1
|
Anderson NR, Shah B, Worth A, Gabbasov R, Menchel B, Ciccaglione K, Blumenthal D, Pierini S, DeLong SC, Abramson S, Condamine T, Klichinsky M. Abstract 4053: A mesothelin targeting chimeric antigen receptor macrophage (CAR-M) for solid tumor immunotherapy: pre-clinical development of CT-1119. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-4053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
While adoptive cell therapies have seen significant success in the treatment of hematological malignancies, solid tumors remain challenging for the field. A significant obstacle is the exclusion of T cells from the tumor microenvironment (TME). In contrast, monocytes/macrophages are naturally recruited to the TME. These cells then have the potential to phagocytose tumor cells, activate the TME, and prime a broad anti-tumor adaptive immune response via T cell recruitment and activation. We have previously developed CT-0508, a chimeric antigen receptor macrophage (CAR-M) targeting HER2 which showed efficacy in a variety of pre-clinical models and is currently in a Phase I clinical trial for patients with HER2+ solid tumors. Mesothelin is overexpressed in a variety of solid tumors, including mesothelioma, lung, pancreatic, and ovarian cancers. To leverage tumor biology with myeloid cells, we engineered primary human macrophages using the chimeric adenoviral vector Ad5f35 to express a CAR containing a human scFv against human mesothelin. We used both in vitro cell based assays and in vivo xenograft models to assess the activity of CT-1119. CAR-M engineered with an Ad5f35 vector demonstrated high CAR expression, high viability, upregulated M1 (anti-tumor) macrophage markers, and downregulated M2 (pro-tumor) macrophage markers. CT-1119 specifically phagocytosed multiple mesothelin expressing tumor cell lines in a CAR-dependent and antigen-dependent manner. CT-1119 demonstrated robust in vitro killing of the relevant tumor cell lines A549 and MES-OV expressing mesothelin. CAR engagement also induced the release of pro-inflammatory cytokines such as TNFα following stimulation with mesothelin in both cell-free and cell-based contexts in a dose-dependent manner. In vivo, CT-1119 significantly reduced tumor burden in a murine xenograft model of lung cancer. Similarly, human monocytes targeting mesothelin were successfully generated using the same Ad5f35 vector and demonstrated specific activity against mesothelin positive tumor cells. The presented results demonstrate that CT-1119, an autologous human anti-mesothelin CAR-M, can cause phagocytosis, tumor cell killing, and pro-inflammatory cytokine release in response to stimulation with mesothelin. These results show that CAR-M is a feasible approach for the treatment of mesothelin expressing sold tumors via the potential for induction of a systemic anti-tumor response.
Citation Format: Nicholas R. Anderson, Brinda Shah, Alison Worth, Rashid Gabbasov, Brett Menchel, Kerri Ciccaglione, Daniel Blumenthal, Stefano Pierini, Sabrina Ceeraz DeLong, Sascha Abramson, Thomas Condamine, Michael Klichinsky. A mesothelin targeting chimeric antigen receptor macrophage (CAR-M) for solid tumor immunotherapy: pre-clinical development of CT-1119. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4053.
Collapse
|
2
|
Schuetz C, Gerke J, Ege M, Walter J, Kusters M, Worth A, Kanakry JA, Dimitrova D, Wolska-Kuśnierz B, Chen K, Unal E, Karakukcu M, Pashchenko O, Leiding J, Kawai T, Amrolia PJ, Berghuis D, Buechner J, Buchbinder D, Cowan MJ, Gennery AR, Güngör T, Heimall J, Miano M, Meyts I, Morris EC, Rivière J, Sharapova SO, Shaw PJ, Slatter M, Honig M, Veys P, Fischer A, Cavazzana M, Moshous D, Schulz A, Albert MH, Puck JM, Lankester AC, Notarangelo LD, Neven B. Hypomorphic RAG deficiency: impact of disease burden on survival and thymic recovery argues for early diagnosis and HSCT. Blood 2023; 141:713-724. [PMID: 36279417 PMCID: PMC10082356 DOI: 10.1182/blood.2022017667] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [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] [Received: 07/21/2022] [Revised: 09/19/2022] [Accepted: 10/04/2022] [Indexed: 11/20/2022] Open
Abstract
Patients with hypomorphic mutations in the RAG1 or RAG2 gene present with either Omenn syndrome or atypical combined immunodeficiency with a wide phenotypic range. Hematopoietic stem cell transplantation (HSCT) is potentially curative, but data are scarce. We report on a worldwide cohort of 60 patients with hypomorphic RAG variants who underwent HSCT, 78% of whom experienced infections (29% active at HSCT), 72% had autoimmunity, and 18% had granulomas pretransplant. These complications are frequently associated with organ damage. Eight individuals (13%) were diagnosed by newborn screening or family history. HSCT was performed at a median of 3.4 years (range 0.3-42.9 years) from matched unrelated donors, matched sibling or matched family donors, or mismatched donors in 48%, 22%, and 30% of the patients, respectively. Grafts were T-cell depleted in 15 cases (25%). Overall survival at 1 and 4 years was 77.5% and 67.5% (median follow-up of 39 months). Infection was the main cause of death. In univariable analysis, active infection, organ damage pre-HSCT, T-cell depletion of the graft, and transplant from a mismatched family donor were predictive of worse outcome, whereas organ damage and T-cell depletion remained significant in multivariable analysis (hazard ratio [HR] = 6.01, HR = 8.46, respectively). All patients diagnosed by newborn screening or family history survived. Cumulative incidences of acute and chronic graft-versus-host disease were 35% and 22%, respectively. Cumulative incidences of new-onset autoimmunity was 15%. Immune reconstitution, particularly recovery of naïve CD4+ T cells, was faster and more robust in patients transplanted before 3.5 years of age, and without organ damage. These findings support the indication for early transplantation.
Collapse
Affiliation(s)
- C. Schuetz
- Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - J. Gerke
- Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M. Ege
- Dr. von Hauner Children’s Hospital at Ludwig-Maximilians-Universität, München, Germany
- Helmholtz Zentrum München, Neuherberg, Germany
| | - J. Walter
- Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL
- Division of Allergy and Immunology, Department of Medicine, Johns Hopkins All Children’s Hospital, St. Petersburg, FL
| | - M. Kusters
- Department of Immunology and Gene therapy, Great Ormond Street Hospital, NHS Foundation trust, London, United Kingdom
| | - A. Worth
- Department of Immunology and Gene therapy, Great Ormond Street Hospital, NHS Foundation trust, London, United Kingdom
| | - J. A. Kanakry
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - D. Dimitrova
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - B. Wolska-Kuśnierz
- Department of Immunology, Children's Memorial Health Institute, Warsaw, Poland
| | - K. Chen
- Division of Allergy and Immunology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | - E. Unal
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
| | - M. Karakukcu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
| | - O. Pashchenko
- Department of Immunology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - J. Leiding
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Orlando Health Arnold Pamer Hospital for Children, Orlando, FL
| | - T. Kawai
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - P. J. Amrolia
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - D. Berghuis
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - J. Buechner
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
| | - D. Buchbinder
- Division of Hematology, Children's Hospital of Orange County, Orange, CA
| | - M. J. Cowan
- Division of Allergy, Immunology, and Blood and Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - A. R. Gennery
- Translational and Clinical Research Institute, Newcastle University, Paediatric Haematopoietic Stem Cell Transplant Unit, Great North Children’s Hospital, Newcastle upon Tyne, United Kingdom
| | - T. Güngör
- Department of Hematology/Oncology/Immunology, Gene-therapy, and Stem Cell Transplantation, University Children’s Hospital Zurich–Eleonore Foundation & Children’s Research Center, Zürich, Switzerland
| | - J. Heimall
- Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
| | - M. Miano
- IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - I. Meyts
- Department of Pediatrics, Department of Microbiology and Immunology, University Hospitals Leuven, Leuven, Belgium
| | - E. C. Morris
- UCL Institute of Immunity & Transplantation, University College London Hospitals NHS Foundation Trust, Royal Free London Hospital NHS Foundation Trust, London, United Kingdom
| | - J. Rivière
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S. O. Sharapova
- Research Department, Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
| | - P. J. Shaw
- Blood Transplant and Cell Therapies, Children’s Hospital at Westmead, Sydney, Australia
| | - M. Slatter
- Paediatric Immunology & HSCT, Great North Children's Hospital, Newcastle upon Tyne, United Kingdom
| | - M. Honig
- Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
| | - P. Veys
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - A. Fischer
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Collège de France, Paris, France
| | - M. Cavazzana
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Département de Biothérapie, Hôpital Universitaire Necker-Enfants Malades, Groupe Hospitalier Paris Centre, Assistance Publique–Hopitaux de Paris, Paris, France
- Centre d’Investigation Clinique Biothérapie, Groupe hospitalier Universitaire paris centre, Assistance Publique-Hôpitaux de Paris, INSERM CIC 1416, Paris, France
| | - D. Moshous
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - A. Schulz
- Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
| | - M. H. Albert
- Pediatric SCT Program, Dr. von Hauner University Children’s Hospital, Ludwig-Maximilians Universität, München, Germany
| | - J. M. Puck
- Division of Allergy, Immunology, and Blood and Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - A. C. Lankester
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - L. D. Notarangelo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - B. Neven
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
| | - Inborn Errors Working Party (IEWP) of the European Society for Immunodeficiencies (ESID) and European Society for Blood and Marrow Transplantation (EBMT) and the Primary Immune Deficiency Treatment Consortium (PIDTC)
- Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Dr. von Hauner Children’s Hospital at Ludwig-Maximilians-Universität, München, Germany
- Helmholtz Zentrum München, Neuherberg, Germany
- Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL
- Division of Allergy and Immunology, Department of Medicine, Johns Hopkins All Children’s Hospital, St. Petersburg, FL
- Department of Immunology and Gene therapy, Great Ormond Street Hospital, NHS Foundation trust, London, United Kingdom
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
- Department of Immunology, Children's Memorial Health Institute, Warsaw, Poland
- Division of Allergy and Immunology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
- Department of Immunology, Pirogov Russian National Research Medical University, Moscow, Russia
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Orlando Health Arnold Pamer Hospital for Children, Orlando, FL
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
- Division of Hematology, Children's Hospital of Orange County, Orange, CA
- Division of Allergy, Immunology, and Blood and Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, CA
- Translational and Clinical Research Institute, Newcastle University, Paediatric Haematopoietic Stem Cell Transplant Unit, Great North Children’s Hospital, Newcastle upon Tyne, United Kingdom
- Department of Hematology/Oncology/Immunology, Gene-therapy, and Stem Cell Transplantation, University Children’s Hospital Zurich–Eleonore Foundation & Children’s Research Center, Zürich, Switzerland
- Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Pediatrics, Department of Microbiology and Immunology, University Hospitals Leuven, Leuven, Belgium
- UCL Institute of Immunity & Transplantation, University College London Hospitals NHS Foundation Trust, Royal Free London Hospital NHS Foundation Trust, London, United Kingdom
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
- Research Department, Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
- Blood Transplant and Cell Therapies, Children’s Hospital at Westmead, Sydney, Australia
- Paediatric Immunology & HSCT, Great North Children's Hospital, Newcastle upon Tyne, United Kingdom
- Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Collège de France, Paris, France
- Département de Biothérapie, Hôpital Universitaire Necker-Enfants Malades, Groupe Hospitalier Paris Centre, Assistance Publique–Hopitaux de Paris, Paris, France
- Centre d’Investigation Clinique Biothérapie, Groupe hospitalier Universitaire paris centre, Assistance Publique-Hôpitaux de Paris, INSERM CIC 1416, Paris, France
- Pediatric SCT Program, Dr. von Hauner University Children’s Hospital, Ludwig-Maximilians Universität, München, Germany
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| |
Collapse
|
3
|
Mirji G, Worth A, Bhat S, Sayed M, Kannan T, Goldman A, Tang HY, Liu Q, Auslander N, Dang C, Abdel-Mohsen M, Kossenkov A, Stanger B, Shinde R. Abstract C023: A microbiome-produced metabolite drives immunostimulatory macrophages and boosts response to immune checkpoint inhibitors in pancreatic cancer. Cancer Res 2022. [DOI: 10.1158/1538-7445.panca22-c023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Abstract
The composition of the gut microbiome controls innate and adaptive immunity and has emerged as a key regulator of tumor growth and the success of immune checkpoint blockade (ICB) therapy. However, the underlying mechanisms remain unclear. Pancreatic ductal adenocarcinoma (PDAC) tends to be refractory to therapy, including ICB. We found that the gut microbe-derived metabolite trimethylamine N-oxide (TMAO) enhances anti-tumor immunity to PDAC. Delivery of TMAO given intraperitoneally or via dietary choline supplement to PDAC-bearing mice reduces tumor growth and is associated with an immunostimulatory tumor-associated macrophage (TAM) phenotype and activated effector T cell response in the tumor microenvironment. Mechanistically, TMAO signals through potentiating type-I interferon (IFN) pathway and confers anti-tumor effects in a type-I IFN dependent manner. Notably, delivering TMAO-primed macrophages alone produced similar anti-tumor effects. Combining TMAO with ICB (anti-PD1 and/or anti-Tim3) significantly reduced tumor burden and improved survival beyond TMAO or ICB alone. Finally, the levels of trimethylamine (TMA)-producing bacteria and of CutC gene expression correlate with improved survivorship and response to anti-PD1 in cancer patients. Together, our study identifies the gut microbial metabolite TMAO as an important driver of anti-tumor immunity and lays the groundwork for new therapeutic strategies.
