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Tabár L, Tucker L, Davenport RR, Mullet JG, Hsiu-Hsi Chen AT, Ming-Fang Yen A, Yueh-Hsia Chiu S, Gladwell J, Olinger K, Dean PB. The use of mammographic tumour feature significantly improves outcome prediction of breast cancers smaller than 15 mm: a reproducibility study from two comprehensive breast centres. MEMO-MAGAZINE OF EUROPEAN MEDICAL ONCOLOGY 2011. [DOI: 10.1007/s12254-011-0287-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Forbes LJL, Linsell L, Atkins L, Burgess C, Tucker L, Omar L, Ramirez AJ. A promoting early presentation intervention increases breast cancer awareness in older women after 2 years: a randomised controlled trial. Br J Cancer 2011; 105:18-21. [PMID: 21654683 PMCID: PMC3137419 DOI: 10.1038/bjc.2011.205] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: We have developed the Promoting Early Presentation (PEP) Intervention to equip older women with the knowledge, skills, confidence and motivation to present promptly with breast symptoms, and thereby improve survival from breast cancer. The PEP Intervention consists of a 10-min interaction between a radiographer and an older woman, supported by a booklet. Our previous report showed that at 1 year, the PEP intervention increased the proportion who were breast cancer aware compared with usual care. Methods: We randomised 867 women aged 67–70 years attending for their final routine appointment on the National Health Service Breast Screening Programme to receive the PEP Intervention, a booklet alone or usual care. The primary outcome was breast cancer awareness measured using a validated questionnaire asking about knowledge of breast cancer symptoms, knowledge that the risk of breast cancer increases with age and breast checking behaviour. Results: At 2 years, the PEP Intervention increased the proportion who were breast cancer aware compared with usual care (21 vs 6% odds ratio 8.1, 95% confidence interval 2.7–25.0). Conclusions: The uniquely large and sustained effect of the PEP Intervention on breast cancer awareness increases the likelihood that a woman will present promptly should she develop breast cancer symptoms up to many years later.
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Forster AS, Forbes LJL, Atkins L, Patnick J, Sellars S, Tucker L, Baxter R, Ramirez AJ. Evaluation and implementation of an intervention to promote early presentation. BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000020.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Linsell L, Forbes LJL, Kapari M, Burgess C, Omar L, Tucker L, Ramirez AJ. A randomised controlled trial of an intervention to promote early presentation of breast cancer in older women: effect on breast cancer awareness. Br J Cancer 2009; 101 Suppl 2:S40-8. [PMID: 19956161 PMCID: PMC2790707 DOI: 10.1038/sj.bjc.6605389] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There is virtually no evidence for the effectiveness of interventions to promote early presentation in breast cancer. We aimed to test the efficacy of an intervention to equip older women with the knowledge, skills, confidence and motivation to detect symptoms and seek help promptly, with the aim of promoting early presentation with breast cancer symptoms. METHODS We randomised 867 women aged 67-70 years attending for their final routine appointment on the UK NHS Breast Screening Programme to receive: a scripted 10-min interaction with a radiographer plus a booklet, a booklet alone or usual care. The primary outcome was whether or not a woman was breast cancer aware based on knowledge of breast cancer symptoms and age-related risk, and reported breast checking. RESULTS At 1 month, the intervention increased the proportion who were breast cancer aware compared with usual care (interaction arm: 32.8% vs 4.1%; odds ratio (OR): 24.0, 95% confidence interval (CI): 7.7-73.7; booklet arm: 12.7% vs 4.1%; OR: 4.4, 95% CI: 1.6-12.0). At 1 year, the effects of the interaction plus booklet, and the booklet, on breast cancer awareness were largely sustained, although the interaction plus booklet remained much more effective. CONCLUSIONS An intervention to equip older women with the knowledge, skills, confidence and motivation to detect breast cancer symptoms and seek help promptly increases breast cancer awareness at 1 year. Future research will evaluate whether the intervention promotes early presentation and reduces breast cancer mortality.
