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Borges VM, Vannier-Santos MA, de Souza W. Subverted transferrin trafficking in Leishmania-infected macrophages. Parasitol Res 1998; 84:811-22. [PMID: 9797066 DOI: 10.1007/s004360050493] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The intracellular fate of human transferrin (HTf) in macrophages infected by Leishmania was investigated. Binding of HTf-gold complexes at 4 degrees C was competitively inhibited by native holoHTf but not by apoHTf. Infected and uninfected macrophages displayed rather distinct HTf trafficking. Pulse-chase experiments using uninfected macrophages loaded with 15-nm gold-conjugated bovine serum albumin (BSA) and then incubated with 5-nm gold-conjugated HTf revealed a remarkable segregation of these tracers in distinct compartments. Nevertheless, Leishmania-infected macrophages presented extensive particle colocalization at both 60 min and 18 h. Light and electron microscopy immunolabeling indicated that HTf was delivered to the parasitophorous vacuole, formed patches on the amastigote surface, and was endocytosed via the flagellar pocket. Double-staining assays showed the colocalization of biotinylated HTf and its receptor in association with the parasitophorous vacuole. To approach the Tf-binding sites of amastigotes we performed HTf-fluorescein isothiocyanate (FITC) assays. Staining was diffuse at 4 degrees C and punctate at 35 degrees C, and only the former was sensitive to ethidium bromide, indicating an eventual temperature-dependent endocytic process. Within parasites, HTf was found in cysteine-proteinase-rich structures, suggesting that the protein can be endocytosed by intracellular amastigotes and sorted to the parasite endosomal-lysosomal compartments rather than being recycled. The treatment of infected macrophages with holoHTf, but not apoHTf, promoted the parasite's intracellular survival. These results suggest that Leishmania amastigotes can exploit and subvert the host-cell endocytic system and indicate the role of Tf-carried iron in the outcome of leishmanial infection.
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38 |
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Borges V, Ferreira R, Nunes A, Nogueira P, Borrego MJ, Gomes JP. Normalization strategies for real-time expression data in Chlamydia trachomatis. J Microbiol Methods 2010; 82:256-64. [PMID: 20619305 DOI: 10.1016/j.mimet.2010.06.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Revised: 06/24/2010] [Accepted: 06/29/2010] [Indexed: 11/26/2022]
Abstract
Chlamydia trachomatis is a widespread obligate intracellular pathogen genetically non-tractable for which transcriptomics is a fundamental tool to better understand its biology. However, the suitability of endogenous controls for normalization of transcriptomic data in this bacterium still needs validation. We aimed to assess the stability of 10 genes for their potential use as endogenous controls in real-time quantitative PCR assays at both normal and stress (D-cycloserine treatment) growth conditions throughout the developmental cycle of three C. trachomatis strains with different tissue tropism. Normalization was performed by real-time absolute quantification of the bacterial genomes. We also tested the applicability of two widely used softwares (geNorm and Normfinder) to our data. For all strains, we found that 16SrRNA was the most stably expressed gene throughout the chlamydial normal developmental cycle, which indicates its potential use as endogenous control in relative expression assays. However, it was highly unstable under D-cycloserine treatment (where oppA_2 was top-ranked), suggesting prudence when using ribosomal genes in expression experiments involving stress conditions. The geNorm and Normfinder algorithms revealed contrasting results and seem inappropriate for the selected pool of genes. Considering the multiplicity of experimental conditions, there should be an in loco validation of endogenous controls, where 16SrRNA appears to be in the front line. Alternatively, normalization of expression data against genomic DNA, which is less influenced by experimental constraints that are especially relevant for intracellular organisms, likely constitutes a good option. Moreover, the number of genomes also seems to be less subject to variation than expression of endogenous controls when working under stress conditions. The present study constitutes the first evaluation of putative endogenous controls for real-time expression assays in C. trachomatis.
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Validation Study |
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28 |
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Costa J, Ortiz-Ibañez K, Salerni G, Borges V, Carrera C, Puig S, Malvehy J. Dermoscopic patterns of melanoma metastases: interobserver consistency and accuracy for metastasis recognition. Br J Dermatol 2014; 169:91-9. [PMID: 23495915 DOI: 10.1111/bjd.12314] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cutaneous metastases of malignant melanoma (CMMM) can be confused with other skin lesions. Dermoscopy could be helpful in the differential diagnosis. OBJECTIVES To describe distinctive dermoscopic patterns that are reproducible and accurate in the identification of CMMM. METHODS A retrospective study of 146 dermoscopic images of CMMM from 42 patients attending a melanoma unit between 2002 and 2009 was performed. Firstly, two investigators established six dermoscopic patterns for CMMM. The correlation of 73 dermoscopic images with their distinctive patterns was assessed by four independent dermatologists to evaluate the reproducibility in the identification of the patterns. Finally, 163 dermoscopic images, including CMMM and nonmetastatic lesions, were evaluated by the same four dermatologists to calculate the accuracy of the patterns in the recognition of CMMM. RESULTS Five CMMM dermoscopic patterns had a good interobserver agreement (blue naevus-like, naevus-like, angioma-like, vascular and unspecific). When CMMM were classified according to these patterns, correlation between the investigators and the four dermatologists ranged from κ = 0.56 to κ = 0.7. In total, 71 CMMM, 16 angiomas, 22 blue naevi, 15 malignant melanomas, 11 seborrhoeic keratoses, 15 melanocytic naevi with a globular pattern and 13 pink lesions with a vascular pattern were evaluated according to the previously described CMMM dermoscopy patterns, showing an overall sensitivity of 67.9% (range 54.9-76%) and a specificity of 79.9% (range 68.5-93.5%) for the diagnosis of CMMM. CONCLUSIONS Five dermoscopic patterns of CMMM with good interobserver agreement obtained a high sensitivity and specificity in the diagnosis of metastasis, with the accuracy varying according to the experience of the observer.