Citation Format: Gauri Mirji, Alison Worth, Sajad Bhat, Mohamed Sayed, Toshitha Kannan, Aaron Goldman, Hsin-Yao Tang, Qin Liu, Noam Auslander, Chi Dang, Mohamed Abdel-Mohsen, Andrew Kossenkov, Ben Stanger, Rahul Shinde. A microbiome-produced metabolite drives immunostimulatory macrophages and boosts response to immune checkpoint inhibitors in pancreatic cancer [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer; 2022 Sep 13-16; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2022;82(22 Suppl):Abstract nr C023.
Collapse
Affiliation(s)
| | | | - Sajad Bhat
- 1The Wistar Institute, Philadelphia, PA,
| | | | | | | | | | - Qin Liu
- 1The Wistar Institute, Philadelphia, PA,
| | | | - Chi Dang
- 1The Wistar Institute, Philadelphia, PA,
| | | | | | - Ben Stanger
- 2University of Pennsylvania, Philadelphia, PA
| | | |
Collapse
|
4
|
Patel D, Lee TJ, Kumar S, Vyavahare S, Worth A, Hill WD, Hamrick M, Isales CM, Shinde RS, Fulzele S. Alterations in bone metabolites with age in C57BL/6 mice model. Biogerontology 2022; 23:629-640. [PMID: 36056226 PMCID: PMC10918568 DOI: 10.1007/s10522-022-09986-7] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 08/17/2022] [Indexed: 11/28/2022]
Abstract
Understanding the pathophysiology behind age-related diseases is an urgent need as the elderly population continues to grow. With age, there is a high risk of musculoskeletal deterioration and associated morbidity and mortality. Although the exact mechanism behind age-related degeneration is unknown, it is well established that alteration in cellular metabolism is one of the important contributing factors. Alteration in signaling pathways with age leads to the accumulation or depletion of several metabolites that play a vital role in musculoskeletal pathophysiology. This study aimed to identify age-related changes in bone tissue metabolites in C57BL/6 mice. We then correlated the differentially expressed metabolites with their functions in bone biology. In both aged males and females, hydroxyproline, glutamine, and alpha-linolenic acid levels were decreased. In aged females, Ornithine (p value = 0.001), L-Proline (p value = 0.008), Uridine (p value = 0.001), Aspartic Acid (p value = 0.004) levels were significantly decreased, and glutamate (p value = 0.002) was elevated. In aged males, N-acetyl-D-glucosamine (pvalue = 0.010), Adrenic acid (pvalue = 0.0099), Arachidonic acid (p value = 0.029) and Allantoin (p value = 0.004) levels were decreased. Metabolic pathway analysis revealed that purine and D-glutamine and D-glutamate metabolism were significantly altered in both sexes, while arginine biosynthesis in females and lipid metabolism in males were highly affected. These differences in metabolic signaling might be one of the reasons for the discrepancy in musculoskeletal disease manifestation between the two sexes. Understanding the role of these metabolites play in the aging bone will allow for new sex-specific targeted therapies against the progression of musculoskeletal diseases.
Collapse
Affiliation(s)
- Dhara Patel
- Department of Medicine, Augusta University, Augusta, GA, 30912, USA
| | - Tae Jin Lee
- Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, 30912, USA
| | - Sandeep Kumar
- Department of Cell Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Sagar Vyavahare
- Department of Cell Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Alison Worth
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute Cancer Center, Philadelphia, PA, USA
| | - William D Hill
- Medical University of South Carolina, Charleston, SC, 29403, USA
| | - Mark Hamrick
- Department of Cell Biology and Anatomy, Augusta University, Augusta, GA, USA
- Center for Healthy Aging, Augusta University, Augusta, GA, USA
| | - Carlos M Isales
- Department of Medicine, Augusta University, Augusta, GA, 30912, USA
- Center for Healthy Aging, Augusta University, Augusta, GA, USA
| | - Rahul S Shinde
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute Cancer Center, Philadelphia, PA, USA
| | - Sadanand Fulzele
- Department of Medicine, Augusta University, Augusta, GA, 30912, USA.
- Department of Cell Biology and Anatomy, Augusta University, Augusta, GA, USA.
- Center for Healthy Aging, Augusta University, Augusta, GA, USA.
| |
Collapse
|
5
|
Mirji G, Worth A, Bhat SA, Sayed ME, Kannan T, Goldman AR, Tang HY, Liu Q, Auslander N, Dang CV, Abdel-Mohsen M, Kossenkov A, Stanger BZ, Shinde RS. The microbiome-derived metabolite TMAO drives immune activation and boosts responses to immune checkpoint blockade in pancreatic cancer. Sci Immunol 2022; 7:eabn0704. [PMID: 36083892 PMCID: PMC9925043 DOI: 10.1126/sciimmunol.abn0704] [Citation(s) in RCA: 74] [Impact Index Per Article: 37.0] [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: 01/12/2023]
Abstract
The composition of the gut microbiome can control innate and adaptive immunity and has emerged as a key regulator of tumor growth, especially in the context of immune checkpoint blockade (ICB) therapy. However, the underlying mechanisms for how the microbiome affects tumor growth remain unclear. Pancreatic ductal adenocarcinoma (PDAC) tends to be refractory to therapy, including ICB. Using a nontargeted, liquid chromatography-tandem mass spectrometry-based metabolomic screen, we identified the gut microbe-derived metabolite trimethylamine N-oxide (TMAO), which enhanced antitumor immunity to PDAC. Delivery of TMAO intraperitoneally or via a dietary choline supplement to orthotopic PDAC-bearing mice reduced tumor growth, associated with an immunostimulatory tumor-associated macrophage (TAM) phenotype, and activated effector T cell response in the tumor microenvironment. Mechanistically, TMAO potentiated the type I interferon (IFN) pathway and conferred antitumor effects in a type I IFN-dependent manner. Delivering TMAO-primed macrophages intravenously produced similar antitumor effects. Combining TMAO with ICB (anti-PD1 and/or anti-Tim3) in a mouse model of PDAC significantly reduced tumor burden and improved survival beyond TMAO or ICB alone. Last, the levels of bacteria containing CutC (an enzyme that generates trimethylamine, the TMAO precursor) correlated with long-term survival in patients with PDAC and improved response to anti-PD1 in patients with melanoma. Together, our study identifies the gut microbial metabolite TMAO as a driver of antitumor immunity and lays the groundwork for potential therapeutic strategies targeting TMAO.
Collapse
Affiliation(s)
- Gauri Mirji
- Immunology, Microenvironment & Metastasis Program, The Wistar Institute, Philadelphia, PA, USA
| | - Alison Worth
- Immunology, Microenvironment & Metastasis Program, The Wistar Institute, Philadelphia, PA, USA
| | - Sajad Ahmad Bhat
- Immunology, Microenvironment & Metastasis Program, The Wistar Institute, Philadelphia, PA, USA
| | - Mohamed El Sayed
- Immunology, Microenvironment & Metastasis Program, The Wistar Institute, Philadelphia, PA, USA
| | - Toshitha Kannan
- Bioinformatics Facility, The Wistar Institute, Philadelphia, PA, USA
| | - Aaron R Goldman
- Proteomics and Metabolomics Facility, The Wistar Institute, Philadelphia, PA, USA
| | - Hsin-Yao Tang
- Proteomics and Metabolomics Facility, The Wistar Institute, Philadelphia, PA, USA
| | - Qin Liu
- Molecular and Cellular Oncogenesis Program, The Wistar Institute, Philadelphia, PA, USA
| | - Noam Auslander
- Molecular and Cellular Oncogenesis Program, The Wistar Institute, Philadelphia, PA, USA
| | - Chi V Dang
- Molecular and Cellular Oncogenesis Program, The Wistar Institute, Philadelphia, PA, USA
- Ludwig Institute for Cancer Research, New York, NY USA
| | - Mohamed Abdel-Mohsen
- Immunology, Microenvironment & Metastasis Program, The Wistar Institute, Philadelphia, PA, USA
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, USA
| | - Andrew Kossenkov
- Bioinformatics Facility, The Wistar Institute, Philadelphia, PA, USA
| | - Ben Z Stanger
- Abramson Family Cancer Research Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Cell & Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Institute for Regenerative Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rahul S Shinde
- Immunology, Microenvironment & Metastasis Program, The Wistar Institute, Philadelphia, PA, USA
| |
Collapse
|
6
|
Hollnagel H, Bellion P, Buist H, Gadhia S, Lovell D, Melching-Kollmuss S, Worth A, Boobis A. CEC07-01 Introduction to TTC – concept, databases, excluded substances and sources of uncertainty. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.037] [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: 11/16/2022]
|
7
|
Pierini S, Gabbasov R, Worth A, Ramos I, Blumenthal D, Ohtani Y, Gabitova L, Ball M, Abramson S, Condamine T, Klichinsky M. Abstract 2112: Chimeric antigen receptor macrophages (CAR-M) sensitize solid tumors to anti-PD1 immunotherapy. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-2112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Despite the remarkable efficacy achieved by CAR-T cell therapy in hematologic malignancies, achieving efficacy against solid tumors has been challenging. We previously developed human CAR-M and demonstrated that adoptive cell transfer of CAR-M into xenograft models of human cancer controls tumor progression and improves overall survival1. Given that CAR-M are M1-polarized macrophages with the potential to remodel the tumor microenvironment (TME) and act as professional antigen presenting cells, we developed an immunocompetent animal model to evaluate the interaction of CAR-M with the endogenous immune system and to study the combinatorial approach of CAR-M with blockade of the PD1/PDL1 T cell checkpoint axis. Murine bone marrow-derived macrophages were engineered to express an anti-HER2 CAR using the chimeric adenoviral vector Ad5f35. In addition to efficient gene delivery, Ad5f35 transduction promoted a pro-inflammatory (M1) phenotype in murine macrophages. Anti-HER2 CAR-M, but not control macrophages, phagocytosed and killed HER2-overexpressing tumor cell lines. CAR-M induced MHC-I expression on tumor cells and enhanced the cytotoxicity of CD8+ T cells. To evaluate the safety and efficacy of CAR-M therapy, immunocompetent mice were engrafted with HER2+ tumors and treated with syngeneic HER2-CAR or untransduced (UTD) macrophages. CAR-M treated mice showed significant tumor control and improved survival compared to control groups. Analysis of the TME showed increased intratumoral immune infiltration - as well as an increase in T cell responsiveness to tumor-associated antigens, indicating enhanced epitope spreading. Given the impact of CAR-M on the endogenous adaptive immune system, we evaluated the combination of CAR-M with anti-PD1 in tumors resistant to anti-PD1 monotherapy and found that the combination further reprogrammed the TME, significantly enhanced tumor control, and improved overall survival compared to monotherapy with either agent. Mice that achieved complete responses (CRs) after CAR-M therapy were protected against antigen-negative relapse in a HER2-negative rechallenge model, indicating long-term anti-tumor immunity. Finally, the combination of CAR-M with anti-PD1 did not trigger sustained elevations of serum analytes associated with cytokine release syndrome (CRS) and was well tolerated across numerous safety assessments. These results demonstrate that CAR-M reprogram the TME, induce epitope spreading, and orchestrate a systemic immune response against solid tumors. Moreover, our findings provide rationale for the combination of CAR-M with immune checkpoint inhibitors. The anti-HER2 CAR-M, CT-0508, is under evaluation in a phase I clinical trial for patients with HER2 overexpressing solid tumors.
