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Caon E, Martins M, Hodgetts H, Blanken L, Vilia MG, Levi A, Thanapirom K, Al-Akkad W, Abu-Hanna J, Baselli G, Hall AR, Luong TV, Taanman JW, Vacca M, Valenti L, Romeo S, Mazza G, Pinzani M, Rombouts K. Exploring the impact of the PNPLA3 I148M variant on primary human hepatic stellate cells using 3D extracellular matrix models. J Hepatol 2024:S0168-8278(24)00110-7. [PMID: 38365182 DOI: 10.1016/j.jhep.2024.01.032] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/24/2024] [Accepted: 01/27/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND & AIMS The PNPLA3 rs738409 C>G (encoding for I148M) variant is a risk locus for the fibrogenic progression of chronic liver diseases, a process driven by hepatic stellate cells (HSCs). We investigated how the PNPLA3 I148M variant affects HSC biology using transcriptomic data and validated findings in 3D-culture models. METHODS RNA sequencing was performed on 2D-cultured primary human HSCs and liver biopsies of individuals with obesity, genotyped for the PNPLA3 I148M variant. Data were validated in wild-type (WT) or PNPLA3 I148M variant-carrying HSCs cultured on 3D extracellular matrix (ECM) scaffolds from human healthy and cirrhotic livers, with/without TGFB1 or cytosporone B (Csn-B) treatment. RESULTS Transcriptomic analyses of liver biopsies and HSCs highlighted shared PNPLA3 I148M-driven dysregulated pathways related to mitochondrial function, antioxidant response, ECM remodelling and TGFB1 signalling. Analogous pathways were dysregulated in WT/PNPLA3-I148M HSCs cultured in 3D liver scaffolds. Mitochondrial dysfunction in PNPLA3-I148M cells was linked to respiratory chain complex IV insufficiency. Antioxidant capacity was lower in PNPLA3-I148M HSCs, while reactive oxygen species secretion was increased in PNPLA3-I148M HSCs and higher in bioengineered cirrhotic vs. healthy scaffolds. TGFB1 signalling followed the same trend. In PNPLA3-I148M cells, expression and activation of the endogenous TGFB1 inhibitor NR4A1 were decreased: treatment with the Csn-B agonist increased total NR4A1 in HSCs cultured in healthy but not in cirrhotic 3D scaffolds. NR4A1 regulation by TGFB1/Csn-B was linked to Akt signalling in PNPLA3-WT HSCs and to Erk signalling in PNPLA3-I148M HSCs. CONCLUSION HSCs carrying the PNPLA3 I148M variant have impaired mitochondrial function, antioxidant responses, and increased TGFB1 signalling, which dampens antifibrotic NR4A1 activity. These features are exacerbated by cirrhotic ECM, highlighting the dual impact of the PNPLA3 I148M variant and the fibrotic microenvironment in progressive chronic liver diseases. IMPACT AND IMPLICATIONS Hepatic stellate cells (HSCs) play a key role in the fibrogenic process associated with chronic liver disease. The PNPLA3 genetic mutation has been linked with increased risk of fibrogenesis, but its role in HSCs requires further investigation. Here, by using comparative transcriptomics and a novel 3D in vitro model, we demonstrate the impact of the PNPLA3 genetic mutation on primary human HSCs' behaviour, and we show that it affects the cell's mitochondrial function and antioxidant response, as well as the antifibrotic gene NR4A1. Our publicly available transcriptomic data, 3D platform and our findings on NR4A1 could facilitate the discovery of targets to develop more effective treatments for chronic liver diseases.
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Affiliation(s)
- Elisabetta Caon
- Regenerative Medicine and Fibrosis Group, Institute for Liver and Digestive Health, University College London, Royal Free Campus, London, UK
| | - Maria Martins
- Regenerative Medicine and Fibrosis Group, Institute for Liver and Digestive Health, University College London, Royal Free Campus, London, UK
| | - Harry Hodgetts
- Regenerative Medicine and Fibrosis Group, Institute for Liver and Digestive Health, University College London, Royal Free Campus, London, UK
| | - Lieke Blanken
- Regenerative Medicine and Fibrosis Group, Institute for Liver and Digestive Health, University College London, Royal Free Campus, London, UK
| | - Maria Giovanna Vilia
- Regenerative Medicine and Fibrosis Group, Institute for Liver and Digestive Health, University College London, Royal Free Campus, London, UK
| | - Ana Levi
- Regenerative Medicine and Fibrosis Group, Institute for Liver and Digestive Health, University College London, Royal Free Campus, London, UK
| | - Kessarin Thanapirom
- Regenerative Medicine and Fibrosis Group, Institute for Liver and Digestive Health, University College London, Royal Free Campus, London, UK
| | - Walid Al-Akkad
- Regenerative Medicine and Fibrosis Group, Institute for Liver and Digestive Health, University College London, Royal Free Campus, London, UK
| | - Jeries Abu-Hanna
- Research Department of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, London, UK
| | - Guido Baselli
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Andrew R Hall
- Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust, London, UK; Department of Cellular Pathology, Royal Free London NHS Foundation Trust, London, UK
| | - Tu Vinh Luong
- Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust, London, UK; Department of Cellular Pathology, Royal Free London NHS Foundation Trust, London, UK
| | - Jan-Willem Taanman
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London UK
| | - Michele Vacca
- Laboratory of Hepatic Metabolism and NAFLD, Roger Williams Institute of Hepatology, London, UK; Clinica Medica "Frugoni", Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy; Precision Medicine, Biological Resource Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Romeo
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - Giuseppe Mazza
- Regenerative Medicine and Fibrosis Group, Institute for Liver and Digestive Health, University College London, Royal Free Campus, London, UK
| | - Massimo Pinzani
- Regenerative Medicine and Fibrosis Group, Institute for Liver and Digestive Health, University College London, Royal Free Campus, London, UK
| | - Krista Rombouts
- Regenerative Medicine and Fibrosis Group, Institute for Liver and Digestive Health, University College London, Royal Free Campus, London, UK.
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2
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Levi A, Pugsley A, Fernandes MA, Turner GR, Gilboa A. Drawing improves memory in patients with hippocampal damage. Mem Cognit 2024:10.3758/s13421-023-01505-4. [PMID: 38180603 DOI: 10.3758/s13421-023-01505-4] [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] [Accepted: 12/04/2023] [Indexed: 01/06/2024]
Abstract
The hippocampus plays a critical role in the formation of declarative memories, and hippocampal damage leads to significant impairments in new memory formation. Drawing can serve as a form of multi-modal encoding that improves declarative memory performance relative to other multimodal encoding strategies such as writing. We examined whether, and to what extent, patients with hippocampal damage could benefit from the mnemonic strategy of drawing. Three patients with focal hippocampal damage, and one patient with both hippocampal and cortical lesions, in addition to 22 age-, sex-, and education-matched controls, were shown a list of words one at a time during encoding and instructed to either draw a picture or repeatedly write each word for 40 s. Following a brief filled delay, free recall and recognition memory for words from both encoding trial types were assessed. Controls showed enhanced recall and recognition memory for words drawn versus those that were written, an effect that was even more pronounced in patients with focal hippocampal damage. By contrast, the patient with both hippocampal and cortical lesions showed no drawing-mediated boost in either recall or recognition memory. These findings demonstrate that drawing is an effective encoding strategy, likely accruing from the engagement of extra-hippocampal processes including the integration of cortical-based motor, visual, and semantic processing, enabling more elaborative encoding.
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Affiliation(s)
- A Levi
- Rotman Research Institute at Baycrest Hospital, 3560 Bathurst St., North York, Ontario, M6A 2E1, Canada.
- Department of Psychology, York University, Toronto, Ontario, Canada.
| | - A Pugsley
- Rotman Research Institute at Baycrest Hospital, 3560 Bathurst St., North York, Ontario, M6A 2E1, Canada
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - M A Fernandes
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - G R Turner
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - A Gilboa
- Rotman Research Institute at Baycrest Hospital, 3560 Bathurst St., North York, Ontario, M6A 2E1, Canada.
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada.
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
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3
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Schamroth Pravda N, Mishaev R, Levi A, Witberg G, Shapira Y, Orvin K, Talmor Barkan Y, Hamdan A, Sharoni R, Perl L, Sagie A, Vaknin Assa H, Kornowski R, Codner P. 5-year outcomes of patients with mitral structural valve deterioration treated with transcatheter valve in valve implantation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2113] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
The Valve-in-Valve (ViV) technique is an emerging alternative for the treatment of bioprosthetic structural valve deterioration (SVD) in the mitral position. We report on intermediate-term outcomes of patients with symptomatic SVD in the mitral position who were treated by transcatheter mitral valve-in-valve (TM-ViV) implantation during the years 2010–2019 in our center. Three main outcomes were examined during the follow-up period: NYHA functional class, TM-ViV hemodynamic data per echocardiography, and mortality. Our cohort consisted of 49 patients (mean age 77.4±10.5 years, 65.3% female). The indications for TM-ViV were mainly for regurgitant pathology (77.6%). All 49 patients were treated with a balloon-expandable device. The procedure was performed via transapical access in 17 cases (34.7%) and transfemoral vein / trans-atrial septal puncture in 32 cases (65.3%). Mean follow-up was 4.4±2.0 years. 98% and 91% of patients were in NYHA I/II at 1 and 5 years respectively. Mitral regurgitation was ≥ moderate in 86.3% of patients prior to the procedure and this decreased to 0% (p<0.001) following the procedure and was maintained over 2 years follow-up. The mean trans-mitral valve gradients decreased from pre-procedural values of 10.1±5.1mmHg to 7.0±2.4mmHg at one month following the procedure (p=0.03). Mortality at one year was 16% (95%, CI 5–26) and 35% (95%, CI 18–49) at 5 years. ViV in the mitral position offers an effective and durable treatment option for patients with SVD at high surgical risk.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - R Mishaev
- Tel Aviv University, Sackler Medical School , Tel Aviv , Israel
| | - A Levi
- Rabin Medical Center , Petah Tikva , Israel
| | - G Witberg
- Rabin Medical Center , Petah Tikva , Israel
| | - Y Shapira
- Rabin Medical Center , Petah Tikva , Israel
| | - K Orvin
- Rabin Medical Center , Petah Tikva , Israel
| | | | - A Hamdan
- Rabin Medical Center , Petah Tikva , Israel
| | - R Sharoni
- Rabin Medical Center , Petah Tikva , Israel
| | - L Perl
- Rabin Medical Center , Petah Tikva , Israel
| | - A Sagie
- Rabin Medical Center , Petah Tikva , Israel
| | | | | | - P Codner
- Rabin Medical Center , Petah Tikva , Israel
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4
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Kheifets M, Vons SA, Bental T, Vaknin-Assa H, Perl L, Kornowski R, Levi A. Temporal trends in complex PCI interventions. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1243] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Accumulated experience combined with technological advancements in the field of complex percutaneous coronary intervention (C-PCI), have led to a gradual increase in both quantity and complexity of PCI procedures over the last 20 years. Despite the amount and frequency of these complex interventions, data regarding outcomes is lacking.
Methods
The study was based on a prospective registry of 20,301 consecutive procedures with a follow up of at least 1 year. C-PCIs were defined as at least one of the following: Chronic total occlusion (CTO), left main (LM), bifurcation or saphenous vein graft (SVG) PCI. We compared trends during four different time periods (2008–2010, 2011–2013, 2014–2016, 2017–2019). Endpoints included mortality and major adverse cardiac events [MACE: death, repeat myocardial infarction (re-MI), and target vessel revascularization (TVR)] at 1 year.
Results
The rate of C-PCI procedures has risen significantly since 2017 (p<0.01), driven mainly by bifurcation and LM interventions (p<0.01). At 1-year, rates of death (p<0.001), re-MI (p<0.001), TVR (p=0.001) and MACE (p<0.001), were all significantly higher in the C-PCI group, as compared to the non-complex group. Rates of TVR (p=0.01) and MACE (p<0.001) at 1-year, were significantly higher in the C-PCIs which were performed between 2008–2010 and 2011–2013, as compared to C-PCIs performed between 2014–2016 and 2017–2019. Death rates did not significantly differ between C-PCI periods.