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Research Support, Non-U.S. Gov't |
11 |
27 |
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Goulart FO, Godke BA, Borges V, Azevedo-Silva SMC, Mendes MF, Cendoroglo MS, Ferraz HB. Fatigue in a cohort of geriatric patients with and without Parkinson's disease. Braz J Med Biol Res 2010; 42:771-5. [PMID: 19649404 DOI: 10.1590/s0100-879x2009000800014] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2008] [Accepted: 05/18/2009] [Indexed: 11/21/2022] Open
Abstract
We evaluated the frequency of fatigue in geriatric patients with and without Parkinson's disease (PD) and correlated it with depression and excessive daytime sleepiness. We evaluated 100 patients from Hospital São Paulo, 50 with PD from the Neurologic Outpatient Clinic and 50 with non-neurologic diseases or oncologic diseases from the Geriatric Outpatient Clinic (controls). All patients who scored 28 or more on the Fatigue Severity Scale (FSS) were considered to have fatigue. Also, all patients were submitted to a structured interview to diagnose depression by the criteria of the American Psychiatric Association (DSM-IV, 4th version) and were evaluated by the Modified Impact of Fatigue Scale and the Epworth Sleepiness Scale (ESE) to detect excessive daytime sleepiness. Demographic and disease details of all PD patients were recorded and the patients were examined and rated by the Unified Parkinson's Disease Rating Sale (UPDRS) and Hoehn-Yahr staging. Frequency of fatigue (FSS >or=28) was 70% for PD and 22% for controls. Twenty of 35 PD patients with fatigue had concomitant depression. Compared to controls, PD patients were found more frequently to have depression by DSM-IV criteria (44 vs 8%, respectively) and excessive daytime sleepiness by the ESE (44 vs 16%), although only depression was associated with fatigue. Fatigue was more frequent among depressed PD and control patients and was not correlated with PD duration or with UPDRS motor scores. ESE scores did not differ between patients with or without fatigue.
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Journal Article |
15 |
21 |
5
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Rodríguez NE, Lockard RD, Turcotte EA, Araújo-Santos T, Bozza PT, Borges VM, Wilson ME. Lipid bodies accumulation in Leishmania infantum-infected C57BL/6 macrophages. Parasite Immunol 2017; 39. [PMID: 28518475 DOI: 10.1111/pim.12443] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 05/14/2017] [Indexed: 12/20/2022]
Abstract
Lipid bodies (LBs) are intracellular accumulations of neutral lipids surrounded by a single membrane. These organelles are involved in the production of eicosanoids, which modulate immunity by either promoting or dampening inflammatory responses. Leishmania infantum, the etiological agent of visceral leishmaniasis in Brazil, is an intracellular parasite that causes disease by suppressing macrophage microbicidal responses. C57BL/6 mouse bone marrow-derived macrophages infected with L. infantum strain LcJ had higher numbers of LB+ cells (P<.0001) and total LBs than noninfected cultures. Large (>3 μm) LBs were present inside parasitophorous vacuoles (PVs). These results contrast with those of L. infantum-infected BALB/c macrophages, in which the only LBs are derived from parasite, not macrophage origin. Increased LBs in C57BL/6 macrophages in close association with parasites would position host LBs where they could modulate L. infantum infection. These results imply a potential influence of the host genetics on the role of LBs in host-pathogen interactions. Overall, our data support a model in which the expression, and the role of LBs upon infection, ultimately depends on the specific combination of host-pathogen interactions.
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Journal Article |
8 |
18 |
6
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Benetton SA, Borges VM, Chang TKH, McErlane KM. Role of individual human cytochrome P450 enzymes in thein vitrometabolism of hydromorphone. Xenobiotica 2008; 34:335-44. [PMID: 15268978 DOI: 10.1080/00498250310001657559] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
1. The aim was to identify the individual human cytochrome P450 (CYP) enzymes responsible for the in vitro N-demethylation of hydromorphone and to determine the potential effect of the inhibition of this metabolic pathway on the formation of other hydromorphone metabolites. 2. Hydromorphone was metabolized to norhydromorphone (apparent Km = 206 - 822 microM, Vmax = 104 - 834 pmol min(-1) mg(-1) protein) and dihydroisomorphine (apparent Km = 62 - 557 microM, Vmax = 17 - 122 pmol min(-1) mg(-1) protein) by human liver microsomes. 5. In pooled human liver microsomes, troleandomycin, ketoconazole and sulfaphenazole reduced norhydromorphone formation by an average of 45, 50 and 25%, respectively, whereas furafylline, quinidine and omeprazole had no effect. In an individual liver microsome sample with a high CYP3A protein content, troleandomycin and ketoconazole inhibited norhydromorphone formation by 80%. 5. The reduction in norhydromorphone formation by troleandomycin and ketoconazole was accompanied by a stimulation in dihydroisomorphine production. Recombinant CYP3A4, CYP3A5, CYP2C9 and CYP2D6, but not CYP1A2, catalysed norhydromorphone formation, whereas none of these enzymes was active in dihydroisomorphine formation. 6. In summary, CYP3A and, to a lesser extent, CYP2C9 catalysed hydromorphone N-demethylation in human liver microsomes. The inhibition of norhydromorphone formation by troleandomycin and ketoconazole resulted in a stimulation of microsomal dihydroisomorphine formation.
