institute, San Antonio, TX, USA
| | - T McDonald
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | | | - M Moncuquet
- LESIA, Observatoire de Paris, Meudon, France
| | - S J Monson
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | - F S Mozer
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - S D Murphy
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - J Odom
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - R Oliverson
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - J Olson
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - E N Parker
- Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL, USA
| | - D Pankow
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - T Phan
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - E Quataert
- Astronomy Department, University of California, Berkeley, CA, USA
| | - T Quinn
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | | | - C Salem
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - D Seitz
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - D A Sheppard
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - A Siy
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - K Stevens
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - D Summers
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - A Szabo
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - M Timofeeva
- LPC2E, CNRS, 3A avenue de la Recherche Scientifique, Orléans, France
| | - A Vaivads
- Swedish Institute of Space Physics (IRF), Uppsala, Sweden
| | - M Velli
- Earth, Planetary, and Space Sciences, UCLA, Los Angelos, CA, USA
| | - A Yehle
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - D Werthimer
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J R Wygant
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
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van Veen EM, Lottermoser BG, Parbhakar-Fox A, Fox N, Hunt J. A new test for plant bioaccessibility in sulphidic wastes and soils: A case study from the Wheal Maid historic tailings repository in Cornwall, UK. Sci Total Environ 2016; 563-564:835-844. [PMID: 26858107 DOI: 10.1016/j.scitotenv.2016.01.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 12/09/2015] [Accepted: 01/11/2016] [Indexed: 06/05/2023]
Abstract
Currently, bioaccessibility testing at contaminated sites is dominated by techniques designed to assess oral bioaccessibility to humans. Determining the plant bioaccessibility of toxic trace elements is also important. In mining landscapes, sulphides are an important source of potentially toxic elements. Simple tests to evaluate readily leachable metals and metalloids exist but do not extract elements temporarily constrained within the sulphide fraction. Sequential extractions describe the association of trace elements with different geochemical fractions but are time consuming, costly and provide excessive detail. This paper proposes a new test for plant bioaccessibility in sulphidic mine wastes and soils that uses hydrogen peroxide to simulate environmental oxidation. The bioaccessible fraction determined is operationally defined and does not predict actual plant uptake. The test targets a) the portion of an element that is currently available in the pore water for uptake by plant roots and also b) the fraction that is temporarily constrained in sulphide minerals but may become available upon oxidation of the substrate. A case study was conducted at a historic mine waste repository site in Cornwall, U.K. where near total As concentrations were extremely elevated and Cd, Cu, Pb, Sb and Zn were also high. Our test determined that bioaccessible concentrations of As, Cd, Cu and Zn and to a lesser extent Sb and Pb were highest in samples of pyritic grey tailings. This is attributed to sulphide mineral oxidation and, particularly for Cd and Zn, the dissolution of soluble secondary minerals. High As concentrations in the marbled tailings were not bioaccessible. Results from the case study show that this new test provides useful information on the future bioaccessibility of contaminants, allowing for classification of mineralised sulphidic waste materials which otherwise cannot be obtained using established geochemical and mineralogical techniques. Furthermore, the test is rapid, repeatable and cost effective.
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Affiliation(s)
- E M van Veen
- Environment and Sustainability Institute and Camborne School of Mines, University of Exeter, Penryn Campus, Penryn, Cornwall, TR10 9FE, UK
| | - B G Lottermoser
- Institute of Mineral Resources Engineering, Wuellnerstrasse 2, RWTH Aachen University, 52056 Aachen, Germany
| | - A Parbhakar-Fox
- School of Physical Sciences, University of Tasmania, Hobart, Tasmania 7001, Australia
| | - N Fox
- School of Physical Sciences, University of Tasmania, Hobart, Tasmania 7001, Australia
| | - J Hunt
- GeMMe, University of Liege, Liege, 4000, Belgium
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Gudmann N, Fox N, Karsdal M, Bay-Jensen A, Schmitz J, Siebuhr A. THU0373 Degradation Fragments of Collagen I and V Are Early Disease Markers in β-Glucan Triggered Spondyloarthritis in SKG Mice. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Chow E, Fox N, Gama R. Effect of low serum total protein on sodium and potassium measurement by ion-selective electrodes in critically ill patients. Br J Biomed Sci 2016; 65:128-31. [PMID: 18986099 DOI: 10.1080/09674845.2008.11732815] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- E. Chow
- Department Clinical Chemistry, New Cross Hospital, Wolverhampton, West Midlands, UK
| | - N. Fox
- Department Clinical Chemistry, New Cross Hospital, Wolverhampton, West Midlands, UK
| | - R. Gama
- Department Clinical Chemistry, New Cross Hospital, Wolverhampton, West Midlands, UK
- Research Institute, Healthcare Sciences, Wolverhampton University, Wolverhampton, West MidlandsUK
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22
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Elson KM, Fox N, Tipper JL, Kirkham J, Hall RM, Fisher J, Ingham E, Ingham E. Non-destructive monitoring of viability in an ex vivo organ culture model of osteochondral tissue. Eur Cell Mater 2015; 29:356-69; discussion 369. [PMID: 26122871 DOI: 10.22203/ecm.v029a27] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [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] [Indexed: 01/31/2023] Open
Abstract
Organ culture is an increasingly important tool in research, with advantages over monolayer cell culture due to the inherent natural environment of tissues. Successful organ cultures must retain cell viability. The aim of this study was to produce viable and non-viable osteochondral organ cultures, to assess the accumulation of soluble markers in the conditioned medium for predicting tissue viability. Porcine femoral osteochondral plugs were cultured for 20 days, with the addition of Triton X-100 on day 6 (to induce necrosis), camptothecin (to induce apoptosis) or no toxic additives. Tissue viability was assessed by the tissue destructive XTT (2,3-bis[2-methoxy-4-nitro-5-sulfophenyl]-2H-tetrazolium-5-carboxyanilide tetrazolium salt) assay method and LIVE/DEAD® staining of the cartilage at days 0, 6 and 20. Tissue structure was assessed by histological evaluation using haematoxylin & eosin and safranin O. Conditioned medium was assessed every 3-4 days for glucose depletion, and levels of lactate dehydrogenase (LDH), alkaline phosphatase (AP), glycosaminoglycans (GAGs), and matrix metalloproteinase (MMP)-2 and MMP-9. Necrotic cultures immediately showed a reduction in glucose consumption, and an immediate increase in LDH, GAG, MMP-2 and MMP-9 levels. Apoptotic cultures showed a delayed reduction in glucose consumption and delayed increase in LDH, a small rise in MMP-2 and MMP-9, but no significant effect on GAGs released into the conditioned medium. The data showed that tissue viability could be monitored by assessing the conditioned medium for the aforementioned markers, negating the need for tissue destructive assays. Physiologically relevant whole- or part-joint organ culture models, necessary for research and pre-clinical assessment of therapies, could be monitored this way, reducing the need to sacrifice tissues to determine viability, and hence reducing the sample numbers necessary.