Conclusions
Although frequency of C-PCIs is on the rise, overall outcomes become increasingly better, as compared to earlier periods. Unfortunately, this has not translated into a decrease in mortality.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Kheifets
- Rabin Medical Center , Petah Tikva , Israel
| | - S A Vons
- Rabin Medical Center , Petah Tikva , Israel
| | - T Bental
- Rabin Medical Center , Petah Tikva , Israel
| | | | - L Perl
- Rabin Medical Center , Petah Tikva , Israel
| | | | - A Levi
- Rabin Medical Center , Petah Tikva , Israel
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5
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Skalsky K, Levi A, Bental T, Vaknin-Assa H, Assali A, Steinmetz T, Kornowski R, Perl L. Acute kidney injury definition following PCI and cardiovascular outcomes. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1108] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Acute kidney injury (AKI) is a complication of percutaneous coronary intervention (PCI), known to increase rates of adverse medical events. We aimed to identify the optimal definition of AKI in predicting of adverse cardiovascular outcomes and mortality post PCI.
Methods
From a large registry of patients undergoing PCI between 2006–2018 (n=25,690) at two hospitals, consecutive patients were assessed for the presence of AKI according to four different definitions: a relative elevation of ≥25% or ≥50%; or an absolute elevation of ≥0.3 mg/dL or ≥0.5 mg/dL in serum creatinine at 48 hours post PCI. We assessed the calculated rates of AKI according to the different definitions. The discriminant capacity for 30-day and 1-year mortality and MACE (MACE: all-cause death, myocardial infarction, target-vessel revascularization and coronary artery bypass graft surgery) of each definition was calculated using ROC curves and AUCs.
Results
Data of 15,153 patients was available for final analysis. Rates of AKI were 12.1%, 3.2%, 8.1% and 3.9% according to the four definitions, respectively. The discriminant capacity of adverse outcomes was highest among those defined as AKI according to the third definition - an absolute elevation of ≥0.3 mg/dL in serum creatinine with an AUC of 0.82 (95% CI 0.80–0.84) for 30-day mortality (P value = 0.036) and an AUC of 0.78 (CI 0.76–0.79) for 30 days MACE.
Conclusions
An absolute elevation of ≥0.3 mg/dL in serum creatinine 48 hours post PCI predicts overall mortality and MACE most accurately.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Skalsky
- Rabin Medical Center, Petah Tikva, Israel
| | - A Levi
- Rabin Medical Center, Petah Tikva, Israel
| | - T Bental
- Rabin Medical Center, Petah Tikva, Israel
| | | | - A Assali
- Meir Medical Center, Kfar Saba, Israel
| | | | | | - L Perl
- Rabin Medical Center, Petah Tikva, Israel
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6
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Skalsky K, Abu T, Levi A, Bental T, Hirsh R, Samara A, Vaknin-Assa H, Perl L, Codner P, Rosengarten D, Kramer MR, Kornowski R, Hadsai D. Preoperative evaluation of pulmonary hypertension in lung transplant candidates: echocardiography versus right heart catheterization. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2794] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Right heart catheterization (RHC) and echocardiography are both routinely used for pulmonary hypertension (PH) assessment in LT candidates, although this is not mandatory according to guidelines. We aim to describe the correlation between the pulmonary artery systolic pressure (PASP) measured by echocardiography to that measured by RHC in this population.
Methods
From a retrospective registry of 461 LT candidates, undergoing RHC between 2015–2019, 393 consecutive patients were assessed for the presence of pulmonary hypertension according to two methods – echocardiography and RHC. The primary outcome was the correlation between the estimated PASP measured by echocardiography to that measured by RHC. Secondary outcome was the accuracy of the echocardiographic assessment of PH.
Results
Patients were predominantly males (63.6%) with a mean age of 61.46±8.33y. The two most common etiologies for lung failure were interstitial lung disease or pulmonary fibrosis (52.2%) and chronic obstructive pulmonary disease (30.5%). Estimated PASP as measured by echocardiography was available in 89.31% of the patients, with a mean value of 49.5±20.02 mmHg. Mean PASP measured by RHC was 42.47±17.96 mmHg. The correlation between the two measurements was moderate (Pearson's correlation: r=0.609, p<0.01). The accuracy of the echocardiographic estimation of PASP was poor with >10 mmHg differences between the two values in 79.9% of the patients.
Conclusions
In the pre-surgical evaluation of LT candidates, echocardiographic estimation of PASP has moderate correlation with the PASP measured by RHC and relatively poor accuracy.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Skalsky
- Rabin Medical Center, Petah Tikva, Israel
| | - T Abu
- Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - A Levi
- Rabin Medical Center, Petah Tikva, Israel
| | - T Bental
- Rabin Medical Center, Petah Tikva, Israel
| | - R Hirsh
- Rabin Medical Center, Petah Tikva, Israel
| | - A Samara
- Rabin Medical Center, Petah Tikva, Israel
| | | | - L Perl
- Rabin Medical Center, Petah Tikva, Israel
| | - P Codner
- Rabin Medical Center, Petah Tikva, Israel
| | | | - M R Kramer
- Rabin Medical Center, Petah Tikva, Israel
| | | | - D Hadsai
- Rabin Medical Center, Petah Tikva, Israel
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7
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Schamroth Pravda N, Codner P, Vaknin Assa H, Vitberg G, Perl L, Shapira Y, Levi A, Mishaev R, Talmor Barkan Y, Sharoni R, Hamdan A, Landes U, Kornowski R. Long term outcomes of patients with aortic structural valve deterioration treated with transcatheter valve in valve implantation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1627] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The Valve-in-Valve (ViV) technique is an established alternative for the treatment of structural bioprosthetic valve deterioration (SVD). Data describing the long term follow up of patients treated with this approach is scarce. We report on our long-term follow up outcomes of patients with SVD in the Aortic position treated with ViV.
Methods
Included were patients with symptomatic SVD in the aortic position valve who were treated by Valve in valve transcatheter aortic valve implantation (ViV-TAVI) during the years 20102019 in our center. Three main outcomes were examined during follow up: NYHA functional class, hemodynamic of the VIV-TAVI per echocardiography, and overall mortality.
Results
Our cohort consisted of 84 patients (mean age 78.8±8.9 years). The indications for aortic ViV were: SVD isolated aortic stenosis in 37.6%, SVD isolated aortic regurgitation in 42.2% and combined valve pathology in 20.0%. Self-expandable and balloon-expandable devices were used in 73 (85.9%) and 12 (14.1%), respectively. Average time of follow up was 3.74±2.4 years. 95% and 91% of patients were in NYHA functional class I/II at 1 and 5 year follow up respectively. At one year the mean trans-aortic valve pressure was 15.3±9.3 and rates of ≥ moderate aortic regurgitation were 3.7%. Survival was 91.4% (95% CI 85.6–97.7) at one year and 79.5% (95% CI 70.2–90.0) at 3 years.
Conclusion
ViV in the aortic position offers an effective and durable treatment option for patient with SVD, with low rates of all-cause mortality, excellent hemodynamic and improved functional capacity at 3 years follow up.
Funding Acknowledgement
Type of funding sources: None. NYHA functional class over follow up
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Affiliation(s)
| | - P Codner
- Rabin Medical Center, Petah Tikva, Israel
| | | | - G Vitberg
- Rabin Medical Center, Petah Tikva, Israel
| | - L Perl
- Rabin Medical Center, Petah Tikva, Israel
| | - Y Shapira
- Rabin Medical Center, Petah Tikva, Israel
| | - A Levi
- Rabin Medical Center, Petah Tikva, Israel
| | - R Mishaev
- Tel Aviv University, Sackler Medical School, Tel Aviv, Israel
| | | | - R Sharoni
- Rabin Medical Center, Petah Tikva, Israel
| | - A Hamdan
- Rabin Medical Center, Petah Tikva, Israel
| | - U Landes
- Rabin Medical Center, Petah Tikva, Israel
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8
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Kheifets M, Levi A, Bental T, Perl L, Codner P, Wittberg G, Talmor-Barkan Y, Landes U, Samara A, Greenberg G, Erez A, Vaknin-Assa H, Kornowski R. Biodegradable polymer drug eluting stents versus durable polymer drug eluting stents for percutaneous coronary intervention. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2137] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Invasive angiography with subsequent revascularization is a widely used treatment method in patients with coronary heart disease. Although biodegradable polymer drug eluting stents (BP-DES) have been used for almost a decade now, clinical trials regarding their long-term outcomes are both sparse and inconsistent. We aimed to compare the long-term outcomes of patients undergoing percutaneous coronary intervention (PCI) with BP-DES versus durable polymer drug eluting stents (DP-DES).
Methods
Among 11,517 PCIs with second generation drug eluting stents preformed in our institution between 2007 and 2019, we identified 8042 procedures performed using DP-DES and 3475 using BP-DES. The primary outcome was the composite of all-cause mortality, recurrent myocardial infarction (re-MI), target vessel revascularization (TVR) and coronary artery bypass grafting (CABG). Propensity score matching was used to create a well-balanced cohort.
Results
Mean follow up was 4.8 years. Of the 3,413 matched pairs, 21% were females, and the mean age was 66. At one year, the primary outcome occurred in 9.6% patients versus 8.3% (p=0.05), and TVR rate was 4.1% versus 3% (p=0.005) in patients with DP-DES and BP-DES respectively. Within 5 years, the primary outcome occurred in in 24.9% versus 24.8% (p=0.83), and the rate of TVR was 9.8% versus 9.1% (p=0.07) in patients with DP-DES and BP-DES respectively.
Conclusions
Similar rates of the composite outcome were observed throughout the entire follow-up. TVR rates were lower in the DP-DES group at 1-year but equalized within 5 years.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Kheifets
- Rabin Medical Center, Cardiology, Petah Tikva, Israel
| | - A Levi
- Rabin Medical Center, Cardiology, Petah Tikva, Israel
| | - T Bental
- Rabin Medical Center, Cardiology, Petah Tikva, Israel
| | - L Perl
- Rabin Medical Center, Cardiology, Petah Tikva, Israel
| | - P Codner
- Rabin Medical Center, Cardiology, Petah Tikva, Israel
| | - G Wittberg
- Rabin Medical Center, Cardiology, Petah Tikva, Israel
| | | | - U Landes
- Rabin Medical Center, Cardiology, Petah Tikva, Israel
| | - A Samara
- Rabin Medical Center, Cardiology, Petah Tikva, Israel
| | - G Greenberg
- Rabin Medical Center, Cardiology, Petah Tikva, Israel
| | - A Erez
- Rabin Medical Center, Cardiology, Petah Tikva, Israel
| | - H Vaknin-Assa
- Rabin Medical Center, Cardiology, Petah Tikva, Israel
| | - R Kornowski
- Rabin Medical Center, Cardiology, Petah Tikva, Israel
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9
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Eliaz R, Mengesha B, Ovdat T, Iakobishvili Z, Hasdai D, Kheifets M, Klempfner R, Beigel R, Kalmanovich E, Alcalai R, Levi A. Reversible P2Y12 inhibitor versus irreversible P2Y12 inhibitor in ACS patients undergoing PCI (the acute coronary syndrome israeli survey (ACSIS). Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1414] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Based on data from randomized controlled trials, both American and European guidelines recommend treating acute coronary syndrome (ACS) patients with second generation P2Y12 inhibitors.1,2 Direct head-to-head comparison of these agents was scarce until the recent publication of the ISAR-REACT-5 study which demonstrated the superiority of the Irreversible thienopyridine type P2Y12 inhibitor (prodrug) over the reversible P2Y12 inhibitor in terms of 1-year composite of death, myocardial infarction (MI), and stroke.3,4,5 Given the unexpected outcomes of this trial, we sought to perform a comparison of ticagrelor and prasugrel in real-life ACS patients.
Purpose
To compare the outcomes of ACS (acute coronary syndrome) patients undergoing in-hospital PCI (percutaneous coronary intervention) treated with the Irreversible thienopyridine type P2Y12 inhibitor (prodrug) versus the reversible P2Y12 inhibitor.