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Borges VM, Lopes UG, De Souza W, Vannier-Santos MA. Cell structure and cytokinesis alterations in multidrug-resistant Leishmania (Leishmania) amazonensis. Parasitol Res 2004; 95:90-6. [PMID: 15592939 DOI: 10.1007/s00436-004-1248-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2004] [Accepted: 09/28/2004] [Indexed: 10/26/2022]
Abstract
Multidrug-resistant Leishmania (Leishmania) amazonensis may be obtained by in vitro selection with vinblastine. In order to determine whether this phenotype is linked to structural alterations, we analyzed the cell architecture by electron microscopy. The vinblastine resistant CL2 clone of L. (L.) amazonensis, but not wild-type parasites, showed a cytokinesis dysfunction. The CL2 promastigotes had multiple nuclei, kinetoplasts and flagella, suggesting that vinblastine resistance may be associated with truncated cell division. The subpellicular microtubule plasma membrane connection was also affected. Wild-type parasites treated with vinblastine displayed similar alterations, presenting lobulated and multinucleated cells. Taken together, these data indicate that antimicrotubule drug-selected parasites may show evidence of the mutation of cytoskeleton proteins, impairing normal cell function.
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Research Support, Non-U.S. Gov't |
21 |
13 |
8
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Ferraz HB, De Andrade LA, Silva SM, Borges V, Rocha MS. [Postural tremor and dystonia. Clinical aspects and physiopathological considerations]. ARQUIVOS DE NEURO-PSIQUIATRIA 1994; 52:466-70. [PMID: 7611937 DOI: 10.1590/s0004-282x1994000400002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The coexistence of tremor and dystonia is usually seen but there is not a satisfactory explanation for it. Some consider that essential tremor (ET) and idiopathic dystonia (ID) may be genetically linked. To clarify this relationship we evaluated the frequency of postural hand tremor in ID and symptomatic dystonia (SD) patients. We studied the records of patients with dystonia seen in our Movement Disorders Unit. ID was considered when there was no other neurological abnormality in the examination aside from dystonia, normal laboratorial tests and neuroimaging related to dystonia, and a negative past history for any known cause for it, except for genetic predisposition. We analyzed the clinical characteristics of dystonia and the occurrence of postural tremor. We collected 185 patients, being 120 with ID and 65 with SD. Tremor was seen in 27 (22.5%) of ID and 14 (21.5%) of SD. Tremor was present in either focal, segmental or generalized dystonia in both ID and SD. Family history for ET was absent in all patients. The similar frequency of tremor in ID and SD patients suggests that the pathophysiologic derangement resulting in dystonia can favor the development of tremor.
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English Abstract |
31 |
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9
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Borges V, Ferraz HB, de Andrade LA. Alcohol-sensitive hereditary essential myoclonus with dystonia: a study of 6 Brazilian patients. Neurol Sci 2000; 21:373-7. [PMID: 11441575 DOI: 10.1007/s100720070053] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We present the clinical profile of a group of patients with myoclonus and dystonia sensitive to alcohol and address these cases in the context of essential myoclonus. Six patients from 4 families were selected: 4 men and 2 women with myoclonus affecting predominantly the arms. Active movements of these segments elicited the dystonic and myoclonic movements. A marked improvement with alcohol intake was seen. Laboratory findings including EEG, SSEP, and cranial CT and MRI were normal. Surface EMG recording showed bursts with duration of 30-112 ms in 3 patients. One patient showed a triphasic recording pattern (agonist-antagonist-agonist) of ballistic type. Our findings suggest that the myoclonus-dystonia disorder is present in Brazilian patients.
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Case Reports |
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10
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Junior S, Riker A, Silvestre B, Moreira W, Oliveira-Jr A, Borges V. DYNASTI-Dynamic Multiple RPL Instances for Multiple IoT Applications in Smart City. SENSORS 2020; 20:s20113130. [PMID: 32492935 PMCID: PMC7313695 DOI: 10.3390/s20113130] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/19/2020] [Accepted: 05/28/2020] [Indexed: 11/16/2022]
Abstract
Internet of Things (IoT) is evolving to multi-application scenarios in smart cities, which demand specific traffic patterns and requirements. Multi-applications share resources from a single multi-hop wireless networks, where smart devices collaborate to send collected data over a Low-Power and Lossy Networks (LLNs). Routing Protocol for LLNs (RPL) emerged as a routing protocol to be used in IoT scenarios where the devices have limited resources. Instances are RPL mechanisms that play a key role in order to support the IoT scenarios with multiple applications, but it is not standardized yet. Although there are related works proposing multiple instances in RPL on the same IoT network, those works still have limitations to support multiple applications. For instance, there is a lack of flexibility and dynamism in management of multiple instances and service differentiation for applications. In this context, the goal of this work is to develop a solution called DYNAmic multiple RPL instanceS for multiple ioT applicatIons (DYNASTI), which provides more dynamism and flexibility by managing multiple instances of RPL. As a result of this, the traffic performance of multiple applications is enhanced through the routing, taking into consideration the distinct requirements of the applications. In addition, DYNASTI enables the support of sporadic applications as well as the coexistence between regular and sporadic applications. DYNASTI achieved results that demonstrate a significant improvement in reducing the number of control messages, which resulted in increased packet received, decreased end-to-end delay, reduced energy consumption, and an improvement in service differentiation to multiple applications.
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Ferraz HB, Andrade LA, Tumas V, Calia LC, Borges V. Rural or urban living and Parkinson's disease. ARQUIVOS DE NEURO-PSIQUIATRIA 1996; 54:37-41. [PMID: 8736142 DOI: 10.1590/s0004-282x1996000100006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Although the precise etiology of Parkinson's disease (PD) is as yet unknown, it appears that certain environmental factors are involved. Prior living in a rural area has been implicated as a possible risk factor for PD, particularly in the early onset type. We evaluated the role of previous living conditions in the clinical correlates and outcome characteristics of 118 PD patients. All of them were seen from January 1987 to October 1992. The Rural Group (RG) comprised 71 patients (60.2%) who had lived in the rural area for at least 10 years (mainly in early phase of life) and the Urban Group (UG) consisted of 47 patients (39.8%) who had lived their entire life in an urban environment. The average age at the beginning of the symptoms was 58.8 in the RG and 54.1 in the UG. The mixed form of the disease (tremor, rigidity and akinesia) was the most frequent in both groups. A minimum 6-month follow-up period was undertaken with 63 patients (average 20 months) and no difference in response to treatment or in progression of the illness was detected between the two groups. Our data show that the previous living environment does not appear to be a determining factor in either the clinical or outcome characteristics of PD.
