1
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Lau CH, Rouhani MJ, Maughan EF, Orr JC, Kolluri KK, Pearce DR, Haughey EK, Sutton L, Flatau S, Balboa PL, Bageta ML, O'Callaghan C, Smith CM, Janes SM, Hewitt R, Petrof G, Martinez AE, McGrath JA, Butler CR, Hynds RE. Lentiviral expression of wild-type LAMA3A restores cell adhesion in airway basal cells from children with epidermolysis bullosa. Mol Ther 2024; 32:1497-1509. [PMID: 38429928 DOI: 10.1016/j.ymthe.2024.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/26/2024] [Accepted: 02/27/2024] [Indexed: 03/03/2024] Open
Abstract
The hallmark of epidermolysis bullosa (EB) is fragile attachment of epithelia due to genetic variants in cell adhesion genes. We describe 16 EB patients treated in the ear, nose, and throat department of a tertiary pediatric hospital linked to the United Kingdom's national EB unit between 1992 and 2023. Patients suffered a high degree of morbidity and mortality from laryngotracheal stenosis. Variants in laminin subunit alpha-3 (LAMA3) were found in 10/15 patients where genotype was available. LAMA3 encodes a subunit of the laminin-332 heterotrimeric extracellular matrix protein complex and is expressed by airway epithelial basal stem cells. We investigated the benefit of restoring wild-type LAMA3 expression in primary EB patient-derived basal cell cultures. EB basal cells demonstrated weak adhesion to cell culture substrates, but could otherwise be expanded similarly to non-EB basal cells. In vitro lentiviral overexpression of LAMA3A in EB basal cells enabled them to differentiate in air-liquid interface cultures, producing cilia with normal ciliary beat frequency. Moreover, transduction restored cell adhesion to levels comparable to a non-EB donor culture. These data provide proof of concept for a combined cell and gene therapy approach to treat airway disease in LAMA3-affected EB.
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Affiliation(s)
- Chun Hang Lau
- Epithelial Cell Biology in ENT Research (EpiCENTR) Group, UCL Great Ormond Street Institute of Child Health, University College London, 20c Guilford Street, London WC1N 1DZ, UK
| | - Maral J Rouhani
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, UK; Ear, Nose, and Throat Department, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Elizabeth F Maughan
- Epithelial Cell Biology in ENT Research (EpiCENTR) Group, UCL Great Ormond Street Institute of Child Health, University College London, 20c Guilford Street, London WC1N 1DZ, UK; Ear, Nose, and Throat Department, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Jessica C Orr
- Epithelial Cell Biology in ENT Research (EpiCENTR) Group, UCL Great Ormond Street Institute of Child Health, University College London, 20c Guilford Street, London WC1N 1DZ, UK; Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, UK
| | - Krishna K Kolluri
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, UK
| | - David R Pearce
- UCL Cancer Institute, University College London, 72 Huntley Street, London WC1E 6DD, UK
| | - Elizabeth K Haughey
- Infection, Immunity, and Inflammation Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - Liam Sutton
- Ear, Nose, and Throat Department, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Sam Flatau
- Ear, Nose, and Throat Department, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Pablo Lopez Balboa
- Department of Dermatology, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Maria Laura Bageta
- Department of Dermatology, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Christopher O'Callaghan
- Infection, Immunity, and Inflammation Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - Claire M Smith
- Infection, Immunity, and Inflammation Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - Sam M Janes
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, UK
| | - Richard Hewitt
- Ear, Nose, and Throat Department, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Gabriela Petrof
- Department of Dermatology, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - Anna E Martinez
- Department of Dermatology, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK
| | - John A McGrath
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, Guy's Hospital, St Thomas Street, London SE1 9RT, UK
| | - Colin R Butler
- Epithelial Cell Biology in ENT Research (EpiCENTR) Group, UCL Great Ormond Street Institute of Child Health, University College London, 20c Guilford Street, London WC1N 1DZ, UK; Ear, Nose, and Throat Department, Great Ormond Street Hospital NHS Foundation Trust, London WC1N 3JH, UK.
| | - Robert E Hynds
- Epithelial Cell Biology in ENT Research (EpiCENTR) Group, UCL Great Ormond Street Institute of Child Health, University College London, 20c Guilford Street, London WC1N 1DZ, UK; UCL Cancer Institute, University College London, 72 Huntley Street, London WC1E 6DD, UK.
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2
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Gerli MFM, Calà G, Beesley MA, Sina B, Tullie L, Sun KY, Panariello F, Michielin F, Davidson JR, Russo FM, Jones BC, Lee DDH, Savvidis S, Xenakis T, Simcock IC, Straatman-Iwanowska AA, Hirst RA, David AL, O'Callaghan C, Olivo A, Eaton S, Loukogeorgakis SP, Cacchiarelli D, Deprest J, Li VSW, Giobbe GG, De Coppi P. Single-cell guided prenatal derivation of primary fetal epithelial organoids from human amniotic and tracheal fluids. Nat Med 2024; 30:875-887. [PMID: 38438734 PMCID: PMC10957479 DOI: 10.1038/s41591-024-02807-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/05/2024] [Indexed: 03/06/2024]
Abstract
Isolation of tissue-specific fetal stem cells and derivation of primary organoids is limited to samples obtained from termination of pregnancies, hampering prenatal investigation of fetal development and congenital diseases. Therefore, new patient-specific in vitro models are needed. To this aim, isolation and expansion of fetal stem cells during pregnancy, without the need for tissue samples or reprogramming, would be advantageous. Amniotic fluid (AF) is a source of cells from multiple developing organs. Using single-cell analysis, we characterized the cellular identities present in human AF. We identified and isolated viable epithelial stem/progenitor cells of fetal gastrointestinal, renal and pulmonary origin. Upon culture, these cells formed clonal epithelial organoids, manifesting small intestine, kidney tubule and lung identity. AF organoids exhibit transcriptomic, protein expression and functional features of their tissue of origin. With relevance for prenatal disease modeling, we derived lung organoids from AF and tracheal fluid cells of congenital diaphragmatic hernia fetuses, recapitulating some features of the disease. AF organoids are derived in a timeline compatible with prenatal intervention, potentially allowing investigation of therapeutic tools and regenerative medicine strategies personalized to the fetus at clinically relevant developmental stages.
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Affiliation(s)
- Mattia Francesco Maria Gerli
- Department of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, London, UK.
- Great Ormond Street Institute of Child Health, University College London, London, UK.
| | - Giuseppe Calà
- Department of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, London, UK
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Max Arran Beesley
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Beatrice Sina
- Great Ormond Street Institute of Child Health, University College London, London, UK
- Politecnico di Milano, Milan, Italy
| | - Lucinda Tullie
- Great Ormond Street Institute of Child Health, University College London, London, UK
- Stem Cell and Cancer Biology Laboratory, The Francis Crick Institute, London, UK
| | - Kylin Yunyan Sun
- Department of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, London, UK
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Francesco Panariello
- Armenise/Harvard Laboratory of Integrative Genomics, Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Federica Michielin
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Joseph R Davidson
- Great Ormond Street Institute of Child Health, University College London, London, UK
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Francesca Maria Russo
- Department of Development and Regeneration, Woman and Child and UZ Leuven Clinical Department of Obstetrics and Gynaecology, KU Leuven, Leuven, Belgium
| | - Brendan C Jones
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Dani Do Hyang Lee
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Savvas Savvidis
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Theodoros Xenakis
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Ian C Simcock
- Great Ormond Street Institute of Child Health, University College London, London, UK
- Department of Radiology, Great Ormond Street Hospital, London, UK
| | | | - Robert A Hirst
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Anna L David
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
- Department of Development and Regeneration, Woman and Child and UZ Leuven Clinical Department of Obstetrics and Gynaecology, KU Leuven, Leuven, Belgium
| | | | - Alessandro Olivo
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Simon Eaton
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Stavros P Loukogeorgakis
- Great Ormond Street Institute of Child Health, University College London, London, UK
- Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Davide Cacchiarelli
- Armenise/Harvard Laboratory of Integrative Genomics, Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
- Department of Translational Medicine, University of Naples Federico II, Naples, Italy
- Genomics and Experimental Medicine Program, Scuola Superiore Meridionale, Naples, Italy
| | - Jan Deprest
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
- Department of Development and Regeneration, Woman and Child and UZ Leuven Clinical Department of Obstetrics and Gynaecology, KU Leuven, Leuven, Belgium
| | - Vivian S W Li
- Stem Cell and Cancer Biology Laboratory, The Francis Crick Institute, London, UK
| | | | - Paolo De Coppi
- Great Ormond Street Institute of Child Health, University College London, London, UK.
- Department of Development and Regeneration, Woman and Child and UZ Leuven Clinical Department of Obstetrics and Gynaecology, KU Leuven, Leuven, Belgium.
- Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
- Medical and Surgical Department of the Fetus, Newborn and Infant, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy.
- NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK.
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3
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Smith RL, Bartley L, O'Callaghan C, Haberska L, Marshall C. NEMA NU 2-2018 evaluation and image quality optimization of a new generation digital 32-cm axial field-of-view Omni Legend PET-CT using a genetic evolutionary algorithm. Biomed Phys Eng Express 2024; 10:025032. [PMID: 38346328 DOI: 10.1088/2057-1976/ad286c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/12/2024] [Indexed: 02/21/2024]
Abstract
A performance evaluation was conducted on the new General Electric (GE) digital Omni Legend PET-CT system with 32 cm extended field of view. The first commercially available clinical digital bismuth germanate system. The system does not use time of flight (ToF). Testing was performed in accordance with the NEMA NU2-2018 standard. A comparison was made between two other commercial GE scanners with extended fields of view; the Discovery MI - 6 ring (ToF enabled) and the Discovery IQ (non-ToF). A genetic evolutionary algorithm was developed to optimize image reconstruction parameters from image quality assessments. The Omni demonstrated average spatial resolutions at 1 cm radial offset as 3.9 mm FWHM. The total system sensitivity at the center was 44.36 cps/kBq. The peak NECR was measured as 501 kcps at 17.8 kBq ml-1with a 35.48% scatter fraction. The maximum count-rate error below NECR peak was 5.5%. Using standard iterative reconstructions, sphere contrast recovery coefficients were from 52.7 ± 3.2% (10 mm) to 92.5 ± 2.4% (37 mm). The PET-CT co-registration accuracy was 2.4 mm. In place of ToF, the Omni employs software corrections through a pre-trained neural network (PDL) (trained on non-ToF to ToF) that takes Bayesian penalized likelihood reconstruction (Q.Clear) images as input. The optimum parameters for image reconstruction, determined using the genetic algorithm were a Q.Clear parameter,β, of 350 and a 'medium' PDL setting. Using standard iterative reconstructions, the Omni initially showed increased background variability compared to the Discovery MI. With optimized PDL reconstruction parameters selected using the genetic algorithm the performance of the Omni surpassed that of the Discovery MI on all NEMA tests. The genetic algorithm's demonstrated ability to enhance image quality in PET-CT imaging underscores the importance of algorithm driven optimization and underscores the requirement to validate its use in the clinical setting.
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Affiliation(s)
- Rhodri Lyn Smith
- The Wales Research and Diagnostic Positron Emission Tomography Imaging Centre, Cardiff University, School of Medicine, Cardiff, CF14 4XN, Wales, United Kingdom
| | - Lee Bartley
- Radiology, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, CF14 4XW, Wales, United Kingdom
| | - Christopher O'Callaghan
- Radiology, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, CF14 4XW, Wales, United Kingdom
| | - Luiza Haberska
- The Wales Research and Diagnostic Positron Emission Tomography Imaging Centre, Cardiff University, School of Medicine, Cardiff, CF14 4XN, Wales, United Kingdom
| | - Chris Marshall
- The Wales Research and Diagnostic Positron Emission Tomography Imaging Centre, Cardiff University, School of Medicine, Cardiff, CF14 4XN, Wales, United Kingdom
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4
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Navaratnam AMD, O'Callaghan C, Beale S, Nguyen V, Aryee A, Braithwaite I, Byrne TE, Fong WLE, Fragaszy E, Geismar C, Hoskins S, Kovar J, Patel P, Shrotri M, Weber S, Yavlinsky A, Aldridge RW, Hayward AC. Eyeglasses and risk of COVID-19 transmission-analysis of the Virus Watch Community Cohort study. Int J Infect Dis 2024; 139:28-33. [PMID: 38008351 DOI: 10.1016/j.ijid.2023.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 11/28/2023] Open
Abstract
OBJECTIVES The importance of SARS-CoV-2 transmission via the eyes is unknown, with previous studies mainly focusing on protective eyewear in healthcare settings. This study aimed to test the hypothesis that wearing eyeglasses is associated with a lower risk of COVID-19. METHODS Participants from the Virus Watch prospective community cohort study responded to a questionnaire on the use of eyeglasses and contact lenses. Infection was confirmed through data linkage, self-reported positive results, and, for a subgroup, monthly capillary antibody testing. Multivariable logistic regression models, controlling for age, sex, income, and occupation, were used to identify the odds of infection depending on frequency and purpose of eyeglasses or contact lenses use. RESULTS A total of 19,166 participants responded to the questionnaire, with 13,681 (71.3%, CI 70.7-72.0) reporting they wore eyeglasses. Multivariable logistic regression model showed a 15% lower odds of infection for those who reported using eyeglasses always for general use (odds ratio [OR] 0.85, 95% 0.77-0.95, P = 0.002) compared to those who never wore eyeglasses. The protective effect was reduced for those who said wearing eyeglasses interfered with mask-wearing and was absent for contact lens wearers. CONCLUSIONS People who wear eyeglasses have a moderate reduction in risk of COVID-19 infection, highlighting that eye protection may make a valuable contribution to the reduction of transmission in community and healthcare settings.
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Affiliation(s)
| | - Christopher O'Callaghan
- Infection, Immunity & Inflammation Department, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Sarah Beale
- Institute of Health Informatics, University College London, London, UK; Institute of Epidemiology and Health Care, University College London, London, UK
| | - Vincent Nguyen
- Institute of Health Informatics, University College London, London, UK
| | - Anna Aryee
- Institute of Health Informatics, University College London, London, UK
| | | | - Thomas E Byrne
- Institute of Health Informatics, University College London, London, UK
| | | | - Ellen Fragaszy
- Institute of Health Informatics, University College London, London, UK; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Cyril Geismar
- Institute of Health Informatics, University College London, London, UK
| | - Susan Hoskins
- Institute of Health Informatics, University College London, London, UK
| | - Jana Kovar
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Parth Patel
- Institute of Health Informatics, University College London, London, UK
| | - Madhumita Shrotri
- Institute of Health Informatics, University College London, London, UK
| | - Sophie Weber
- Institute of Health Informatics, University College London, London, UK
| | - Alexei Yavlinsky
- Institute of Health Informatics, University College London, London, UK
| | - Robert W Aldridge
- Institute of Health Informatics, University College London, London, UK
| | - Andrew C Hayward
- Institute of Epidemiology and Health Care, University College London, London, UK
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5
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Dawes WJ, Grant O, Reitemeier SC, Tetlow S, Lee D, Hirst RA, O'Callaghan C. High-Speed Video Microscopy of Ependymal Cilia in Brain Organotypic and Cell Culture Models. Methods Mol Biol 2024; 2725:239-250. [PMID: 37856029 DOI: 10.1007/978-1-0716-3507-0_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
The wall of the ventricular system within the neuraxis is lined almost entirely by E1 ependymal cells, each of which projects multiple motile cilia from their apical surface into the cerebrospinal fluid (CSF). This specialized layer of E1 cells constitutes the border between the CSF and the brain interstitial fluid (BIF), and by controlling influx and efflux across the CSF to BIF interface, it is increasingly recognized to play an integral role in modulating and maintaining the brain microenvironment. The motile cilia have been shown to be responsive to changes in the CSF microenvironment, and while the physiological role of this mechanism remains incompletely understood, manipulating this control mechanism may influence the brain microenvironment potentially opening a new frontier in therapeutic intervention.In this paper, we describe our techniques for preparing organotypic slices from the murine brain parenchyma and establishing cell cultures of multiciliated ependymal cells from mouse and rat neonatal brain tissue. Our methodology generates a functional readout of ciliary function, specifically high-speed video microscopy (HSVM) enables the quantification of ciliary beat frequency (CBF), and characterization of ciliary beat pattern.
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Affiliation(s)
- William J Dawes
- Alder Hey Children's Hospital, University of Liverpool, Liverpool, UK.
- UCL Great Ormond Street Hospital, London, UK.
| | | | | | - Sarah Tetlow
- Alder Hey Children's Hospital, University of Liverpool, Liverpool, UK
| | - Dani Lee
- UCL Great Ormond Street Institute of Child Health & GOSH UCL BRC, London, UK
| | - Robert A Hirst
- Centre for PCD Diagnosis and Research, Department of Respiratory Sciences, University of Leicester, Leicester, UK
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6
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Walton T, Gui M, Velkova S, Fassad MR, Hirst RA, Haarman E, O'Callaghan C, Bottier M, Burgoyne T, Mitchison HM, Brown A. Axonemal structures reveal mechanoregulatory and disease mechanisms. Nature 2023; 618:625-633. [PMID: 37258679 PMCID: PMC10266980 DOI: 10.1038/s41586-023-06140-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 04/27/2023] [Indexed: 06/02/2023]
Abstract
Motile cilia and flagella beat rhythmically on the surface of cells to power the flow of fluid and to enable spermatozoa and unicellular eukaryotes to swim. In humans, defective ciliary motility can lead to male infertility and a congenital disorder called primary ciliary dyskinesia (PCD), in which impaired clearance of mucus by the cilia causes chronic respiratory infections1. Ciliary movement is generated by the axoneme, a molecular machine consisting of microtubules, ATP-powered dynein motors and regulatory complexes2. The size and complexity of the axoneme has so far prevented the development of an atomic model, hindering efforts to understand how it functions. Here we capitalize on recent developments in artificial intelligence-enabled structure prediction and cryo-electron microscopy (cryo-EM) to determine the structure of the 96-nm modular repeats of axonemes from the flagella of the alga Chlamydomonas reinhardtii and human respiratory cilia. Our atomic models provide insights into the conservation and specialization of axonemes, the interconnectivity between dyneins and their regulators, and the mechanisms that maintain axonemal periodicity. Correlated conformational changes in mechanoregulatory complexes with their associated axonemal dynein motors provide a mechanism for the long-hypothesized mechanotransduction pathway to regulate ciliary motility. Structures of respiratory-cilia doublet microtubules from four individuals with PCD reveal how the loss of individual docking factors can selectively eradicate periodically repeating structures.
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Affiliation(s)
- Travis Walton
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Miao Gui
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA
- Liangzhu Laboratory, Zhejiang University, Hangzhou, China
| | - Simona Velkova
- Genetics and Genomic Medicine Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Mahmoud R Fassad
- Genetics and Genomic Medicine Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Department of Human Genetics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Robert A Hirst
- Centre for PCD Diagnosis and Research, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Eric Haarman
- Department of Pediatric Respiratory Medicine and Allergy, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Christopher O'Callaghan
- Infection, Immunity & Inflammation Department, NIHR GOSH BRC, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Mathieu Bottier
- Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Thomas Burgoyne
- Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Institute of Ophthalmology, University College London, London, UK
| | - Hannah M Mitchison
- Genetics and Genomic Medicine Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Alan Brown
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA.