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Holman RR, Paul S, Farmer A, Tucker L, Stratton IM, Neil HAW. Atorvastatin in Factorial with Omega-3 EE90 Risk Reduction in Diabetes (AFORRD): a randomised controlled trial. Diabetologia 2009; 52:50-9. [PMID: 19002433 DOI: 10.1007/s00125-008-1179-5] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Accepted: 08/22/2008] [Indexed: 10/21/2022]
Abstract
AIMS/HYPOTHESIS The aim of the study was to examine the impact of statin or omega-3-acid ethyl esters 90 (omega-3 EE90; omega-3-acid ethyl esters 90 refers to a mixture of ethyl esters of n-3 fatty acids) on estimated cardiovascular disease (CVD) risk in community-based people with type 2 diabetes but without known CVD and not taking lipid-lowering therapy. METHODS A central computer randomised 800 patients in 59 UK general practices to atorvastatin (n = 401, 20 mg/day) or placebo (n = 399) and omega-3 EE90 (n = 397, 2 g/day) or placebo (n = 403) in a concealed factorial manner. Participants with LDL-cholesterol <2.6 mmol/l, triacylglycerol <1.5 mmol/l and estimated 10-year CVD risk <20% were compared at 4 months. RESULTS Mean (SD) age was 63.5 (11.7) years, HbA(1c) 6.9 (1.1) % and known diabetes duration (median [interquartile range]) was 4 (2-8) years. Fifty-seven per cent were men, 90% white and 74% had an estimated 10-year CVD risk >or=20%. Of 732 patients with 4-month data, more allocated atorvastatin (n = 371) compared with placebo (n = 361) achieved LDL-cholesterol <2.6 mmol/l (91% vs 24%, p < 0.001) and had estimated 10-year CVD risks <20% (38% vs 26%, p < 0.001). No differences were seen between those allocated omega-3 EE90 (n = 371) compared with placebo (n = 361) for participants achieving triacylglycerol <1.5 mmol/l (65% vs 60%, p = 0.18) or estimated 10-year CVD risks <20% (34% vs 30%, p = 0.18). There were no side effects of note. CONCLUSIONS/INTERPRETATION Many community-based diabetic patients without known CVD remain at high CVD risk despite statin treatment and require additional risk-reduction strategies. The impact of omega-3 EE90 on CVD risk will remain uncertain until clinical endpoint trial results are available. TRIAL REGISTRATION ISRCT no. 76737502.
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Gloyn AL, van de Bunt M, Stratton IM, Lonie L, Tucker L, Ellard S, Holman RR. Prevalence of GCK mutations in individuals screened for fasting hyperglycaemia. Diabetologia 2009; 52:172-4. [PMID: 19002431 DOI: 10.1007/s00125-008-1188-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Accepted: 10/03/2008] [Indexed: 10/21/2022]
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Tucker L, Omar L, Burgess C, Kedge L, Whelehan P, Ramirez A. Promoting early presentation of breast cancer amongst older women: radiographers' experiences of taking on a new role. Breast Cancer Res 2008. [PMCID: PMC3332646 DOI: 10.1186/bcr2079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Burgess C, Whelehan P, Omar L, Tucker L, Kedge L, Ramirez A. Is it feasible to train diagnostic radiographers to deliver a psycho-educational intervention to promote early presentation of breast cancer amongst older women? A pilot study. Breast Cancer Res 2008. [PMCID: PMC3332589 DOI: 10.1186/bcr2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Owens B, Tucker L, Collins MA, McCracken KJ. Effects of different feed additives alone or in combination on broiler performance, gut microflora and ileal histology. Br Poult Sci 2008; 49:202-12. [PMID: 18409095 DOI: 10.1080/00071660802004890] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
1. The objectives of this experiment were to investigate the effects of different xylanases, alone or in combination with different organic acid and oligosaccharide sources, on bird performance, gut microflora and ileal histology. 2. Birds were given a diet based on a commercial formulation, which was split into 8 batches. Batch 1 contained the antibiotic growth promoter Avilamycin and acted as the positive control. To batch 2 the enzyme Allzyme PT was added and to batch 3 Allzyme PT was added with the organic acid and oligosaccharide mixture Avimos. To batch 4, Allzyme PT was added with the oligosaccharide mixture Biomos. To batch 5, yeast extract 2012 was added with the organic acid mixture Gustor and the enzyme xylanase XP20. To batch 6, yeast extract 2012 and feed acidifier Gustor were added as before, with the enzyme Avizyme 1300. Batches 7 and 8 both acted as negative experimental controls, with no added growth promoters. 3. A total of 64 birds were housed in individual wire cages in each of three consecutive experimental replicates (24 birds/treatment). Birds were fed ad libitum from 7 to 28 d and a 7-d excreta collection was carried out to determine apparent metabolisable energy (AME) content. 4. At 28 d, the birds were killed and viscosity of jejunal digesta supernatant and gizzard weight were determined. Samples were taken from the crop, ileum and caecum and analysed for viable presumptive lactic acid bacteria and coliforms. The overall microbial flora was determined using denaturing gradient gel electrophoresis of 16S ribosomal DNA followed by DNA sequence analysis in order to assign amplicons to a bacterial species. Ileal sections were also collected for histological analysis. 5. Total live weight gain (12%) and gain:feed (9%) were significantly improved for all diets containing additives, compared to the negative control diets. All diets containing xylanases gave significantly lower in vivo viscosity values than the positive and negative controls. Diet treatment significantly affected viable coliform numbers in the ileum and also viable lactobacilli in the ileum and caecum. A substantial proportion of the bacteria present in the GI tract (40%) belong to unknown species. No effects of diet treatment on histological measurements were observed in this study. 6. All the additive combinations studied were at least as effective as the antibiotic growth promoter and the results for Allzyme PT suggest that xylanase alone is as effective as any of the combinations studied.
