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van Rossum C, de Bree K, de Jong G, Bartels R, Heeren G, Nabuurs M, Meijer C, Tostmann A, Aquarius R. Usability and outcomes of self-monitored surgical wound healing using a smartphone-based application by patients following neurosurgery. J Hosp Infect 2024; 148:138-144. [PMID: 38554806 DOI: 10.1016/j.jhin.2024.03.011] [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] [Received: 12/22/2023] [Revised: 03/15/2024] [Accepted: 03/17/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND The Radboudumc developed a smartphone application (WondGezond) to collect surgical wound-healing information provided by the patient. AIM To evaluate usability and outcomes to assess its potential for early surgical site infection (SSI) detection. METHODS Patients surgically treated for degenerative spinal disorders or carpal tunnel syndrome between August 2020 and February 2023 were enrolled one day post surgery and asked to download the app via a quick-response (QR) code. Participants uploaded a photo and answered four questions about their wound daily, for 14 days. Afterwards, participants indicated whether they received treatment for a suspected SSI (participant-reported outcome). Two neurosurgeons independently assessed photos and questionnaire answers for suspected SSIs (physician-assessed outcome). The association between both outcomes was determined by calculating sensitivity, specificity, and positive and negative predictive value (PPV/NPV). FINDINGS After 2009 surgeries, 1695 QR-codes were distributed and 412 (21%) were activated. In all, 232 (56%) participants completed the 14-day period of whom 22 (10%) reported SSI treatment. Physician assessment identified 15 (7%) SSIs. Concordance was reached in 88% of cases. Among 27 discordant cases were 17 false-positives and 10 false-negatives, resulting in low sensitivity (33%) and PPV (23%), but high NPV (95%). CONCLUSION WondGezond provides clinicians with information regarding wound healing and SSIs to follow-up on patients at risk, while possibly also reducing antibiotic (over)treatment and unnecessary visits for patients without issues in wound healing. However, the low participation and false-positive results render the app in its current form unsuitable for surveillance purposes. Further validation of WondGezond is required.
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Affiliation(s)
- C van Rossum
- Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - K de Bree
- Department of Neurosurgery, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Neurosurgery, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands
| | - G de Jong
- Department of Oral & Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - R Bartels
- Department of Neurosurgery, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Neurosurgery, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands
| | - G Heeren
- Department of Medical Microbiology and Immunology, Dicoon/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - M Nabuurs
- Department of Medical Microbiology and Immunology, Dicoon/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - C Meijer
- Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A Tostmann
- Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands; Regional Antimicrobial Resistance and Infection Prevention Network Gelderland, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - R Aquarius
- Department of Neurosurgery, Radboud University Medical Centre, Nijmegen, The Netherlands
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Heresi G, Abe K, Forfia P, Jevnikar M, Moiseeva O, Kopeć G, Sheares K, Skoro-Sajer N, Terra-Filho M, Whitford H, Beaudet A, Gressin V, Meijer C, Zhai Z. Assessment of Clinical Practices and Unmet Needs in Chronic Thromboembolic Pulmonary Hypertension (CTEPH) - A Global Cross-Sectional Scientific Survey (CLARITY). J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1087] [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: 04/05/2023] Open
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Skoro-Sajer N, Kopec G, Abe K, Forfia P, Heresi G, Jevnikar M, Sheares K, Terra-Filho M, Whitford H, Zhai Z, Beaudet A, Gressin V, Meijer C, Moiseeva O. Chronic thromboembolic pulmonary hypertension global cross-sectional scientific survey (CLARITY) – interim results on the adoption and perception of guidelines. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1867] [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: 11/12/2022] Open
Abstract
Abstract
Background
The chronic thromboembolic pulmonary hypertension (CTEPH) global cross-sectional scientific survey (CLARITY) was established to provide insights into current clinical practices and unmet needs in the diagnosis and treatment of CTEPH. The European Society of Cardiology (ESC) plays a leading role in establishing guidelines (GLs) for clinical decision-making in acute pulmonary embolism (PE) and CTEPH. It is of interest to better understand how these GLs affect real-world practice.
Purpose
To assess the adoption and perception of clinical practice GLs among medical specialists working in the fields of cardiology.
Methods
The online survey was developed by an independent committee of 11 international CTEPH experts using the Delphi method and designed to elicit responses regarding disease awareness and management, including follow-up after acute PE and diagnosis of suspected CTEPH. Logic functions were implemented to ensure respondents only viewed questions relevant to their clinical practice. To date, professional members of 17 Scientific Societies and other medical organizations were invited to respond to the survey. For this interim analysis response data were collected from 10.09.2021 to 10.02.2022.
Results
Out of 242 respondents, 107 specialized in cardiology (44%) and 7 specialized in angiology (3%) were included in this interim analysis. Respondents were from Europe (75%, n=85), Asia Pacific (20%, n=23) and the Americas (5%, n=6) and generally had 15–29 (40%, n=45) or 5–14 (37%, n=42) years of working experience. Of the 67 respondents (59%) that did not work in a pulmonary hypertension (PH)/CTEPH expert centre, only 24 (36%) were affiliated with such a centre.
Of respondents involved in acute PE management (n=101) and CTEPH diagnosis (n=87), 87 (86%) and 71 (82%) reported following the 2019 PE ESC/European Respiratory Society (ERS) and 2015 PH ESC/ERS GLs, respectively. Regardless of country, a higher proportion of respondents from Asia Pacific also reported using national GLs for PE (44%, n=10) and CTEPH (52%, n=12) compared to respondents from Europe (15%, n=11; 25%, n=15) and the Americas (25%, n=1; 40%, n=2). Overall, GLs were perceived to facilitate clinical practice (Fig. 1).
Lack of GLs to screen for CTEPH following acute PE was more often reported as a barrier by respondents from Asia Pacific and those working in an expert centre. Low adherence to GLs was reported as a barrier to CTEPH diagnosis by approximately 1/3 of respondents, irrespective of care setting, and in higher proportion among those with more working experience.
Conclusion
Despite the availability of GLs, reported barriers indicate an opportunity for educational activities to improve adoption and adherence to GLs. Observed differences and potential gaps between clinical practice and the GLs warrant further exploration through additional global insights collected by the survey throughout April 2022.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): This survey is sponsored by Actelion Pharmaceuticals Ltd, a Janssen Pharmaceutical Company of Johnson & Johnson
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Affiliation(s)
| | - G Kopec
- Jagiellonian University Medical College, John Paul II Hospital, Pulmonary Circulation Centre , Krakow , Poland
| | - K Abe
- Kyushu University Hospital , Fukuoka , Japan
| | - P Forfia
- Temple University Hospital , Philadelphia , United States of America
| | - G Heresi
- Cleveland Clinic , Cleveland , United States of America
| | - M Jevnikar
- Hospital Kremlin Bicetre , Paris , France
| | - K Sheares
- Royal Papworth Hospital , Cambridge , United Kingdom
| | - M Terra-Filho
- Heart Institute of the University of Sao Paulo (InCor), Pulmonary Division , Sao Paulo , Brazil
| | - H Whitford
- The Alfred Hospital , Melbourne , Australia
| | - Z Zhai
- China-Japan Friendship Hospital, National Center for Respiratory Medicine , Beijing , China
| | - A Beaudet
- Actelion Pharmaceuticals Ltd , Allschwil , Switzerland
| | - V Gressin
- Actelion Pharmaceuticals Ltd , Allschwil , Switzerland
| | - C Meijer
- Monitor Deloitte , Zaventem , Belgium
| | - O Moiseeva
- Almazov National Medical Research Centre , Saint Petersburg , Russian Federation
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de Mooij CEM, van der Velden WJFM, Verweij PE, de Haan AFJ, van Groningen LFJ, Meijer C, Hopman J, Blijlevens NMA. Surveillance of catheter-related bloodstream infections in haemato-oncology patients: comparison of two definitions. J Hosp Infect 2020; 105:686-690. [PMID: 32339616 DOI: 10.1016/j.jhin.2020.04.027] [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] [Received: 02/07/2020] [Accepted: 04/17/2020] [Indexed: 10/24/2022]
Abstract
In the Netherlands, the PREZIES surveillance is used for registration and surveillance of central venous catheter (CVC) -related bloodstream infections (CRBSI). We investigated how this Dutch definition correlated with internationally used definitions for CRBSI, central line-associated bloodstream infections (CLABSI) and mucosal barrier injury laboratory-confirmed bloodstream infections (MBI-LCBI). We determined that the Dutch PREZIES definition of CRBSI is appropriate for surveillance control of CVC care bundle use in haemato-oncology patients managed with multi-lumen CVCs.
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Affiliation(s)
- C E M de Mooij
- Radboud Institute for Health Sciences, Department of Haematology, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - W J F M van der Velden
- Radboud Institute for Health Sciences, Department of Haematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - P E Verweij
- Radboudumc Center for Infectious Diseases, Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - A F J de Haan
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands
| | - L F J van Groningen
- Radboud Institute for Health Sciences, Department of Haematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - C Meijer
- Radboudumc Center for Infectious Diseases, Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - J Hopman
- Radboudumc Center for Infectious Diseases, Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - N M A Blijlevens
- Radboud Institute for Health Sciences, Department of Haematology, Radboud University Medical Center, Nijmegen, the Netherlands
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5
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Vingerhoets C, van Oudenaren MJF, Bloemen OJN, Boot E, van Duin EDA, Evers LJM, Fiksinski AM, Breetvelt EJ, Palmer LD, Vergaelen E, Vogels A, Meijer C, Booij J, de Haan L, Swillen A, Vorstman JAS, Bassett AS, van Amelsvoort TAMJ. Low prevalence of substance use in people with 22q11.2 deletion syndrome. Br J Psychiatry 2019; 215:661-667. [PMID: 30604657 DOI: 10.1192/bjp.2018.258] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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] [Indexed: 11/23/2022]
Abstract
BACKGROUND 22q11.2 deletion syndrome (22q11DS), one of the most common recurrent copy number variant disorders, is associated with dopaminergic abnormalities and increased risk for psychotic disorders. AIMS Given the elevated prevalence of substance use and dopaminergic abnormalities in non-deleted patients with psychosis, we investigated the prevalence of substance use in 22q11DS, compared with that in non-deleted patients with psychosis and matched healthy controls. METHOD This cross-sectional study involved 434 patients with 22q11DS, 265 non-deleted patients with psychosis and 134 healthy controls. Psychiatric diagnosis, full-scale IQ and COMT Val158Met genotype were determined in the 22q11DS group. Substance use data were collected according to the Composite International Diagnostic Interview. RESULTS The prevalence of total substance use (36.9%) and substance use disorders (1.2%), and weekly amounts of alcohol and nicotine use, in patients with 22q11DS was significantly lower than in non-deleted patients with psychosis or controls. Compared with patients with 22q11DS, healthy controls were 20 times more likely to use substances in general (P < 0.001); results were also significant for alcohol and nicotine use separately. Within the 22q11DS group, there was no relationship between the prevalence of substance use and psychosis or COMT genotype. Male patients with 22q11DS were more likely to use substances than female patients with 22q11DS. CONCLUSIONS The results suggest that patients with 22q11DS are at decreased risk for substance use and substance use disorders despite the increased risk of psychotic disorders. Further research into neurobiological and environmental factors involved in substance use in 22q11DS is necessary to elucidate the mechanisms involved. DECLARATION OF INTEREST None.