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Comparative Study |
29 |
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12
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Andrade LA, Borges V, Ferraz HB, Azevedo-Silva SM. [Botulinum toxin A: experience in the treatment of 115 patients]. ARQUIVOS DE NEURO-PSIQUIATRIA 1997; 55:553-7. [PMID: 9629404 DOI: 10.1590/s0004-282x1997000400006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Botulinum toxin A is the more efficient therapy of focal dystonias and hemifacial spasm. Our experience with botulinum toxin A injections in 115 patients is reported. Marked or total improvement was achieved in all 45 patients with hemifacial spasm, in 70% of 20 patients with essential blepharospasm and in 71.4% of 14 patients with Meige's syndrome. In 65.2% of 23 patients with cervical dystonia marked but no total improvement was obtained. The worse results were seen in the 6 patients with hand dystonia (writers cramp), in whom marked improvement was obtained in just two. Mild and transient complications occurred in up to 24.4%, eyelid ptosis and eyelid weakness being the most frequent. One patient with Meige's syndrome had an aspiration pneumonia following dysphagia. Our results are in agreement with others, showing that botulinun toxin A is a useful and safe treatment for these conditions.
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English Abstract |
28 |
6 |
13
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Borges V, Ferraz HB, de Andrade LA. [Essential tremor: clinical characterization in a sample of 176 patients]. ARQUIVOS DE NEURO-PSIQUIATRIA 1994; 52:161-5. [PMID: 7826244 DOI: 10.1590/s0004-282x1994000200005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We reviewed the clinical records of 176 patients with essential tremor (ET) according to sex, age of onset, family history, tremor characteristics and body distribution. The patients were divided into two groups: familial (F) and non familial (NF). A positive family history for tremor was observed in 47.2% of the patients. Action and postural tremor were the most frequent characteristic (49.4%), postural alone in 26.7% and action alone in 9.1%. Rest tremor was recorded in 10.2%, always associated with other characteristics. There were no clinical differences between the F and NF groups. Hands were involved in 94.9% and the head in 26.5%. Isolated tremor of the hands was the most frequent form of presentation with some greater frequency in males. Sixty per cent of the patients who presented head tremor either isolated or not, were females. The presence or absence of family history did not show difference in this proportion. The age of onset ranged between 4 and 85 years. In the F group a lower mean of onset (36.5 years) was seen in males with statistical significance. In male patients with combined action and postural tremor a lower age of onset was found. The fact of a patient having either parent affected by ET produced no difference in the age of onset. Familial or non familial ET bearing some differences, may not be considered as distinct entities.
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English Abstract |
31 |
5 |
14
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Ferraz HB, Azevedo-Silva SM, Borges V, Rocha MS, Andrade LA. [Apomorphine: an alternative in the control of motor fluctuations in Parkinson's disease]. ARQUIVOS DE NEURO-PSIQUIATRIA 1995; 53:245-51. [PMID: 7487531 DOI: 10.1590/s0004-282x1995000200010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Levodopa-induced motor fluctuations (MF) is a disabling complication of Parkinson's disease (PD) and is usually refractory to conventional treatment. Apomorphine, a dopamine agonist with affinity for both D1 and D2 receptors, has been emerged as an useful alternative in the management of MF of PD. The frequency of nausea and vomiting prevented its use in the past, but the simultaneous administration of domperidone has proved to be able to control these side effects. Although apomorphine has been successfully used to control levodopa-induced MF in other countries, it has not been considered in the management of PD in Brazil. We report here our initial experience with subcutaneous injections of apomorphine combined to oral domperidone. We administered apomorphine in doses ranging from 1.5 to 3 mg in four PD patients with MF of our outpatient clinic. All the doses administered switched the "off" state to a motor response qualitatively similar to what is seen in the "on" phase induced by levodopa, including the occurrence of dyskinesia. The latency to turn "on" after apomorphine ranged from 7 to 30 minutes and the duration of the response ranged from 60 to 85 minutes. We observed yawning in all four patients, labial paresthesia in one patient and an inspecific unpleasant sensation in another patient. These side effects were not significant in our four patients. Our data show that the use of apomorphine adds a reliable and effective strategy in the management of MF of PD patients.
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Case Reports |
30 |
4 |
15
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Rocha MS, Andrade LA, Ferraz HB, Borges V. [Levodopa-induced dyskinesia in 176 patients with Parkinson's disease]. ARQUIVOS DE NEURO-PSIQUIATRIA 1995; 53:737-42. [PMID: 8729765 DOI: 10.1590/s0004-282x1995000500004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Dyskinesias are frequently observed in parkinsonian patients during levodopa treatment. The occurrence of these movement disorders usually makes the therapeutic management of the patients very difficult. The clinical characteristics of 176 patients with dyskinesias were retrospectively studied. Dyskinesias occurred, on average, after 6.2 years of duration of Parkinson's disease and after 4.2 years on treatment with levodopa. Patients were more likely to have dyskinesias during more advanced stages (measured by Hoehn and Yahr scale). Peak of dose and square wave were the types of dyskinesia more frequently described and were associated with choreic movements in most cases. Dystonia occurred in 40% of the cases and was predominant in end of dose and diphasic dyskinesias. Thirty-five percent of dystonia cases presented as "early morning dystonia". Chorea was the most frequent involuntary movement and mostly generalized. Dystonia was most commonly described in lower limbs. Orofacial dyskinesia, when occurred alone, was more frequently seen in old rather than young patients. When dyskinesia was unilateral it was more likely to occur in the side where Parkinson's disease was more severe.