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Affiliation(s)
- K M Elson
- School of Biomedical Science, 7-59 Garstang Building, University of Leeds, Leeds, LS2 9JT,
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Wilson CL, Jurk D, Fullard N, Banks P, Page A, Luli S, Elsharkawy AM, Gieling RG, Chakraborty JB, Fox C, Richardson C, Callaghan K, Blair GE, Fox N, Lagnado A, Passos JF, Moore AJ, Smith GR, Tiniakos DG, Mann J, Oakley F, Mann DA. NFκB1 is a suppressor of neutrophil-driven hepatocellular carcinoma. Nat Commun 2015; 6:6818. [PMID: 25879839 PMCID: PMC4410629 DOI: 10.1038/ncomms7818] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [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: 10/24/2014] [Accepted: 03/02/2015] [Indexed: 02/07/2023] Open
Abstract
Hepatocellular carcinoma (HCC) develops on the background of chronic hepatitis.
Leukocytes found within the HCC microenvironment are implicated as regulators of
tumour growth. We show that diethylnitrosamine (DEN)-induced murine HCC is
attenuated by antibody-mediated depletion of hepatic neutrophils, the latter
stimulating hepatocellular ROS and telomere DNA damage. We additionally report a
previously unappreciated tumour suppressor function for hepatocellular nfkb1
operating via p50:p50 dimers and the co-repressor HDAC1. These anti-inflammatory
proteins combine to transcriptionally repress hepatic expression of a S100A8/9,
CXCL1 and CXCL2 neutrophil chemokine network. Loss of nfkb1 promotes
ageing-associated chronic liver disease (CLD), characterized by steatosis,
neutrophillia, fibrosis, hepatocyte telomere damage and HCC.
Nfkb1S340A/S340Amice carrying a mutation
designed to selectively disrupt p50:p50:HDAC1 complexes are more susceptible to HCC;
by contrast, mice lacking S100A9 express reduced neutrophil chemokines and are
protected from HCC. Inhibiting neutrophil accumulation in CLD or targeting their
tumour-promoting activities may offer therapeutic opportunities in HCC. The role of neutrophils in cancer development is not widely
appreciated. Here, the authors show that NF-κB-deficient hepatocytes
overproduce chemokines, leading to hepatocellular carcinoma due to excessive neutrophil
recruitment, and that neutrophil depletion prevents liver cancer in these
mice.
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Affiliation(s)
- C L Wilson
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - D Jurk
- Newcastle University Institute for Ageing and Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK
| | - N Fullard
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - P Banks
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - A Page
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - S Luli
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - A M Elsharkawy
- Liver Unit, University Hospitals Birmingham, Birmingham B15 2TH, UK
| | - R G Gieling
- Hypoxia and Therapeutics Group, Manchester Pharmacy School, University of Manchester, Manchester M13 9PT, UK
| | - J Bagchi Chakraborty
- Department of Medicine, Immunology and Inflammation, Imperial College of Science, Technology and Medicine, Hammersmith Hospital, London W12 0NN, UK
| | - C Fox
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - C Richardson
- Centre for Behaviour and Evolution/Institute of Neuroscience, Medical School, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK
| | - K Callaghan
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - G E Blair
- Faculty of Biological Sciences, School of Molecular and Cellular Biology, University of Leeds, Garstang Building, Leeds LS2 9JT, UK
| | - N Fox
- Faculty of Biological Sciences, School of Molecular and Cellular Biology, University of Leeds, Garstang Building, Leeds LS2 9JT, UK
| | - A Lagnado
- Newcastle University Institute for Ageing and Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK
| | - J F Passos
- Newcastle University Institute for Ageing and Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK
| | - A J Moore
- Institute for Cell and Molecular Biosciences, Newcastle University, Catherine Cookson Building, Framlington Place, Newcastle Upon Tyne NE2 4HH, UK
| | - G R Smith
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - D G Tiniakos
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - J Mann
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - F Oakley
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - D A Mann
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
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Fox N. PRESYMPTOMATIC TREATMENT FOR THE DEMENTIAS: PLAUSABILITY AND PERILS. Journal of Neurology, Neurosurgery & Psychiatry 2014. [DOI: 10.1136/jnnp-2014-308883.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Slattery C, Beck J, Harper L, Adamson G, Abdi Z, Uphill J, Campbell T, Druyeh R, Mahoney C, Rohrer J, Kenny J, Lowe J, Leung K, Barnes J, Clegg S, Blair M, Nicholas J, Guerreiro R, Rowe J, Ponto C, Zerr I, Kretzschmar H, Gambetti P, Crutch S, Warren J, Rossor M, Fox N, Collinge J, Schott J, Mead S. TREM2 VARIANTS INCREASE RISK OF TYPICAL EARLY-ONSET ALZHEIMER'S DISEASE BUT NOT OF PRION OR FRONTOTEMPORAL DEMENTIA. Journal of Neurology, Neurosurgery & Psychiatry 2014. [DOI: 10.1136/jnnp-2014-308883.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mahoney C, Yeatman T, Rohrer JD, Manning E, Leung KK, Rossor MN, Warren JD, Fox N. THE EVOLUTION OF FRONTOTEMPORAL DEMENTIA DUE TO THE MAPT MUTATION: A SEVENTEEN YEAR NATURAL HISTORY STUDY. J Neurol Neurosurg Psychiatry 2013. [DOI: 10.1136/jnnp-2013-306573.86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mills SM, Mallmann J, Santacruz AM, Fuqua A, Carril M, Aisen PS, Althage MC, Belyew S, Benzinger TL, Brooks WS, Buckles VD, Cairns NJ, Clifford D, Danek A, Fagan AM, Farlow M, Fox N, Ghetti B, Goate AM, Heinrichs D, Hornbeck R, Jack C, Jucker M, Klunk WE, Marcus DS, Martins RN, Masters CM, Mayeux R, McDade E, Morris JC, Oliver A, Ringman JM, Rossor MN, Salloway S, Schofield PR, Snider J, Snyder P, Sperling RA, Stewart C, Thomas RG, Xiong C, Bateman RJ. Preclinical trials in autosomal dominant AD: implementation of the DIAN-TU trial. Rev Neurol (Paris) 2013; 169:737-43. [PMID: 24016464 DOI: 10.1016/j.neurol.2013.07.017] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [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: 07/15/2013] [Accepted: 07/19/2013] [Indexed: 10/26/2022]
Abstract
The Dominantly Inherited Alzheimer's Network Trials Unit (DIAN-TU) was formed to direct the design and management of interventional therapeutic trials of international DIAN and autosomal dominant Alzheimer's disease (ADAD) participants. The goal of the DIAN-TU is to implement safe trials that have the highest likelihood of success while advancing scientific understanding of these diseases and clinical effects of proposed therapies. The DIAN-TU has launched a trial design that leverages the existing infrastructure of the ongoing DIAN observational study, takes advantage of a variety of drug targets, incorporates the latest results of biomarker and cognitive data collected during the observational study, and implements biomarkers measuring Alzheimer's disease (AD) biological processes to improve the efficiency of trial design. The DIAN-TU trial design is unique due to the sophisticated design of multiple drugs, multiple pharmaceutical partners, academics servings as sponsor, geographic distribution of a rare population and intensive safety and biomarker assessments. The implementation of the operational aspects such as home health research delivery, safety magnetic resonance imagings (MRIs) at remote locations, monitoring clinical and cognitive measures, and regulatory management involving multiple pharmaceutical sponsors of the complex DIAN-TU trial are described.