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7
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Lenglin V, Wong S, O'Callaghan C, Erzinçlioğlu S, Hornberger M, Lebouvier T, Piguet O, Bourgeois-Gironde S, Bertoux M. Zero the hero: Evidence for involvement of the ventromedial prefrontal cortex in affective bias for free items. Cortex 2023; 160:24-42. [PMID: 36680922 DOI: 10.1016/j.cortex.2022.12.009] [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: 07/28/2022] [Revised: 10/31/2022] [Accepted: 12/06/2022] [Indexed: 12/30/2022]
Abstract
Recent evidence from psycho-economics shows that when the price of an item decreases to the extent that it becomes available for free, one can observe a remarkable increase of subjective utility toward this item. This phenomenon, which is not observed for any other price but zero, has been termed the zero-price effect (ZPE). The ZPE is attributed to an affective heuristic where the positive affect elicited by the free status of an item provides a mental shortcut biasing choice towards that item. Given that the ZPE relies on affective processing, a key role of the ventromedial prefrontal cortex (vmPFC) has been proposed, yet neuroscientific studies of the ZPE remain scarce. This study aimed to explore the role of the vmPFC in the ZPE using a novel, within-subject assessment in participants with either an acquired (lesion patients) or degenerative (behavioural-variant frontotemporal dementia patients) lesion of the vmPFC, and age-matched healthy controls. All participants were asked to make a series of choices between pairs of items that varied in price. One choice trial involved an equal decrease of both item prices, such that one of the items was priced zero. In contrast to controls, patients with both vmPFC-lesion and behavioural-variant frontotemporal dementia showed marked reductions in zero-related changes of preference in pairs of gift-cards, but not for pairs of food items. Our findings suggest that affective evaluations driving the ZPE are altered in patients with focal or degenerative damage to the vmPFC. This supports the notion of a key role of the vmPFC in the ZPE and, more generally, the importance of this region in value-based affective decision-making. Our findings also highlight the potential utility of affective heuristic tasks in future clinical assessments.
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Affiliation(s)
- V Lenglin
- Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, LiCEND & DistALZ, Lille, France; ETHICS EA7446, Lille Catholic University, Lille, France
| | - S Wong
- The University of Sydney, School of Psychology and Brain & Mind Centre, Sydney, Australia; Flinders University, College of Education, Psychology & Social Work, Adelaide, Australia
| | - C O'Callaghan
- The University of Sydney, Brain & Mind Centre and School of Medical Sciences, Faculty of Medicine and Health, Sydney, Australia
| | - S Erzinçlioğlu
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge UK
| | - M Hornberger
- Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK; Norwich Medical School, University of East Anglia, Norwich, UK
| | - T Lebouvier
- Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, LiCEND & DistALZ, Lille, France
| | - O Piguet
- The University of Sydney, School of Psychology and Brain & Mind Centre, Sydney, Australia
| | - S Bourgeois-Gironde
- Department of Economics, Université Paris 2 - Panthéon-Assas, Paris, France; Institut Jean-Nicod, Ecole Normale Supérieure, PSL Research University, Paris, France.
| | - M Bertoux
- Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, LiCEND & DistALZ, Lille, France; Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK.
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Chau JFT, Lee M, Chui MMC, Yu MHC, Fung JLF, Mak CCY, Chau CSK, Siu KK, Hung J, Yeung KS, Kwong AKY, O'Callaghan C, Lau YL, Lee CWD, Chung BHY, Lee SL. Functional Evaluation and Genetic Landscape of Children and Young Adults Referred for Assessment of Bronchiectasis. Front Genet 2022; 13:933381. [PMID: 36003331 PMCID: PMC9393783 DOI: 10.3389/fgene.2022.933381] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 06/23/2022] [Indexed: 11/14/2022] Open
Abstract
Bronchiectasis is the abnormal dilation of the airway which may be caused by various etiologies in children. Beyond the more recognized cause of bacterial and viral infections and primary immunodeficiencies, other genetic conditions such as cystic fibrosis and primary ciliary dyskinesia (PCD) can also contribute to the disease. Currently, there is still debate on whether genome sequencing (GS) or exome sequencing reanalysis (rES) would be beneficial if the initial targeted testing results returned negative. This study aims to provide a back-to-back comparison between rES and GS to explore the best integrated approach for the functional and genetics evaluation for patients referred for assessment of bronchiectasis. In phase 1, an initial 60 patients were analyzed by exome sequencing (ES) with one additional individual recruited later as an affected sibling for ES. Functional evaluation of the nasal nitric oxide test, transmission electron microscopy, and high-speed video microscopy were also conducted when possible. In phase 2, GS was performed on 30 selected cases with trio samples available. To provide a back-to-back comparison, two teams of genome analysts were alternatively allocated to GS or rES and were blinded to each other’s analysis. The time for bioinformatics, analysis, and diagnostic utility was recorded for evaluation. ES revealed five positive diagnoses (5/60, 8.3%) in phase 1, and four additional diagnoses were made by rES and GS (4/30, 13%) during phase 2. Subsequently, one additional positive diagnosis was identified in a sibling by ES and an overall diagnostic yield of 10/61 (16.4%) was reached. Among those patients with a clinical suspicion of PCD (n = 31/61), the diagnostic yield was 26% (n = 8/31). While GS did not increase the diagnostic yield, we showed that a variant of uncertain significance could only be detected by GS due to improved coverage over ES and hence is a potential benefit for GS in the future. We show that genetic testing is an essential component for the diagnosis of early-onset bronchiectasis and is most effective when used in combination with functional tools such as TEM or HSVM. Our comparison of rES vs. GS suggests that rES and GS are comparable in clinical diagnosis.
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Affiliation(s)
- Jeffrey Fong Ting Chau
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Mianne Lee
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Martin Man Chun Chui
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Mullin Ho Chung Yu
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Jasmine Lee Fong Fung
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Christopher Chun Yu Mak
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Christy Shuk-Kuen Chau
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Pok Fu Lam, Hong Kong SAR, China
| | - Ka Ka Siu
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Pok Fu Lam, Hong Kong SAR, China
| | - Jacqueline Hung
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Pok Fu Lam, Hong Kong SAR, China
| | - Kit San Yeung
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Anna Ka Yee Kwong
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Christopher O'Callaghan
- UCL Great Ormond Street Institute of Child Health, UCL and GOSH NIHR BRC, London, United Kingdom
| | - Yu Lung Lau
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Pok Fu Lam, Hong Kong SAR, China
| | - Chun-Wai Davy Lee
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- Department of Paediatrics and Adolescent Medicine, Duchess of Kent Children’s Hospital, Pok Fu Lam, Hong Kong SAR, China
| | - Brian Hon-Yin Chung
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Pok Fu Lam, Hong Kong SAR, China
- Department of Paediatrics and Adolescent Medicine, Duchess of Kent Children’s Hospital, Pok Fu Lam, Hong Kong SAR, China
- *Correspondence: Brian Hon-Yin Chung, ; So-Lun Lee,
| | - So-Lun Lee
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Pok Fu Lam, Hong Kong SAR, China
- *Correspondence: Brian Hon-Yin Chung, ; So-Lun Lee,
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Lee DDH, Cardinale D, Saman Y, Hirst RA, Wilson N, Corden V, Rutman A, de Haro T, Hynds RE, McHugh T, Rea P, Smith CM, O'Callaghan C. COVID-19: Extensive epithelial damage and ciliary dyskinesia in hospitalised patients. Rhinology 2022; 60:155-158. [PMID: 35112671 DOI: 10.4193/rhin21.233] [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: 11/08/2022]
Abstract
Infection with SARS-CoV-2 can cause severe respiratory disease and it is predicted that the COVID-19 pandemic will leave a substantial number of patients with long-term respiratory complications (1).
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Affiliation(s)
- D D H Lee
- UCL Great Ormond Street Institute of Child Health, UCL and NIHR GOSH BRC, London, U.K
| | - D Cardinale
- UCL Great Ormond Street Institute of Child Health, UCL and NIHR GOSH BRC, London, U.K
| | - Y Saman
- Department of ENT, University Hospitals of Leicester, Leicester, UK
| | - R A Hirst
- Centre for PCD Diagnosis and Research, Department of Respiratory Sciences, University of Leicester, Leicester, U.K
| | - N Wilson
- Cellular Pathology Department, University Hospitals of Leicester, Leicester, U.K
| | - V Corden
- Cellular Pathology Department, University Hospitals of Leicester, Leicester, U.K
| | - A Rutman
- Centre for PCD Diagnosis and Research, Department of Respiratory Sciences, University of Leicester, Leicester, U.K
| | - T de Haro
- Cellular Pathology Department, University Hospitals of Leicester, Leicester, U.K
| | - R E Hynds
- UCL Cancer Institute, University College London, U.K
| | - T McHugh
- UCL Centre for Clinical Microbiology, University College London, U.K
| | - P Rea
- Department of ENT, University Hospitals of Leicester, Leicester, UK
| | - C M Smith
- UCL Great Ormond Street Institute of Child Health, UCL and NIHR GOSH BRC, London, U.K
| | - C O'Callaghan
- UCL Great Ormond Street Institute of Child Health, UCL and NIHR GOSH BRC, London, U.K.,Centre for PCD Diagnosis and Research, Department of Respiratory Sciences, University of Leicester, Leicester, U.K
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10
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Frauenfelder C, Hall A, Walsh B, Ross A, Broughton E, Hynds RE, Nandi R, O'Callaghan C, Butler CR. Use of Simulation to Visualize Healthcare Worker Exposure to Aerosol in the Operating Room. Simul Healthc 2022; 17:66-67. [PMID: 33993138 PMCID: PMC8808760 DOI: 10.1097/sih.0000000000000581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
SUMMARY STATEMENT Simulation resources offer an opportunity to highlight aerosol dispersion within the operating room environment. We demonstrate our methodology with a supporting video that can offer operating room teams support in their practical understanding of aerosol exposure and the importance of personal protective equipment.
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Yoshida M, Worlock KB, Huang N, Lindeboom RGH, Butler CR, Kumasaka N, Dominguez Conde C, Mamanova L, Bolt L, Richardson L, Polanski K, Madissoon E, Barnes JL, Allen-Hyttinen J, Kilich E, Jones BC, de Wilton A, Wilbrey-Clark A, Sungnak W, Pett JP, Weller J, Prigmore E, Yung H, Mehta P, Saleh A, Saigal A, Chu V, Cohen JM, Cane C, Iordanidou A, Shibuya S, Reuschl AK, Herczeg IT, Argento AC, Wunderink RG, Smith SB, Poor TA, Gao CA, Dematte JE, Reynolds G, Haniffa M, Bowyer GS, Coates M, Clatworthy MR, Calero-Nieto FJ, Göttgens B, O'Callaghan C, Sebire NJ, Jolly C, De Coppi P, Smith CM, Misharin AV, Janes SM, Teichmann SA, Nikolić MZ, Meyer KB. Local and systemic responses to SARS-CoV-2 infection in children and adults. Nature 2022; 602:321-327. [PMID: 34937051 PMCID: PMC8828466 DOI: 10.1038/s41586-021-04345-x] [Citation(s) in RCA: 147] [Impact Index Per Article: 73.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 12/14/2021] [Indexed: 02/03/2023]
Abstract
It is not fully understood why COVID-19 is typically milder in children1-3. Here, to examine the differences between children and adults in their response to SARS-CoV-2 infection, we analysed paediatric and adult patients with COVID-19 as well as healthy control individuals (total n = 93) using single-cell multi-omic profiling of matched nasal, tracheal, bronchial and blood samples. In the airways of healthy paediatric individuals, we observed cells that were already in an interferon-activated state, which after SARS-CoV-2 infection was further induced especially in airway immune cells. We postulate that higher paediatric innate interferon responses restrict viral replication and disease progression. The systemic response in children was characterized by increases in naive lymphocytes and a depletion of natural killer cells, whereas, in adults, cytotoxic T cells and interferon-stimulated subpopulations were significantly increased. We provide evidence that dendritic cells initiate interferon signalling in early infection, and identify epithelial cell states associated with COVID-19 and age. Our matching nasal and blood data show a strong interferon response in the airways with the induction of systemic interferon-stimulated populations, which were substantially reduced in paediatric patients. Together, we provide several mechanisms that explain the milder clinical syndrome observed in children.
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Affiliation(s)
- Masahiro Yoshida
- UCL Respiratory, Division of Medicine, University College London, London, UK
- Division of Respiratory Diseases, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Kaylee B Worlock
- UCL Respiratory, Division of Medicine, University College London, London, UK
| | - Ni Huang
- Wellcome Sanger Institute, Cambridge, UK
| | | | - Colin R Butler
- NIHR Great Ormond Street BRC and UCL Institute of Child Health, London, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | | | | | | | - Liam Bolt
- Wellcome Sanger Institute, Cambridge, UK
| | | | | | - Elo Madissoon
- Wellcome Sanger Institute, Cambridge, UK
- European Molecular Biology Laboratory, European Bioinformatics Institute, Cambridge, UK
| | - Josephine L Barnes
- UCL Respiratory, Division of Medicine, University College London, London, UK
| | | | - Eliz Kilich
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Brendan C Jones
- NIHR Great Ormond Street BRC and UCL Institute of Child Health, London, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Angus de Wilton
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | | | | | | | | | - Henry Yung
- UCL Respiratory, Division of Medicine, University College London, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Puja Mehta
- UCL Respiratory, Division of Medicine, University College London, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Aarash Saleh
- Royal Free Hospital NHS Foundation Trust, London, UK
| | - Anita Saigal
- Royal Free Hospital NHS Foundation Trust, London, UK
| | - Vivian Chu
- Royal Free Hospital NHS Foundation Trust, London, UK
| | - Jonathan M Cohen
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Clare Cane
- Royal Free Hospital NHS Foundation Trust, London, UK
| | | | - Soichi Shibuya
- NIHR Great Ormond Street BRC and UCL Institute of Child Health, London, UK
| | - Ann-Kathrin Reuschl
- UCL Division of Infection and Immunity, University College London, London, UK
| | - Iván T Herczeg
- UCL Respiratory, Division of Medicine, University College London, London, UK
| | - A Christine Argento
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Richard G Wunderink
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sean B Smith
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Taylor A Poor
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Catherine A Gao
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jane E Dematte
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gary Reynolds
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Muzlifah Haniffa
- Wellcome Sanger Institute, Cambridge, UK
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Matthew Coates
- Department of Medicine, University of Cambridge, Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Menna R Clatworthy
- Wellcome Sanger Institute, Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | | | - Berthold Göttgens
- Wellcome, MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
| | - Christopher O'Callaghan
- NIHR Great Ormond Street BRC and UCL Institute of Child Health, London, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Neil J Sebire
- NIHR Great Ormond Street BRC and UCL Institute of Child Health, London, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Clare Jolly
- UCL Division of Infection and Immunity, University College London, London, UK
| | - Paolo De Coppi
- NIHR Great Ormond Street BRC and UCL Institute of Child Health, London, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Claire M Smith
- NIHR Great Ormond Street BRC and UCL Institute of Child Health, London, UK
| | - Alexander V Misharin
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sam M Janes
- UCL Respiratory, Division of Medicine, University College London, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Sarah A Teichmann
- Wellcome Sanger Institute, Cambridge, UK
- Department of Physics, Cavendish Laboratory, University of Cambridge, Cambridge, UK
| | - Marko Z Nikolić
- UCL Respiratory, Division of Medicine, University College London, London, UK.
- University College London Hospitals NHS Foundation Trust, London, UK.
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12
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Rowlands C, Thomas HB, Lord J, Wai HA, Arno G, Beaman G, Sergouniotis P, Gomes-Silva B, Campbell C, Gossan N, Hardcastle C, Webb K, O'Callaghan C, Hirst RA, Ramsden S, Jones E, Clayton-Smith J, Webster AR, Douglas AGL, O'Keefe RT, Newman WG, Baralle D, Black GCM, Ellingford JM. Comparison of in silico strategies to prioritize rare genomic variants impacting RNA splicing for the diagnosis of genomic disorders. Sci Rep 2021; 11:20607. [PMID: 34663891 PMCID: PMC8523691 DOI: 10.1038/s41598-021-99747-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/13/2021] [Indexed: 12/22/2022] Open
Abstract
The development of computational methods to assess pathogenicity of pre-messenger RNA splicing variants is critical for diagnosis of human disease. We assessed the capability of eight algorithms, and a consensus approach, to prioritize 249 variants of uncertain significance (VUSs) that underwent splicing functional analyses. The capability of algorithms to differentiate VUSs away from the immediate splice site as being 'pathogenic' or 'benign' is likely to have substantial impact on diagnostic testing. We show that SpliceAI is the best single strategy in this regard, but that combined usage of tools using a weighted approach can increase accuracy further. We incorporated prioritization strategies alongside diagnostic testing for rare disorders. We show that 15% of 2783 referred individuals carry rare variants expected to impact splicing that were not initially identified as 'pathogenic' or 'likely pathogenic'; one in five of these cases could lead to new or refined diagnoses.
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Affiliation(s)
- Charlie Rowlands
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, St Mary's Hospital, Manchester, UK
- Division of Evolution and Genomic Sciences, Neuroscience and Mental Health Domain, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Huw B Thomas
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, St Mary's Hospital, Manchester, UK
- Division of Evolution and Genomic Sciences, Neuroscience and Mental Health Domain, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jenny Lord
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Htoo A Wai
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Gavin Arno
- Institute of Ophthalmology, UCL, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Glenda Beaman
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, St Mary's Hospital, Manchester, UK
- Division of Evolution and Genomic Sciences, Neuroscience and Mental Health Domain, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Panagiotis Sergouniotis
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, St Mary's Hospital, Manchester, UK
- Division of Evolution and Genomic Sciences, Neuroscience and Mental Health Domain, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Beatriz Gomes-Silva
- Division of Evolution and Genomic Sciences, Neuroscience and Mental Health Domain, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Christopher Campbell
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, St Mary's Hospital, Manchester, UK
| | - Nicole Gossan
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, St Mary's Hospital, Manchester, UK
| | - Claire Hardcastle
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, St Mary's Hospital, Manchester, UK
| | - Kevin Webb
- Manchester Adult Cystic Fibrosis Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Christopher O'Callaghan
- Respiratory, Critical Care and Anaesthesia, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Children's Hospital & NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
- Centre for PCD Diagnosis and Research, Department of Infection, Immunity and Inflammation, RKCSB, University of Leicester, Leicester, UK
| | - Robert A Hirst
- Centre for PCD Diagnosis and Research, Department of Infection, Immunity and Inflammation, RKCSB, University of Leicester, Leicester, UK
| | - Simon Ramsden
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, St Mary's Hospital, Manchester, UK
| | - Elizabeth Jones
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, St Mary's Hospital, Manchester, UK
| | - Jill Clayton-Smith
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, St Mary's Hospital, Manchester, UK
- Division of Evolution and Genomic Sciences, Neuroscience and Mental Health Domain, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Andrew R Webster
- Institute of Ophthalmology, UCL, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Andrew G L Douglas
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- Wessex Clinical Genetics Service, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Raymond T O'Keefe
- Division of Evolution and Genomic Sciences, Neuroscience and Mental Health Domain, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - William G Newman
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, St Mary's Hospital, Manchester, UK
- Division of Evolution and Genomic Sciences, Neuroscience and Mental Health Domain, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Diana Baralle
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- Wessex Clinical Genetics Service, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Graeme C M Black
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, St Mary's Hospital, Manchester, UK.