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Affiliation(s)
- Claudia Vingerhoets
- Psychologist, Postdoctoral Researcher, Department of Psychiatry and Psychology, Maastricht University; and Department of Nuclear Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Mathilde J F van Oudenaren
- Psychologist, Research Assistant, Department of Nuclear Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Oswald J N Bloemen
- Psychiatrist, Senior Researcher, Department of Psychiatry and Psychology, Maastricht University; and Center for Mental Health Care Innova, GGz Centraal, the Netherlands
| | - Erik Boot
- Specialist in Intellectual Disability Medicine, Honorary Researcher, Department of Nuclear Medicine, Academic Medical Center, Amsterdam; S Heeren Loo Zorggroep; Department of Psychiatry and Psychology, Maastricht University, the Netherlands; The Dalglish Family 22q Clinic and Centre for Mental Health, University Health Network; Department of Psychiatry, University of Toronto; and Clinical Genetics Research Program, Centre for Addiction and Mental Health, Ontario, Canada
| | - Esther D A van Duin
- Department of Psychiatry and Psychology, Maastricht University; and Department of Nuclear Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Laurens J M Evers
- Psychiatrist, Department of Psychiatry and Psychology, Maastricht University, the Netherlands
| | - Ania M Fiksinski
- Psychologist, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands; and The Dalglish Family 22q Clinic and Centre for Addiction and Mental Health, Canada
| | - Elemi J Breetvelt
- Child Psychiatrist, Epidemiologist, The Dalglish Family 22q Clinic and Centre for Addiction and Mental Health, Canada
| | - Lisa D Palmer
- Social Worker, The Dalglish Family 22q Clinic and Centre for Addiction and Mental Health, Canada
| | - Elfi Vergaelen
- Psychiatrist in training, Center for Human Genetics, KU Leuven, Belgium
| | - Annick Vogels
- Professor, Child Psychiatrist, Center for Human Genetics, University Hospital Gasthuisberg, Department of Human Genetics, KU Leuven, Belgium
| | - Carin Meijer
- Psychologist, Senior Researcher, Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | - Jan Booij
- Professor of Experimental Nuclear Medicine, Department of Nuclear Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | | | - Liewe de Haan
- Professor, Psychiatrist, Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | - Ann Swillen
- Professor, Center for Human Genetics, University Hospital Gasthuisberg, Department of Human Genetics, KU Leuven, Belgium
| | - Jacob A S Vorstman
- Associate Professor, Child Psychiatrist, The Hospital for Sick Children, Toronto; and University of Toronto, Canada
| | - Anne S Bassett
- Professor / Psychiatrist, The Dalglish Family 22q Clinic; Clinical Genetics Research Program, Toronto General Hospital; Centre for Addiction and Mental Health, Toronto; and Department of Psychiatry, University of Toronto, Canada
| | - Therese A M J van Amelsvoort
- Professor of Transitional Psychiatry, Psychiatrist, Department of Psychiatry and Psychology, Maastricht University, the Netherlands
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Pos K, Franke N, Smit F, Wijnen BFM, Staring ABP, Van der Gaag M, Meijer C, de Haan L, Velthorst E, Schirmbeck F. Cognitive behavioral therapy for social activation in recent-onset psychosis: Randomized controlled trial. J Consult Clin Psychol 2019; 87:151-160. [DOI: 10.1037/ccp0000362] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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7
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Steggink LC, van Beek AP, Boer H, Meijer C, Lubberts S, Oosting SF, de Jong IJ, van Ginkel RJ, Lefrandt JD, Gietema JA, Nuver J. Insulin-like factor 3, luteinizing hormone and testosterone in testicular cancer patients: effects of β-hCG and cancer treatment. Andrology 2019; 7:441-448. [DOI: 10.1111/andr.12581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 08/01/2018] [Accepted: 11/30/2018] [Indexed: 01/09/2023]
Affiliation(s)
- L. C. Steggink
- Department of Medical Oncology; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - A. P. van Beek
- Division of Endocrinology; Department of Internal Medicine; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - H. Boer
- Department of Medical Oncology; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - C. Meijer
- Department of Medical Oncology; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - S. Lubberts
- Department of Medical Oncology; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - S. F. Oosting
- Department of Medical Oncology; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - I. J. de Jong
- Department of Urology; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - R. J. van Ginkel
- Division of Surgical Oncology; Department of Surgery; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - J. D. Lefrandt
- Division of Vascular Medicine; Department of Internal Medicine; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - J. A. Gietema
- Department of Medical Oncology; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - J. Nuver
- Department of Medical Oncology; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
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8
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Stelwagen J, Lubberts S, Steggink L, Steursma G, Kruyt L, Donkerbroek J, van Roon A, van Gessel A, van de Zande S, Meijer C, Wempe J, Gräfin zu Eulenburg C, Nuver J, Walenkamp A, Lefrandt J, Gietema J. Vascular damage and pulmonary function in very long-term survivors of testicular cancer (TC) treated with cisplatin-based chemotherapy (CT). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy283.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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9
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de Boer JP, Abbink JJ, Brouwer MC, Meijer C, Roem D, Voorn GP, Lambers JWJ, van Mourik JA, Hack CE. PAI-1 Synthesis in the Human Hepatoma Cell Line Hep G2 Is Increased by Cytokines - Evidence that the Liver Contributes to Acute Phase Behaviour of PAI-1. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1647480] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryThe acute phase behaviour of the fast inhibitor of tissue-type plasminogen activator (PAI-1) in vivo has been attributed to increased synthesis by endothelial cells. However, most other acute phase proteins in vivo are synthesized in the liver, which process is regulated by cytokines and can be studied in the hepatoma derived cell line HepG2.In this study, we investigated whether the synthesis of PAI-1 by HepG2 cells is regulated by the cytokines recombinant IL-1, rlL-6 and rTNF. Recombinant IL-1 and rTNF each increased PAI-1 synthesis by Hep G2 cells two to three fold, whereas rIL-6 hardly had an effect. Mixtures of rIL-1, rIL-6 and rTNF increased PAI-1 synthesis up to eleven fold. The effects observed were not due to non-specific effects on Hep G2 cell metabolism, since synthesis of alpha-2-antiplasmin was not effected by any of those cytokines, whereas fibrinogen synthesis was increased three to four fold by rIL-6, but was unaffected by rIL-1. Thus, our results demonstrate that synthesis of PAI-1 by Hep G2 cells is regulated by cytokines and implicate that the acute phase behaviour of PAI-1 in vivo at least in part may be due to an increased synthesis by the liver.
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Affiliation(s)
- J P de Boer
- The Central Laboratory of the Netherlands Red Cross Blood Transfusion Service and Laboratory for Experimental and Clinical Immunology, University of Amsterdam, Amsterdam
| | - J J Abbink
- The Central Laboratory of the Netherlands Red Cross Blood Transfusion Service and Laboratory for Experimental and Clinical Immunology, University of Amsterdam, Amsterdam
| | - M C Brouwer
- The Central Laboratory of the Netherlands Red Cross Blood Transfusion Service and Laboratory for Experimental and Clinical Immunology, University of Amsterdam, Amsterdam
| | - C Meijer
- The Central Laboratory of the Netherlands Red Cross Blood Transfusion Service and Laboratory for Experimental and Clinical Immunology, University of Amsterdam, Amsterdam
| | - D Roem
- The Central Laboratory of the Netherlands Red Cross Blood Transfusion Service and Laboratory for Experimental and Clinical Immunology, University of Amsterdam, Amsterdam
| | - G P Voorn
- The Department of Infectious Disease, University of Leiden, Delft, The Netherlands
| | - J W J Lambers
- The Department of Cell, Gist Brocades, Delft, The Netherlands
| | - J A van Mourik
- The Central Laboratory of the Netherlands Red Cross Blood Transfusion Service and Laboratory for Experimental and Clinical Immunology, University of Amsterdam, Amsterdam
| | - C E Hack
- The Central Laboratory of the Netherlands Red Cross Blood Transfusion Service and Laboratory for Experimental and Clinical Immunology, University of Amsterdam, Amsterdam
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van Rooijen G, Isvoranu AM, Kruijt OH, van Borkulo CD, Meijer CJ, Wigman JTW, Ruhé HG, de Haan L, Cahn W, de Haan L, Kahn RS, Meijer C, Myin-Germeys I, van Os J, Bartels-Velthuis AA. A state-independent network of depressive, negative and positive symptoms in male patients with schizophrenia spectrum disorders. Schizophr Res 2018; 193:232-239. [PMID: 28844638 DOI: 10.1016/j.schres.2017.07.035] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/14/2017] [Accepted: 07/15/2017] [Indexed: 12/18/2022]
Abstract
Depressive symptoms occur frequently in patients with schizophrenia. Several factor analytical studies investigated the associations between positive, negative and depressive symptoms and reported difficulties differentiating between these symptom domains. Here, we argue that a network approach may offer insights into these associations, by exploring interrelations between symptoms. The aims of current study were to I) construct a network of positive, negative and depressive symptoms in male patients with schizophrenia to investigate interactions between individual symptoms; II) identify the most central symptoms within this network and III) examine group-level differences in network connectivity between remitted and non-remitted patients. We computed a network of depressive, positive and negative symptoms in a sample of 470 male patients diagnosed with a psychotic disorder. Depressive symptoms were assessed with the Calgary Depression Rating Scale for Schizophrenia, while psychotic symptoms were assessed with the Positive and Negative Syndrome Scale. Networks of male patients who fulfilled remission criteria (Andreasen et al., 2005) and non-remitters for psychosis were compared. Our results indicate that depressive symptoms are mostly associated with suicidality and may act as moderator between psychotic symptoms and suicidality. In addition, 'depressed mood', 'observed depression', 'poor rapport', 'stereotyped thinking' and 'delusions' were central symptoms within the network. Finally, although remitted male patients had a similar network structure compared to non-remitters the networks differed significantly in terms of global strength. In conclusion, clinical symptoms of schizophrenia were linked in a stable way, independent of symptomatic remission while the number of connections appears to be dependent on remission status.
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Affiliation(s)
- Geeske van Rooijen
- University of Amsterdam, Academic Medical Center, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands.
| | - Adela-Maria Isvoranu
- University of Amsterdam, Department of Psychology, Psychological Methods, Nieuwe Achtergracht 129-B, 1018 WT Amsterdam, The Netherlands.
| | - Olle H Kruijt
- University of Amsterdam, Academic Medical Center, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands.
| | - Claudia D van Borkulo
- University of Amsterdam, Department of Psychology, Psychological Methods, Nieuwe Achtergracht 129-B, 1018 WT Amsterdam, The Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
| | - Carin J Meijer
- University of Amsterdam, Academic Medical Center, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands.
| | - Johanna T W Wigman
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
| | - Henricus G Ruhé
- University of Amsterdam, Academic Medical Center, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands; Warneford Hospital, Department of Psychiatry, University of Oxford, United Kingdom.
| | - Lieuwe de Haan
- University of Amsterdam, Academic Medical Center, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands.
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11
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Borrelli M, Maglio M, Korponay-Szabó IR, Vass V, Mearin ML, Meijer C, Niv-Drori H, Ribes-Koninckx C, Roca M, Shamir R, Troncone R, Auricchio R. Intestinal anti-transglutaminase 2 immunoglobulin A deposits in children at risk for coeliac disease (CD): data from the PreventCD study. Clin Exp Immunol 2017; 191:311-317. [PMID: 29114847 DOI: 10.1111/cei.13078] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2017] [Indexed: 11/28/2022] Open
Abstract
In coeliac disease (CD), anti-tissue transglutaminase 2 immunoglobulin (Ig)A antibodies (anti-TG2) are produced and deposited in the intestine. PreventCD (www.preventcd.com) is a European multi-centre study, which investigates the influence of infant nutrition and that of genetic, immunological and other environmental factors on the risk of developing CD. The aim of the current study was to evaluate the appearance of intestinal anti-TG2 deposits in very early intestinal biopsies from at-risk infants and their predictive value for villous atrophy. Sixty-five small bowel biopsies, performed in 62 children, were investigated for the presence of intestinal anti-TG2 extracellular IgA deposits by using double immunofluorescence. The biopsies were performed in the presence of elevated serum levels of CD-associated antibodies and/or symptoms suggesting disease. Deposits of anti-TG2 IgA were present in 53 of 53 CD patients and three of three potential CD patients. In potential CD patients, mucosal deposits showed a patchy distribution characterized by some areas completely negative, whereas active CD patients had uniformly present and evident mucosal deposits. Only one of six patients without CD (negative for serum anti-TG2 and with normal mucosa) had intestinal deposits with a patchy distribution and a weak staining. Two of the 53 CD patients received a definitive diagnosis of CD after a second or third biopsy; mucosal deposits of anti-TG2 IgA were evaluated in all samples. Before developing villous atrophy, both patients had anti-TG2 deposits in normal mucosal architecture, antibodies in one patient being absent in serum. We demonstrated that in CD the intestinal deposits of anti-TG2 are a constant presence and appear very early in the natural history of disease.