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Affiliation(s)
- S M Mills
- DIAN-TU, Washington University, 660, S. Euclid Avenue, Campus Box 8111, St. Louis, MO 63108, USA
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Hamdan S, Verbeke CS, Fox N, Booth J, Bottley G, Pandha HS, Blair GE. The roles of cell surface attachment molecules and coagulation Factor X in adenovirus 5-mediated gene transfer in pancreatic cancer cells. Cancer Gene Ther 2011; 18:478-88. [PMID: 21566668 DOI: 10.1038/cgt.2011.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Transduction of 11 pancreatic cancer cell lines with a replication-deficient adenovirus 5 expressing enhanced green fluorescent protein (Ad5EGFP) was analyzed and variable EGFP levels were observed, ranging from <1% to ∼40% of cells transduced, depending on the cell line. Efficient Ad5EGFP transduction was associated mainly with higher levels of cell surface Coxsackie and adenovirus receptor (CAR) but not with expression of α(v)β(3) and α(v)β(5) integrins and was fiber dependent. Reduction of CAR by RNA interference resulted in a corresponding decrease in Ad5EGFP transduction. Pre-treatment of Ad5EGFP with blood coagulation Factor X increased virus entry even in the presence of low CAR levels generated by RNA interference, suggesting a potential alternative route of Ad5 entry into pancreatic cancer cells. Immunohistochemistry carried out on 188 pancreatic ductal adenocarcinomas and 68 matched controls showed that CAR was absent in 102 (54%) of adenocarcinomas, whereas moderate and strong staining was observed in 58 (31%) and 28 (15%) cases, respectively. Weak or absent CAR immunolabeling correlated with poor histological differentiation of pancreatic cancer. In normal tissue, strong immunolabeling was detected in islet cells and in the majority of inter- and intralobular pancreatic ducts.
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Affiliation(s)
- S Hamdan
- Institute of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, UK
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30
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Pawel JV, Harvey J, Spigel D, Dediu M, Reck M, Cebotaru C, Kumm E, Gallant G, Fox N, Camidge D. A randomized phase IItrial of mapatumumab, a TRAIL R1 agonist monoclonal antibody, in combination with carboplatin and paclitaxel in patients with advanced NSCLC. Pneumologie 2011. [DOI: 10.1055/s-0031-1272244] [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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31
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Sun W, Nelson D, Alberts SR, Poordad F, Leong S, Teitelbaum UR, Woods L, Fox N, O'Neil BH. Phase Ib study of mapatumumab in combination with sorafenib in patients with advanced hepatocellular carcinoma (HCC) and chronic viral hepatitis. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.261] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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
261 Background: Mapatumumab is a fully human agonist monoclonal antibody to the tumor necrosis factor-related apoptosis-inducing ligand receptor 1 (TRAIL-R1). Sorafenib targets Mcl-1, a key TRAIL resistance protein, and accordingly could enhance mapatumumab's pro-apoptotic activity. Based on this and on preclinical data on mapatumumab in HCC cell lines, the current dose-escalation study is evaluating mapatumumab in combination with sorafenib in patients with advanced HCC. Methods: Eligible patients had advanced HCC, Child-Pugh A or Model for End-Stage Liver Disease score < 15, and were positive for hepatitis B surface antigen or hepatitis C antibody. Intravenous mapatumumab was administered at 3, 10 or 30 mg/kg every 21 days with sorafenib (400 mg twice daily) until disease progression or unacceptable toxicity. Dose-limiting toxicities (DLTs) included events considered at least possibly related to mapatumumab and/or its interaction with sorafenib. Tumor measurements were performed every 2 cycles. Dose escalation required at least 3 patients in a cohort to receive >= 50% of full-dose sorafenib in the first 2 cycles. Results: To date, 19 patients have been enrolled in the 3 mg/kg (n=6), 10 mg/kg (n=9) and 30 mg/kg (n=4) cohorts and have received a median of 4 cycles (range 1 to 24 cycles); 4 patients have received >= 11 cycles. The maximum tolerated dose has not been reached. DLTs that prompted expansion of the 3 mg/kg and 10 mg/kg cohorts were elevations of amylase and/or lipase (1 at 3 mg/kg, 1 at 10 mg/kg). Other Grade 3-4 events considered at least possibly related to mapatumumab and/or its interaction with sorafenib included hepatic pain (1/17), thrombocytopenia (1/17), increased aspartate aminotransferase (1/17), increased lipase (1/17), and increased gamma-glutamyltransferase (1/17). Two patients have had a partial response and 4 patients have had stable disease lasting > 12 weeks, based on investigator assessment. Conclusions: Mapatumumab was well-tolerated at doses up to 30 mg/kg in combination with sorafenib in patients with HCC and viral hepatitis. A randomized phase II study of this combination in patients with advanced HCC is planned. [Table: see text]
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Affiliation(s)
- W. Sun
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; University of Florida, Gainesville, FL; Mayo Clinic, Rochester, MN; Cedars-Sinai Medical Center, Los Angeles, CA; University of Colorado Cancer Center, Aurora, CO; University of North Carolina at Chapel Hill, Chapel Hill, NC; Human Genome Sciences, Rockville, MD; Division of Hematology and Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - D. Nelson
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; University of Florida, Gainesville, FL; Mayo Clinic, Rochester, MN; Cedars-Sinai Medical Center, Los Angeles, CA; University of Colorado Cancer Center, Aurora, CO; University of North Carolina at Chapel Hill, Chapel Hill, NC; Human Genome Sciences, Rockville, MD; Division of Hematology and Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - S. R. Alberts
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; University of Florida, Gainesville, FL; Mayo Clinic, Rochester, MN; Cedars-Sinai Medical Center, Los Angeles, CA; University of Colorado Cancer Center, Aurora, CO; University of North Carolina at Chapel Hill, Chapel Hill, NC; Human Genome Sciences, Rockville, MD; Division of Hematology and Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - F. Poordad