- Division of Evolution and Genomic Sciences, Neuroscience and Mental Health Domain, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
| | - Jamie M Ellingford
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, St Mary's Hospital, Manchester, UK.
- Division of Evolution and Genomic Sciences, Neuroscience and Mental Health Domain, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
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13
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Lee DDH, Cardinale D, Nigro E, Butler CR, Rutman A, Fassad MR, Hirst RA, Moulding D, Agrotis A, Forsythe E, Peckham D, Robson E, Smith CM, Somavarapu S, Beales PL, Hart SL, Janes SM, Mitchison HM, Ketteler R, Hynds RE, O'Callaghan C. Higher throughput drug screening for rare respiratory diseases: readthrough therapy in primary ciliary dyskinesia. Eur Respir J 2021; 58:13993003.00455-2020. [PMID: 33795320 PMCID: PMC8514977 DOI: 10.1183/13993003.00455-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 03/01/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Development of therapeutic approaches for rare respiratory diseases is hampered by the lack of systems that allow medium-to-high-throughput screening of fully differentiated respiratory epithelium from affected patients. This is a particular problem for primary ciliary dyskinesia (PCD), a rare genetic disease caused by mutations in genes that adversely affect ciliary movement and consequently mucociliary transport. Primary cell culture of basal epithelial cells from nasal brush biopsies followed by ciliated differentiation at the air-liquid interface (ALI) has proven to be a useful tool in PCD diagnostics but the technique's broader utility, including in pre-clinical PCD research, has been restricted by the limited number of basal cells that can be expanded from such biopsies. METHODS We describe an immunofluorescence screening method, enabled by extensive expansion of basal cells from PCD patients and the directed differentiation of these cells into ciliated epithelium in miniaturised 96-well transwell format ALI cultures. As proof-of-principle, we performed a personalised investigation in a patient with a rare and severe form of PCD (reduced generation of motile cilia), in this case caused by a homozygous nonsense mutation in the MCIDAS gene. RESULTS Initial analyses of ciliary ultrastructure, beat pattern and beat frequency in the 96-well transwell format ALI cultures indicate that a range of different PCD defects can be retained in these cultures. The screening system in our proof-of-principal investigation allowed drugs that induce translational readthrough to be evaluated alone or in combination with nonsense-mediated decay inhibitors. We observed restoration of basal body formation but not the generation of cilia in the patient's nasal epithelial cells in vitro. CONCLUSION: Our study provides a platform for higher throughput analyses of airway epithelia that is applicable in a range of settings and suggests novel avenues for drug evaluation and development in PCD caused by nonsense mutations.
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Affiliation(s)
- Dani Do Hyang Lee
- UCL Great Ormond Street Institute of Child Health, London, UK
- D.D.H. Lee and D. Cardinale contributed equally
| | - Daniela Cardinale
- UCL Great Ormond Street Institute of Child Health, London, UK
- D.D.H. Lee and D. Cardinale contributed equally
| | - Ersilia Nigro
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, UK
| | - Colin R Butler
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, UK
| | - Andrew Rutman
- Centre for PCD Diagnosis and Research, Dept of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Mahmoud R Fassad
- Ciliary Disease Section, Genetics and Genomic Medicine Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health, London, UK
- Dept of Human Genetics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Robert A Hirst
- Centre for PCD Diagnosis and Research, Dept of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Dale Moulding
- Developmental Biology and Cancer, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Alexander Agrotis
- MRC Laboratory for Molecular Cell Biology, University College London, London, UK
| | - Elisabeth Forsythe
- Ciliary Disease Section, Genetics and Genomic Medicine Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Daniel Peckham
- Leeds Institute for Medical Research, University of Leeds, Leeds, UK
| | - Evie Robson
- Leeds Institute for Medical Research, University of Leeds, Leeds, UK
| | - Claire M Smith
- UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Philip L Beales
- Ciliary Disease Section, Genetics and Genomic Medicine Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Stephen L Hart
- Ciliary Disease Section, Genetics and Genomic Medicine Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sam M Janes
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, UK
| | - Hannah M Mitchison
- Ciliary Disease Section, Genetics and Genomic Medicine Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Robin Ketteler
- MRC Laboratory for Molecular Cell Biology, University College London, London, UK
| | - Robert E Hynds
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, UK
- UCL Cancer Institute, University College London, London, UK
- R.E. Hynds and C. O'Callaghan contributed equally to this article as lead authors and supervised the work
| | - Christopher O'Callaghan
- UCL Great Ormond Street Institute of Child Health, London, UK
- Centre for PCD Diagnosis and Research, Dept of Respiratory Sciences, University of Leicester, Leicester, UK
- R.E. Hynds and C. O'Callaghan contributed equally to this article as lead authors and supervised the work
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14
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Thomas B, Koh MS, O'Callaghan C, Allen JC, Rutman A, Hirst RA, Connolly J, Low SY, Thun How O, Chian Min L, Lim WT, Lin Ean Oon L, He Q, Teoh OH, Lapperre TS. Dysfunctional Bronchial Cilia Are a Feature of Chronic Obstructive Pulmonary Disease (COPD). COPD 2021; 18:657-663. [PMID: 34468237 DOI: 10.1080/15412555.2021.1963695] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Impaired mucociliary clearance may increase COPD exacerbation risk. We aimed to compare bronchial ciliary function and epithelial ultrastructure of COPD patients to healthy controls and explore its relationship to exacerbator phenotypes (frequent [FE] and infrequent [IFE] exacerbator). In this cross-sectional study, 16 COPD patients and 12 controls underwent bronchial brushings. Ciliary beat frequency (CBF) and dyskinesia index (DI; % of dyskinetic cilia) were assessed using digital high-speed video microscopy, and epithelial ultrastructure using transmission electron microscopy (TEM). Bronchial epithelium in COPD showed lower CBF and higher DI, compared to controls (median [IQR] CBF: 6.8 (6.1-7.2) Hz vs 8.5 (7.7-8.9) Hz, p<0.001 and DI: 73.8 (60.7-89.8) % vs 14.5 (11.2-16.9) %, p<0.001, respectively). This was true for FE and IFE phenotypes of COPD, which were similar in terms of bronchial CBF or DI. Subgroup analyses demonstrated lower CBF and higher DI in FE and IFE COPD phenotypes compared to controls, irrespective of smoking status. TEM showed more loss of cilia, extrusion of cells, cytoplasmic blebs and dead cells in COPD patients versus controls. Profound dysfunction of bronchial cilia is a feature of COPD irrespective of exacerbation phenotype and smoking status, which is likely to contribute to poor mucus clearance in COPD.Supplemental data for this article is available online at https://doi.org/10.1080/15412555.2021.1963695 .
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Affiliation(s)
- Biju Thomas
- Department of Respiratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Mariko Siyue Koh
- Duke-NUS Medical School, Singapore, Singapore.,Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore, Singapore
| | - Christopher O'Callaghan
- Respiratory, Critical Care and Anaesthesia, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - John Carson Allen
- Department of Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Andrew Rutman
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | - Robert Anthony Hirst
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | - John Connolly
- A*STAR, Institute of Molecular and Cell Biology, Singapore, Singapore
| | - Su Ying Low
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore, Singapore
| | - Ong Thun How
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore, Singapore
| | - Loo Chian Min
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore, Singapore
| | - Wan Teck Lim
- Duke-NUS Medical School, Singapore, Singapore.,A*STAR, Institute of Molecular and Cell Biology, Singapore, Singapore.,Singhealth Investigational Medicine Unit, Singapore General Hospital, Singapore, Singapore
| | - Lynette Lin Ean Oon
- Duke-NUS Medical School, Singapore, Singapore.,Department of Molecular Pathology, Singapore General Hospital, Singapore, Singapore
| | - Qixian He
- Department of Respiratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Oon Hoe Teoh
- Department of Respiratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Therese Sophie Lapperre
- Duke-NUS Medical School, Singapore, Singapore.,Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore, Singapore.,Department of Pulmonology, University Hospital Antwerp, Antwerp, Belgium.,Laboratory of Experimental Medicine and Paediatrics, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
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15
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Lam WY, Tang CSM, So MT, Yue H, Hsu JS, Chung PHY, Nicholls JM, Yeung F, Lee CWD, Ngo DN, Nguyen PAH, Mitchison HM, Jenkins D, O'Callaghan C, Garcia-Barceló MM, Lee SL, Sham PC, Lui VCH, Tam PKH. Identification of a wide spectrum of ciliary gene mutations in nonsyndromic biliary atresia patients implicates ciliary dysfunction as a novel disease mechanism. EBioMedicine 2021; 71:103530. [PMID: 34455394 PMCID: PMC8403738 DOI: 10.1016/j.ebiom.2021.103530] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 07/09/2021] [Accepted: 07/27/2021] [Indexed: 12/12/2022] Open
Abstract
Background Biliary atresia (BA) is the most common obstructive cholangiopathy in neonates, often progressing to end-stage cirrhosis. BA pathogenesis is believed to be multifactorial, but the genetic contribution, especially for nonsyndromic BA (common form: > 85%) remains poorly defined. Methods We conducted whole exome sequencing on 89 nonsyndromic BA trios to identify rare variants contributing to BA etiology. Functional evaluation using patients’ liver biopsies, human cell and zebrafish models were performed. Clinical impact on respiratory system was assessed with clinical evaluation, nasal nitric oxide (nNO), high speed video analysis and transmission electron microscopy. Findings We detected rare, deleterious de novo or biallelic variants in liver-expressed ciliary genes in 31.5% (28/89) of the BA patients. Burden test revealed 2.6-fold (odds ratio (OR) [95% confidence intervals (CI)]= 2.58 [1.15–6.07], adjusted p = 0.034) over-representation of rare, deleterious mutations in liver-expressed ciliary gene set in patients compared to controls. Functional analyses further demonstrated absence of cilia in the BA livers with KIF3B and TTC17 mutations, and knockdown of PCNT, KIF3B and TTC17 in human control fibroblasts and cholangiocytes resulted in reduced number of cilia. Additionally, CRISPR/Cas9-engineered zebrafish knockouts of KIF3B, PCNT and TTC17 displayed reduced biliary flow. Abnormally low level of nNO was detected in 80% (8/10) of BA patients carrying deleterious ciliary mutations, implicating the intrinsic ciliary defects. Interpretation Our findings support strong genetic susceptibility for nonsyndromic BA. Ciliary gene mutations leading to cholangiocyte cilia malformation and dysfunction could be a key biological mechanism in BA pathogenesis. Funding The study is supported by General Research Fund, HMRF Commissioned Paediatric Research at HKCH and Li Ka Shing Faculty of Medicine Enhanced New Staff Start-up Fund.
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Affiliation(s)
- Wai-Yee Lam
- Division of Paediatric Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, LKS Faculty of Medicine Building, 21 Sassoon Road, Hong Kong SAR, China; Dr Li Dak-Sum Research Centre, The University of Hong Kong, Hong Kong SAR, China
| | - Clara Sze-Man Tang
- Division of Paediatric Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, LKS Faculty of Medicine Building, 21 Sassoon Road, Hong Kong SAR, China; Dr Li Dak-Sum Research Centre, The University of Hong Kong, Hong Kong SAR, China
| | - Man-Ting So
- Division of Paediatric Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, LKS Faculty of Medicine Building, 21 Sassoon Road, Hong Kong SAR, China
| | - Haibing Yue
- Division of Paediatric Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, LKS Faculty of Medicine Building, 21 Sassoon Road, Hong Kong SAR, China
| | - Jacob Shujui Hsu
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Patrick Ho-Yu Chung
- Division of Paediatric Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, LKS Faculty of Medicine Building, 21 Sassoon Road, Hong Kong SAR, China
| | - John M Nicholls
- Department of Pathology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Fanny Yeung
- Division of Paediatric Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, LKS Faculty of Medicine Building, 21 Sassoon Road, Hong Kong SAR, China
| | - Chun-Wai Davy Lee
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | | | | | - Hannah M Mitchison
- Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Dagan Jenkins
- Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Christopher O'Callaghan
- Respiratory, Critical Care & Anaesthesia Section, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Maria-Mercè Garcia-Barceló
- Division of Paediatric Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, LKS Faculty of Medicine Building, 21 Sassoon Road, Hong Kong SAR, China
| | - So-Lun Lee
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong SAR, China
| | - Pak-Chung Sham
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Vincent Chi-Hang Lui
- Division of Paediatric Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, LKS Faculty of Medicine Building, 21 Sassoon Road, Hong Kong SAR, China; Dr Li Dak-Sum Research Centre, The University of Hong Kong, Hong Kong SAR, China.
| | - Paul Kwong-Hang Tam
- Division of Paediatric Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, LKS Faculty of Medicine Building, 21 Sassoon Road, Hong Kong SAR, China; Dr Li Dak-Sum Research Centre, The University of Hong Kong, Hong Kong SAR, China.
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16
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O'Callaghan C, Tran A, Tam N, Wen LM, Harris-Roxas. Promoting the get healthy information and coaching service (GHS) in Australian-Chinese communities: facilitators and barriers. Health Promot Int 2021; 37:6354875. [PMID: 34410388 DOI: 10.1093/heapro/daab129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Obesity and being overweight are major public health concerns that health coaching can assist people to manage through encouraging self-management and behaviour change. The Get Healthy Information and Coaching Service (GHS) is a telephone health coaching service in Australia that has effectively improved the health of the general population but has had less participation of culturally and linguistically diverse (CALD) populations. The Chinese population is the largest migrant group in Australia with increased risk of diabetes but had reduced access to the GHS program due to communication barriers. The GHS developed a pilot program for Chinese (Mandarin and Cantonese-speaking) communities using bilingual coaches and translated material to address these barriers. Qualitative research was undertaken with Chinese stakeholders (14 interviews) and 11 program participants from the group which had completed the program (2 focus groups in Mandarin and Cantonese) to understand their experiences and the success of promotional activities. This research does not contain the experiences of the people that withdrew from the program. The bilingual program was culturally and linguistically appropriate and addressed risk factors for chronic conditions. Participants formed positive relationships with bilingual coaches who they preferred to interpreters. They felt the program promoted healthy eating, weight and physical activity. Although Chinese stakeholders had concerns about participants' ability to goal set, participants said they met their health goals and were committed to the GHS program. Strategies to enhance the program included promoting the bilingual GHS to the communities and stakeholders. Factors to consider beyond language in adapting the program to the Australian Chinese communities include meeting the heterogenous needs of the older population, ensuring community engagement and addressing cultural beliefs and practices.
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Affiliation(s)
- C O'Callaghan
- Centre for Primary Health Care and Equity, The University of New South Wales, Sydney, NSW 2052, Australia.,Population and Community Health, South Eastern Sydney Local Health District, Darlinghurst, NSW 2010, Australia
| | - A Tran
- Centre for Primary Health Care and Equity, The University of New South Wales, Sydney, NSW 2052, Australia
| | - N Tam
- Population and Community Health, South Eastern Sydney Local Health District, Darlinghurst, NSW 2010, Australia.,Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - L M Wen
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, NSW 2050, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Harris-Roxas
- Centre for Primary Health Care and Equity, The University of New South Wales, Sydney, NSW 2052, Australia.,Population and Community Health, South Eastern Sydney Local Health District, Darlinghurst, NSW 2010, Australia
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17
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Aw KL, Lee SH, McLarnon M, Raveendran D, O'Callaghan C, Mullan G, Fearon M, Samuel S, Sekar V, Rogan P. 326 Student Perceptions of Neurosurgery: Evaluating the Role of Undergraduate Neuroscience Societies. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Many institutions lack an organized system of informal network for medical students wishing to explore neurosurgery. We sought to evaluate the role of extracurricular neurosurgical events in influencing student perceptions of neurosurgery.
Method
Participants for this study were recruited from a neurosurgical careers seminar and practical workshop. Responses were collected prospectively using a multi-method strategy consisting of closed and open-ended questions. Additionally, semi-structured interviews were conducted to gain a deeper insight of students’ evaluation of these events and their perceptions of neurosurgery.
Results
A total of 124 students attended our extracurricular neurosurgery events. These events showed benefits in clinical knowledge and career planning. Students perceived the practical workshops to be useful in improving their basic surgical skills. Semi-structured interviews revealed that students felt their opportunities in exploring clinical neurosciences to be limited, which was seen as contributing towards the wider culture of neurophobia.
Conclusions
Undergraduate neuroscience societies provide useful educational platforms for students interested in neurosurgery, even in regions lacking institutional neuroscience networks. To help mitigate the wider culture of neurophobia, undergraduate neuroscience societies should focus on non-academic aspects of neurosurgery that are more personal and engaging, in an effort to spark interest in those who have had little exposure to the specialty.
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Affiliation(s)
- K L Aw
- Queen's University Belfast, Belfast, United Kingdom
| | - S H Lee
- Queen's University Belfast, Belfast, United Kingdom
| | - M McLarnon
- Queen's University Belfast, Belfast, United Kingdom
| | - D Raveendran
- Queen's University Belfast, Belfast, United Kingdom
| | | | - G Mullan
- Queen's University Belfast, Belfast, United Kingdom
| | - M Fearon
- Queen's University Belfast, Belfast, United Kingdom
| | - S Samuel
- Queen's University Belfast, Belfast, United Kingdom
| | - V Sekar
- Queen's University Belfast, Belfast, United Kingdom
| | - P Rogan
- Queen's University Belfast, Belfast, United Kingdom
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18
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Mehrban N, Cardinale D, Gallo SC, Lee DDH, Arne Scott D, Dong H, Bowen J, Woolfson DN, Birchall MA, O'Callaghan C. α-Helical peptides on plasma-treated polymers promote ciliation of airway epithelial cells. Mater Sci Eng C Mater Biol Appl 2021; 122:111935. [PMID: 33641925 DOI: 10.1016/j.msec.2021.111935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/11/2021] [Accepted: 01/30/2021] [Indexed: 11/30/2022]
Abstract
Airway respiratory epithelium forms a physical barrier through intercellular tight junctions, which prevents debris from passing through to the internal environment while ciliated epithelial cells expel particulate-trapping mucus up the airway. Polymeric solutions to loss of airway structure and integrity have been unable to fully restore functional epithelium. We hypothesised that plasma treatment of polymers would permit adsorption of α-helical peptides and that this would promote functional differentiation of airway epithelial cells. Five candidate plasma compositions are compared; Air, N2, H2, H2:N2 and Air:N2. X-ray photoelectron spectroscopy shows changes in at% N and C 1s peaks after plasma treatment while electron microscopy indicates successful adsorption of hydrogelating self-assembling fibres (hSAF) on all samples. Subsequently, adsorbed hSAFs support human nasal epithelial cell attachment and proliferation and induce differentiation at an air-liquid interface. Transepithelial measurements show that the cells form tight junctions and produce cilia beating at the normal expected frequency of 10-11 Hz after 28 days in culture. The synthetic peptide system described in this study offers potential superiority as an epithelial regeneration substrate over present "gold-standard" materials, such as collagen, as they are controllable and can be chemically functionalised to support a variety of in vivo environments. Using the hSAF peptides described here in combination with plasma-treated polymeric surfaces could offer a way of improving the functionality and integration of implantable polymers for aerodigestive tract reconstruction and regeneration.