Citation Format: Stefano Pierini, Rashid Gabbasov, Alison Worth, Ilyssa Ramos, Daniel Blumenthal, Yumi Ohtani, Linara Gabitova, Michael Ball, Sascha Abramson, Thomas Condamine, Michael Klichinsky. Chimeric antigen receptor macrophages (CAR-M) sensitize solid tumors to anti-PD1 immunotherapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2112.
Collapse
|
8
|
Pierini S, Klichinsky M, Gabbasov R, Worth A, Ramos I, Blumenthal D, Gabitova L, Abramson S, Condamine T, Ball M, Ohtani Y. 139 Chimeric antigen receptor macrophages (CAR-M) elicit a systemic anti-tumor immune response and synergize with PD1 blockade in immunocompetent mouse models of HER2+ solid tumors. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BackgroundDespite the remarkable efficacy achieved by CAR-T therapy in hematologic malignancies, application in solid tumors has been challenging. We previously developed human CAR-M and demonstrated that adoptive transfer of CAR-M into xenograft models of human cancer controls tumor progression and improves overall survival.1 Given that CAR-M are M1-polarized macrophages with the potential to remodel the tumor microenvironment (TME) and act as professional antigen presenting cells, we developed an immunocompetent animal model to evaluate the interaction of CAR-M with the TME and the adaptive immune system.MethodsMurine bone marrow-derived macrophages were engineered to express an anti-HER2 CAR using the chimeric adenoviral vector Ad5f35. To evaluate the safety and efficacy of CAR-M therapy, immunocompetent mice were engrafted with HER2+ tumors and treated with syngeneic CAR-M monotherapy or in combination with a PD1 blocking antibody. Tumors were collected at various time points and dynamic changes in the TME were assessed using flow cytometry, immunohistochemistry, and gene expression analysis.ResultsIn addition to efficient gene delivery, Ad5f35 transduction promoted a pro-inflammatory (M1) phenotype in murine macrophages. CAR-M, but not control macrophages, phagocytosed and killed HER2-overexpressing tumor cell lines. CAR-M induced MHC-I expression on tumor cells and enhanced the cytotoxicity of CD8+ T cells. In vivo, CAR-M led to significant tumor regression and improved overall survival in multiple syngeneic models. Analysis of the TME showed that CAR-M led to increased infiltration of intratumoral CD4+ and CD8+ T, NK, and dendritic cells – as well as an increase in T cell responsiveness to tumor-associated antigens, indicating enhanced epitope spreading. Given the impact of CAR-M on the endogenous adaptive immune system, we evaluated the combination of CAR-M with anti-PD1 in the CT26-HER2 model, which is resistant to anti-PD1 monotherapy, and found that the combination further reprogrammed the TME, enhanced tumor control, and improved overall survival compared to monotherapy with either agent. Mice that achieved complete responses (CRs) after CAR-M therapy were protected against antigen-negative relapse, indicating long-term anti-tumor immunity. Finally, the combination of CAR-M with anti-PD1 did not trigger sustained elevations of any serum analyte associated with cytokine release syndrome (CRS) and was well tolerated across numerous safety assessmentsConclusionsThese results demonstrate that CAR-M reprogram the TME, induce epitope spreading, and orchestrate a systemic immune response against solid tumors. Moreover, our findings provide rationale for the combination of CAR-M with immune checkpoint inhibitors for the treatment of solid tumors.ReferenceKlichinsky M, Ruella M, Shestova O, et al. Human chimeric antigen receptor macrophages for cancer immunotherapy. Nat Biotechnol 2020;38(8):947–953
Collapse
|
9
|
Devereux S, Jack M, Worth A, Bridges J. Calcaneotibial screws for immobilisation of the tarsocrural joint of dogs in extension: effect of the angle of screw placement on the force to failure in a canine cadaveric model. N Z Vet J 2021; 69:294-298. [PMID: 34013827 DOI: 10.1080/00480169.2021.1931522] [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: 10/21/2022]
Abstract
AIMS To compare the force to failure under axial loading of a calcaneotibial screw placed approximately perpendicular to the tibia with that of a screw placed perpendicular to the calcaneus, when used to immobilise the tarsus in an ex vivo canine model. METHODS Twelve pairs of cadaveric hindlimbs from large breed dogs, without orthopaedic or soft tissue disease, were prepared by transecting the limb at the level of the stifle and stripping the limbs of all musculature from the stifle to mid-metatarsus, including removal of the common calcaneal tendon from all limbs. The limbs in each pair were randomly assigned to receive a calcaneotibial screw placed perpendicular to the long axis of either the calcaneus (C group) or the tibia (T group) with the tarsus in full extension. The distal limb was potted in resin and the proximal tibia was pinned to allow biomechanical testing in compressive loading. Testing was performed to apply an axial load using a material testing machine in a proximodistal direction through the tibia, advancing at a rate of 10 mm/second. The force to failure was recorded in kN and compared between groups. RESULTS The median force to failure of the C group was 0.86 (min 0.50; max 1.64) kN which was higher than the T group which had a median force to failure of 0.74 (min 0.26, max1.05) kN (p = 0.004). All modes of failure were by screw pull-out. CONCLUSIONS A calcaneotibial screw placed at an angle approximately perpendicular to the long axis of the calcaneus, has a higher force to failure under axial loading than a calcaneotibial screw that is placed at an angle approximately perpendicular to the tibia, in a canine cadaveric model. CLINICAL RELEVANCE A temporary calcaneotibial screw is a common method of immobilising the tarsus in extension to protect primary repair of a common calcaneal tendon injury. Placing a calcaneotibial screw perpendicular to the calcaneus may be a more reliable option for immobilisation of the tarsus to protect a common calcaneal tendon repair compared to screws placed perpendicular to the tibia. However extrapolation of these results into a clinical setting requires caution.
Collapse
Affiliation(s)
- S Devereux
- Massey University Veterinary Teaching Hospital, School of Veterinary science, Massey University, Palmerston North, New Zealand
| | - M Jack
- Cave Veterinary Specialists, Wellington, UK
| | - A Worth
- Massey University Veterinary Teaching Hospital, School of Veterinary science, Massey University, Palmerston North, New Zealand
| | - J Bridges
- Massey University Veterinary Teaching Hospital, School of Veterinary science, Massey University, Palmerston North, New Zealand
| |
Collapse
|
10
|
Mahmood H, Kiani HR, Sheraz SY, Nair H, Worth A, Campbell H, Sheikh A, Hazir T. To document Pneumonia case management practices in selected communities of Pakistan. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The cornerstone of ARI control programs is standardized case management. According to this strategy thousands of healthcare providers have been trained in Pakistan. Given unchanged mortality statistics, there is a concern that these pieces of training have not been able to deliver the outcome.
Purpose of Study
To document current under-five pneumonia case management practices at the community level, first level care facility (FLCF) and specialist level across Pakistan.
Methodology
32 structured; disguised observations were done using an observation tool based on standard WHO pneumonia case management guidelines from each of four administrative units and the federal capital of Pakistan across the LHW level, FLCF and tertiary level. Thus, a total of 160 observations were made.
Results
At the community level, 100% LHW's did not ask for danger signs & did not expose the chest, 98% misdiagnosed pneumonia and100% prescribed antibiotics to irrespective of diagnosis. At FLCF 0.6% inquired about danger signs, 98% did not expose the chest, 80% did not use WHO classification for diagnosing pneumonia and 100% prescribed antibiotics irrespective of diagnosis. At GP's and specialist level in the private sector, 28 % inquired about at least one danger sign, 82% exposed chest, 58% did not use WHO classification for diagnosis, and 17% wrongly prescribed antibiotics. Whereas in public sector, 7% inquired about at least one danger sign, 78% exposed chest, 64% did not use WHO classification for diagnosis and 28% wrongly prescribed antibiotics.
Acknowledgment of Funding
This research was commissioned by the National Institute of Health Research using Official Development Assistance (ODA) funding. The views expressed in this publication are those of the author(s) and not necessarily those of NHS, the National Institute of Health Research, or the development of Health.
Key messages
Standard pneumonia case management guidelines are not been followed at any level of healthcare systems in Pakistan. Pneumonia case management strategies need to be revised to manage the disease.
Collapse
Affiliation(s)
- H Mahmood
- Maternal Neonatal and Child Health Research Network, Islamabad, Pakistan
| | - H R Kiani
- Maternal Neonatal and Child Health Research Network, Islamabad, Pakistan
| | - S Y Sheraz
- International Research Force, IRF, Pakistan
| | - H Nair
- University of Edinburgh, Scotland, UK
| | - A Worth
- University of Edinburgh, Scotland, UK
| | | | - A Sheikh
- University of Edinburgh, Scotland, UK
| | - T Hazir
- Maternal Neonatal and Child Health Research Network, Islamabad, Pakistan
| |
Collapse
|
11
|
Bopp S, Kienzler A, Worth A. The challenge of combined exposure to multiple chemicals: scientific and regulatory approaches to protect human health. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Every day we are exposed to low levels of hundreds of different manmade chemicals present for example in our food, consumer products and the air we breathe. Combined exposure to multiple chemicals can lead to adverse effects on human health or the ecosystem, even if single chemicals in the mixtures are below their individual safety thresholds. However, current safety assessment practice is primarily based on understanding the potential risk posed by single chemicals rather than their 'real life' combinations. In particular, while manufactured products such as pesticide formulations or cosmetic products are covered, unintentional mixtures which are coincidentally formed such as mixtures of contaminants in indoor air, are not consistently addressed. Their composition is often unknown and changes over time. The assessment of unintentional mixtures is therefore usually limited to specific legislative sectors only, such as pesticide residues in food.
Generally, methodologies to address chemical mixtures have been developed; however, there are still several data and methodological gaps to be addressed. New approach methodologies can support the filling of knowledge gaps on the toxicity and mode(s) of action of individual chemicals, to unravel links between chemical exposure and health effects. (Bio)Monitoring, modelling, and better data sharing will support the derivation of more realistic co-exposure scenarios. Considering the large number of possible combinations of chemicals in mixtures, prioritization is needed, so that actions first address mixtures of highest concern and chemicals that drive the mixture risk. As chemicals with different applications and regulated separately might lead to similar toxicological effects, it is important to consider chemical mixtures across legislative sectors.
This contribution to the workshop will summarise current challenges and ways forward in the risk assessment and risk management of mixtures for protecting public health.