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Affiliation(s)
- M Borrelli
- Department of Medical Translational Science, Section of Paediatrics
| | - M Maglio
- European Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II, Naples, Italy
| | - I R Korponay-Szabó
- Department of Paediatrics, University of Debrecen Medical School, Debrecen.,Institute of Pathology, Heim Pál Children's Hospital, Budapest, Hungary
| | - V Vass
- Institute of Pathology, Heim Pál Children's Hospital, Budapest, Hungary
| | - M L Mearin
- Department of Paediatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - C Meijer
- Department of Paediatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - H Niv-Drori
- Institute of Pathology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
| | - C Ribes-Koninckx
- Unidad de Enfermedad Celíaca e Inmunopatología Digestiva, Medical Research Institute La Fe, Valencia, Spain.,Pediatric Gastrohepatology Unit, University Hospital La Fe, Valencia, Spain
| | - M Roca
- Unidad de Enfermedad Celíaca e Inmunopatología Digestiva, Medical Research Institute La Fe, Valencia, Spain
| | - R Shamir
- Institute of Gastroenterology, Nutrition and Liver Diseases Schneider Children's Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - R Troncone
- Department of Medical Translational Science, Section of Paediatrics.,European Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II, Naples, Italy
| | - R Auricchio
- Department of Medical Translational Science, Section of Paediatrics.,European Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II, Naples, Italy
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12
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Peeters SCT, Gronenschild EHBM, van Amelsvoort T, van Os J, Marcelis M, Kahn R, Wiersma D, Bruggeman R, Cahn W, de Haan L, Meijer C, Myin-Germeys I. Reduced specialized processing in psychotic disorder: a graph theoretical analysis of cerebral functional connectivity. Brain Behav 2016; 6:e00508. [PMID: 27688938 PMCID: PMC5036431 DOI: 10.1002/brb3.508] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 04/24/2016] [Accepted: 04/29/2016] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Previous research has shown that the human brain can be represented as a complex functional network that is characterized by specific topological properties, such as clustering coefficient, characteristic path length, and global/local efficiency. Patients with psychotic disorder may have alterations in these properties with respect to controls, indicating altered efficiency of network organization. This study examined graph theoretical changes in relation to differential genetic risk for the disorder and aimed to identify clinical correlates. METHODS Anatomical and resting-state MRI brain scans were obtained from 73 patients with psychotic disorder, 83 unaffected siblings, and 72 controls. Topological measures (i.e., clustering coefficient, characteristic path length, and small-worldness) were used as dependent variables in a multilevel random regression analysis to investigate group differences. In addition, associations with (subclinical) psychotic/cognitive symptoms were examined. RESULTS Patients had a significantly lower clustering coefficient compared to siblings and controls, with no difference between the latter groups. No group differences were observed for characteristic path length and small-worldness. None of the topological properties were associated with (sub)clinical psychotic and cognitive symptoms. CONCLUSIONS The reduced ability for specialized processing (reflected by a lower clustering coefficient) within highly interconnected brain regions observed in the patient group may indicate state-related network alterations. There was no evidence for an intermediate phenotype and no evidence for psychopathology-related alterations.
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Affiliation(s)
- Sanne C T Peeters
- Department of Psychiatry & Neuropsychology School for Mental Health and Neuroscience EURON Maastricht University Medical Center PO Box 616 6200 MD Maastricht The Netherlands; Faculty of Psychology and Educational Sciences Open University of the Netherlands Heerlen The Netherlands
| | - Ed H B M Gronenschild
- Department of Psychiatry & Neuropsychology School for Mental Health and Neuroscience EURON Maastricht University Medical Center PO Box 616 6200 MD Maastricht The Netherlands
| | - Therese van Amelsvoort
- Department of Psychiatry & Neuropsychology School for Mental Health and Neuroscience EURON Maastricht University Medical Center PO Box 616 6200 MD Maastricht The Netherlands
| | - Jim van Os
- Department of Psychiatry & Neuropsychology School for Mental Health and Neuroscience EURON Maastricht University Medical Center PO Box 616 6200 MD Maastricht The Netherlands; Department of Psychosis Studies Institute of Psychiatry King's Health Partners King's College London London UK
| | - Machteld Marcelis
- Department of Psychiatry & Neuropsychology School for Mental Health and Neuroscience EURON Maastricht University Medical Center PO Box 616 6200 MD Maastricht The Netherlands; Institute for Mental Health Care Eindhoven (GGzE) Eindhoven The Netherlands
| | | | - Rene Kahn
- Department of Psychiatry & Neuropsychology School for Mental Health and Neuroscience EURON Maastricht University Medical Center PO Box 616 6200 MD Maastricht The Netherlands
| | - Durk Wiersma
- Department of Psychiatry & Neuropsychology School for Mental Health and Neuroscience EURON Maastricht University Medical Center PO Box 616 6200 MD Maastricht The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry & Neuropsychology School for Mental Health and Neuroscience EURON Maastricht University Medical Center PO Box 616 6200 MD Maastricht The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry & Neuropsychology School for Mental Health and Neuroscience EURON Maastricht University Medical Center PO Box 616 6200 MD Maastricht The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry & Neuropsychology School for Mental Health and Neuroscience EURON Maastricht University Medical Center PO Box 616 6200 MD Maastricht The Netherlands
| | - Carin Meijer
- Department of Psychiatry & Neuropsychology School for Mental Health and Neuroscience EURON Maastricht University Medical Center PO Box 616 6200 MD Maastricht The Netherlands
| | - Inez Myin-Germeys
- Department of Psychiatry & Neuropsychology School for Mental Health and Neuroscience EURON Maastricht University Medical Center PO Box 616 6200 MD Maastricht The Netherlands
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13
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Lubberts S, Boer H, Altena R, Meijer C, van Roon AM, Zwart N, Oosting SF, Kamphuisen PW, Nuver J, Smit AJ, Mulder AB, Lefrandt JD, Gietema JA. Vascular fingerprint and vascular damage markers associated with vascular events in testicular cancer patients during and after chemotherapy. Eur J Cancer 2016; 63:180-8. [PMID: 27322917 DOI: 10.1016/j.ejca.2016.05.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 05/13/2016] [Accepted: 05/17/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Metastatic testicular cancer (TC) can be cured with bleomycin, etoposide and cisplatin (BEP) chemotherapy. This comes at the price of an increased cardiovascular disease risk, not only years afterwards, but also during and shortly after chemotherapy. To prevent cardiovascular events, high-risk patients should be identified. The aim of this study was to assess BEP-chemotherapy induced vascular damage and to find risk factors for early vascular events. PATIENTS AND METHODS A prospective cohort study was performed in (B)EP treated TC patients. Development of venous and arterial vascular events was assessed. Vascular damage markers (von Willebrand factor [vWF], coagulation factor VIII [FVIII], intima media thickness [IMT]) and cardiovascular risk factors were assessed before and until 1 year after chemotherapy. Before start of chemotherapy a vascular fingerprint was estimated. Presence of ≥3 risk factors was defined as high-risk vascular fingerprint: body mass index >25 kg/m(2), current smoking, blood pressure >140/90 mm Hg, total cholesterol >5.1 and/or low-density lipoprotein >2.5 mmol/L or glucose ≥7 mmol/L. RESULTS Seventy-three patients were included. Eight (11%) developed vascular events (four arterial events, four pulmonary embolisms). vWF and FVIII increased during chemotherapy, especially in patients with vascular events. Sixteen patients (22%) had a high-risk vascular fingerprint before start of chemotherapy. These patients had arterial events more often (3/16 [19%] versus 1/57 [2%]; p = 0.031) and higher vWF levels and IMT. CONCLUSIONS Endothelial activation and upregulation of procoagulant activity seem important mechanisms involved in early (B)EP-chemotherapy-induced vascular events. Before chemotherapy, a quarter already had cardiovascular risk factors. A vascular fingerprint could identify patients at risk for arterial events. This vascular fingerprint, when validated, can be used as a tool to select patients who may benefit from preventive strategies.
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Affiliation(s)
- S Lubberts
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - H Boer
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - R Altena
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - C Meijer
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A M van Roon
- Department of Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - N Zwart
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - S F Oosting
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - P W Kamphuisen
- Department of Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J Nuver
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A J Smit
- Department of Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A B Mulder
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J D Lefrandt
- Department of Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J A Gietema
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
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14
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Medema S, Mocking RJT, Koeter MWJ, Vaz FM, Meijer C, de Haan L, van Beveren NJM, Kahn R, de Haan L, van Os J, Wiersma D, Bruggeman R, Cahn W, Meijer C, Myin-Germeys I. Levels of Red Blood Cell Fatty Acids in Patients With Psychosis, Their Unaffected Siblings, and Healthy Controls. Schizophr Bull 2016; 42:358-68. [PMID: 26385764 PMCID: PMC4753602 DOI: 10.1093/schbul/sbv133] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Two recent meta-analyses showed decreased red blood cell (RBC) polyunsaturated fatty acids (FA) in schizophrenia and related disorders. However, both these meta-analyses report considerable heterogeneity, probably related to differences in patient samples between studies. Here, we investigated whether variations in RBC FA are associated with psychosis, and thus may be an intermediate phenotype of the disorder. METHODS For the present study, a total of 215 patients (87% outpatients), 187 siblings, and 98 controls were investigated for multiple FA analyses. Based on previous studies, we investigated docosahexaenoic acid (DHA), docosapentaenoic acid (DPA), arachidonic acid (AA), linoleic acid (LA), nervonic acid (NA), and eicasopentaenoic acid (EPA). On an exploratory basis, a large number of additional FA were investigated. Multilevel mixed models were used to compare the FA between the 3 groups. RESULTS Compared to controls, both patients and siblings showed significantly increased DHA, DPA, AA, and NA. LA was significantly higher in siblings compared to controls. EPA was not significantly different between the 3 groups. Also the exploratory FA were increased in patients and siblings. CONCLUSIONS We found increased RBC FA DHA, DPA, AA, and NA in patients and siblings compared to controls. The direction of change is similar in both patients and siblings, which may suggest a shared environment and/or an intermediate phenotype. Differences between patient samples reflecting stage of disorder, dietary patterns, medication use, and drug abuse are possible modifiers of FA, contributing to the heterogeneity in findings concerning FA in schizophrenia patients.
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Affiliation(s)
- Suzanne Medema
- Department of Psychiatry, Antes Center for Mental Health Care, Rotterdam, The Netherlands; Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Roel J T Mocking
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Maarten W J Koeter
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Frédéric M Vaz
- Laboratory of Genetic and Metabolic Diseases, Academic Medical Center, Amsterdam, The Netherlands
| | - Carin Meijer
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Nico J M van Beveren
- Department of Psychiatry, Antes Center for Mental Health Care, Rotterdam, The Netherlands; Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands; Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands;
| | - René Kahn
- Department of Psychiatry, University Medical Centre Utrecht, Rudolf Magnus Institute of Neuroscience, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Psychology, Maastricht University Medical Center, The Netherlands
| | - Durk Wiersma
- Department of Psychiatry, University Medical Center Groningen, The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry, University Medical Center Groningen, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, University Medical Centre Utrecht, Rudolf Magnus Institute of Neuroscience, The Netherlands
| | - Carin Meijer
- Department of Psychiatry, Antes Center for Mental Health Care, Rotterdam, The Netherlands
| | - Inez Myin-Germeys
- Department of Psychiatry and Psychology, Maastricht University Medical Center, The Netherlands
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15
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Boyette LL, Nederlof J, Meijer C, de Boer F, de Haan L. Three year stability of Five-Factor Model personality traits in relation to changes in symptom levels in patients with schizophrenia or related disorders. Psychiatry Res 2015; 229:539-44. [PMID: 26099654 DOI: 10.1016/j.psychres.2015.05.057] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [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: 08/19/2014] [Revised: 05/13/2015] [Accepted: 05/15/2015] [Indexed: 11/15/2022]
Abstract
Five-Factor Model (FFM) personality traits are related to a wide range of clinical outcome in patients with psychotic disorders. However, it is not sufficiently clear whether psychotic illness, particularly fluctuation in negative symptoms and psychotic relapse, affects personality. The current study examined the 3-year temporal stability of FFM traits in 91 patients with non-affective psychotic disorders with a maximum duration of illness of 10 years and 32 control subjects without a (family member with) a diagnosis of psychotic illness. In patients, change in negative symptoms predicted changes in Neuroticism and (inversely) in Extraversion and Openness. However, when correcting for depressive symptoms, negative symptoms no longer predicted change in any FFM trait. Clinical characteristics, such as psychotic relapse, were also not found to be related to change in FFM traits. Patients showed a slight increase in Conscientiousness levels, the other FFM traits showed mean-level stability. Rank-order stability of the FFM traits was moderate to strong, although weaker for Neuroticism in patients. Our findings indicate that psychotic symptoms exert limited effect on the stability of FFM traits in patients with psychotic disorders. Consistent with general population findings, one should guard against state-trait confusion between Neuroticism/Extraversion and depression.