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; University of Florida, Gainesville, FL; Mayo Clinic, Rochester, MN; Cedars-Sinai Medical Center, Los Angeles, CA; University of Colorado Cancer Center, Aurora, CO; University of North Carolina at Chapel Hill, Chapel Hill, NC; Human Genome Sciences, Rockville, MD; Division of Hematology and Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - S. Leong
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; University of Florida, Gainesville, FL; Mayo Clinic, Rochester, MN; Cedars-Sinai Medical Center, Los Angeles, CA; University of Colorado Cancer Center, Aurora, CO; University of North Carolina at Chapel Hill, Chapel Hill, NC; Human Genome Sciences, Rockville, MD; Division of Hematology and Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - U. R. Teitelbaum
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; University of Florida, Gainesville, FL; Mayo Clinic, Rochester, MN; Cedars-Sinai Medical Center, Los Angeles, CA; University of Colorado Cancer Center, Aurora, CO; University of North Carolina at Chapel Hill, Chapel Hill, NC; Human Genome Sciences, Rockville, MD; Division of Hematology and Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - L. Woods
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; University of Florida, Gainesville, FL; Mayo Clinic, Rochester, MN; Cedars-Sinai Medical Center, Los Angeles, CA; University of Colorado Cancer Center, Aurora, CO; University of North Carolina at Chapel Hill, Chapel Hill, NC; Human Genome Sciences, Rockville, MD; Division of Hematology and Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - N. Fox
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; University of Florida, Gainesville, FL; Mayo Clinic, Rochester, MN; Cedars-Sinai Medical Center, Los Angeles, CA; University of Colorado Cancer Center, Aurora, CO; University of North Carolina at Chapel Hill, Chapel Hill, NC; Human Genome Sciences, Rockville, MD; Division of Hematology and Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - B. H. O'Neil
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; University of Florida, Gainesville, FL; Mayo Clinic, Rochester, MN; Cedars-Sinai Medical Center, Los Angeles, CA; University of Colorado Cancer Center, Aurora, CO; University of North Carolina at Chapel Hill, Chapel Hill, NC; Human Genome Sciences, Rockville, MD; Division of Hematology and Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Lahiri N, Tabrizi SJ, Kennard C, Durr A, Leavitt BR, Fox N, Roos RA. POMD07 Quantitative assessment of biological and clinical manifestations of Huntington's disease before and after diagnosis--the TRACK-HD study. Journal of Neurology, Neurosurgery & Psychiatry 2010. [DOI: 10.1136/jnnp.2010.226340.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Fox N. 006 Clinical advances in our understanding and classification of the dementias. Journal of Neurology, Neurosurgery & Psychiatry 2010. [DOI: 10.1136/jnnp.2010.217554.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Von Pawel J, Harvey JH, Spigel DR, Dediu M, Reck M, Cebotaru CL, Kumm E, Gallant G, Fox N, Camidge DR. A randomized phase II trial of mapatumumab, a TRAIL-R1 agonist monoclonal antibody, in combination with carboplatin and paclitaxel in patients with advanced NSCLC. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.18_suppl.lba7501] [Citation(s) in RCA: 16] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA7501 Background: Mapatumumab, a fully human agonist monoclonal antibody, targets and activates the death receptor TRAIL-R1. We conducted this randomized, controlled phase II trial to evaluate mapatumumab in combination with carboplatin and paclitaxel as first-line therapy in advanced non-small call lung cancer (NSCLC). Methods: Patients were required to have histologically or cytologically confirmed Stage IIIB or IV advanced primary NSCLC with measurable disease by RECIST. Patients were randomly assigned to Arm A, paclitaxel 200 mg/m2 + carboplatin AUC 6.0 (PC); Arm B, PC + mapatumumab 10 mg/kg; or Arm C, PC + mapatumumab 30 mg/kg. Cycles were repeated every 21 days; patients completed up to 6 cycles in the absence of evidence of disease progression or unacceptable toxicity. Patients in Arms B and C could receive additional cycles of mapatumumab in the absence of disease progression. The co-primary endpoints were response rate (RR; complete response + partial response) and progression-free survival (PFS). Images were read by independent radiologists blinded to treatment group assignment, as well as locally. Results: 111 patients were enrolled at 22 sites in 4 countries. Addition of mapatumumab to PC did not improve RR or PFS. RR and PFS, based on the independent read, and overall survival results are summarized below. The results based on local reading also showed no benefit from the addition of mapatumumab to PC. Adverse events were generally balanced across treatment groups; there was no evidence that mapatumumab exacerbated toxicities associated with PC. Conclusions: The results do not support further evaluation of mapatumumab in combination with PC in patients with advanced NSCLC. Additional trials of mapatumumab in other indications are ongoing. [Table: see text] [Table: see text]
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Affiliation(s)
- J. Von Pawel
- Asklepios Klinikum Gauting, Munich, Germany; Birmingham Hematology and Oncology Associates, Birmingham, AL; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Institute of Oncology Bucharest, Bucharest, Romania; Hospital Grosshansdorf, Grosshansdorf, Germany; Oncology Institute I. Chiricuta, Cluj, Romania; Human Genome Sciences, Rockville, MD; University of Colorado Denver, Aurora, CO
| | - J. H. Harvey
- Asklepios Klinikum Gauting, Munich, Germany; Birmingham Hematology and Oncology Associates, Birmingham, AL; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Institute of Oncology Bucharest, Bucharest, Romania; Hospital Grosshansdorf, Grosshansdorf, Germany; Oncology Institute I. Chiricuta, Cluj, Romania; Human Genome Sciences, Rockville, MD; University of Colorado Denver, Aurora, CO
| | - D. R. Spigel
- Asklepios Klinikum Gauting, Munich, Germany; Birmingham Hematology and Oncology Associates, Birmingham, AL; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Institute of Oncology Bucharest, Bucharest, Romania; Hospital Grosshansdorf, Grosshansdorf, Germany; Oncology Institute I. Chiricuta, Cluj, Romania; Human Genome Sciences, Rockville, MD; University of Colorado Denver, Aurora, CO
| | - M. Dediu
- Asklepios Klinikum Gauting, Munich, Germany; Birmingham Hematology and Oncology Associates, Birmingham, AL; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Institute of Oncology Bucharest, Bucharest, Romania; Hospital Grosshansdorf, Grosshansdorf, Germany; Oncology Institute I. Chiricuta, Cluj, Romania; Human Genome Sciences, Rockville, MD; University of Colorado Denver, Aurora, CO