Collapse
Affiliation(s)
- S Bopp
- European Commission, Joint Research Centre, Ispra, Italy
| | - A Kienzler
- European Commission, Joint Research Centre, Ispra, Italy
| | - A Worth
- European Commission, Joint Research Centre, Ispra, Italy
| |
Collapse
|
12
|
Madia F, Worth A, Whelan M, Corvi R. Carcinogenicity assessment: technical and political challenges. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
The rising rates of cancer incidence and prevalence identified by the WHO are of serious concern. The scientific advances of the past twenty years have helped to describe major properties of the cancer disease, enabling therapies that are more sophisticated. It has become clear that the management of relevant risk factors can also significantly reduce cancer occurrence worldwide. Public health policy actions cannot be decoupled from environmental policy actions, since exposure to chemicals through air, soil, water and food can contribute to cancer as well as other chronic diseases. Furthermore, due to the increasing global trend of chemical production including novel compounds, chemical exposure patterns are foreseen to change, posing high demands on chemical safety assessment, and creating potential protection gaps. The safety assessment of carcinogenicity needs to evolve to keep pace with changes in the chemical environment and cancer epidemiology. The presentation focusses on EC-JRC recommendations and future strategies for carcinogenicity safety assessment. This also includes discussion on how the traditional data streams of regulatory toxicology, together with new available assessment methods can inform, along with indicators of public health status based on biomonitoring and clinical data, a more holistic human-relevant and impactful approach to carcinogenicity assessment and overall prevention of cancer disease.
Collapse
Affiliation(s)
- F Madia
- European Commission, Joint Research Centre, Ispra, Italy
| | - A Worth
- European Commission, Joint Research Centre, Ispra, Italy
| | - M Whelan
- European Commission, Joint Research Centre, Ispra, Italy
| | - R Corvi
- European Commission, Joint Research Centre, Ispra, Italy
| |
Collapse
|
13
|
Shillitoe B, Bangs C, Guzman D, Gennery AR, Longhurst HJ, Slatter M, Edgar DM, Thomas M, Worth A, Huissoon A, Arkwright PD, Jolles S, Bourne H, Alachkar H, Savic S, Kumararatne DS, Patel S, Baxendale H, Noorani S, Yong PFK, Waruiru C, Pavaladurai V, Kelleher P, Herriot R, Bernatonienne J, Bhole M, Steele C, Hayman G, Richter A, Gompels M, Chopra C, Garcez T, Buckland M. The United Kingdom Primary Immune Deficiency (UKPID) registry 2012 to 2017. Clin Exp Immunol 2019; 192:284-291. [PMID: 29878323 DOI: 10.1111/cei.13125] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2018] [Indexed: 01/25/2023] Open
Abstract
This is the second report of the United Kingdom Primary Immunodeficiency (UKPID) registry. The registry will be a decade old in 2018 and, as of August 2017, had recruited 4758 patients encompassing 97% of immunology centres within the United Kingdom. This represents a doubling of recruitment into the registry since we reported on 2229 patients included in our first report of 2013. Minimum PID prevalence in the United Kingdom is currently 5·90/100 000 and an average incidence of PID between 1980 and 2000 of 7·6 cases per 100 000 UK live births. Data are presented on the frequency of diseases recorded, disease prevalence, diagnostic delay and treatment modality, including haematopoietic stem cell transplantation (HSCT) and gene therapy. The registry provides valuable information to clinicians, researchers, service commissioners and industry alike on PID within the United Kingdom, which may not otherwise be available without the existence of a well-established registry.
Collapse
Affiliation(s)
- B Shillitoe
- On behalf of the UKPIN Registry Committee, UKPIN, London, UK.,Great North Children's Hospital, Newcastle upon Tyne, UK.,Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - C Bangs
- On behalf of the UKPIN Registry Committee, UKPIN, London, UK.,Manchester University NHS Foundation Trust, Manchester, UK
| | - D Guzman
- On behalf of the UKPIN Registry Committee, UKPIN, London, UK.,UCL Centre for Immunodeficiency, Royal Free Hospital, London, UK
| | - A R Gennery
- On behalf of the UKPIN Registry Committee, UKPIN, London, UK.,Great North Children's Hospital, Newcastle upon Tyne, UK.,Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - H J Longhurst
- Addenbrooke's Hospital, Cambridge Universities NHS Foundation Trust, Cambridge, UK
| | - M Slatter
- Great North Children's Hospital, Newcastle upon Tyne, UK.,Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | | | - M Thomas
- NHS Greater Glasgow and Clyde, Glasgow, UK
| | - A Worth
- On behalf of the UKPIN Registry Committee, UKPIN, London, UK.,Great Ormond Street Hospital and Institute of Child Health, London, UK
| | - A Huissoon
- Heart of England NHS Foundation Trust, Birmingham, Birmingham, UK
| | - P D Arkwright
- Manchester University NHS Foundation Trust, Manchester, UK
| | - S Jolles
- University Hospital of Wales, Cardiff, UK
| | - H Bourne
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - H Alachkar
- Salford Royal NHS Foundation Trust, Salford, UK
| | - S Savic
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - D S Kumararatne
- Addenbrooke's Hospital, Cambridge Universities NHS Foundation Trust, Cambridge, UK
| | - S Patel
- John Radcliffe Hospital, Headington, Oxford, UK
| | - H Baxendale
- Papworth NHS Foundation Trust, Cambridge, UK
| | - S Noorani
- Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - P F K Yong
- Frimley Health NHS Foundation Trust, Frimley, UK
| | - C Waruiru
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - V Pavaladurai
- Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - P Kelleher
- Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | | | - J Bernatonienne
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - M Bhole
- The Dudley Group NHS Foundation Trust, Dudley, UK
| | | | - G Hayman
- Epsom and St Helier University Hospitals NHS Trust, St Helier, UK
| | - A Richter
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Gompels
- North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | | | - T Garcez
- Manchester University NHS Foundation Trust, Manchester, UK
| | - M Buckland
- On behalf of the UKPIN Registry Committee, UKPIN, London, UK.,UCL Centre for Immunodeficiency, Royal Free Hospital, London, UK.,Great Ormond Street Hospital and Institute of Child Health, London, UK
| |
Collapse
|
14
|
Lamon L, Asturiol D, Vilchez A, Ruperez-Illescas R, Cabellos J, Richarz A, Worth A. Computational models for the assessment of manufactured nanomaterials: Development of model reporting standards and mapping of the model landscape. Comput Toxicol 2019; 9:143-151. [PMID: 31008416 PMCID: PMC6472618 DOI: 10.1016/j.comtox.2018.12.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 12/05/2018] [Accepted: 12/11/2018] [Indexed: 01/31/2023]
Abstract
Different types of computational models have been developed for predicting the biokinetics, environmental fate, exposure levels and toxicological effects of chemicals and manufactured nanomaterials (MNs). However, these models are not described in a consistent manner in the scientific literature, which is one of the barriers to their broader use and acceptance, especially for regulatory purposes. Quantitative structure-activity relationships (QSARs) are in silico models based on the assumption that the activity of a substance is related to its chemical structure. These models can be used to provide information on (eco)toxicological effects in hazard assessment. In an environmental risk assessment, environmental exposure models can be used to estimate the predicted environmental concentration (PEC). In addition, physiologically based kinetic (PBK) models can be used in various ways to support a human health risk assessment. In this paper, we first propose model reporting templates for systematically and transparently describing models that could potentially be used to support regulatory risk assessments of MNs, for example under the REACH regulation. The model reporting templates include (a) the adaptation of the QSAR Model Reporting Format (QMRF) to report models for MNs, and (b) the development of a model reporting template for PBK and environmental exposure models applicable to MNs. Second, we show the usefulness of these templates to report different models, resulting in an overview of the landscape of available computational models for MNs.
Collapse
Affiliation(s)
- L. Lamon
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - D. Asturiol
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - A. Vilchez
- Leitat Technological Center, c/de la Innovació 2, Terrassa, Barcelona, Spain
| | - R. Ruperez-Illescas
- Leitat Technological Center, c/de la Innovació 2, Terrassa, Barcelona, Spain
| | - J. Cabellos
- Leitat Technological Center, c/de la Innovació 2, Terrassa, Barcelona, Spain
| | - A. Richarz
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - A. Worth
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| |
Collapse
|
15
|
Paini A, Leonard J, Joossens E, Bessems J, Desalegn A, Dorne J, Gosling J, Heringa M, Klaric M, Kliment T, Kramer N, Loizou G, Louisse J, Lumen A, Madden J, Patterson E, Proença S, Punt A, Setzer R, Suciu N, Troutman J, Yoon M, Worth A, Tan Y. Next generation physiologically based kinetic (NG-PBK) models in support of regulatory decision making. Comput Toxicol 2019; 9:61-72. [PMID: 31008414 PMCID: PMC6472623 DOI: 10.1016/j.comtox.2018.11.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 11/02/2018] [Accepted: 11/08/2018] [Indexed: 02/06/2023]
Abstract
The fields of toxicology and chemical risk assessment seek to reduce, and eventually replace, the use of animals for the prediction of toxicity in humans. In this context, physiologically based kinetic (PBK) modelling based on in vitro and in silico kinetic data has the potential to a play significant role in reducing animal testing, by providing a methodology capable of incorporating in vitro human data to facilitate the development of in vitro to in vivo extrapolation of hazard information. In the present article, we discuss the challenges in: 1) applying PBK modelling to support regulatory decision making under the toxicology and risk-assessment paradigm shift towards animal replacement; 2) constructing PBK models without in vivo animal kinetic data, while relying solely on in vitro or in silico methods for model parameterization; and 3) assessing the validity and credibility of PBK models built largely using non-animal data. The strengths, uncertainties, and limitations of PBK models developed using in vitro or in silico data are discussed in an effort to establish a higher degree of confidence in the application of such models in a regulatory context. The article summarises the outcome of an expert workshop hosted by the European Commission Joint Research Centre (EC-JRC) - European Union Reference Laboratory for Alternatives to Animal Testing (EURL ECVAM), on "Physiologically-Based Kinetic modelling in risk assessment - reaching a whole new level in regulatory decision-making" held in Ispra, Italy, in November 2016, along with results from an international survey conducted in 2017 and recently reported activities occurring within the PBK modelling field. The discussions presented herein highlight the potential applications of next generation (NG)-PBK modelling, based on new data streams.
