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Wilson HC, Hashemi S, Smith CA, Sallee D, Kim DW, Slesnick TC. Comparison of Cardiac Computed Tomography and Magnetic Resonance Angiography Measurements for Determination of Candidacy for Transcatheter Pulmonary Valve Replacement in Native or Postsurgical Right Ventricular Outflow Tracts. Am J Cardiol 2023; 206:98-100. [PMID: 37690151 DOI: 10.1016/j.amjcard.2023.08.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/11/2023] [Accepted: 08/20/2023] [Indexed: 09/12/2023]
Affiliation(s)
- Hunter C Wilson
- Department of Pediatrics, Division of Pediatric Cardiology, Children's Healthcare of Atlanta, Atlanta, Georgia; Department of Pediatrics, Division of Pediatric Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | - Sassan Hashemi
- Department of Pediatrics, Division of Pediatric Cardiology, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Clayton A Smith
- Department of Pediatrics, Division of Pediatric Cardiology, Children's Healthcare of Atlanta, Atlanta, Georgia; Department of Pediatrics, Division of Pediatric Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | - Denver Sallee
- Department of Pediatrics, Division of Pediatric Cardiology, Children's Healthcare of Atlanta, Atlanta, Georgia; Department of Pediatrics, Division of Pediatric Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | - Dennis W Kim
- Department of Pediatrics, Division of Pediatric Cardiology, Children's Healthcare of Atlanta, Atlanta, Georgia; Department of Pediatrics, Division of Pediatric Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | - Timothy C Slesnick
- Department of Pediatrics, Division of Pediatric Cardiology, Children's Healthcare of Atlanta, Atlanta, Georgia; Department of Pediatrics, Division of Pediatric Cardiology, Emory University School of Medicine, Atlanta, Georgia.
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Sheth AI, Engel K, Tolison H, Althoff MJ, Amaya ML, Krug A, Young T, Pei S, Patel SB, Minhajuddin M, Winters A, Miller R, Shelton I, St-Germain J, Ling T, Jones C, Raught B, Gillen A, Ransom M, Staggs S, Smith CA, Pollyea DA, Stevens BM, Jordan CT. Targeting Acute Myeloid Leukemia Stem Cells Through Perturbation of Mitochondrial Calcium. bioRxiv 2023:2023.10.02.560330. [PMID: 37873284 PMCID: PMC10592899 DOI: 10.1101/2023.10.02.560330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
We previously reported that acute myeloid leukemia stem cells (LSCs) are uniquely reliant on oxidative phosphorylation (OXPHOS) for survival. Moreover, maintenance of OXPHOS is dependent on BCL2, creating a therapeutic opportunity to target LSCs using the BCL2 inhibitor drug venetoclax. While venetoclax-based regimens have indeed shown promising clinical activity, the emergence of drug resistance is prevalent. Thus, in the present study, we investigated how mitochondrial properties may influence mechanisms that dictate venetoclax responsiveness. Our data show that utilization of mitochondrial calcium is fundamentally different between drug responsive and non-responsive LSCs. By comparison, venetoclax-resistant LSCs demonstrate a more active metabolic (i.e., OXPHOS) status with relatively high steady-state levels of calcium. Consequently, we tested genetic and pharmacological approaches to target the mitochondrial calcium uniporter, MCU. We demonstrate that inhibition of calcium uptake sharply reduces OXPHOS and leads to eradication of venetoclax-resistant LSCs. These findings demonstrate a central role for calcium signaling in the biology of LSCs and provide a therapeutic avenue for clinical management of venetoclax resistance.
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Affiliation(s)
- Anagha Inguva Sheth
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Krysta Engel
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
- These authors contributed equally
| | - Hunter Tolison
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
- These authors contributed equally
| | - Mark J Althoff
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Maria L. Amaya
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Anna Krug
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Tracy Young
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Shanshan Pei
- Liangzhu Laboratory, Zhejiang University Medical Center, Bone Marrow Transplantation Center, Hangzhou, China
| | - Sweta B. Patel
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Mohammad Minhajuddin
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Amanda Winters
- Division of Pediatric Hematology and Oncology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Regan Miller
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Ian Shelton
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jonathan St-Germain
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Tianyi Ling
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Courtney Jones
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Brian Raught
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Austin Gillen
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Monica Ransom
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Sarah Staggs
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Clayton A. Smith
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Daniel A. Pollyea
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Brett M. Stevens
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Craig T. Jordan
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO, USA
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Pei S, Shelton IT, Gillen AE, Stevens BM, Gasparetto M, Wang Y, Liu L, Liu J, Brunetti TM, Engel K, Staggs S, Showers W, Sheth AI, Amaya ML, Minhajuddin M, Winters A, Patel SB, Tolison H, Krug AE, Young TN, Schowinsky J, McMahon CM, Smith CA, Pollyea DA, Jordan CT. A Novel Type of Monocytic Leukemia Stem Cell Revealed by the Clinical Use of Venetoclax-Based Therapy. Cancer Discov 2023; 13:2032-2049. [PMID: 37358260 PMCID: PMC10527971 DOI: 10.1158/2159-8290.cd-22-1297] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [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: 11/15/2022] [Revised: 04/21/2023] [Accepted: 06/22/2023] [Indexed: 06/27/2023]
Abstract
The BCL2 inhibitor venetoclax has recently emerged as an important component of acute myeloid leukemia (AML) therapy. Notably, use of this agent has revealed a previously unrecognized form of pathogenesis characterized by monocytic disease progression. We demonstrate that this form of disease arises from a fundamentally different type of leukemia stem cell (LSC), which we designate as monocytic LSC (m-LSC), that is developmentally and clinically distinct from the more well-described primitive LSC (p-LSC). The m-LSC is distinguished by a unique immunophenotype (CD34-, CD4+, CD11b-, CD14-, CD36-), unique transcriptional state, reliance on purine metabolism, and selective sensitivity to cladribine. Critically, in some instances, m-LSC and p-LSC subtypes can co-reside in the same patient with AML and simultaneously contribute to overall tumor biology. Thus, our findings demonstrate that LSC heterogeneity has direct clinical significance and highlight the need to distinguish and target m-LSCs as a means to improve clinical outcomes with venetoclax-based regimens. SIGNIFICANCE These studies identify and characterize a new type of human acute myeloid LSC that is responsible for monocytic disease progression in patients with AML treated with venetoclax-based regimens. Our studies describe the phenotype, molecular properties, and drug sensitivities of this unique LSC subclass. This article is featured in Selected Articles from This Issue, p. 1949.
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Affiliation(s)
- Shanshan Pei
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Liangzhu Laboratory, Zhejiang University, Hangzhou, China
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- These authors contributed equally
| | - Ian T Shelton
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
- These authors contributed equally
| | - Austin E Gillen
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
- Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA
| | - Brett M Stevens
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Maura Gasparetto
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Yanan Wang
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Liangzhu Laboratory, Zhejiang University, Hangzhou, China
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
| | - Lina Liu
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Liangzhu Laboratory, Zhejiang University, Hangzhou, China
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
| | - Jun Liu
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Liangzhu Laboratory, Zhejiang University, Hangzhou, China
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
| | - Tonya M Brunetti
- University of Colorado Cancer Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Immunology & Microbiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Krysta Engel
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Sarah Staggs
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - William Showers
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Anagha Inguva Sheth
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Maria L Amaya
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
- Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA
| | - Mohammad Minhajuddin
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Amanda Winters
- Center for Cancer and Blood Disorders, Department of Pediatrics, University of Colorado, Aurora, Colorado, USA
| | - Sweta B Patel
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Hunter Tolison
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Anna E Krug
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Tracy N Young
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jeffrey Schowinsky
- Dept of Pathology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Christine M McMahon
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Clayton A Smith
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Daniel A Pollyea
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Craig T Jordan
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado, USA
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Kent A, Schwartz M, McMahon C, Amaya M, Smith CA, Tobin J, Marciano K, Rezac R, Bosma G, Pollyea DA, Gutman JA. Venetoclax is safe and tolerable as post-transplant maintenance therapy for AML patients at high risk for relapse. Bone Marrow Transplant 2023; 58:849-854. [PMID: 37185614 DOI: 10.1038/s41409-023-01987-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 05/17/2023]
Abstract
Relapse is the most common cause of mortality in acute myeloid leukemia (AML) patients after allogeneic stem cell transplant (SCT). Post-SCT maintenance strategies that prevent relapse are desirable but must be well tolerated and convenient to administer. We hypothesized single agent venetoclax (ven) may be an effective maintenance therapy among high relapse risk patients. Between February 2019 and December 2021, we administered post-SCT ven maintenance to 49 AML patients at high-risk for relapse as a prospectively defined off-label practice at our institution. Ven was planned to be administered until 1-year post-SCT. While temporary interruptions were common (67.3% of all patients), of those with >1 year follow up, 22/25 (88%) completed the full year of planned therapy. Cytopenias (40.8%) and gastrointestinal adverse events (34.7%) were the most common toxicities. At 1-year post-SCT, overall survival (OS) and relapse-free survival (RFS) were 70% and 67% respectively. Our experience demonstrates single agent ven is a safe, tolerable, and feasible maintenance therapy that may improve RFS and OS in high relapse risk post-SCT patients.
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Affiliation(s)
- Andrew Kent
- The University of Colorado School of Medicine, Division of Hematology, Aurora, CO, USA
| | - Marc Schwartz
- The University of Colorado School of Medicine, Division of Hematology, Aurora, CO, USA
| | - Christine McMahon
- The University of Colorado School of Medicine, Division of Hematology, Aurora, CO, USA
| | - Maria Amaya
- The University of Colorado School of Medicine, Division of Hematology, Aurora, CO, USA
| | - Clayton A Smith
- The University of Colorado School of Medicine, Division of Hematology, Aurora, CO, USA
| | - Jennifer Tobin
- The University of Colorado School of Medicine, Division of Hematology, Aurora, CO, USA
| | - Kelsey Marciano
- The University of Colorado School of Medicine, Division of Hematology, Aurora, CO, USA
| | - Rebecca Rezac
- The University of Colorado School of Medicine, Division of Hematology, Aurora, CO, USA
| | - Grace Bosma
- The University of Colorado School of Medicine, Division of Hematology, Aurora, CO, USA
| | - Daniel A Pollyea
- The University of Colorado School of Medicine, Division of Hematology, Aurora, CO, USA
| | - Jonathan A Gutman
- The University of Colorado School of Medicine, Division of Hematology, Aurora, CO, USA.