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English Abstract |
30 |
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16
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O'Day S, Borges V, Chmielowski B, Rao R, Abu-Khalaf M, Stopeck A, Lowe J, Mattson P, Breuer K, Gargano M, Bose N, Uhlik M, Graff J, Chisamore M, Cox J, Osterwalder B. Abstract P2-09-08: Imprime PGG, a novel innate immune modulator, combined with pembrolizumab in a phase 2 multicenter, open label study in chemotherapy-resistant metastatic triple negative breast cancer (TNBC). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-09-08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: CPI monotherapy provides substantial clinical benefit to patients (pts) in multiple cancers, yet response rates are limited (˜15-30%) and fails to benefit the majority. In these pts there is limited or no ongoing T cell-based immune response. Imprime PGG (Imprime), a novel beta glucan derived from Saccharomyces, may expand the clinical benefit of CPI therapy by stimulating an anti-cancer immune response. Acting as a pathogen-associated molecularpattern (PAMP), Imprime enlists innate immune functions including cytotoxic effector mechanisms, reversal of immunosuppression and cross-talk with the adaptive immune system.Imprime-mediated innate immune activation requires formation of an immune complex with naturally-occurring anti-beta glucan antibodies (ABA); sufficient ABA levels is required for complex formation. Imprime is now being studied in combination with pembrolizumab (KEYTRUDA®,Pembro), a humanized mAb against PD-1 which has been previously studied in TNBC pts.
Methods: In this study of patients who previously failed chemotherapy for metastatic TNBC, Imprime is being used in combination with Pembro in a Simon 2 stage design. Asample size of 12 evaluable pts in Stage 1 was planned.Evaluable pts received at least one dose of study treatment (tx), had measurable disease at baseline per RECIST v1.1, had at least one post-baseline scan or discontinued tx as a result of progressive disease, death, or a tx-related adverse event before the first post-baseline scan.Pts received Imprime (4 mg/kg IV days 1, 8, 15 of each 3-week cycle) + Pembro 200 mg on D1 of each cycle. Criteria to advance to Stage 2 were ≤4 grade 3/4 AEs during the first tx cycle (other than infusion reactions) and ≥1 objective response. Study primary endpoints are ORR and safety; secondary endpoints are TTR, CRR, DoR, PFS, and OS. Exploratory endpoints include ORR and PFS per irRECIST. Biopsies and blood samples are being collected to assess tx impact on immune activating events at the tumor site and in the periphery.
Results: A review of efficacy and safety data was conducted at the end of Stage 1. Thirteen pts (12 evaluable) were enrolled into Stage 1. Safety review noted 2 grade 3 adverse events that met protocol definition of Stage 1 events (1 pt: cellulitis and 1 pt: pleural infusion; both unrelated to treatment). Two events lead to 2 pts discontinuing treatment (infusion reaction and pancreatitis) and only 1 autoimmune event was observed (pancreatitis). Observed efficacy responses in the evaluable pts included 1 complete response (CR; ongoing) and 2 partial responses (PR; ongoing). Secondary efficacy endpoints have not been assessed. Early translational results support proposed MOA and analysis of Stage 1 translational data is ongoing.
Conclusion: The use of Imprime with Pembro was well tolerated and met both safety and efficacy requirements to move forward with Stage 2 of the study. No significant safety concerns were identified in Stage 1. Further investigation is thus warranted and enrollment into Stage 2 is ongoing. Updated data will be presented.
Citation Format: O'Day S, Borges V, Chmielowski B, Rao R, Abu-Khalaf M, Stopeck A, Lowe J, Mattson P, Breuer K, Gargano M, Bose N, Uhlik M, Graff J, Chisamore M, Cox J, Osterwalder B. Imprime PGG, a novel innate immune modulator, combined with pembrolizumab in a phase 2 multicenter, open label study in chemotherapy-resistant metastatic triple negative breast cancer (TNBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-09-08.
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Teruel N, Borges VM, Najmanovich R. Surfaces: a software to quantify and visualize interactions within and between proteins and ligands. Bioinformatics 2023; 39:btad608. [PMID: 37788107 PMCID: PMC10568369 DOI: 10.1093/bioinformatics/btad608] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/23/2023] [Accepted: 09/29/2023] [Indexed: 10/05/2023] Open
Abstract
SUMMARY Computational methods for the quantification and visualization of the relative contribution of molecular interactions to the stability of biomolecular structures and complexes are fundamental to understand, modulate and engineer biological processes. Here, we present Surfaces, an easy to use, fast and customizable software for quantification and visualization of molecular interactions based on the calculation of surface areas in contact. Surfaces calculations shows equivalent or better correlations with experimental data as computationally expensive methods based on molecular dynamics. AVAILABILITY AND IMPLEMENTATION All scripts are available at https://github.com/NRGLab/Surfaces. Surface's documentation is available at https://surfaces-tutorial.readthedocs.io/en/latest/index.html.
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Shagisultanova E, Diamond J, Stopeck A, Pusztai L, O'Regan R, Gradishar W, Brown-Glaberman U, Chalasani P, McSpadden T, Borakove M, Shedin T, Kabos P, Borges V. Abstract OT1-03-06: Phase IB/II clinical trial to evaluate safety and efficacy of tucatinib in combination with palbociclib and letrozole in patients with hormone receptor positive and HER2-positive metastatic breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot1-03-06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Breast cancers overexpressing HER2-oncogene and hormone receptors (HR) represent therapeutic challenge because of a bi-directional cross-talk between HR and HER2 pathways leading to tumor progression and drug resistance. There is a strong rationale for evaluation of novel targeted drug combinations in this breast cancer subtype.