Collapse
Affiliation(s)
- A. Paini
- European Commission Joint Research Centre, Ispra, Italy
| | - J.A. Leonard
- Oak Ridge Institute for Science and Education, 100 ORAU Way, Oak Ridge, TN 37830, USA
| | - E. Joossens
- European Commission Joint Research Centre, Ispra, Italy
| | - J.G.M. Bessems
- European Commission Joint Research Centre, Ispra, Italy
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - A. Desalegn
- European Commission Joint Research Centre, Ispra, Italy
| | - J.L. Dorne
- European Food Safety Authority, 1a, Via Carlo Magno, 1A, 43126 Parma PR, Italy
| | - J.P. Gosling
- School of Mathematics, University of Leeds, Leeds, UK
| | - M.B. Heringa
- RIVM - The National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - T. Kliment
- European Commission Joint Research Centre, Ispra, Italy
| | - N.I. Kramer
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80177, 3508TD Utrecht, The Netherlands
| | - G. Loizou
- Health and Safety Executive, Buxton, UK
| | - J. Louisse
- Division of Toxicology, Wageningen University, Tuinlaan 5, 6703 HE Wageningen, The Netherlands
- RIKILT Wageningen University and Research, Akkermaalsbos 2, 6708 WB Wageningen, The Netherlands
| | - A. Lumen
- Division of Biochemical Toxicology, National Center for Toxicological Research, US Food and Drug Administration, Jefferson, AR 72079, USA
| | - J.C. Madden
- School of Pharmacy and Bimolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool L3 3AF, UK
| | - E.A. Patterson
- School of Engineering, University of Liverpool, Liverpool L69 3GH, UK
| | - S. Proença
- European Commission Joint Research Centre, Ispra, Italy
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80177, 3508TD Utrecht, The Netherlands
| | - A. Punt
- RIKILT Wageningen University and Research, Akkermaalsbos 2, 6708 WB Wageningen, The Netherlands
| | - R.W. Setzer
- U.S. Environmental Protection Agency, National Exposure Research Laboratory, 109 TW Alexander Drive, Research Triangle Park, NC 27709, USA
| | - N. Suciu
- DiSTAS, Università Cattolica del Sacro Cuore, Piacenza, Italy
| | - J. Troutman
- Central Product Safety, The Procter & Gamble Company, Cincinnati, OH, USA
| | - M. Yoon
- ScitoVation, 6 Davis Drive, PO Box 110566, Research Triangle Park, NC 27709, USA
- ToxStrategies, Research Triangle Park Office, 1249 Kildaire Farm Road 134, Cary, NC 27511, USA
| | - A. Worth
- European Commission Joint Research Centre, Ispra, Italy
| | - Y.M. Tan
- School of Engineering, University of Liverpool, Liverpool L69 3GH, UK
| |
Collapse
|
16
|
Lamon L, Asturiol D, Vilchez A, Cabellos J, Damásio J, Janer G, Richarz A, Worth A. Physiologically based mathematical models of nanomaterials for regulatory toxicology: A review. Comput Toxicol 2019; 9:133-142. [PMID: 31008415 PMCID: PMC6472634 DOI: 10.1016/j.comtox.2018.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 10/20/2018] [Accepted: 10/23/2018] [Indexed: 11/20/2022]
Abstract
The development of physiologically based (PB) models to support safety assessments in the field of nanotechnology has grown steadily during the last decade. This review reports on the availability of PB models for toxicokinetic (TK) and toxicodynamic (TD) processes, including in vitro and in vivo dosimetry models applied to manufactured nanomaterials (MNs). In addition to reporting on the state-of-the-art in the scientific literature concerning the availability of physiologically based kinetic (PBK) models, we evaluate their relevance for regulatory applications, mainly considering the EU REACH regulation. First, we performed a literature search to identify all available PBK models. Then, we systematically reported the content of the identified papers in a tailored template to build a consistent inventory, thereby supporting model comparison. We also described model availability for physiologically based dynamic (PBD) and in vitro and in vivo dosimetry models according to the same template. For completeness, a number of classical toxicokinetic (CTK) models were also included in the inventory. The review describes the PBK model landscape applied to MNs on the basis of the type of MNs covered by the models, their stated applicability domain, the type of (nano-specific) inputs required, and the type of outputs generated. We identify the main assumptions made during model development that may influence the uncertainty in the final assessment, and we assess the REACH relevance of the available models within each model category. Finally, we compare the state of PB model acceptance for chemicals and for MNs. In general, PB model acceptance is limited by the absence of standardised reporting formats, psychological factors such as the complexity of the models, and technical considerations such as lack of blood:tissue partitioning data for model calibration/validation.
Collapse
Affiliation(s)
- L. Lamon
- European Commission, Joint Research Centre, Ispra (VA), Italy
| | - D. Asturiol
- European Commission, Joint Research Centre, Ispra (VA), Italy
| | - A. Vilchez
- Leitat Technological Center, c/de la Innovació 2, Terrassa, Barcelona, Spain
| | - J. Cabellos
- Leitat Technological Center, c/de la Innovació 2, Terrassa, Barcelona, Spain
| | - J. Damásio
- Leitat Technological Center, c/de la Innovació 2, Terrassa, Barcelona, Spain
| | - G. Janer
- Leitat Technological Center, c/de la Innovació 2, Terrassa, Barcelona, Spain
| | - A. Richarz
- European Commission, Joint Research Centre, Ispra (VA), Italy
| | - A. Worth
- European Commission, Joint Research Centre, Ispra (VA), Italy
| |
Collapse
|
17
|
Lamon L, Asturiol D, Richarz A, Joossens E, Graepel R, Aschberger K, Worth A. Grouping of nanomaterials to read-across hazard endpoints: from data collection to assessment of the grouping hypothesis by application of chemoinformatic techniques. Part Fibre Toxicol 2018; 15:37. [PMID: 30249272 PMCID: PMC6154922 DOI: 10.1186/s12989-018-0273-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [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: 01/11/2018] [Accepted: 08/28/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An increasing number of manufactured nanomaterials (NMs) are being used in industrial products and need to be registered under the REACH legislation. The hazard characterisation of all these forms is not only technically challenging but resource and time demanding. The use of non-testing strategies like read-across is deemed essential to assure the assessment of all NMs in due time and at lower cost. The fact that read-across is based on the structural similarity of substances represents an additional difficulty for NMs as in general their structure is not unequivocally defined. In such a scenario, the identification of physicochemical properties affecting the hazard potential of NMs is crucial to define a grouping hypothesis and predict the toxicological hazards of similar NMs. In order to promote the read-across of NMs, ECHA has recently published "Recommendations for nanomaterials applicable to the guidance on QSARs and Grouping", but no practical examples were provided in the document. Due to the lack of publicly available data and the inherent difficulties of reading-across NMs, only a few examples of read-across of NMs can be found in the literature. This manuscript presents the first case study of the practical process of grouping and read-across of NMs following the workflow proposed by ECHA. METHODS The workflow proposed by ECHA was used and slightly modified to present the read-across case study. The Read-Across Assessment Framework (RAAF) was used to evaluate the uncertainties of a read-across within NMs. Chemoinformatic techniques were used to support the grouping hypothesis and identify key physicochemical properties. RESULTS A dataset of 6 nanoforms of TiO2 with more than 100 physicochemical properties each was collected. In vitro comet assay result was selected as the endpoint to read-across due to data availability. A correlation between the presence of coating or large amounts of impurities and negative comet assay results was observed. CONCLUSION The workflow proposed by ECHA to read-across NMs was applied successfully. Chemoinformatic techniques were shown to provide key evidence for the assessment of the grouping hypothesis and the definition of similar NMs. The RAAF was found to be applicable to NMs.
Collapse
Affiliation(s)
- L Lamon
- European Commission, Joint Research Centre, Ispra, Varese, Italy
| | - D Asturiol
- European Commission, Joint Research Centre, Ispra, Varese, Italy.
| | - A Richarz
- European Commission, Joint Research Centre, Ispra, Varese, Italy
| | - E Joossens
- European Commission, Joint Research Centre, Ispra, Varese, Italy
| | - R Graepel
- European Commission, Joint Research Centre, Ispra, Varese, Italy
| | - K Aschberger
- European Commission, Joint Research Centre, Ispra, Varese, Italy
| | - A Worth
- European Commission, Joint Research Centre, Ispra, Varese, Italy
| |
Collapse
|
18
|
Hanssen-Doose A, Albrecht C, Schmidt SCE, Woll A, Worth A. Quantitative und qualitative Merkmale des Schulsports in Deutschland im Zusammenhang mit der Gesundheit der Schülerinnen und Schüler. Ger J Exerc Sport Res 2018. [DOI: 10.1007/s12662-018-0542-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
19
|
Affiliation(s)
- L. Lamon
- European Commission, Joint Research Centre, Ispra, Italy
| | - K. Aschberger
- European Commission, Joint Research Centre, Ispra, Italy
| | - D. Asturiol
- European Commission, Joint Research Centre, Ispra, Italy
| | - A. Richarz
- European Commission, Joint Research Centre, Ispra, Italy
| | - A. Worth
- European Commission, Joint Research Centre, Ispra, Italy
| |
Collapse
|
20
|
Madia F, Worth A, Prieto-Peraita P, Whelan M, Corvi R. PO-097 Integration of data across toxicity endpoints to explore new ways for carcinogenicity safety assessment of chemicals. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.624] [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: 11/04/2022] Open
|
21
|
Kitrinos KM, Corsa AC, Worth A, Hedskog C, Brainard DM, Miller MD, Mo H. Nonstructural protein 5A resistance profile in patients with chronic hepatitis C treated with ledipasvir-containing regimens without sofosbuvir. J Viral Hepat 2018; 25:126-133. [PMID: 28833932 DOI: 10.1111/jvh.12783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 07/21/2017] [Indexed: 01/16/2023]
Abstract
The study aimed to evaluate the effects of baseline hepatitis C virus (HCV) nonstructural protein 5A (NS5A) resistance-associated substitutions (RASs) on sustained virologic response to ledipasvir (LDV)-containing regimens in the absence of sofosbuvir (SOF) in patients with HCV genotype (GT) 1 infection across 6 phase 2 clinical studies. We analysed data from 1103 patients who received either LDV + vedroprevir (NS3 protease inhibitor) + tegobuvir (NS5B inhibitor) ± ribavirin or LDV + ribavirin + pegylated interferon. Population sequencing of HCV NS5A was performed at baseline and at virologic failure from patient plasma samples. Of 1045 patients with available baseline sequences, 747 (67.7%) had GT1a, and 298 (26.9%) had GT1b infection. The overall prevalence of NS5A RASs at baseline was 9.4%; 7.6% (57/747) and 13.8% (41/298) of patients with GT1a and GT1b infection, respectively. The majority of GT1a-infected patients with NS5A RASs at baseline had a single NS5A RAS (78.9%) at NS5A positions K24R, M28T, Q30H/L, L31M and Y93H/N/C/S. The spectrum of NS5A RASs detected in GT1b patients was much less diverse compared to GT1a patients, with all patients harbouring a single NS5A RAS either L31M or Y93H/C. For patients treated with LDV-containing regimens in the absence of SOF, the presence of baseline NS5A RASs was associated with low SVR rates. In patients with virologic failure, nearly all had either pre-existing and/or emergent NS5A RASs: 287/287 (100%) and 40/42 (95.2%) patients with GT1a and GT1b infection, respectively. Three novel NS5A substitutions were identified as emergent NS5A RASs: K26E and S38F in GT1a; and L31I in GT1b. In conclusion, the presence of NS5A RASs at baseline reduced the SVR rate in patients treated with LDV in combination vedroprevir + tegobuvir ± ribavirin or ribavirin + pegylated interferon. Virologic failure was associated with the detection of NS5A RASs in nearly all patients. These results suggest that the resistance barrier may differ depending on HCV drug combination and may be more important than that of the individual DAAs.
Collapse
Affiliation(s)
| | - A C Corsa
- Gilead Sciences, Inc., Foster City, CA, USA
| | - A Worth
- Gilead Sciences, Inc., Foster City, CA, USA
| | - C Hedskog
- Gilead Sciences, Inc., Foster City, CA, USA
| | | | - M D Miller
- Gilead Sciences, Inc., Foster City, CA, USA
| | - H Mo
- Gilead Sciences, Inc., Foster City, CA, USA
| |
Collapse
|
22
|
Paini A, Mennecozzi M, Horvat T, Gerloff K, Palosaari T, Sala Benito J, Worth A. Practical use of the Virtual Cell Based Assay: Simulation of repeated exposure experiments in liver cell lines. Toxicol In Vitro 2017; 45:233-240. [DOI: 10.1016/j.tiv.2016.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 09/05/2016] [Accepted: 10/12/2016] [Indexed: 11/26/2022]
|
23
|
Sewell DA, Hammersley VS, Robertson A, Devereux G, Stoddart A, Weir CJ, Worth A, Sheikh A. A pilot randomised controlled trial investigating a Mediterranean diet intervention in pregnant women for the primary prevention of allergic diseases in infants. J Hum Nutr Diet 2017; 30:604-614. [PMID: 28211106 DOI: 10.1111/jhn.12469] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Observational studies suggest a potentially protective role of the Mediterranean diet (MD) in allergic diseases, including asthma. Large scale randomised controlled trials (RCTs) are needed to test the hypothesised allergy-prevention benefits of a MD during pregnancy. The present two-arm pilot RCT in pregnant women at high-risk of having a child who would develop allergic disease investigated maternal recruitment, retention and acceptability of an MD dietary intervention in the UK. The trial also assessed the effect of the intervention on MD adherence scores at 12 and at 24 weeks post-randomisation. METHODS Thirty women were recruited at around 12 weeks of gestation. Retention was high (28 out of 30; 93%). The intervention was acceptable to participants. Mean (SD) adherence to the MD at baseline was 12.4 (2.9) in the intervention arm (n = 14) and 13.0 (1.9) in the control arm (n = 16), where 24 represents maximal adherence. There was a favourable short-term change in MD score: the adjusted mean difference (intervention - control) in the change in MD score from baseline to 12 weeks post-randomisation was 2.4 (95% confidence interval = 0.6-4.2, P = 0.012). CONCLUSIONS The trial provides important insights into recruitment, retention and sustaining the dietary intervention, which will be used in the design of a large RCT.