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5
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Pickard SS, Armstrong AK, Balasubramanian S, Buddhe S, Crum K, Kong G, Lang SM, Lee MV, Lopez L, Natarajan SS, Norris MD, Parra DA, Parthiban A, Powell AJ, Priromprintr B, Rogers LS, Sachdeva S, Shah SS, Smith CA, Stern KWD, Xiang Y, Young LT, Sachdeva R. Appropriateness of cardiovascular computed tomography and magnetic resonance imaging in patients with conotruncal defects. J Cardiovasc Comput Tomogr 2023:S1934-5925(23)00048-5. [PMID: 36868899 DOI: 10.1016/j.jcct.2023.01.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/11/2022] [Accepted: 01/24/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND To promote the rational use of cardiovascular imaging in patients with congenital heart disease, the American College of Cardiology developed Appropriate Use Criteria (AUC), but its clinical application and pre-release benchmarks have not been evaluated. We aimed to evaluate the appropriateness of indications for cardiovascular magnetic resonance (CMR) and cardiovascular computed tomography (CCT) in patients with conotruncal defects and to identify factors associated with maybe or rarely appropriate (M/R) indications. METHODS Twelve centers each contributed a median of 147 studies performed prior to AUC publication (01/2020) on patients with conotruncal defects. To incorporate patient characteristics and center-level effects, a hierarchical generalized linear mixed model was used. RESULTS Of the 1753 studies (80% CMR, and 20% CCT), 16% were rated M/R. Center M/R ranged from 4 to 39%. Infants accounted for 8.4% of studies. In multivariable analyses, patient- and study-level factors associated with M/R rating included: age <1 year (OR 1.90 [1.15-3.13]), truncus arteriosus (vs. tetralogy of Fallot, OR 2.55 [1.5-4.35]), and CCT (vs. CMR, OR 2.67 [1.87-3.83]). None of the provider- or center-level factors reached statistical significance in the multivariable model. CONCLUSIONS Most CMRs and CCTs ordered for the follow-up care of patients with conotruncal defects were rated appropriate. However, there was significant center-level variation in appropriateness ratings. Younger age, CCT, and truncus arteriosus were independently associated with higher odds of M/R rating. These findings could inform future quality improvement initiatives and further exploration of factors resulting in center-level variation.
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Affiliation(s)
- Sarah S Pickard
- Department of Cardiology, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | | | - Sowmya Balasubramanian
- Department of Pediatrics, University of Michigan, C.S. Mott Children's Hospital, AnnArbor, MI, USA
| | - Sujatha Buddhe
- Department of Cardiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Kimberly Crum
- Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Grace Kong
- Department of Pediatrics, Division of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Kravis Children's Heart Center, New York, NY, USA
| | - Sean M Lang
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Marc V Lee
- Nationwide Children's Hospital, The Heart Center, Columbus, OH, USA
| | - Leo Lopez
- Department of Pediatrics, Divison of Pediatric Cardiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Shobha S Natarajan
- Department of Pediatrics, Divison of Pediatric Cardiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark D Norris
- Department of Pediatrics, University of Michigan, C.S. Mott Children's Hospital, AnnArbor, MI, USA
| | - David A Parra
- Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Anitha Parthiban
- Department of Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Andrew J Powell
- Department of Cardiology, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Bryant Priromprintr
- Department of Pediatrics, Divison of Pediatric Cardiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Lindsay S Rogers
- Department of Pediatrics, Divison of Pediatric Cardiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Shagun Sachdeva
- Department of Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Sanket S Shah
- Department of Pediatrics, Divison of Pediatric Cardiology, Children's Mercy Kansas City, University of Missouri, Kansas City, MO, USA
| | - Clayton A Smith
- Pediatric Biostatistics Core, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
| | - Kenan W D Stern
- Department of Pediatrics, Division of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Kravis Children's Heart Center, New York, NY, USA
| | - Yijin Xiang
- Pediatric Biostatistics Core, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
| | - Luciana T Young
- Department of Cardiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Ritu Sachdeva
- Department of Pediatrics, Division of Pediatric Cardiology, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA.
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Lake KE, Colonetta MM, Smith CA, Martinez-Algarin K, Saunders K, Mohta S, Pena J, McArthur HL, Reddy SM, Roussos-Torres ET, Chen EH, Chan IS. Organoid generation from mouse mammary tumors captures the genetic heterogeneity of clinically relevant copy number alterations. bioRxiv 2023:2023.01.29.526141. [PMID: 36778256 PMCID: PMC9915482 DOI: 10.1101/2023.01.29.526141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Breast cancer metastases exhibit many different genetic alterations, including copy number amplifications. Using publicly available datasets, we identify copy number amplifications in metastatic breast tumor samples and using our organoid-based metastasis assays, and we validate FGFR1 is amplified in collectively migrating organoids. Because the heterogeneity of breast tumors is increasingly becoming relevant to clinical practice, we demonstrate our organoid method captures genetic heterogeneity of individual tumors.
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Cornelius SL, Colonnetta MM, Lake KE, Smith CA, Zhang YA, Roussos-Torres ET, Reddy SM, Chen EH, Chan IS. Generating and Imaging Mouse and Human Epithelial Organoids from Normal and Tumor Mammary Tissue Without Passaging. J Vis Exp 2022. [PMID: 36440890 PMCID: PMC10149050 DOI: 10.3791/64626] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Organoids are a reliable method for modeling organ tissue due to their self-organizing properties and retention of function and architecture after propagation from primary tissue or stem cells. This method of organoid generation forgoes single-cell differentiation through multiple passages and instead uses differential centrifugation to isolate mammary epithelial organoids from mechanically and enzymatically dissociated tissues. This protocol provides a streamlined technique for rapidly producing small and large epithelial organoids from both mouse and human mammary tissue in addition to techniques for organoid embedding in collagen and basement extracellular matrix. Furthermore, instructions for in-gel fixation and immunofluorescent staining are provided for the purpose of visualizing organoid morphology and density. These methodologies are suitable for myriad downstream analyses, such as co-culturing with immune cells and ex vivo metastasis modeling via collagen invasion assay. These analyses serve to better elucidate cell-cell behavior and create a more complete understanding of interactions within the tumor microenvironment.
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Affiliation(s)
- Serena L Cornelius
- Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center; Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center
| | - Megan M Colonnetta
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center; Department of Molecular Biology, University of Texas Southwestern Medical Center; Hamon Center for Regenerative Science and Medicine, University of Texas Southwestern Medical Center; Department of Cell Biology, University of Texas Southwestern Medical Center
| | - Katherine E Lake
- Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center; Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center
| | - Clayton A Smith
- Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center; Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center
| | - Yu-An Zhang
- Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center; Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center
| | - Evanthia T Roussos-Torres
- Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California
| | - Sangeetha M Reddy
- Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center; Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center
| | - Elizabeth H Chen
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center; Department of Molecular Biology, University of Texas Southwestern Medical Center; Hamon Center for Regenerative Science and Medicine, University of Texas Southwestern Medical Center; Department of Cell Biology, University of Texas Southwestern Medical Center
| | - Isaac S Chan
- Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center; Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center; Department of Molecular Biology, University of Texas Southwestern Medical Center; Hamon Center for Regenerative Science and Medicine, University of Texas Southwestern Medical Center;
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8
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Pollyea DA, Winters A, McMahon C, Schwartz M, Jordan CT, Rabinovitch R, Abbott D, Smith CA, Gutman JA. Venetoclax and azacitidine followed by allogeneic transplant results in excellent outcomes and may improve outcomes versus maintenance therapy among newly diagnosed AML patients older than 60. Bone Marrow Transplant 2021; 57:160-166. [PMID: 34645926 DOI: 10.1038/s41409-021-01476-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/06/2021] [Accepted: 09/17/2021] [Indexed: 11/10/2022]
Abstract
The combination of venetoclax (ven) and azacitidine (aza) has resulted in high response rates in the upfront treatment of AML in patients age > 75 and patients unfit for intensive chemotherapy. Given the poor historical outcomes in patients age ≥ 60 treated with induction chemotherapy, ven/aza has become our institutional preference for the initial treatment of non-core binding factor (CBF) AML patients age ≥ 60. The benefit of allogeneic stem cell transplant (SCT) in patients who achieve response to ven/aza is uncertain. We report outcomes of SCT-eligible patients treated at our center. Between 1/2015 and 1/2020, 119 newly diagnosed non-CBF AML patients age ≥ 60 received ven/aza as initial therapy. 21 patients underwent SCT; 31 additional patients were potentially SCT eligible but deferred SCT. Overall survival (OS) was significantly greater among SCT patients (median survival not reached) versus potentially SCT eligible patients not undergoing SCT (median 518 days) (p = 0.01). Our data suggest that ven/aza followed by SCT in newly diagnosed AML patients older than ≥ 60 results in excellent outcomes and likely improves outcomes over maintenance therapy. Ongoing investigation will further refine the optimal timing of and selection of patients for SCT based on prognostic disease features and response assessments.
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Affiliation(s)
| | - Amanda Winters
- Division of Hematology, University of Colorado, Denver, USA
| | | | - Marc Schwartz
- Division of Hematology, University of Colorado, Denver, USA
| | - Craig T Jordan
- Division of Hematology, University of Colorado, Denver, USA
| | | | - Diana Abbott
- Division of Hematology, University of Colorado, Denver, USA
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9
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Maimaitiyiming Y, Wang QQ, Yang C, Ogra Y, Lou Y, Smith CA, Hussain L, Shao YM, Lin J, Liu J, Wang L, Zhu Y, Lou H, Huang Y, Li X, Chang KJ, Chen H, Li H, Huang Y, Tse E, Sun J, Bu N, Chiou SH, Zhang YF, Hua HY, Ma LY, Huang P, Ge MH, Cao FL, Cheng X, Sun H, Zhou J, Vasliou V, Xu P, Jin J, Bjorklund M, Zhu HH, Hsu CH, Naranmandura H. Hyperthermia Selectively Destabilizes Oncogenic Fusion Proteins. Blood Cancer Discov 2021; 2:388-401. [PMID: 34661159 PMCID: PMC8513904 DOI: 10.1158/2643-3230.bcd-20-0188] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 10/19/2020] [Revised: 03/09/2021] [Accepted: 04/27/2021] [Indexed: 11/16/2022] Open
Abstract
The PML/RARα fusion protein is the oncogenic driver in acute promyelocytic leukemia (APL). Although most APL cases are cured by PML/RARα-targeting therapy, relapse and resistance can occur due to drug-resistant mutations. Here we report that thermal stress destabilizes the PML/RARα protein, including clinically identified drug-resistant mutants. AML1/ETO and TEL/AML1 oncofusions show similar heat shock susceptibility. Mechanistically, mild hyperthermia stimulates aggregation of PML/RARα in complex with nuclear receptor corepressors leading to ubiquitin-mediated degradation via the SIAH2 E3 ligase. Hyperthermia and arsenic therapy destabilize PML/RARα via distinct mechanisms and are synergistic in primary patient samples and in vivo, including three refractory APL cases. Collectively, our results suggest that by taking advantage of a biophysical vulnerability of PML/RARα, thermal therapy may improve prognosis in drug-resistant or otherwise refractory APL. These findings serve as a paradigm for therapeutic targeting of fusion oncoprotein-associated cancers by hyperthermia. SIGNIFICANCE Hyperthermia destabilizes oncofusion proteins including PML/RARα and acts synergistically with standard arsenic therapy in relapsed and refractory APL. The results open up the possibility that heat shock sensitivity may be an easily targetable vulnerability of oncofusion-driven cancers.See related commentary by Wu et al., p. 300.