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Affiliation(s)
- Nazia Mehrban
- UCL Ear Institute, University College London, 332 Grays Inn Rd, London WC1X 8EE, UK.
| | - Daniela Cardinale
- Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford St, London WC1N 1EH, UK
| | - Santiago C Gallo
- Institute for Frontier Materials, Deakin University, 75 Pigdons Rd, Victoria, VIC 3216, Australia
| | - Dani D H Lee
- Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford St, London WC1N 1EH, UK
| | - D Arne Scott
- School of Chemistry, University of Bristol, Cantock's Close, Bristol BS8 1TS, UK
| | - Hanshan Dong
- School of Metallurgy and Materials, University of Birmingham, Elms Rd, Birmingham B15 2SE, UK
| | - James Bowen
- School of Engineering & Innovation, The Open University, Walton Hall, Milton Keynes MK7 6AA, UK
| | - Derek N Woolfson
- School of Chemistry, University of Bristol, Cantock's Close, Bristol BS8 1TS, UK; School of Biochemistry, University of Bristol, University Walk, Bristol BS8 1TD, UK; Bristol BioDesign Institute, University of Bristol, 24 Tyndall Avenue, Bristol BS8 1TQ, UK
| | - Martin A Birchall
- UCL Ear Institute, University College London, 332 Grays Inn Rd, London WC1X 8EE, UK
| | - Christopher O'Callaghan
- Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford St, London WC1N 1EH, UK
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19
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Lee SL, O'Callaghan C, Lau YL, Lee CWD. Functional analysis and evaluation of respiratory cilia in healthy Chinese children. Respir Res 2020; 21:259. [PMID: 33036612 PMCID: PMC7545929 DOI: 10.1186/s12931-020-01506-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 06/09/2020] [Accepted: 09/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To aid in the diagnosis of Primary Ciliary Dyskinesia (PCD) and to evaluate the respiratory epithelium in respiratory disease, normal age-related reference ranges are needed for ciliary beat frequency (CBF), beat pattern and ultrastructure. Our aim was to establish reference ranges for healthy Chinese children. METHODS Ciliated epithelial samples were obtained from 135 healthy Chinese children aged below 18 years by brushing the inferior nasal turbinate. CBF and beat pattern were analysed from high speed video recordings. Epithelial integrity and ciliary ultrastructure were assessed using transmission electronic microscopy. RESULTS The mean CBF from 135 children studied was 10.1 Hz (95% CI 9.8 to 10.4). Approximately 20% (ranged 18.0-24.2%) of ciliated epithelial edges were found to have areas of dyskinetically beating cilia. Normal beat pattern was observed in ciliated epithelium from all subjects. We did not find any effect of exposure to second hand smoke on CBF in our subjects. Microtubular defects were found in 9.3% of all of the cilia counted in these children, while other ciliary ultrastructural defects were found in less than 3%. CONCLUSIONS We established the reference range for CBF, beat pattern and ultrastructure in healthy Chinese children. Using similar methodology, we found a lower overall mean CBF than previously obtained European values. This study highlights the need to establish normative data for ciliary function in different populations.
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Affiliation(s)
- So-Lun Lee
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, HKSAR, China. .,Department of Paediatrics and Adolescent Medicine, Duchess of Kent Children's Hospital, HKSAR, China.
| | - Christopher O'Callaghan
- Respiratory, Critical Care and Anaesthesia, UCL Great Ormond Street Institute of Child Health and GOSH NIHR BRC, London, UK
| | - Yu-Lung Lau
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, HKSAR, China
| | - Chun-Wai Davy Lee
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, HKSAR, China
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20
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Lee DDH, Cardinale D, Terakosolphan W, Sornsute A, Radhakrishnan P, Coppel J, Smith CM, Satyanarayana S, Forbes B, O'Callaghan C. Fluticasone Particles Bind to Motile Respiratory Cilia: A Mechanism for Enhanced Lung and Systemic Exposure? J Aerosol Med Pulm Drug Deliv 2020; 34:181-188. [PMID: 32960118 DOI: 10.1089/jamp.2020.1598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Inhaled corticosteroids (ICSs) are the main prophylactic treatment for asthma and are used in other diseases, including chronic pulmonary obstructive disease, yet the interaction of ICS particles with the ciliated epithelium remains unclear. The aim of this study was to investigate the earliest interaction of aerosolized fluticasone propionate (FP) particles with human ciliated respiratory epithelium. Methods: A bespoke system was developed to allow aerosolized FP particles to be delivered to ciliated epithelial cultures by nebulization and from a pressurized metered-dose inhaler (pMDI) through a spacer with interactions observed in real time using high-speed video microscopy. Interaction with nonrespiratory cilia was investigated using steroids on brain ependymal ciliary cultures. The dissolution rate of steroid particles was determined. Results: FP particles delivered by aerosol attached to the tips of rapidly beating cilia. Within 2 hours, 8.7% ± 1.8% (nebulization) and 12.1% ± 2.1% (pMDI through spacer) of ciliated cells had one or more particles attached to motile cilia. These levels decreased to 5.8% ± 1.6% (p = 0.59; nebulization) and 5.3% ± 2.2% (p = 0.14; pMDI through spacer) at 24 hours. Particle attachment did not affect ciliary beat frequency (p > 0.05) but significantly (p < 0.001) reduced ciliary beat amplitude. Steroid particles also attached to the tips of motile ependymal brain cilia and also reduced beat amplitude (24 hours: >2 particles bound p < 0.001). Dissolution of FP particles was slow with only 22.8% ± 1.3% of nebulized and 12.8% ± 0.5% of pMDI-delivered drug dissolving by 24 hours. Conclusions: FP particles adhere to the tips of rapidly moving cilia with significant numbers remaining bound at 24 hours, resisting the shear stress generated by ciliary beating. In vivo, this mechanism may predispose to high local drug concentrations and enhance respiratory and systemic corticosteroid exposure.
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Affiliation(s)
- Dani Do Hyang Lee
- Respiratory, Critical Care, and Anesthesia, UCL Great Ormond Street Children's Hospital Institute of Child Health & NIHR GOSH BRC, London, United Kingdom
| | - Daniela Cardinale
- Respiratory, Critical Care, and Anesthesia, UCL Great Ormond Street Children's Hospital Institute of Child Health & NIHR GOSH BRC, London, United Kingdom
| | | | - Acom Sornsute
- Pharmaceutics, UCL School of Pharmacy, London, United Kingdom
| | - Priya Radhakrishnan
- Respiratory, Critical Care, and Anesthesia, UCL Great Ormond Street Children's Hospital Institute of Child Health & NIHR GOSH BRC, London, United Kingdom
| | - Jonathan Coppel
- Respiratory, Critical Care, and Anesthesia, UCL Great Ormond Street Children's Hospital Institute of Child Health & NIHR GOSH BRC, London, United Kingdom
| | - Claire M Smith
- Respiratory, Critical Care, and Anesthesia, UCL Great Ormond Street Children's Hospital Institute of Child Health & NIHR GOSH BRC, London, United Kingdom
| | | | - Ben Forbes
- Institute of Pharmaceutical Science, King's College London, London, United Kingdom
| | - Christopher O'Callaghan
- Respiratory, Critical Care, and Anesthesia, UCL Great Ormond Street Children's Hospital Institute of Child Health & NIHR GOSH BRC, London, United Kingdom
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21
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Rubbo B, Best S, Hirst RA, Shoemark A, Goggin P, Carr SB, Chetcuti P, Hogg C, Kenia P, Lucas JS, Moya E, Narayanan M, O'Callaghan C, Williamson M, Walker WT. Clinical features and management of children with primary ciliary dyskinesia in England. Arch Dis Child 2020; 105:724-729. [PMID: 32156696 DOI: 10.1136/archdischild-2019-317687] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 11/26/2019] [Accepted: 02/03/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE In England, the National Health Service commissioned a National Management Service for children with primary ciliary dyskinesia (PCD). The aims of this study were to describe the health of children seen in this Service and compare lung function to children with cystic fibrosis (CF). DESIGN Multi-centre service evaluation of the English National Management PCD Service. SETTING Four nationally commissioned PCD centres in England. PATIENTS 333 children with PCD reviewed in the Service in 2015; lung function data were also compared with 2970 children with CF. RESULTS Median age at diagnosis for PCD was 2.6 years, significantly lower in children with situs inversus (1.0 vs 6.0 years, p<0.001). Compared with national data from the CF Registry, mean (SD) %predicted forced expiratory volume in one second (FEV1) was 76.8% in PCD (n=240) and 85.0% in CF, and FEV1 was lower in children with PCD up to the age of 15 years. Approximately half of children had some hearing impairment, with 26% requiring hearing aids. Children with a lower body mass index (BMI) had lower FEV1 (p<0.001). One-third of children had positive respiratory cultures at review, 54% of these grew Haemophilus influenzae. CONCLUSIONS We provide evidence that children with PCD in England have worse lung function than those with CF. Nutritional status should be considered in PCD management, as those with a lower BMI have significantly lower FEV1. Hearing impairment is common but seems to improve with age. Well-designed and powered randomised controlled trials on management of PCD are needed to inform best clinical practice.
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Affiliation(s)
- Bruna Rubbo
- School of Clinical and Experimental Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,Primary Ciliary Dyskinesia Centre, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sunayna Best
- Department of Paediatric Respiratory Medicine, Paediatric Primary Ciliary Dyskinesia Centre, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Robert Anthony Hirst
- PCD Diagnosis and Research, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Amelia Shoemark
- Department of Paediatric Respiratory Medicine, Paediatric Primary Ciliary Dyskinesia Centre, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Patricia Goggin
- School of Clinical and Experimental Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,Primary Ciliary Dyskinesia Centre, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Siobhan B Carr
- Department of Paediatric Respiratory Medicine, Paediatric Primary Ciliary Dyskinesia Centre, Royal Brompton and Harefield NHS Foundation Trust, London, UK.,National Heart and Lung Institute, Imperial College, London, UK
| | - Philip Chetcuti
- Respiratory Paediatrics, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Claire Hogg
- Department of Paediatric Respiratory Medicine, Paediatric Primary Ciliary Dyskinesia Centre, Royal Brompton and Harefield NHS Foundation Trust, London, UK.,National Heart and Lung Institute, Imperial College, London, UK
| | - Priti Kenia
- Department of Respiratory Medicine, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Jane S Lucas
- Primary Ciliary Dyskinesia Centre, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Eduardo Moya
- Paediatric Department, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Manjith Narayanan
- PCD Diagnosis and Research, Department of Respiratory Sciences, University of Leicester, Leicester, UK.,Leicester National Primary Ciliary Dyskinesia diagnosis and management service, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Christopher O'Callaghan
- Leicester National Primary Ciliary Dyskinesia diagnosis and management service, University Hospitals of Leicester NHS Trust, Leicester, UK.,UCL Great Ormond Street Institute of Child Health, GOSH NIHR BRC, London, United Kingdom
| | - Michael Williamson
- Leicester National Primary Ciliary Dyskinesia diagnosis and management service, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Woolf Theodore Walker
- Primary Ciliary Dyskinesia Centre, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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22
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Robson EA, Dixon L, Causon L, Dawes W, Benenati M, Fassad M, Hirst RA, Kenia P, Moya EF, Patel M, Peckham D, Rutman A, Mitchison HM, Mankad K, O'Callaghan C. Hydrocephalus and diffuse choroid plexus hyperplasia in primary ciliary dyskinesia-related MCIDAS mutation. Neurol Genet 2020; 6:e482. [PMID: 32802948 PMCID: PMC7371369 DOI: 10.1212/nxg.0000000000000482] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 06/09/2020] [Indexed: 12/31/2022]
Abstract
Objective To report a neuroradiologic phenotype associated with reduced generation of multiple motile cilia (RGMC) and mutations in the multicilin gene. We hypothesize that the observed phenotype may reflect the emerging role that ependymal cilia play in regulating CSF production. Method Clinical and radiologic records were retrospectively reviewed for 7 consecutive patients diagnosed by the Leicester UK national primary ciliary dyskinesia (PCD) diagnostic laboratory. Results On MRI scanning, all patients demonstrated hydrocephalus, choroid plexus hyperplasia (CPH), and arachnoid cysts. No patient had any sign of neurologic deficit. All patients had significant lung disease. Conclusions We conclude that there is a high incidence of hydrocephalus, arachnoid cysts, and CPH in MCIDAS-associated RGMC. In all cases, the observed hydrocephalus seems arrested in childhood without progression or adverse neurologic sequelae. Our new observation of CPH, which is associated with CSF overproduction, is the first macroscopic evidence that ependymal cilia may be involved in the regulation of CSF production and flow. We suggest that brain imaging should be performed in all cases of RGMC and that a diagnosis of PCD or RGMC be strongly considered in patients with unexplained hydrocephalus and a lifelong “wet”-sounding cough.
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Affiliation(s)
- Evie Alexandra Robson
- North of England Paediatric Primary Ciliary Dyskinesia Management Service (E.A.R., E.F.M., D.P.), Leeds General Infirmary, Great George Street, UK; Department of Radiology (L.D., W.D., M.B., K.M.), Great Ormond Street Hospital for Children, London, UK; Centre for PCD Diagnosis and Research (R.A.H., A.R., C.O.), Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, UK; Birmingham Women's and Children's Hospital (L.C., P.K.), Steelhouse Lane, Birmingham, UK; Genetics and Genomic Medicine Programme (M.F., H.M.), University College London, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Human Genetics (M.F.), Medical Research Institute, Alexandria University, El- Hadra, Alexandria, Egypt; The North of England Adult Primary Ciliary Dyskinesia Management service, St James's University Hospital, Leeds, UK; and UCL Great Ormond Street Institute of Child Health & NIHR GOSH BRC (C.O.), London, UK
| | - Luke Dixon
- North of England Paediatric Primary Ciliary Dyskinesia Management Service (E.A.R., E.F.M., D.P.), Leeds General Infirmary, Great George Street, UK; Department of Radiology (L.D., W.D., M.B., K.M.), Great Ormond Street Hospital for Children, London, UK; Centre for PCD Diagnosis and Research (R.A.H., A.R., C.O.), Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, UK; Birmingham Women's and Children's Hospital (L.C., P.K.), Steelhouse Lane, Birmingham, UK; Genetics and Genomic Medicine Programme (M.F., H.M.), University College London, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Human Genetics (M.F.), Medical Research Institute, Alexandria University, El- Hadra, Alexandria, Egypt; The North of England Adult Primary Ciliary Dyskinesia Management service, St James's University Hospital, Leeds, UK; and UCL Great Ormond Street Institute of Child Health & NIHR GOSH BRC (C.O.), London, UK
| | - Liam Causon
- North of England Paediatric Primary Ciliary Dyskinesia Management Service (E.A.R., E.F.M., D.P.), Leeds General Infirmary, Great George Street, UK; Department of Radiology (L.D., W.D., M.B., K.M.), Great Ormond Street Hospital for Children, London, UK; Centre for PCD Diagnosis and Research (R.A.H., A.R., C.O.), Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, UK; Birmingham Women's and Children's Hospital (L.C., P.K.), Steelhouse Lane, Birmingham, UK; Genetics and Genomic Medicine Programme (M.F., H.M.), University College London, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Human Genetics (M.F.), Medical Research Institute, Alexandria University, El- Hadra, Alexandria, Egypt; The North of England Adult Primary Ciliary Dyskinesia Management service, St James's University Hospital, Leeds, UK; and UCL Great Ormond Street Institute of Child Health & NIHR GOSH BRC (C.O.), London, UK
| | - William Dawes
- North of England Paediatric Primary Ciliary Dyskinesia Management Service (E.A.R., E.F.M., D.P.), Leeds General Infirmary, Great George Street, UK; Department of Radiology (L.D., W.D., M.B., K.M.), Great Ormond Street Hospital for Children, London, UK; Centre for PCD Diagnosis and Research (R.A.H., A.R., C.O.), Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, UK; Birmingham Women's and Children's Hospital (L.C., P.K.), Steelhouse Lane, Birmingham, UK; Genetics and Genomic Medicine Programme (M.F., H.M.), University College London, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Human Genetics (M.F.), Medical Research Institute, Alexandria University, El- Hadra, Alexandria, Egypt; The North of England Adult Primary Ciliary Dyskinesia Management service, St James's University Hospital, Leeds, UK; and UCL Great Ormond Street Institute of Child Health & NIHR GOSH BRC (C.O.), London, UK
| | - Massimo Benenati
- North of England Paediatric Primary Ciliary Dyskinesia Management Service (E.A.R., E.F.M., D.P.), Leeds General Infirmary, Great George Street, UK; Department of Radiology (L.D., W.D., M.B., K.M.), Great Ormond Street Hospital for Children, London, UK; Centre for PCD Diagnosis and Research (R.A.H., A.R., C.O.), Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, UK; Birmingham Women's and Children's Hospital (L.C., P.K.), Steelhouse Lane, Birmingham, UK; Genetics and Genomic Medicine Programme (M.F., H.M.), University College London, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Human Genetics (M.F.), Medical Research Institute, Alexandria University, El- Hadra, Alexandria, Egypt; The North of England Adult Primary Ciliary Dyskinesia Management service, St James's University Hospital, Leeds, UK; and UCL Great Ormond Street Institute of Child Health & NIHR GOSH BRC (C.O.), London, UK
| | - Mahmoud Fassad
- North of England Paediatric Primary Ciliary Dyskinesia Management Service (E.A.R., E.F.M., D.P.), Leeds General Infirmary, Great George Street, UK; Department of Radiology (L.D., W.D., M.B., K.M.), Great Ormond Street Hospital for Children, London, UK; Centre for PCD Diagnosis and Research (R.A.H., A.R., C.O.), Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, UK; Birmingham Women's and Children's Hospital (L.C., P.K.), Steelhouse Lane, Birmingham, UK; Genetics and Genomic Medicine Programme (M.F., H.M.), University College London, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Human Genetics (M.F.), Medical Research Institute, Alexandria University, El- Hadra, Alexandria, Egypt; The North of England Adult Primary Ciliary Dyskinesia Management service, St James's University Hospital, Leeds, UK; and UCL Great Ormond Street Institute of Child Health & NIHR GOSH BRC (C.O.), London, UK
| | - Robert Anthony Hirst
- North of England Paediatric Primary Ciliary Dyskinesia Management Service (E.A.R., E.F.M., D.P.), Leeds General Infirmary, Great George Street, UK; Department of Radiology (L.D., W.D., M.B., K.M.), Great Ormond Street Hospital for Children, London, UK; Centre for PCD Diagnosis and Research (R.A.H., A.R., C.O.), Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, UK; Birmingham Women's and Children's Hospital (L.C., P.K.), Steelhouse Lane, Birmingham, UK; Genetics and Genomic Medicine Programme (M.F., H.M.), University College London, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Human Genetics (M.F.), Medical Research Institute, Alexandria University, El- Hadra, Alexandria, Egypt; The North of England Adult Primary Ciliary Dyskinesia Management service, St James's University Hospital, Leeds, UK; and UCL Great Ormond Street Institute of Child Health & NIHR GOSH BRC (C.O.), London, UK
| | - Priti Kenia
- North of England Paediatric Primary Ciliary Dyskinesia Management Service (E.A.R., E.F.M., D.P.), Leeds General Infirmary, Great George Street, UK; Department of Radiology (L.D., W.D., M.B., K.M.), Great Ormond Street Hospital for Children, London, UK; Centre for PCD Diagnosis and Research (R.A.H., A.R., C.O.), Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, UK; Birmingham Women's and Children's Hospital (L.C., P.K.), Steelhouse Lane, Birmingham, UK; Genetics and Genomic Medicine Programme (M.F., H.M.), University College London, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Human Genetics (M.F.), Medical Research Institute, Alexandria University, El- Hadra, Alexandria, Egypt; The North of England Adult Primary Ciliary Dyskinesia Management service, St James's University Hospital, Leeds, UK; and UCL Great Ormond Street Institute of Child Health & NIHR GOSH BRC (C.O.), London, UK
