1
|
Barrett LW, Fear VS, Foley B, Audsley K, Barnes S, Newnes H, McDonnell A, Wood FM, Fear MW, Waithman J. Non-severe burn injury increases cancer incidence in mice and has long-term impacts on the activation and function of T cells. Burns & Trauma 2022; 10:tkac016. [PMID: 35505970 PMCID: PMC9054911 DOI: 10.1093/burnst/tkac016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/13/2022] [Indexed: 11/30/2022]
Abstract
Background Recent evidence suggests that burn patients are at increased risk of hospital admission for infection, mental health conditions, cardiovascular disease and cancer for many years after discharge for the burn injury itself. Burn injury has also been shown to induce sustained immune system dysfunction. This change to immune function may contribute to the increased risk of chronic disease observed. However, the mechanisms that disrupt long-term immune function in response to burn trauma, and their link to long-term morbidity, remain unknown. In this study we investigated changes to immune function after burn injury using a murine model of non-severe injury. Methods An established mouse model of non-severe burn injury (full thickness burn equivalent to 8% total body surface area) was used in combination with an orthotopic model of B16 melanoma to investigate the link between burns and cancer. Considering that CD8+ T cells are important drivers of effective tumour suppression in this model, we also investigated potential dysregulation of this immune population using mouse models of burn injury in combination with herpes simplex virus infection. Flow cytometry was used to detect and quantify cell populations of interest and changes in immune function. Results We demonstrate that 4 weeks after a non-severe burn injury, mice were significantly more susceptible to tumour development than controls using an orthotopic model of B16 melanoma. In addition, our results reveal that CD8+ T cell expansion, differentiation and memory potential is significantly impaired at 1 month post-burn. Conclusions Our data suggests that CD8+ T cell-mediated immunity may be dysfunctional for a sustained period after even non-severe burn injury. Further studies in patients to validate these findings may support clinical intervention to restore or protect immunity in patients after burn injury and reduce the increased risk of secondary morbidities observed.
Collapse
Affiliation(s)
- Lucy W Barrett
- Burn Injury Research Unit, School of Biomedical Sciences, University of Western Australia, Crawley, WA, 6009, Australia
- Telethon Kids Institute, University of Western Australia, Northern Entrance, Perth Children’s Hospital, 15 Hospital Ave, Nedlands, WA, 6009, Australia
- Fiona Wood Foundation, Fiona Stanley Hospital, MNH (B), Main Hospital, CD 15, Level 4, Burns Unit, 102-118 Murdoch Drive, Murdoch, WA, 6150, Australia
| | - Vanessa S Fear
- Telethon Kids Institute, University of Western Australia, Northern Entrance, Perth Children’s Hospital, 15 Hospital Ave, Nedlands, WA, 6009, Australia
| | - Bree Foley
- Telethon Kids Institute, University of Western Australia, Northern Entrance, Perth Children’s Hospital, 15 Hospital Ave, Nedlands, WA, 6009, Australia
| | - Katherine Audsley
- Telethon Kids Institute, University of Western Australia, Northern Entrance, Perth Children’s Hospital, 15 Hospital Ave, Nedlands, WA, 6009, Australia
| | - Samantha Barnes
- Telethon Kids Institute, University of Western Australia, Northern Entrance, Perth Children’s Hospital, 15 Hospital Ave, Nedlands, WA, 6009, Australia
| | - Hannah Newnes
- Telethon Kids Institute, University of Western Australia, Northern Entrance, Perth Children’s Hospital, 15 Hospital Ave, Nedlands, WA, 6009, Australia
| | - Alison McDonnell
- Telethon Kids Institute, University of Western Australia, Northern Entrance, Perth Children’s Hospital, 15 Hospital Ave, Nedlands, WA, 6009, Australia
| | - Fiona M Wood
- Burn Injury Research Unit, School of Biomedical Sciences, University of Western Australia, Crawley, WA, 6009, Australia
- Fiona Wood Foundation, Fiona Stanley Hospital, MNH (B), Main Hospital, CD 15, Level 4, Burns Unit, 102-118 Murdoch Drive, Murdoch, WA, 6150, Australia
- Burns Service of Western Australia, WA Department of Health, Nedlands, WA, 6009, Australia
| | - Mark W Fear
- Fiona Wood Foundation, Fiona Stanley Hospital, MNH (B), Main Hospital, CD 15, Level 4, Burns Unit, 102-118 Murdoch Drive, Murdoch, WA, 6150, Australia
- Burns Service of Western Australia, WA Department of Health, Nedlands, WA, 6009, Australia
| | - Jason Waithman
- Telethon Kids Institute, University of Western Australia, Northern Entrance, Perth Children’s Hospital, 15 Hospital Ave, Nedlands, WA, 6009, Australia
| |
Collapse
|
2
|
Audsley KM, Wagner T, Ta C, Newnes HV, Buzzai AC, Barnes SA, Wylie B, Armitage J, Kaisho T, Bosco A, McDonnell A, Cruickshank M, Fear VS, Foley B, Waithman J. IFNβ Is a Potent Adjuvant for Cancer Vaccination Strategies. Front Immunol 2021; 12:735133. [PMID: 34552594 PMCID: PMC8450325 DOI: 10.3389/fimmu.2021.735133] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/19/2021] [Indexed: 12/30/2022] Open
Abstract
Cancer vaccination drives the generation of anti-tumor T cell immunity and can be enhanced by the inclusion of effective immune adjuvants such as type I interferons (IFNs). Whilst type I IFNs have been shown to promote cross-priming of T cells, the role of individual subtypes remains unclear. Here we systematically compared the capacity of distinct type I IFN subtypes to enhance T cell responses to a whole-cell vaccination strategy in a pre-clinical murine model. We show that vaccination in combination with IFNβ induces significantly greater expansion of tumor-specific CD8+ T cells than the other type I IFN subtypes tested. Optimal expansion was dependent on the presence of XCR1+ dendritic cells, CD4+ T cells, and CD40/CD40L signaling. Therapeutically, vaccination with IFNβ delayed tumor progression when compared to vaccination without IFN. When vaccinated in combination with anti-PD-L1 checkpoint blockade therapy (CPB), the inclusion of IFNβ associated with more mice experiencing complete regression and a trend in increased overall survival. This work demonstrates the potent adjuvant activity of IFNβ, highlighting its potential to enhance cancer vaccination strategies alone and in combination with CPB.