| | - M. Reck
- Asklepios Klinikum Gauting, Munich, Germany; Birmingham Hematology and Oncology Associates, Birmingham, AL; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Institute of Oncology Bucharest, Bucharest, Romania; Hospital Grosshansdorf, Grosshansdorf, Germany; Oncology Institute I. Chiricuta, Cluj, Romania; Human Genome Sciences, Rockville, MD; University of Colorado Denver, Aurora, CO
| | - C. L. Cebotaru
- Asklepios Klinikum Gauting, Munich, Germany; Birmingham Hematology and Oncology Associates, Birmingham, AL; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Institute of Oncology Bucharest, Bucharest, Romania; Hospital Grosshansdorf, Grosshansdorf, Germany; Oncology Institute I. Chiricuta, Cluj, Romania; Human Genome Sciences, Rockville, MD; University of Colorado Denver, Aurora, CO
| | - E. Kumm
- Asklepios Klinikum Gauting, Munich, Germany; Birmingham Hematology and Oncology Associates, Birmingham, AL; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Institute of Oncology Bucharest, Bucharest, Romania; Hospital Grosshansdorf, Grosshansdorf, Germany; Oncology Institute I. Chiricuta, Cluj, Romania; Human Genome Sciences, Rockville, MD; University of Colorado Denver, Aurora, CO
| | - G. Gallant
- Asklepios Klinikum Gauting, Munich, Germany; Birmingham Hematology and Oncology Associates, Birmingham, AL; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Institute of Oncology Bucharest, Bucharest, Romania; Hospital Grosshansdorf, Grosshansdorf, Germany; Oncology Institute I. Chiricuta, Cluj, Romania; Human Genome Sciences, Rockville, MD; University of Colorado Denver, Aurora, CO
| | - N. Fox
- Asklepios Klinikum Gauting, Munich, Germany; Birmingham Hematology and Oncology Associates, Birmingham, AL; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Institute of Oncology Bucharest, Bucharest, Romania; Hospital Grosshansdorf, Grosshansdorf, Germany; Oncology Institute I. Chiricuta, Cluj, Romania; Human Genome Sciences, Rockville, MD; University of Colorado Denver, Aurora, CO
| | - D. R. Camidge
- Asklepios Klinikum Gauting, Munich, Germany; Birmingham Hematology and Oncology Associates, Birmingham, AL; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Institute of Oncology Bucharest, Bucharest, Romania; Hospital Grosshansdorf, Grosshansdorf, Germany; Oncology Institute I. Chiricuta, Cluj, Romania; Human Genome Sciences, Rockville, MD; University of Colorado Denver, Aurora, CO
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Laskowitz DT, Kolls BJ, Salloway SP, Black R, Sperling R, Fox N, Gilman S, Schenk D, Grundman M. A PHASE 2 MULTIPLE ASCENDING DOSE TRIAL OF BAPINEUZUMAB IN MILD TO MODERATE ALZHEIMER DISEASE. Neurology 2010; 74:2026; author reply 2026-7. [DOI: 10.1212/wnl.0b013e3181e03844] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Vasu V, Fox N, Heneghan C, Sezer S. Using the Lomb periodogram for non-contact estimation of respiration rates. Annu Int Conf IEEE Eng Med Biol Soc 2010; 2010:2407-2410. [PMID: 21095694 DOI: 10.1109/iembs.2010.5626125] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We describe a contact-less method for measurement of respiration rate during sleep using a 5.8GHz radio-frequency bio-motion sensor. The sensor operates by sensing phase shifts in reflected radio waves from the torso caused by respiratory movements and other bodily movements such as twitches, positional changes etc. These non-respiratory motion artefacts can obscure reliable estimation of breathinig rates if conventional spectral analysis is used. This paper reports on the accuracy of the respiration rate estimates obtained via algorithmic approaches using Lomb-periodogram based analysis (which can deal with missing or corrupted data), as compared to conventional spectral analysis. Gold-standard respiration rates are derived by expert scoring of respiration rates measured through polysomnography (PSG) from sensors (Respiratory Inductance Plethysmography (RIP) belts) in contact with the subject in an accredited sleep laboratory. Specifically, respiration rates for 15-minute segments chosen from 10 subjects free of Sleep-Disorded Breathing (AHI〈5) were selected for analysis in this paper. Comparison to the expert annotation indicates strong agreement, with the Lomb-periodogram respiration rates with the average error between the measurements being less than 0.4 breaths/min and a standard deviation of 0.3 breaths/minute. Moreover, we showed that the proposed algorithm could track respiration rate over the complete night's recordings for those 10 subjects. We conclude that the non-contact biomotion sensor may provide a promising approach to continuous respiration rate monitoring of reasonable accuracy.
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Affiliation(s)
- V Vasu
- The Institute of Electronics, Communications and Information Technology, Queen's University Belfast, BT3 9DT, Northern Ireland, U.K
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Vasu V, Fox N, Brabetz T, Wren M, Heneghan C, Sezer S. Detection of cardiac activity using a 5.8 GHz radio frequency sensor. Annu Int Conf IEEE Eng Med Biol Soc 2009; 2009:4682-6. [PMID: 19964829 DOI: 10.1109/iembs.2009.5334223] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A 5.8-GHz ISM-Band radio-frequency sensor has been developed for non-contact measurement of respiration and heart rate from stationary and semi-stationary subjects at a distance of 0.5 to 1.5 meters. We report on the accuracy of the heart rate measurements obtained using two algorithmic approaches, as compared to a reference heart rate obtained using a pulse oximeter. Simultaneous Photoplethysmograph (PPG) and non-contact sensor recordings were recorded over fifteen minute periods for ten healthy subjects (8M/2F, ages 29.6 + or - 5.6 yrs) One algorithm is based on automated detection of individual peaks associated with each cardiac cycle; a second algorithm extracts a heart rate over a 60-second period using spectral analysis. Peaks were also extracted manually for comparison with the automated method. The peak-detection methods were less accurate than the spectral methods, but suggest the possibility of acquiring beat by beat data; the spectral algorithms measured heart rate to within + or -10% for the ten subjects chosen. Non-contact measurement of heart rate will be useful in chronic disease monitoring for conditions such as heart failure and cardiovascular disease.