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Affiliation(s)
- Yasen Maimaitiyiming
- Department of Hematology of First Affiliated Hospital, and Department of Public Health, Zhejiang University School of Medicine, Hangzhou, China
- Women's Hospital, Institute of Genetics, and Department of Environmental Medicine, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Laboratory for Systems and Precision Medicine, Zhejiang University Medical Center, Hangzhou, China
| | - Qian Qian Wang
- Department of Hematology of First Affiliated Hospital, and Department of Public Health, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Laboratory for Systems and Precision Medicine, Zhejiang University Medical Center, Hangzhou, China
| | - Chang Yang
- Department of Hematology of First Affiliated Hospital, and Department of Public Health, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Laboratory for Systems and Precision Medicine, Zhejiang University Medical Center, Hangzhou, China
| | - Yasumitsu Ogra
- Department of Toxicology, Graduate School of Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Yinjun Lou
- Department of Hematology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Clayton A. Smith
- Blood Disorders and Cellular Therapies Center, University of Colorado Hospital, Denver, Colorado
| | - Liaqat Hussain
- Department of Hematology of First Affiliated Hospital, and Department of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Ming Shao
- Department of Pharmacology, Inner Mongolia Medical University, Hohhot, China
| | - Jiebo Lin
- Women's Hospital, Institute of Genetics, and Department of Environmental Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinfeng Liu
- Women's Hospital, Institute of Genetics, and Department of Environmental Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Lingfang Wang
- Women's Hospital, Institute of Genetics, and Department of Environmental Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Yong Zhu
- Department of Environmental Sciences, Yale University School of Public Health, New Haven, Connecticut
| | - Haiyan Lou
- Department of Hematology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuan Huang
- Zhejiang Province Lishui Municipal Hospital, Lishui, China
| | - Xiaoxia Li
- Department of Hematology, the First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Kao-Jung Chang
- Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan, China
| | - Hao Chen
- Division of Newborn Medicine and Program in Epigenetics, Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hongyan Li
- Department of Chemistry, the University of Hong Kong, Hong Kong, China
| | - Ying Huang
- Institute of Genetics, Zhejiang University, and Department of Genetics, School of Medicine, Zhejiang University, Hangzhou, China
| | - Eric Tse
- Department of Medicine, the University of Hong Kong and Queen Mary Hospital, Hong Kong, China
| | - Jie Sun
- Department of Hematology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Na Bu
- Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Shih-Hwa Chiou
- Taipei Veterans General Hospital Department of Medical Research, Taipei, Taiwan, China
| | - Yan Fang Zhang
- Department of Hematology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | | | - Li Ya Ma
- Department of Hematology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ping Huang
- Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Ming Hua Ge
- Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Feng-Lin Cao
- Department of Hematology, the First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Xiaodong Cheng
- Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hongzhe Sun
- Department of Chemistry, the University of Hong Kong, Hong Kong, China
| | - Jin Zhou
- Department of Hematology, the First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Vasilis Vasliou
- Department of Environmental Sciences, Yale University School of Public Health, New Haven, Connecticut
| | - Pengfei Xu
- Institute of Genetics, Zhejiang University, and Department of Genetics, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Jin
- Department of Hematology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mikael Bjorklund
- Zhejiang University–University of Edinburgh Institute, Zhejiang University School of Medicine, Hangzhou, China
| | - Hong-Hu Zhu
- Zhejiang Laboratory for Systems and Precision Medicine, Zhejiang University Medical Center, Hangzhou, China
- Department of Hematology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chih-Hung Hsu
- Women's Hospital, Institute of Genetics, and Department of Environmental Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Hua Naranmandura
- Department of Hematology of First Affiliated Hospital, and Department of Public Health, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Laboratory for Systems and Precision Medicine, Zhejiang University Medical Center, Hangzhou, China
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10
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Abstract
Over the past several decades numerous preclinical and clinical studies have pursued new approaches for the treatment of acute myeloid leukemia (AML). While some degree of clinical response has been demonstrated for many therapies, for the most part, fundamental changes in the treatment landscape have been lacking. Recently, the use of the BCL-2 inhibitor venetoclax has emerged as a potent therapy for a majority of newly diagnosed AML patients. Venetoclax regimens have shown broad response rates with deep and durable remissions, with a superior toxicity profile compared with traditional intensive chemotherapy agents. Numerous ongoing studies are now using venetoclax in combination with a wide range of other agents as investigators seek even more effective and well-tolerated regimens. Notably, however, while the empirical results of BCL-2 inhibition are encouraging, the mechanisms that have led to these successful clinical outcomes remain unclear. Intriguingly, the activity of venetoclax in AML patients appears to go beyond simply modulating canonical antiapoptosis mechanisms; in addition, the efficacy of venetoclax is linked to its combined use with conventional low-intensity backbone therapies. This article will evaluate the state of the field, provide a summary of key considerations, and propose directions for future studies.
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Affiliation(s)
- Daniel A. Pollyea
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado 80045, USA
| | - Shanshan Pei
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado 80045, USA
| | - Brett M. Stevens
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado 80045, USA
| | - Clayton A. Smith
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado 80045, USA
| | - Craig T. Jordan
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado 80045, USA
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11
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Walker ZJ, Idler BM, Davis LN, Stevens BM, VanWyngarden MJ, Ohlstrom D, Bearrows SC, Hammes A, Smith CA, Jordan CT, Mark TM, Forsberg PA, Sherbenou DW. Exploiting Protein Translation Dependence in Multiple Myeloma with Omacetaxine-Based Therapy. Clin Cancer Res 2020; 27:819-830. [PMID: 33109736 DOI: 10.1158/1078-0432.ccr-20-2246] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/18/2020] [Accepted: 10/22/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE The prognosis of patients with multiple myeloma who are resistant to proteasome inhibitors, immunomodulatory drugs (IMiD), and daratumumab is extremely poor. Even B-cell maturation antigen-specific chimeric antigen receptor T-cell therapies provide only a temporary benefit before patients succumb to their disease. In this article, we interrogate the unique sensitivity of multiple myeloma cells to the alternative strategy of blocking protein translation with omacetaxine. EXPERIMENTAL DESIGN We determined protein translation levels (n = 17) and sensitivity to omacetaxine (n = 51) of primary multiple myeloma patient samples. Synergy was evaluated between omacetaxine and IMiDs in vitro, ex vivo, and in vivo. Underlying mechanism was investigated via proteomic analysis. RESULTS Almost universally, primary patient multiple myeloma cells exhibit >2.5-fold increased rates of protein translation compared with normal marrow cells. Ex vivo treatment with omacetaxine resulted in >50% reduction in viable multiple myeloma cells. In this cohort, high levels of translation serve as a biomarker for patient multiple myeloma cell sensitivity to omacetaxine. Unexpectedly, omacetaxine demonstrated synergy with IMiDs in multiple myeloma cell lines in vitro. In addition, in an IMiD-resistant relapsed patient sample, omacetaxine/IMiD combination treatment resensitized the multiple myeloma cells to the IMiD. Proteomic analysis found that the omacetaxine/IMiD combination treatment produced a double-hit on the IRF4/c-MYC pathway, which is critical to multiple myeloma survival. CONCLUSIONS Overall, protein translation inhibitors represent a potential new drug class for myeloma treatment and provide a rationale for conducting clinical trials with omacetaxine alone and in combination with IMiDs for patients with relapsed/refractory multiple myeloma.
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Affiliation(s)
- Zachary J Walker
- Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Beau M Idler
- Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Lorraine N Davis
- Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Brett M Stevens
- Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Michael J VanWyngarden
- Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Denis Ohlstrom
- Biomedical Sciences and Biotechnology, Graduate School, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Shelby C Bearrows
- Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Andrew Hammes
- Center for Innovative Design and Analysis, Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Clayton A Smith
- Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,University of Colorado Cancer Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Craig T Jordan
- Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,University of Colorado Cancer Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Tomer M Mark
- Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Peter A Forsberg
- Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Daniel W Sherbenou
- Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado. .,University of Colorado Cancer Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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12
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Jonk Y, Snow KI, Thayer D, McGuire C, Bratesman S, Smith CA, Ziller E. Pent-up demand for care among dual-eligible victims of elder financial exploitation in Maine. J Elder Abuse Negl 2020; 32:334-356. [PMID: 32886027 DOI: 10.1080/08946566.2020.1806980] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Elder financial exploitation (EFE), the misuse of a vulnerable adult's property or resources for personal gain, is a form of elder abuse. This study addresses whether dual-eligible EFE victims were experiencing pent-up demand for health services alleviated through investigation by Adult Protective Services (APS). A quasi-experimental design addressed health service utilization and costs for 131 dual-eligible Maine APS clients over age 60 with substantiated allegations of EFE relative to comparable non-APS controls. APS case files spanning 2007-2012 were linked to 2006-2014 Medicare and Medicaid claims data. Service utilization and costs were analyzed 1 year prior, during, and 2 years after the initial APS investigation. Difference in differences logistic regression and generalized linear models addressed the likelihood of incurring costs and expenditure levels relative to matched controls, respectively. Victims of EFE had higher overall odds of using inpatient and long-term services and supports (LTSS) and higher odds of using LTSS post-investigation than controls. Higher overall levels of outpatient and prescriptions expenditures and higher inpatient expenditures during the APS event year contributed toward APS clients incurring $1,142 higher PMPM total costs than controls. Victims of EFE were experiencing significant pent-up demand for health services post-APS involvement.