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Affiliation(s)
- Lindy-Lou Boyette
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands.
| | - Jan Nederlof
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Carin Meijer
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Froukje de Boer
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
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16
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Boer H, Proost JH, Nuver J, Bunskoek S, Gietema JQ, Geubels BM, Altena R, Zwart N, Oosting SF, Vonk JM, Lefrandt JD, Uges DRA, Meijer C, de Vries EGE, Gietema JA. Long-term exposure to circulating platinum is associated with late effects of treatment in testicular cancer survivors. Ann Oncol 2015; 26:2305-10. [PMID: 26347114 PMCID: PMC4621032 DOI: 10.1093/annonc/mdv369] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [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: 05/19/2015] [Accepted: 08/28/2015] [Indexed: 11/17/2022] Open
Abstract
Cisplatin is an essential part of testicular cancer treatment. We investigated whether long-term exposure to circulating platinum (Pt) plays a role in the development of late effects in survivors. We assessed Pt decay in samples collected 1–13 years after chemotherapy. Renal function is a strong determinant of exposure to Pt. Higher exposure to Pt is associated with an increased prevalence of adverse effects hypogonadism and hypertension. Background The success of cisplatin-based (Platinol, Bristol-Myers Squibb Company, New York, NY, USA) chemotherapy for testicular cancer comes at the price of long-term and late effects related to healthy tissue damage. We assessed and modelled serum platinum (Pt) decay after chemotherapy and determined relationships between long-term circulating Pt levels and known late effects. Patients and methods In 99 testicular cancer survivors, treated with cisplatin-based chemotherapy, serum and 24-h urine samples were collected during follow-up (1–13 years after treatment). To build a population pharmacokinetic model, measured Pt data were simultaneously analysed, together with cisplatin dose, age, weight and height using the NONMEM software. Based on this model, area under the curve between 1 and 3 years after treatment (Pt AUC1–3 years) was calculated for each patient. Predicted long-term Pt exposure was related to renal function and to late effects of treatment assessed median 9 (3–15) years after chemotherapy. Results Decay of Pt was best described by a two-compartment model. Mean terminal T1/2 was 3.7 (range 2.5–5.2) years. Pt AUC1–3 years correlated with cumulative cisplatin dose, and creatinine clearance before and 1 year after treatment. Patients with paraesthesia had higher Pt AUC1–3 years (30.9 versus 27.0 µg/l month) compared with those without paraesthesia (P = 0.021). Patients with hypogonadism, elevated LDL-cholesterol levels or hypertension also had higher Pt AUC1–3 years. Conclusions Renal function before and after cisplatin treatment is an important determinant of long-term Pt exposure. Known long-term effects of testicular cancer treatment, such as paraesthesia, hypogonadism, hypercholesterolaemia and hypertension, are associated with long-term circulating Pt exposure.
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Affiliation(s)
- H Boer
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - J H Proost
- Department of Hospital Pharmacy, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - J Nuver
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - S Bunskoek
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - J Q Gietema
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - B M Geubels
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - R Altena
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - N Zwart
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - S F Oosting
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - J M Vonk
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - J D Lefrandt
- Department of Vascular Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - D R A Uges
- Department of Hospital Pharmacy, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - C Meijer
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - E G E de Vries
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - J A Gietema
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
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17
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Korver-Nieberg N, Berry K, Meijer C, de Haan L, Ponizovsky AM. Associations between attachment and psychopathology dimensions in a large sample of patients with psychosis. Psychiatry Res 2015; 228:83-8. [PMID: 25953341 DOI: 10.1016/j.psychres.2015.04.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [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: 06/10/2014] [Revised: 03/11/2015] [Accepted: 04/16/2015] [Indexed: 10/23/2022]
Abstract
Attachment theory is a powerful theoretical framework that complements and extents current models psychosis. We tested the hypothesis that attachment anxiety and avoidance are differentially associated with the severity of positive, negative and general psychopathology symptoms in patients with a diagnosis of psychosis. Five hundred patients with DSM-IV or ICD-10 diagnoses of psychotic disorders (schizophrenia, schizoaffective or non-affective psychosis) from independent samples from Netherlands, United Kingdom and Israel completed the Relationship Questionnaire. Psychopathology was assessed with the Positive and Negative Syndromes Scale. We used both categorical and dimensional approach to attachment data, which were analyzed using ANOVA with post-hoc tests, Pearson's correlations and multiple regression analysis. The conservative level of statistical significance was established (p < 0.001) to control for multiple testing. After adjustment for possible confounders, attachment anxiety predicted severity of positive symptoms as well as affective symptoms. Both attachment anxiety and avoidance were associated with severity of hallucinations and persecution Contrary to predictions, attachment avoidance was not associated with overall scores for negative symptoms, although there was some evidence of relatively weaker association between avoidance and social and emotional withdrawal.
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Affiliation(s)
- Nikie Korver-Nieberg
- Department Early Psychosis, Academic Psychiatric Center, Amsterdam, The Netherlands
| | - Katherine Berry
- School of Psychological Sciences, University of Manchester, Manchester, United Kingdom
| | - Carin Meijer
- Department Early Psychosis, Academic Psychiatric Center, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Department Early Psychosis, Academic Psychiatric Center, Amsterdam, The Netherlands
| | - Alexander M Ponizovsky
- Research Unit, Mental Health Services, Ministry of Health, 39 Yirmiyahu St. P.O. Box 1176, Jerusalem 9446724, Israel.
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18
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Schirmbeck F, Boyette LL, van der Valk R, Meijer C, Dingemans P, Van R, de Haan L, Kahn RS, de Haan L, van Os J, Wiersma D, Bruggeman R, Cahn W, Meijer C, Myin-Germeys I. Relevance of Five-Factor Model personality traits for obsessive-compulsive symptoms in patients with psychotic disorders and their un-affected siblings. Psychiatry Res 2015; 225:464-70. [PMID: 25613659 DOI: 10.1016/j.psychres.2014.11.066] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 06/11/2014] [Revised: 10/17/2014] [Accepted: 11/30/2014] [Indexed: 11/29/2022]
Abstract
High rates of obsessive-compulsive symptoms (OCS) in schizophrenia require pathogenic explanations. Personality traits may represent risk and resiliency factors for the development of mental disorders and their comorbidities. The aim of the present study was to explore the associations between Five-Factor Model (FFM) personality traits and the liability for OCS in patients with psychotic disorders and in their un-affected siblings. FFM traits, occurrence and severity of OCS and (subclinical) psychotic symptoms were assessed in 208 patients and in 281 siblings. Differences in FFM traits between participants with vs. without comorbid OCS were examined and the predictive value of FFM traits on group categorization was evaluated. Associations between FFM traits and OCS severity were investigated. Patients and siblings with OCS showed significantly higher Neuroticism compared to their counterparts without OCS. Neuroticism was positively associated with higher OCS severity and significantly predicted group assignment in both patients and in siblings. Patients with comorbid OCS presented with lower scores on Extraversion and Conscientiousness. Higher Neuroticism, and to a lesser degree lower Extraversion and Conscientiousness might add to the vulnerability of patients with a psychotic disorder to also develop OCS. Future prospective studies are needed to elucidate proposed personality-psychopathology interrelations and possible mediating factors.
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Affiliation(s)
- Frederike Schirmbeck
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands.
| | - Lindy-Lou Boyette
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | | | - Carin Meijer
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Peter Dingemans
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Rien Van
- Arkin Mental Health Department, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | | | - René S Kahn
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht The Netherlands
| | - Lieuwe de Haan
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Jim van Os
- Maastricht University Medical Center, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands
| | - Durk Wiersma
- University Medical Center Groningen, Department of Psychiatry, University of Groningen, The Netherlands
| | - Richard Bruggeman
- University Medical Center Groningen, Department of Psychiatry, University of Groningen, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht The Netherlands
| | - Carin Meijer
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Inez Myin-Germeys
- Maastricht University Medical Center, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands
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19
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Velthorst E, Koeter M, van der Gaag M, Nieman DH, Fett AKJ, Smit F, Staring ABP, Meijer C, de Haan L. Adapted cognitive-behavioural therapy required for targeting negative symptoms in schizophrenia: meta-analysis and meta-regression. Psychol Med 2015; 45:453-465. [PMID: 24993642 DOI: 10.1017/s0033291714001147] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND There is an increasing interest in cognitive-behavioural therapy (CBT) interventions targeting negative symptoms in schizophrenia. To date, CBT trials primarily focused on positive symptoms and investigated change in negative symptoms only as a secondary outcome. To enhance insight into factors contributing to improvement of negative symptoms, and to identify subgroups of patients that may benefit most from CBT directed at ameliorating negative symptoms, we reviewed all available evidence on these outcomes. METHOD A systematic search of the literature was conducted in PsychInfo, PubMed and the Cochrane register to identify randomized controlled trials reporting on the impact of CBT interventions on negative symptoms in schizophrenia. Random-effects meta-analyses were performed on end-of-treatment, short-term and long-term changes in negative symptoms. RESULTS A total of 35 publications covering 30 trials in 2312 patients, published between 1993 and 2013, were included. Our results showed studies' pooled effect on symptom alleviation to be small [Hedges' g = 0.093, 95% confidence interval (CI) -0.028 to 0.214, p = 0.130] and heterogeneous (Q = 73.067, degrees of freedom = 29, p < 0.001, τ 2 = 0.081, I 2 = 60.31) in studies with negative symptoms as a secondary outcome. Similar results were found for studies focused on negative symptom reduction (Hedges' g = 0.157, 95% CI -0.10 to 0.409, p = 0.225). Meta-regression revealed that stronger treatment effects were associated with earlier year of publication, lower study quality and with CBT provided individually (as compared with group-based). CONCLUSIONS The co-occurring beneficial effect of conventional CBT on negative symptoms found in older studies was not supported by more recent studies. It is now necessary to further disentangle effective treatment ingredients of older studies in order to guide the development of future CBT interventions aimed at negative symptom reduction.
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Affiliation(s)
- E Velthorst
- Academic Medical Center,Department of Psychiatry, Amsterdam,The Netherlands
| | - M Koeter
- Academic Medical Center,Department of Psychiatry, Amsterdam,The Netherlands
| | - M van der Gaag
- Parnassia Psychiatric Institute,The Hague,The Netherlands
| | - D H Nieman
- Academic Medical Center,Department of Psychiatry, Amsterdam,The Netherlands
| | - A-K J Fett
- Academic Medical Center,Department of Psychiatry, Amsterdam,The Netherlands
| | - F Smit
- Department of Clinical Psychology, EMGO Institute for Health and Care Research,VU University,Amsterdam,The Netherlands
| | - A B P Staring
- Altrecht Psychiatric Institute,Utrecht,The Netherlands
| | - C Meijer
- Academic Medical Center,Department of Psychiatry, Amsterdam,The Netherlands
| | - L de Haan
- Academic Medical Center,Department of Psychiatry, Amsterdam,The Netherlands
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20
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Boyette LL, van Dam D, Meijer C, Velthorst E, Cahn W, de Haan L, Kahn R, de Haan L, van Os J, Wiersma D, Bruggeman R, Cahn W, Meijer C, Myin-Germeys I. Personality compensates for impaired quality of life and social functioning in patients with psychotic disorders who experienced traumatic events. Schizophr Bull 2014; 40:1356-65. [PMID: 24771304 PMCID: PMC4193722 DOI: 10.1093/schbul/sbu057] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Patients with psychotic disorders who experienced childhood trauma show more social dysfunction than patients without traumatic experiences. However, this may not hold for all patients with traumatic experiences. Little is known about the potential compensating role of Five-Factor Model personality traits within this group, despite their strong predictive value for social functioning and well-being in the general population. METHODS Our sample consisted of 195 patients with psychotic disorders (74% diagnosed with schizophrenia) and 132 controls. Cluster analyses were conducted to identify and validate distinct personality profiles. General linear model analyses were conducted to examine whether patients with different profiles differed in social functioning and quality of life (QoL), while controlling for possible confounders. Mediation models were tested to assess potential causal links. RESULTS In general, patients with higher levels of self-reported traumatic experiences (PT+) showed lower QoL and more social withdrawal compared with patients with lower traumatic experiences (PT-). Two clusters reflecting personality profiles were identified. PT+ with the first profile (lower neuroticism and higher extraversion, openness, agreeableness, and conscientiousness) presented higher levels of QoL and better social functioning in several areas, including less withdrawal, compared with both PT+ and PT- with the second profile. PT+ and PT- with the first personality profile did not differ in QoL and social functioning. Mediation analyses suggested that personality traits mediate the relation between traumatic experiences and QoL and social withdrawal. CONCLUSIONS Our findings indicate that personality may "buffer" the impact of childhood traumatic experiences on functional outcome in patients with psychotic disorders.
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Affiliation(s)
- Lindy-Lou Boyette
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands;
| | - Daniëlla van Dam
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - Carin Meijer
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - René Kahn
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - Jim van Os
- Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands
| | - Durk Wiersma
- Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Carin Meijer
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - Inez Myin-Germeys
- Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands
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21
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van Beveren NJM, Schwarz E, Noll R, Guest PC, Meijer C, de Haan L, Bahn S. Evidence for disturbed insulin and growth hormone signaling as potential risk factors in the development of schizophrenia. Transl Psychiatry 2014; 4:e430. [PMID: 25158005 PMCID: PMC4150237 DOI: 10.1038/tp.2014.52] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 05/07/2014] [Accepted: 05/21/2014] [Indexed: 01/03/2023] Open
Abstract
Molecular abnormalities in metabolic, hormonal and immune pathways are present in peripheral body fluids of a significant subgroup of schizophrenia patients. The authors have tested whether such disturbances also occur in psychiatrically ill and unaffected siblings of schizophrenia patients with the aim of identifying potential contributing factors to disease vulnerability. The subjects were recruited as part of the Genetic Risk and OUtcome of Psychosis (GROUP) study. The authors used multiplexed immunoassays to measure the levels of 184 molecules in serum from 112 schizophrenia patients, 133 siblings and 87 unrelated controls. Consistent with the findings of previous studies, serum from schizophrenia patients contained higher levels of insulin, C-peptide and proinsulin, decreased levels of growth hormone and altered concentrations of molecules involved in inflammation. In addition, significant differences were found in the levels of some of these proteins in siblings diagnosed with mood disorders (n=16) and in unaffected siblings (n=117). Most significantly, the insulin/growth hormone ratio was higher across all groups compared with the controls. Taken together, these findings suggest the presence of a molecular endophenotype involving disruption of insulin and growth factor signaling pathways as an increased risk factor for schizophrenia.