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Affiliation(s)
- V Vasu
- The Institute of Electronics, Communications and Information Technology, Queen's University Belfast, Belfast BT3 9DT, Northern Ireland, U.K
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Okello A, Edison P, Archer HA, Turkheimer FE, Kennedy J, Bullock R, Walker Z, Kennedy A, Fox N, Rossor M, Brooks DJ. Microglial activation and amyloid deposition in mild cognitive impairment: a PET study. Neurology 2009; 72:56-62. [PMID: 19122031 DOI: 10.1212/01.wnl.0000338622.27876.0d] [Citation(s) in RCA: 261] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Activated microglia may play a role in the pathogenesis of Alzheimer disease (AD) as they cluster around beta-amyloid (Abeta) plaques. They are, therefore, a potential therapeutic target in both AD and its prodrome amnestic mild cognitive impairment (MCI). OBJECTIVE To characterize in vivo with (11)C-(R)-PK11195 and (11)C-PIB PET the distribution of microglial activation and amyloid deposition in patients with amnestic MCI. METHODS Fourteen subjects with MCI had (11)C-(R)-PK11195 and (11)C-PIB PET with psychometric tests. RESULTS Seven out of 14 (50%) patients with MCI had increased cortical (11)C-PIB retention (p < 0.001) while 5 out of 13 (38%) subjects with MCI showed increased (11)C-(R)-PK11195 uptake. The MCI subgroup with increased (11)C-PIB retention also showed increased cortical (11)C-(R)-PK11195 binding (p < 0.036) though this increase only remained significant in frontal cortex after a correction for multiple comparisons. There was no correlation between regional levels of (11)C-(R)-PK11195 and (11)C-PIB binding in individual patients with MCI: only three of the five MCI cases with increased (11)C-(R)-PK11195 binding had increased levels of (11)C-PIB retention. CONCLUSIONS Our findings indicate that, while amyloid deposition and microglial activation can be detected in vivo in around 50% of patients with mild cognitive impairment (MCI), these pathologies can occur independently. The detection of microglial activation in patients with MCI suggests that anti-inflammatory therapies may be relevant to the prevention of AD.
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Affiliation(s)
- A Okello
- Division of Neuroscience and Mental Health, Faculty of Medicine, Imperial College London, London, UK.
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Stewart NJ, Bettiol SS, Kreiss A, Fox N, Woods GM. Mitogen-induced responses in lymphocytes from platypus, the Tasmanian devil and the eastern barred bandicoot. Aust Vet J 2008; 86:408-13. [PMID: 18826514 DOI: 10.1111/j.1751-0813.2008.00349.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE As the platypus (Ornithorhynchus anatinus), the Tasmanian devil (Sarcophilus harrisi) and the eastern barred bandicoot (Perameles gunni) are currently at risk of serious population decline or extinction from fatal diseases in Tasmania, the goal of the present study was to describe the normal immune response of these species to challenge using the lymphocyte proliferation assay, to give a solid basis for further studies. METHODS For this preliminary study, we performed lymphocyte proliferation assays on peripheral blood mononuclear cells (PBMC) from the three species. We used the common mitogens phytohaemagglutinin (PHA), concanavalin A (ConA), lipopolysaccharide (LPS) and pokeweed mitogen (PWM). RESULTS All three species recorded the highest stimulation index (SI) with the T-cell mitogens PHA and ConA. Tasmanian devils and bandicoots had greater responses than platypuses, although variability between individual animals was high. CONCLUSION For the first time, we report the normal cellular response of the platypus, the Tasmanian devil and the eastern barred bandicoot to a range of commonly used mitogens.
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Affiliation(s)
- N J Stewart
- University of Tasmania, School of Medicine, Hobart Tasmania, Australia.
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Gagliano N, Passarello B, Johnson S, Fox N, Resurreccion D, Moore C, Woods P, Pirrung J, Laskowsi Jones L. 209: Implementation of a Team Training Program for Trauma Care: The BETTER (Bringing Enhanced Team Training to the Emergency Room) Initiative. Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.06.227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Fox N, Sadick N. Electrocardiographic changes in hypothermia. Intern Med J 2008; 38:608-9. [DOI: 10.1111/j.1445-5994.2007.01604.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Karas G, Sluimer J, Goekoop R, van der Flier W, Rombouts SARB, Vrenken H, Scheltens P, Fox N, Barkhof F. Amnestic mild cognitive impairment: structural MR imaging findings predictive of conversion to Alzheimer disease. AJNR Am J Neuroradiol 2008; 29:944-9. [PMID: 18296551 DOI: 10.3174/ajnr.a0949] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Mild cognitive impairment (MCI) is considered by many to be a prodromal phase of Alzheimer disease (AD). We used voxel-based morphometry (VBM) to find out whether structural differences on MR imaging could offer insight into the development of clinical AD in patients with amnestic MCI at 3-year follow-up. MATERIALS AND METHODS Twenty-four amnestic patients with MCI were included. After 3 years, 46% had progressed to AD (n = 11; age, 72.7 +/- 4.8 years; women/men, 8/3). For 13 patients (age, 72.4 +/- 8.6 years; women/men, 10/3), the diagnosis remained MCI. Baseline MR imaging at 1.5T included a coronal heavily T1-weighted 3D gradient-echo sequence. Localized gray matter differences were assessed with VBM. RESULTS The converters had less gray matter volume in medial (including the hippocampus) and lateral temporal lobe, parietal lobe, and lateral temporal lobe structures. After correction for age, sex, total gray matter volume, and neuropsychological evaluation, left-sided atrophy remained statistically significant. Specifically, converters had more left parietal atrophy (angular gyrus and inferior parietal lobule) and left lateral temporal lobe atrophy (superior and middle temporal gyrus) than stable patients with MCI. CONCLUSION By studying 2 MCI populations, converters versus nonconverters, we found atrophy beyond the medial temporal lobe to be characteristic of patients with MCI who will progress to dementia. Atrophy of structures such as the left lateral temporal lobe and left parietal cortex may independently predict conversion.
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Affiliation(s)
- G Karas
- Department of Diagnostic Radiology, VU University Medical Center, Amsterdam, the Netherlands.