Collapse
Affiliation(s)
- D A Sewell
- School of Energy, Geosciences, Infrastructure and Society, Heriot-Watt University, Edinburgh, UK
| | - V S Hammersley
- School of Energy, Geosciences, Infrastructure and Society, Heriot-Watt University, Edinburgh, UK.,Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, Medical School, The University of Edinburgh, Edinburgh, UK
| | - A Robertson
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, Medical School, The University of Edinburgh, Edinburgh, UK
| | - G Devereux
- Child Health, University of Aberdeen, Royal Aberdeen Children's Hospital, Aberdeen, UK
| | - A Stoddart
- Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, Medical School, The University of Edinburgh, Edinburgh, UK.,Edinburgh Health Services Research Unit, Edinburgh, UK
| | - C J Weir
- Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, Medical School, The University of Edinburgh, Edinburgh, UK.,Edinburgh Health Services Research Unit, Edinburgh, UK
| | - A Worth
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, Medical School, The University of Edinburgh, Edinburgh, UK.,Wellcome Trust Clinical Research Facility, Western General Hospital, Edinburgh, UK
| | - A Sheikh
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, Medical School, The University of Edinburgh, Edinburgh, UK
| |
Collapse
|
24
|
Albrecht C, Hanssen-Doose A, Oriwol D, Bös K, Worth A. Beeinflusst eine Veränderung des BMI die Entwicklung der motorischen Leistungsfähigkeit im Kindes- und Jugendalter? Ergebnisse der Motorik-Modul Studie (MoMo). B & G 2016. [DOI: 10.1055/s-0042-112632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- C. Albrecht
- Pädagogische Hochschule Karlsruhe, Institut für Bewegungserziehung und Sport, Arbeitsbereich Bewegungsbildung, Diagnostik und Sport
| | - A. Hanssen-Doose
- Pädagogische Hochschule Karlsruhe, Institut für Bewegungserziehung und Sport, Arbeitsbereich Bewegungsbildung, Diagnostik und Sport
| | - D. Oriwol
- Pädagogische Hochschule Karlsruhe, Institut für Bewegungserziehung und Sport, Arbeitsbereich Bewegungsbildung, Diagnostik und Sport
| | - K. Bös
- Karlsruher Institut für Technologie, Institut für Sport und Sportwissenschaft
| | - A. Worth
- Pädagogische Hochschule Karlsruhe, Institut für Bewegungserziehung und Sport, Arbeitsbereich Bewegungsbildung, Diagnostik und Sport
| |
Collapse
|
25
|
Richarz A, Bois F, Exner T, Judson R, Mahony C, Ouedraogo G, Paini A, White A, Worth A, Berggren E. Applied chemical safety assessment case study for repeated dose toxicity integrating non-animal methods. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1807] [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: 11/24/2022]
|
26
|
Richarz A, Berggren E, Worth A. Evaluation of read-across argumentation according to the ECHA Read-Across Assessment Framework (RAAF). Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1305] [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: 11/16/2022]
|
27
|
Dusinska M, Boland S, Saunders M, Juillerat-Jeanneret L, Tran L, Pojana G, Marcomini A, Volkovova K, Tulinska J, Knudsen LE, Gombau L, Whelan M, Collins AR, Marano F, Housiadas C, Bilanicova D, Halamoda Kenzaoui B, Correia Carreira S, Magdolenova Z, Fjellsbø LM, Huk A, Handy R, Walker L, Barancokova M, Bartonova A, Burello E, Castell J, Cowie H, Drlickova M, Guadagnini R, Harris G, Harju M, Heimstad ES, Hurbankova M, Kazimirova A, Kovacikova Z, Kuricova M, Liskova A, Milcamps A, Neubauerova E, Palosaari T, Papazafiri P, Pilou M, Poulsen MS, Ross B, Runden-Pran E, Sebekova K, Staruchova M, Vallotto D, Worth A. Towards an alternative testing strategy for nanomaterials used in nanomedicine: lessons from NanoTEST. Nanotoxicology 2016; 9 Suppl 1:118-32. [PMID: 25923349 DOI: 10.3109/17435390.2014.991431] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [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: 11/13/2022]
Abstract
In spite of recent advances in describing the health outcomes of exposure to nanoparticles (NPs), it still remains unclear how exactly NPs interact with their cellular targets. Size, surface, mass, geometry, and composition may all play a beneficial role as well as causing toxicity. Concerns of scientists, politicians and the public about potential health hazards associated with NPs need to be answered. With the variety of exposure routes available, there is potential for NPs to reach every organ in the body but we know little about the impact this might have. The main objective of the FP7 NanoTEST project ( www.nanotest-fp7.eu ) was a better understanding of mechanisms of interactions of NPs employed in nanomedicine with cells, tissues and organs and to address critical issues relating to toxicity testing especially with respect to alternatives to tests on animals. Here we describe an approach towards alternative testing strategies for hazard and risk assessment of nanomaterials, highlighting the adaptation of standard methods demanded by the special physicochemical features of nanomaterials and bioavailability studies. The work has assessed a broad range of toxicity tests, cell models and NP types and concentrations taking into account the inherent impact of NP properties and the effects of changes in experimental conditions using well-characterized NPs. The results of the studies have been used to generate recommendations for a suitable and robust testing strategy which can be applied to new medical NPs as they are developed.
Collapse
Affiliation(s)
- M Dusinska
- Health Effects Laboratory-MILK, NILU - Norwegian Institute for Air Research , Kjeller , Norway
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Gaveras EM, Kristiansen M, Worth A, Irshad T, Sheikh A. Social support for South Asian parents with severe illness: a multiperspective qualitative study. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv171.018] [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: 11/12/2022] Open
|
29
|
Worth A, Yang C. Computational modelling for TTC assessment. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.039] [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: 11/26/2022]
|
30
|
Munn S, Gerloff K, Landesmann B, Palosaari T, Worth A, Whelan M. Using AOPs to predict Nanoparticle-induced liver toxicity. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.614] [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: 11/17/2022]
|
31
|
Bopp S, van der Linden S, Kienzler A, Bessems J, Berggren E, Worth A. Approaches, experiences and future directions in assessing human and environmental health risks from chemical mixtures – Results of an international expert survey. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.988] [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: 11/26/2022]
|
32
|
Cronin M, Bois F, Fioravanzo E, Meinl T, Neagu D, Worth A, Yang C, Richarz AN. Computational chemistry solutions supporting chemical safety assessment: Lessons learned for using in silico approaches. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.576] [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]
|
33
|
Gajewska M, Paini A, Sala Benito JV, Burton J, Worth A, Urani C, Briesen H, Schramm KW. In vitro-to-in vivo correlation of the skin penetration, liver clearance and hepatotoxicity of caffeine. Food Chem Toxicol 2014; 75:39-49. [PMID: 25455898 DOI: 10.1016/j.fct.2014.10.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 10/13/2014] [Accepted: 10/14/2014] [Indexed: 11/29/2022]
Abstract
This work illustrates the use of Physiologically-Based Toxicokinetic (PBTK) modelling for the healthy Caucasian population in in vitro-to-in vivo correlation of kinetic measures of caffeine skin penetration and liver clearance (based on literature experiments), as well as dose metrics of caffeine-induced measured HepaRG toxicity. We applied a simple correlation factor to quantify the in vitro and in vivo differences in the amount of caffeine permeated through the skin and concentration-time profiles of caffeine in the liver. We developed a multi-scale computational approach by linking the PBTK model with a Virtual Cell-Based Assay to relate an external oral and dermal dose with the measured in vitro HepaRG cell viability. The results revealed higher in vivo skin permeation profiles than those determined in vitro using identical exposure conditions. Liver clearance of caffeine derived from in vitro metabolism rates was found to be much slower than the optimised in vivo clearance with respect to caffeine plasma concentrations. Finally, HepaRG cell viability was shown to remain almost unchanged for external caffeine doses of 5-400 mg for both oral and dermal absorption routes. We modelled single exposure to caffeine only.
Collapse
Affiliation(s)
- M Gajewska
- Systems Toxicology Unit, EURL ECVAM, Institute for Health and Consumer Protection, European Commission, Joint Research Centre, Ispra, VA 21027, Italy; Wissenschaftszentrum Weihenstephan für Ernährung, Landnutzung und Umwelt, Department für Biowissenschaften, TUM, Weihenstephaner Steig 23, Freising 85350, Germany.
| | - A Paini
- Systems Toxicology Unit, EURL ECVAM, Institute for Health and Consumer Protection, European Commission, Joint Research Centre, Ispra, VA 21027, Italy
| | - J V Sala Benito
- Systems Toxicology Unit, EURL ECVAM, Institute for Health and Consumer Protection, European Commission, Joint Research Centre, Ispra, VA 21027, Italy
| | - J Burton
- Systems Toxicology Unit, EURL ECVAM, Institute for Health and Consumer Protection, European Commission, Joint Research Centre, Ispra, VA 21027, Italy
| | - A Worth
- Systems Toxicology Unit, EURL ECVAM, Institute for Health and Consumer Protection, European Commission, Joint Research Centre, Ispra, VA 21027, Italy
| | - C Urani
- Department of Earth and Environmental Sciences, University of Milano Bicocca, Piazza della Scienza 1, Milano, Italy
| | - H Briesen
- Wissenschaftszentrum Weihenstephan für Ernährung, Landnutzung und Umwelt, Lehrstuhl für Systemverfahrenstechnik, TUM, Weihenstephaner Steig 23, Freising 85350, Germany
| | - K-W Schramm
- Wissenschaftszentrum Weihenstephan für Ernährung, Landnutzung und Umwelt, Department für Biowissenschaften, TUM, Weihenstephaner Steig 23, Freising 85350, Germany; Molecular EXposomics (MEX), Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstr.1, Neuherberg D-85764, Germany
| |
Collapse
|
34
|
Gajewska M, Worth A, Urani C, Briesen H, Schramm KW. The acute effects of daily nicotine intake on heart rate--a toxicokinetic and toxicodynamic modelling study. Regul Toxicol Pharmacol 2014; 70:312-24. [PMID: 25066669 DOI: 10.1016/j.yrtph.2014.07.015] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 07/16/2014] [Accepted: 07/17/2014] [Indexed: 11/29/2022]
Abstract
Joint physiologically-based toxicokinetic and toxicodynamic (PBTK/TD) modelling was applied to simulate concentration-time profiles of nicotine, a well-known stimulant, in the human body following single and repeated dosing. Both kinetic and dynamic models were first calibrated by using in vivo literature data for the Caucasian population. The models were then used to estimate the blood and liver concentrations of nicotine in terms of the Area Under Curve (AUC) and the peak concentration (Cmax) for selected exposure scenarios based on inhalation (cigarette smoking), oral intake (nicotine lozenges) and dermal absorption (nicotine patches). The model simulations indicated that whereas frequent cigarette smoking gives rise to high AUC and Cmax in blood, the use of nicotine-rich dermal patches leads to high AUC and Cmax in the liver. Venous blood concentrations were used to estimate one of the most common acute effects, mean heart rate, both at rest and during exercise. These estimations showed that cigarette smoking causes a high peak heart rate, whereas dermal absorption causes a high mean heart rate over 48h. This study illustrates the potential of using PBTK/TD modelling in the safety assessment of nicotine-containing products.