Methods
ACSIS (Acute Coronary Syndrome in Israel) is a national ACS snapshot survey conducted in all 25 cardiology departments in Israel since 2000 over a two-month period, every two to three years. Both the Irreversible thienopyridine type P2Y12 inhibitor (prodrug) and the reversible P2Y12 inhibitor were commercially introduced in Israel in 2010. We therefore considered patients enrolled in ACSIS surveys 2010–2018 for the present analysis.
Results
Among 7,233 patients enrolled to the ACSIS (Acute Coronary Syndrome in Israel) registry between 2010 and 2018, we identified 1133 eligible patients treated with the Irreversible thienopyridine type P2Y12 inhibitor (prodrug) and 825 with the reversible P2Y12 inhibitor. In hospital complication rates, including rates of stent thrombosis, were roughly similar between groups. Compared to the reversible P2Y12 inhibitor, the Irreversible thienopyridine type P2Y12 inhibitor (prodrug) was associated with lower 1-year death in ST-elevation myocardial infarction (STEMI) patient compared to non-ST-elevation ACS (NSTE-ACS) patients (p for interaction 0.03). In propensity score matched STEMI patients (502 receiving the Irreversible thienopyridine type P2Y12 inhibitor (prodrug), 251 the reversible P2Y12 inhibitor) 30-day re-hospitalization rate (p<0.05), 30-day MACE (the composite of death, MI, stroke, urgent revascularization; p=0.006), and 1-year mortality rates (p=0.08) were higher in the the reversible P2Y12 inhibitor group compared to the the Irreversible thienopyridine type P2Y12 inhibitor (prodrug) group; In NSTE-ACS patients, outcomes were not impacted by drug choice.
Conclusion
The Irreversible thienopyridine type P2Y12 inhibitor (prodrug) was more effective than the reversible P2Y12 inhibitor in STEMI patients, but not in NSTE-ACS patients.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): the Israeli working group on acute cardiac care of the Israel heart society
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Affiliation(s)
- R Eliaz
- Hadassah-Hebrew University, Jerusalem, Israel
| | - B Mengesha
- Tel Aviv University, 2. Shamir Medical Center, Tel Aviv, Israel
| | - T Ovdat
- Tel Aviv University, Israel Center for Cardiovascular Research, Sheba Medical Center, Tel Aviv, Israel
| | - Z Iakobishvili
- Tel Aviv University, 5. Kupat Holim Clalit, Tel Aviv district, Tel Aviv, Israel
| | - D Hasdai
- Tel Aviv University, 6. Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel, Tel Aviv, Israel
| | - M Kheifets
- Tel Aviv University, 6. Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel, Tel Aviv, Israel
| | - R Klempfner
- Tel Aviv University, Israel Center for Cardiovascular Research, Sheba Medical Center, Tel Aviv, Israel
| | - R Beigel
- Tel Aviv University, 6. Department of Cardiology, Rabin Medical Center, Tel Aviv, Israel
| | - E Kalmanovich
- Tel Aviv University, 2. Shamir Medical Center, Tel Aviv, Israel
| | - R Alcalai
- Hadassah-Hebrew University, Jerusalem, Israel
| | - A Levi
- Tel Aviv University, 2. Shamir Medical Center, Tel Aviv, Israel
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10
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Galili E, Levi A, Lapidoth M, Barzilai A, Hodak E, Rimon U. Percutaneous ethanol sclerotherapy is a promising treatment for recalcitrant angiolymphoid hyperplasia with eosinophilia. Clin Exp Dermatol 2021; 47:568-572. [PMID: 34559911 DOI: 10.1111/ced.14940] [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] [Received: 05/07/2021] [Revised: 08/31/2021] [Accepted: 09/20/2021] [Indexed: 11/29/2022]
Abstract
Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare benign vascular proliferation, which manifests as characteristic red nodules and papules, mostly located on the scalp and periauricular regions. Patients seek treatment for both aesthetic and functional reasons, as lesions may ulcerate, bleed and itch. Many therapeutic approaches have been reported, with variable success, and relapse remains a troublesome issue. The aim of this study was to report our experience treating ALHE using percutaneous ethanol sclerotherapy (PES). We present a retrospective case series of three patients treated with PES (1-2 treatment sessions each). All patients had tried and failed other treatments prior to this intervention, but following PES treatment, all patients demonstrated significant improvement, which was sustained at follow-up (range 8-17 months after first treatment). Adverse effects were tolerable and transient. This case series demonstrates PES as a promising treatment for recalcitrant ALHE.
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Affiliation(s)
- E Galili
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Levi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
| | - M Lapidoth
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
| | - A Barzilai
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Hodak
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
| | - U Rimon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Interventional Radiology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
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11
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Dautzenberg B, Levi A, Adler M, Gaillard R. Transdermal nicotine in non-smokers: A systematic review to design COVID-19 clinical trials. Respir Med Res 2021; 80:100844. [PMID: 34153704 PMCID: PMC8183099 DOI: 10.1016/j.resmer.2021.100844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/21/2020] [Revised: 05/26/2021] [Accepted: 05/29/2021] [Indexed: 01/08/2023]
Abstract
Recent data show an interaction between COVID-19 and nicotine and indicate the need for an assessment of transdermal nicotine use in non-smokers. Assessments have been conducted into the short-term cognitive effects of nicotine and into diseases such as Parkinson's, Tourette syndrome, ADHD or ulcerative colitis. METHODS Analyses of nicotine administration protocols and safety were conducted after reviewing Medline and Science Direct databases performing a search using the words [transdermal nicotine] AND [non-smoker] AND selected diseases. RESULTS Among 298 articles identified, there were 35 reviewed publications reporting on 33 studies of non-smokers receiving transdermal nicotine for >48hours. In the 16 randomized trials, 7 crossover, 1 case/control and 9 open studies patients received an initial nicotine dose of between 2.5mg and 15mg/day. In 22 studies, daily doses increased by 2 to 7 steps in 3 to 96 days until the dose was between 5mg and 105mg/day. The target nicotine dose was 19.06±20.89mg/day. The 987 non-smokers (534 never-smokers, 326 ex-smokers and 127 classified as "non-smokers") received or did not receive nicotine. The most common side-effects were nausea and skin itching. Forty-three (7.1%) non-smokers stopped treatment because of an adverse event of nicotine. No hospitalization related to nicotine side-effects were reported. CONCLUSION Despite a relatively safe tolerance profile, transdermal nicotine therapy in non-smokers can only be used in clinical trials. There is a lack of formal assessment of the potential risk of developing a tobacco addiction. This review offers baseline data to set a transdermal nicotine protocol for non-smokers with a new purpose.
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Affiliation(s)
- B Dautzenberg
- APHP Sorbonne University, Pitié-Salpêtrière Hospital, 75013 Paris, France; Institut Arthur Vernes, Smoking Cessation Unit, 75006 Paris, France.
| | - A Levi
- Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, 75014 Paris, France
| | - M Adler
- Smoking Cessation Unit, Hôpital Antoine, Béclère APHP, 92140 Clamart, France
| | - R Gaillard
- Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, 75014 Paris, France; Université de Paris, 75006 Paris, France; Unité de Neuropathologie expérimentale, Département Santé Globale, Institut Pasteur, 75015 Paris, France
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12
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Greenberger S, Stein R, Ollech A, Hartstein ME, Benyamini O, Yalon M, Levi A, Lapidoth M, Barzilai A. Agminated benign vascular tumour successfully treated with trametinib. Br J Dermatol 2021; 184:1195-1197. [PMID: 33452815 DOI: 10.1111/bjd.19814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/11/2021] [Accepted: 01/11/2021] [Indexed: 11/29/2022]
Affiliation(s)
- S Greenberger
- Pediatric Dermatology Service, Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel
| | - R Stein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel.,Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology and Visual Sciences, Yitzhak Shamir Medical Center, Tel Aviv University, Tzrifin, Israel
| | - A Ollech
- Pediatric Dermatology Service, Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel
| | - M E Hartstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel.,Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology and Visual Sciences, Yitzhak Shamir Medical Center, Tel Aviv University, Tzrifin, Israel
| | - O Benyamini
- Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology and Visual Sciences, Yitzhak Shamir Medical Center, Tel Aviv University, Tzrifin, Israel
| | - M Yalon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel.,Pediatric Neuro-Oncology Service, Pediatric Hemato-Oncology Department, Chaim Sheba Medical Center, Tel HaShomer, 52621, Israel
| | - A Levi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel.,Department of Dermatology, Laser Unit, Rabin Medical Center, Petach Tikva, Israel
| | - M Lapidoth
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel.,Department of Dermatology, Laser Unit, Rabin Medical Center, Petach Tikva, Israel
| | - A Barzilai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel.,Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
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13
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Laskaratos FM, Levi A, Schwach G, Pfragner R, Hall A, Xia D, von Stempel C, Bretherton J, Thanapirom K, Alexander S, Ogunbiyi O, Watkins J, Luong TV, Toumpanakis C, Mandair D, Caplin M, Rombouts K. Transcriptomic Profiling of In Vitro Tumor-Stromal Cell Paracrine Crosstalk Identifies Involvement of the Integrin Signaling Pathway in the Pathogenesis of Mesenteric Fibrosis in Human Small Intestinal Neuroendocrine Neoplasms. Front Oncol 2021; 11:629665. [PMID: 33718208 PMCID: PMC7943728 DOI: 10.3389/fonc.2021.629665] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 01/15/2021] [Indexed: 12/22/2022] Open
Abstract
Aim Analysis of the pathophysiology of mesenteric fibrosis (MF) in small intestinal neuroendocrine tumors (SI-NETs) in an in vitro paracrine model and in human SI-NET tissue samples. Methods An indirect co-culture model of SI-NET cells KRJ-I and P-STS with stromal cells HEK293 was designed to evaluate the paracrine effects on cell metabolic activity, gene expression by RT2 PCR Profilers to analyse cancer and fibrosis related genes, and RNA sequencing. The integrin signaling pathway, a specific Ingenuity enriched pathway, was further explored in a cohort of human SI-NET tissues by performing protein analysis and immunohistochemistry. Results RT Profiler array analysis demonstrated several genes to be significantly up- or down-regulated in a cell specific manner as a result of the paracrine effect. This was further confirmed by employing RNA sequencing revealing multiple signaling pathways involved in carcinogenesis and fibrogenesis that were significantly affected in these cell lines. A significant upregulation in the expression of various integrin pathway – related genes was identified in the mesenteric mass of fibrotic SI-NET as confirmed by RT-qPCR and immunohistochemistry. Protein analysis demonstrated downstream activation of the MAPK and mTOR pathways in some patients with fibrotic SI-NETs. Conclusion This study has provided the first comprehensive analysis of the crosstalk of SI-NET cells with stromal cells. A novel pathway – the integrin pathway – was identified and further validated and confirmed in a cohort of human SI-NET tissue featured by a dual role in fibrogenesis/carcinogenesis within the neoplastic fibrotic microenvironment.