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Blasi A, Fox S, Everdell N, Volein A, Tucker L, Csibra G, Gibson AP, Hebden JC, Johnson MH, Elwell CE. Investigation of depth dependent changes in cerebral haemodynamics during face perception in infants. Phys Med Biol 2007; 52:6849-64. [DOI: 10.1088/0031-9155/52/23/005] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Snelling AM, Adams TB, Korba C, Tucker L. Stages of Change Algorithm for Calcium Intake by Male College Students. ACTA ACUST UNITED AC 2006; 106:904-7. [PMID: 16720130 DOI: 10.1016/j.jada.2006.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2005] [Indexed: 11/26/2022]
Abstract
Using a sample of college-aged men, we evaluated the validity of a staging algorithm for dairy calcium intake that had been previously validated in a sample of college women. College-aged men enrolled at a private university in the United States were randomly selected to participate. The sample consisted of 180 male participants. Self-reported calcium intake was measured using a 26-item food frequency questionnaire. Stages of change classifications were based on a four-question algorithm for dairy calcium intake and a three-item self-efficacy questionnaire. Significant differences were found between dairy/calcium intake levels between pre-contemplation, contemplation/preparation, and action/maintenance groups. Results also showed that 46% of participants were in the action/maintenance stage. There was a significant difference in self-efficacy between members of the pre-action and action stages. The study suggests that this stage of change algorithm for dairy calcium intake is valid for use in a male college student population.
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Politch J, Xu C, Tucker L, Anderson D. Separation of HIV-1 from the motile sperm fraction: comparison of gradient/swim-up and double tube techniques. Fertil Steril 2001. [DOI: 10.1016/s0015-0282(01)02162-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Isenberg D, Katz D, Maddison P, Watts R, Tucker L, Cooke A. Induction of anti-DNA antibodies: commentary on article by Satake et al. Lupus 2001; 10:63-5. [PMID: 11243512 DOI: 10.1191/096120301667736481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Falcone M, Yeung B, Tucker L, Rodriguez E, Krahl T, Sarvetnick N. IL-4 triggers autoimmune diabetes by increasing self-antigen presentation within the pancreatic Islets. Clin Immunol 2001; 98:190-9. [PMID: 11161975 DOI: 10.1006/clim.2000.4979] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Several findings have recently questioned the long held hypothesis that cytokines belonging to the Th2 pathway are protective in T-cell-mediated autoimmunity. Among them, there is our previous report that pancreatic expression of IL-4 activated islet antigen-specific BDC2.5 T cells and rendered them able to trigger insulin-dependent diabetes mellitus in ins-IL-4/BDC2.5 mice (Mueller et al., Immunity, 7, 1997). Here we analyze the mechanisms underlying IL-4-mediated activation of the self-reactive BDC2.5 T cells. IL-4 is mainly known as the Th2-driving cytokine. However, IL-4 is also critical for DC maturation and upregulation of antigen uptake and presentation by macrophages. In our model, we found that pancreatic expression of IL-4 activated self-reactive BDC2.5 T cells by increasing islet antigen presentation by macrophages and dendritic cells. IL-4 could have triggered self-antigen presentation within the pancreatic islets both by driving maturation of DC from a tolerizing to a priming state and by increasing self-antigen uptake by macrophages.