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Affiliation(s)
- Yvonne Jonk
- Muskie School of Public Service, University of Southern Maine , Portland, ME, USA
| | - Kimberly I Snow
- Muskie School of Public Service, University of Southern Maine , Portland, ME, USA
| | - D Thayer
- Muskie School of Public Service, University of Southern Maine , Portland, ME, USA
| | - C McGuire
- Muskie School of Public Service, University of Southern Maine , Portland, ME, USA
| | - S Bratesman
- Muskie School of Public Service, University of Southern Maine , Portland, ME, USA
| | - C A Smith
- School of Social Work, University of Maryland , Baltimore, School of Social Work, MD, USA
| | - E Ziller
- Muskie School of Public Service, University of Southern Maine , Portland, ME, USA
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13
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Jones CL, Stevens BM, Pollyea DA, Culp-Hill R, Reisz JA, Nemkov T, Gehrke S, Gamboni F, Krug A, Winters A, Pei S, Gustafson A, Ye H, Inguva A, Amaya M, Minhajuddin M, Abbott D, Becker MW, DeGregori J, Smith CA, D'Alessandro A, Jordan CT. Nicotinamide Metabolism Mediates Resistance to Venetoclax in Relapsed Acute Myeloid Leukemia Stem Cells. Cell Stem Cell 2020; 27:748-764.e4. [PMID: 32822582 DOI: 10.1016/j.stem.2020.07.021] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [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: 10/12/2019] [Revised: 02/28/2020] [Accepted: 07/29/2020] [Indexed: 12/31/2022]
Abstract
We previously demonstrated that leukemia stem cells (LSCs) in de novo acute myeloid leukemia (AML) patients are selectively reliant on amino acid metabolism and that treatment with the combination of venetoclax and azacitidine (ven/aza) inhibits amino acid metabolism, leading to cell death. In contrast, ven/aza fails to eradicate LSCs in relapsed/refractory (R/R) patients, suggesting altered metabolic properties. Detailed metabolomic analysis revealed elevated nicotinamide metabolism in relapsed LSCs, which activates both amino acid metabolism and fatty acid oxidation to drive OXPHOS, thereby providing a means for LSCs to circumvent the cytotoxic effects of ven/aza therapy. Genetic and pharmacological inhibition of nicotinamide phosphoribosyltransferase (NAMPT), the rate-limiting enzyme in nicotinamide metabolism, demonstrated selective eradication of R/R LSCs while sparing normal hematopoietic stem/progenitor cells. Altogether, these findings demonstrate that elevated nicotinamide metabolism is both the mechanistic basis for ven/aza resistance and a metabolic vulnerability of R/R LSCs.
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Affiliation(s)
- Courtney L Jones
- Division of Hematology, University of Colorado Denver, Aurora, CO 80045, USA.
| | - Brett M Stevens
- Division of Hematology, University of Colorado Denver, Aurora, CO 80045, USA
| | - Daniel A Pollyea
- Division of Hematology, University of Colorado Denver, Aurora, CO 80045, USA
| | - Rachel Culp-Hill
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, CO 80045, USA
| | - Julie A Reisz
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, CO 80045, USA
| | - Travis Nemkov
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, CO 80045, USA
| | - Sarah Gehrke
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, CO 80045, USA
| | - Fabia Gamboni
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, CO 80045, USA
| | - Anna Krug
- Division of Hematology, University of Colorado Denver, Aurora, CO 80045, USA
| | - Amanda Winters
- Division of Hematology, University of Colorado Denver, Aurora, CO 80045, USA
| | - Shanshan Pei
- Division of Hematology, University of Colorado Denver, Aurora, CO 80045, USA
| | - Annika Gustafson
- Division of Hematology, University of Colorado Denver, Aurora, CO 80045, USA
| | - Haobin Ye
- Division of Hematology, University of Colorado Denver, Aurora, CO 80045, USA
| | - Anagha Inguva
- Division of Hematology, University of Colorado Denver, Aurora, CO 80045, USA
| | - Maria Amaya
- Division of Hematology, University of Colorado Denver, Aurora, CO 80045, USA
| | | | - Diana Abbott
- Department of Biostatistics and Informatics, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Michael W Becker
- Department of Medicine, Division of Hematology/Oncology, University of Rochester, Rochester, NY 14627, USA
| | - James DeGregori
- Division of Hematology, University of Colorado Denver, Aurora, CO 80045, USA; Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, CO 80045, USA
| | - Clayton A Smith
- Division of Hematology, University of Colorado Denver, Aurora, CO 80045, USA
| | - Angelo D'Alessandro
- Division of Hematology, University of Colorado Denver, Aurora, CO 80045, USA; Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, CO 80045, USA
| | - Craig T Jordan
- Division of Hematology, University of Colorado Denver, Aurora, CO 80045, USA.
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14
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Smith CA, Nolan J, Tritz DJ, Heavener TE, Pelton J, Cook K, Vassar M. Evaluation of reproducible and transparent research practices in pulmonology. Pulmonology 2020; 27:134-143. [PMID: 32739326 DOI: 10.1016/j.pulmoe.2020.07.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 07/01/2020] [Accepted: 07/03/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Study reproducibility is valuable for validating or refuting results. Provision of reproducibility indicators, such as materials, protocols, and raw data in a study improve its potential for reproduction. Efforts to reproduce noteworthy studies in the biomedical sciences have resulted in an overwhelming majority of them being found to be unreplicable, causing concern for the integrity of research in other fields, including medical specialties. Here, we analyzed the reproducibility of studies in the field of pulmonology. METHODS 500 pulmonology articles were randomly selected from an initial PubMed search for data extraction. Two authors scoured these articles for reproducibility indicators including materials, protocols, raw data, analysis scripts, inclusion in systematic reviews, and citations by replication studies as well as other factors of research transparency including open accessibility, funding source and competing interest disclosures, and study preregistration. FINDINGS Few publications included statements regarding materials (10%), protocols (1%), data (15%), and analysis script (0%) availability. Less than 10% indicated preregistration. More than half of the publications analyzed failed to provide a funding statement. Conversely, 63% of the publications were open access and 73% included a conflict of interest statement. INTERPRETATION Overall, our study indicates pulmonology research is currently lacking in efforts to increase replicability. Future studies should focus on providing sufficient information regarding materials, protocols, raw data, and analysis scripts, among other indicators, for the sake of clinical decisions that depend on replicable or refutable results from the primary literature.
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Affiliation(s)
- C A Smith
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, 1111 W. 17th St., Tulsa, OK 74107 USA.
| | - J Nolan
- Kansas City University of Medicine and Biosciences, 2901 St Johns Blvd, Joplin, MO 64804, USA
| | - D J Tritz
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, 1111 W. 17th St., Tulsa, OK 74107 USA
| | - T E Heavener
- Department of Medicine, Citizens Memorial Hospital, 1500 N. Oakland Ave, Bolivar, MO 65613 USA
| | - J Pelton
- Department of Internal Medicine, Oklahoma State University Medical Center, 744 W. 9th St., Tulsa, OK 74127 USA
| | - K Cook
- Department of Internal Medicine, Oklahoma State University Medical Center, 744 W. 9th St., Tulsa, OK 74127 USA
| | - M Vassar
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, 1111 W. 17th St., Tulsa, OK 74107 USA
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15
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Smith CA, Tuson A, Thornton C, Dahlen HG. The safety and effectiveness of mind body interventions for women with pregnancy induced hypertension and or preeclampsia: A systematic review and meta-analysis. Complement Ther Med 2020; 52:102469. [PMID: 32951719 DOI: 10.1016/j.ctim.2020.102469] [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] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES To undertake a systematic review of the safety and effectiveness of mind body approaches for women with hypertensive disorders in pregnancy (HDP). DESIGN A search was undertaken of databases from inception to 2019 for randomised and quasi randomised controlled trials. MAIN OUTCOME MEASURES The primary outcome was a reduction in systolic and / or diastolic blood pressure for women with hypertension and or preeclampsia in pregnancy. RESULTS 121 studies were identified and eight studies were included in this review. These included mind body interventions examining yoga, guided imagery, relaxation, music, and acupuncture for HDP. Two studies of relaxation found a reduction in systolic (MD -11.3, 95%CI -13.23 to -9.39) and diastolic blood pressure (MD -6.59, 95%CI -9.43 to -3.75) and reduced stress (MD -11.4, 95%CI -16.5 to -6.3). In one study of yoga, the risk of developing HDP was reduced (RR 0.28, 95% CI 0.09 to 0.91, 59 women) and a second study found a reduction in stress at the end of the intervention of yoga. One trial of guided imagery found a reduction in mean arterial blood pressure compared to the control (4.35, 95% -8.04 to -0.66, p=0.02). Overall there was no effect on the development of preeclampsia, use of anti-hypertensive medication and any neonatal outcomes from the interventions evaluated. Few trials reported on safety outcomes, one trial of acupuncture reported one case of placental abruption and three cases of acupuncture related side effects. CONCLUSION Few high quality trials have examined the effectiveness and safety of mind body interventions to manage HDP. Relaxation, yoga, guided imagery and music may have some potential benefit. Safety issues are completely unclear and thus the risk-benefit ratio of all interventions could not be determined. Further research is recommended.
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Affiliation(s)
- C A Smith
- NICM Health Research Institute, Western Sydney University, Penrith, 2751, Australia.
| | - A Tuson
- Registered Midwife and Western Sydney University Summer Scholar, Western Sydney University Penrith, 2751, Australia.
| | - Charlene Thornton
- College of Nursing and Health Sciences, Flinders University, Bedford Park, 5042, Australia.
| | - Hannah G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Penrith, 2751, Australia.
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16
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Rygg JR, Smith RF, Lazicki AE, Braun DG, Fratanduono DE, Kraus RG, McNaney JM, Swift DC, Wehrenberg CE, Coppari F, Ahmed MF, Barrios MA, Blobaum KJM, Collins GW, Cook AL, Di Nicola P, Dzenitis EG, Gonzales S, Heidl BF, Hohenberger M, House A, Izumi N, Kalantar DH, Khan SF, Kohut TR, Kumar C, Masters ND, Polsin DN, Regan SP, Smith CA, Vignes RM, Wall MA, Ward J, Wark JS, Zobrist TL, Arsenlis A, Eggert JH. X-ray diffraction at the National Ignition Facility. Rev Sci Instrum 2020; 91:043902. [PMID: 32357733 DOI: 10.1063/1.5129698] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 03/20/2020] [Indexed: 06/11/2023]
Abstract
We report details of an experimental platform implemented at the National Ignition Facility to obtain in situ powder diffraction data from solids dynamically compressed to extreme pressures. Thin samples are sandwiched between tamper layers and ramp compressed using a gradual increase in the drive-laser irradiance. Pressure history in the sample is determined using high-precision velocimetry measurements. Up to two independently timed pulses of x rays are produced at or near the time of peak pressure by laser illumination of thin metal foils. The quasi-monochromatic x-ray pulses have a mean wavelength selectable between 0.6 Å and 1.9 Å depending on the foil material. The diffracted signal is recorded on image plates with a typical 2θ x-ray scattering angle uncertainty of about 0.2° and resolution of about 1°. Analytic expressions are reported for systematic corrections to 2θ due to finite pinhole size and sample offset. A new variant of a nonlinear background subtraction algorithm is described, which has been used to observe diffraction lines at signal-to-background ratios as low as a few percent. Variations in system response over the detector area are compensated in order to obtain accurate line intensities; this system response calculation includes a new analytic approximation for image-plate sensitivity as a function of photon energy and incident angle. This experimental platform has been used up to 2 TPa (20 Mbar) to determine the crystal structure, measure the density, and evaluate the strain-induced texturing of a variety of compressed samples spanning periods 2-7 on the periodic table.