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Affiliation(s)
- Faidon-Marios Laskaratos
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom.,Regenerative Medicine and Fibrosis Group, Institute for Liver and Digestive Health, Royal Free Hospital, University College London, London, United Kingdom
| | - Ana Levi
- Regenerative Medicine and Fibrosis Group, Institute for Liver and Digestive Health, Royal Free Hospital, University College London, London, United Kingdom
| | - Gert Schwach
- Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Roswitha Pfragner
- Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Andrew Hall
- Academic Centre for Cellular Pathology, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Dong Xia
- Royal Veterinary College, University of London, London, United Kingdom
| | - Conrad von Stempel
- Radiology Department, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Josephine Bretherton
- Radiology Department, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Kessarin Thanapirom
- Regenerative Medicine and Fibrosis Group, Institute for Liver and Digestive Health, Royal Free Hospital, University College London, London, United Kingdom
| | - Sarah Alexander
- Academic Centre for Cellular Pathology, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Olagunju Ogunbiyi
- Department of Colorectal Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Jennifer Watkins
- Academic Centre for Cellular Pathology, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Tu Vinh Luong
- Academic Centre for Cellular Pathology, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Christos Toumpanakis
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Dalvinder Mandair
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Martyn Caplin
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Krista Rombouts
- Regenerative Medicine and Fibrosis Group, Institute for Liver and Digestive Health, Royal Free Hospital, University College London, London, United Kingdom
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14
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Lepidoth M, Levi A. Post acne scars treatment ‐ do picosecond lasers offer a superior non‐ablative modality? J Eur Acad Dermatol Venereol 2020; 34:2687-2688. [DOI: 10.1111/jdv.17017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 11/28/2022]
Affiliation(s)
- M. Lepidoth
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Laser UnitDivision of DermatologyRabin Medical Center Petah‐Tikva Israel
| | - A. Levi
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Laser UnitDivision of DermatologyRabin Medical Center Petah‐Tikva Israel
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15
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Kostrzewski T, Maraver P, Ouro-Gnao L, Levi A, Snow S, Miedzik A, Rombouts K, Hughes D. A Microphysiological System for Studying Nonalcoholic Steatohepatitis. Hepatol Commun 2019; 4:77-91. [PMID: 31909357 PMCID: PMC6939502 DOI: 10.1002/hep4.1450] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 10/25/2019] [Indexed: 12/14/2022] Open
Abstract
Nonalcoholic steatohepatitis (NASH) is the most severe form of nonalcoholic fatty liver disease (NAFLD), which to date has no approved drug treatments. There is an urgent need for better understanding of the genetic and molecular pathways that underlie NAFLD/NASH, and currently available preclinical models, be they in vivo or in vitro, do not fully represent key aspects of the human disease state. We have developed a human in vitro co‐culture NASH model using primary human hepatocytes, Kupffer cells and hepatic stellate cells, which are cultured together as microtissues in a perfused three‐dimensional microphysiological system (MPS). The microtissues were cultured in medium containing free fatty acids for at least 2 weeks, to induce a NASH‐like phenotype. The co‐culture microtissues within the MPS display a NASH‐like phenotype, showing key features of the disease including hepatic fat accumulation, the production of an inflammatory milieu, and the expression of profibrotic markers. Addition of lipopolysaccharide resulted in a more pro‐inflammatory milieu. In the model, obeticholic acid ameliorated the NASH phenotype. Microtissues were formed from both wild‐type and patatin‐like phospholipase domain containing 3 (PNPLA3) I148M mutant hepatic stellate cells. Stellate cells carrying the mutation enhanced the overall disease state of the model and in particular produced a more pro‐inflammatory milieu. Conclusion: The MPS model displays a phenotype akin to advanced NAFLD or NASH and has utility as a tool for exploring mechanisms underlying the disease. Furthermore, we demonstrate that in co‐culture the PNPLA3 I148M mutation alone can cause hepatic stellate cells to enhance the overall NASH disease phenotype.
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Affiliation(s)
| | - Paloma Maraver
- CN Bio Innovations Ltd. Welwyn Garden City Hertfordshire United Kingdom
| | - Larissa Ouro-Gnao
- CN Bio Innovations Ltd. Welwyn Garden City Hertfordshire United Kingdom
| | - Ana Levi
- Institute for Liver and Digestive Health, Regenerative Medicine and Fibrosis Group, Royal Free University College London United Kingdom
| | - Sophie Snow
- CN Bio Innovations Ltd. Welwyn Garden City Hertfordshire United Kingdom
| | - Alina Miedzik
- CN Bio Innovations Ltd. Welwyn Garden City Hertfordshire United Kingdom
| | - Krista Rombouts
- Institute for Liver and Digestive Health, Regenerative Medicine and Fibrosis Group, Royal Free University College London United Kingdom
| | - David Hughes
- CN Bio Innovations Ltd. Welwyn Garden City Hertfordshire United Kingdom
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16
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Edel Y, Mamet R, Snast I, Kaftory R, Mazor S, Hodak E, Lapidoth M, Elis A, Molad Y, Levi A. Epidemiology of cutaneous porphyria in Israel: a nationwide cohort study. J Eur Acad Dermatol Venereol 2019; 34:184-187. [PMID: 31264284 DOI: 10.1111/jdv.15769] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 06/13/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND From a dermatologist's perspective, there are four major types of cutaneous porphyrias (CPs): porphyria cutanea tarda (PCT), erythropoietic protoporphyria (EPP), variegate porphyria (VP) and hereditary coproporphyria (HCP). Scarce data are available regarding the epidemiology of CPs. OBJECTIVES To describe the epidemiology of CPs in Israel, including distribution, incidence and prevalence rates of major types. METHODS This retrospective study includes all patients who were diagnosed with CPs between the years 1988-2018. It is based on data from Israel's National Service for the Biochemical Diagnoses of Porphyrias, and Israeli patients' nationwide electronic medical charts. Incidence and prevalence rates were calculated. RESULTS Of 173 patients with CPs diagnosed during a 30-year period, 65 (38%) had VP, 62 (36%) had PCT, 31 (18%) had HCP and 15 (9%) had EPP; with incidence rates of 0.29, 0.30, 0.17, 0.07, and prevalence rates of 6.3, 4.8, 2.9, 1.6, respectively, per million population. Characteristics of patients with PCT differed from those with other CPs with regard to lack of family history, older mean age at diagnosis [51 vs. 36 (VP), 35 (HCP) and 25 (EPP) years] and male predominance (81% vs. similar distribution). All patients with PCT were diagnosed at adulthood, while 20%, 19% and 15% of patients with VP, HCP and EPP, respectively, were diagnosed during childhood or adolescence. CONCLUSIONS Variegate porphyria and PCT were found to be the most prevalent in Israel; however, CPs might be underdiagnosed, thus dermatologists' awareness of these rare disorders is highly important.
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Affiliation(s)
- Y Edel
- National Service for the Biochemical Diagnoses of Porphyrias, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.,Rheumatology Unit, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Mamet
- National Service for the Biochemical Diagnoses of Porphyrias, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - I Snast
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Photodermatosis Clinic, Department of Dermatology, Beilinson Hospital, Petach Tikva, Israel
| | - R Kaftory
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Mazor
- Department of Community Dentistry, School of Dental Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - E Hodak
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Photodermatosis Clinic, Department of Dermatology, Beilinson Hospital, Petach Tikva, Israel
| | - M Lapidoth
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Photodermatosis Clinic, Department of Dermatology, Beilinson Hospital, Petach Tikva, Israel
| | - A Elis
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department "C" of internal, Belinson Hospital, Petah Tikva, Israel
| | - Y Molad
- Rheumatology Unit, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - A Levi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Photodermatosis Clinic, Department of Dermatology, Beilinson Hospital, Petach Tikva, Israel
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17
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Snast I, Lapidoth M, Uvaidov V, Enk CD, Mazor S, Hodak E, Levi A. Real-life experience in the treatment of solar urticaria: retrospective cohort study. Clin Exp Dermatol 2019; 44:e164-e170. [PMID: 30828851 DOI: 10.1111/ced.13960] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Solar urticaria (SU) is a rare photodermatosis causing a significant impact on patients' quality of life (QoL), and treatment is often challenging. AIM To analyse clinical experience with a tailored stepwise therapeutic approach. METHODS A retrospective cohort design was used. Patients with suspected SU underwent laboratory investigations and photoprovocation. Those with a high minimal urticaria dose (MUD) were treated with a single antihistamine (protocol 1), and those with a lower MUD received three types of antihistamines (protocol 2); both protocols included a leucotriene receptor antagonist (LRA). In cases of failure, treatment was switched to omalizumab at doses of < 300 mg/month with incremental dosage increases as necessary (monthly dose range, 150-600 mg/month). Symptom relief and photoprovocation under treatment were evaluated. RESULTS In total, 30 patients (10 men, 20 women) were enrolled. Most (87%) were sensitive to visible light (1-70 J/cm2 ) with or without extension to ultraviolet A. Of the 30 patients, 23 opted for our stepwise approach: 22 achieved complete remission on protocols 1 or 2 (n = 17) or after switching to omalizumab (n = 5), and another patient achieved partial remission under omalizumab. There were no treatment-related severe adverse effects. CONCLUSIONS Symptoms of SU can be well controlled by treatment with antihistamines and an LRA tailored to the degree of photosensitivity, followed by omalizumab in refractory cases. This has important implications for patient QoL.
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Affiliation(s)
- I Snast
- Photodermatosis Service, Department of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Lapidoth
- Photodermatosis Service, Department of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - V Uvaidov
- Photodermatosis Service, Department of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - C D Enk
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - S Mazor
- Department of Community Dentistry, School of Dental Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - E Hodak
- Photodermatosis Service, Department of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Levi
- Photodermatosis Service, Department of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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18
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Soto-Perez-de-Celis E, Vazquez J, Kim H, Sun CL, Somlo G, Yuan Y, Waisman JR, Mortimer JE, Kruper L, Taylor L, Patel NH, Moreno J, Charles K, Roberts E, Uranga C, Levi A, Katheria V, Paredero-Perez I, Mitani D, Hurria A. Abstract P6-16-04: A self-administered geriatric assessment tool for Spanish-speaking older women with breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-16-04] [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
Background: Almost a quarter of older adults in the United States will identify themselves as Hispanic/Latino by 2060. Our group has previously developed and validated a self-administered geriatric assessment tool which can be used to identify functional, psychological, social and cognitive impairments among older patients with various types of cancer. Among English-speaking older adults, completing this tool using paper/pencil or a tablet takes a median of 15-21 minutes (min), with < 10% needing assistance to answer it (Hurria, JOP 2016). However, the utilization of this tool among Spanish-speaking older adults has not been tested. We assessed the feasibility of administering a translated and validated Spanish version of our geriatric assessment tool for older Hispanic women with breast cancer, and identified their preferred format (tablet or paper/pencil).
Methods: Spanish-speaking women aged ≥ 65 years with a diagnosis of breast cancer completed the geriatric assessment twice on the same day. Patients were randomized into 3 groups: paper/pencil twice; tablet and paper/pencil in random order; and tablet twice. We assessed the proportion of patients requiring assistance to complete the geriatric assessment, the time needed to complete it, and the proportion of patients who thought the geriatric assessment was difficult/very difficult.
Results: 140 older women with breast cancer completed the geriatric assessment twice and were evaluable. Mean age was 71.6 years (SD 5.8), 53% had ≤ 8th grade education, 43% were married, 45% were retired, 32% were homemakers, and 6% were employed. The participants came from 13 different Spanish-speaking countries, although 70% were born in Mexico. For 90%, Spanish was their primary language, and 75% spoke only in Spanish at home. Regarding computer skills, 64% of the patients said they had none. 39% (n = 54) were unable to complete the geriatric assessment on their own; mean time to complete the geriatric assessment was 29 min (range 8-90); and 28% (n = 39) thought the geriatric assessment was difficult/very difficult. The most common reasons for needing assistance were difficulty understanding questions (39%) and visual problems (31%). Patients with ≤ 8th grade education took longer to complete the geriatric assessment (mean 37.2 vs 29.4 min, p < 0.01), and more often needed help completing the assessment (51% vs 19%, p < 0.01) than those with ≥9th grade education. 53% of the participants preferred using a tablet to answer the geriatric assessment, while 47% preferred paper/pencil.
Conclusions: A substantial proportion of Spanish-speaking older women with breast cancer required assistance to complete our self-administered geriatric assessment tool. This may be a consequence of the low educational level we found among this patient population. Tailoring assessments for diverse populations with particular attention to educational level is needed in multicultural settings.
Citation Format: Soto-Perez-de-Celis E, Vazquez J, Kim H, Sun C-L, Somlo G, Yuan Y, Waisman JR, Mortimer JE, Kruper L, Taylor L, Patel NH, Moreno J, Charles K, Roberts E, Uranga C, Levi A, Katheria V, Paredero-Perez I, Mitani D, Hurria A. A self-administered geriatric assessment tool for Spanish-speaking older women with breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-16-04.