Collapse
MESH Headings
- Adjuvants, Immunologic/pharmacology
- Animals
- B7-H1 Antigen/antagonists & inhibitors
- B7-H1 Antigen/metabolism
- CD8-Positive T-Lymphocytes/drug effects
- CD8-Positive T-Lymphocytes/immunology
- CD8-Positive T-Lymphocytes/metabolism
- Cancer Vaccines/pharmacology
- Cell Line, Tumor
- Cell Proliferation/drug effects
- Female
- Immune Checkpoint Inhibitors/pharmacology
- Interferon-beta/genetics
- Interferon-beta/metabolism
- Interferon-beta/pharmacology
- Lymphocyte Activation/drug effects
- Lymphocytes, Tumor-Infiltrating/drug effects
- Lymphocytes, Tumor-Infiltrating/immunology
- Lymphocytes, Tumor-Infiltrating/metabolism
- Melanoma, Experimental/immunology
- Melanoma, Experimental/metabolism
- Melanoma, Experimental/pathology
- Melanoma, Experimental/therapy
- Mice, Inbred C57BL
- Mice, Transgenic
- Skin Neoplasms/immunology
- Skin Neoplasms/metabolism
- Skin Neoplasms/pathology
- Skin Neoplasms/therapy
- Vaccination
- Mice
Collapse
Affiliation(s)
- Katherine M. Audsley
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Teagan Wagner
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
- Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Clara Ta
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Hannah V. Newnes
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Anthony C. Buzzai
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
- Department of Experimental Dermatology, University of Magdeburg, Magdeburg, Germany
| | - Samantha A. Barnes
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Ben Wylie
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Jesse Armitage
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Tsuneyasu Kaisho
- Department of Immunology, Institute of Advanced Medicine, Wakayama Medical University, Wakayama, Japan
| | - Anthony Bosco
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Alison McDonnell
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Mark Cruickshank
- School of Biomedical Sciences, The University of Western Australia, Nedlands, WA, Australia
| | - Vanessa S. Fear
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Bree Foley
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Jason Waithman
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| |
Collapse
|
3
|
Cook AM, McDonnell A, Millward MJ, Creaney J, Hasani A, McMullen M, Meniawy T, Robinson BWS, Lake RA, Nowak AK. A phase 1b clinical trial optimizing regulatory T cell depletion in combination with platinum-based chemotherapy in thoracic cancers. Expert Rev Anticancer Ther 2021; 21:465-474. [PMID: 33509005 DOI: 10.1080/14737140.2021.1882308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Single-agent cyclophosphamide can deplete regulatory T-cells (Treg). We aimed to determine optimal dosing and scheduling of oral cyclophosphamide, alongside pemetrexed-based chemotherapy, to deplete Treg in mesothelioma or non-small-cell lung cancer patients.Methods: 31 Patients received pemetrexed ± cisplatin or carboplatin on day 1 of a 21-day cycle (maximum 6 cycles). From cycle two, patients received cyclophosphamide, 50 mg/day, with intrapatient escalation to maximum 100/150 mg/day alternately. Immunological changes were examined by flow cytometry. Primary endpoint was Treg proportion of CD4+ T-cells, with doses tailored to target Treg nadir <4%.Results: Reduction in Treg proportion was observed on day 8 of all cycles, and was not augmented by cyclophosphamide. Few patients achieved the <4% Treg target. Treg proliferation reached nadir one week after chemotherapy, and peaked on day 1 of the subsequent cycle. Efficacy parameters were similar to chemotherapy alone. Seventeen percent of patients ceased cyclophosphamide due to toxicity.Conclusions: Specific Treg depletion to the degree seen with single-agent cyclophosphamide was not observed during pemetrexed-based chemotherapy. This study highlights the poor evidence basis for use of cyclophosphamide as an immunotherapeutic in combination with chemotherapy, and the importance of detailed flow cytometry studies.Trial registration: Clinical trial registration: www.anzctr.org.au identifier is ACTRN12609000260224.