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Judkowski V, Pinilla C, Schroder K, Tucker L, Sarvetnick N, Wilson DB. Identification of MHC class II-restricted peptide ligands, including a glutamic acid decarboxylase 65 sequence, that stimulate diabetogenic T cells from transgenic BDC2.5 nonobese diabetic mice. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2001; 166:908-17. [PMID: 11145667 DOI: 10.4049/jimmunol.166.2.908] [Citation(s) in RCA: 165] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Nonobese diabetic (NOD) mice spontaneously develop insulitis and destruction of pancreatic islet beta cells similar to type 1 diabetes mellitis in humans. Insulitis also occurs in the BDC2.5 TCR transgenic line of NOD mice that express the rearranged TCR alpha- and beta-chain genes of a diabetogenic NOD CD4 T cell clone. When activated with syngeneic islet cells in culture, BDC2.5 T cells adoptively transfer disease to NOD recipients, but the identity of the islet cell Ag responsible for pathogenicity is not known. To characterize the autoantigen(s) involved, BDC2.5 T cells were used to screen a combinatorial peptide library arranged in a positional scanning format. We identified more than 100 decapeptides that stimulate these T cells at nanomolar concentrations; they are then capable of transferring disease to NOD-scid mice. Surprisingly, some of the peptides include sequences similar (8 of 10 residues) to those found within the 528-539 fragment of glutamic acid decarboxylase 65. Although this 12-mer glutamic acid decarboxylase 65 fragment is only slightly stimulatory for BDC2.5 T cells (EC(50) > 100 microM), a larger 16-mer fragment, 526-541, shows activity in the low micromolar range (EC(50) = 2.3 microM). Finally, T cells from prediabetic NOD mice respond spontaneously to these peptide analogs in culture; this finding validates them as being related to a critical autoantigen involved in the etiology of spontaneous diabetes and indicates that their further characterization is important for a better understanding of underlying disease mechanisms.
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Balasa B, La Cava A, Van Gunst K, Mocnik L, Balakrishna D, Nguyen N, Tucker L, Sarvetnick N. A mechanism for IL-10-mediated diabetes in the nonobese diabetic (NOD) mouse: ICAM-1 deficiency blocks accelerated diabetes. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2000; 165:7330-7. [PMID: 11120869 DOI: 10.4049/jimmunol.165.12.7330] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Neonatal islet-specific expression of IL-10 in nonobese diabetic (NOD) mice accelerates the onset of diabetes, whereas systemic treatment of young NOD mice with IL-10 prevents diabetes. The mechanism for acceleration of diabetes in IL-10-NOD mice is not known. Here we show, by adoptive transfers, that prediabetic or diabetic NOD splenocytes upon encountering IL-10 in the pancreatic islets readily promoted diabetes. This outcome suggests that the compartment of exposure, not the timing, confers proinflammatory effects on this molecule. Moreover, injection of IL-10-deficient NOD splenocytes into transgenic IL-10-NOD.scid/scid mice elicited accelerated disease, demonstrating that pancreatic IL-10 but not endogenous IL-10 is sufficient for the acceleration of diabetes. Immunohistochemical analysis revealed hyperexpression of ICAM-1 on the vascular endothelium of IL-10-NOD mice. The finding suggests that IL-10 may promote diabetes via an ICAM-1-dependent pathway. We found that introduction of ICAM-1 deficiency into IL-10-NOD mice as well as into NOD mice prevented accelerated insulitis and diabetes. Failure to develop insulitis and diabetes was preceded by the absence of GAD65-specific T cell responses. The data suggest that ICAM-1 plays a role in the formation of the "immunological synapse", thereby affecting the generation and/or expansion of islet-specific T cells. In addition, ICAM-1 also played a role in the effector phase of autoimmune diabetes because adoptive transfer of diabetogenic BDC2.5 T cells failed to elicit clinical disease in ICAM-1-deficient IL-10-NOD and NOD mice. These findings provide evidence that pancreatic IL-10 is sufficient to drive pathogenic autoimmune responses and accelerates diabetes via an ICAM-1-dependent pathway.