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Affiliation(s)
- N J M van Beveren
- Department of Neuroscience, Erasmus Medical Center, Rotterdam, The Netherlands,Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands,Department 'Nieuwe Kennis', Delta Center for Mental Health Care, Rotterdam, The Netherlands,Department of Neuroscience, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands. E-mail: or
| | - E Schwarz
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK
| | - R Noll
- Department of Psychology, DeSales University, Center Valley, PA, USA
| | - P C Guest
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK
| | - C Meijer
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - L de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - S Bahn
- Department of Neuroscience, Erasmus Medical Center, Rotterdam, The Netherlands,Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK,Department of Neuroscience, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands. E-mail: or
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22
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Pavlov K, Meijer C, van den Berg A, Peters FTM, Kruyt FAE, Kleibeuker JH. Embryological signaling pathways in Barrett's metaplasia development and malignant transformation; mechanisms and therapeutic opportunities. Crit Rev Oncol Hematol 2014; 92:25-37. [PMID: 24935219 DOI: 10.1016/j.critrevonc.2014.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 03/24/2014] [Accepted: 05/02/2014] [Indexed: 01/07/2023] Open
Abstract
Barrett's metaplasia of the esophagus (BE) is the precursor lesion of esophageal adenocarcinoma (EAC), a deadly disease with a 5-year overall survival of less than 20%. The molecular mechanisms of BE development and its transformation to EAC are poorly understood and current surveillance and treatment strategies are of limited efficacy. Increasing evidence suggests that aberrant signaling through pathways active in the embryological development of the esophagus contributes to BE development and progression to EAC. We discuss the role that the Bone morphogenetic protein, Hedgehog, Wingless-Type MMTV Integration Site Family (WNT) and Retinoic acid signaling pathways play during embryological development of the esophagus and their contribution to BE development and malignant transformation. Modulation of these pathways provides new therapeutic opportunities. By integrating findings in developmental biology with those from translational research and clinical trials, this review provides a platform for future studies aimed at improving current management of BE and EAC.
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Affiliation(s)
- K Pavlov
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - C Meijer
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A van den Berg
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - F T M Peters
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - F A E Kruyt
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J H Kleibeuker
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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23
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Van Dillen IJ, Mulder NH, Meijer C, Dam WA, Kamstra E, De Vries L, Meersma GJ, Van der Zee AGJ, De Vries EFJ, Vaalburg W, Hospers GAP. Antagonism of HSV-tk Transfection and Ganciclovir Treatment on Chemotherapeutic Drug Sensitivity. J Chemother 2013; 17:289-96. [PMID: 16038523 DOI: 10.1179/joc.2005.17.3.289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 10/31/2022]
Abstract
Our study focused on the influence of herpes simplex virus thymidine kinase (HSV-tk) expression and ganciclovir (GCV) treatment on the sensitivity of C6 glioma cells to frequently used chemotherapeutic drugs, i.e. adriamycin (ADR), cisplatin (CDDP), 5-fluorouracil (5-FU), and methotrexate (MTX). Transfection with HSV-tk revealed an increased sensitivity to GCV and CDDP and a decreased sensitivity to ADR and MTX. No significant differences were found in sensitivity to 5-FU. Combined treatment in a HSV-tk negative cell line revealed an additive effect when GCV was combined with ADR, whereas an antagonistic effect was found when GCV was combined with CDDP, 5-FU, or MTX. Comparable results were obtained in an HSV-tk positive cell line, apart from CDDP, which showed an additive effect. In conclusion, both HSV-tk transfection and subsequent GCV treatment can influence the sensitivity of tumor cells to various chemotherapeutic drugs in an antagonistic manner. Therefore, combining HSV-tk/GCV gene therapy with chemotherapy might not always be beneficial.
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Affiliation(s)
- I J Van Dillen
- Department of Medical Oncology, Groningen University Hospital, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
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24
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Spierings E, Nabuurs-Franssen M, Hopman J, Meijer C, Spierings P, Perencevich E, Voss A. P141: Media and hand hygiene: are healthcare workers receiving the correct example? Antimicrob Resist Infect Control 2013. [PMCID: PMC3687971 DOI: 10.1186/2047-2994-2-s1-p141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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25
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Sotiriou A, Blaauw RH, Meijer C, Gijsbers LH, van der Burg B, Vervoort J, Rietjens IMCM. Correlation between activation of PPARγ and resistin downregulation in a mouse adipocyte cell line by a series of thiazolidinediones. Toxicol In Vitro 2013; 27:1425-32. [PMID: 23563205 DOI: 10.1016/j.tiv.2013.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 03/18/2013] [Accepted: 03/20/2013] [Indexed: 11/18/2022]
Abstract
The present study shows significant correlations between the EC50 for PPARγ activation in a reporter gene cell line and resistin downregulation in mouse adipocytes, and between the IC50 for resistin downregulation and the already published minimum effective dose for antihyperglycemic activity in a mouse model. These correlations indicate that PPARγ mediated downregulation of resistin might promote insulin sensitivity and that downregulation of resistin in mouse adipocytes provides an adequate and possibly more direct bioassay for screening of newly developed antihyperglycemic compounds. Because of the higher throughput of the PPARγ the resistin downregulation assays seems most suitable to be used as a second tier in a tiered screening strategy.
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Affiliation(s)
- A Sotiriou
- Division of Toxicology, Wageningen University, 6703 HE, Wageningen, The Netherlands.
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26
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Vothknecht S, Meijer C, Zwinderman A, Kikkert M, Dekker J, van Beveren N, Schoevers R, de Haan L. Psychometric evaluation of the Subjective Well-being Under Neuroleptic Treatment Scale (SWN) in patients with schizophrenia, their relatives and controls. Psychiatry Res 2013; 206:62-7. [PMID: 23021423 DOI: 10.1016/j.psychres.2012.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [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: 11/15/2011] [Revised: 08/12/2012] [Accepted: 09/06/2012] [Indexed: 11/18/2022]
Abstract
The objective of this study was to evaluate the psychometric properties of the 20-item version of the Subjective Well-being Under Neuroleptic Treatment Scale (SWN) in patients, their siblings and parents and in healthy controls. In order to study heritability of subjective well-being, assessment in unaffected relatives and healthy controls is necessary. Data were obtained from the Dutch GROUP study (Genetic Risk and Outcome of Psychosis), a large cohort study on non-affective psychotic disorders incorporating patients, their relatives and healthy controls. The SWN scale and other relevant assessments were completed by 545 schizophrenia patients, 541 siblings, 75 parents, and 280 healthy controls. Reliability within the four groups ranged between Cronbach's alpha 0.88 and 0.92. Factor analysis indicated a single factor structure of the SWN scale, which makes only SWN total scores relevant.The WHO-Quality of Life psychological domain correlated highly with SWN total scores in all groups. Subclinical psychotic experiences were found to be associated with SWN total scores in relatives and healthy controls, supporting the psychosis continuum concept. The 20-item SWN scale is a reliable measure for subjective well-being that can also be used in relatives and healthy controls to investigate genetic and psychological dispositions of subjective well-being.
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Affiliation(s)
- Sylke Vothknecht
- Arkin Mental Health Amsterdam, Department of Training and Research, Amsterdam, The Netherlands.
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27
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Velthorst E, Meijer C. The association between social anhedonia, withdrawal and psychotic experiences in general and high-risk populations. Schizophr Res 2012; 138:290-4. [PMID: 22484023 DOI: 10.1016/j.schres.2012.03.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [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: 11/01/2011] [Revised: 03/05/2012] [Accepted: 03/12/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Social anhedonia (SA) and withdrawal are clinically relevant phenomena in schizophrenia. To examine the nature of the overlap between SA, withdrawal and positive symptoms, we investigated whether the co-occurrence of these phenotypes is more prominent in siblings of patients with a psychotic disorder compared to healthy controls, and if this association is independent of the amount of distress caused by psychotic experiences (PEs). METHOD Data were derived from 646 unaffected siblings and 326 healthy controls who were included in the Dutch Genetic Risk and Outcome in Psychosis (GROUP) study. PEs were assessed with the Community Assessment of Psychic Experiences and the Structured Interview for Schizotypy-Revised was used to examine social anhedonia and withdrawal. RESULTS Our results show relatively small but significant cross-sectional associations between SA, withdrawal and PEs in unaffected siblings and none in the control group, irrespective of the level of distress caused by PEs. CONCLUSIONS The findings of the present study suggest that the overlap between SA, withdrawal and psychotic symptoms often reported in schizophrenia patients, may at least partly reflect a shared genetic vulnerability, instead of merely being either a state marker of - or reaction to - acute psychotic symptoms.
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Affiliation(s)
- Eva Velthorst
- Academic Medical Centre, University of Amsterdam, Department of Psychiatry, Meibergdreef 5,1105 AZ, Amsterdam, The Netherlands
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28
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Altena R, Boer H, Meijer C, Nuver J, van Roon AM, Zwart N, De Vries E, Lefrandt JD, Smit AJ, Gietema JA. Association of Raynaud's phenomenon after bleomycin etoposide cisplatin (BEP) chemotherapy for testicular cancer (TC) with accelerated atherosclerosis. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4631] [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: 11/20/2022] Open
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29
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de Bruin D, van Ieperen E, Arts EGJM, Hoekstra HJ, Dijck-Brouwer JD, Meijer C, Zwart N, Kema IP, de Jong IJ, Gietema JA. Semen quality in men with disseminated testicular cancer (TC): Relation with CAG repeats in the androgen receptor gene and with single nucleotide polymorphisms (SNPs) in the 5 alpha reductase gene. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15098] [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: 11/20/2022] Open
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30
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Boer H, Meijer C, Dijck-Brouwer JD, Kema IP, Lefrandt JD, Zwart N, Boezen HM, Smit AJ, Gietema JA. Association of single-nucleotide polymorphism (SNP) in the 5-alpha-reductase gene (SRD5A2) with increased prevalence of metabolic syndrome in chemotherapy-treated testicular cancer (TC) survivors. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4564] [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: 11/20/2022] Open
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31
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Boyette L, Swets M, Meijer C, Wouters L. Factor structure of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) in a large sample of patients with schizophrenia or related disorders and comorbid obsessive-compulsive symptoms. Psychiatry Res 2011; 186:409-13. [PMID: 20800902 DOI: 10.1016/j.psychres.2010.07.048] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [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: 02/22/2010] [Revised: 06/07/2010] [Accepted: 07/29/2010] [Indexed: 10/19/2022]
Abstract
In the past decade there has been an increasing interest in the levels of obsessive-compulsive symptoms (OCS) found in patients with schizophrenia or related disorders. The widely acknowledged gold standard measure of the severity of OCS is the content-free version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) (Goodman et al., 1989a,b). However, factor analytic research in patients with obsessive-compulsive disorder (OCD) provided varied results. So far no study has been conducted on the factor structure of the Y-BOCS in patients with schizophrenia. The present study addresses this issue. We administered the Y-BOCS in a sample of 217 patients with schizophrenia or related disorders and comorbid OCS who participated in a multicentre cohort study. We used principal component analysis (PCA) to explore the underlying factor structure. A two-factor solution consistent with the originally proposed scoring structure of the Y-BOCS provided the optimal fit. We also found some support for a three-factor solution consistent with earlier findings by Kim et al. and Moritz et al. (Kim et al., 1994; Moritz et al., 2002). The produced factors showed good reliability and strong correlations with the Y-BOCS Total score. However, the resistance to compulsion item failed to demonstrate adequate correlation to the Total score, a finding consistent with earlier findings in several studies with patients with OCD.