Collapse
Affiliation(s)
- Alistair M Cook
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,National Centre for Asbestos Related Diseases, University of Western Australia, Crawley, Australia
| | - Alison McDonnell
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,National Centre for Asbestos Related Diseases, University of Western Australia, Crawley, Australia
| | - Michael J Millward
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Jenette Creaney
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,National Centre for Asbestos Related Diseases, University of Western Australia, Crawley, Australia
| | - Arman Hasani
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Michelle McMullen
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Tarek Meniawy
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,National Centre for Asbestos Related Diseases, University of Western Australia, Crawley, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Bruce W S Robinson
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,National Centre for Asbestos Related Diseases, University of Western Australia, Crawley, Australia.,Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Richard A Lake
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,National Centre for Asbestos Related Diseases, University of Western Australia, Crawley, Australia
| | - Anna K Nowak
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.,National Centre for Asbestos Related Diseases, University of Western Australia, Crawley, Australia.,Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia.,Department of Nuclear Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| |
Collapse
|
4
|
Armitage JD, Newnes HV, McDonnell A, Bosco A, Waithman J. Fine-Tuning the Tumour Microenvironment: Current Perspectives on the Mechanisms of Tumour Immunosuppression. Cells 2021; 10:cells10010056. [PMID: 33401460 PMCID: PMC7823446 DOI: 10.3390/cells10010056] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 02/07/2023] Open
Abstract
Immunotherapy has revolutionised the treatment of cancers by harnessing the power of the immune system to eradicate malignant tissue. However, it is well recognised that some cancers are highly resistant to these therapies, which is in part attributed to the immunosuppressive landscape of the tumour microenvironment (TME). The contexture of the TME is highly heterogeneous and contains a complex architecture of immune, stromal, vascular and tumour cells in addition to acellular components such as the extracellular matrix. While understanding the dynamics of the TME has been instrumental in predicting durable responses to immunotherapy and developing new treatment strategies, recent evidence challenges the fundamental paradigms of how tumours can effectively subvert immunosurveillance. Here, we discuss the various immunosuppressive features of the TME and how fine-tuning these mechanisms, rather than ablating them completely, may result in a more comprehensive and balanced anti-tumour response.
Collapse
Affiliation(s)
- Jesse D. Armitage
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA 6009, Australia; (J.D.A.); (H.V.N.); (A.M.)
| | - Hannah V. Newnes
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA 6009, Australia; (J.D.A.); (H.V.N.); (A.M.)
| | - Alison McDonnell
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA 6009, Australia; (J.D.A.); (H.V.N.); (A.M.)
- National Centre for Asbestos Related Diseases, QEII Medical Centre, The University of Western Australia, Nedlands, WA 6009, Australia
| | - Anthony Bosco
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA 6009, Australia; (J.D.A.); (H.V.N.); (A.M.)
- Correspondence: (A.B.); (J.W.)
| | - Jason Waithman
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA 6009, Australia; (J.D.A.); (H.V.N.); (A.M.)
- Correspondence: (A.B.); (J.W.)
| |
Collapse
|
5
|
Grisham R, Giri D, McDonnell A, Iasonos A, Zhou Q, Li K, Girshman J, O'Cearbhaill R, Zamarin D, Aghajanian C. Phase II study of enzalutamide in androgen receptor positive (AR+) recurrent high-grade and low-grade serous ovarian cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.06.046] [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: 10/23/2022]
|
6
|
Buzzai AC, Wagner T, Audsley KM, Newnes HV, Barrett LW, Barnes S, Wylie BC, Stone S, McDonnell A, Fear VS, Foley B, Waithman J. Diverse Anti-Tumor Immune Potential Driven by Individual IFNα Subtypes. Front Immunol 2020; 11:542. [PMID: 32308653 PMCID: PMC7145903 DOI: 10.3389/fimmu.2020.00542] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/10/2020] [Indexed: 12/29/2022] Open
Abstract
Immunotherapies harnessing T cell immunity have shown remarkable clinical success for the management of cancer. However, only a proportion of patients benefit from these treatments. The presence of type I interferon (IFN) within the tumor microenvironment is critical for driving effective tumor-specific T cell immunity. Individuals can produce 12 distinct subtypes of IFNα, which all signal through a common receptor. Despite reported differences in anti-viral potencies, the concept that distinct IFNα subtypes can improve anti-cancer treatments remains unclear. We tested whether expression of unique IFNα subtypes confined to the tumor microenvironment enhances tumor control. This was systematically evaluated by transplantation of B16 murine melanoma cells secreting five unique IFNα subtypes (B16_IFNα2; B16_IFNα4; B16_IFNα5; B16_IFNα6; B16_IFNα9) into a pre-clinical murine model. We show that IFNα2 and IFNα9 are the only subtypes capable of completely controlling tumor outgrowth, with this protection dependent on the presence of an adaptive immune response. We next determined whether these differences extended to other model systems and found that the adoptive transfer of tumor-specific CD8+ T cells engineered to secrete IFNα9 delays tumor growth significantly and improves survival, whereas no enhanced survival was observed using T cells secreting IFNα4. Overall, our data shows that the expression of distinct IFNα subtypes within the tumor microenvironment results in different anti-tumor activities, and differentially affects the efficacy of a cancer therapy targeting established disease.
Collapse
Affiliation(s)
- Anthony C Buzzai
- Telethon Kids Cancer Centre, Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Teagan Wagner
- Telethon Kids Cancer Centre, Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Katherine M Audsley
- Telethon Kids Cancer Centre, Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Hannah V Newnes
- Telethon Kids Cancer Centre, Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Lucy W Barrett
- Telethon Kids Cancer Centre, Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Samantha Barnes
- Telethon Kids Cancer Centre, Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Ben C Wylie
- PYC Therapeutics, QEII Medical Centre, Harry Perkins Institute for Medical Research, Nedlands, WA, Australia
| | - Shane Stone
- PYC Therapeutics, QEII Medical Centre, Harry Perkins Institute for Medical Research, Nedlands, WA, Australia
| | - Alison McDonnell
- Telethon Kids Cancer Centre, Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia.,National Centre for Asbestos Related Diseases, QEII Medical Centre, The University of Western Australia, Nedlands, WA, Australia
| | - Vanessa S Fear
- Telethon Kids Cancer Centre, Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Bree Foley
- Telethon Kids Cancer Centre, Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Jason Waithman
- Telethon Kids Cancer Centre, Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| |
Collapse
|
7
|
Abstract
INTRODUCTION Combination chemotherapy is currently standard care for advanced mesothelioma. Checkpoint blockade is a promising new treatment. AREAS COVERED This review covers clinical use and biomarkers of checkpoint blockade. Medline search used keywords 'mesothelioma' combined with 'checkpoint blockade' OR 'PD-L1' OR 'PD1' OR 'anti-CTLA4'; the search terms AND 'clinical trial' or AND 'biomarker*' were added. Handsearching covered abstracts from relevant meetings from 2016 to 2018 and reference lists. Data informed a narrative review. EXPERT OPINION Single agent anti-CTLA4 blockade is inactive in mesothelioma. Single agent PD-1 blockade as second or subsequent treatment gives 20-29% partial responses; no randomized comparisons against placebo or chemotherapy are available. Biomarkers of response have been difficult to identify. There is no consensus as to whether tumor PD-L1 expression predicts outcomes. Combination checkpoint inhibitors (CTLA4 and PD1 blockade) provide a small incremental increase in response rates and progression-free survival. Chemoimmunotherapy is the next frontier.