| | - Eduardo Fernandez Moya
- North of England Paediatric Primary Ciliary Dyskinesia Management Service (E.A.R., E.F.M., D.P.), Leeds General Infirmary, Great George Street, UK; Department of Radiology (L.D., W.D., M.B., K.M.), Great Ormond Street Hospital for Children, London, UK; Centre for PCD Diagnosis and Research (R.A.H., A.R., C.O.), Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, UK; Birmingham Women's and Children's Hospital (L.C., P.K.), Steelhouse Lane, Birmingham, UK; Genetics and Genomic Medicine Programme (M.F., H.M.), University College London, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Human Genetics (M.F.), Medical Research Institute, Alexandria University, El- Hadra, Alexandria, Egypt; The North of England Adult Primary Ciliary Dyskinesia Management service, St James's University Hospital, Leeds, UK; and UCL Great Ormond Street Institute of Child Health & NIHR GOSH BRC (C.O.), London, UK
| | - Mitali Patel
- North of England Paediatric Primary Ciliary Dyskinesia Management Service (E.A.R., E.F.M., D.P.), Leeds General Infirmary, Great George Street, UK; Department of Radiology (L.D., W.D., M.B., K.M.), Great Ormond Street Hospital for Children, London, UK; Centre for PCD Diagnosis and Research (R.A.H., A.R., C.O.), Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, UK; Birmingham Women's and Children's Hospital (L.C., P.K.), Steelhouse Lane, Birmingham, UK; Genetics and Genomic Medicine Programme (M.F., H.M.), University College London, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Human Genetics (M.F.), Medical Research Institute, Alexandria University, El- Hadra, Alexandria, Egypt; The North of England Adult Primary Ciliary Dyskinesia Management service, St James's University Hospital, Leeds, UK; and UCL Great Ormond Street Institute of Child Health & NIHR GOSH BRC (C.O.), London, UK
| | - Daniel Peckham
- North of England Paediatric Primary Ciliary Dyskinesia Management Service (E.A.R., E.F.M., D.P.), Leeds General Infirmary, Great George Street, UK; Department of Radiology (L.D., W.D., M.B., K.M.), Great Ormond Street Hospital for Children, London, UK; Centre for PCD Diagnosis and Research (R.A.H., A.R., C.O.), Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, UK; Birmingham Women's and Children's Hospital (L.C., P.K.), Steelhouse Lane, Birmingham, UK; Genetics and Genomic Medicine Programme (M.F., H.M.), University College London, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Human Genetics (M.F.), Medical Research Institute, Alexandria University, El- Hadra, Alexandria, Egypt; The North of England Adult Primary Ciliary Dyskinesia Management service, St James's University Hospital, Leeds, UK; and UCL Great Ormond Street Institute of Child Health & NIHR GOSH BRC (C.O.), London, UK
| | - Andrew Rutman
- North of England Paediatric Primary Ciliary Dyskinesia Management Service (E.A.R., E.F.M., D.P.), Leeds General Infirmary, Great George Street, UK; Department of Radiology (L.D., W.D., M.B., K.M.), Great Ormond Street Hospital for Children, London, UK; Centre for PCD Diagnosis and Research (R.A.H., A.R., C.O.), Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, UK; Birmingham Women's and Children's Hospital (L.C., P.K.), Steelhouse Lane, Birmingham, UK; Genetics and Genomic Medicine Programme (M.F., H.M.), University College London, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Human Genetics (M.F.), Medical Research Institute, Alexandria University, El- Hadra, Alexandria, Egypt; The North of England Adult Primary Ciliary Dyskinesia Management service, St James's University Hospital, Leeds, UK; and UCL Great Ormond Street Institute of Child Health & NIHR GOSH BRC (C.O.), London, UK
| | - Hannah M Mitchison
- North of England Paediatric Primary Ciliary Dyskinesia Management Service (E.A.R., E.F.M., D.P.), Leeds General Infirmary, Great George Street, UK; Department of Radiology (L.D., W.D., M.B., K.M.), Great Ormond Street Hospital for Children, London, UK; Centre for PCD Diagnosis and Research (R.A.H., A.R., C.O.), Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, UK; Birmingham Women's and Children's Hospital (L.C., P.K.), Steelhouse Lane, Birmingham, UK; Genetics and Genomic Medicine Programme (M.F., H.M.), University College London, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Human Genetics (M.F.), Medical Research Institute, Alexandria University, El- Hadra, Alexandria, Egypt; The North of England Adult Primary Ciliary Dyskinesia Management service, St James's University Hospital, Leeds, UK; and UCL Great Ormond Street Institute of Child Health & NIHR GOSH BRC (C.O.), London, UK
| | - Kshitij Mankad
- North of England Paediatric Primary Ciliary Dyskinesia Management Service (E.A.R., E.F.M., D.P.), Leeds General Infirmary, Great George Street, UK; Department of Radiology (L.D., W.D., M.B., K.M.), Great Ormond Street Hospital for Children, London, UK; Centre for PCD Diagnosis and Research (R.A.H., A.R., C.O.), Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, UK; Birmingham Women's and Children's Hospital (L.C., P.K.), Steelhouse Lane, Birmingham, UK; Genetics and Genomic Medicine Programme (M.F., H.M.), University College London, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Human Genetics (M.F.), Medical Research Institute, Alexandria University, El- Hadra, Alexandria, Egypt; The North of England Adult Primary Ciliary Dyskinesia Management service, St James's University Hospital, Leeds, UK; and UCL Great Ormond Street Institute of Child Health & NIHR GOSH BRC (C.O.), London, UK
| | - Christopher O'Callaghan
- North of England Paediatric Primary Ciliary Dyskinesia Management Service (E.A.R., E.F.M., D.P.), Leeds General Infirmary, Great George Street, UK; Department of Radiology (L.D., W.D., M.B., K.M.), Great Ormond Street Hospital for Children, London, UK; Centre for PCD Diagnosis and Research (R.A.H., A.R., C.O.), Department of Respiratory Sciences, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, UK; Birmingham Women's and Children's Hospital (L.C., P.K.), Steelhouse Lane, Birmingham, UK; Genetics and Genomic Medicine Programme (M.F., H.M.), University College London, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Human Genetics (M.F.), Medical Research Institute, Alexandria University, El- Hadra, Alexandria, Egypt; The North of England Adult Primary Ciliary Dyskinesia Management service, St James's University Hospital, Leeds, UK; and UCL Great Ormond Street Institute of Child Health & NIHR GOSH BRC (C.O.), London, UK
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23
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Hamilton NJI, Lee DDH, Gowers KHC, Butler CR, Maughan EF, Jevans B, Orr JC, McCann CJ, Burns AJ, MacNeil S, Birchall MA, O'Callaghan C, Hynds RE, Janes SM. Bioengineered airway epithelial grafts with mucociliary function based on collagen IV- and laminin-containing extracellular matrix scaffolds. Eur Respir J 2020; 55:1901200. [PMID: 32444408 PMCID: PMC7301290 DOI: 10.1183/13993003.01200-2019] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 02/26/2020] [Indexed: 12/15/2022]
Abstract
Current methods to replace damaged upper airway epithelium with exogenous cells are limited. Existing strategies use grafts that lack mucociliary function, leading to infection and the retention of secretions and keratin debris. Strategies that regenerate airway epithelium with mucociliary function are clearly desirable and would enable new treatments for complex airway disease.Here, we investigated the influence of the extracellular matrix (ECM) on airway epithelial cell adherence, proliferation and mucociliary function in the context of bioengineered mucosal grafts. In vitro, primary human bronchial epithelial cells (HBECs) adhered most readily to collagen IV. Biological, biomimetic and synthetic scaffolds were compared in terms of their ECM protein content and airway epithelial cell adherence.Collagen IV and laminin were preserved on the surface of decellularised dermis and epithelial cell attachment to decellularised dermis was greater than to the biomimetic or synthetic alternatives tested. Blocking epithelial integrin α2 led to decreased adherence to collagen IV and to decellularised dermis scaffolds. At air-liquid interface (ALI), bronchial epithelial cells cultured on decellularised dermis scaffolds formed a differentiated respiratory epithelium with mucociliary function. Using in vivo chick chorioallantoic membrane (CAM), rabbit airway and immunocompromised mouse models, we showed short-term preservation of the cell layer following transplantation.Our results demonstrate the feasibility of generating HBEC grafts on clinically applicable decellularised dermis scaffolds and identify matrix proteins and integrins important for this process. The long-term survivability of pre-differentiated epithelia and the relative merits of this approach against transplanting basal cells should be assessed further in pre-clinical airway transplantation models.
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Affiliation(s)
- Nick J I Hamilton
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- UCL Ear Institute, The Royal National Throat Nose and Ear Hospital, London, UK
- Nick J.I. Hamilton and Sam M. Janes are joint-senior authors
| | - Dani Do Hyang Lee
- Respiratory, Critical Care and Anaesthesia, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Kate H C Gowers
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Colin R Butler
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Elizabeth F Maughan
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Benjamin Jevans
- Stem Cell and Regenerative Medicine, Birth Defects Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Jessica C Orr
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Conor J McCann
- Stem Cell and Regenerative Medicine, Birth Defects Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Alan J Burns
- Stem Cell and Regenerative Medicine, Birth Defects Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sheila MacNeil
- Dept of Materials and Science Engineering, The Kroto Research Institute, North Campus, University of Sheffield, Sheffield, UK
| | - Martin A Birchall
- UCL Ear Institute, The Royal National Throat Nose and Ear Hospital, London, UK
| | - Christopher O'Callaghan
- Respiratory, Critical Care and Anaesthesia, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Robert E Hynds
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Sam M Janes
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Nick J.I. Hamilton and Sam M. Janes are joint-senior authors
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24
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Bauman G, Ding K, Chin J, Nair S, Iaboni A, Crook J, Klotz L, Dearnaley D, Horwitz E, O'Callaghan C. Cryosurgery Versus Primary Androgen Deprivation Therapy for Locally Recurrent Prostate Cancer After Primary Radiotherapy: A Propensity-Matched Survival Analysis. Cureus 2020; 12:e7983. [PMID: 32391232 PMCID: PMC7205382 DOI: 10.7759/cureus.7983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/06/2020] [Indexed: 11/09/2022] Open
Abstract
Background Optimal management of isolated local recurrence of prostate cancer after primary radiotherapy remains to be defined. Up-front androgen deprivation therapy (ADT) is widely used but may adversely affect the quality of life and is essentially a palliative treatment. Local salvage carries a different side-effect profile and is potentially curative, but it has not been compared to ADT. Materials and methods We conducted a propensity-matched analysis of cohorts of men treated with either whole gland cryotherapy (CRYO) or primary ADT following the diagnosis of locally recurrent prostate cancer. Our specific objectives were to compare overall survival (OS) and prostate cancer-specific mortality (PCSM) between CRYO vs. ADT. Results After a one-to-one matching, 169 patients from each cohort were included in comparisons. Median follow-up time was 6.7 years (ADT) vs. 18 years (CRYO). The 10-year PCSM was 18.5% (ADT) vs. 16.2% (CRYO), which was not statistically different [hazard ratioo (HR): 0.69, 95% CI: 0.36-1.34, p=0.27]. The median OS was 12.3 years (CRYO) versus 10.2 years (ADT) (HR: 0.63, 95% CI: 0.42-0.95, p=0.03). Conclusions While PCSM was similar between the two strategies, CRYO was associated with a longer OS compared to primary ADT. Given the retrospective nature of the trial, these results should be considered hypothesis-generating, and phase III trials comparing these two options are required to further explore these findings.
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Affiliation(s)
- Glenn Bauman
- Radiation Oncology, London Regional Cancer Program - London Health Sciences Centre, London, CAN
| | - Keyue Ding
- Canadian Cancer Trials Group, Queen's University, Kingston, CAN
| | - Joseph Chin
- Surgery - Division of Urology, Western University, London, CAN
| | - Shiva Nair
- Surgery - Division of Urology, London Health Sciences Centre, London, CAN
| | | | | | | | - David Dearnaley
- Radiation Oncology, Royal Marsden United Kingdom Trust, London, GBR
| | - Eric Horwitz
- Radiation Oncology, Fox Chase Cancer Center, Philadelphia, USA
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Baqar S, Kong YW, Chen AX, O'Callaghan C, MacIsaac RJ, Bouterakos M, Lambert GW, Jerums G, Lambert EE, Ekinci EI. Effect of Salt Supplementation on Sympathetic Activity and Endothelial Function in Salt-Sensitive Type 2 Diabetes. J Clin Endocrinol Metab 2020; 105:5639695. [PMID: 31761946 DOI: 10.1210/clinem/dgz219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Received: 07/20/2019] [Accepted: 11/23/2019] [Indexed: 12/22/2022]
Abstract
CONTEXT Lower sodium intake is paradoxically associated with higher mortality in type 2 diabetes (T2D). OBJECTIVE To determine whether sympathetic nervous system (SNS) activation and endothelial dysfunction contribute to these observations, we examined the effect of salt supplementation on these systems in people with T2D with habitual low sodium. We hypothesized that salt supplementation would lower SNS activity and improve endothelial function compared to placebo. DESIGN We conducted a randomized, double-blinded, placebo-controlled crossover trial. SETTING The study took place in a tertiary referral diabetes outpatient clinic. PARTICIPANTS Twenty-two people with T2D with habitual low sodium intake (24-hour urine sodium <150 mmol/24h) were included. INTERVENTION Salt supplementation (100 mmol NaCl/24h) or placebo for 3 weeks was administered. MAIN OUTCOME MEASURES The primary outcome of SNS activity and endothelial function was assessed as follows: Microneurography assessed muscle sympathetic nerve activity (MSNA), pulse amplitude tonometry assessed endothelial function via reactive hyperemic index (RHI), and arterial stiffness was assessed via augmentation index (AI). Secondary outcomes included cardiac baroreflex, serum aldosterone, ambulatory blood pressure monitoring (ABPM), heart rate variability (HRV), and salt sensitivity. RESULTS Compared to placebo, salt supplementation increased MSNA (burst frequency P = .047, burst incidence P = .016); however, RHI (P = .24), AI (P = .201), ABPM (systolic P = .09, diastolic P = .14), and HRV were unaffected. Salt supplementation improved baroreflex (slope P = .026) and lowered aldosterone (P = .004), and in salt-resistant individuals there was a trend toward improved RHI (P = .07). CONCLUSIONS In people with T2D and low habitual sodium intake, salt supplementation increased SNS activity without altering endothelial function or blood pressure but improved baroreflex function, a predictor of cardiac mortality. Salt-resistant individuals trended toward improved endothelial function with salt supplementation.
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Affiliation(s)
- Sara Baqar
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Yee Wen Kong
- Department of Medicine, Austin Health, Heidelberg, Victoria, Australia
| | - Angela X Chen
- Department of Medicine, Austin Health, Heidelberg, Victoria, Australia
| | | | - Richard J MacIsaac
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
- Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne and The University of Melbourne, Fitzroy, Victoria, Australia
| | - Maree Bouterakos
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Gavin W Lambert
- Human Neurotransmitters Laboratory, Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia
- Iverson Health Innovation Research Institute and Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - George Jerums
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Elisabeth E Lambert
- Human Neurotransmitters Laboratory, Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia
- Iverson Health Innovation Research Institute and Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Elif I Ekinci
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
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26
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Lee DDH, Petris A, Hynds RE, O'Callaghan C. Ciliated Epithelial Cell Differentiation at Air-Liquid Interface Using Commercially Available Culture Media. Methods Mol Biol 2020; 2109:275-291. [PMID: 31707647 PMCID: PMC7116769 DOI: 10.1007/7651_2019_269] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
The human nasal epithelium contains basal stem/progenitor cells that produce differentiated multiciliated and mucosecretory progeny. Basal epithelial cells can be expanded in cell culture and instructed to differentiate at an air-liquid interface using transwell membranes and differentiation media. For basal cell expansion, we have used 3T3-J2 co-culture in epithelial culture medium containing EGF, insulin, and a RHO-associated protein kinase (ROCK) inhibitor, Y-27632 (3T3 + Y). Here we describe our protocols for ciliated differentiation of these cultures at air-liquid interface and compare four commercially available differentiation media, across nine donor cell cultures (six healthy, two patients with chronic obstructive pulmonary disease (COPD), and one with primary ciliary dyskinesia (PCD)). Bright-field and immunofluorescence imaging suggested broad similarity between differentiation protocols. Subtle differences were seen in transepithelial electrical resistance (TEER), ciliary beat frequency, mucus production, and the extent to which basal cells are retained in differentiated cultures. Overall, the specific differentiation medium used in our air-liquid interface culture protocol was not a major determinant of ciliation, and our data suggest that the differentiation potential of basal cells at the outset is a more critical factor in air-liquid interface culture outcome. Detailed information on the constituents of the differentiation media was only available from one of the four manufacturers, a factor that may have profound implications in the interpretation of some research studies.
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Affiliation(s)
- Dani Do Hyang Lee
- Respiratory, Critical Care & Anaesthesia, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Alina Petris
- Respiratory, Critical Care & Anaesthesia, UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Christopher O'Callaghan
- Respiratory, Critical Care & Anaesthesia, UCL Great Ormond Street Institute of Child Health, London, UK.
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27
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Chen AX, Moran JL, Libianto R, Baqar S, O'Callaghan C, MacIsaac RJ, Jerums G, Ekinci EI. Effect of angiotensin II receptor blocker and salt supplementation on short-term blood pressure variability in type 2 diabetes. J Hum Hypertens 2019; 34:143-150. [PMID: 31501493 DOI: 10.1038/s41371-019-0238-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/21/2019] [Accepted: 08/01/2019] [Indexed: 11/09/2022]
Abstract
High blood pressure variability (BPV) has been associated with increased cardiovascular (CV) risk. The effect of dietary salt and renin-angiotensin-aldosterone system (RAAS) activity on short-term BPV in type 2 diabetes mellitus (T2DM) is not well characterised. We aimed to determine the effect of dietary salt (sodium chloride, NaCl) supplementation on 24-h mean arterial BPV (24hBPV) during angiotensin II receptor blocker (telmisartan) use and to evaluate the effects of age, sex, plasma renin activity (PRA) and serum aldosterone on 24hBPV. In a randomised, double-blind, crossover study, patients with T2DM (n = 28), treated with telmisartan received NaCl (100 mmol/24 h) or placebo capsules during 2 weeks of telmisartan. Following a 6-week washout, the protocol was repeated in reverse. 24hBPV was evaluated as a co-efficient of variation [CV (%) = mean/standard deviation] × 100). Twenty-four hour urinary sodium excretion, ambulatory BP and biochemical tests were performed at each phase. Results were analysed using a linear mixed model to generate predicted values for 24hBPV. Predicted 24hBPV was higher with telmisartan vs baseline (p = 0.01), with a trend towards reduced 24hBPV with salt (p = 0.052). Predicted 24hBPV was lower in females (p = 0.017), increasing age (p = 0.001) and increasing PRA (p = 0.011). In patients with T2DM, predicted 24hBPV increased from baseline with telmisartan, but there was no additional increase in predicted 24hBPV with salt supplementation. This suggests that in the short-term, salt supplementation has no apparent deleterious effects on 24hBPV. Long-term studies are required to evaluate the effect of 24hBPV on CV outcomes in patients with T2DM.