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MESH Headings
- Adoptive Transfer
- Animals
- Autoantigens/immunology
- Diabetes Mellitus, Type 1/etiology
- Diabetes Mellitus, Type 1/genetics
- Diabetes Mellitus, Type 1/immunology
- Diabetes Mellitus, Type 1/prevention & control
- Female
- Glutamate Decarboxylase/immunology
- Immunity, Innate/genetics
- Intercellular Adhesion Molecule-1/biosynthesis
- Intercellular Adhesion Molecule-1/genetics
- Interleukin-10/biosynthesis
- Interleukin-10/deficiency
- Interleukin-10/genetics
- Interleukin-10/physiology
- Islets of Langerhans/pathology
- Isoenzymes/immunology
- Lymphocyte Activation
- Lymphocyte Transfusion
- Mice
- Mice, Inbred BALB C
- Mice, Inbred NOD
- Mice, Knockout
- Mice, SCID
- Mice, Transgenic
- Pancreas/immunology
- Pancreas/metabolism
- Spleen/cytology
- Spleen/immunology
- Spleen/metabolism
- Spleen/transplantation
- T-Lymphocytes/enzymology
- T-Lymphocytes/immunology
- Transgenes/immunology
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Zwerdling T, Davies S, Lazar L, Crawford B, Tucker L, Boughner A, Richter-Beck L. Unique aspects of caring for dying children and their families. Am J Hosp Palliat Care 2000; 17:305-11. [PMID: 11886054 DOI: 10.1177/104990910001700507] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Pediatric hospice has become an important service for children and their families in the past decade. In this article we present unique aspects of StarShine, the hospice of Children's Hospital Medical Center in Cincinnati, Ohio. Length-of-service data demonstrate the need to find innovative ways of encouraging earlier referral to hospice. Several specialized aspects of care, such as long-term bereavement, pet visitation and social services for the family are presented. The initiation of a novel in-home pain management program is described. StarShine has not followed an adult hospice model, and as such, we discuss those unique aspects of dying pediatric patients and suggest specific solutions and interventions designed for children.
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Duffy CM, Tucker L, Burgos-Vargas R. Update on functional assessment tools. J Rheumatol Suppl 2000; 58:11-4. [PMID: 10782850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
In recent years, there has been a tremendous growth in the development of measurement instruments that evaluate health status, functional status, disability, and quality of life in adults with rheumatic diseases. In the past decade, similar measures have been developed for application in children with rheumatic diseases. These include the Childhood Arthritis Impact Measurement Scales (CHAIMS), the Childhood Health Assessment Questionnaire (CHAQ), the Juvenile Arthritis Functional Assessment Report (JAFAR), the Juvenile Arthritis Self-report Index (JASI), the Juvenile Arthritis Quality of Life Questionnaire (JAQQ), and the Childhood Arthritis Health Profile (CAHP). The latter 2 instruments assess health related quality of life (HRQOL) and they are discussed here. The need to adapt this kind of instrument for use in an international climate creates an interesting dilemma and this is discussed.
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Tucker L, Lodhavia N, Terreault D. Physicians in Rhode Island. MEDICINE AND HEALTH, RHODE ISLAND 2000; 83:108-11. [PMID: 10821010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Panther LA, Tucker L, Xu C, Tuomala RE, Mullins JI, Anderson DJ. Genital tract human immunodeficiency virus type 1 (HIV-1) shedding and inflammation and HIV-1 env diversity in perinatal HIV-1 transmission. J Infect Dis 2000; 181:555-63. [PMID: 10669339 DOI: 10.1086/315230] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
This study sought to identify genital tract characteristics associated with vertical transmission of human immunodeficiency virus type 1 (HIV-1). HIV-1 DNA and RNA, HIV-1 env diversity, and inflammatory cells were quantified in cervicovaginal lavages (CVLs) of 24 women enrolled in the Women and Infants Transmission Study; 7 women transmitted HIV-1 perinatally. Vaginal candidiasis, HIV-1 culture positivity, levels of HIV-1 DNA and cell-free RNA, and HIV-1 env diversity were significantly higher in the CVLs of transmitters. CVL HIV-1 DNA levels correlated with higher levels of inflammatory cells and cell-free HIV-1 RNA. Of subjects with paired blood and CVL specimens, there was more HIV-1 env heterogeneity between blood and CVLs in transmitters than in nontransmitters. In summary, increased HIV-1 shedding is correlated with a more complex population of HIV-1 quasispecies in the genital tracts of parturient women, which may increase the probability that a fetotropic strain is transmitted.