Collapse
Affiliation(s)
- Anna K Nowak
- a National Centre for Asbestos Related Diseases , University of Western Australia , Crawley , Australia
- b Institute for Respiratory Health, University of Western Australia , Nedlands , Australia
- c Medical School , University of Western Australia , Crawley , Australia
| | - Alison McDonnell
- a National Centre for Asbestos Related Diseases , University of Western Australia , Crawley , Australia
- b Institute for Respiratory Health, University of Western Australia , Nedlands , Australia
- c Medical School , University of Western Australia , Crawley , Australia
| | - Alistair Cook
- a National Centre for Asbestos Related Diseases , University of Western Australia , Crawley , Australia
- b Institute for Respiratory Health, University of Western Australia , Nedlands , Australia
- c Medical School , University of Western Australia , Crawley , Australia
| |
Collapse
|
8
|
Bilsland J, Bictash M, Nitzsche A, Cao L, Stevens E, McDonnell A, Ali Z, Whiting P. Application of induced pluripotent stem cell technology for disease modelling and drug discovery in peripheral sensory neurons. Neuromuscul Disord 2017. [DOI: 10.1016/s0960-8966(17)30220-1] [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: 10/19/2022]
|
9
|
Meniawy T, Lake R, McDonnell A, Millward M, Nowak A. 263 Up regulation of PD-L1 on peripheral blood CD3+ T cells predicts poor prognosis in patients with non-small cell lung cancer (NSCLC) treated with epidermal growth factor receptor (EGFR) inhibitors. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30148-4] [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: 11/27/2022]
|
10
|
McDonnell A, Downing T, Zhu X, Ryan R, Rossano J, Glatz A. Cumulative Exposure to Medical Sources of Ionizing Radiation in the First Year After Pediatric Heart Transplantation. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.585] [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: 11/15/2022] Open
|
11
|
Tod A, Redman J, McDonnell A, White J, Borthwick D. 125A The impact of lung cancer nurse specialists on access to anti-cancer treatment – implications for the Multidisciplinary Team (MDT). Lung Cancer 2014. [DOI: 10.1016/s0169-5002(14)70126-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
12
|
Guerin M, Brummell S, Tod A, McDonnell A, Beattie V, Ibottson R. 116 Emerging roles in lung cancer care – an exploration of the work of unregistered practitioners. Lung Cancer 2014. [DOI: 10.1016/s0169-5002(14)70116-3] [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: 10/25/2022]
|
13
|
Dagnan D, Hull A, McDonnell A. The controllability beliefs scale used with carers of people with intellectual disabilities: psychometric properties. J Intellect Disabil Res 2013; 57:422-428. [PMID: 22471440 DOI: 10.1111/j.1365-2788.2012.01554.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Beliefs about the controllability of behaviour have been consistently shown to be important in understanding the responses of carers to the challenging behaviour of people with intellectual disabilities (IDs). This paper reports the reliability and validity of the controllability beliefs scale (CBS), a 15-item measure of beliefs regarding the controllability of challenging behaviour when used with carers of people with IDs. METHODS Two hundred and sixty-four carers of people with IDs completed the CBS, 74 people also completed the modified attributional style questionnaire and the self-injury behavioural understanding questionnaire scale to determine concurrent and convergent validity and 34 people completed the scale twice within a 2- to 4-week period to determine test-retest reliability. RESULTS The scale has a two-factor structure and has adequate internal reliable. The scale is significantly correlated with the controllability, internality and stability items from the Modified Attributional Style Questionnaire, showed expected associations with behavioural and internal emotional understanding items from the self-injury behavioural understanding questionnaire. The scale has good test-retest reliability. CONCLUSIONS The data support use of the CBS in clinical practice and research to assess carers' beliefs regarding challenging behaviour of people with IDs.
Collapse
Affiliation(s)
- D Dagnan
- Cumbria Partnership NHS Trust, Community Learning Disabilities Service, Workington, Cumbria, UK.