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Affiliation(s)
- J R Rygg
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - R F Smith
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - A E Lazicki
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - D G Braun
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - D E Fratanduono
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - R G Kraus
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - J M McNaney
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - D C Swift
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - C E Wehrenberg
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - F Coppari
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - M F Ahmed
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - M A Barrios
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - K J M Blobaum
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - G W Collins
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - A L Cook
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - P Di Nicola
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - E G Dzenitis
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - S Gonzales
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - B F Heidl
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - M Hohenberger
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - A House
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - N Izumi
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - D H Kalantar
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - S F Khan
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - T R Kohut
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - C Kumar
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - N D Masters
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - D N Polsin
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623, USA
| | - S P Regan
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623, USA
| | - C A Smith
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - R M Vignes
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - M A Wall
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - J Ward
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - J S Wark
- Department of Physics, Clarendon Laboratory, University of Oxford, Parks Road, Oxford OX1 3PU, United Kingdom
| | - T L Zobrist
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - A Arsenlis
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - J H Eggert
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
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Pei S, Pollyea DA, Gustafson A, Stevens BM, Minhajuddin M, Fu R, Riemondy KA, Gillen AE, Sheridan RM, Kim J, Costello JC, Amaya ML, Inguva A, Winters A, Ye H, Krug A, Jones CL, Adane B, Khan N, Ponder J, Schowinsky J, Abbott D, Hammes A, Myers JR, Ashton JM, Nemkov T, D'Alessandro A, Gutman JA, Ramsey HE, Savona MR, Smith CA, Jordan CT. Monocytic Subclones Confer Resistance to Venetoclax-Based Therapy in Patients with Acute Myeloid Leukemia. Cancer Discov 2020; 10:536-551. [PMID: 31974170 PMCID: PMC7124979 DOI: 10.1158/2159-8290.cd-19-0710] [Citation(s) in RCA: 221] [Impact Index Per Article: 55.3] [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: 06/26/2019] [Revised: 12/03/2019] [Accepted: 01/17/2020] [Indexed: 12/12/2022]
Abstract
Venetoclax-based therapy can induce responses in approximately 70% of older previously untreated patients with acute myeloid leukemia (AML). However, up-front resistance as well as relapse following initial response demonstrates the need for a deeper understanding of resistance mechanisms. In the present study, we report that responses to venetoclax +azacitidine in patients with AML correlate closely with developmental stage, where phenotypically primitive AML is sensitive, but monocytic AML is more resistant. Mechanistically, resistant monocytic AML has a distinct transcriptomic profile, loses expression of venetoclax target BCL2, and relies on MCL1 to mediate oxidative phosphorylation and survival. This differential sensitivity drives a selective process in patients which favors the outgrowth of monocytic subpopulations at relapse. Based on these findings, we conclude that resistance to venetoclax + azacitidine can arise due to biological properties intrinsic to monocytic differentiation. We propose that optimal AML therapies should be designed so as to independently target AML subclones that may arise at differing stages of pathogenesis. SIGNIFICANCE: Identifying characteristics of patients who respond poorly to venetoclax-based therapy and devising alternative therapeutic strategies for such patients are important topics in AML. We show that venetoclax resistance can arise due to intrinsic molecular/metabolic properties of monocytic AML cells and that such properties can potentially be targeted with alternative strategies.
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Affiliation(s)
- Shanshan Pei
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado
| | - Daniel A Pollyea
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado
| | - Annika Gustafson
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado
| | - Brett M Stevens
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado
| | - Mohammad Minhajuddin
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado
| | - Rui Fu
- RNA Bioscience Initiative, University of Colorado School of Medicine, Aurora, Colorado
| | - Kent A Riemondy
- RNA Bioscience Initiative, University of Colorado School of Medicine, Aurora, Colorado
| | - Austin E Gillen
- RNA Bioscience Initiative, University of Colorado School of Medicine, Aurora, Colorado
| | - Ryan M Sheridan
- RNA Bioscience Initiative, University of Colorado School of Medicine, Aurora, Colorado
| | - Jihye Kim
- Division of Medical Oncology, University of Colorado School of Medicine, Aurora, Colorado
| | - James C Costello
- Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Maria L Amaya
- Division of Medical Oncology, University of Colorado School of Medicine, Aurora, Colorado
| | - Anagha Inguva
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado
| | - Amanda Winters
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Haobin Ye
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado
| | - Anna Krug
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado
| | - Courtney L Jones
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado
| | - Biniam Adane
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado
| | - Nabilah Khan
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado
| | - Jessica Ponder
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado
| | - Jeffrey Schowinsky
- Department of Pathology, University of Colorado School of Medicine, Aurora, Colorado
| | - Diana Abbott
- Center for Innovative Design and Analysis, Colorado School of Public Health, Aurora, Colorado
| | - Andrew Hammes
- Center for Innovative Design and Analysis, Colorado School of Public Health, Aurora, Colorado
| | - Jason R Myers
- Genomics Research Center, University of Rochester, Rochester, New York
| | - John M Ashton
- Genomics Research Center, University of Rochester, Rochester, New York
| | - Travis Nemkov
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, Colorado
| | - Angelo D'Alessandro
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Aurora, Colorado
| | - Jonathan A Gutman
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado
| | - Haley E Ramsey
- Department of Internal Medicine, Vanderbilt University School of Medicine, Vanderbilt-Ingram Cancer Center, Nashville, Tennessee
| | - Michael R Savona
- Department of Internal Medicine, Vanderbilt University School of Medicine, Vanderbilt-Ingram Cancer Center, Nashville, Tennessee
| | - Clayton A Smith
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado
| | - Craig T Jordan
- Division of Hematology, University of Colorado School of Medicine, Aurora, Colorado.
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18
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Smith CA, McCracken C, Thomas AS, Spector LG, St Louis JD, Oster ME, Moller JH, Kochilas L. Long-term Outcomes of Tetralogy of Fallot: A Study From the Pediatric Cardiac Care Consortium. JAMA Cardiol 2020; 4:34-41. [PMID: 30566184 DOI: 10.1001/jamacardio.2018.4255] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Importance Tetralogy of Fallot (TOF) is a surgically repairable form of cyanotic congenital heart disease. Multicenter data for long-term survival following repair are sparse. Objective To evaluate the long-term transplant-free survival of TOF by surgical strategy adjusted for era and patient characteristics. Design, Setting, and Participants Retrospective cohort study enriched with data from the National Death Index and the Organ Procurement and Transplantation Network through 2014. Multicenter cohort from the Pediatric Cardiac Care Consortium (PCCC), a large, US-based clinical registry for interventions for congenital heart disease. The cohort included patients with adequate identifiers for linkage with the National Death Index and the Organ Procurement and Transplantation Network who were enrolled in the PCCC registry between 1982 and 2003 and survived surgical repair of simple TOF. Data were analyzed between September 2015 and April 2018. Exposures We examined patient-associated and surgery-associated risk factors affecting survival. Main Outcomes and Measures We analyzed the transplant-free survival during early (<6 years) and late (≥6 years) phase after TOF surgical repair. Results Of the 3283 patients who survived repair for simple TOF and met the study's inclusion criteria, 56.4% were male and 43.6% were female. Twenty-five-year survival following TOF repair was 94.5%. Multivariable analysis demonstrated increased risk of early mortality with staged repair (HR, 2.68; 95% CI, 1.59-4.49) and non-valve-sparing operation (HR, 3.76; 95% CI, 1.53-9.19). Presence of a genetic abnormality was associated with increased risk of death both in the early (HR, 3.64; 95% CI, 2.05-6.47) and late postoperative phase (HR, 4.41; 95% CI, 2.62-7.44). Conclusions and Relevance Long-term survival after simple TOF repair is excellent. Staged repair and non-valve-sparing operations were negatively associated with survival in the early postrepair phase but not the late postrepair phase. These data are important for patients with repaired TOF and their caretakers and may guide surgical strategies for optimizing the long-term outcomes of this population.
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Affiliation(s)
- Clayton A Smith
- Department of Pediatrics, Emory University School of Medicine.,Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Courtney McCracken
- Department of Pediatrics, Emory University School of Medicine.,Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Amanda S Thomas
- Department of Pediatrics, Emory University School of Medicine
| | - Logan G Spector
- Department of Pediatrics, University of Minnesota, Minneapolis
| | - James D St Louis
- Department of Pediatric Surgery, University of Missouri, Kansas City School of Medicine
| | - Matthew E Oster
- Department of Pediatrics, Emory University School of Medicine.,Children's Healthcare of Atlanta, Atlanta, Georgia
| | - James H Moller
- Department of Internal Medicine, University of Minnesota, Minneapolis
| | - Lazaros Kochilas
- Department of Pediatrics, Emory University School of Medicine.,Children's Healthcare of Atlanta, Atlanta, Georgia
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19
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Weingarten AJ, Menachem JN, Smith CA, Frischhertz BP, Book WM. Usefulness of midodrine in protein-losing enteropathy. J Heart Lung Transplant 2019; 38:784-787. [DOI: 10.1016/j.healun.2019.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 04/01/2019] [Accepted: 04/07/2019] [Indexed: 01/23/2023] Open
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20
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Smith CA, Oster M, Kochilas L. We Can Learn From the Past, but We Must Pave the Future of Congenital Heart Disease Research-Reply. JAMA Cardiol 2019; 4:600. [PMID: 31017614 DOI: 10.1001/jamacardio.2019.1076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Clayton A Smith
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.,Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Matt Oster
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.,Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Lazaros Kochilas
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.,Children's Healthcare of Atlanta, Atlanta, Georgia
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21
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Ewings RA, Stewart JR, Perring TG, Bewley RI, Le MD, Raspino D, Pooley DE, Škoro G, Waller SP, Zacek D, Smith CA, Riehl-Shaw RC. Upgrade to the MAPS neutron time-of-flight chopper spectrometer. Rev Sci Instrum 2019; 90:035110. [PMID: 30927771 DOI: 10.1063/1.5086255] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/01/2019] [Indexed: 05/23/2023]
Abstract
The MAPS direct geometry time-of-flight chopper spectrometer at the ISIS pulsed neutron and muon source has been in operation since 1999, and its novel use of a large array of position-sensitive neutron detectors paved the way for a later generations of chopper spectrometers around the world. Almost two decades of experience of user operations on MAPS, together with lessons learned from the operation of new generation instruments, led to a decision to perform three parallel upgrades to the instrument. These were to replace the primary beamline collimation with supermirror neutron guides, to install a disk chopper, and to modify the geometry of the poisoning in the water moderator viewed by MAPS. Together, these upgrades were expected to increase the neutron flux substantially, to allow more flexible use of repetition rate multiplication and to reduce some sources of background. Here, we report the details of these upgrades and compare the performance of the instrument before and after their installation as well as to Monte Carlo simulations. These illustrate that the instrument is performing in line with, and in some respects in excess of, expectations. It is anticipated that the improvement in performance will have a significant impact on the capabilities of the instrument. A few examples of scientific commissioning are presented to illustrate some of the possibilities.