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Mulgrew AT, Nasvadi G, Butt A, Cheema R, Fox N, Fleetham JA, Ryan CF, Cooper P, Ayas NT. Risk and severity of motor vehicle crashes in patients with obstructive sleep apnoea/hypopnoea. Thorax 2008; 63:536-41. [PMID: 18234904 DOI: 10.1136/thx.2007.085464] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Obstructive sleep apnoea/hypopnoea (OSAH) appears to be associated with an increased risk of motor vehicle crashes (MVCs). However, its impact on crash patterns, particularly the severity of crashes, has not been well described. A study was undertaken to determine whether OSAH severity influenced crash severity in patients referred for investigation of suspected sleep-disordered breathing. METHODS Objective crash data (including the nature of crashes) for 783 patients with suspected OSAH for the 3 years prior to polysomnography were obtained from provincial insurance records and compared with data for 783 age- and sex-matched controls. The patient group was 71% male with a mean age of 50 years, a mean apnoea-hypopnoea index (AHI) of 22 events/h and a mean Epworth Sleepiness Scale score of 10. RESULTS There were 375 crashes in the 3-year period, 252 in patients and 123 in controls. Compared with controls, patients with mild, moderate and severe OSAH had an increased rate of MVCs with relative risks of 2.6 (95% CI 1.7 to 3.9), 1.9 (95% CI 1.2 to 2.8) and 2.0 (95% CI 1.4 to 3.0), respectively. Patients with suspected OSAH and normal polysomnography (AHI 0-5) did not have an increased rate of MVC (relative risk 1.5 (95% CI 0.9 to 2.5), p = 0.21). When the impact of OSAH on MVC associated with personal injury was examined, patients with mild, moderate and severe OSAH had a substantially higher rate of MVCs than controls with relative risks of 4.8 (95% CI 1.8 to 12.4), 3.0 (95% CI 1.3 to 7.0) and 4.3 (95% CI 1.8 to 8.9), respectively, whereas patients without OSAH had similar crash rates to controls with a relative risk of 0.6 (95% CI 0.2 to 2.5). Very severe MVCs (head-on collisions or those involving pedestrians or cyclists) were rare, but 80% of these occurred in patients with OSAH (p = 0.06). CONCLUSION Patients with OSAH have increased rates of MVCs, and disproportionately increased rates of MVCs are associated with personal injury.
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Affiliation(s)
- A T Mulgrew
- Diamond Health Centre, 2775 Laurel St, Vancouver, British Columbia, Canada
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Mulgrew AT, Ryan CF, Fleetham JA, Cheema R, Fox N, Koehoorn M, Fitzgerald JM, Marra C, Ayas NT. The impact of obstructive sleep apnea and daytime sleepiness on work limitation. Sleep Med 2007; 9:42-53. [PMID: 17825611 DOI: 10.1016/j.sleep.2007.01.009] [Citation(s) in RCA: 144] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2006] [Revised: 01/03/2007] [Accepted: 01/03/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND Many patients with obstructive sleep apnea (OSA) participate in the work force. However, the impact of OSA and sleepiness on work performance is unclear. METHODS To address this issue, we administered the Epworth Sleepiness Scale (ESS), the Work Limitations Questionnaire (WLQ), and an occupational survey to patients undergoing full-night polysomnography for the investigation of sleep-disordered breathing. Of 498 patients enrolled in the study, 428 (86.0%) completed the questionnaires. Their mean age+/-standard deviation (SD) was 49+/-12 years, mean body mass index (BMI) was 31+/-7 kg/m(2) mean apnea hypopnea index (AHI) was 21+/-22 events/h, and mean ESS score was 10+/-5. Subjects worked a mean of 39+/-18 h per week. The first 100 patients to complete the survey were followed up at two years. RESULTS In the group as a whole, there was no significant relationship between severity of OSA and the four dimensions of work limitation. However, in blue-collar workers, significant differences were detected between patients with mild OSA (AHI 5-15/h) and those with severe OSA (AHI>30/h) with respect to time management (limited 23.1% of the time vs. 43.8%, p=0.05) and mental/personnel interactions (17.9% vs. 33.0%, p=0.05). In contrast, there were strong associations between subjective sleepiness (as assessed by the ESS) and three of the four scales of work limitation. That is, patients with an ESS of 5 had much less work limitation compared to those with an ESS 18 in terms of time management (19.7% vs. 38.6 %, p<0.001), mental-interpersonal relationships (15.5% vs. 36.0%, p<0.001) and work output (16.8% vs. 36.0%; p<0.001). Of the group followed up, 49 returned surveys and 33 who were using continuous positive airway pressure (CPAP) showed significant improvements between the initial and second follow-up in time management (26% vs. 9%, p=0.0005), mental-interpersonal relationships (16% vs. 11.0%, p=0.014) and work output (18% vs. 10%; p<0.009). CONCLUSION We have demonstrated a clear relationship between excessive sleepiness and decreased work productivity in a population referred for suspected sleep-disordered breathing. Screening for sleepiness and sleep-disordered breathing in the workplace has the potential to identify a reversible cause of low work productivity.
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Affiliation(s)
- A T Mulgrew
- Department of Medicine and Division of Respiratory Medicine, University of British Columbia, Vancouver, BC, Canada
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Petzold A, Keir G, Warren J, Fox N, Rossor MN. A Systematic Review and Meta-Analysis of CSF Neurofilament Protein Levels as Biomarkers in Dementia. NEURODEGENER DIS 2007; 4:185-94. [PMID: 17596713 DOI: 10.1159/000101843] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [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: 11/19/2022] Open
Abstract
BACKGROUND Loss of cortical neurons is a key pathological feature in neurodegenerative dementias. Cerebrospinal fluid (CSF) neurofilaments (Nf) are a biomarker for neuronal death and axonal loss. OBJECTIVE To perform a meta-analysis to investigate the value of CSF Nf levels for the laboratory-supported differential diagnosis of neurodegenerative dementias. METHODS A systematic review and meta-analysis of studies on CSF Nf heavy (NfH) and light (NfL) levels in patients with dementia. The dementia subgroups analysed were Alzheimer (AD), frontotemporal lobe dementia (FTLD), vascular dementia (SVD), minimal cognitive deficit (MCI). RESULTS We identified 12 studies on CSF NfH and NfL levels which met the inclusion criteria and 11 were of a quality good enough to be used in this meta-analysis. CSF data was available on 818 patients (306 AD, 106 SVD, 98 FTLD, 25 MCI, 283 controls). Overall CSF NfH and NfL levels were higher in patients with AD, FTLD and SVD when compared to controls. The size of the effect ranged from 0.71 to 1.38. The strongest effect was observed for the comparison of FTLD patients with controls, both for NfL (1.38) and NfH (0.74). CSF NfL were also able to separate patients with FTLD from those with AD. CONCLUSION At present we cannot recommend CSF NfH and NfL levels for use as a screening test in the diagnosis of dementia because of the rather small effect size. However, both neurofilament proteins may be of value for targeted investigation of some patients with FTLD, SVD and AD.
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Affiliation(s)
- A Petzold
- Department of Neuroimmunology, Institute of Neurology, UCL, London, UK.