Collapse
Affiliation(s)
- M Gajewska
- Systems Toxicology Unit and EURL ECVAM, Institute for Health and Consumer Protection, European Commission, Joint Research Centre, 21027 Ispra, VA, Italy; University of Milano Bicocca, Dep. of Earth and Environmental Sciences, Piazza della Scienza 1, Milano, Italy; TUM, Wissenschaftszentrum Weihenstephan für Ernährung und Landnutzung, Department für Biowissenschaften, Weihenstephaner Steig 23, 85350 Freising, Germany.
| | - A Worth
- Systems Toxicology Unit and EURL ECVAM, Institute for Health and Consumer Protection, European Commission, Joint Research Centre, 21027 Ispra, VA, Italy
| | - C Urani
- University of Milano Bicocca, Dep. of Earth and Environmental Sciences, Piazza della Scienza 1, Milano, Italy
| | - H Briesen
- TUM, Wissenschaftszentrum Weihenstephan für Ernährung und Landnutzung, Lehrstuhl für Systemverfahrenstechnik, Weihenstephaner Steig 23, 85350 Freising, Germany
| | - K-W Schramm
- TUM, Wissenschaftszentrum Weihenstephan für Ernährung und Landnutzung, Department für Biowissenschaften, Weihenstephaner Steig 23, 85350 Freising, Germany; Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Molecular EXposomics (MEX), Ingolstädter Landstr.1, D-85764 Neuherberg, Germany
| |
Collapse
|
35
|
Salvilla SA, Dubois AEJ, Flokstra-de Blok BMJ, Panesar SS, Worth A, Patel S, Muraro A, Halken S, Hoffmann-Sommergruber K, DunnGalvin A, Hourihane JO, Regent L, de Jong NW, Roberts G, Sheikh A. Disease-specific health-related quality of life instruments for IgE-mediated food allergy. Allergy 2014; 69:834-44. [PMID: 24836207 DOI: 10.1111/all.12427] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2014] [Indexed: 11/28/2022]
Abstract
This is one of seven interlinked systematic reviews undertaken on behalf of the European Academy of Allergy and Clinical Immunology as part of their Guidelines for Food Allergy and Anaphylaxis, which focuses on instruments developed for IgE-mediated food allergy. Disease-specific questionnaires are significantly more sensitive than generic ones in measuring the response to interventions or future treatments, as well as estimating the general burden of food allergy. The aim of this systematic review was therefore to identify which disease-specific, validated instruments can be employed to enable assessment of the impact of, and investigations and interventions for, IgE-mediated food allergy on health-related quality of life (HRQL). Using a sensitive search strategy, we searched seven electronic bibliographic databases to identify disease-specific quality of life (QOL) tools relating to IgE-mediated food allergy. From the 17 eligible studies, we identified seven disease-specific HRQL instruments, which were then subjected to detailed quality appraisal. This revealed that these instruments have undergone formal development and validation processes, and have robust psychometric properties, and therefore provide a robust means of establishing the impact of food allergy on QOL. Suitable instruments are now available for use in children, adolescents, parents/caregivers, and adults. Further work must continue to develop a clinical minimal important difference for food allergy and for making these instruments available in a wider range of European languages.
Collapse
Affiliation(s)
- S. A. Salvilla
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
| | - A. E. J. Dubois
- Department of Pediatric Pulmonology and Pediatric Allergy; GRIAC Research Institute; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
| | - B. M. J. Flokstra-de Blok
- Department of General Practice; GRIAC Research Institute; University of Groningen; University Medical Centre Groningen; Groningen the Netherlands
| | - S. S. Panesar
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
| | - A. Worth
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
| | - S. Patel
- St. George's University; Cranmer Terrace; London UK
| | - A. Muraro
- Padua General University Hospital; Padua Italy
| | - S. Halken
- Odense University Hospital; Odense C Denmark
| | - K. Hoffmann-Sommergruber
- Department of Pathophysiology and Allergy Research; Medical University of Vienna; Vienna Austria
| | - A. DunnGalvin
- Department of Paediatrics and Child Health; University College; Cork Ireland
| | - J. O’B. Hourihane
- Department of Paediatrics and Child Health; University College; Cork Ireland
| | - L. Regent
- The Anaphylaxis Campaign; Farnborough Hampshire UK
| | - N. W. de Jong
- Department of Internal Medicine; Section Allergology; ErasmusMC; Rotterdam the Netherlands
| | - G. Roberts
- David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Newport Isle of Wight
- NIHR Southampton Respiratory Biomedical Research Unit; University of Southampton and University Hospital Southampton NHS Foundation Trust
- Human Development and Health Academic Unit; Faculty of Medicine; University of Southampton; Southampton UK
| | - A. Sheikh
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
- Division of General Internal Medicine and Primary Care; Brigham and Women's Hospital/Harvard Medical School; Boston MA USA
| | | |
Collapse
|
36
|
Muraro A, Dubois AEJ, DunnGalvin A, Hourihane JO, de Jong NW, Meyer R, Panesar SS, Roberts G, Salvilla S, Sheikh A, Worth A, Flokstra-de Blok BMJ. EAACI Food Allergy and Anaphylaxis Guidelines. Food allergy health-related quality of life measures. Allergy 2014; 69:845-53. [PMID: 24785644 DOI: 10.1111/all.12405] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2014] [Indexed: 12/17/2022]
Abstract
Instruments have been developed and validated for the measurement of health-related quality of life in patients with food allergy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Guidelines for Food Allergy and Anaphylaxis Group. It draws on a systematic review of the literature on quality of life instruments for food allergy and the Appraisal of Guidelines for Research & Evaluation (AGREE II) guideline development process. Guidance is provided on the use of such instruments in research, and the current limitations of their use in clinical practice are described. Gaps in current knowledge as well as areas of future interest are also discussed. This document is relevant to healthcare workers dealing with food-allergic patients, scientists engaging in food allergy research and policy makers involved in regulatory aspects concerning food allergy and safety.
Collapse
Affiliation(s)
- A. Muraro
- Department of Mother and Child Health; The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region; University of Padua; Padua Italy
| | - A. E. J. Dubois
- Department of Pediatric Pulmonology and Pediatric Allergy; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
- GRIAC Research Institute; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - A. DunnGalvin
- Department of Pediatrics and Child Health; School of Applied Psychology; School of Medicine; University College Cork; Cork Ireland
| | - J. O'B. Hourihane
- Department of Paediatrics and Child Health; University College Cork; Cork Ireland
| | - N. W. de Jong
- Department of Internal Medicine; Section of Allergology; Erasmus MC; Rotterdam the Netherlands
| | - R. Meyer
- Department Gastroenterology; Great Ormond Street Hospital for Sick Children; London UK
| | - S. S. Panesar
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
| | - G. Roberts
- David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Isle of Wight UK
- NIHR Respiratory Biomedical Research Unit; University Hospital Southampton NHS Foundation Trust and University of Southampton Faculty of Medicine; Southampton UK
- Human Development and Health Academic Unit; Faculty of Medicine; University of Southampton; Southampton UK
| | - S. Salvilla
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
| | - A. Sheikh
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
- Division of General Internal Medicine and Primary Care; Brigham and Women's Hospital/Harvard Medical School; Boston MA USA
| | - A. Worth
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
| | - B. M. J. Flokstra-de Blok
- GRIAC Research Institute; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
- Department of General Practice; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | | |
Collapse
|
37
|
Ammann S, Elling R, Gyrd-Hansen M, Dückers G, Bredius R, Burns SO, Edgar JDM, Worth A, Brandau H, Warnatz K, Zur Stadt U, Hasselblatt P, Schwarz K, Ehl S, Speckmann C. A new functional assay for the diagnosis of X-linked inhibitor of apoptosis (XIAP) deficiency. Clin Exp Immunol 2014; 176:394-400. [PMID: 24611904 DOI: 10.1111/cei.12306] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2014] [Indexed: 12/15/2022] Open
Abstract
X-linked inhibitor of apoptosis (XIAP) deficiency, caused by mutations in BIRC4, is an immunodeficiency associated with immune dysregulation and a highly variable clinical presentation. Current diagnostic screening tests such as flow cytometry for XIAP expression or lymphocyte apoptosis assays have significant limitations. Based on recent evidence that XIAP is essential for nucleotide-binding and oligomerization domains (NOD)1/2 signalling, we evaluated the use of a simple flow cytometric assay assessing tumour necrosis factor (TNF) production of monocytes in response to NOD2 stimulation by muramyl dipeptides (L18-MDP) for the functional diagnosis of XIAP deficiency. We investigated 12 patients with XIAP deficiency, six female carriers and relevant disease controls. Irrespective of the diverse clinical phenotype, the extent of residual protein expression or the nature of the mutation, the TNF response was severely reduced in all patients. On average, L18-MDP induced TNF production in 25% of monocytes from healthy donors or female carriers, while fewer than 6% of monocytes responded in affected patients. Notably, the assay clearly discriminated affected patients from disease controls with other immunodeficiencies accompanied by lymphoproliferation, hypogammaglobulinaemia or inflammatory bowel disease. Functional testing of the NOD2 signalling pathway is an easy, fast and reliable assay in the diagnostic evaluation of patients with suspected XIAP deficiency.