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Affiliation(s)
- R A Ewings
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - J R Stewart
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - T G Perring
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - R I Bewley
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - M D Le
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - D Raspino
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - D E Pooley
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - G Škoro
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - S P Waller
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - D Zacek
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - C A Smith
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 0QX, United Kingdom
| | - R C Riehl-Shaw
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 0QX, United Kingdom
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22
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Gasparetto M, Pei S, Minhajuddin M, Stevens B, Smith CA, Seligman P. Low ferroportin expression in AML is correlated with good risk cytogenetics, improved outcomes and increased sensitivity to chemotherapy. Leuk Res 2019; 80:1-10. [PMID: 30852438 DOI: 10.1016/j.leukres.2019.02.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 02/25/2019] [Accepted: 02/27/2019] [Indexed: 12/31/2022]
Abstract
Iron metabolism is altered in a variety of cancers; however, little is known about the role of iron metabolism in the biology and response to therapy of acute myeloid leukemia (AML). Here we show that SLC40A1, the gene encoding the iron exporter ferroportin (FPN), is variably expressed among primary AMLs and that low levels are associated with good prognosis and improved outcomes. In particular, core binding factor (CBF) AMLs, which are associated with good outcomes with chemotherapy, consistently have low level of SLC40A1 expression. AML cell lines that expressed relatively low levels of FPN endogenously, or were engineered via gene knockdown, had an increased sensitivity to chemotherapy relative to controls expressing high levels of FPN. Primary FPNlow AML bulk cells also had increased sensitivity to Ara-C treatment, iron treatment and the combination of Ara-C and iron relative to FPNhigh cells. FPNlow leukemic stem cells (LSCs) had decreased viability following addition of iron alone and in combination with Ara-C treatment relative to FPNhigh LSCs. Together these observations suggest a model where FPN mediated iron metabolism may play a role in chemosensitivity and outcome to therapy in AML.
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Affiliation(s)
- Maura Gasparetto
- Division of Hematology, University of Colorado Medical Center, Aurora, CO, USA.
| | - Shanshan Pei
- Division of Hematology, University of Colorado Medical Center, Aurora, CO, USA
| | | | - Brett Stevens
- Division of Hematology, University of Colorado Medical Center, Aurora, CO, USA
| | - Clayton A Smith
- Division of Hematology, University of Colorado Medical Center, Aurora, CO, USA
| | - Paul Seligman
- Division of Hematology, University of Colorado Medical Center, Aurora, CO, USA
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23
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Smith CA, Kachnic LA. Evolving Treatment Paradigm in the Treatment of Locally Advanced Rectal Cancer. J Natl Compr Canc Netw 2018; 16:909-915. [PMID: 30006431 DOI: 10.6004/jnccn.2018.7032] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/10/2018] [Indexed: 11/17/2022]
Abstract
Locally advanced rectal cancer (LARC) carries higher risks of local and distant recurrence when treated with surgical resection alone. Multiple treatment strategies have been investigated to reduce recurrence risk and improve survival. Currently, there are 3 primary strategies for managing LARC: (1) preoperative long-course radiotherapy (RT) combined with radiosensitizing chemotherapy, which is better tolerated than postoperative chemoradiotherapy and provides tumor downstaging and improved pathologic complete response (pCR), followed by postoperative chemotherapy; (2) preoperative short-course RT alone as an alternative strategy for reducing the risk of local recurrence, followed by adjuvant postoperative chemotherapy; and (3) total neoadjuvant therapy with induction chemotherapy followed by chemoradiotherapy to improve pCR and reduce the difficulty of delivering chemotherapy in the postoperative setting. In addition to these currently recommended treatment paradigms, promising new strategies are available for treatment reduction. Neoadjuvant chemotherapy alone may allow for omission of RT in select patients with favorable LARC. For patients who have complete clinical responses to neoadjuvant chemotherapy and RT, nonoperative management is being considered for sphincter preservation, with surgery used as salvage. These are active areas of investigation in both institutional and cooperative group trials. The results are anticipated to provide better tailoring of neoadjuvant therapy based on patient tumor and disease response characteristics.
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24
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Pei S, Minhajuddin M, Adane B, Khan N, Stevens BM, Mack SC, Lai S, Rich JN, Inguva A, Shannon KM, Kim H, Tan AC, Myers JR, Ashton JM, Neff T, Pollyea DA, Smith CA, Jordan CT. AMPK/FIS1-Mediated Mitophagy Is Required for Self-Renewal of Human AML Stem Cells. Cell Stem Cell 2018; 23:86-100.e6. [PMID: 29910151 DOI: 10.1016/j.stem.2018.05.021] [Citation(s) in RCA: 159] [Impact Index Per Article: 26.5] [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: 10/24/2017] [Revised: 03/30/2018] [Accepted: 05/21/2018] [Indexed: 12/24/2022]
Abstract
Leukemia stem cells (LSCs) are thought to drive the genesis of acute myeloid leukemia (AML) as well as relapse following chemotherapy. Because of their unique biology, developing effective methods to eradicate LSCs has been a significant challenge. In the present study, we demonstrate that intrinsic overexpression of the mitochondrial dynamics regulator FIS1 mediates mitophagy activity that is essential for primitive AML cells. Depletion of FIS1 attenuates mitophagy and leads to inactivation of GSK3, myeloid differentiation, cell cycle arrest, and a profound loss of LSC self-renewal potential. Further, we report that the central metabolic stress regulator AMPK is also intrinsically activated in LSC populations and is upstream of FIS1. Inhibition of AMPK signaling recapitulates the biological effect of FIS1 loss. These data suggest a model in which LSCs co-opt AMPK/FIS1-mediated mitophagy as a means to maintain stem cell properties that may be otherwise compromised by the stresses induced by oncogenic transformation.
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Affiliation(s)
- Shanshan Pei
- Division of Hematology, University of Colorado, Aurora, CO 80045, USA
| | | | - Biniam Adane
- Division of Hematology, University of Colorado, Aurora, CO 80045, USA
| | - Nabilah Khan
- Division of Hematology, University of Colorado, Aurora, CO 80045, USA
| | - Brett M Stevens
- Division of Hematology, University of Colorado, Aurora, CO 80045, USA
| | - Stephen C Mack
- Department of Stem Cell Biology and Regenerative Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Sisi Lai
- Department of Stem Cell Biology and Regenerative Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Jeremy N Rich
- Department of Stem Cell Biology and Regenerative Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Anagha Inguva
- Division of Hematology, University of Colorado, Aurora, CO 80045, USA
| | - Kevin M Shannon
- Department of Pediatrics, University of California - San Francisco, San Francisco, CA 94143, USA
| | - Hyunmin Kim
- Division of Medical Oncology, Department of Medicine, University of Colorado, Aurora, CO 80045, USA
| | - Aik-Choon Tan
- Division of Medical Oncology, Department of Medicine, University of Colorado, Aurora, CO 80045, USA
| | - Jason R Myers
- Genomics Research Center, University of Rochester, NY 14642, USA
| | - John M Ashton
- Genomics Research Center, University of Rochester, NY 14642, USA
| | - Tobias Neff
- Department of Pediatrics, Section of Pediatric Hematology/Oncology/Bone Marrow Transplantation, University of Colorado Denver, Aurora, CO 80045, USA
| | - Daniel A Pollyea
- Division of Hematology, University of Colorado, Aurora, CO 80045, USA
| | - Clayton A Smith
- Division of Hematology, University of Colorado, Aurora, CO 80045, USA
| | - Craig T Jordan
- Division of Hematology, University of Colorado, Aurora, CO 80045, USA.
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25
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Sharma P, Pollyea DA, Smith CA, Purev E, Kamdar M, Haverkos B, Sherbenou D, Rabinovitch R, Hammes A, Gutman JA. Thiotepa-Based Intensified Reduced-Intensity Conditioning Adult Double-Unit Cord Blood Hematopoietic Stem Cell Transplantation Results in Decreased Relapse Rate and Improved Survival Compared with Transplantation Following Standard Reduced-Intensity Conditioning: A Retrospective Cohort Comparison. Biol Blood Marrow Transplant 2018; 24:1671-1677. [PMID: 29684565 DOI: 10.1016/j.bbmt.2018.04.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 11/10/2017] [Accepted: 04/14/2018] [Indexed: 12/24/2022]
Abstract
The "Minnesota" reduced-intensity conditioning (RIC) cord blood transplantation (CBT) regimen (standard RIC) of fludarabine (Flu) (200 mg/m2), cyclophosphamide (Cy) (50 mg/kg), and 200- or 300-cGy total body irradiation (TBI) is the most published RIC CBT regimen. Though well tolerated, high relapse rates remain a concern with this regimen. Intensification of conditioning may reduce relapse without increasing transplant-related mortality (TRM). We performed a retrospective cohort comparison of outcomes in adult patients who underwent first double-unit CBT with standard RIC as compared with the intensified regimen of Flu 150 mg/m2, Cy 50 mg/kg, thiotepa 10 mg/kg, and 400-cGy TBI (intensified RIC). Of the 99 patients studied, 47 received intensified RIC. Acute myelogenous leukemia was the major indication for transplant. The median age at transplant was 67 years (range, 24 to 74 years) and 54 years (range, 25 to 67 years) in standard RIC and intensified RIC, respectively. Median hematopoietic stem cell transplantation comorbidity index was 3 (range, 0 to 5) and 1 (range, 0 to 6) in the standard RIC and intensified RIC groups, respectively. Median follow-up among survivors was 22 months (range, 3.7 to 79 months) following standard RIC and 15 months (range, 2.8 to 36 months) following intensified RIC. The cumulative incidence (CI) of relapse was significantly lower following intensified RIC compared with standard RIC (P = .0013); this finding maintained significance in multivariate analysis (P = .045). TRM was comparable between the 2 groups (P = .99). Overall survival (OS) was significantly improved following intensified RIC as compared with standard RIC (P = .03). Median OS was 17 months following standard RIC versus not reached followed intensified RIC. The CI of grade II to IV acute graft-versus-host disease (GVHD) was significantly higher in the intensified RIC cohort than the standard RIC-cohort (P = .007), while CI of grade III to IV acute GVHD, any chronic GVHD, and moderate-to-severe chronic GVHD was comparable in each cohort (P = .20, P = .21, and P = .61, respectively). This retrospective analysis shows an improvement in OS and decreased relapse without increase in TRM in patients receiving intensified RIC as compared with standard RIC. Our data suggest that consideration of thiotepa-based intensified RIC may improve outcomes in fit, older patients undergoing double-unit CBT.