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Edison P, Archer HA, Hinz R, Hammers A, Pavese N, Tai YF, Hotton G, Cutler D, Fox N, Kennedy A, Rossor M, Brooks DJ. Amyloid, hypometabolism, and cognition in Alzheimer disease: an [11C]PIB and [18F]FDG PET study. Neurology 2006; 68:501-8. [PMID: 17065593 DOI: 10.1212/01.wnl.0000244749.20056.d4] [Citation(s) in RCA: 368] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the association between brain amyloid load in Alzheimer disease (AD) measured by [11C]PIB-PET, regional cerebral glucose metabolism (rCMRGlc) measured by [18F]FDG-PET, and cognition. METHODS Nineteen subjects with AD and 14 controls had [11C]PIB-PET and underwent a battery of psychometric tests. Twelve of those subjects with AD and eight controls had [18F]FDG-PET. Parametric images of [11C]PIB binding and rCMRGlc were interrogated with a region-of-interest atlas and statistical parametric mapping. [11C]PIB binding and rCMRGlc were correlated with scores on psychometric tests. RESULTS AD subjects showed twofold increases in mean [11C]PIB binding in cingulate, frontal, temporal, parietal, and occipital cortical areas. Higher cortical amyloid load correlated with lower scores on facial and word recognition tests. Two patients fulfilling the clinical criteria for AD had normal [11C]PIB at baseline. Over 20 months this remained normal in one but increased in the cingulate of the other. Mean levels of temporal and parietal rCMRGlc were reduced by 20% in AD and these correlated with mini mental scores, immediate recall, and recognition memory test for words. Higher [11C]PIB uptake correlated with lower rCMRGlc in temporal and parietal cortices. CONCLUSION [11C]PIB-PET detected an increased amyloid plaque load in 89% of patients with clinically probable Alzheimer disease (AD). The high frontal amyloid load detected by [11C]PIB-PET in AD in the face of spared glucose metabolism is of interest and suggests that amyloid plaque formation may not be directly responsible for neuronal dysfunction in this disorder.
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Affiliation(s)
- P Edison
- MRC Clinical Sciences Centre and Division of Neuroscience, Hammersmith Hospital, Imperial College London, London, UK
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Jones B, Flier W, Pijnenburg J, Scheltens P, Fox N, Smith S, Stam C. P36.4 Differences in EEG synchronisation likelihood measurements between young and old onset Alzheimer’s disease. Clin Neurophysiol 2006. [DOI: 10.1016/j.clinph.2006.06.615] [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: 10/24/2022]
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Patnaik A, Wakelee H, Mita M, Fitzgerald A, Hill M, Fox N, Howard T, Ullrich S, Tolcher A, Sikic B. HGS-ETR2—A fully human monoclonal antibody to TRAIL-R2: Results of a phase I trial in patients with advanced solid tumors. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [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
3012 Background: HGS-ETR2 is a fully-human high-affinity monoclonal antibody that is agonistic to the Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand Receptor 2 (TRAIL-R2, DR5). TRAIL-R2 is expressed more widely on the surface of tumor cells than normal cells; binding of HGS-ETR2 to TRAIL-R2 leads to activation of the extrinsic apoptosis pathway. HGS-ETR2 shows anti-tumor activity at doses ≥ 0.3 mg/kg in xenograft models, both as a single agent and in combination with chemotherapeutic agents. Methods: This phase 1, dose-escalation study assessed the safety, tolerability, pharmacokinetics and immunogenicity of HGS-ETR2 administered IV every 14 days in patients with advanced solid tumors. Patients received HGS-ETR2 until disease progression or unacceptable toxicity. Tumor measurements were repeated every 2 months. Results: To date, 31 patients have received 167 courses of HGS-ETR2 over 5 dose levels: 0.1, 0.3, 1.0, 3.0 and 10.0 mg/kg q14 days. The majority (26 of 31) received at least 4 courses. One patient experienced a dose-limiting toxicity of grade 3 hyperamylasemia at the 10 mg/kg dose level. The event was determined to be possibly related to HGS-ETR2 and also possibly related to a nutritional supplement. Stable disease was achieved in 10 patients for 4 to 16 cycles. One patient with chemotherapy-refractive Hodgkin’s disease had a tumor regression of abdominal disease. HGS-ETR2 pharmacokinetics were linear up to 10 mg/kg. At the 10 mg/kg dose, the pharmacokinetics were characterized by a mean (SD) t1/2β of 11 (4) days, CL of 6.0 (0.7) mL/day, and V1 of 47 (8) mL/kg, slightly larger than the plasma volume. The 1.8-fold larger Vss of 85 (27) mL/kg indicates that HGS-ETR2 distributes outside the plasma compartment. Human anti-human antibody formation has not been detected. Conclusions: HGS-ETR2 can be safely administered every 14 days at doses up to and including 10 mg/kg. Further evaluation of HGS-ETR2 is planned, including studies of HGS-ETR2 in combination with chemotherapeutic agents. [Table: see text]
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Affiliation(s)
- A. Patnaik
- Cancer Therapy and Research Center, San Antonio, TX; Stanford University School of Medicine, Stanford, CA; Human Genome Sciences, Rockville, MD
| | - H. Wakelee
- Cancer Therapy and Research Center, San Antonio, TX; Stanford University School of Medicine, Stanford, CA; Human Genome Sciences, Rockville, MD
| | - M. Mita
- Cancer Therapy and Research Center, San Antonio, TX; Stanford University School of Medicine, Stanford, CA; Human Genome Sciences, Rockville, MD
| | - A. Fitzgerald
- Cancer Therapy and Research Center, San Antonio, TX; Stanford University School of Medicine, Stanford, CA; Human Genome Sciences, Rockville, MD
| | - M. Hill
- Cancer Therapy and Research Center, San Antonio, TX; Stanford University School of Medicine, Stanford, CA; Human Genome Sciences, Rockville, MD
| | - N. Fox
- Cancer Therapy and Research Center, San Antonio, TX; Stanford University School of Medicine, Stanford, CA; Human Genome Sciences, Rockville, MD
| | - T. Howard
- Cancer Therapy and Research Center, San Antonio, TX; Stanford University School of Medicine, Stanford, CA; Human Genome Sciences, Rockville, MD
| | - S. Ullrich
- Cancer Therapy and Research Center, San Antonio, TX; Stanford University School of Medicine, Stanford, CA; Human Genome Sciences, Rockville, MD
| | - A. Tolcher
- Cancer Therapy and Research Center, San Antonio, TX; Stanford University School of Medicine, Stanford, CA; Human Genome Sciences, Rockville, MD
| | - B. Sikic
- Cancer Therapy and Research Center, San Antonio, TX; Stanford University School of Medicine, Stanford, CA; Human Genome Sciences, Rockville, MD
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