We designed a phase IB /II clinical trial to test the combination of novel oral HER2 small molecule inhibitor tucatinib with CDK4/6 inhibitor palbociclib and aromatase inhibitor letrozole in patients with HR+/HER2+ metastatic breast cancer (NCT03054363). In addition to the rationale for the synergy of targeting HR, HER2 and CDK4/6 pathways simultaneously in this disease setting and its potential for anti-tumor efficacy, we propose this novel combination of three oral agents, if well tolerated, will be highly patient-centered as an effective non-chemotherapy based regimen for treatment of HR+/HER2+ breast cancer.
This multicenter clinical trial is conducted through the Academic Breast Cancer Consortium (ABRCC), with the University of Colorado Cancer Center as the lead site.
Target enrollment: 40 patients (20 patients in phase IB and 20 patients in phase II part).
Main inclusion criteria:
1. HR+/HER2+ locally advanced unresectable / metastatic breast cancer
2. Measurable or evaluable disease. Bone only disease is allowed.
3. Subjects without brain metastases are eligible; subjects with untreated asymptomatic CNS metastases not needing immediate local therapy, and subjects with stable brain metastases previously treated with radiation therapy or surgery are eligible
4. ECOG 0-1
5. Postmenopausal women, or premenopausal women on ovarian suppression
6. Prior treatments:
- At least two approved HER2-targeted agents (trastuzumab, pertuzumab, or TDM-1) at any time in the course of the disease
- At least 1 line of HER2-targeted therapy in the metastatic setting (with the exception of asymptomatic subjects with oligometastatic or bone / soft tissue only disease who, on investigator opinion, are appropriate for a front line single agent anti-endocrine therapy per NCCN guidelines)
- Up to 2 lines of prior endocrine therapy in the metastatic setting are allowed
7. Adequate organ and marrow function
Main exclusion criteria:
1. Previously treated progressing brain metastases
2. Brain metastases and contraindications to undergo contrast brain MRI
3. Toxicities of prior cancer therapies that have not resolved to grade 1 or less, except peripheral neuropathy, which must have resolved to grade 2 or less, and alopecia
4. Previous treatment with EGFR or HER2 tyrosine kinase inhibitors or CDK4/6 inhibitors
5. Systemic anti-cancer therapy or radiation within 2 weeks of the first dose of study drugs
6. Active bacterial, fungal or viral infections, hepatitis B, C, or HIV
7. Clinically significant cardio-vascular disease
Primary objectives:
- Phase IB: safety and tolerability of combination therapy
- Phase II: efficacy by PFS
Exploratory assessment of biomarkers of resistance and response will be performed in the blood and biopsy samples
Study contact: Elena Shagisultanova, MD, PhD, elena.shagisultanova@ucdenver.edu
Citation Format: Shagisultanova E, Diamond J, Stopeck A, Pusztai L, O'Regan R, Gradishar W, Brown-Glaberman U, Chalasani P, McSpadden T, Borakove M, Shedin T, Kabos P, Borges V. Phase IB/II clinical trial to evaluate safety and efficacy of tucatinib in combination with palbociclib and letrozole in patients with hormone receptor positive and HER2-positive metastatic breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT1-03-06.
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Gamelas V, Borges V, Santos S, Santos J, Silva MJ, Bernardes C, Ramos J. Gastrointestinal: Olmesartan-induced enterocolopathy: A new presentation of a known entity. J Gastroenterol Hepatol 2021; 36:1150. [PMID: 33305434 DOI: 10.1111/jgh.15332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 10/07/2020] [Accepted: 11/03/2020] [Indexed: 12/09/2022]
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Partridge AH, Rosenberg SM, Rajagopal PS, Ruddy KJ, Tamimi RM, Schapira L, Come S, Borges V, Gelber S. Abstract P4-10-04: Employment trends in young women following a breast cancer diagnosis. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-10-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Workplace concerns are particularly salient for young women with breast cancer (BC), and a cancer diagnosis (dx) and treatment may affect their careers. We sought to evaluate the perceived impact of dx on employment, describe job changes, and identify factors associated with transition out of the workforce after dx of BC at a young age.
Methods: As part of an ongoing, multi-center cohort of young women diagnosed with BC at age ≤ 40, we surveyed women with early-stage BC about their pre- and post-dx employment status. Additional items assessed socio-demographic and treatment information; tumor characteristics were ascertained via pathology and medical record review. We used logistic regression to identify predictors of transitioning from pre-dx employment to unemployment at 1 year after dx. Among women employed 1 year after dx, we evaluated job satisfaction, perceived impact of dx on job performance, accommodations made by employers, and perceived likelihood of employment in the future.
Results: 76% of women (555/730) were employed both before dx and at 1 year; 13% were not employed at either time point; 7% were employed pre-dx but unemployed at 1 year; 4% were not employed prior to dx but reported employment at 1 year. Among women employed 1 year after dx, 74% (427/581) were somewhat or completely satisfied with their job. Only 6% said cancer or treatment limited their ability to perform their job quite a bit or very much; 38% said their ability was affected a little bit. Most (63%) said their employers had made accommodations for them, and almost all women (93%) said it was very likely they would be working in 1 year. In multivariable analyses (Table 1), women with stage 3 disease (vs. stage 1), were more likely to transition out of the workforce following dx, while women with a college or graduate degree (vs. no college degree) were less likely to transition out.
Conclusion: Most young women with early stage BC remain employed and report a willingness by their employer to make accommodations following a breast cancer dx. While few women reported that their dx or treatment limited their job performance, the finding that women with more advanced disease were more likely to transition out of the workforce suggests an impact of dx/treatment burden on employment. Women without a college degree were also at risk for unemployment post-dx, suggesting that job type, socioeconomic status, and environment affect employment outcomes. Attention to these subgroups of women is warranted to ensure that they are sufficiently supported given the potential adverse psychosocial and financial impacts of unemployment on patients, families, communities, and society.