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Affiliation(s)
- Prashant Sharma
- Division of Hematology, University of Colorado Denver, Denver, Colorado
| | - Daniel A Pollyea
- Division of Hematology, University of Colorado Denver, Denver, Colorado
| | - Clayton A Smith
- Division of Hematology, University of Colorado Denver, Denver, Colorado
| | - Enkhtsetseg Purev
- Division of Hematology, University of Colorado Denver, Denver, Colorado
| | - Manali Kamdar
- Division of Hematology, University of Colorado Denver, Denver, Colorado
| | - Bradley Haverkos
- Division of Hematology, University of Colorado Denver, Denver, Colorado
| | - Daniel Sherbenou
- Division of Hematology, University of Colorado Denver, Denver, Colorado
| | | | - Andrew Hammes
- Division of Hematology, University of Colorado Denver, Denver, Colorado
| | - Jonathan A Gutman
- Division of Hematology, University of Colorado Denver, Denver, Colorado.
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26
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Smith CA, Mont S, Traver G, Sekhar KR, Crooks PA, Freeman ML. Targeting Enox1 in tumor stroma increases the efficacy of fractionated radiotherapy. Oncotarget 2018; 7:77926-77936. [PMID: 27788492 PMCID: PMC5363632 DOI: 10.18632/oncotarget.12845] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 10/14/2016] [Indexed: 02/07/2023] Open
Abstract
The goal of this investigation was to clarify the question of whether targeting Enox1 in tumor stroma would synergistically enhance the survival of tumor-bearing mice treated with fractionated radiotherapy. Enox1, a NADH oxidase, is expressed in tumor vasculature and stroma. However, it is not expressed in many tumor types, including HT-29 colorectal carcinoma cells. Pharmacological inhibition of Enox1 in endothelial cells inhibited repair of DNA double strand breaks, as measured by γH2AX and 53BP1 foci formation, as well as neutral comet assays. For 4 consecutive days athymic mice bearing HT-29 hindlimb xenografts were injected with a small molecule inhibitor of Enox1 or solvent control. Tumors were then administered 2 Gy of x-rays. On day 5 tumors were administered a single ‘top-up’ fraction of 30 Gy, the purpose of which was to amplify intrinsic differences in the radiation fractionation regimen produced by Enox1 targeting. Pharmacological targeting of Enox1 resulted in 80% of the tumor-bearing mice surviving at 90 days compared to only 40% of tumor-bearing mice treated with solvent control. The increase in survival was not a consequence of reoxygenation, as measured by pimonidazole immunostaining. These results are interpreted to indicate that targeting of Enox1 in tumor stroma significantly enhances the effectiveness of 2 Gy fractionated radiotherapy and identifies Enox1 as a potential therapeutic target.
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Affiliation(s)
- Clayton A Smith
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN 37232, USA.,Current Address: Department of Radiation Oncology, Mitchell Cancer Institute, University of South Alabama, Mobile, AL 36604, USA
| | - Stacey Mont
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Geri Traver
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Konjeti R Sekhar
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Peter A Crooks
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Michael L Freeman
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
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Abstract
CA 549 is one of several carcinoma associated mucin antigens proposed as a breast cancer tumor marker. In this study, the performance characteristics of the CA 549 assay were validated and the clinical utility of the test was compared with that of other breast cancer markers including CA 15-3, CA M26, CA M29 and carcinoembryonic antigen. The upper limit of normal was established as 15.5 U/ml based on data for 250 control subjects apparently free of disease. Overall, CA 549 had a low negative predictive value (0.51) due to a low sensitivity in the detection of early breast cancer. However, the test had a high positive predictive value (0.93) reflecting a high specificity for the disease. In 56 patients with advanced breast cancer, the sensitivity was 0.71 for CA 549 alone and 0.79-0.84 for CA 549 combined with any of the other markers studied.
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Crawford DF, Smith CA, Whyte G. Image-based closed-loop feedback for highly mono-dispersed microdroplet production. Sci Rep 2017; 7:10545. [PMID: 28874820 PMCID: PMC5585215 DOI: 10.1038/s41598-017-11254-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 08/21/2017] [Indexed: 11/19/2022] Open
Abstract
Micron-scale droplets isolated by an immiscible liquid can provide miniaturised reaction vessels which can be manipulated in microfluidic networks, and has seen a rapid growth in development. In many experiments, the precise volume of these microdroplets is a critical parameter which can be influenced by many external factors. In this work, we demonstrate the combination of imaging-based feedback and pressure driven pumping to accurately control the size of microdroplets produced in a microfluidic device. The use of fast-response, pressure-driving pumps allows the microfluidic flow to be quickly and accurately changed, while directly measuring the droplet size allows the user to define the more meaningful parameters of droplet size and generation frequency rather than flow rates or pressures. The feedback loop enables the drift correction of pressure based pumps, and leads to a large increase in the mono-dispersity of the droplets produced over long periods. We also show how this can be extended to control multiple liquid flows, allowing the frequency of droplet formation or the average concentration of living cells per droplet to be controlled and kept constant.
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Affiliation(s)
- D F Crawford
- Institute of Biochemistry, Biophysics and Bioengineering, Heriot-Watt University, Edinburgh, EH14 4AS, UK
| | - C A Smith
- Sphere Fluidics Limited, The Jonas-Webb Building, Babraham Research Campus, Babraham, Cambridge, CB22 3AT, UK
| | - G Whyte
- Institute of Biochemistry, Biophysics and Bioengineering, Heriot-Watt University, Edinburgh, EH14 4AS, UK.
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Abstract
Management of anal carcinoma began as abdominoperineal resection and has evolved to combined chemotherapy and radiation. Early randomized trials demonstrated superior clinical outcomes of combined modality therapy over radiotherapy alone. Subsequent trials investigated alterations in the standard backbone of radiotherapy concurrent with 5-fluorouracil and mitomycin C with intent to maintain clinical outcomes while reducing treatment-related morbidity. The addition of intensity-modulated radiotherapy to radiation planning and delivery has subsequently reduced acute toxicity and detrimental treatment breaks. Ongoing and future trials are aimed at reducing therapy in favorable patient populations to decrease morbidity while intensifying treatment in patients with negative prognostic factors.
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Affiliation(s)
- Clayton A Smith
- Division of Radiation Oncology, Mitchell Cancer Institute, University of South Alabama, 1660 Spring Hill Avenue, Mobile, AL 36604, USA
| | - Lisa A Kachnic
- Department of Radiation Oncology, Vanderbilt University Medical Center, 2220 Pierce Avenue, Preston Research Building B-1003, Nashville, TN 37232, USA.
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Melani C, Major A, Schowinsky J, Roschewski M, Pittaluga S, Jaffe ES, Pack SD, Abdullaev Z, Ahlman MA, Kwak JJ, Morgan R, Rabinovitch R, Pan Z, Haverkos BM, Gutman JA, Pollyea DA, Smith CA, Wilson WH, Kamdar M. PD-1 Blockade in Mediastinal Gray-Zone Lymphoma. N Engl J Med 2017; 377:89-91. [PMID: 28679093 PMCID: PMC5628739 DOI: 10.1056/nejmc1704767] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
| | - Ajay Major
- University of Colorado School of Medicine, Aurora, CO
| | | | | | | | | | | | | | | | | | | | | | - Zenggang Pan
- University of Colorado School of Medicine, Aurora, CO
| | | | | | | | | | | | - Manali Kamdar
- University of Colorado School of Medicine, Aurora, CO
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Abstract
Management of locally advanced rectal cancer has evolved over time from surgical resection alone to multimodality therapy with preoperative radiation, chemotherapy, and total mesorectal excision resulting in excellent local control rates. Refinements in neoadjuvant therapies and their sequencing have improved pathologic complete response rates such that consideration of selective radiation and nonoperative management are now active clinical trial questions. Advances in radiation treatment planning and delivery techniques may allow for further reduction in acute treatment-related toxicity in select patient populations. Collectively, therapeutic strategies remain focused on improving outcomes for patients with higher-risk disease and reducing the morbidity of treatment.
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Affiliation(s)
- Clayton A Smith
- Division of Radiation Oncology, University of South Alabama Mitchell Cancer Institute, 1660 Spring Hill Avenue, Mobile, AL 36604, USA.
| | - Lisa A Kachnic
- Department of Radiation Oncology, Vanderbilt University Medical Center, 2220 Pierce Avenue, Preston Research Building B-1003, Nashville, TN 37232, USA
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Gasparetto M, Pei S, Minhajuddin M, Khan N, Pollyea DA, Myers JR, Ashton JM, Becker MW, Vasiliou V, Humphries KR, Jordan CT, Smith CA. Targeted therapy for a subset of acute myeloid leukemias that lack expression of aldehyde dehydrogenase 1A1. Haematologica 2017; 102:1054-1065. [PMID: 28280079 PMCID: PMC5451337 DOI: 10.3324/haematol.2016.159053] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 11/02/2016] [Accepted: 03/08/2017] [Indexed: 12/20/2022] Open
Abstract
Aldehyde dehydrogenase 1A1 (ALDH1A1) activity is high in hematopoietic stem cells and functions in part to protect stem cells from reactive aldehydes and other toxic compounds. In contrast, we found that approximately 25% of all acute myeloid leukemias expressed low or undetectable levels of ALDH1A1 and that this ALDH1A1− subset of leukemias correlates with good prognosis cytogenetics. ALDH1A1− cell lines as well as primary leukemia cells were found to be sensitive to treatment with compounds that directly and indirectly generate toxic ALDH substrates including 4-hydroxynonenal and the clinically relevant compounds arsenic trioxide and 4-hydroperoxycyclophosphamide. In contrast, normal hematopoietic stem cells were relatively resistant to these compounds. Using a murine xenotransplant model to emulate a clinical treatment strategy, established ALDH1A1− leukemias were also sensitive to in vivo treatment with cyclophosphamide combined with arsenic trioxide. These results demonstrate that targeting ALDH1A1− leukemic cells with toxic ALDH1A1 substrates such as arsenic and cyclophosphamide may be a novel targeted therapeutic strategy for this subset of acute myeloid leukemias.
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Affiliation(s)
| | - Shanshan Pei
- Division of Hematology, University of Colorado, Aurora, CO, USA
| | | | - Nabilah Khan
- Division of Hematology, University of Colorado, Aurora, CO, USA
| | | | - Jason R Myers
- Genomics Research Center, University of Rochester, NY, USA
| | - John M Ashton
- Genomics Research Center, University of Rochester, NY, USA
| | - Michael W Becker
- Department of Medicine, University of Rochester Medical Center, NY, USA
| | - Vasilis Vasiliou
- Department of Environmental Health Sciences, Yale University, New Haven, CT, USA
| | - Keith R Humphries
- Terry Fox Laboratory, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Craig T Jordan
- Division of Hematology, University of Colorado, Aurora, CO, USA
| | - Clayton A Smith
- Division of Hematology, University of Colorado, Aurora, CO, USA
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Abstract
Retinal ganglion cell (RGC) loss is the hallmark of optic neuropathies, including glaucoma, where damage to RGC axons occurs at the level of the optic nerve head. In experimental glaucoma, damage is assessed at the axon level (in the retinal nerve fibre layer and optic nerve head) or at the soma level (in the retina). In clinical glaucoma where measurements are generally limited to non-invasive techniques, structural measurements of the retinal nerve fibre layer and optic nerve head, or functional measurements with perimetry provide surrogate estimates of RGC integrity. These surrogate measurements, while clinically useful, are several levels removed from estimating actual RGC loss. Advances in imaging, labelling techniques, and transgenic medicine are making enormous strides in experimental glaucoma, providing knowledge on the pathophysiology of glaucoma, its progression and testing new therapeutic avenues. Advances are also being made in functional imaging of RGCs. Future efforts will now be directed towards translating these advances to clinical care.