Collapse
Affiliation(s)
- S Ammann
- Center of Chronic Immunodeficiency, University Medical Center, Freiburg, Germany; Faculty of Biology, University of Freiburg, Freiburg, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Gajewska M, Worth A, Urani C, Briesen H, Schramm KW. Application of physiologically-based toxicokinetic modelling in oral-to-dermal extrapolation of threshold doses of cosmetic ingredients. Toxicol Lett 2014; 227:189-202. [DOI: 10.1016/j.toxlet.2014.03.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 03/18/2014] [Accepted: 03/19/2014] [Indexed: 11/26/2022]
|
39
|
Hiwarkar P, Gajdosova E, Qasim W, Worth A, Breuer J, Chiesa R, Ridout D, Edelsten C, Moore A, Amrolia P, Veys P, Rao K. Frequent Occurrence of Cytomegalovirus Retinitis During Immune Reconstitution Warrants Regular Ophthalmic Screening in High-Risk Pediatric Allogeneic Hematopoietic Stem Cell Transplant Recipients. Clin Infect Dis 2014; 58:1700-6. [DOI: 10.1093/cid/ciu201] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
|
40
|
Kendall M, Buckingham S, Ferguson S, Sheikh A, Murray SA, Boyd K, Pinnock H, MacNee W, Worth A, White P. HELPING PEOPLE WITH VERY SEVERE COPD: FEASIBILITY STUDY OF A NOVEL COMMUNITY-BASED HOLISTIC INTERVENTION. BMJ Support Palliat Care 2014. [DOI: 10.1136/bmjspcare-2014-000653.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
41
|
Götte M, Kesting S, Albrecht C, Worth A, Bös K, Boos J. MOON-test - determination of motor performance in the pediatric oncology. Klin Padiatr 2013; 225:133-7. [PMID: 23599231 DOI: 10.1055/s-0033-1343411] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Pediatric cancer patients suffer from various negative consequences due to the disease, the medical therapy and the inactivity during the intensive treatment. Only few studies have systematically identified the adverse effects of cancer on motor performance in childhood. METHODS To determine the motor performance of pediatric cancer patients, a motor performance test was developed which is applicable for this specific patient group. Eight test items with reference values for healthy children were merged to the MOON-test (test for motor performance in the oncology). RESULTS MOON was tested for feasibility and acceptance in 33 patients aged 4-18 years. Feasibility was confirmed for children with different types of cancer (hematological malignancies and solid tumors) and with amputation, endoprosthesis, during aplasia as well as reduced general condition. Furthermore the patients showed a broad acceptance. CONCLUSION Based on the study findings, the use of MOON-test as a standardized motor performance diagnostic tool in clinical routine of oncological acute clinics as well as rehabilitation clinics can be recommended.·
Collapse
Affiliation(s)
- M Götte
- Department of Pediatric Hematology and Oncology, University Hospital of Muenster, Germany
| | | | | | | | | | | |
Collapse
|
42
|
Woll A, Worth A, Mündermann A, Hölling H, Jekauc D, Bös K. Age- and sex-dependent disparity in physical fitness between obese and normal weight children and adolescents. J Sports Med Phys Fitness 2013; 53:48-55. [PMID: 23470911] [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: 06/01/2023]
Abstract
AIM Aim of the present study was to determine whether the association between obesity and physical fitness in children and adolescents is age- and sex-specific. METHODS A total of 4519 children and adolescents aged 4-17 years grouped by age (4-5, 6-10, 11-13 and 14-17 years), sex and BMI (normal-weight: BMI≤90th percentile; overweight: BMI>90th percentile; adipose: BMI>97th percentile) participated in this large-scale representative cross-sectional study. Endurance, strength, flexibility and fine and gross motor coordination was measured using the following physical fitness tests: PWC170, push-ups test, standing long-jumps, side-to-side jumps, one-minute single leg stance on the dominant leg, balancing backwards on three beams of different width, lowest point reached by the fingertips while standing on a box with legs extended, reaction to colour changes of traffic light, tracing lines without touching the rim and sorting 25 pens. RESULTS Overweight and obese boys and girls had lower physical fitness values describing endurance, strength and gross motor coordination than normal-weight boys and girls, respectively (P<0.001 for all; boys: -12% and -19%, respectively; girls: -9% and -19%, respectively). Differences in physical fitness between weight groups were greater in older groups (P<0.001). Fine motor skills and flexibility values did not differ between weight groups. CONCLUSION The disparity in physical fitness, in particular in endurance, strength and gross motor coordination, between obese and normalweight is greater in adolescents than in children. Physical fitness programs are warranted for all overweight and obese children and adolescents but especially for overweight and obese adolescents.
Collapse
Affiliation(s)
- A Woll
- Division of Sport Science, Universität Konstanz, Konstanz, Germany.
| | | | | | | | | | | |
Collapse
|
43
|
Xu Z, Chen Y, Huang A, Varghese Z, Moorhead J, Powis S, Li Q, Ruan X, Espe KM, Raila J, Henze A, Krane V, Schweigert FJ, Hocher B, Wanner C, Drechsler C, Sahni N, Gupta KL, Prasad R, Rana SV, Bhalla A, Carrero JJ, Barany P, Yilmaz MI, Qureshi AR, Sonmez A, Heimburger O, Ozgurtas T, Yenicesu M, Lindholm B, Stenvinkel P, Schneider A, Drechsler C, Krane V, Krieter DH, Fraass U, Schneider MP, Wanner C, Leu K, Mortensen R, Worth A, Singh S, Schatz P, Young P, Wojchowski D, Green J. Treatment of malnutrition and anaemia. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
44
|
Gallagher M, Worth A, Cunningham-Burley S, Sheikh A. Epinephrine auto-injector use in adolescents at risk of anaphylaxis: a qualitative study in Scotland, UK. Clin Exp Allergy 2011; 41:869-77. [PMID: 21481022 DOI: 10.1111/j.1365-2222.2011.03743.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Adolescents with severe allergies are at particular risk of severe and fatal anaphylactic reactions. Epinephrine (adrenaline) is known to be under-utilized by teenagers. OBJECTIVE We sought to gain knowledge of adolescents' attitudes towards and experience of epinephrine auto-injectors in order to inform improvements in patient education. METHODS A qualitative study of adolescents in Scotland, UK with a history of anaphylaxis and their parents. In-depth interviews explored adolescents' accounts of anaphylactic reactions, including issues related to using epinephrine auto-injectors. Focus groups with adolescents and parents were used to discuss interventions to improve adolescent self-management of anaphylaxis. RESULTS Twenty-six adolescents and 28 parents were interviewed. Eight adolescents and 10 parents participated in separate focus groups. Most adolescents had not used the auto-injector in an anaphylactic emergency. We identified multi-faceted barriers to use, including: failure to recognize anaphylaxis; uncertainty about auto-injector technique and when to administer it; fear of using the auto-injector. Most adolescents reported carrying auto-injectors some of the time, though several found this inconvenient due to the size; only one reported non-use of an auto-injector because it had not been carried. CONCLUSION AND CLINICAL RELEVANCE Adolescents and parents reported under-use of epinephrine auto-injectors. Carriage is insufficient to ensure that auto-injectors are used. Barriers to use are multiple and complex, and unlikely to be overcome using simple educational interventions. Auto-injector training currently offered is often inadequate preparation for an emergency. A more comprehensive approach is needed, addressing the psychosocial dimensions of anaphylactic emergencies as well as treatment. Training should ideally be provided by specialist allergists or nurses, but can also be provided and reinforced in primary care.
Collapse
Affiliation(s)
- M Gallagher
- Allergy & Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Medical School, Edinburgh, UK
| | | | | | | |
Collapse
|
45
|
Worth A. Role of the European Commission's Joint Research Centre in computational toxicology. Toxicol Lett 2010. [DOI: 10.1016/j.toxlet.2010.03.116] [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]
|
46
|
Benigni R, Bossa C, Worth A. Structural analysis and predictive value of the rodent in vivo micronucleus assay results. Mutagenesis 2010; 25:335-41. [DOI: 10.1093/mutage/geq010] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
47
|
Dusinska M, Dusinska M, Fjellsbø LM, Magdolenova Z, Rinna A, Runden Pran E, Bartonova A, Heimstad ES, Harju M, Tran L, Ross B, Juillerat L, Halamoda Kenzaui B, Marano F, Boland S, Guadaginini R, Saunders M, Cartwright L, Carreira S, Whelan M, Kelin CH, Worth A, Palosaari T, Burello E, Housiadas C, Pilou M, Volkovova K, Tulinska J, Kazimirova A, Barancokova M, Sebekova K, Hurbankova M, Kovacikova Z, Knudsen L, Poulsen MS, Mose T, Vilà M, Gombau L, Fernandez B, Castell J, Marcomini A, Pojana G, Bilanicova D, Vallotto D. Testing strategies for the safety of nanoparticles used in medical applications. Nanomedicine (Lond) 2009; 4:605-7. [DOI: 10.2217/nnm.09.47] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Maria Dusinska
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - M Dusinska
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - LM Fjellsbø
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - Z Magdolenova
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - A Rinna
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - E Runden Pran
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - A Bartonova
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - ES Heimstad
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - M Harju
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - L Tran
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - B Ross
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - L Juillerat
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - B Halamoda Kenzaui
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - F Marano
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - S Boland
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - R Guadaginini
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - M Saunders
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - L Cartwright
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - S Carreira
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - M Whelan
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - CH Kelin
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - A Worth
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - T Palosaari
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - E Burello
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - C Housiadas
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - M Pilou
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - K Volkovova
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - J Tulinska
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - A Kazimirova
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - M Barancokova
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - K Sebekova
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - M Hurbankova
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - Z Kovacikova
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - L Knudsen
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - MS Poulsen
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - T Mose
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - M Vilà
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - L Gombau
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - B Fernandez
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - J Castell
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - A Marcomini
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - G Pojana
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - D Bilanicova
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| | - D Vallotto
- Health Effects Group, Norwegian Institute for Air Research (NILU), Centre for Ecology and Economics, POB 100, Instituttvn. 18, N-2027 Kjeller, Norway
| |
Collapse
|
48
|
|
49
|
Abstract
BACKGROUND Anaphylaxis is a potentially life-threatening disorder that can affect people of all ages. Young people are at a disproportionately increased risk of anaphylaxis deaths for reasons that include a failure to institute appropriate long-term management regimens. A pre-requisite for effective supported self-management of young people with anaphylaxis is a better understanding of the factors that contribute to risk-taking behaviour. OBJECTIVE To explore the psychosocial impact of living with anaphylaxis on adolescents and their parents; their management of the condition; and perceptions of health care provision. METHODS In-depth interviews were conducted with 15 participants, these comprising of seven adolescents aged between 13 and 16 years with a history of clinician-diagnosed anaphylaxis and eight of their parents, in this Scottish community-based exploratory qualitative study. RESULTS Adolescents in this study typically perceived anaphylaxis as 'no big deal', describing a relatively low impact on their day-to-day life when compared with their parents. This could largely be explained by the fact that most adolescents could not remember an anaphylactic reaction. Key obstacles to effective long-term self-management included inadequate knowledge to support detailed situation-specific risk assessment, this being compounded by a lack of confidence to make further enquiries about the ingredients of meals when with peers. Parents reported anxiety about 'handing over' the main responsibility for avoidance and emergency management to their children. Medical support for these families was very limited, with primary care teams in some cases actively hindering effective self-management. CONCLUSION Having a child with anaphylaxis can have a significant long-term psychological impact on parents and this anxiety may in some cases be transferred from parents onto their children. Parents and adolescents may benefit from tailored information to support the transition from parental- to self-management by adolescents. Access to appropriate national health service primary and specialist care was in some cases currently inadequate to support effective long-term management. Further, more in-depth research in a more heterogeneous group of adolescents is needed.
Collapse
Affiliation(s)
- N Akeson
- Allergy & Respiratory Research Group, Division of Community Health Sciences: General Practice Section, University of Edinburgh, Edinburgh, UK
| | | | | |
Collapse
|
50
|
Opper E, Worth A, Wagner M, Bös K. Motorik-Modul (MoMo) im Rahmen des Kinder- und Jugendgesundheitssurveys (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50:879-88. [PMID: 17514474 DOI: 10.1007/s00103-007-0251-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [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: 11/27/2022]
Abstract
Motor fitness and physical activity are important aspects of a healthy development in childhood and adolescence. However, the assessment of motor fitness and physical activity is not subject to standardized criteria; furthermore, the samples investigated do not provide a representative image of the whole population. Therefore, the existing data only allow very limited statements on the state and development of motor fitness and physical activity. The "Motorik" module, as part of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), offers nationwide representative data on the motor fitness and physical activity of children and adolescents for the first time. Besides the baseline-analysis, another aim is to analyse the complex relationship between motor fitness, physical activity and health. Motor fitness, based on the systematisation of motor abilities, was assessed using a test profile. The test profile consists of 11 items measuring cardiorespiratory fitness, strength, coordination and mobility. Physical activity was assessed using a questionnaire containing 51 items on the duration, intensity and frequency of physical activity in everyday life, during leisure time, at school and in sports clubs. The above-mentioned questionnaire subtopics were supplemented by questions on the weekly prevalence of at least 60 minutes of daily physical activity, on material and local conditions, as well as on cognition and motivation for physical activity. In the years 2004 to 2006, the motor fitness and physical activity of 4,529 children and young people between the ages of 4 and 17 years was investigated on 168 sample points in the context of the "Motorik" module. Half of the children and adolescents investigated belong to the middle class, approximately 15% have a background of migration. The majority of the subjects come from small towns, about a quarter live in the city, less than 20% are settled in rural areas.
Collapse
|