| | | | | |
Collapse
|
14
|
Vail DM, Husbands BD, Kamerling SG, Simpson H, Kurzman ID, McDonnell A. Phase I study to determine the maximal tolerated dose and dose-limiting toxicities of orally administered idarubicin in dogs with lymphoma. J Vet Intern Med 2012; 26:608-13. [PMID: 22404399 DOI: 10.1111/j.1939-1676.2012.00896.x] [Citation(s) in RCA: 2] [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] [Received: 11/19/2011] [Revised: 01/04/2012] [Accepted: 01/24/2012] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Idarubicin, a PO bioavailable anthracycline antibiotic-class chemotherapeutic, could have substantial convenience advantages over currently available similar class agents in use that require IV delivery. OBJECTIVES The primary objective of this study was to determine the maximally tolerated dose (MTD), dose-limiting toxicities (DLTs), and basic pharmacokinetic parameters of oral idarubicin exposure in dogs with lymphoma after a single oral dose. A secondary objective was to document preliminary antitumor efficacy in an expanded treatment cohort using the established MTD. ANIMALS Client-owned dogs with measurable lymphoma. METHODS Dogs (n = 31) were enrolled in a prospective open label phase I study of oral idarubicin. By means of a 3 + 3 cohort design, dose escalations were made with 3 dogs per dose level, and the MTD was established based on the number of patients experiencing a DLT. Plasma concentrations of idarubicin and idarubicinol were determined by postdose sampling. Assessment of antitumor efficacy focused on evaluation of accessible, measurable lymph nodes and skin lesions by modified RECIST guidelines. RESULTS The MTD in dogs > 15 kg body weight was 22 mg/m(2) . Adverse hematologic events (neutropenia and thrombocytopenia) were the predominant DLT and generally correlated with higher plasma concentrations of idarubicin and idarubicinol. CONCLUSIONS AND CLINICAL IMPORTANCE PO administered idarubicin was generally well-tolerated and had preliminary antitumor activity in dogs with lymphoma. Furthermore, the potential clinical advantage of a safe and efficacious oral anthracycline alternative supports further investigations of this agent in repeated-dose, randomized clinical trials.
Collapse
Affiliation(s)
- D M Vail
- School of Veterinary Medicine and Carbone Comprehensive Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | | | | | | | | | | |
Collapse
|
15
|
Allmark P, Tod AM, McDonnell A, Al-Alawy K, Mann K, Hollis E, Qutishat D, Williamson M, Iliff A. Evaluation of the impact of a smoke-free home initiative in Rotherham, a deprived district in Northern England. Eur J Public Health 2011; 22:248-51. [DOI: 10.1093/eurpub/ckr072] [Citation(s) in RCA: 4] [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: 11/13/2022] Open
|
16
|
Currie AJ, Prosser A, McDonnell A, Cleaver AL, Robinson BWS, Freeman GJ, van der Most RG. Dual control of antitumor CD8 T cells through the programmed death-1/programmed death-ligand 1 pathway and immunosuppressive CD4 T cells: regulation and counterregulation. J Immunol 2010; 183:7898-908. [PMID: 20007574 DOI: 10.4049/jimmunol.0901060] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Tumors have evolved multiple mechanisms to evade immune destruction. One of these is expression of T cell inhibitory ligands such as programmed death-ligand 1 (PD-L1; B7-H1). In this study, we show that PD-L1 is highly expressed on mesothelioma tumor cells and within the tumor stroma. However, PD-L1 blockade only marginally affected tumor growth and was associated with the emergence of activated programmed death-1(+) ICOS(+) CD4 T cells in tumor-draining lymph nodes, whereas few activated CD8 T cells were present. Full activation of antitumor CD8 T cells, characterized as programmed death-1(+) ICOS(+) Ki-67(+) and displaying CTL activity, was only observed when CD4 T cells were depleted, suggesting that a population of suppressive CD4 T cells exists. ICOS(+) foxp3(+) regulatory T cells were found to be regulated through PD-L1, identifying one potentially suppressive CD4 T cell population. Thus, PD-L1 blockade activates antitumor CD8 T cell most potently in the absence of CD4 T cells. These findings have implications for the development of PD-L1-based therapies.
Collapse
Affiliation(s)
- Andrew J Currie
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
| | | | | | | | | | | | | |
Collapse
|
17
|
McDonnell A. A protocol for the loss of SEP responses during spinal cord monitoring. Clin Neurophysiol 2007. [DOI: 10.1016/j.clinph.2006.07.180] [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: 10/23/2022]
|
18
|
Abstract
BACKGROUND The introduction of acute pain teams (APTs) in every hospital performing surgery in the UK has been recommended in order to reduce postoperative pain. However, recent evidence suggests that many APTs are under-resourced. Purchasers may be more prepared to invest in these services if they are persuaded that they result in measurable improvements in patient outcomes. AIM A systematic review of the literature and meta-analysis were performed to determine the effectiveness of APTs in improving the quality of analgesia and other postoperative outcomes of adult patients undergoing surgery. METHODS A broad search strategy using the terms 'pain team' and 'pain service' was adapted for a variety of databases. Key journals were hand-searched and reference lists of selected reports were reviewed. Subject experts and study authors were contacted. Studies describing the impact of the APT/acute pain service (APS) on postoperative pain relief, other postoperative outcomes or the processes of postoperative pain were included. Study quality was assessed using a multidimensional instrument. A broad qualitative overview of the included studies was conducted. Continuous outcome data for pain in the first 24 hours postoperatively (in one case worst pain at 24-48 hours) were pooled. RESULTS Fifteen studies were included in the review. There were considerable differences in study design and quality, the nature of the APT and the outcomes measured. Of the nine studies measuring pain, it was possible to present data as Standardized Mean Differences for only four studies. Quantitative synthesis indicates a statistically significant overall estimate of effect using a fixed effects model only. LIMITATIONS Only published studies in English were included. Study inclusion decisions and data extraction were performed by one reviewer only. CONCLUSION There is insufficient robust research to assess the impact of APTs on postoperative outcomes of adult patients or on the processes of postoperative pain relief.