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Affiliation(s)
- E Soto-Perez-de-Celis
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - J Vazquez
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - H Kim
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - C-L Sun
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - G Somlo
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - Y Yuan
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - JR Waisman
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - JE Mortimer
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - L Kruper
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - L Taylor
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - NH Patel
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - J Moreno
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - K Charles
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - E Roberts
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - C Uranga
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - A Levi
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - V Katheria
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - I Paredero-Perez
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - D Mitani
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
| | - A Hurria
- City of Hope, Duarte, CA; Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Hospital Universitario Doctor Peset, Valencia, Spain
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Sherman S, Amitay-Laish I, Kremer N, Dalal A, Solomon Cohen E, Bercovich E, Noyman Y, Levi A, Pavlovsky L, Prag Naveh H, Hodak E. Mycosis fungoides is associated with melanoma in Israeli patients. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30535-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Marrone G, De Chiara F, Böttcher K, Levi A, Dhar D, Longato L, Mazza G, Zhang Z, Marrali M, Fernández-Iglesias A, Hall A, Luong TV, Viollet B, Pinzani M, Rombouts K. The adenosine monophosphate-activated protein kinase-vacuolar adenosine triphosphatase-pH axis: A key regulator of the profibrogenic phenotype of human hepatic stellate cells. Hepatology 2018; 68:1140-1153. [PMID: 29663481 DOI: 10.1002/hep.30029] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/06/2018] [Accepted: 04/10/2018] [Indexed: 12/18/2022]
Abstract
UNLABELLED Liver fibrosis and cirrhosis are characterized by activation of hepatic stellate cells (HSCs), which is associated with higher intracellular pH (pHi). The vacuolar H+ adenosine-triphosphatase (v-ATPase) multisubunit complex is a key regulator of pHi homeostasis. The present work investigated the functional role of v-ATPase in primary human HSC (hHSC) activation and its modulation by specific adenosine monophosphate-activated protein kinase (AMPK) subunits. We demonstrate that the expression of different v-ATPase subunits was increased in in vivo and in vitro activated hHSCs compared to nonactivated hHSCs. Specific inhibition of v-ATPase with bafilomycin and KM91104 induced a down-regulation of the HSC fibrogenic gene profile, which coincided with increased lysosomal pH, decreased pHi, activation of AMPK, reduced proliferation, and lower metabolic activity. Similarly, pharmacological activation of AMPK by treatment with diflunisal, A769662, and ZLN024 reduced the expression of v-ATPase subunits and profibrogenic markers. v-ATPase expression was differently regulated by the AMPK α1 subunit (AMPKα1) and AMPKα2, as demonstrated in mouse embryo fibroblasts specifically deficient for AMPK α subunits. In addition, activation of v-ATPase in hHSCs was shown to be AMPKα1-dependent. Accordingly, pharmacological activation of AMPK in AMPKα1-depleted hHSCs prevented v-ATPase down-regulation. Finally, we showed that v-ATPase expression was increased in fibrotic livers from bile duct-ligated mice and in human cirrhotic livers. CONCLUSION The down-regulation of v-ATPase might represent a promising target for the development of antifibrotic strategies. (Hepatology 2018).
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Affiliation(s)
- Giusi Marrone
- Regenerative Medicine & Fibrosis Group, Institute for Liver & Digestive Health, London, UK
| | - Francesco De Chiara
- Liver Failure Group, Institute for Liver & Digestive Health, University College London, Royal Free Hospital, London, UK
| | - Katrin Böttcher
- Regenerative Medicine & Fibrosis Group, Institute for Liver & Digestive Health, London, UK
| | - Ana Levi
- Regenerative Medicine & Fibrosis Group, Institute for Liver & Digestive Health, London, UK
| | - Dipok Dhar
- Regenerative Medicine & Fibrosis Group, Institute for Liver & Digestive Health, London, UK
| | - Lisa Longato
- Regenerative Medicine & Fibrosis Group, Institute for Liver & Digestive Health, London, UK
| | - Giuseppe Mazza
- Regenerative Medicine & Fibrosis Group, Institute for Liver & Digestive Health, London, UK
| | - Zhenzhen Zhang
- Regenerative Medicine & Fibrosis Group, Institute for Liver & Digestive Health, London, UK
| | - Martina Marrali
- Regenerative Medicine & Fibrosis Group, Institute for Liver & Digestive Health, London, UK
| | - Anabel Fernández-Iglesias
- Liver Vascular Biology Research Group, Barcelona Hepatic Hemodynamic Laboratory, IDIBAPS Biomedical Research Institute-CIBEREHD, Barcelona, Spain
| | - Andrew Hall
- Regenerative Medicine & Fibrosis Group, Institute for Liver & Digestive Health, London, UK
| | - Tu Vinh Luong
- Department of Cellular Pathology, Royal Free Hospital, London, UK
| | - Benoit Viollet
- INSERM, Institut Cochin.,CNRS UMR 8104, Sorbonne Paris cité, Paris, France.,Université Paris Descartes, Sorbonne Paris cité, Paris, France
| | - Massimo Pinzani
- Regenerative Medicine & Fibrosis Group, Institute for Liver & Digestive Health, London, UK
| | - Krista Rombouts
- Regenerative Medicine & Fibrosis Group, Institute for Liver & Digestive Health, London, UK
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O'Connor T, Soto-Perez-de-Celis E, Blanchard S, Chapman A, Kimmick G, Muss H, Luu T, Waisman JR, Li D, Mortimer J, Yuan Y, Somlo G, Stewart D, Katheria V, Levi A, Hurria A. Abstract P5-21-08: Tolerability of the combination of lapatinib and trastuzumab in older patients with HER2 positive metastatic breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-21-08] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Older adults are less likely to be included in clinical trials leading to the approval of novel cancer treatments. The Institute of Medicine and ASCO have identified therapeutic phase II trials as a key research priority to increase the evidence base for older adults with cancer. While targeted therapies may represent a less toxic option for older patients, few trials have studied their tolerability and efficacy in older adults. Here, we present a phase II study (NCT01273610) of the combination of trastuzumab and lapatinib in older patients with HER2+ metastatic breast cancer (MBC), incorporating geriatric oncology principles in the study design.
Methods: Patients age ≥ 60 years with MBC and any number of prior chemotherapy (CT) lines received trastuzumab (either 4mg/kg loading dose followed by 2mg/kg weekly or 8mg/kg followed by 6mg/kg q/3 weeks) plus lapatinib 1000 mg/m2 daily in 21-day cycles. Patients completed a pre-treatment geriatric assessment including measures of function, comorbidity, cognition, nutrition, and psychosocial status. A toxicity risk score developed for older adults receiving cytotoxic CT was calculated for each patient (Hurria et al. JCO 2011 & 2016). Relationships between tolerability (dose reductions and grade (G) ≥ 3 toxicity attributed to treatment) and risk score analyzed using a log2 transformation were assessed using generalized linear models, Student's t tests, and Fisher's exact test. Response rate (RR) and progression free survival (PFS) were evaluated.
Results: 40 patients (mean age 72 [60-92]) were accrued from 04/11 to 05/15. 25% (n = 10) were ≥ 75 years of age. 65% of patients (n = 26) had HR+ tumors and 35% (n = 14) were receiving ≥ 3rd line treatment. Median number of cycles was 4 (0-28). RR was 23% (n = 9, 95% CI 11-38%; 1 complete, 8 partial). 23% (n = 9) achieved stable disease. PFS was 2.7 months (95% CI 2.5-12). Based on the toxicity risk score, 21% (n = 8), 54% (n = 21), and 26% (n = 10) were at low, intermediate, and high risk. 70% (n = 28) of patients had G ≥ 2 toxicities and 20% (n = 8) G ≥ 3 toxicities. G 2 and 3 diarrhea occurred in 28% (n = 11) and 5% (n = 2) respectively. 5% (n = 2) were hospitalized due to treatment-related toxicity. No G ≥ 3 cardiac toxicities were observed. 23% of patients (n = 9) had treatment delays, and 43% (n = 17) required a lapatinib dose reduction. The mean toxicity risk score was higher in patients who required dose reductions (Student's t: p = 0.02). No statistically significant relationship was found between toxicity risk scores and the presence of G ≥ 3 treatment toxicity (logistic regression: OR = 3.08, 95% CI [0.54, 21.2], p = 0.22).
Conclusions: Among older patients with MBC (79% at intermediate or high risk of G ≥ 3 cytotoxic CT toxicity), trastuzumab and lapatinib were well tolerated, with only 20% experiencing G3 toxicities. The toxicity risk score was not found to be significantly related with treatment toxicity, which may be explained by the very low incidence of G3 events. Patients with a low toxicity risk score were not likely to require a lapatinib dose reduction.
Citation Format: O'Connor T, Soto-Perez-de-Celis E, Blanchard S, Chapman A, Kimmick G, Muss H, Luu T, Waisman JR, Li D, Mortimer J, Yuan Y, Somlo G, Stewart D, Katheria V, Levi A, Hurria A. Tolerability of the combination of lapatinib and trastuzumab in older patients with HER2 positive metastatic breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-21-08.
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Affiliation(s)
- T O'Connor
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - E Soto-Perez-de-Celis
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - S Blanchard
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - A Chapman
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - G Kimmick
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - H Muss
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - T Luu
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - JR Waisman
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - D Li
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - J Mortimer
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - Y Yuan
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - G Somlo
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - D Stewart
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - V Katheria
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - A Levi
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
| | - A Hurria
- City of Hope, Duarte, CA; UNC Lineberger Cancer Center, Chapel Hill, NC; Thomas Jefferson University Hospital, Philadelphia, PA; Duke Cancer Center, Durham, NC; Roswell Park Cancer Institute, Buffalo, NY
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Krieger Y, Rubin G, Schulz A, Rosenberg N, Levi A, Singer A, Rosenberg L, Shoham Y. Bromelain-based enzymatic debridement and minimal invasive modality (mim) care of deeply burned hands. Ann Burns Fire Disasters 2017; 30:198-204. [PMID: 29849523 PMCID: PMC5946757] [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] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 08/05/2017] [Indexed: 06/08/2023]
Abstract
The objective was to critically review the data and assess the implications of NexoBrid [NexoBrid-NXB formerly Debrase Gel Dressing-DGD]a in the special field of deep hand burns. Detailed analysis of endpoints in the treatment of hand burn patients was conducted as part of a multi-center, open label, randomized, controlled two-arm study to evaluate the safety and efficacy of NXB enzymatic debridement, comparing it to the current standard of care (SOC). These results were compared to a large cohort of patients treated with NXB in a previous, single arm study. Thirty-one burned hands were treated with NXB and 41 hand burns were in the SOC group. In the NXB group, 4 out of 31 hand burns (12.9%) required some excisional debridement compared to 29 out of the 41 (70.7%) in the SOC group (p<0.0001). Mean percentage of burn wound area excised in the NXB group was 4.4 ± 13.1% compared to 52.0 ± 41.4% in the SOC group (p<0.0001). None of the NXB-treated hands required escharotomy compared to 4 out of the 41 (9.7%) in the SOC group. NXB enzymatic debridement demonstrated a statistically significant reduction in burn wound excision and auto-grafting compared to SOC, and seems to prevent the need for emergency escharotomy. a DGD is produced by MediWound and distributed under the name NexoBrid®.