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Affiliation(s)
- Angela X Chen
- Department of Endocrinology, Austin Health, Melbourne, VIC, Australia
| | - John L Moran
- Queen Elizabeth Hospital, Adelaide, SA, Australia
| | - Renata Libianto
- Department of Endocrinology, Austin Health, Melbourne, VIC, Australia.,Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Sara Baqar
- Department of Endocrinology, Austin Health, Melbourne, VIC, Australia.,Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Christopher O'Callaghan
- Department of Medicine, University of Melbourne, Melbourne, VIC, Australia.,Department of Clinical Pharmacology, Austin Health, Melbourne, VIC, Australia
| | - Richard J MacIsaac
- Department of Medicine, University of Melbourne, Melbourne, VIC, Australia.,Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - George Jerums
- Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Elif I Ekinci
- Department of Endocrinology, Austin Health, Melbourne, VIC, Australia. .,Department of Medicine, University of Melbourne, Melbourne, VIC, Australia.
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28
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Sud S, O'Callaghan C, Jonker C, Karapetis C, Price T, Tebbutt N, Shapiro J, Van Hazel G, Pavlakis N, Gibbs P, Jeffrey M, Siu L, Gill S, Wong R, Jonker D, Tu D, Goodwin R. Hypertension as a predictor of advanced colorectal cancer outcome and cetuximab treatment response. ACTA ACUST UNITED AC 2018; 25:e516-e526. [PMID: 30607118 DOI: 10.3747/co.25.4069] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Adrenergic receptor stimulation is involved in the development of hypertension (htn) and has been implicated in cancer progression and dissemination of metastases in various tumours, including colon cancer. Adrenergic antagonists such as beta-blockers (bbs) demonstrate inhibition of invasion and migration in colon cancer cell lines and have been associated with decreased mortality in colorectal cancer (crc). We examined the association of baseline htn and bb use with overall (os) and progression-free survival (pfs) in patients with pretreated, chemotherapy refractory, metastatic crc (mcrc). We also examined baseline htn as a predictor of cetuximab efficacy. Methods Using data from the Canadian Cancer Trials Group co.17 study [cetuximab vs. best supportive care (bsc)], we coded baseline htn and use of anti-htn medications, including bbs, for 572 patients. The chi-square test was used to assess the associations between those variables and baseline characteristics. Cox regression models were used for univariate and multivariate analyses of os and pfs by htn diagnosis and bb use. Results Baseline htn, bb use, and anti-htn medication use were not found to be prognostic for improved os. Baseline htn and bb use were not significant predictors of cetuximab benefit. Conclusions In chemorefractory mcrc, neither baseline htn nor bb use is a significant prognostic factor. Baseline htn and bb use are not predictive of cetuximab benefit. Further investigation to determine whether baseline htn or bb use have a similarly insignificant impact on prognosis in patients receiving earlier lines of treatment remains warranted.
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Affiliation(s)
- S Sud
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON
| | - C O'Callaghan
- ncic Clinical Trials Group, Queen's University, Kingston, ON
| | - C Jonker
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON
| | - C Karapetis
- Flinders University and Flinders Medical Centre, Flinders Centre for Innovation in Cancer, Bedford Park, SA
| | - T Price
- The Queen Elizabeth and University of Adelaide, Adelaide, SA
| | | | - J Shapiro
- Department of Medical Oncology, Monash University, Melbourne, VIC
| | | | - N Pavlakis
- Royal North Shore Hospital, Northern Clinical School, University of Sydney, St. Leonards, NSW
| | - P Gibbs
- Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - M Jeffrey
- Oncology Service, Christchurch Hospital, Christchurch, N.Z
| | - L Siu
- Princess Margaret Cancer Centre, University of Toronto, Toronto, ON
| | - S Gill
- University of British Columbia, BC Cancer, Vancouver, BC
| | - R Wong
- CancerCare Manitoba, Winnipeg, MB
| | - D Jonker
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON
| | - D Tu
- ncic Clinical Trials Group, Queen's University, Kingston, ON
| | - R Goodwin
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON
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29
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Best S, Shoemark A, Rubbo B, Patel MP, Fassad MR, Dixon M, Rogers AV, Hirst RA, Rutman A, Ollosson S, Jackson CL, Goggin P, Thomas S, Pengelly R, Cullup T, Pissaridou E, Hayward J, Onoufriadis A, O'Callaghan C, Loebinger MR, Wilson R, Chung EM, Kenia P, Doughty VL, Carvalho JS, Lucas JS, Mitchison HM, Hogg C. Risk factors for situs defects and congenital heart disease in primary ciliary dyskinesia. Thorax 2018; 74:203-205. [PMID: 30166424 DOI: 10.1136/thoraxjnl-2018-212104] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/04/2018] [Accepted: 07/23/2018] [Indexed: 11/04/2022]
Abstract
Primary ciliary dyskinesia (PCD) is associated with abnormal organ positioning (situs) and congenital heart disease (CHD). This study investigated genotype-phenotype associations in PCD to facilitate risk predictions for cardiac and laterality defects. This retrospective cohort study of 389 UK patients with PCD found 51% had abnormal situs and 25% had CHD and/or laterality defects other than situs inversus totalis. Patients with biallelic mutations in a subset of nine PCD genes had normal situs. Patients with consanguineous parents had higher odds of situs abnormalities than patients with non-consanguineous parents. Patients with abnormal situs had higher odds of CHD and/or laterality defects.
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Affiliation(s)
- Sunayna Best
- Genetics and Genomic Medicine, University College London (UCL) Great Ormond Street Institute of Child Health, London, UK.,PCD Diagnostic Team, Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, UK
| | - Amelia Shoemark
- PCD Diagnostic Team, Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, UK.,School of Medicine, University of Dundee, Dundee, UK
| | - Bruna Rubbo
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mitali P Patel
- Genetics and Genomic Medicine, University College London (UCL) Great Ormond Street Institute of Child Health, London, UK
| | - Mahmoud R Fassad
- Genetics and Genomic Medicine, University College London (UCL) Great Ormond Street Institute of Child Health, London, UK.,Human Genetics Department, Alexandria University, Alexandria, Egypt
| | - Mellisa Dixon
- PCD Diagnostic Team, Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, UK
| | - Andrew V Rogers
- PCD Diagnostic Team, Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, UK.,Host Defence Unit, Royal Brompton and Harefield NHS Trust, London, UK
| | - Robert A Hirst
- Department of Infection, Immunity and Inflammation, Centre for PCD Diagnosis and Research, RKCSB, University of Leicester, Leicester, UK
| | - Andrew Rutman
- Department of Infection, Immunity and Inflammation, Centre for PCD Diagnosis and Research, RKCSB, University of Leicester, Leicester, UK
| | - Sarah Ollosson
- PCD Diagnostic Team, Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, UK
| | - Claire L Jackson
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Patricia Goggin
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Simon Thomas
- Human Genetics and Genomic Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury District Hospital, Salisbury, UK
| | - Reuben Pengelly
- Human Genetics and Genomic Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Thomas Cullup
- North East Thames Regional Genetics Service, Great Ormond Street Hospital for Children, London, UK
| | - Eleni Pissaridou
- Population, Policy and Practice Programme, University College London (UCL) Great Ormond Street Institute of Child Health, London, UK
| | - Jane Hayward
- Genetics and Genomic Medicine, University College London (UCL) Great Ormond Street Institute of Child Health, London, UK.,North East Thames Regional Genetics Service, Great Ormond Street Hospital for Children, London, UK
| | - Alexandros Onoufriadis
- Division of Genetics and Molecular Medicine, Department of Medical and Molecular Genetics, King's College London School of Medicine, Guy's Hospital, London, UK
| | - Christopher O'Callaghan
- Department of Infection, Immunity and Inflammation, Centre for PCD Diagnosis and Research, RKCSB, University of Leicester, Leicester, UK.,Department of Respiratory, Critical Care and Anaesthesia, University College London (UCL) Great Ormond Street Institute of Child Health, London, UK
| | | | - Robert Wilson
- Host Defence Unit, Royal Brompton and Harefield NHS Trust, London, UK
| | - Eddie Mk Chung
- Population, Policy and Practice Programme, University College London (UCL) Great Ormond Street Institute of Child Health, London, UK
| | - Priti Kenia
- Department of Respiratory Paediatrics, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Victoria L Doughty
- Brompton Centre for Fetal Cardiology, Royal Brompton and Harefield NHS Trust, London, UK
| | - Julene S Carvalho
- Brompton Centre for Fetal Cardiology, Royal Brompton and Harefield NHS Trust, London, UK.,Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK.,Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK
| | - Jane S Lucas
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Hannah M Mitchison
- Genetics and Genomic Medicine, University College London (UCL) Great Ormond Street Institute of Child Health, London, UK
| | - Claire Hogg
- PCD Diagnostic Team, Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, UK
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30
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Tagalakis AD, Munye MM, Ivanova R, Chen H, Smith CM, Aldossary AM, Rosa LZ, Moulding D, Barnes JL, Kafetzis KN, Jones SA, Baines DL, Moss GWJ, O'Callaghan C, McAnulty RJ, Hart SL. Effective silencing of ENaC by siRNA delivered with epithelial-targeted nanocomplexes in human cystic fibrosis cells and in mouse lung. Thorax 2018; 73:847-856. [PMID: 29748250 PMCID: PMC6109249 DOI: 10.1136/thoraxjnl-2017-210670] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [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: 06/20/2017] [Revised: 04/08/2018] [Accepted: 04/09/2018] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Loss of the cystic fibrosis transmembrane conductance regulator in cystic fibrosis (CF) leads to hyperabsorption of sodium and fluid from the airway due to upregulation of the epithelial sodium channel (ENaC). Thickened mucus and depleted airway surface liquid (ASL) then lead to impaired mucociliary clearance. ENaC regulation is thus a promising target for CF therapy. Our aim was to develop siRNA nanocomplexes that mediate effective silencing of airway epithelial ENaC in vitro and in vivo with functional correction of epithelial ion and fluid transport. METHODS We investigated translocation of nanocomplexes through mucus and their transfection efficiency in primary CF epithelial cells grown at air-liquid interface (ALI).Short interfering RNA (SiRNA)-mediated silencing was examined by quantitative RT-PCR and western analysis of ENaC. Transepithelial potential (Vt), short circuit current (Isc), ASL depth and ciliary beat frequency (CBF) were measured for functional analysis. Inflammation was analysed by histological analysis of normal mouse lung tissue sections. RESULTS Nanocomplexes translocated more rapidly than siRNA alone through mucus. Transfections of primary CF epithelial cells with nanocomplexes targeting αENaC siRNA, reduced αENaC and βENaC mRNA by 30%. Transfections reduced Vt, the amiloride-sensitive Isc and mucus protein concentration while increasing ASL depth and CBF to normal levels. A single dose of siRNA in mouse lung silenced ENaC by approximately 30%, which persisted for at least 7 days. Three doses of siRNA increased silencing to approximately 50%. CONCLUSION Nanoparticle-mediated delivery of ENaCsiRNA to ALI cultures corrected aspects of the mucociliary defect in human CF cells and offers effective delivery and silencing in vivo.
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Affiliation(s)
- Aristides D Tagalakis
- Experimental and Personalised Medicine Section, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mustafa M Munye
- Experimental and Personalised Medicine Section, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Rositsa Ivanova
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - Hanpeng Chen
- Institute of Pharmaceutical Science, Faculty of Life Science and Medicine, King's College London, London, UK
| | - Claire M Smith
- Respiratory, Critical Care and Anaesthesia, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Ahmad M Aldossary
- Experimental and Personalised Medicine Section, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Luca Z Rosa
- Experimental and Personalised Medicine Section, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Dale Moulding
- UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Konstantinos N Kafetzis
- Experimental and Personalised Medicine Section, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Stuart A Jones
- Institute of Pharmaceutical Science, Faculty of Life Science and Medicine, King's College London, London, UK
| | - Deborah L Baines
- Institute of Infection and Immunity, St George's University of London, London, UK
| | - Guy W J Moss
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - Christopher O'Callaghan
- Respiratory, Critical Care and Anaesthesia, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Robin J McAnulty
- UCL Respiratory Centre for Inflammation and Tissue Repair, London, UK
| | - Stephen L Hart
- Experimental and Personalised Medicine Section, UCL Great Ormond Street Institute of Child Health, London, UK
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31
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Fang X, Goh MY, O'Callaghan C, Berlowitz D. Relationship between autonomic cardiovascular control and obstructive sleep apnoea in persons with spinal cord injury: a retrospective study. Spinal Cord Ser Cases 2018; 4:29. [PMID: 29619250 DOI: 10.1038/s41394-018-0062-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 01/16/2018] [Accepted: 02/26/2018] [Indexed: 12/20/2022] Open
Abstract
Study design Retrospective study. Objective To determine if there is an association between obstructive sleep apnoea (OSA) and blood pressure (BP) pattern or heart rate variability (HRV) in people with spinal cord injury (SCI). Setting A state-based spinal cord service in Victoria, Australia. Methods We identified 42 subjects who had ambulatory BP monitoring (ABPM) within 6 months of a diagnostic sleep study at Austin Hospital between 2009 and 2014. Markers for autonomic function, including circadian BP pattern and HRV were extracted from the ABPM study database. Apnoea/hypopnoea index (AHI), arousals/hour and oxygen desaturation index were extracted from the sleep study database. Subjects with a nocturnal systolic BP dipping more than 10% of daytime value were defined as dippers, between 10 and 0% were non-dippers and those with a higher night than day systolic BP were reverse dippers. Severity of OSA is classified as non-OSA (AHI < 5), mild (AHI 5-15), moderate (AHI 15-30) and severe (AHI > 30). Results Subjects (n = 42) were predominantly male (85.7%), aged 44 ± 15.4 (mean ± SD), with a BMI of 24.4 ± 5.7 (mean ± SD) and mainly tetraplegic (92.9%). There was no difference in AHI, oxygen desaturation index or arousals/hour between dippers, non-dippers and reverse dippers. None of the HRV parameters differed between dippers, non-dippers and reverse dippers. No differences were found in 24 h, night-time, daytime or nocturnal dip in BP between subjects with non-OSA, mild, moderate and severe OSA. Conclusion We found no relationship between BP pattern or HRV and the severity of OSA in persons with SCI.
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Affiliation(s)
- Xizhe Fang
- 1Institute for Breathing and Sleep, Austin Hospital, Heidelberg, VIC Australia.,2University of Melbourne, Melbourne, VIC Australia
| | - Min Yin Goh
- 2University of Melbourne, Melbourne, VIC Australia.,3Department of Clinical Pharmacology, Austin Hospital, Heidelberg, VIC Australia.,The Spinal Research Institute, Melbourne, VIC Australia
| | - Christopher O'Callaghan
- 2University of Melbourne, Melbourne, VIC Australia.,3Department of Clinical Pharmacology, Austin Hospital, Heidelberg, VIC Australia
| | - David Berlowitz
- 1Institute for Breathing and Sleep, Austin Hospital, Heidelberg, VIC Australia
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32
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Kulkarni N, Kantar A, Costella S, Ragazzo V, Piacentini G, Boner A, O'Callaghan C. Macrophage Phagocytosis and Allergen Avoidance in Children With Asthma. Front Pediatr 2018; 6:206. [PMID: 30116724 PMCID: PMC6082964 DOI: 10.3389/fped.2018.00206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 07/02/2018] [Indexed: 01/07/2023] Open
Abstract
Background and Objective: Airway macrophages perform the crucial functions of presenting antigens, clearing pathogens, and apoptotic cells. Macrophage phagocytosis is increased in adults with mild asthma and allergen exposure is known to activate macrophages. However, it is not clear whether the mechanism behind this is due to a primary defect or environmental factors such as allergen or lipopolysaccaride (LPS) exposure. Our aim was to assess the phagocytic function of airway macrophages in children with mild to moderate asthma after residence in a low allergen\LPS environment at high altitude. Methods: Sputum induction was performed in children with asthma at baseline and after residence for a 3 weeks' period at a high-altitude asthma center that has very low ambient allergen levels. The markers of eosinophilic inflammation (including percentage of macrophage cytoplasm with red hue) and phagocytosis of fluorescein isothiocyanate-labeled, heat-killed Staphylococcus aureus by airway macrophages was analyzed. Internalized bacteria were quantified using confocal microscopy. Results: The median bacterial count [mean (standard deviation)] per macrophage was significantly lower [39.55 (4.51) vs. 73.26 (39.42) (p = 0.006)] after residence at high altitude. No association was observed between markers of eosinophilic inflammation and bacterial phagocytosis. Conclusions: The results suggest that the mechanism behind the enhanced phagocytosis of bacteria in childhood asthma may be secondary to allergen or possibly LPS exposure.