Table 1. Multivariable analysis of factors associated with transition out of workforce 1year post-dx (N=634) OR (95% CI)Stage (ref=1) 04.52 (0.60-33.85)21.11 (0.48-2.58)34.05 (1.53-10.72)*White non-Hispanic (ref=non-WNH)1.47 (0.56-3.81)College graduate (ref=no college degree)0.44 (0.22-0.90)*Married/Living as married (ref=unmarried)0.95 (0.43-2.08)Parous (ref=nulliparous)1.75 (0.83-3.69)Age at diagnosis (years)0.98 (0.90-1.06)Mastectomy (ref=lumpectomy)1.74 (0.75-4.05)Endocrine therapy (ref=none)0.75 (0.41-1.39)Chemotherapy (ref=none)5.20 (0.93-29.22)Radiation (ref=none)1.38 (0.64-2.96)*p<0.05
Citation Format: Partridge AH, Rosenberg SM, Rajagopal PS, Ruddy KJ, Tamimi RM, Schapira L, Come S, Borges V, Gelber S. Employment trends in young women following a breast cancer diagnosis. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-10-04.
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de Freitas A, Donate PB, e Silva Castanheira FV, Borges V, Nascimento DC, Talbot J, Alves-Filho JC, Cunha F. Aryl hydrocarbon receptor activation increases survival in polymicrobial sepsis. Crit Care 2014. [PMCID: PMC4273856 DOI: 10.1186/cc14039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kim HJ, Dominici L, Rosenberg S, Pak LM, Poorvu PD, Ruddy K, Tamimi R, Schapira L, Come S, Peppercorn J, Borges V, Warner E, Vardeh H, Collins L, King T, Partridge A. Abstract GS6-01: Surgical treatment after neoadjuvant systemic therapy in young women with breast cancer: Results from a prospective cohort study. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs6-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Young women are more likely than older women to present with higher stage breast cancer (BC) and may benefit to a greater extent from downstaging with neoadjuvant systemic treatment (NST). Young age is also associated with greater likelihood of pathologic complete response (pCR). Using a large prospective cohort of young women with BC, we investigated response to neoadjuvant therapy, eligibility for breast conserving surgery (BCS) pre- and post-NST, and surgical treatment.
Methods
The Young Women's Breast Cancer Study (YWS) is a multi-center cohort of women diagnosed with BC at age ≤40, that enrolled 1302 patients from 2006 to 2016. Disease characteristics and treatment information were obtained through medical record and central pathology review. Surgical recommendation before and after NST, conversion from BCS borderline/ineligible to BCS eligible, surgery, documented reasons for choosing mastectomy (MTX) among BCS eligible women, and final pathologic response were independently reviewed.
Results
Among 1302 women enrolled in YWS, 801 (62%) presented with unilateral stage I-III breast cancer and 317(40%) received NST. Median age was 36 years old (22-40). Pre-NST, 85/317 (27%) were BCS eligible, 49 (15%) were borderline, and 169 (53%) were not eligible (16 inflammatory breast cancer (IBC), 88 large tumor size /cosmetic, 48 diffuse calcifications, and 83 multicentricity). Among the 218 patients who were BCS ineligible/borderline pre-NST, 82 (38%) became eligible for BCS after NST. 4 patients who were BCS eligible pre-NST became ineligible. Of all patients eligible for BCS post-NST (n=163), 80 (49%) attempted BCS, 74 (93%) of whom were successful, and 83 (51%) chose MTX. Reasons for choosing MTX included: patient preference (38/83 (46%)), BRCA or TP53 mutation (31 (37%)), family history (3 (4%)), unknown (11 (13%)). On final pathology, 75 (24%) patients had pCR. Among patients who achieved a pCR, 48 (64%) underwent MTX, fewer than half (21/48 (44%)) were for anatomic indications (IBC, large tumor at diagnosis, diffuse calcifications, multicentric disease).
Conclusion
While NST doubled the proportion of young women eligible for BCS, nearly half chose MTX regardless of response to NST, mostly for personal preference or high-risk preventative reasons. These data highlight that surgical decision making among young women with breast cancer is often driven by factors beyond extent of disease and clinical response to therapy.
Table 1.Clinical-pathologic characteristicsCharacteristicsNumber%Pre NST surgical recommendation BCS eligible8526.8Borderline4915.5BCS ineligible16953.3Unknown144.4Clinical Response Complete20263.7Partial9229.0Stable30.9Progressing72.2Unknown134.1Pathologic Response pCR (No invasive or DCIS)7524No pCR24276Post NST Surgical recommendation BCS eligible16351.4BCS ineligible14445.4Unknown103.2Attempted surgery BCS8025.2MTX23674.1Unknown20.6Final Surgery BCS7423.3MTX24176unknown20.6
Citation Format: Kim HJ, Dominici L, Rosenberg S, Pak LM, Poorvu PD, Ruddy K, Tamimi R, Schapira L, Come S, Peppercorn J, Borges V, Warner E, Vardeh H, Collins L, King T, Partridge A. Surgical treatment after neoadjuvant systemic therapy in young women with breast cancer: Results from a prospective cohort study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS6-01.