Collapse
Affiliation(s)
- A McDonnell
- Medical Care Research Unit, ScHARR, University of Sheffield, Sheffield, UK.
| | | | | |
Collapse
|
19
|
McDonnell A, Davies S, Brown J, Shewan J. Practice nurses and the prevention of cardiovascular disease and stroke: the extent of evidence-based practice. Prim Health Care Res Dev 2001. [DOI: 10.1191/146342301678227851] [Citation(s) in RCA: 2] [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: 11/05/2022] Open
|
20
|
Davis L, Barbera M, McDonnell A, McIntyre K, Sternglanz R, Jin Q, Loidl J, Engebrecht J. The Saccharomyces cerevisiae MUM2 gene interacts with the DNA replication machinery and is required for meiotic levels of double strand breaks. Genetics 2001; 157:1179-89. [PMID: 11238403 PMCID: PMC1461570 DOI: 10.1093/genetics/157.3.1179] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Saccharomyces cerevisiae MUM2 gene is essential for meiotic, but not mitotic, DNA replication and thus sporulation. Genetic interactions between MUM2 and a component of the origin recognition complex and polymerase alpha-primase suggest that MUM2 influences the function of the DNA replication machinery. Early meiotic gene expression is induced to a much greater extent in mum2 cells than in meiotic cells treated with the DNA synthesis inhibitor hydroxyurea. This result indicates that the mum2 meiotic arrest is downstream of the arrest induced by hydroxyurea and suggests that DNA synthesis is initiated in the mutant. Genetic analyses indicate that the recombination that occurs in mum2 mutants is dependent on the normal recombination machinery and on synaptonemal complex components and therefore is not a consequence of lesions created by incompletely replicated DNA. Both meiotic ectopic and allelic recombination are similarly reduced in the mum2 mutant, and the levels are consistent with the levels of meiosis-specific DSBs that are generated. Cytological analyses of mum2 mutants show that chromosome pairing and synapsis occur, although at reduced levels compared to wild type. Given the near-wild-type levels of meiotic gene expression, pairing, and synapsis, we suggest that the reduction in DNA replication is directly responsible for the reduced level of DSBs and meiotic recombination.
Collapse
Affiliation(s)
- L Davis
- Department of Pharmacological Sciences, Graduate Program in Genetics, State University of New York, Stony Brook, New York 11794-8651, USA
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Abstract
Clinical audit plays an important role in monitoring the provision of care for patients whatever their condition. Care pathways define the steps and expected course of events in the care of patients with a specific clinical problem over a set time scale. This paper describes a study undertaken in a multisite cancer unit to develop a tool for monitoring the progress of lung cancer patients through a care pathway and auditing key standards within the pathway. Important issues associated with the development of this tool are highlighted. The process of developing this tool involved the following steps: a review of the literature dealing with the management of lung cancer patients; interviews with key personnel in primary, secondary, tertiary and palliative care; development of a paper-based series of forms representing key steps in the patient's care pathway; 3-month trial of the paper-based tool; analysis of completion rates and interviews with form users to evaluate effectiveness; and recommendations for creating an electronic record using the experience and lessons learned from the paper version. The paper forms developed through this multistage process were found to be acceptable to users and have the potential to provide accurate information at key points for audit throughout the patient's time within the health-care system for their lung cancer condition. The flexibility of this methodology allows it to be adapted readily to a variety of clinical situations and conditions.
Collapse
Affiliation(s)
- E Kaltenthaler
- School of Health and Related Research, University of Sheffield, UK
| | | | | |
Collapse
|
22
|
McDonnell A, Love S, Tait A, Lichtenfels JR, Matthews JB. Phylogenetic analysis of partial mitochondrial cytochrome oxidase c subunit I and large ribosomal RNA sequences and nuclear internal transcribed spacer I sequences from species of Cyathostominae and Strongylinae (Nematoda, Order Strongylida), parasites of the horse. Parasitology 2000; 121 Pt 6:649-59. [PMID: 11155936 DOI: 10.1017/s003118200000696x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [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: 11/07/2022]
Abstract
Three nucleotide data sets, one nuclear (ITS-2) and two mitochondrial (COI and l-rRNA), have been investigated in order to determine relationships among species of Strongylinae and Cyathostominae, intestinal parasites of the horse. The data exhibited a strong mutational bias towards A and T and in the COI gene, silent sites appeared to saturate rapidly partly due to this substitution bias. Thus, the COI gene was found to be less phylogenetically informative than the l-rRNA and ITS-2 genes. Combined analysis of the l-rRNA and ITS-2 genes supported a monophyletic clade of the cyathostomes with Tridentoinfundibulum gobi, which had previously been classified as a nematode of' uncertain origin'. The Strongylinae grouped consistently outside the clade containing the cyathostomes and T. gobi. Molecular analysis failed to provide strong evidence for the separation of cyathostomes into classical genera, as previously defined by morphological classification.
Collapse
Affiliation(s)
- A McDonnell
- Department of Veterinary Parasitology, University of Glasgow Veterinary School.
| | | | | | | | | |
Collapse
|
23
|
Allen JE, Daub J, Guiliano D, McDonnell A, Lizotte-Waniewski M, Taylor DW, Blaxter M. Analysis of genes expressed at the infective larval stage validates utility of Litomosoides sigmodontis as a murine model for filarial vaccine development. Infect Immun 2000; 68:5454-8. [PMID: 10948183 PMCID: PMC101817 DOI: 10.1128/iai.68.9.5454-5458.2000] [Citation(s) in RCA: 47] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We used an expressed sequence tag approach to analyze genes expressed by the infective larvae of the rodent filarial parasite Litomosoides sigmodontis. One hundred fifty two new genes were identified, including several proposed as vaccine candidates in studies with human filarial parasites. Our findings have important implications for the use of L. sigmodontis as a model for filarial infection.