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Affiliation(s)
- Neeta Kulkarni
- Department of Infection, Immunity and Inflammation, Institute for Lung Health, University of Leicester, Leicester, United Kingdom
| | - Ahmad Kantar
- Pediatric Cough and Asthma Center, Istituti Ospedalieri Bergamaschi, University and Research Hospitals, Bergamo, Italy
| | - Silvia Costella
- High Altitude Paediatric Asthma Centre in Misurina, Pio XII Institute, Belluno, Italy
| | - Vincenzo Ragazzo
- Department of Pediatrics, Versilia Hospital, Lido di Camaiore, Italy
| | - Giorgio Piacentini
- Pediatrics Section, Department of Surgery, Dentistry, Paediatrics, and Gynaecology, University of Verona, Verona, Italy
| | - Attilio Boner
- Pediatrics Section, Department of Surgery, Dentistry, Paediatrics, and Gynaecology, University of Verona, Verona, Italy
| | - Christopher O'Callaghan
- Respiratory, Critical Care and Anaesthesia, UCL Great Ormond Street Institute of Child Health, NIHR Great Ormond Street Hospital Biomedical Research Centre, Great Ormond Street Children's Hospital, London, United Kingdom
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33
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Wann A, Luen S, Day D, Spain L, O'Callaghan C, Yeo B, White S. Breath alcohol concentrations in patients undergoing taxane chemotherapy: An observational pilot study (BrACT study). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx676.006] [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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34
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Libianto R, Moran J, O'Callaghan C, Baqar S, Chen AX, Baker ST, Clarke M, MacIsaac RJ, Jerums G, Ekinci EI. Relationship between urinary sodium-to-potassium ratio and ambulatory blood pressure in patients with diabetes mellitus. Clin Exp Pharmacol Physiol 2017; 45:94-97. [DOI: 10.1111/1440-1681.12852] [Citation(s) in RCA: 4] [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: 01/27/2017] [Revised: 08/24/2017] [Accepted: 08/25/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Renata Libianto
- Department of Medicine; The University of Melbourne; Melbourne Vic. Australia
| | - John Moran
- Intensive Care Unit; Queen Elizabeth Hospital; Adelaide SA Australia
| | | | - Sara Baqar
- Department of Endocrinology; Austin Health; Melbourne Vic. Australia
| | - Angela X Chen
- Department of Endocrinology; Flinders Medical Centre; Adelaide SA Australia
| | - Scott T Baker
- Department of Endocrinology; Austin Health; Melbourne Vic. Australia
| | - Michelle Clarke
- Department of Endocrinology; Austin Health; Melbourne Vic. Australia
| | - Richard J MacIsaac
- Department of Medicine; The University of Melbourne; Melbourne Vic. Australia
- Department of Endocrinology and Diabetes; St Vincent's Hospital Melbourne; Melbourne Vic. Australia
| | - George Jerums
- Department of Medicine; The University of Melbourne; Melbourne Vic. Australia
- Department of Endocrinology; Austin Health; Melbourne Vic. Australia
| | - Elif I Ekinci
- Department of Medicine; The University of Melbourne; Melbourne Vic. Australia
- Department of Endocrinology; Austin Health; Melbourne Vic. Australia
- Menzies School of Health Research; Darwin NT Australia
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35
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Shoemark A, Moya E, Hirst RA, Patel MP, Robson EA, Hayward J, Scully J, Fassad MR, Lamb W, Schmidts M, Dixon M, Patel-King RS, Rogers AV, Rutman A, Jackson CL, Goggin P, Rubbo B, Ollosson S, Carr S, Walker W, Adler B, Loebinger MR, Wilson R, Bush A, Williams H, Boustred C, Jenkins L, Sheridan E, Chung EMK, Watson CM, Cullup T, Lucas JS, Kenia P, O'Callaghan C, King SM, Hogg C, Mitchison HM. High prevalence of CCDC103 p.His154Pro mutation causing primary ciliary dyskinesia disrupts protein oligomerisation and is associated with normal diagnostic investigations. Thorax 2017; 73:157-166. [PMID: 28790179 DOI: 10.1136/thoraxjnl-2017-209999] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [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: 01/16/2017] [Revised: 06/07/2017] [Accepted: 07/03/2017] [Indexed: 11/03/2022]
Abstract
RATIONALE Primary ciliary dyskinesia is a genetically heterogeneous inherited condition characterised by progressive lung disease arising from abnormal cilia function. Approximately half of patients have situs inversus. The estimated prevalence of primary ciliary dyskinesia in the UK South Asian population is 1:2265. Early, accurate diagnosis is key to implementing appropriate management but clinical diagnostic tests can be equivocal. OBJECTIVES To determine the importance of genetic screening for primary ciliary dyskinesia in a UK South Asian population with a typical clinical phenotype, where standard testing is inconclusive. METHODS Next-generation sequencing was used to screen 86 South Asian patients who had a clinical history consistent with primary ciliary dyskinesia. The effect of a CCDC103 p.His154Pro missense variant compared with other dynein arm-associated gene mutations on diagnostic/phenotypic variability was tested. CCDC103 p.His154Pro variant pathogenicity was assessed by oligomerisation assay. RESULTS Sixteen of 86 (19%) patients carried a homozygous CCDC103 p.His154Pro mutation which was found to disrupt protein oligomerisation. Variable diagnostic test results were obtained including normal nasal nitric oxide levels, normal ciliary beat pattern and frequency and a spectrum of partial and normal dynein arm retention. Fifteen (94%) patients or their sibling(s) had situs inversus suggesting CCDC103 p.His154Pro patients without situs inversus are missed. CONCLUSIONS The CCDC103 p.His154Pro mutation is more prevalent than previously thought in the South Asian community and causes primary ciliary dyskinesia that can be difficult to diagnose using pathology-based clinical tests. Genetic testing is critical when there is a strong clinical phenotype with inconclusive standard diagnostic tests.
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Affiliation(s)
- Amelia Shoemark
- Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, National Heart and Lung Institute, London, UK
| | - Eduardo Moya
- Division of Services for Women and Children, Women's and Newborn Unit Bradford Royal Infirmary, University of Bradford, Bradford, UK
| | - Robert A Hirst
- Department of Infection, Centre for PCD Diagnosis and Research, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Mitali P Patel
- Genetics and Genomic Medicine, University College London, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Evelyn A Robson
- Division of Services for Women and Children, Women's and Newborn Unit Bradford Royal Infirmary, University of Bradford, Bradford, UK
| | - Jane Hayward
- Genetics and Genomic Medicine, University College London, UCL Great Ormond Street Institute of Child Health, London, UK.,North East Thames Regional Genetics Service, Great Ormond Street Hospital for Children, London, UK
| | - Juliet Scully
- Genetics and Genomic Medicine, University College London, UCL Great Ormond Street Institute of Child Health, London, UK.,Neuroscience and Mental Health Research Institute, School of Medicine and School of Bioscience, Cardiff University, London, UK
| | - Mahmoud R Fassad
- Genetics and Genomic Medicine, University College London, UCL Great Ormond Street Institute of Child Health, London, UK.,Human Genetics Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - William Lamb
- Genetics and Genomic Medicine, University College London, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Miriam Schmidts
- Genome Research Division, Human Genetics Department, Radboud University Medical Center and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands.,Pediatric Genetics Division, Center for Pediatrics and Adolescent Medicine, University of Freiburg Medical Center, Freiburg, Germany
| | - Mellisa Dixon
- Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, National Heart and Lung Institute, London, UK
| | - Ramila S Patel-King
- Department of Molecular Biology and Biophysics, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Andrew V Rogers
- Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, National Heart and Lung Institute, London, UK.,Department of Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, UK
| | - Andrew Rutman
- Department of Infection, Centre for PCD Diagnosis and Research, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Claire L Jackson
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust and Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK.,NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Patricia Goggin
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust and Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK.,NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Bruna Rubbo
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust and Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK.,NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sarah Ollosson
- Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, National Heart and Lung Institute, London, UK
| | - Siobhán Carr
- Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, National Heart and Lung Institute, London, UK
| | - Woolf Walker
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust and Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK.,NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Beryl Adler
- Department of Paediatrics, Luton and Dunstable Hospital NHS Trust, Luton, UK
| | - Michael R Loebinger
- Department of Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, UK
| | - Robert Wilson
- Department of Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, UK
| | - Andrew Bush
- Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, National Heart and Lung Institute, London, UK.,Department of Paediatric Respiratory Medicine, National Heart and Lung Institute, Imperial College, London, UK
| | - Hywel Williams
- Centre for Translational Omics-GOSgene, Genetics and Genomic Medicine, University College London, Institute of Child Health, London, UK
| | - Christopher Boustred
- North East Thames Regional Genetics Service, Great Ormond Street Hospital for Children, London, UK
| | - Lucy Jenkins
- North East Thames Regional Genetics Service, Great Ormond Street Hospital for Children, London, UK
| | - Eamonn Sheridan
- Yorkshire Regional Genetics Service and School of Medicine, University of Leeds, St. James's University Hospital, Leeds, UK
| | - Eddie M K Chung
- Population, Policy and Practice Programme, University College London, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Christopher M Watson
- Yorkshire Regional Genetics Service and School of Medicine, University of Leeds, St. James's University Hospital, Leeds, UK
| | - Thomas Cullup
- North East Thames Regional Genetics Service, Great Ormond Street Hospital for Children, London, UK
| | - Jane S Lucas
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust and Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK.,NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Priti Kenia
- Department of Respiratory Paediatrics, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Christopher O'Callaghan
- Department of Infection, Centre for PCD Diagnosis and Research, Immunity and Inflammation, University of Leicester, Leicester, UK.,Infection, Immunity, Inflammation and Physiological Medicine, University College London, Institute of Child Health, London, UK
| | - Stephen M King
- Department of Molecular Biology and Biophysics, University of Connecticut Health Center, Farmington, Connecticut, USA.,Institute for Systems Genomics, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Claire Hogg
- Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, National Heart and Lung Institute, London, UK
| | - Hannah M Mitchison
- Genetics and Genomic Medicine, University College London, UCL Great Ormond Street Institute of Child Health, London, UK
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36
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Butler CR, Hynds RE, Gowers KHC, Lee DDH, Brown JM, Crowley C, Teixeira VH, Smith CM, Urbani L, Hamilton NJ, Thakrar RM, Booth HL, Birchall MA, De Coppi P, Giangreco A, O'Callaghan C, Janes SM. Rapid Expansion of Human Epithelial Stem Cells Suitable for Airway Tissue Engineering. Am J Respir Crit Care Med 2017; 194:156-68. [PMID: 26840431 DOI: 10.1164/rccm.201507-1414oc] [Citation(s) in RCA: 141] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
RATIONALE Stem cell-based tracheal replacement represents an emerging therapeutic option for patients with otherwise untreatable airway diseases including long-segment congenital tracheal stenosis and upper airway tumors. Clinical experience demonstrates that restoration of mucociliary clearance in the lungs after transplantation of tissue-engineered grafts is critical, with preclinical studies showing that seeding scaffolds with autologous mucosa improves regeneration. High epithelial cell-seeding densities are required in regenerative medicine, and existing techniques are inadequate to achieve coverage of clinically suitable grafts. OBJECTIVES To define a scalable cell culture system to deliver airway epithelium to clinical grafts. METHODS Human respiratory epithelial cells derived from endobronchial biopsies were cultured using a combination of mitotically inactivated fibroblasts and Rho-associated protein kinase (ROCK) inhibition using Y-27632 (3T3+Y). Cells were analyzed by immunofluorescence, quantitative polymerase chain reaction, and flow cytometry to assess airway stem cell marker expression. Karyotyping and multiplex ligation-dependent probe amplification were performed to assess cell safety. Differentiation capacity was tested in three-dimensional tracheospheres, organotypic cultures, air-liquid interface cultures, and an in vivo tracheal xenograft model. Ciliary function was assessed in air-liquid interface cultures. MEASUREMENTS AND MAIN RESULTS 3T3-J2 feeder cells and ROCK inhibition allowed rapid expansion of airway basal cells. These cells were capable of multipotent differentiation in vitro, generating both ciliated and goblet cell lineages. Cilia were functional with normal beat frequency and pattern. Cultured cells repopulated tracheal scaffolds in a heterotopic transplantation xenograft model. CONCLUSIONS Our method generates large numbers of functional airway basal epithelial cells with the efficiency demanded by clinical transplantation, suggesting its suitability for use in tracheal reconstruction.
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Affiliation(s)
- Colin R Butler
- 1 Lungs for Living Research Centre, UCL Respiratory, University College London, London, United Kingdom
| | - Robert E Hynds
- 1 Lungs for Living Research Centre, UCL Respiratory, University College London, London, United Kingdom
| | - Kate H C Gowers
- 1 Lungs for Living Research Centre, UCL Respiratory, University College London, London, United Kingdom
| | - Dani Do Hyang Lee
- 2 Respiratory, Critical Care, and Anesthesia, Institute of Child Health, University College London, London, United Kingdom
| | - James M Brown
- 1 Lungs for Living Research Centre, UCL Respiratory, University College London, London, United Kingdom
| | - Claire Crowley
- 3 Stem Cell and Regenerative Medicine Section, Great Ormond Street Hospital and UCL Institute of Child Health, London, United Kingdom
| | - Vitor H Teixeira
- 1 Lungs for Living Research Centre, UCL Respiratory, University College London, London, United Kingdom
| | - Claire M Smith
- 2 Respiratory, Critical Care, and Anesthesia, Institute of Child Health, University College London, London, United Kingdom
| | - Luca Urbani
- 3 Stem Cell and Regenerative Medicine Section, Great Ormond Street Hospital and UCL Institute of Child Health, London, United Kingdom
| | - Nicholas J Hamilton
- 1 Lungs for Living Research Centre, UCL Respiratory, University College London, London, United Kingdom
| | - Ricky M Thakrar
- 1 Lungs for Living Research Centre, UCL Respiratory, University College London, London, United Kingdom
| | - Helen L Booth
- 4 Department of Thoracic Medicine, University College London Hospitals, London, United Kingdom; and
| | - Martin A Birchall
- 5 UCL Ear Institute, Royal National Throat, Nose and Ear Hospital, London, United Kingdom
| | - Paolo De Coppi
- 3 Stem Cell and Regenerative Medicine Section, Great Ormond Street Hospital and UCL Institute of Child Health, London, United Kingdom
| | - Adam Giangreco
- 1 Lungs for Living Research Centre, UCL Respiratory, University College London, London, United Kingdom
| | - Christopher O'Callaghan
- 2 Respiratory, Critical Care, and Anesthesia, Institute of Child Health, University College London, London, United Kingdom
| | - Sam M Janes
- 1 Lungs for Living Research Centre, UCL Respiratory, University College London, London, United Kingdom.,4 Department of Thoracic Medicine, University College London Hospitals, London, United Kingdom; and
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37
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Thomas B, Hirst RA, Brett-Pitt MH, Williams G, Andrew PW, Sousa AR, Marshall RP, Brightling C, O'Callaghan C. Severe asthma: Differential chemokine response of airway epithelial cells. J Allergy Clin Immunol 2017; 140:1149-1152.e10. [PMID: 28412395 DOI: 10.1016/j.jaci.2017.02.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 02/03/2017] [Accepted: 02/27/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Biju Thomas
- Centre for PCD diagnosis and Research, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, United Kingdom; KK Women's and Children's Hospital, Singapore
| | - Robert Anthony Hirst
- Centre for PCD diagnosis and Research, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, United Kingdom
| | - Mina H Brett-Pitt
- Centre for PCD diagnosis and Research, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, United Kingdom
| | - Gwyneth Williams
- Centre for PCD diagnosis and Research, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, United Kingdom
| | - Peter W Andrew
- Centre for PCD diagnosis and Research, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, United Kingdom
| | - Ana R Sousa
- Respiratory Unit, Glaxo SmithKline, Stevenage, Herts, United Kingdom
| | | | - Chrostopher Brightling
- Centre for PCD diagnosis and Research, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, United Kingdom
| | - Christopher O'Callaghan
- Centre for PCD diagnosis and Research, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, United Kingdom; Respiratory, Critical Care & Anaesthesia, Institute of Child Health, UCL Great Ormond Street Hospital, Institute of Child Health, London, United Kingdom.
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38
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Mulcahy D, O'Callaghan C, Hannigan A. Nurse Triage in an Irish Out-of-hours General Practice Co-Operative. Ir Med J 2017; 110:530. [PMID: 28657243] [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: 06/07/2023]
Abstract
Specially trained triage nurses play a crucial role in the operation of out-of-hours GP co-operatives. This study aimed to establish the proportion of all patient contacts with the out-of-hours GP co-operative based in the Mid-West of Ireland (Shannondoc), which were managed by triage nurses. A retrospective, descriptive analysis was conducted on the database of contacts to the Shannondoc urgent, out-of-hours primary care co-operative. Of the 110,039 contacts to the service in 2013, 19,147 (17.4%) were classified as being managed by nurses and 14.2% were managed by nurse telephone triage alone. Twenty-four percent of the 19,147 calls managed by nurses involved children under six years. Triage nurses play an important role in administering safe medical advice over the phone. This has implications for the training of triage nurses and the future planning of urgent out-of-hours primary care services.
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Affiliation(s)
- D Mulcahy
- Harbour's Brink Medical Centre, Aghada, Midleton, Co. Cork
| | | | - A Hannigan
- Graduate Entry Medical School, University of Limerick, Limerick
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39
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Munye MM, Shoemark A, Hirst RA, Delhove JM, Sharp TV, McKay TR, O'Callaghan C, Baines DL, Howe SJ, Hart SL. BMI-1 extends proliferative potential of human bronchial epithelial cells while retaining their mucociliary differentiation capacity. Am J Physiol Lung Cell Mol Physiol 2016; 312:L258-L267. [PMID: 27979861 DOI: 10.1152/ajplung.00471.2016] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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: 10/17/2016] [Revised: 12/13/2016] [Accepted: 12/14/2016] [Indexed: 12/15/2022] Open
Abstract
Air-liquid interface (ALI) culture of primary airway epithelial cells enables mucociliary differentiation providing an in vitro model of the human airway, but their proliferative potential is limited. To extend proliferation, these cells were previously transduced with viral oncogenes or mouse Bmi-1 + hTERT, but the resultant cell lines did not undergo mucociliary differentiation. We hypothesized that use of human BMI-1 alone would increase the proliferative potential of bronchial epithelial cells while retaining their mucociliary differentiation potential. Cystic fibrosis (CF) and non-CF bronchial epithelial cells were transduced by lentivirus with BMI-1 and then their morphology, replication kinetics, and karyotype were assessed. When differentiated at ALI, mucin production, ciliary function, and transepithelial electrophysiology were measured. Finally, shRNA knockdown of DNAH5 in BMI-1 cells was used to model primary ciliary dyskinesia (PCD). BMI-1-transduced basal cells showed normal cell morphology, karyotype, and doubling times despite extensive passaging. The cell lines underwent mucociliary differentiation when cultured at ALI with abundant ciliation and production of the gel-forming mucins MUC5AC and MUC5B evident. Cilia displayed a normal beat frequency and 9+2 ultrastructure. Electrophysiological characteristics of BMI-1-transduced cells were similar to those of untransduced cells. shRNA knockdown of DNAH5 in BMI-1 cells produced immotile cilia and absence of DNAH5 in the ciliary axoneme as seen in cells from patients with PCD. BMI-1 delayed senescence in bronchial epithelial cells, increasing their proliferative potential but maintaining mucociliary differentiation at ALI. We have shown these cells are amenable to genetic manipulation and can be used to produce novel disease models for research and dissemination.
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Affiliation(s)
- Mustafa M Munye
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Amelia Shoemark
- Imperial College London, UK Electron Microscopy Department, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
| | - Robert A Hirst
- Primary Ciliary Dyskinesia Centre Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, United Kingdom
| | - Juliette M Delhove
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Tyson V Sharp
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Tristan R McKay
- School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom; and
| | - Christopher O'Callaghan
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Deborah L Baines
- Institute for Infection and Immunity, St George's, University of London, London, United Kingdom
| | - Steven J Howe
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Stephen L Hart
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom;
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40
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Affiliation(s)
- Andrew Blaikie
- University of St Andrews School of Medicine, St Andrews KY16 9TF, UK
| | | | - Sahib Y Tuteja
- University of St Andrews School of Medicine, St Andrews KY16 9TF, UK
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41
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Fairfield JA, Rocha CG, O'Callaghan C, Ferreira MS, Boland JJ. Co-percolation to tune conductive behaviour in dynamical metallic nanowire networks. Nanoscale 2016; 8:18516-18523. [PMID: 27782246 DOI: 10.1039/c6nr06276h] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Nanowire networks act as self-healing smart materials, whose sheet resistance can be tuned via an externally applied voltage stimulus. This memristive response occurs due to modification of junction resistances to form a connectivity path across the lowest barrier junctions in the network. While most network studies have been performed on expensive noble metal nanowires like silver, networks of inexpensive nickel nanowires with a nickel oxide coating can also demonstrate resistive switching, a common feature of metal oxides with filamentary conduction. However, networks made from solely nickel nanowires have high operation voltages which prohibit large-scale material applications. Here we show, using both experiment and simulation, that a heterogeneous network of nickel and silver nanowires allows optimization of the activation voltage, as well as tuning of the conduction behavior to be either resistive switching, memristive, or a combination of both. Small percentages of silver nanowires, below the percolation threshold, induce these changes in electrical behaviour, even for low area coverage and hence very transparent films. Silver nanowires act as current concentrators, amplifying conductivity locally as shown in our computational dynamical activation framework for networks of junctions. These results demonstrate that a heterogeneous nanowire network can act as a cost-effective adaptive material with minimal use of noble metal nanowires, without losing memristive behaviour that is essential for smart sensing and neuromorphic applications.