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Affiliation(s)
- Lindy Boyette
- Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands
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32
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Altena R, De Haas EC, Tibbe AG, Smit AJ, van Roon A, Meijer C, Boezen MH, van der Meer J, Sleijfer DT, Gietema JA. Changes in circulating endothelial cells (CECs) during treatment with cisplatin-based chemotherapy for testicular cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e16009] [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: 11/20/2022] Open
Abstract
e16009 Background: Chemotherapy (CT)-induced endothelial damage is an important pathogenic factor for cardiovascular morbidity in testicular cancer (TC) patients (pts). Therefore, we studied early markers of endothelial damage as predictors of cancer treatment-related cardiovascular morbidity. Methods: We prospectively assessed markers of endothelial damage in TC pts treated at the University Medical Center Groningen, before, during, 4 weeks and one year after completion of standard CT (3 or 4 three weekly cycles with bleomycin, etoposide and cisplatin). The number of circulating endothelial cells (CECs), identified by CD146+, CD105+ and CD45− using the CellSearch system, and plasma levels of von Willebrand Factor (vWF) were measured. Results: 30 TC pts were included (median age 34 years, range 20–47). Before start of CT, CECs were not associated with disease stage or leukocyte count. The number of CECs progressively increased over the 9–12 week CT period [baseline: median (range) 25/mL (6–137); maximum number during CT: 134/mL (28–320; p<0.001); 4 weeks after completion of CT: 66/mL (18–316; p=0.005)]. One year post treatment, CECs were not different from baseline [N= 10; 13/mL (6–31; p=0.263)]. vWF levels also progressively increased during CT [baseline: median 105% (range 50–377); maximum level during CT: 289% (175–464; p<0.001); 4 weeks after completion of CT: vWF 124% (56–274; p=0.149)]. One year after CT, vWF levels were 115% (61–184; p=0.285). During CT, numbers of CECs and vWF levels correlated positively (r=0.283; p<0.001), whereas maximum CECs increase and maximum vWF increase were not associated (r=0.098; p=0.605). Two pts had a cerebral infarction during CT. In one pt, vWF increased before the event; in both pts CECs increased directly afterwards. Conclusions: During CT for disseminated TC, CECs and vWF progressively increased during consecutive cycles. CECs remained increased 4 wks after completion of CT, whereas vWF returned to baseline levels. The magnitude of changes was not equal in every pt. Therefore, both CECs and vWF might be early predictive markers for chemotherapy-induced cardiovascular toxicity, and may serve as intermediate endpoint in intervention studies. [Table: see text]
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Affiliation(s)
- R. Altena
- University Medical Center Groningen, Groningen, Netherlands; Veridex LLC, Enschede, Netherlands
| | - E. C. De Haas
- University Medical Center Groningen, Groningen, Netherlands; Veridex LLC, Enschede, Netherlands
| | - A. G. Tibbe
- University Medical Center Groningen, Groningen, Netherlands; Veridex LLC, Enschede, Netherlands
| | - A. J. Smit
- University Medical Center Groningen, Groningen, Netherlands; Veridex LLC, Enschede, Netherlands
| | - A. van Roon
- University Medical Center Groningen, Groningen, Netherlands; Veridex LLC, Enschede, Netherlands
| | - C. Meijer
- University Medical Center Groningen, Groningen, Netherlands; Veridex LLC, Enschede, Netherlands
| | - M. H. Boezen
- University Medical Center Groningen, Groningen, Netherlands; Veridex LLC, Enschede, Netherlands
| | - J. van der Meer
- University Medical Center Groningen, Groningen, Netherlands; Veridex LLC, Enschede, Netherlands
| | - D. T. Sleijfer
- University Medical Center Groningen, Groningen, Netherlands; Veridex LLC, Enschede, Netherlands
| | - J. A. Gietema
- University Medical Center Groningen, Groningen, Netherlands; Veridex LLC, Enschede, Netherlands
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33
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de Haas EC, Zwart N, Meijer C, Boezen HM, Suurmeijer AJ, van der Meer J, Hoekstra HJ, van Leeuwen FE, Sleijffer DT, Gietema JA. Association of plasminogen-activator inhibitor 1 (PAI-1) 4G/5G gene polymorphism with survival and chemotherapy-related vascular toxicity in non-seminomatous testicular cancer (TC). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5083] [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: 11/20/2022] Open
Abstract
5083 Background: High PAI-1 expression by tumor has been associated with poor prognosis in different cancer types, while high systemic PAI-1 levels may increase the risk of vascular thrombosis. We investigated whether the 4G/5G del/ins polymorphism in the PAI-1 promoter (rs1799889; 4G might lead to higher transcription), is associated with differences in survival and prevalence of cardiovascular events in TC. Methods: Data were collected on survival and cardiovascular events (venous thromboembolism [VTE] and coronary heart disease [CHD]) of TC patients treated with standard platinum based chemotherapy from 1977–2004. PAI-1 genotype was determined from non-tumor genomic DNA by a Taqman SNP assay. Genotypes were compared for survival (Kaplan-Meier curves + log-rank and Cox-regression analysis), disease outcome (logistic regression) and prevalence of VTE and CHD (χ2-test). Results: Data are available for 324 patients with median follow-up of 10 yrs (range 0–28). The 3 genotypes 4G/4G (n = 84), 4G/5G (n = 164), and 5G/5G (n = 76) do not differ in age and initial chemotherapy regime. However, the 4G/4G variant shows a higher prevalence of International Germ Cell Cancer Classification (IGCCC) poor prognosis compared to 4G/5G + 5G/5G (24% vs 10%; p = 0.003), as well as a decreased TC related survival compared to 4G/5G + 5G/5G (83% vs 94%; p = 0.001) with a hazard ratio of 2.68 for TC related death (95%CI 1.26–5.72; adjusted for IGCCC p = 0.011). In addition, the 4G/4G variant shows an odds ratio of 3.35 for refractory TC and early relapses (<2 yrs) (95% CI 1.48–7.58; p = 0.004). The 3 genotypes do not differ significantly in prevalence of VTE (4G/4G 11.9%, 4G/5G 8.5%, 5G/5G 7.9%; p = 0.616) and CHD during/after chemotherapy (4G/4G 6.0%; 4G/5G 4.9%; 5G/5G 2.6%; p = 0.594). Conclusions: The 4G/4G variant of the PAI-1 4G/5G gene polymorphism is associated with IGCCC poor prognosis, reduced survival and higher prevalence of refractory disease and early relapses. No effect on vascular toxicity was found. The 4G/4G variant of the PAI-1 gene may be an unfavorable prognostic factor as well as an unfavorable predictive factor for response to chemotherapy in patients with TC. No significant financial relationships to disclose.
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Affiliation(s)
- E. C. de Haas
- University Medical Center Groningen, Groningen, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands
| | - N. Zwart
- University Medical Center Groningen, Groningen, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands
| | - C. Meijer
- University Medical Center Groningen, Groningen, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands
| | - H. M. Boezen
- University Medical Center Groningen, Groningen, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands
| | - A. J. Suurmeijer
- University Medical Center Groningen, Groningen, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands
| | - J. van der Meer
- University Medical Center Groningen, Groningen, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands
| | - H. J. Hoekstra
- University Medical Center Groningen, Groningen, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands
| | - F. E. van Leeuwen
- University Medical Center Groningen, Groningen, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands
| | - D. T. Sleijffer
- University Medical Center Groningen, Groningen, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands
| | - J. A. Gietema
- University Medical Center Groningen, Groningen, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands
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Muñoz N, Hernandez-Suarez G, Méndez F, Molano M, Posso H, Moreno V, Murillo R, Ronderos M, Meijer C, Muñoz A. Persistence of HPV infection and risk of high-grade cervical intraepithelial neoplasia in a cohort of Colombian women. Br J Cancer 2009; 100:1184-90. [PMID: 19293802 PMCID: PMC2669994 DOI: 10.1038/sj.bjc.6604972] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [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] [Indexed: 11/09/2022] Open
Abstract
Little is known about the dynamics of human papillomavirus (HPV) infection and subsequent development of high-grade cervical intraepithelial neoplasia (CIN2/3), particularly in women >30 years of age. This information is needed to assess the impact of HPV vaccines and consider new screening strategies. A cohort of 1728 women 15–85 years old with normal cytology at baseline was followed every 6 months for an average of 9 years. Women with squamous intraepithelial lesions were referred for biopsy and treatment. The Kaplan–Meier method was used to estimate the median duration of infection and Cox regression analysis was undertaken to assess determinants of clearance and risk of CIN2/3 associated with HPV persistence. No difference in the likelihood of clearance was observed by HPV type or woman's age, with the exception of lower clearance for HPV16 infection in women under 30 years of age. Viral load was inversely associated with clearance. In conclusion, viral load is the main determinant of persistence, and persistence of HPV16 infections carry a higher risk of CIN2/3.
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Affiliation(s)
- N Muñoz
- Subdirección de Investigaciones y Salud Publica, Instituto Nacional de Cancerología, Bogotá, Colombia
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Liebrich C, Brummer O, Von Wasielewski R, Wegener G, Meijer C, Iftner T, Petry KU. Primary cervical cancer truly negative for high-risk human papillomavirus is a rare but distinct entity that can affect virgins and young adolescents. EUR J GYNAECOL ONCOL 2009; 30:45-48. [PMID: 19317256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Cancer of the uterine cervix is almost exclusively associated with human papillomavirus (HPV). Carcinogenesis is slow, the minimal time from initial HPV infection to invasive carcinoma seems to be less than ten years. In order to identify rapid onset cervical cancer, we carried out a retrospective re-analysis of an extended cohort of patients with invasive cervical cancer, and reviewed cases identified within the cancer registry of Lower Saxony or using Medline or ISI data. No instances of a rapid-onset cancer or true HPV-DNA negative cancer were found among our hospital cohort of 178 women with primary cancer of the uterine cervix. Registry data identified four out of 5,878 patients who were diagnosed with primary cervical cancer at 14 to 20 years of age. They were classified as clear-cell and endometriod adenocarcinoma and tested persistently negative for high-risk HPV-DNA. Fourteen more cases of cervical cancer in virgins and very young women were identified by a Medline search, mostly with unknown histologic type or rare subtypes of adenocarcinoma. In conclusion, rare adenocarcinoma of the uterine cervix may represent an entity unrelated to HPV, thus explaining instances of rapid onset cervical cancer.
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Affiliation(s)
- C Liebrich
- Schwerpunkt gynäkologische Onkologie, Frauenklinik, Klinikum der Stadt Wolfsburg, Wolfsburg, Germany
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Rikhof B, van der Graaf WTA, Meijer C, Le PTK, Meersma GJ, de Jong S, Fletcher JA, Suurmeijer AJH. Abundant Fas expression by gastrointestinal stromal tumours may serve as a therapeutic target for MegaFasL. Br J Cancer 2008; 99:1600-6. [PMID: 18941456 PMCID: PMC2584951 DOI: 10.1038/sj.bjc.6604736] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [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] [Indexed: 12/24/2022] Open
Abstract
Although the tyrosine kinase inhibitor imatinib has been shown to be an active agent in patients with gastrointestinal stromal tumours (GIST), complete remissions are almost never seen and most patients finally experience disease progression during their course of treatment. An alternative therapeutic option is to target death receptors such as Fas. We showed that a panel of imatinib-sensitive (GIST882) and imatinib-resistant (GIST48, GIST430 and GIST430K-) cell lines expressed Fas. MegaFasL, a recently developed hexameric form of soluble Fas ligand (FasL), appeared to be an active apoptosis-inducing agent in these cell lines. Moreover, MegaFasL potentiated the apoptotic effects of imatinib. Immunohistochemical evaluations, in 45 primary GISTs, underscored the relevance of the Fas pathway: Fas was expressed in all GISTs and was expressed strongly in 93%, whereas FasL was expressed at moderate and strong levels in 35 and 53% of GISTs, respectively. Fas and FasL expression were positively correlated in these primary GISTs, but there was no association between Fas or FasL expression and primary site, histological subtype, tumour size, mitotic index, risk classification, and KIT mutation status. The abundant immunohistochemical Fas and FasL expression were corroborated by western blot analysis. In conclusion, our data implicate Fas as a potential therapeutic target in GIST.
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Affiliation(s)
- B Rikhof
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Rikhof B, van Doorn J, Suurmeijer A, Rautenberg M, Jager P, Gietema J, Meijer C, de Jong S, van der Graaf W. Insulin-like growth factor (IGF)-II in gastrointestinal stromal tumors (GIST): expression, secretion, and clinical relevance. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.20504] [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: 11/20/2022] Open
Abstract
20504 Background: Non-islet cell tumor induced hypoglycemia (NICTH) has been reported anecdotically in patients with a GIST and is associated with increased plasma levels of ‘big’-IGF-II, a high molecular weight form of IGF-II. The role of IGF-II in GIST is unknown. In non- GIST cancer, it has been suggested to be an autocrine growth factor, mainly acting by its major growth promoting receptors IGF-1 receptor (IGF- 1R) and the isoform A of the insulin receptor (IR). We investigated the clinical and biological relevance of (‘big’-)IGF-II in GIST. Methods: Plasma levels of ‘big’-IGF-II, and their relationship with disease status and NICTH, were determined in 25 consecutive GIST patients treated with imatinib (n=24) or sunitinib (n=1). Plasma samples were collected prior to, 1 week, and median 5 months after start of treatment. The levels of ‘big’-IGF-II were measured by specific radioimmunoassay (RIA). Results were compared with those obtained from healthy subjects and expressed as standard deviation scores (SDS). Paraffin-embedded GISTs (n=69) were analyzed for IGF-II, IGF-1R and IR expression by RNA in situ hybridization and immunohistochemistry (IHC). IGF-II secretion by the GIST882 cell line was analyzed by ELISA and western blotting. Results: Before treatment and/or during follow-up, 4 of 25 patients (16%) showed increased (i.e. SDS >2.0) plasma levels of ‘big’-IGF-II. Three of them developed NICTH. Patients with metastatic disease, high serum LDH, or total tumor size >12 cm had the highest ‘big’-IGF-II levels (for all p<0.05). 87% of GISTs expressed IGF-II mRNA, being excessive in tumors from patients with NICTH. These results were confirmed by IHC. GIST882 cells secreted mainly high molecular weight forms of IGF-II. The various GISTs and GIST882 cells did not express IGF-1R or IR. Conclusions: NICTH seems not to be a rare phenomenon in GIST patients. We showed for the first time that most GISTs express and secrete (‘big’-)IGF-II. Therefore, it is likely that many patients are at risk of developing NICTH, presumably especially in case of high tumor bulk. The exact role of (‘big’-)IGF-II in GIST is still not elucidated, as it does not seem to act as an autocrine growth factor since IGF-IR and IR isoform A are lacking. No significant financial relationships to disclose.