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Affiliation(s)
- Y. Krieger
- Department of Plastic Surgery and Burn Unit, Soroka Medical Center, The Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - G. Rubin
- Orthopedic Department, Emek Medical Center, Afula / Faculty of Medicine, Technion, Haifa, Israel
| | - A. Schulz
- Klinik für Plastische Chirurgie, Handchirurgie - Schwerbrandverletztenzentrum - Krankenhaus Merheim, Lehrstuhl für Plastische Chirurgie der Universität Witten/Herdecke, Köln, Germany
| | - N. Rosenberg
- Cleft Lip & Palate & Craniofacial Deformities Unite, Department of Plastic Surgery, Meir Hospital Kfar Saba, Israel / MediWound Ltd. Israel
| | - A. Levi
- Cleft Lip & Palate & Craniofacial Deformities Unite, Department of Plastic Surgery, Meir Hospital Kfar Saba, Israel / MediWound Ltd. Israel
| | - A.J. Singer
- Department of Emergency Medicine, Stony Brook University, Stony Brook, NY, USA
| | - L. Rosenberg
- Department of Plastic Surgery and Burn Unit, Soroka Medical Center, The Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Y. Shoham
- Department of Plastic Surgery and Burn Unit, Soroka Medical Center, The Ben-Gurion University of the Negev, Beer Sheva, Israel
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Zusman O, Landes U, Orvin K, Levi A, Witberg G, Assali A, Vaknin-Assa H, Sharony R, Hamdan A, Shapira Y, Sagie A, Kornowski R. P6333Transcatheter aortic valve implantation futility risk model development and validation among treated aortic stenosis patients. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hammer Y, Soudry A, Levi A, Talmor-Barkan Y, Leshem-Lev D, Singer J, Kornowski R, Lev E. P3483Effect of vitamin D on endothelial progenitor cells function. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Maya I, Kahana S, Yeshaya J, Tenne T, Yacobson S, Agmon-Fishman I, Cohen-Vig L, Levi A, Reinstein E, Basel-Vanagaite L, Sharony R. Chromosomal microarray analysis in fetuses with aberrant right subclavian artery. Ultrasound Obstet Gynecol 2017; 49:337-341. [PMID: 27063194 DOI: 10.1002/uog.15935] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/29/2016] [Accepted: 04/05/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate the association between aberrant right subclavian artery (ARSA), with or without additional risk factors for aneuploidy or ultrasound abnormality, and results of chromosomal microarray analysis (CMA). METHODS This was a multicenter study of fetuses diagnosed with ARSA that underwent genetic analysis by CMA, all samples being analyzed in the same laboratory. Clinical investigation included nuchal translucency measurement, first- and second-trimester maternal serum screening, early and late second-trimester fetal anatomy scans and fetal echocardiography. Comparative genomic hybridization microarray analysis or single-nucleotide polymorphism array technology was used for CMA of DNA samples obtained from amniotic fluid. RESULTS CMA results were available for 63 fetuses with ARSA. In 36 fetuses, ARSA was an isolated finding, and no pathogenic variant was found. Additional ultrasound findings and/or risk factors for aneuploidy were present in 27 fetuses, five of which had pathogenic CMA results. Of these five, trisomy 21 was detected in a fetus with echogenic intracardiac focus (EIF), 22q11 deletion was detected in a fetus with EIF and an increased risk of trisomy 21 of 1:230 from maternal serum screening, 22q11 duplication was detected in a fetus with hypoplastic right kidney and choroid plexus cyst and 22q11 deletion was detected in a fetus with right aortic arch and clubfoot. The fifth fetus had increased nuchal translucency thickness (4 mm) and a ventricular septal defect, and CMA identified both 22q11 deletion and 1q21 duplication. CONCLUSIONS In fetuses with isolated ARSA, an invasive procedure for CMA is not indicated. However, CMA is recommended when additional ultrasound abnormalities or risk factors for aneuploidy are observed. The chromosomal findings in four of the five cases with an abnormal CMA result in our study would not have been detected by standard fetal chromosomal testing. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- I Maya
- The Raphael Recanati Genetics Institute, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Kahana
- The Raphael Recanati Genetics Institute, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - J Yeshaya
- The Raphael Recanati Genetics Institute, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - T Tenne
- The Genetics Institute, Meir Medical Center, Kfar Saba, Israel
| | - S Yacobson
- The Raphael Recanati Genetics Institute, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - I Agmon-Fishman
- The Raphael Recanati Genetics Institute, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - L Cohen-Vig
- Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - A Levi
- Department of Cardiology, Meir Medical Center, Kfar Saba, Israel
| | - E Reinstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Genetics Institute, Meir Medical Center, Kfar Saba, Israel
| | - L Basel-Vanagaite
- The Raphael Recanati Genetics Institute, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Genetics Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Felsenstein Medical Research Center, Rabin Medical Center, Petah Tikva, Israel
| | - R Sharony
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Genetics Institute, Meir Medical Center, Kfar Saba, Israel
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
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Politi Y, Levi A, Enk CD, Lapidoth M. Integrated cooling-vacuum-assisted 1540-nm erbium:glass laser is effective in treating mild-to-moderate acne vulgaris. Lasers Med Sci 2015; 30:2389-93. [PMID: 26428932 DOI: 10.1007/s10103-015-1816-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 09/22/2015] [Indexed: 11/26/2022]
Abstract
Acne treatment by a mid-infrared laser may be unsatisfactory due to deeply situated acne-affected sebaceous glands which serve as its target. Skin manipulation by vacuum and contact cooling may improve laser-skin interaction, reduce pain sensation, and increase overall safety and efficacy. To evaluate the safety and efficacy of acne treatment using an integrated cooling-vacuum-assisted 1540-nm erbium:glass laser, a prospective interventional study was conducted. It included 12 patients (seven men and five women) suffering from mild-to-moderate acne vulgaris. The device utilizes a mid-infrared 1540-nm laser (Alma Lasers Ltd. Caesarea, Israel), which is integrated with combined cooling-vacuum-assisted technology. An acne lesion is initially manipulated upon contact by a vacuum-cooling-assisted tip, followed by three to four stacked laser pulses (500-600 mJ, 4 mm spot size, and frequency of 2 Hz). Patients underwent four to six treatment sessions with a 2-week interval and were followed-up 1 and 3 months after the last treatment. Clinical photographs were taken by high-resolution digital camera before and after treatment. Clinical evaluation was performed by two independent dermatologists, and results were graded on a scale of 0 (exacerbation) to 4 (76-100 % improvement). Patients' and physicians' satisfaction was also recorded. Pain perception and adverse effects were evaluated as well. All patients demonstrated a moderate to significant improvement (average score of 3.6 and 2.0 within 1 and 3 months, respectively, following last treatment session). No side effects, besides a transient erythema, were observed. Cooling-vacuum-assisted 1540-nm laser is safe and effective for the treatment of acne vulgaris.
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Affiliation(s)
- Y Politi
- Herzelia Dermatolgy and Laser Center, Herzelia Pituach, Israel
| | - A Levi
- Department of Dermatology, Laser Unit, Rabin Medical Center, Petah-Tikva, Israel.
| | - C D Enk
- Department of Dermatology, Hadassah Medical Organization-The Hebrew University Medical School, Jerusalem, Israel
| | - M Lapidoth
- Department of Dermatology, Laser Unit, Rabin Medical Center, Petah-Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Affiliation(s)
- A Levi
- Photodermatosis Clinic and Laser Unit, Department of Dermatology, Rabin Medical Center, Petah-Tikva, Israel.
| | - Y Tal
- Allergy and Clinical Immunology Unit, Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Z Dranitzki
- Allergy and Clinical Immunology Unit, Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - M Shalit
- Allergy and Clinical Immunology Unit, Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - C D Enk
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Knight AL, Barros-Parada W, Bosch D, Escudero-Colomar LA, Fuentes-Contreras E, Hernández-Sánchez J, Jung C, Kim Y, Kovanci OB, Levi A, Lo P, Molinari F, Valls J, Gemeno C. Similar worldwide patterns in the sex pheromone signal and response in the oriental fruit moth, Grapholita molesta (Lepidoptera: Tortricidae). Bull Entomol Res 2015; 105:23-31. [PMID: 25234707 DOI: 10.1017/s0007485314000637] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The response of Grapholita molesta (Busck) males to three-component sex pheromone blends containing a 100% ratio of the major sex pheromone component, (Z)-8-dodecenyl acetate and a 10% ratio of (Z)-8-dodecenol, but with varying ratios of (E)-8-dodecenyl acetate (0.4, 5.4, 10.4, 30.4, and 100.1% E-blends) was tested with populations in eight stone and pome fruit orchards in Europe, Asia, and North and South America. Traps baited with the 5.4% E-blend caught significantly more males than traps with any other blend with all populations. Significantly more males were caught in traps baited with the 10.4% E-blend than in traps with the remaining blends, except with the 0.4% E-blend in Turkey. Significant differences in male moth catches occurred between the other blends with the 0.4>30.4% E-blend, and the 30.4>100.1% E-blend. Male moth catches with the 100.1% E-blend only differed from the hexane control in Chile. No apparent differences were noted to these blends in populations collected from pome or stone fruits. Flight tunnel assays to synthetic blends with a subset of populations were similar to the field results, but the breadth of the most attractive E-blends was wider. Flight tunnel assays also demonstrated a high level of male-female cross-attraction among field-collected populations. Female gland extracts from field-collected populations did not show any significant variation in their three-component blends. The only exceptions in these assays were that long-term laboratory populations were less responsive and attractive, and produced different blend ratios of the two minor components than recently collected field populations.
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Affiliation(s)
- A L Knight
- USDA,ARS, Yakima Agricultural Research Laboratory, Wapato, WA 98951,USA
| | - W Barros-Parada
- Facultad de Ciencias Agrarias,Universidad de Talca,Casilla 747, Talca,Chile
| | - D Bosch
- UdL-IRTA,Av. Alcalde Rovira Roure 191, 25198 Lleida,Spain
| | | | | | - J Hernández-Sánchez
- IHBI,Queensland University of Technology,60 Musk Ave/cnr. Blamey St, Kelvin Grove, QLD, 4059,Australia
| | | | - Y Kim
- Department of Bioresource Sciences,Andong National University,Andong 760-749,Republic of Korea
| | - O B Kovanci
- Faculty of Agriculture, Department of Plant Protection,Uludag University,Gorukle Kampusu 16059 Bursa,Turkey
| | - A Levi
- Department of Crop and Forest Sciences,University of Lleida,Av. Alcalde Rovira Roure 191, 25198 Lleida,Spain
| | - P Lo
- Plant and Food Research,Hawkes Bay, 4157 Havelock North,New Zealand
| | - F Molinari
- Entomology and Plant Pathology Institute,Catholic University of Sacro Cuore,Via Emilia Parmense 84, 29100 Piacenza,Italy
| | - J Valls
- Biostatistics Unit. Institut de Recerca Biomèdica de Lleida (IRBLLEIDA),Hospital Universitari Arnau de Vilanova de Lleida (HUAV),C/ Rovira Roure 80, 25198 Lleida,Spain
| | - C Gemeno
- Department of Crop and Forest Sciences,University of Lleida,Av. Alcalde Rovira Roure 191, 25198 Lleida,Spain
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Uziel Y, Kwint Y, Matitiahu A, Levi A, Pearl L, Barash J. PReS-FINAL-2192: Late cardiac assessment in children who were diagnosed with post streptococcal reactive arthritis - a long term study. Pediatr Rheumatol Online J 2013. [PMCID: PMC4045116 DOI: 10.1186/1546-0096-11-s2-o27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Musto P, Simeon V, Martorelli MC, Petrucci MT, Cascavilla N, Di Raimondo F, Caravita T, Morabito F, Offidani M, Olivieri A, Benevolo G, Mina R, Guariglia R, D'Arena G, Mansueto G, Filardi N, Nobile F, Levi A, Falcone A, Cavalli M, Pietrantuono G, Villani O, Bringhen S, Omedè P, Lerose R, Agnelli L, Todoerti K, Neri A, Boccadoro M, Palumbo A. Lenalidomide and low-dose dexamethasone for newly diagnosed primary plasma cell leukemia. Leukemia 2013; 28:222-5. [PMID: 23958922 DOI: 10.1038/leu.2013.241] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- P Musto
- Scientific Direction, Centro di Riferimento Oncologico della Basilicata, Istituto di Ricovero e Cura a Carattere Scientifico, Rionero in Vulture (Pz), Italy
| | - V Simeon
- Laboratory of Pre-clinical and Translational Research, Centro di Riferimento Oncologico della Basilicata, Istituto di Ricovero e Cura a Carattere Scientifico, Rionero in Vulture (Pz), Italy
| | - M C Martorelli
- Unit of Hematology and Hemopoietic Stem Cell Transplantation, Centro di Riferimento Oncologico della Basilicata, Istituto di Ricovero e Cura a Carattere Scientifico, Rionero in Vulture (Pz), Italy
| | - M T Petrucci
- Department of Cellular Biotechnologies and Hematology, La Sapienza University, Rome, Italy