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Schedin PJ, Lyons TR, O'Brien J, Callihan E, Russell T, Martinson H, Tan AC, Hansen K, Keely PJ, Borges V. BS3-2: Mammary Stroma as an NSAID Target; Implications for Pregnancy-Associated Breast Cancer. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-bs3-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Utilizing a young women's breast cancer cohort from the University of Colorado Cancer Center, we show that women diagnosed as late as five-ten years postpartum have worse prognosis than nulliparous women or women diagnosed during pregnancy, and represent ∼50% of all young women's breast cancer patients. We propose that breast involution following pregnancy accounts for this poor prognosis. Characterization of involution identifies tissue remodeling programs that share similarities with microenvironments known to promote metastasis. Using SHG imaging, we find fibrillar collagen bundles with radially-aligned fibers similar to those observed in invasive tumors deposited in the involuting gland. By immunohistochemistry and FACS we find macrophages with an M2-polarization-like profile similar to tumor-associated macrophages at abundant levels during involution. In three independent mouse models for postpartum breast cancer, we isolate postpartum mammary gland involution as a driving force for cancer progression. Mammary tumors arising in the mouse involuting microenvironment express COX-2 and isolated tumor cells are motile and invasive in a collagen-1/COX-2 dependent manner. Targeting involution-macrophages as likely mediators of tumor promotion was accomplished using a previously described mouse transgenic model. Macrophage depletion during involution had catastrophic effects on normal mammary gland involution. Conversely, inhibition of COX-2 with celecoxib, aspirin or ibuprofen did not interfere with postpartum lobular regression. COX-2 inhibition did decrease tumor growth, local tumor cell dispersion and lung metastasis. NSAID treatment also suppressed collagen and tenascin-C deposition in the involuting microenvironment, suggesting that modulation of extracellular matrix proteins may be a novel mechanism by which NSAIDs exhibit chemopreventive activity. Our studies indicate two distinct roles for COX-2 in the postpartum setting. COX-2 activity within the tumor cell is required for invasiveness and COX-2 activity in the host promotes collagen fibrillogenesis. Several correlative observations implicate the collagen/COX-2 pathway in postpartum breast cancer in women: involuting breast tissue has increased collagen with radially aligned fibers, analysis of 11 publically available microarray data sets shows high COL1A and COX-2 independently correlate with decreased relapse free-survival in young breast cancer patients, and COX-2 protein is observed in DCIS lesions in postpartum cases at higher levels than nulliparous cases.
In summary, our studies suggest further research into COX-2 inhibitor use might provide a novel strategy to improve the prognosis of young women should they be diagnosed with postpartum breast cancer. The question of whether an NSAID based intervention study could be aimed at recently pregnant women at high risk for breast cancer also remains to be determined, but is an extremely desirable objective given that the ∼ 6 million pregnancies in the US per year.
Supported by grants from DoD Synergistic Idea Awards BC060531 & BC10400/001, Komen Foundation KG090629, DoD Idea Award BC074970 to PJK, ACS New England Division Postdoctoral Fellowship Spin Odyssey PF-08-257-01-CSM to TRL and DoD Predoctoral Grants BC073482 to JO and BC100910 to HM.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr BS3-2.
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Paplomata E, Borges V, Loi S, Abramson V, Hamilton E, Hurvitz S, Lin N, Walker L, Murthy RK. Abstract OT2-07-08: Withdrawn. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot2-07-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
Citation Format: Paplomata E, Borges V, Loi S, Abramson V, Hamilton E, Hurvitz S, Lin N, Walker L, Murthy RK. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT2-07-08.
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Lyons TR, O'Brien JH, Borges V, Schedin PJ. Common wound healing signature in murine and human involuting breast, implications for pregnancy-associated breast cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-1049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #1049
Full term pregnancy increases breast cancer risk for up to ten years after childbirth and breast cancer diagnosed during this time has been referred to as pregnancy associated breast cancer (PABC). PABC patients have high rates of metastasis, which is independent of known prognostic factors. Following parturition or lactation, during involution, the breast returns to its pre-pregnant state and in the rat model, we found mammary gland involution employs tissue remodeling programs activated during wound healing and inflammation including high matrix metalloproteinase -2, -3, and -9 activities, release of bioactive fragments of FN and LN, deposition of fibrillar collagen, and increased cytokine levels, including TGFβ1, TGFβ3 and CTGF. We hypothesize that this physiologically normal, but pro-inflammatory remodeling of the gland accounts for the high rate of metastases seen in PABC.
 To further define involution features common to wound healing that may account for the metastasis promoting attributes of PABC, the question of whether macrophages are recruited to the involuting gland was investigated in both rat mammary and human breast tissue. Using the macrophage marker CD68, a lysosomal associated protein, the number of CD68 positive cells in rat mammary glands increased more than 6 fold during involution. Involution-associated macrophages were identified as subtype M2-like by arginase-1 expression and lack of subtype M1-marker iNOS expression. To address the question of whether breast involution in women also is characterized by a wound-healing signature, formalin fixed breast biopsy tissues were obtained for women who were either pregnant, lactating, or whose breast tissue was actively involuting at the time of biopsy. Using a novel computer assisted imaging program, over 200 images of human breast tissue have been quantitated for CD68. CD68 staining in the human breast followed the same trend as in rat, with 5 times more staining in involuting compared to pregnant or lactating tissue. Total leukocyte number, as assessed by CD45 antibody, and oncofetal ECM protein tenascin-C staining were also increased in involuting human breast tissue. With respect to these three stromal markers, involuting human breast tissue was more similar to breast cancer stroma (N=50 images) than stroma from breasts of nulliparous women (N=30 images). These data demonstrate for the first time that human mammary gland involution is characterized by a pro-inflammatory microenvironment, implicating physiologic tissue inflammation in the poor prognosis of PABC.
 In a newly developed animal model for PABC, MCF10DCIS cells were injected orthotopically into SCID mice whose mammary glands were either quiescent (virgin mice) or actively remodeling following weaning (involuting mice). Tumor incidence was 78% in involuting and 50% in virgin mice. Further, tumor multiplicity, size and DCIS conversion to locally invasive lesions were significantly higher in the involuting mice than control virgin mice. This model is being utilized for mechanistic and chemopreventive studies of PABC.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1049.
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