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Affiliation(s)
- B. Rikhof
- University Medical Center Groningen, Groningen, The Netherlands; University Medical Center Utrecht, Utrecht, The Netherlands
| | - J. van Doorn
- University Medical Center Groningen, Groningen, The Netherlands; University Medical Center Utrecht, Utrecht, The Netherlands
| | - A. Suurmeijer
- University Medical Center Groningen, Groningen, The Netherlands; University Medical Center Utrecht, Utrecht, The Netherlands
| | - M. Rautenberg
- University Medical Center Groningen, Groningen, The Netherlands; University Medical Center Utrecht, Utrecht, The Netherlands
| | - P. Jager
- University Medical Center Groningen, Groningen, The Netherlands; University Medical Center Utrecht, Utrecht, The Netherlands
| | - J. Gietema
- University Medical Center Groningen, Groningen, The Netherlands; University Medical Center Utrecht, Utrecht, The Netherlands
| | - C. Meijer
- University Medical Center Groningen, Groningen, The Netherlands; University Medical Center Utrecht, Utrecht, The Netherlands
| | - S. de Jong
- University Medical Center Groningen, Groningen, The Netherlands; University Medical Center Utrecht, Utrecht, The Netherlands
| | - W. van der Graaf
- University Medical Center Groningen, Groningen, The Netherlands; University Medical Center Utrecht, Utrecht, The Netherlands
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de Haas EC, Zwart N, Meijer C, Boezen HM, van der Steege G, Sleijfer DT, Gietema JA. Impact of homozygote variant of bleomycin hydrolase (BLMH) gene on survival after chemotherapy for testicular cancer (TC). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5022] [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: 11/20/2022] Open
Abstract
5022 Background: With bleomycin, etoposide and cisplatin, cure of disseminated TC exceeds 80%. Next to tumor characteristics, response to chemotherapy may be determined by polymorphisms of genes involved in metabolism or target pathways of cytotoxic drugs. We investigated whether the A1450G polymorphic site in the gene for BLMH, an enzyme that inactivates bleomycin, is associated with differences in survival. Methods: Data were collected on survival of non-seminomatous TC patients treated with bleomycin and platinum from 1977–2003. BLMH genotype was determined from genomic DNA by PCR + restriction fragment length polymorphism analysis. The 3 genotypes [AA (wild-type), AG (heterozygote variant) and GG (homozygote variant)] were compared for patient characteristics, prognostic factors and received chemotherapy (Mann-Whitney U or χ2 test) and survival (Kaplan-Meier + log-rank test and Cox regression). Results: Data on BLMH genotype and survival were available for 304/372 patients (82%) with median follow-up of 10 yrs (range 0–27). The 3 genotypes AA (n=140), AG (n=133) and GG (n=31) did not differ significantly with respect to age, IGCCC prognosis, creatinine clearance and received dose of bleomycin and platinum. Overall survival of the GG genotype (61%) was worse than the overall survival of AA and AG combined (83%) (p=0.004), due to worse TC related survival of GG (71%) compared to AA + AG (90%) (p=0.001). Homozygote variants (GG) had a significantly increased risk for TC related death (odds ratio (OR) = 4.97) compared to wildtypes (AA) ( table ). Conclusion: Germline presence of the homozygote variant (GG) of the BLMH gene appears to be an unfavorable prognostic factor for TC related death after chemotherapy, in addition to the commonly used IGCCC prognosis. It is unclear whether this is due to alterations in metabolism or target pathways of bleomycin or other cytotoxic agents, or linkage disequilibrium to a yet unknown involved gene. This needs to be unraveled in future research. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- E. C. de Haas
- University Medical Center Groningen, Groningen, The Netherlands
| | - N. Zwart
- University Medical Center Groningen, Groningen, The Netherlands
| | - C. Meijer
- University Medical Center Groningen, Groningen, The Netherlands
| | - H. M. Boezen
- University Medical Center Groningen, Groningen, The Netherlands
| | | | - D. T. Sleijfer
- University Medical Center Groningen, Groningen, The Netherlands
| | - J. A. Gietema
- University Medical Center Groningen, Groningen, The Netherlands
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De Haas EC, Meijer C, Zwart N, Van der Steege G, Boezen HM, Sleijfer S, Van Leeuwen FE, Smit AJ, Sleijfer DT, Gietema JA. Hemochromatosis gene (HFE) mutations and chemotherapy-related cardiovascular risk profile in testicular cancer survivors (TCS). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.14589] [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: 11/20/2022] Open
Abstract
14589 Background: TCS show an increased incidence of treatment-related cardiovascular disease. Standard chemotherapy (CT) may cause tissue damage by inducing free oxygen radicals through release of redox-active iron from body iron stores. HFE mutations associated with altered body iron load may therefore contribute to an increase in CT-induced free oxygen radicals and tissue damage. We investigated whether two HFE mutations (C282Y and H63D) are associated with cardiovascular risk profile in TCS. Methods: From a group of 90 TCS with a known cardiovascular status (JCO 2005; 23: 3718–25), genomic DNA for genotyping was available for 63 TCS (median (range) age at follow-up 35 y (24–54) and median follow-up duration 7 y (3–13)). Two HFE genotype groups were composed: HFE mutation (mut) (n = 19; any mutation C282Y and/or H63D) and HFE wild type (wt) (n = 44). Both groups were compared for cardiovascular risk profile, using Mann-Whitney U Test or Fisher’s Exact Test. Results: Groups had received comparable CT regimens. Body iron stores as reflected by plasma ferritin and transferrin saturation were not different for the HFE mut vs HFE wt group, respectively 104 μg/l (21–413) vs. 90 μg/l (22–569); p = 0.53 and 31% (20–49) vs. 30% (11–59); p = 0.15. Signs of vascular damage estimated by urinary albumin excretion and Von Willebrand factor levels were not significantly different: respectively 8.3 mg/24 h (4–165) vs. 7.7 mg/24 h (3–647); p = 0.90 and 90% (52–296) vs. 102% (28–235); p = 0.25. The prevalence of cardiovascular risk factors obesity (BMI > 27.8 kg/m2), metabolic syndrome (NCEP ATP III-criteria) and hypertension (mean 24-h blood pressure >135/85 mmHg) are shown in the table. Conclusion: TCS with a mutation in the HFE gene do not show more signs of cardiovascular damage after CT compared to TCS with wt HFE. However, the data suggest that TCS with a HFE mutation may have more frequently cardiovascular risk factors. Further study in a larger group of TCS is needed to explore this observation. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- E. C. De Haas
- University Medical Center, Groningen, The Netherlands; Erasmus University Medical Center, Rotterdam, The Netherlands; Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C. Meijer
- University Medical Center, Groningen, The Netherlands; Erasmus University Medical Center, Rotterdam, The Netherlands; Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - N. Zwart
- University Medical Center, Groningen, The Netherlands; Erasmus University Medical Center, Rotterdam, The Netherlands; Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - G. Van der Steege
- University Medical Center, Groningen, The Netherlands; Erasmus University Medical Center, Rotterdam, The Netherlands; Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - H. M. Boezen
- University Medical Center, Groningen, The Netherlands; Erasmus University Medical Center, Rotterdam, The Netherlands; Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S. Sleijfer
- University Medical Center, Groningen, The Netherlands; Erasmus University Medical Center, Rotterdam, The Netherlands; Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - F. E. Van Leeuwen
- University Medical Center, Groningen, The Netherlands; Erasmus University Medical Center, Rotterdam, The Netherlands; Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A. J. Smit
- University Medical Center, Groningen, The Netherlands; Erasmus University Medical Center, Rotterdam, The Netherlands; Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - D. T. Sleijfer
- University Medical Center, Groningen, The Netherlands; Erasmus University Medical Center, Rotterdam, The Netherlands; Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J. A. Gietema
- University Medical Center, Groningen, The Netherlands; Erasmus University Medical Center, Rotterdam, The Netherlands; Netherlands Cancer Institute, Amsterdam, The Netherlands
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Barkhof E, Haan L, Meijer C, Fouwels A, Keet I, Hulstijn K, Schippers G, Linszen D. Motivational Interviewing in Psychotic Disorders. ACTA ACUST UNITED AC 2006. [DOI: 10.2174/157340006776875932] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Komdeur R, Meijer C, Van Zweeden M, De Jong S, Wesseling J, Hoekstra HJ, van der Graaf WTA. Doxorubicin potentiates TRAIL cytotoxicity and apoptosis and can overcome TRAIL-resistance in rhabdomyosarcoma cells. Int J Oncol 2005; 25:677-84. [PMID: 15289869 DOI: 10.3892/ijo.25.3.677] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Doxorubicin (DOX) and ifosfamide (IFO) are the most active single agents in soft tissue sarcomas (STS). Tumour necrosis factor-alpha (TNF-alpha) is used for STS in the setting of isolated limb perfusions. Like TNF-alpha, TNF-related apoptosis-inducing ligand (TRAIL) induces apoptosis. In contrast to TNF-alpha preliminary studies suggest that TRAIL lacks systemic side effects. The effects of TRAIL alone and in combination with DOX or 4-hydroxy-IFO were evaluated in the TNF-alpha sensitive rhabdomyosarcoma cell line KYM-1, its 5-fold TNF-alpha sensitive subline KD4 and its >150-fold TNF-alpha resistant subline 37B8R. Membrane expression of TRAIL-receptors DR4 (death receptor 4), DR5 (pro-apoptotic), DcR1 (decoy receptor 1), DcR2 (anti-apoptotic) was assessed by flow cytometry. Cytotoxicity was determined by microculture tetrazolium assays. Apoptosis assays were performed with acridine orange. DOX (doxorubicin) and 4-OH-IFO decreased survival in all cell lines; a 2-fold resistance was observed for both drugs in 37B8R. All cell lines expressed DR4 and DR5, but hardly any DcR1 or DcR2. TRAIL was cytotoxic in KYM-1, even more in KD4 and induced massive apoptosis; 37B8R was >500-fold resistant to TRAIL and little apoptosis could be observed. TRAIL plus DOX showed synergistic cytotoxicity in KYM-1 and 37B8R. TRAIL plus 4-OH-IFO showed addition in all three cell lines. DOX plus TRAIL-induced more cytotoxicity and apoptosis in all cell lines compared to TRAIL alone. In 37B8R, DOX overcame resistance to TRAIL. In KYM-1, KD4 and 37B8R, sensitivity and resistance to TNF-alpha and TRAIL parallels. TRAIL-resistance was independent from expression of TRAIL-receptors. DOX with TRAIL could overcome TRAIL-resistance in 37B8R cells.