| | - N Cascavilla
- Division of Hematology and Stem Cell Transplantation, Casa Sollievo della Sofferenza, Istituto di Ricovero e Cura a Carattere Scientifico, San Giovanni Rotondo, Italy
| | - F Di Raimondo
- Division of Hematology, Department of Biomedical Sciences, Azienda Ospedaliera Ferrarotto, University of Catania, Catania, Italy
| | - T Caravita
- Department of Hematology, Azienda Ospedaliera S. Eugenio, Tor Vergata University, Rome, Italy
| | - F Morabito
- Hematology Unit, Azienda Ospedaliera Annunziata, Cosenza, Italy
| | - M Offidani
- Hematology Clinic, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy
| | - A Olivieri
- Hematology and Medicine Clinic, Marche Polytechnic University, Ancona, Italy
| | - G Benevolo
- Hematology 2, Azienda Ospedaliera Città della Salute e della Scienza, Turin, Italy
| | - R Mina
- Division of Hematology, University of Turin, Azienda Ospedaliera S. Giovanni Battista, Turin, Italy
| | - R Guariglia
- Unit of Hematology and Hemopoietic Stem Cell Transplantation, Centro di Riferimento Oncologico della Basilicata, Istituto di Ricovero e Cura a Carattere Scientifico, Rionero in Vulture (Pz), Italy
| | - G D'Arena
- Unit of Hematology and Hemopoietic Stem Cell Transplantation, Centro di Riferimento Oncologico della Basilicata, Istituto di Ricovero e Cura a Carattere Scientifico, Rionero in Vulture (Pz), Italy
| | - G Mansueto
- Unit of Hematology and Hemopoietic Stem Cell Transplantation, Centro di Riferimento Oncologico della Basilicata, Istituto di Ricovero e Cura a Carattere Scientifico, Rionero in Vulture (Pz), Italy
| | - N Filardi
- Unit of Hematology, San Carlo Hospital, Potenza, Italy
| | - F Nobile
- Division of Hematology, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | - A Levi
- Department of Cellular Biotechnologies and Hematology, La Sapienza University, Rome, Italy
| | - A Falcone
- Division of Hematology and Stem Cell Transplantation, Casa Sollievo della Sofferenza, Istituto di Ricovero e Cura a Carattere Scientifico, San Giovanni Rotondo, Italy
| | - M Cavalli
- Division of Hematology, Department of Biomedical Sciences, Azienda Ospedaliera Ferrarotto, University of Catania, Catania, Italy
| | - G Pietrantuono
- Unit of Hematology and Hemopoietic Stem Cell Transplantation, Centro di Riferimento Oncologico della Basilicata, Istituto di Ricovero e Cura a Carattere Scientifico, Rionero in Vulture (Pz), Italy
| | - O Villani
- Unit of Hematology and Hemopoietic Stem Cell Transplantation, Centro di Riferimento Oncologico della Basilicata, Istituto di Ricovero e Cura a Carattere Scientifico, Rionero in Vulture (Pz), Italy
| | - S Bringhen
- Division of Hematology, University of Turin, Azienda Ospedaliera S. Giovanni Battista, Turin, Italy
| | - P Omedè
- Division of Hematology, University of Turin, Azienda Ospedaliera S. Giovanni Battista, Turin, Italy
| | - R Lerose
- Pharmacy Unit, Centro di Riferimento Oncologico della Basilicata, Istituto di Ricovero e Cura a Carattere Scientifico, Rionero in Vulture (Pz), Italy
| | - L Agnelli
- Department of Clinical Sciences and Community Health, University of Milan; Hematology 1, Fondazione Ca' Grande Ospedale Maggiore Policlinico, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - K Todoerti
- Laboratory of Pre-clinical and Translational Research, Centro di Riferimento Oncologico della Basilicata, Istituto di Ricovero e Cura a Carattere Scientifico, Rionero in Vulture (Pz), Italy
| | - A Neri
- Department of Clinical Sciences and Community Health, University of Milan; Hematology 1, Fondazione Ca' Grande Ospedale Maggiore Policlinico, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - M Boccadoro
- Division of Hematology, University of Turin, Azienda Ospedaliera S. Giovanni Battista, Turin, Italy
| | - A Palumbo
- Division of Hematology, University of Turin, Azienda Ospedaliera S. Giovanni Battista, Turin, Italy
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Ling KS, Levi A, Adkins S, Kousik CS, Miller G, Hassell R, Keinath AP. Development and Field Evaluation of Multiple Virus-Resistant Bottle Gourd (Lagenaria siceraria). Plant Dis 2013; 97:1057-1062. [PMID: 30722471 DOI: 10.1094/pdis-07-12-0639-re] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In an effort to develop bottle gourd (Lagenaria siceraria) as a widely adapted rootstock for watermelon grafting, we sought to identify lines with broad resistance to several cucurbit viruses that are economically important in the United States. Preliminary analysis under greenhouse conditions indicated that the currently available commercial watermelon rootstocks were either highly susceptible or somewhat tolerant to one or more viruses. However, in greenhouse screening, several breeding lines of bottle gourd displayed broad-spectrum resistance to four viruses tested, including Zucchini yellow mosaic virus, Watermelon mosaic virus (WMV), Papaya ringspot virus watermelon strain (PRSV-W), and Squash vein yellowing virus. Resistance to PRSV-W and WMV was confirmed through field trials in two consecutive years at two different locations in South Carolina. Two breeding lines (USVL#1-8 and USVL#5-5) with broad-spectrum virus resistance could be useful materials for watermelon rootstock development.
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Affiliation(s)
- K-S Ling
- United States Department of Agriculture-Agricultural Research Service (USDA-ARS), U.S. Vegetable Laboratory, Charleston, SC 29414
| | - A Levi
- United States Department of Agriculture-Agricultural Research Service (USDA-ARS), U.S. Vegetable Laboratory, Charleston, SC 29414
| | - S Adkins
- USDA-ARS, U.S. Horticultural Research Laboratory, Ft. Pierce, FL 34945
| | | | - G Miller
- Edisto Research & Education Center, Clemson University, Blackville, SC 29817
| | - R Hassell
- Coastal Research & Education Center, Clemson University, Charleston, SC 29414
| | - A P Keinath
- Coastal Research & Education Center, Clemson University, Charleston, SC 29414
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Andriani A, Petrucci MT, Caravita T, Montanaro M, Villivà N, Levi A, Siniscalchi A, Bongarzoni V, Pisani F, De Muro M, Coppetelli U, Avvisati G, Zullo A, Agrillo A, Gaglioti D. Evolution of bisphosphonate-related osteonecrosis of the jaw in patients with multiple myeloma and Waldenstrom's macroglobulinemia: a retrospective multicentric study. Blood Cancer J 2012; 2:e62. [PMID: 22829257 PMCID: PMC3317527 DOI: 10.1038/bcj.2012.9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 09/13/2011] [Accepted: 09/28/2011] [Indexed: 02/05/2023] Open
Abstract
Bisphosphonates (BPs) are used intravenously to treat cancer-related conditions for the prevention of pathological fractures. Osteonecrosis of the jaw (BRONJ) is a rare complication reported in 4-15% of patients. We studied, retrospectively, 55 patients with multiple myeloma or Waldenstrom's macroglobulinemia followed up from different haematological departments who developed BRONJ. All patients were treated with BPs for bone lesions and/or fractures. The most common trigger for BRONJ was dental alveolar surgery. After a median observation of 26 months, no death caused by BRONJ complication was reported. In all, 51 patients were treated with antibiotic therapy, and in 6 patients, this was performed in association with surgical debridement of necrotic bone, in 16 with hyperbaric O(2) therapy/ozonotherapy and curettage and in 12 with sequestrectomy and O(2)/hyperbaric therapy. Complete response was observed in 20 cases, partial response in 21, unchanged in 9 and worsening in 3. The association of surgical treatment with antibiotic therapy seems to be more effective in eradicating the necrotic bone than antibiotic treatment alone. O(2) hyperbaric/ozonotherapy is a very effective treatment. The cumulative dosage of BPs is important for the evolution of BRONJ. Because the most common trigger for BRONJ was dental extractions, all patients, before BP treatment, must achieve an optimal periodontal health.
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Affiliation(s)
- A Andriani
- Haematology Unit, P.T.P. Nuovo Regina Margherita, Rome, Italy
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Krieger Y, Shoham Y, Levi A, Bogdanov-Beresovsky A, Silberstien E, Sagi A. Burn treatment framework in Israel. Ann Burns Fire Disasters 2011; 24:199-202. [PMID: 22639563 PMCID: PMC3341875] [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] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Indexed: 06/01/2023]
Abstract
The treatment and hospitalization policies in various hospitals in Israel are influenced by injury severity and by the existence or non-existence of a designated burn treatment body. Severely injured burn victims requiring designated burn treatment are referred to one of Israel's five major burn units located in the highest level trauma centres that have an advanced burn treatment infrastructure. This national distribution of burn centres ensures designated treatment availability in various areas according to Israeli demographics, geography, and security threats. Israel does not have an obligatory burn report policy. Implementation of a national burn repository such as that in the USA will be able to give burn treatment specialists in our country a basis for comparison of treatment standards and allow for better care for burn victims. The Israeli Burn Association has a major role in the processes discussed in the manuscript.
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Affiliation(s)
- Y. Krieger
- Plastic Surgery Department and Burn Unit, Soroka Medical Hospital, The Faculty of Health Sciences, Ben-Gurion University, Be'er Sheva, Israel
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Krieger Y, Oz D, Berezovski B, Silberstein E, Gurfinkel R, Arnon O, Vigoda D, Shoham Y, Rosenberg N, Levi A, Sagi A, Rosenberg L. O28.1 Enzymatic debridement of deeply burned hand: an update. Burns 2011. [DOI: 10.1016/s0305-4179(11)70075-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Taylor D, Levi A, Waldman J, Goodman S, Battistelli M, Karasek D, Weitz T. Training to competence and beyond: evaluation of a standardized training program for establishing and maintaining competence in early aspiration abortion care. Contraception 2011. [DOI: 10.1016/j.contraception.2011.05.048] [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]
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Boccadoro M, Cavallo F, Nagler A, Ben Yehuda D, Omedè P, Cavalli M, Levi A, Crippa C, Siniscalchi A, Brasca P, Carella AM, Zanetti BA, Patriarca F, Pezzati S, Montefusco V, Stanevsky A, Lupo B, Caravita T, Di Raimondo F, Palumbo AP. Melphalan/prednisone/lenalidomide (MPR) versus high-dose melphalan and autologous transplantation (MEL200) in newly diagnosed multiple myeloma (MM) patients: A phase III trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.8020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Buggins AGS, Levi A, Gohil S, Fishlock K, Patten PEM, Calle Y, Yallop D, Devereux S. Evidence for a macromolecular complex in poor prognosis CLL that contains CD38, CD49d, CD44 and MMP-9. Br J Haematol 2011; 154:216-22. [PMID: 21569005 DOI: 10.1111/j.1365-2141.2011.08725.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Progressive chronic lymphocytic leukaemia is characterized by the accumulation of neoplastic B-cells in the tissues and correlates with the expression of prognostic biomarkers, such as CD38, CD49d and matrix metalloproteinase-9 (MMP9), which are involved in migration and tissue invasion. In this study we investigated the physical relationship between these molecules and demonstrated that CD38, CD49d, MMP9 and CD44 were physically associated in a supramolecular cell surface complex. Our findings provide a molecular basis for the correlation between expression of these proteins and prognosis and, as the complex is not present in normal B-cells, suggest a novel leukaemia-specific therapeutic target.
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Affiliation(s)
- Andrea G S Buggins
- Department of Haematological Medicine, King's College London, London, UK.
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Guccini I, Serio D, Condò I, Rufini A, Tomassini B, Mangiola A, Maira G, Anile C, Fina D, Pallone F, Mongiardi MP, Levi A, Ventura N, Testi R, Malisan F. Frataxin participates to the hypoxia-induced response in tumors. Cell Death Dis 2011; 2:e123. [PMID: 21368894 PMCID: PMC3101705 DOI: 10.1038/cddis.2011.5] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Revised: 01/13/2011] [Accepted: 01/19/2011] [Indexed: 01/30/2023]
Abstract
Defective expression of frataxin is responsible for the degenerative disease Friedreich's ataxia. Frataxin is a protein required for cell survival since complete knockout is lethal. Frataxin protects tumor cells against oxidative stress and apoptosis but also acts as a tumor suppressor. The molecular bases of this apparent paradox are missing. We therefore sought to investigate the pathways through which frataxin enhances stress resistance in tumor cells. We found that frataxin expression is upregulated in several tumor cell lines in response to hypoxic stress, a condition often associated with tumor progression. Moreover, frataxin upregulation in response to hypoxia is dependent on hypoxia-inducible factors expression and modulates the activation of the tumor-suppressor p53. Importantly, we show for the first time that frataxin is in fact increased in human tumors in vivo. These results show that frataxin participates to the hypoxia-induced stress response in tumors, thus implying that modulation of its expression could have a critical role in tumor cell survival and/or progression.