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Vassiliadou N, Tucker L, Anderson DJ. Progesterone-induced inhibition of chemokine receptor expression on peripheral blood mononuclear cells correlates with reduced HIV-1 infectability in vitro. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 1999; 162:7510-8. [PMID: 10358206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Recent studies have shown that progesterone, a sex steroid hormone, enhances the sexual transmission of various pathogens, including SIV. The goal of this study was to determine whether progesterone affects mechanisms underlying the sexual transmission of HIV-1. We first studied the effects of various physiologic concentrations of progesterone on the expression of chemokines and chemokine receptors by T cells and macrophages. Chemokines are involved in leukocyte recruitment to peripheral sites; in addition, the chemokine receptors CCR5 and CXCR4 are HIV-1 coreceptors, and their ligands can block HIV-1 infection. Progesterone treatment had no effect on constitutive expression of CCR5 and CXCR4 by nonactivated T cells and macrophages, but significantly inhibited IL-2-induced up-regulation of CCR5 and CXCR4 on activated T cells (p < 0.05). Progesterone also inhibited both mitogen-induced proliferation and chemokine secretion (macrophage inflammatory protein-1alpha, macrophage inflammatory protein-1beta, RANTES) by CD8+ T lymphocytes. Control and progesterone-treated PBMC cultures were also tested for susceptibility to infection by T cell-tropic (HIV-1MN) and macrophage-tropic (HIV-1JR-CSF) viral strains in vitro. Infection with low titers of HIV-1MN was consistently inhibited in progesterone-treated cultures; progesterone effects on infection with the HIV-1JR-CSF strain were more variable, but correlated with progesterone-induced reductions in CCR5 levels. These results indicate that progesterone treatment can inhibit mechanisms underlying HIV-1 transmission, including infection of CD4+ target cells via CXCR4/CCR5 coreceptors and effects on chemokine-mediated recruitment of lymphocytes and monocytes to mucosal epithelia.
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Mayer KH, Boswell S, Goldstein R, Lo W, Xu C, Tucker L, DePasquale MP, D'Aquila R, Anderson DJ. Persistence of human immunodeficiency virus in semen after adding indinavir to combination antiretroviral therapy. Clin Infect Dis 1999; 28:1252-9. [PMID: 10451162 DOI: 10.1086/514775] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Changes in human immunodeficiency virus (HIV) type 1 concentration and protease genotype were evaluated in semen specimens from 22 HIV-positive men before and 6 months after the addition of indinavir to dual nucleoside therapy. Seminal HIV was detected by polymerase chain reaction analysis for DNA or RNA for 59% of men before combination treatment and persisted at 6 months for 31% of the men who initially had seminal HIV detected (P = .026). The maximum levels of cell-free RNA, cell-associated RNA, and proviral DNA in semen before treatment and at 6 months were 400,000 and 10,000 copies/mL, 70,000 and 27,000 copies/mL, and 80,000 and 3,000 copies/mL, respectively. Three of the four men with persistent seminal DNA had plasma viral loads of > 10,000 copies/mL before treatment. One patient who became intolerant to indinavir had seminal HIV RNA detected by PCR analysis after 6 months. Although none of the cultures of semen specimens from the four men with PCR analysis-detectable seminal DNA after 6 months yielded HIV, indinavir resistance mutations were identified in a seminal leukocyte DNA specimen from one patient, and a second patient whose therapy was switched to saquinavir had different protease inhibitor resistance mutations in seminal and blood leukocyte DNA specimens. HIV-1 protease inhibitor resistance mutants may emerge in the semen of patients receiving combination therapy.
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O'Donnell A, Tucker L. Pre-dialysis education. A change in clinical practice. How effective is it? EDTNA/ERCA JOURNAL (ENGLISH ED.) 1999; 25:29-32. [PMID: 10531879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
The last decade has seen a great expansion in the provision of pre-dialysis education within the UK, with our programme in operation since 1996. In order to evaluate its impact on patient care, two methodologies were employed: the first used a satisfaction survey with which to examine patient perception of the programme; the second approach examined resource utilisation, in particular length of stay, as an outcome measure. Difficulties have arisen in discerning the impact of the programme amongst the other education interventions to which the patient is exposed. Comparative length of stay data was used as an alternative means of assessment. The results of the audit led us to question the effectiveness of the methodology that we employed and has led us to propose the development of a standard. It is hoped that the adoption of a more structured approach will not only aid the effectiveness of the programme itself but also facilitate the evaluation process.
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Quayle AJ, Xu C, Tucker L, Anderson DJ. The case against an association between HIV-1 and sperm: molecular evidence. J Reprod Immunol 1998; 41:127-36. [PMID: 10213305 DOI: 10.1016/s0165-0378(98)00053-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this article we present data from our laboratory, and review the literature available, on the potential association between HIV-1 and sperm. We focus on the use of PCR technology to answer this very important question, and emphasise the importance of using highly purified sperm preparations. We conclude that the likelihood of HIV infection/association with viable mature sperm is low.
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