Collapse
Affiliation(s)
- J E Allen
- Institute of Cell, Animal, and Population Biology, University of Edinburgh, Edinburgh EH9 3JT, United Kingdom
| | | | | | | | | | | | | |
Collapse
|
24
|
Abstract
This paper explores the extent to which the design of a research study is influenced by pragmatic as well as theoretical considerations by describing the authors' experience of conducting multiple case studies in the context of a policy-orientated research project. The case studies in question formed part of a collaborative project exploring the development of innovative roles in nursing and the professions allied to medicine. The researchers adopted Yin's approach to the conduct of multiple case studies to explore issues relating to the effectiveness of new roles, their resource implications and educational issues surrounding their development. They address the fact that methodological decisions have practical implications and also explore the effects of practical and ethical issues on research design. Three purposively selected acute National Health Service Trust hospitals in England formed the case study sites for the work recorded in this paper. In each Trust, three nursing roles were selected, making nine cases for study. A variety of data collection strategies were used including semi-structured interviews with post-holders and other stakeholders (n = 51), non-participant observation of meetings, collection of audit, financial and statistical data and review of relevant documentation. This paper describes some of the dilemmas which arose during the course of the study, the rationale for methodological decisions taken to resolve these dilemmas and the steps taken to enhance rigour. In particular, the authors discuss the problems associated with obtaining informed consent in the context of qualitative research and with member validation of transcripts in a context where confidentiality was crucial. The decision to present findings thematically rather than as individual cases is justified both in terms of the nature and purpose of the research and in relation to the particular importance of anonymity and confidentiality in this study. Finally, the degree of reciprocity between researcher and researched is discussed.
Collapse
Affiliation(s)
- A McDonnell
- School of Nursing and Midwifery, University of Sheffield, England.
| | | | | |
Collapse
|
25
|
Collins K, Jones ML, McDonnell A, Read S, Jones R, Cameron A. Do new roles contribute to job satisfaction and retention of staff in nursing and professions allied to medicine? J Nurs Manag 2000; 8:3-12. [PMID: 11013536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND Studies have suggested that job dissatisfaction is a major factor influencing nurses' and occupational therapists' intention to leave their profession. It has also been related to turnover of qualified nurses. However, literature relating to these factors among nurses and professions allied to medicine in innovative roles is scarce. AIMS This paper considers the views of 452 nurses and 162 professionals allied to medicine (PAMs) in innovative roles, on job satisfaction, career development, intention to leave the profession and factors seen as hindering and enhancing effective working. METHODS A self-completion questionnaire was developed as part of a larger study exploring new roles in practice (The ENRiP Study). FINDINGS Overall there was a high level of job satisfaction in both groups (nurses and PAMs). Job satisfaction was significantly related to feeling integrated within the post-holder's own professional group and with immediate colleagues, feeling that the role had improved their career prospects, feeling adequately prepared and trained for the role, and working to protocol. Sixty-eight percent (n = 415) of respondents felt the role had enhanced their career prospects but over a quarter of respondents (n = 163; 27%) said they would leave their profession if they could. Low job satisfaction was significantly related to intention to leave the profession. CONCLUSIONS The vast majority of post-holders in innovative roles felt that the role provided them with a sense of job satisfaction. However, it is essential that the post-holders feel adequately prepared to carry out the role and that the boundaries of their practice are well defined. Career progression and professional integration both being associated with job satisfaction.
Collapse
Affiliation(s)
- K Collins
- School of Health and Related Research, University of Sheffield, UK
| | | | | | | | | | | |
Collapse
|
26
|
McDonnell A. A systematic review to determine the effectiveness of preparatory information in improving the outcomes of adult patients undergoing invasive procedures. ACTA ACUST UNITED AC 1999. [DOI: 10.1016/s1361-9004(99)80003-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
27
|
Hung GC, Chilton NB, Beveridge I, McDonnell A, Lichtenfels JR, Gasser RB. Molecular delineation of Cylicocyclus nassatus and C. ashworthi (Nematoda:Strongylidae). Int J Parasitol 1997; 27:601-5. [PMID: 9193955 DOI: 10.1016/s0020-7519(96)00192-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [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: 02/04/2023]
Abstract
The nucleotide sequences of the first internal transcribed spacer (ITS-1), 5.8S gene and second internal transcribed spacer (ITS-2) of ribosomal DNA have been determined for Cylicocyclus nassatus, C. ashworthi and C. insignis. Pairwise comparisons revealed sequence differences between the taxa ranging from 3.8 to 6.2% for the ITS-2 and 2.2-2.7% for the ITS-1. For the ITS-1, the level of the sequence difference between C. ashworthi and C. nassatus (2.2%) was equivalent to that between C. nassatus and C. insignis (2.2%), indicating that C. ashworthi and C. nassatus represent separate species. Theoretical restriction maps were constructed from the sequence data, and a polymerase chain reaction-linked restriction fragment length polymorphism (PCR-linked RFLP) technique was established to unequivocally distinguish C. ashworthi from C. nassatus.
Collapse
Affiliation(s)
- G C Hung
- Department of Veterinary Science, University of Melbourne, Werribee, Victoria, Australia.
| | | | | | | | | | | |
Collapse
|
28
|
MacKintosh C, Garton AJ, McDonnell A, Barford D, Cohen PT, Tonks NK, Cohen P. Further evidence that inhibitor-2 acts like a chaperone to fold PP1 into its native conformation. FEBS Lett 1996; 397:235-8. [PMID: 8955354 DOI: 10.1016/s0014-5793(96)01175-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The gamma1-isoform of protein phosphatase-1 expressed in Escherichia coli (PP1gamma) and the native PP1 catalytic subunit (PP1C) isolated from skeletal muscle dephosphorylated Ser-14 of glycogen phosphorylase at comparable rates. In contrast, PP1gamma dephosphorylated several tyrosine-phosphorylated proteins at similar rates to authentic protein tyrosine phosphatases (PTPases), but native PP1C was almost inactive towards these substrates. The phosphorylase phosphatase (PhP) and PTPase activities of PP1gamma were inhibited by vanadate with IC50 values (30-100 microM) comparable to authentic PTPases, whereas the PhP activity of native PP1C was insensitive to vanadate. PP1gamma lost its PTPase activity, and its PhP activity became insensitive to vanadate, after interaction with inhibitor-2, followed by the reversible phosphorylation of inhibitor-2 at Thr-72. These findings support and extend the hypothesis that inhibitor-2 functions like a chaperone to fold PP1 into its native conformation, and suggest that the correct folding of PP1 may be critical to prevent the uncontrolled dephosphorylation of cellular phosphotyrosine residues.