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Affiliation(s)
- I Guccini
- Department of Experimental Medicine and Biochemical Sciences, Laboratory of Signal Transduction, University ‘Tor Vergata', Rome, Italy
| | - D Serio
- Department of Experimental Medicine and Biochemical Sciences, Laboratory of Signal Transduction, University ‘Tor Vergata', Rome, Italy
| | - I Condò
- Department of Experimental Medicine and Biochemical Sciences, Laboratory of Signal Transduction, University ‘Tor Vergata', Rome, Italy
| | - A Rufini
- Department of Experimental Medicine and Biochemical Sciences, Laboratory of Signal Transduction, University ‘Tor Vergata', Rome, Italy
| | - B Tomassini
- Department of Experimental Medicine and Biochemical Sciences, Laboratory of Signal Transduction, University ‘Tor Vergata', Rome, Italy
| | - A Mangiola
- Department of Neurosurgery, Catholic University School of Medicine, Rome, Italy
| | - G Maira
- Department of Neurosurgery, Catholic University School of Medicine, Rome, Italy
| | - C Anile
- Department of Neurosurgery, Catholic University School of Medicine, Rome, Italy
| | - D Fina
- Department of Internal Medicine, University ‘Tor Vergata', Rome, Italy
| | - F Pallone
- Department of Internal Medicine, University ‘Tor Vergata', Rome, Italy
| | - M P Mongiardi
- National Research Council of Italy, Cell Biology and Neurobiology Institute and IRCCS Fondazione Santa Lucia, Rome, Italy
| | - A Levi
- National Research Council of Italy, Cell Biology and Neurobiology Institute and IRCCS Fondazione Santa Lucia, Rome, Italy
| | - N Ventura
- Department of Experimental Medicine and Biochemical Sciences, Laboratory of Signal Transduction, University ‘Tor Vergata', Rome, Italy
| | - R Testi
- Department of Experimental Medicine and Biochemical Sciences, Laboratory of Signal Transduction, University ‘Tor Vergata', Rome, Italy
| | - F Malisan
- Department of Experimental Medicine and Biochemical Sciences, Laboratory of Signal Transduction, University ‘Tor Vergata', Rome, Italy
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Polat U, Levi A, Sterkin A, Amiaz R. Abnormal contour filling-in process in patients with depression. J Vis 2010. [DOI: 10.1167/6.6.377] [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] Open
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Levi A. Olympic tears. CMAJ 2010; 182:E205-6. [DOI: 10.1503/cmaj.109-3162] [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: 11/01/2022] Open
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Severini C, La Corte G, Improta G, Broccardo M, Agostini S, Petrella C, Sibilia V, Pagani F, Guidobono F, Bulgarelli I, Ferri GL, Brancia C, Rinaldi AM, Levi A, Possenti R. In vitro and in vivo pharmacological role of TLQP-21, a VGF-derived peptide, in the regulation of rat gastric motor functions. Br J Pharmacol 2009; 157:984-93. [PMID: 19466987 DOI: 10.1111/j.1476-5381.2009.00192.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE Vgf gene expression has been detected in various endocrine and neuronal cells in the gastrointestinal tract. In this study we investigated the pharmacological activity of different VGF-derived peptides. Among these, TLQP-21, corresponding to the 556-576 fragment of the protein was the unique active peptide, and its pharmacological profile was further studied. EXPERIMENTAL APPROACH The effects of TLQP-21 were examined in vitro by smooth muscle contraction in isolated preparations from the rat gastrointestinal tract and, in vivo, by assessing gastric emptying in rats. Rat stomach tissues were also processed for immunohistochemical and biochemical characterization. KEY RESULTS In rat longitudinal forestomach strips, TLQP-21 (100 nmol x L(-1)-10 micromol x L(-1)) concentration-dependently induced muscle contraction (in female rats, EC(50) = 0.47 micromol.L(-1), E(max): 85.7 +/- 7.9 and in male rats, 0.87 micromol x L(-1), E(max): 33.4 +/- 5.3; n = 8), by release of prostaglandin (PG)E(2) and PGF(2a) from the mucosal layer. This effect was significantly antagonized by indomethacin and selective inhibitors of either cyclooxygenase-1 (S560) or cyclooxygenase-2 (NS398). Immunostaining and biochemical studies confirmed the presence of VGF in the gastric neuronal cells. TLQP-21, injected i.c.v. (2-32 nmol per rat), significantly decreased gastric emptying by about 40%. This effect was significantly (P < 0.05) blocked by i.c.v. injection of indomethacin, suggesting that, also in vivo, this peptide acts in the brain stimulating PG release. CONCLUSIONS AND IMPLICATIONS The present results demonstrate that this VGF-derived peptide plays a central and local role in the regulation of rat gastric motor functions.
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Affiliation(s)
- C Severini
- Institute of Neurobiology and Molecular Medicine, 00143 Rome, Italy.
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Bartolomucci A, Moles A, Levi A, Possenti R. Pathophysiological role of TLQP-21: gastrointestinal and metabolic functions. Eat Weight Disord 2008; 13:e49-54. [PMID: 19011364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
The present review summarizes recent findings on the metabolic and gastroenteric role of the VGF gene and a peptide derived by post-translational cleavage of the VGF pro-hormone, i.e. TLQP-21. The vgf gene is widely expressed through the central nervous system as well as in the peripheral nervous system, in myenteric plexus ganglia and also in the glandular portion of the stomach. A few VGF derived peptide have been shown to possess biological activity, among them TLQP-21 attracted particular interest following its identification within rat nervous system. In particular, recent studies from our and other groups implicated TLQP-21 in both the modulation of energy homeostasis, body weight regulation and neuroendocrine functions as well as in the central control of gut functions. Overall, findings available point to a role for TLQP-21 in negatively affecting the body energy balance.
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Affiliation(s)
- A Bartolomucci
- Department of Evolutionary and Functional Biology, University of Parma, 43100 Parma, Italy.
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Bartolomucci A, Rigamonti AE, Bulgarelli I, Torsello A, Locatelli V, Pavone F, Levi A, Possenti R, Muller EE, Moles A. Chronic intracerebroventricular TLQP-21 delivery does not modulate the GH/IGF-1-axis and muscle strength in mice. Growth Horm IGF Res 2007; 17:342-345. [PMID: 17400498 DOI: 10.1016/j.ghir.2007.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2006] [Revised: 01/30/2007] [Accepted: 02/20/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Biallelic ablation of VGF determines a dwarf phenotype. VGF precursor protein encodes for different biologically active peptides none of which has been related to growth or muscular abnormalities. Here we present the first attempt to fill this gap. We tested the hypothesis that a recently identified VGF-derived peptide, TLQP-21, shown to centrally modulate metabolic functions, could also modulate growth hormone (GH)-axis and muscle strength. DESIGN Adult male mice were chronically icv injected with TLQP-21 (15 microg/day for 14 days). Physiological, molecular and behavioral parameters related to the GH/IGF-1-axis were investigated. RESULTS Except for a reduction in the soleus weight, TLQP-21 did not affect GH/IGF-1-axis mediators, muscle strength and muscle weight. CONCLUSIONS Results collected exclude a role for TLQP-21 in modulating the GH/IGF1-axis and muscle functions. VGF-derived peptides involved in the dwarf phenotype of VGF-/- mice have to be identified yet.
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Volpicelli P, Latagliata R, Breccia M, Carmosino I, Stefanizzi C, Iannella E, Levi A, Natalino F, Alimena G. P125 Pregnancy in patients with myelodysplastic syndromes (MDS). Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70195-9] [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: 11/25/2022]
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Breccia M, Gentilini F, Stefanizzi C, Levi A, Natalino F, Latagliata R, Nanni M, Alimena G. P015 Clinical and prognostic features of patients with myelodysplastic/myeloproliferative syndrome categorised as unclassified (MDS/MPD-U) by WHO classification. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70085-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Patti F, Pozzilli C, Montanari E, Pappalardo A, Piazza L, Levi A, Onesti E, Pesci I. Effects of education level and employment status on HRQoL in early relapsing-remitting multiple sclerosis. Mult Scler 2007; 13:783-91. [PMID: 17613607 DOI: 10.1177/1352458506073511] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [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: 11/16/2022]
Abstract
Purpose To evaluate the effects of education level and employment status on health-related quality of life (HRQoL) in a large cohort of patients affected by relapsing-remitting multiple sclerosis (RRMS). Patients This study included 648 patients with RRMS attending 40 Italian MS centers. Inclusion criteria were an Expanded Disability Status Scale (EDSS) score between 1.0 and 5.5; stable disease on enrollment; and no previous treatment with interferons, glatiramer acetate, or immunosuppressive drugs. Quality of life (QoL) was evaluated by the Multiple Sclerosis Quality of Life-54 questionnaire (MSQoL-54). Results Employed patients scored significantly higher than other patient groups in the majority of MSQoL-54 domains. Similarly, patients with academic degrees and secondary education had higher scores than those with primary education (ie, eight years of education) in several domains of HRQoL. Patients who were employed with a high educational level achieved significantly better scores than unemployed patients with a lower educational level. In multivariate analysis, occupation and educational level were found to be significant and independent predictors of HRQoL. Conclusions The results of our study suggest the importance of sustaining employment after a recent diagnosis of MS. In addition, education has a great influence on HRQoL; a higher education level may determine a stronger awareness of the disease, and a better ability to cope with the challenges of a chronic disease such as MS. Multiple Sclerosis 2007; 13: 783-791. http://msj.sagepub.com
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Affiliation(s)
- F Patti
- Department of Neurological Sciences, Multiple Sclerosis Centre, University of Catania, Italy.
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Levi A, Davis A, Hernandez A, Wechter P, Thimmapuram J, Trebitsh T, Tadmor Y, Katzir N, Portnoy V, King S. Genes expressed during the development and ripening of watermelon fruit. Plant Cell Rep 2006; 25:1233-45. [PMID: 16802118 DOI: 10.1007/s00299-006-0163-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2005] [Revised: 03/01/2006] [Accepted: 03/25/2006] [Indexed: 05/10/2023]
Abstract
A normalized cDNA library was constructed using watermelon flesh mRNA from three distinct developmental time-points and was subtracted by hybridization with leaf cDNA. Random cDNA clones of the watermelon flesh subtraction library were sequenced from the 5' end in order to identify potentially informative genes associated with fruit setting, development, and ripening. One-thousand and forty-six 5'-end sequences (expressed sequence tags; ESTs) were assembled into 832 non-redundant sequences, designated as "EST-unigenes". Of these 832 "EST-unigenes", 254 ( approximately 30%) have no significant homology to sequences published so far for other plant species. Additionally, 168 "EST-unigenes" ( approximately 20%) correspond to genes with unknown function, whereas 410 "EST-unigenes" ( approximately 50%) correspond to genes with known function in other plant species. These "EST-unigenes" are mainly associated with metabolism, membrane transport, cytoskeleton synthesis and structure, cell wall formation and cell division, signal transduction, nucleic acid binding and transcription factors, defense and stress response, and secondary metabolism. This study provides the scientific community with novel genetic information for watermelon as well as an expanded pool of genes associated with fruit development in watermelon. These genes will be useful targets in future genetic and functional genomic studies of watermelon and its development.
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Affiliation(s)
- A Levi
- USDA, ARS, U.S. Vegetable Laboratory, 2700 Savannah Highway, Charleston, SC 29414, USA.
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Affiliation(s)
- R. Englman
- a Soreq Nuclear Research Centre , Yavne , Israel
| | - Z. Jaeger
- a Soreq Nuclear Research Centre , Yavne , Israel
| | - A. Levi
- a Soreq Nuclear Research Centre , Yavne , Israel
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