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Affiliation(s)
- R Komdeur
- Department of Surgical Oncology, University Hospital of Groningen, 9700 RB Groningen, The Netherlands
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Nuver J, Van Zweeden M, Lutke Holzik M, Meijer C, Hoekstra H, Suurmeijer A, Hofstra R, Groen H, Sleijfer D, Gietema J. Use of pharmacogenomics in predicting bleomycin-induced pulmonary toxicity in testicular cancer patients. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. Nuver
- University Hospital Groningen, Groningen, Netherlands
| | | | | | - C. Meijer
- University Hospital Groningen, Groningen, Netherlands
| | - H. Hoekstra
- University Hospital Groningen, Groningen, Netherlands
| | - A. Suurmeijer
- University Hospital Groningen, Groningen, Netherlands
| | - R. Hofstra
- University Hospital Groningen, Groningen, Netherlands
| | - H. Groen
- University Hospital Groningen, Groningen, Netherlands
| | - D. Sleijfer
- University Hospital Groningen, Groningen, Netherlands
| | - J. Gietema
- University Hospital Groningen, Groningen, Netherlands
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Prins H, Diks J, Meijer C, Holtz R, Boelens P, Masson S, Daveau M, Scotte´ M, Van Leeuwen P. Kupffer cell depleted rats have an diminished acute phase response following major liver resection. Clin Nutr 2003. [DOI: 10.1016/s0261-5614(03)80202-9] [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: 11/28/2022]
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Fokkema E, De Vries EGE, Groen HJM, Meijer C, Timens W. Expression of apoptosis-related proteins and morphological changes in a rat tumor model of human small cell lung cancer prior to and after treatment with radiotherapy, carboplatin, or combined treatment. Virchows Arch 2003; 442:349-55. [PMID: 12715170 DOI: 10.1007/s00428-003-0763-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2002] [Accepted: 12/20/2002] [Indexed: 11/24/2022]
Abstract
PURPOSE In order to understand the apoptosis pathway in tumor cells, differences in cell morphology and expression of apoptosis-related proteins induced by radiation and/or chemotherapy, were investigated in a rat double tumor model comparing cisplatin-sensitive and -resistant human small cell lung cancer tumors. METHODS The cisplatin-sensitive human small cell lung cancer cell line (GLC4) and its cisplatin-resistant subline (GLC4-CDDP) were each injected subcutaneously in a different hind limb of the rat. After 15-17 days, radiation (10 Gy), carboplatin (25 mg/kg, intraperitoneal), combined treatment, or no treatment was administered. In combined treatment, carboplatin was administered 24 h before radiation. Tumors were removed and fixed 72 h after carboplatin or 48 h after radiation. Paraffin-embedded slides were stained with hematoxylin/eosin for morphology. Expression of the apoptosis-related proteins p53, p21, Rb, bcl-2, bax, c-myc, Fas and Fas-L was assessed immunohistochemically. RESULTS In the GLC4 tumor, carboplatin treatment increased tumor cell size, tumor cell size heterogeneity, and number of apoptotic tumor cells. After radiation and combined treatment, these changes were more pronounced and multinuclear giant cells were observed. In GLC4-CDDP tumors, minimal changes were detected after carboplatin. Following radiation slight increases in tumor cell size, tumor cell size heterogeneity and number of apoptotic tumor cells were observed. No multinuclear giant cells were seen. After combined treatment, GLC4-CDDP showed cellular changes comparable to those in GLC4 cells after radiation or combined treatment, but no giant cells were observed. Untreated, both tumors were equally positive for p53, bax, Fas, Fas-L, c-myc and negative for Rb. Contrary to GLC4, untreated GLC4-CDDP tumors showed no p21 and bcl-2 expression. After combined treatment, an increase in number of bcl-2 positive cells was found in GLC4-CDDP tumors. No p21 was induced in GLC4-CDDP by any treatment modality. In GLC4 tumors, p21 was induced by radiation alone. No further changes in protein expression were induced by any treatment in GLC4 tumors. CONCLUSION Following therapy, morphological changes in cell size and cell size heterogeneity were more pronounced in GLC4 than in GLC4-CDDP tumors. However, morphological changes in GLC4-CCDP tumors after treatment indicate that carboplatin plus radiotherapy may be effective also in cisplatin resistant tumor cells. An increase in p21 in GLC4 after radiation might facilitate apoptosis. The increase in number of Bcl-2 positive cells after combined treatment and the consistently negative p21 status after any treatment in GLC4-CDDP may protect these tumor cells from apoptosis as a part of their resistance mechanism to cisplatin.
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MESH Headings
- Animals
- Antineoplastic Agents/therapeutic use
- Apoptosis/drug effects
- Apoptosis/physiology
- Apoptosis/radiation effects
- Carboplatin/therapeutic use
- Carcinoma, Small Cell/metabolism
- Carcinoma, Small Cell/pathology
- Carcinoma, Small Cell/therapy
- Combined Modality Therapy
- Disease Models, Animal
- Drug Resistance, Neoplasm/physiology
- Drug Resistance, Neoplasm/radiation effects
- Humans
- Immunoenzyme Techniques
- Lung Neoplasms/metabolism
- Lung Neoplasms/pathology
- Lung Neoplasms/therapy
- Neoplasm Proteins/metabolism
- Neoplasms, Experimental/drug therapy
- Neoplasms, Experimental/metabolism
- Neoplasms, Experimental/pathology
- Radiotherapy
- Rats
- Rats, Inbred Strains
- Tumor Cells, Cultured
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Affiliation(s)
- E Fokkema
- Department of Pulmonary Diseases, University Hospital Groningen, The Netherlands
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Bouïs D, Hospers GA, Meijer C, Molema G, Mulder NH. Endothelium in vitro: a review of human vascular endothelial cell lines for blood vessel-related research. Angiogenesis 2002; 4:91-102. [PMID: 11806248 DOI: 10.1023/a:1012259529167] [Citation(s) in RCA: 268] [Impact Index Per Article: 12.2] [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: 11/12/2022]
Abstract
Endothelial cells (EC) are currently used as in vitro model systems for various physiological and pathological processes, especially in angiogenesis research. Primary EC have a limited lifespan and display characteristics that differ from batch to batch due to their multidonor origin. In recent years many groups have established EC lines. This Review gives an overview of the advantages and disadvantages of currently available vascular EC lines. Its aim is to help the investigator to decide which cell line matches his or her research goal best. Truly immortalized cell lines are generally better characterized and more stable in their endothelial traits than EC that were given an extended life span. Presently the best characterized macro- and micro-vascular EC lines are EA.hy926 and HMEC-1, respectively.
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Affiliation(s)
- D Bouïs
- Department of Medical Oncology, University Hospital Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands
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46
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Santos C, Muñoz N, Klug S, Almonte M, Guerrero I, Alvarez M, Velarde C, Galdos O, Castillo M, Walboomers J, Meijer C, Caceres E. HPV types and cofactors causing cervical cancer in Peru. Br J Cancer 2001; 85:966-71. [PMID: 11592767 PMCID: PMC2375092 DOI: 10.1054/bjoc.2001.1948] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2001] [Revised: 06/01/2001] [Accepted: 06/05/2001] [Indexed: 11/23/2022] Open
Abstract
We conducted a hospital-based case-control study in Peru of 198 women with histologically confirmed cervical cancer (173 squamous cell carcinomas and 25 cases of adenocarcinoma/adenosquamous carcinoma) and 196 control women. Information on risk factors was obtained by personal interview. Using PCR-based assays on exfoliated cervical cells and biopsy specimens, HPV DNA was detected in 95.3% of women with squamous cell carcinoma and in 92.0% of women with adenocarcinoma/adenosquamous carcinoma compared with 17.7% in control women. The age-adjusted odds ratio was 116.0 (95% Cl = 48.6-276.0) for squamous cell carcinoma and 51.4 (95% Cl = 11.4-232.0) for adenocarcinoma/adenosquamous carcinoma. The commonest types in women with cervical cancer were HPV 16, 18, 31, 52 and 35. The association with the various HPV types was equally strong for the two most common types (HPV 16 and 18) as for the other less common types. In addition to HPV, long-term use of oral contraceptives and smoking were associated with an increased risk. HPV is the main cause of both squamous cell carcinoma and adenocarcinoma in Peruvian women.
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Affiliation(s)
- C Santos
- Instituto de Enfermedades Neoplásicas Dr Eduardo Cáceres Graziani, Av. Angamos Este 2520, Lima 34, Peru
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47
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Boeke A, van Valkengoed IGM, Morre S, van den Brule AJC, Deville W, Meijer C, Bouter L. Notice of redundancy. Sex Transm Infect 2001; 77:301. [PMID: 11463940 PMCID: PMC1744327 DOI: 10.1136/sti.77.4.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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48
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Wiezer MJ, Boelens PG, Vuylsteke RJ, Nijveldt RJ, Meijer C, Cuesta MA, Meijer S, van Leeuwen PA. Perioperative treatment with bactericidal/permeability-increasing protein (rBPI21) in major liver surgery: a concise summary. Ann Acad Med Singap 2001; 30:226-33. [PMID: 11455733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
INTRODUCTION Major hepatic resections are still associated with considerable morbidity. Gut-derived bacteria and bacterial endotoxin are considered to play a central role in the pathophysiology of complications. Experimental studies suggest that bactericidal/permeability-increasing protein (BPI), which has both antibacterial and endotoxin-neutralising properties, can reduce postoperative complications. MATERIAL AND METHODS A phase II, double-blind, placebo-controlled, multicentre, dose escalation trial was conducted in patients undergoing major liver resection, and clinical outcome, infectious complications, plasma amino acid patterns, coagulation and fibrinolytic cascade systems and neutrophil functions were compared between the two treatment groups and an extra group of patients undergoing major abdominal non-hepatic surgery. RESULTS Drug administration in this patient group was safe, and resulted in a significant reduction of infectious complications. Furthermore, beneficial effects were found in the postoperative amino acid ratio and fibrinolytic cascades, and rBPI21 preserved leukocyte functions. CONCLUSION Administration of rBPI21 in patients undergoing major liver resection is well tolerated and results in improvement of both clinical and biochemical parameters.
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Affiliation(s)
- M J Wiezer
- Department of Surgery, Vrije Universiteit Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
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Meijer C, Wiezer MJ, Hack CE, Boelens PG, Wedel NI, Meijer S, Nijveldt RJ, Statius Muller MG, Wiggers T, Zoetmulder FA, Borel Rinkes IH, Cuesta MA, Gouma DJ, van de Velde CJ, Tilanus HW, Scotté M, Thijs LG, van Leeuwen PA. Coagulopathy following major liver resection: the effect of rBPI21 and the role of decreased synthesis of regulating proteins by the liver. Shock 2001; 15:261-71. [PMID: 11303724 DOI: 10.1097/00024382-200115040-00003] [Citation(s) in RCA: 14] [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] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
This prospective study investigated the role of reduced hepatic synthesis of regulating proteins in coagulopathy after partial hepatectomy (PH) compared with major abdominal surgery (MAS) without involvement of the liver. Furthermore, we studied the effect of rBPI21, an endotoxin-neutralizing agent, on coagulopathy after PH was studied. Compared with MAS, PH resulted in significantly elevated levels of thrombin-antithrombin-III and plasmin-alpha2-antiplasmin complexes. Levels of antithrombin-3, alpha2-antiplasmin, fibrinogen, plasminogen, alpha2-macroglobulin (alpha2-M), and C1-inhibitor remained lower following PH. Treatment with rBPI21 led to significantly lower levels of tissue-type plasminogen activator (t-PA). Post-operative disseminated intravascular coagulation (DIC) was associated with significantly higher bilirubin and t-PA plasma levels and significantly lower levels of alpha2-M. This study indicates that PH induced hepatic failure results in decreased synthesis of hepatic regulating plasma proteins and subsequent activation of coagulation and fibrinolysis. Prevention of t-PA release by rBPI21 may have important clinical implications. Decreased availability of alpha2-M may be a factor in post-operative DIC.
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Affiliation(s)
- C Meijer
- Department of Surgery, University Hospital Vrije Universiteit, Amsterdam, The Netherlands
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50
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Nijveldt RJ, Wiezer MJ, Meijer C, Prins HA, Statius Muller MG, Gouma DJ, Teerlink T, van Gulik TM, Borel Rinkes IH, Tilanus HW, van de Velde CJ, Wiggers T, Zoetmulder FA, Scotté M, Cuesta MA, Meijer S, van Leeuwen PA. Major liver resection results in a changed plasma amino acid pattern as reflected by a decreased Fischer ratio which improves by bactericidal/permeability increasing protein. Liver 2001; 21:56-63. [PMID: 11169074 DOI: 10.1034/j.1600-0676.2001.210109.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND/AIMS Major liver resection results in a high morbidity and mortality, and endotoxin plays a role in post-resection hepatic failure. Severe hepatic failure as seen in hepatitis and cirrhosis may be accompanied by hepatic encephalopathy and is characterized by a typical plasma amino acid pattern reflected by a decreased Fischer ratio. This study was performed to evaluate the plasma amino acid pattern in patients undergoing major liver surgery receiving placebo or the endotoxin-neutralizing agent bactericidal/permeability-increasing protein (rBPI21). PATIENTS AND METHODS Forty-eight patients were randomized in this phase II, dose escalation, multicenter trial. Plasma amino acid profiles were determined preoperatively, and on the first (day 1) and third (day 3) postoperative day. RESULTS In the placebo group the Fischer ratio decreased significantly on both postoperative days. Administration of rBPI21 also resulted in a decreased Fischer ratio on day 1, but not on day 3. Highly elevated alanine plasma levels were observed on day 1 in placebo-treated patients, whereas rBPI21 prevented this elevation. Plasma alanine levels on day 1 correlated with the duration of post-resection hepatic failure. CONCLUSIONS Major liver resection results in a decreased Fischer ratio and a rise in plasma alanine levels. Plasma levels of alanine on the first postoperative day correlated with the duration of the post-resection hepatic failure. rBPI21 improved the Fischer ratio and prevented the rise of plasma alanine levels.
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Affiliation(s)
- R J Nijveldt
- Department of Surgery, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
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