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Affiliation(s)
- J A Fairfield
- School of Chemistry, Trinity College Dublin, Dublin 2, Ireland and Centre for Research on Adaptive Nanostructures and Nanodevices (CRANN), Trinity College Dublin, Dublin 2, Ireland.
| | - C G Rocha
- School of Physics, Trinity College Dublin, Dublin 2, Ireland and Centre for Research on Adaptive Nanostructures and Nanodevices (CRANN), Trinity College Dublin, Dublin 2, Ireland.
| | - C O'Callaghan
- School of Physics, Trinity College Dublin, Dublin 2, Ireland and Centre for Research on Adaptive Nanostructures and Nanodevices (CRANN), Trinity College Dublin, Dublin 2, Ireland.
| | - M S Ferreira
- School of Physics, Trinity College Dublin, Dublin 2, Ireland and Centre for Research on Adaptive Nanostructures and Nanodevices (CRANN), Trinity College Dublin, Dublin 2, Ireland.
| | - J J Boland
- School of Chemistry, Trinity College Dublin, Dublin 2, Ireland and Centre for Research on Adaptive Nanostructures and Nanodevices (CRANN), Trinity College Dublin, Dublin 2, Ireland.
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42
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Hoenderdos K, Lodge KM, Hirst RA, Chen C, Palazzo SGC, Emerenciana A, Summers C, Angyal A, Porter L, Juss JK, O'Callaghan C, Chilvers ER, Condliffe AM. Hypoxia upregulates neutrophil degranulation and potential for tissue injury. Thorax 2016; 71:1030-1038. [PMID: 27581620 PMCID: PMC5099189 DOI: 10.1136/thoraxjnl-2015-207604] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [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: 07/23/2015] [Accepted: 04/04/2016] [Indexed: 01/06/2023]
Abstract
Background The inflamed bronchial mucosal surface is a profoundly hypoxic environment. Neutrophilic airway inflammation and neutrophil-derived proteases have been linked to disease progression in conditions such as COPD and cystic fibrosis, but the effects of hypoxia on potentially harmful neutrophil functional responses such as degranulation are unknown. Methods and results Following exposure to hypoxia (0.8% oxygen, 3 kPa for 4 h), neutrophils stimulated with inflammatory agonists (granulocyte-macrophage colony stimulating factor or platelet-activating factor and formylated peptide) displayed a markedly augmented (twofold to sixfold) release of azurophilic (neutrophil elastase, myeloperoxidase), specific (lactoferrin) and gelatinase (matrix metalloproteinase-9) granule contents. Neutrophil supernatants derived under hypoxic but not normoxic conditions induced extensive airway epithelial cell detachment and death, which was prevented by coincubation with the antiprotease α-1 antitrypsin; both normoxic and hypoxic supernatants impaired ciliary function. Surprisingly, the hypoxic upregulation of neutrophil degranulation was not dependent on hypoxia-inducible factor (HIF), nor was it fully reversed by inhibition of phospholipase C signalling. Hypoxia augmented the resting and cytokine-stimulated phosphorylation of AKT, and inhibition of phosphoinositide 3-kinase (PI3K)γ (but not other PI3K isoforms) prevented the hypoxic upregulation of neutrophil elastase release. Conclusion Hypoxia augments neutrophil degranulation and confers enhanced potential for damage to respiratory airway epithelial cells in a HIF-independent but PI3Kγ-dependent fashion.
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Affiliation(s)
- Kim Hoenderdos
- Department of Medicine, University of Cambridge, Cambridge, UK
| | | | - Robert A Hirst
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Cheng Chen
- Department of Medicine, University of Cambridge, Cambridge, UK
| | | | | | | | - Adri Angyal
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Linsey Porter
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Jatinder K Juss
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Christopher O'Callaghan
- Department of Respiratory Medicine, Portex Unit, Institute of Child Health, University College London, Cambridge, UK
| | | | - Alison M Condliffe
- Department of Medicine, University of Cambridge, Cambridge, UK Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
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43
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Abstract
Anti-neutrophil cytoplasmic antibody-associated vasculitis is an uncommon inflammatory disease of small to medium-sized vessels that frequently presents with rapidly progressive glomerulonephritis and renal failure though it can affect any organ system. If untreated, the vast majority of patients will die within a year. Current treatments improve prognosis but affected patients remain at a substantially higher risk of death and adverse outcomes. We review the classification of the disease, our understanding of the pathogenesis and epidemiology, and propose future directions for research. We also evaluate the evidence supporting established treatment regimens and the progress of clinical trials for newer treatments to inform the design of future studies.
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Affiliation(s)
- B Lazarus
- Department of Kidney Health Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - G T John
- Department of Kidney Health Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - C O'Callaghan
- Department of Kidney Health Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - D Ranganathan
- Department of Kidney Health Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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44
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Hamilton NJ, Kanani M, Roebuck DJ, Hewitt RJ, Cetto R, McLaren CA, Butler CR, Crowley C, Janes SM, O'Callaghan C, Culme-Seymour EJ, Mason C, De Coppi P, Lowdell MW, Elliott MJ, Birchall MA. Reply to: "Recent Advances in Circumferential Tracheal Replacement and Transplantation". Am J Transplant 2016; 16:1336-7. [PMID: 26813777 DOI: 10.1111/ajt.13736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- N J Hamilton
- University College London Ear Institute, Royal National Throat Nose and Ear Hospital, London, UK
| | - M Kanani
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - D J Roebuck
- Department of Radiology, Great Ormond Street Hospital, London, UK
| | - R J Hewitt
- Department of Otorhinolaryngology, Great Ormond Street Hospital, London, UK
| | - R Cetto
- Department of Aeronautics, Imperial College London, London, UK
| | - C A McLaren
- Department of Radiology, Great Ormond Street Hospital, London, UK
| | - C R Butler
- Lungs for Living Research Centre, Rayne Institute, London, UK
| | - C Crowley
- University College London Centre for Nanotechnology and Regenerative Medicine, Royal Free Hospital, London, UK
| | - S M Janes
- Lungs for Living Research Centre, Rayne Institute, London, UK
| | - C O'Callaghan
- Department of Respiratory Medicine, Great Ormond Street Hospital, London, UK
| | | | - C Mason
- London Regenerative Medicine Network, London, UK
| | - P De Coppi
- Department of Surgery, Great Ormond Street Hospital, London, UK
| | - M W Lowdell
- Department of Haematology, Royal Free Hospital, University College London Paul O'Gorman Laboratory of Cellular Therapeutics, London, UK
| | - M J Elliott
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - M A Birchall
- University College London Ear Institute, Royal National Throat Nose and Ear Hospital, London, UK
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45
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Wan WYH, Hollins F, Haste L, Woodman L, Hirst RA, Bolton S, Gomez E, Sutcliffe A, Desai D, Chachi L, Mistry V, Szyndralewiez C, Wardlaw A, Saunders R, O'Callaghan C, Andrew PW, Brightling CE. NADPH Oxidase-4 Overexpression Is Associated With Epithelial Ciliary Dysfunction in Neutrophilic Asthma. Chest 2016; 149:1445-59. [PMID: 26836936 PMCID: PMC4893823 DOI: 10.1016/j.chest.2016.01.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Bronchial epithelial ciliary dysfunction is an important feature of asthma. We sought to determine the role in asthma of neutrophilic inflammation and nicotinamide adenine dinucleotide phosphate (NADPH) oxidases in ciliary dysfunction. METHODS Bronchial epithelial ciliary function was assessed by using video microscopy in fresh ex vivo epithelial strips from patients with asthma stratified according to their sputum cell differentials and in culture specimens from healthy control subjects and patients with asthma. Bronchial epithelial oxidative damage was determined by 8-oxo-dG expression. Nicotinamide adenine dinucleotide phosphate oxidase (NOX)/dual oxidase (DUOX) expression was assessed in bronchial epithelial cells by using microarrays, with NOX4 and DUOX1/2 expression assessed in bronchial biopsy specimens. Ciliary dysfunction following NADPH oxidase inhibition, using GKT137831, was evaluated in fresh epithelial strips from patients with asthma and a murine model of ovalbumin sensitization and challenge. RESULTS Ciliary beat frequency was impaired in patients with asthma with sputum neutrophilia (n = 11) vs those without (n = 10) (5.8 [0.6] Hz vs 8.8 [0.5] Hz; P = .003) and was correlated with sputum neutrophil count (r = -0.70; P < .001). Primary bronchial epithelial cells expressed DUOX1/2 and NOX4. Levels of 8-oxo-dG and NOX4 were elevated in patients with neutrophilic vs nonneutrophilic asthma, DUOX1 was elevated in both, and DUOX2 was elevated in nonneutrophilic asthma in vivo. In primary epithelial cultures, ciliary dysfunction did not persist, although NOX4 expression and reactive oxygen species generation was increased from patients with neutrophilic asthma. GKT137831 both improved ciliary function in ex vivo epithelial strips (n = 13), relative to the intensity of neutrophilic inflammation, and abolished ciliary dysfunction in the murine asthma model with no reduction in inflammation. CONCLUSIONS Ciliary dysfunction is increased in neutrophilic asthma associated with increased NOX4 expression and is attenuated by NADPH oxidase inhibition.
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Affiliation(s)
- Wing-Yan Heidi Wan
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Fay Hollins
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Louise Haste
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester
| | - Lucy Woodman
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Robert A Hirst
- Centre for PCD Diagnosis and Research, Department of Infection, Immunity and Inflammation, RK Clinical Sciences Building, University of Leicester, Leicester
| | - Sarah Bolton
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Edith Gomez
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Amanda Sutcliffe
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Dhananjay Desai
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Latifa Chachi
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Vijay Mistry
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | | | - Andrew Wardlaw
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | - Ruth Saunders
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester
| | | | - Peter W Andrew
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester
| | - Christopher E Brightling
- Institute for Lung Health, Department of Infection, Immunity & Inflammation, Glenfield Hospital, University of Leicester, Leicester.
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46
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Hamilton NJ, Kanani M, Roebuck DJ, Hewitt RJ, Cetto R, Culme‐Seymour EJ, Toll E, Bates AJ, Comerford AP, McLaren CA, Butler CR, Crowley C, McIntyre D, Sebire NJ, Janes SM, O'Callaghan C, Mason C, De Coppi P, Lowdell MW, Elliott MJ, Birchall MA. Tissue-Engineered Tracheal Replacement in a Child: A 4-Year Follow-Up Study. Am J Transplant 2015; 15:2750-7. [PMID: 26037782 PMCID: PMC4737133 DOI: 10.1111/ajt.13318] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [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: 12/10/2014] [Revised: 02/16/2015] [Accepted: 03/07/2015] [Indexed: 02/06/2023]
Abstract
In 2010, a tissue-engineered trachea was transplanted into a 10-year-old child using a decellularized deceased donor trachea repopulated with the recipient's respiratory epithelium and mesenchymal stromal cells. We report the child's clinical progress, tracheal epithelialization and costs over the 4 years. A chronology of events was derived from clinical notes and costs determined using reference costs per procedure. Serial tracheoscopy images, lung function tests and anti-HLA blood samples were compared. Epithelial morphology and T cell, Ki67 and cleaved caspase 3 activity were examined. Computational fluid dynamic simulations determined flow, velocity and airway pressure drops. After the first year following transplantation, the number of interventions fell and the child is currently clinically well and continues in education. Endoscopy demonstrated a complete mucosal lining at 15 months, despite retention of a stent. Histocytology indicates a differentiated respiratory layer and no abnormal immune activity. Computational fluid dynamic analysis demonstrated increased velocity and pressure drops around a distal tracheal narrowing. Cross-sectional area analysis showed restriction of growth within an area of in-stent stenosis. This report demonstrates the long-term viability of a decellularized tissue-engineered trachea within a child. Further research is needed to develop bioengineered pediatric tracheal replacements with lower morbidity, better biomechanics and lower costs.
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Affiliation(s)
- N. J. Hamilton
- University College London Ear InstituteRoyal National Throat Nose and Ear HospitalLondonUK
| | - M. Kanani
- Department of Cardiothoracic SurgeryGreat Ormond Street HospitalLondonUK
| | - D. J. Roebuck
- Department of RadiologyGreat Ormond Street HospitalLondonUK
| | - R. J. Hewitt
- Department of OtorhinolaryngologyGreat Ormond Street HospitalLondonUK
| | - R. Cetto
- Imperial College London, Department of AeronauticsLondonUK
| | | | - E. Toll
- Department of Cardiothoracic SurgeryGreat Ormond Street HospitalLondonUK
| | - A. J. Bates
- Imperial College London, Department of AeronauticsLondonUK
| | | | - C. A. McLaren
- Department of RadiologyGreat Ormond Street HospitalLondonUK
| | - C. R. Butler
- Lungs for Living Research CentreRayne InstituteLondonUK
| | - C. Crowley
- University College London Centre for Nanotechnology and Regenerative MedicineRoyal Free HospitalLondonUK
| | - D. McIntyre
- Department of Cardiothoracic SurgeryGreat Ormond Street HospitalLondonUK
| | - N. J. Sebire
- Department of HistopathologyGreat Ormond Street HospitalLondonUK
| | - S. M. Janes
- Lungs for Living Research CentreRayne InstituteLondonUK
| | - C. O'Callaghan
- Department of Respiratory MedicineGreat Ormond Street HospitalLondonUK
| | - C. Mason
- London Regenerative Medicine NetworkLondonUK
| | - P. De Coppi
- Department of SurgeryGreat Ormond Street HospitalLondonUK
| | - M. W. Lowdell
- Department of HaematologyRoyal Free Hospital, University College London Paul O'Gorman Laboratory of Cellular TherapeuticsLondonUK
| | - M. J. Elliott
- Department of Cardiothoracic SurgeryGreat Ormond Street HospitalLondonUK
| | - M. A. Birchall
- University College London Ear InstituteRoyal National Throat Nose and Ear HospitalLondonUK
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47
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Onoufriadis A, Hjeij R, Watson CM, Slagle CE, Klena NT, Dougherty GW, Kurkowiak M, Loges NT, Diggle CP, Morante NF, Gabriel GC, Lemke KL, Li Y, Pennekamp P, Menchen T, Marthin JK, Mans D, Letteboer SJ, Werner C, Burgoyne T, Westermann C, Rutman A, Carr IM, O'Callaghan C, Moya E, Chung EMK, Sheridan E, Nielsen KG, Roepman R, Burdine RD, Lo CW, Omran H, Mitchison H. Gene discovery for motile cilia disorders: mutation spectrum in primary ciliary dyskinesia and discovery of mutations in CCDC151. Cilia 2015. [PMCID: PMC4518893 DOI: 10.1186/2046-2530-4-s1-p30] [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: 11/25/2022] Open
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48
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Robson E, Moya E, Burgoyne T, Chetcuti P, Dixon M, Hirst R, Hogg C, Mitchison H, O'Callaghan C, Onoufriadis A, Patel M, Rutman A, Sheridan E, Shoemark A. Phenotypic variability of CCDC103 mutation in British Pakistani children with Primary Ciliary Dyskinesia (PCD). Cilia 2015. [PMCID: PMC4518667 DOI: 10.1186/2046-2530-4-s1-p61] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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49
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Hamilton NJ, Kanani M, Roebuck DJ, Hewitt RJ, Cetto R, Culme-Seymour EJ, Toll E, Bates AJ, Comerford AP, McLaren CA, Butler CR, Crowley C, McIntyre D, Sebire NJ, Janes SM, O'Callaghan C, Mason C, De Coppi P, Lowdell MW, Elliott MJ, Birchall MA. Tissue-Engineered Tracheal Replacement in a Child: A 4-Year Follow-Up Study. Am J Transplant 2015. [PMID: 26037782 DOI: 10.1111/ajt.13318.] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In 2010, a tissue-engineered trachea was transplanted into a 10-year-old child using a decellularized deceased donor trachea repopulated with the recipient's respiratory epithelium and mesenchymal stromal cells. We report the child's clinical progress, tracheal epithelialization and costs over the 4 years. A chronology of events was derived from clinical notes and costs determined using reference costs per procedure. Serial tracheoscopy images, lung function tests and anti-HLA blood samples were compared. Epithelial morphology and T cell, Ki67 and cleaved caspase 3 activity were examined. Computational fluid dynamic simulations determined flow, velocity and airway pressure drops. After the first year following transplantation, the number of interventions fell and the child is currently clinically well and continues in education. Endoscopy demonstrated a complete mucosal lining at 15 months, despite retention of a stent. Histocytology indicates a differentiated respiratory layer and no abnormal immune activity. Computational fluid dynamic analysis demonstrated increased velocity and pressure drops around a distal tracheal narrowing. Cross-sectional area analysis showed restriction of growth within an area of in-stent stenosis. This report demonstrates the long-term viability of a decellularized tissue-engineered trachea within a child. Further research is needed to develop bioengineered pediatric tracheal replacements with lower morbidity, better biomechanics and lower costs.
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Affiliation(s)
- N J Hamilton
- University College London Ear Institute, Royal National Throat Nose and Ear Hospital, London, UK
| | - M Kanani
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - D J Roebuck
- Department of Radiology, Great Ormond Street Hospital, London, UK
| | - R J Hewitt
- Department of Otorhinolaryngology, Great Ormond Street Hospital, London, UK
| | - R Cetto
- Imperial College London, Department of Aeronautics, London, UK
| | | | - E Toll
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - A J Bates
- Imperial College London, Department of Aeronautics, London, UK
| | - A P Comerford
- Imperial College London, Department of Aeronautics, London, UK
| | - C A McLaren
- Department of Radiology, Great Ormond Street Hospital, London, UK
| | - C R Butler
- Lungs for Living Research Centre, Rayne Institute, London, UK
| | - C Crowley
- University College London Centre for Nanotechnology and Regenerative Medicine, Royal Free Hospital, London, UK
| | - D McIntyre
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - N J Sebire
- Department of Histopathology, Great Ormond Street Hospital, London, UK
| | - S M Janes
- Lungs for Living Research Centre, Rayne Institute, London, UK
| | - C O'Callaghan
- Department of Respiratory Medicine, Great Ormond Street Hospital, London, UK
| | - C Mason
- London Regenerative Medicine Network, London, UK
| | - P De Coppi
- Department of Surgery, Great Ormond Street Hospital, London, UK
| | - M W Lowdell
- Department of Haematology, Royal Free Hospital, University College London Paul O'Gorman Laboratory of Cellular Therapeutics, London, UK
| | - M J Elliott
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - M A Birchall
- University College London Ear Institute, Royal National Throat Nose and Ear Hospital, London, UK
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50
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Hamilton R, Ding K, Crook J, O'Callaghan C, Higano C, Dearnaley D, Horwitz E, Goldenberg L, Gospodarawicz M, Klotz L. MP73-04 THE ASSOCIATION BETWEEN STATIN USE AND OUTCOMES IN PATIENTS INITIATING ANDROGEN DEPRIVATION THERAPY. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.2680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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