Collapse
Affiliation(s)
- C MacKintosh
- MRC Protein Phosphorylation Unit, Department of Biochemistry, University of Dundee, UK.
| | | | | | | | | | | | | |
Collapse
|
29
|
McDonnell A. Phasing out seclusion through staff training and support. Nurs Times 1996; 92:43-4. [PMID: 8826419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Seclusion raises considerable ethical issues. While many services aim to phase out this practice, little research has been conducted into how this can be achieved. This article describes the phasing out of seclusion from a locked ward in a hospital for people with learning disabilities. The implications of these findings for other services are discussed.
Collapse
|
30
|
Wolcott K, McDonnell A. Malignant hyperthermia: nursing implications. Crit Care Nurse 1990; 10:78-85. [PMID: 2357894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This paper presents the pathophysiology, clinical symptoms, and a standard of care for the patient with MH. The information provided will assist the nurse in interpreting patient and technologic data to identify recurring episodes of MH, and prevent the negative outcomes associated with this syndrome.
Collapse
|
31
|
Abstract
This paper presents the pathophysiology, clinical symptoms, and a standard of care for the patient with MH. The information provided will assist the nurse in interpreting patient and technologic data to identify recurring episodes of MH, and prevent the negative outcomes associated with this syndrome.
Collapse
|
32
|
Abstract
CT-scan measurements of cortical and subcortical atrophy were carried out in 34 patients with Huntington's disease (HD). While a significant correlation was observed between parameters of subcortical atrophy (bicaudate ratio, bifrontal ratio and third ventricular ratio) and duration of the disease, there was no significant correlation between these parameters and age. On the other hand, measurements of cortical atrophy (frontal fissure ratio and cortical sulci ratio) correlated significantly with age but not with duration of the disease. When a group of 24 HD patients were compared on CT-scan measurements with a group of 24 age-matched normal controls, significant differences were obtained for all the variables examined, but the bicaudate ratio showed the highest sensitivity and specificity. Even mildly affected patients, with duration of motor symptoms less than 3 years had higher bicaudate ratios than age-matched controls.
Collapse
Affiliation(s)
- S E Starkstein
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore
| | | | | | | | | | | |
Collapse
|
33
|
Starkstein SE, Brandt J, Folstein S, Strauss M, Berthier ML, Pearlson GD, Wong D, McDonnell A, Folstein M. Neuropsychological and neuroradiological correlates in Huntington's disease. J Neurol Neurosurg Psychiatry 1988; 51:1259-63. [PMID: 2976080 PMCID: PMC1032911 DOI: 10.1136/jnnp.51.10.1259] [Citation(s) in RCA: 63] [Impact Index Per Article: 1.8] [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: 01/03/2023]
Abstract
Measurements of cortical and subcortical atrophy were made on CT scans of 34 patients with Huntington's disease. Significant correlations were found between the bicaudate ratio (BCR) and an eye movement scale (r = 0.44, p less than 0.01), and activities of daily living scale (r = 0.57, p less than 0.001) and the Mini-Mental State Exam (r = 0.49, p less than 0.01). No correlations were found between BCR values and severity of chorea or voluntary motor impairment. A detailed neuropsychological evaluation of 18 Huntington's disease patients showed significant correlations between the BCR and Symbol Digit Modalities test (r = 0.65, p less than 0.01), and parts A (r = 0.72, p less than 0.001) and B (r = 0.80, p less than 0.0001) of the Trail Making Test. These data support work in primates that demonstrates the role of the caudate nucleus in cognitive and oculomotor functions, but not in motor control (which is governed by putamino-subthalamic systems). The specific cognitive skills correlated with caudate atrophy in Huntington's disease are those reported in primate work to be served by the frontal-caudate loop system: eye movements, conceptual tracking, set shifting and psychomotor speed.
Collapse
Affiliation(s)
- S E Starkstein
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Mennuti MT, DiGaetano A, McDonnell A, Cohen AW, Liston RM. Fetal-maternal bleeding associated with genetic amniocentesis: real-time versus static ultrasound. Obstet Gynecol 1983; 62:26-30. [PMID: 6190117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The incidence of fetal to maternal bleeding was studied in 773 consecutive patients having genetic amniocentesis by measuring maternal serum alpha-fetoprotein elevation following the procedure. The frequency of fetal to maternal bleeding was significantly lower in patients having amniocentesis immediately after real-time ultrasound (21 of 429 cases, 4.9%) when compared with patients having static B-mode ultrasound before the procedure (31 of 344 cases, 9.0%). A lower frequency of fetal to maternal bleeding was observed in the real-time group for anterior or partially anterior placentas (8.1%) and posterior or fundal posterior placentas (0%) when compared with the static B-mode group (12.9 and 5.2%, respectively). The rate of spontaneous abortion in patients with fetal to maternal bleeding (12.8%) was significantly higher than the rate in patients who did not demonstrate such bleeding (1.45%). The implications of these findings with regard to the safety of amniocentesis and the benefit of routine preliminary ultrasound evaluation are discussed.
Collapse
|