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Affiliation(s)
- C A Smith
- Department of Physiology and Biophysics, Dalhousie University, Halifax, Nova Scotia, Canada
- Retina and Optic Nerve Research Laboratory, Dalhousie University, Halifax, Nova Scotia, Canada
| | - J R Vianna
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - B C Chauhan
- Department of Physiology and Biophysics, Dalhousie University, Halifax, Nova Scotia, Canada
- Retina and Optic Nerve Research Laboratory, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
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Yang W, Wu G, Broeckel U, Smith CA, Turner V, Haidar CE, Wang S, Carter R, Karol SE, Neale G, Crews KR, Yang JJ, Mullighan CG, Downing JR, Evans WE, Relling MV. Comparison of genome sequencing and clinical genotyping for pharmacogenes. Clin Pharmacol Ther 2016; 100:380-8. [PMID: 27311679 DOI: 10.1002/cpt.411] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 05/23/2016] [Accepted: 06/13/2016] [Indexed: 12/28/2022]
Abstract
We compared whole exome sequencing (WES, n = 176 patients) and whole genome sequencing (WGS, n = 68) and clinical genotyping (DMET array-based approach) for interrogating 13 genes with Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines. We focused on 127 CPIC important variants: 103 single nucleotide variations (SNV), 21 insertion/deletions (Indel), HLA-B alleles, and two CYP2D6 structural variations. WES and WGS provided interrogation of nonoverlapping sets of 115 SNV/Indels with call rate >98%. Among 68 loci interrogated by both WES and DMET, 64 loci (94.1%, confidence interval [CI]: 85.6-98.4%) showed no discrepant genotyping calls. Among 66 loci interrogated by both WGS and DMET, 63 loci (95.5%, CI: 87.2-99.0%) showed no discrepant genotyping calls. In conclusion, even without optimization to interrogate pharmacogenetic variants, WES and WGS displayed potential to provide reliable interrogation of most pharmacogenes and further validation of genome sequencing in a clinical lab setting is warranted.
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Affiliation(s)
- W Yang
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - G Wu
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - U Broeckel
- Human and Molecular Genetics Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - C A Smith
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - V Turner
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - C E Haidar
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - S Wang
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - R Carter
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - S E Karol
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - G Neale
- Hartwell Center, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - K R Crews
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - J J Yang
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - C G Mullighan
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - J R Downing
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - W E Evans
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - M V Relling
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
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Levett KM, Smith CA, Bensoussan A, Dahlen HG. Complementary therapies for labour and birth study: a randomised controlled trial of antenatal integrative medicine for pain management in labour. BMJ Open 2016; 6:e010691. [PMID: 27406639 PMCID: PMC4947718 DOI: 10.1136/bmjopen-2015-010691] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To evaluate the effect of an antenatal integrative medicine education programme in addition to usual care for nulliparous women on intrapartum epidural use. DESIGN Open-label, assessor blind, randomised controlled trial. SETTING 2 public hospitals in Sydney, Australia. POPULATION 176 nulliparous women with low-risk pregnancies, attending hospital-based antenatal clinics. METHODS AND INTERVENTION The Complementary Therapies for Labour and Birth protocol, based on the She Births and acupressure for labour and birth courses, incorporated 6 evidence-based complementary medicine techniques: acupressure, visualisation and relaxation, breathing, massage, yoga techniques, and facilitated partner support. Randomisation occurred at 24-36 weeks' gestation, and participants attended a 2-day antenatal education programme plus standard care, or standard care alone. MAIN OUTCOME MEASURES Rate of analgesic epidural use. Secondary: onset of labour, augmentation, mode of birth, newborn outcomes. RESULTS There was a significant difference in epidural use between the 2 groups: study group (23.9%) standard care (68.7%; risk ratio (RR) 0.37 (95% CI 0.25 to 0.55), p≤0.001). The study group participants reported a reduced rate of augmentation (RR=0.54 (95% CI 0.38 to 0.77), p<0.0001); caesarean section (RR=0.52 (95% CI 0.31 to 0.87), p=0.017); length of second stage (mean difference=-0.32 (95% CI -0.64 to 0.002), p=0.05); any perineal trauma (0.88 (95% CI 0.78 to 0.98), p=0.02) and resuscitation of the newborn (RR=0.47 (95% CI 0.25 to 0.87), p≤0.015). There were no statistically significant differences found in spontaneous onset of labour, pethidine use, rate of postpartum haemorrhage, major perineal trauma (third and fourth degree tears/episiotomy), or admission to special care nursery/neonatal intensive care unit (p=0.25). CONCLUSIONS The Complementary Therapies for Labour and Birth study protocol significantly reduced epidural use and caesarean section. This study provides evidence for integrative medicine as an effective adjunct to antenatal education, and contributes to the body of best practice evidence. TRIAL REGISTRATION NUMBER ACTRN12611001126909.
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Affiliation(s)
- Kate M Levett
- National Institute for Complementary Medicines (NICM), Western Sydney University, Sydney, Australia
| | - C A Smith
- National Institute for Complementary Medicines (NICM), Western Sydney University, Sydney, Australia
| | - A Bensoussan
- National Institute for Complementary Medicines (NICM), Western Sydney University, Sydney, Australia
| | - H G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
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Levett KM, Smith CA, Bensoussan A, Dahlen HG. The Complementary Therapies for Labour and Birth Study making sense of labour and birth - Experiences of women, partners and midwives of a complementary medicine antenatal education course. Midwifery 2016; 40:124-31. [PMID: 27428108 DOI: 10.1016/j.midw.2016.06.011] [Citation(s) in RCA: 18] [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] [Received: 11/03/2015] [Revised: 05/03/2016] [Accepted: 06/08/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE to gain insight into the experiences of women, partners and midwives who participated in the Complementary Therapies for Labour and Birth Study, an evidence based complementary medicine (CM) antenatal education course. DESIGN qualitative in-depth interviews and a focus group as part of the Complementary Therapies for Labour and Birth Study. SETTING AND PARTICIPANTS thirteen low risk primiparous women and seven partners who had participated in the study group of a randomised controlled trial of the complementary therapies for labour and birth study, and 12 midwives caring for these women. The trial was conducted at two public hospitals, and through the Western Sydney University in Sydney, Australia. INTERVENTIONS the Complementary Therapies for Labour and Birth (CTLB) protocol, based on the She Births® course and the Acupressure for labour and birth protocol, incorporated six evidence-based complementary medicine (CM) techniques; acupressure, relaxation, visualisation, breathing, massage, yoga techniques and incorporated facilitated partner support. Randomisation to the trial occurred at 24-36 weeks' gestation, and participants attended a two-day antenatal education programme, plus standard care, or standard care alone. FINDINGS the overarching theme identified in the qualitative data was making sense of labour and birth. Women used information about normal birth physiology from the course to make sense of labour, and to utilise the CM techniques to support normal birth and reduce interventions in labour. Women's, partners' and midwives' experience of the course and its use during birth gave rise to supporting themes such as: working for normal; having a toolkit; and finding what works. KEY CONCLUSIONS the Complementary Therapies for Labour and Birth Study provided women and their partners with knowledge to understand the physiology of normal labour and birth and enabled them to use evidence-based CM tools to support birth and reduce interventions. IMPLICATIONS FOR PRACTICE the Complementary Therapies for Labour and Birth Study introduces concepts of what constitutes normal birth and provides skills to support women, partners and midwives. It appears to be an effective form of antenatal education that supports normal birth, and maternity services need to consider how they can reform current antenatal education in line with this evidence.
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Affiliation(s)
- K M Levett
- National Institute of Complementary Medicines (NICM), Western Sydney University, Sydney, Australia.
| | - C A Smith
- National Institute of Complementary Medicines (NICM), Western Sydney University, Sydney, Australia.
| | - A Bensoussan
- National Institute of Complementary Medicines (NICM), Western Sydney University, Sydney, Australia.
| | - H G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
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Vignes RM, Ahmed MF, Eggert JH, Fisher AC, Kalantar DH, Masters ND, Smith CA, Smith RF. TARDIS-C: A target diagnostic for measuring material structure at high pressure. ACTA ACUST UNITED AC 2016. [DOI: 10.1088/1742-6596/717/1/012115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ratz PH, Miner AS, Huang Y, Smith CA, Barbee RW. Vascular smooth muscle desensitization in rabbit epigastric and mesenteric arteries during hemorrhagic shock. Am J Physiol Heart Circ Physiol 2016; 311:H157-67. [PMID: 27199133 DOI: 10.1152/ajpheart.00926.2015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 05/10/2016] [Indexed: 01/08/2023]
Abstract
The decompensatory phase of hemorrhage (shock) is caused by a poorly defined phenomenon termed vascular hyporeactivity (VHR). VHR may reflect an acute in vivo imbalance in levels of contractile and relaxant stimuli favoring net vascular smooth muscle (VSM) relaxation. Alternatively, VHR may be caused by intrinsic VSM desensitization of contraction resulting from prior exposure to high levels of stimuli that temporarily adjusts cell signaling systems. Net relaxation, but not desensitization, would be expected to resolve rapidly in an artery segment removed from the in vivo shock environment and examined in vitro in a fresh solution. Our aim was to 1) induce shock in rabbits and apply an in vitro mechanical analysis on muscular arteries isolated pre- and postshock to determine whether VHR involves intrinsic VSM desensitization, and 2) identify whether net VSM relaxation induced by nitric oxide and cyclic nucleotide-dependent protein kinase activation in vitro can be sustained for some time after relaxant stimulus washout. The potencies of phenylephrine- and histamine-induced contractions in in vitro epigastric artery removed from rabbits posthemorrhage were decreased by ∼0.3 log units compared with the control contralateral epigastric artery removed prehemorrhage. Moreover, a decrease in KCl-induced tonic, relative to phasic, tension of in vitro mesenteric artery correlated with the degree of shock severity as assessed by rates of lactate and K(+) accumulation. VSM desensitization was also caused by tyramine in vivo and PE in vitro, but not by relaxant agents in vitro. Together, these results support the hypothesis that VHR during hemorrhagic decompensation involves contractile stimulus-induced long-lasting, intrinsic VSM desensitization.
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Affiliation(s)
- P H Ratz
- Department of Biochemistry and Molecular Biology, Virginia Commonwealth University, Richmond, Virginia; and
| | - A S Miner
- Department of Biochemistry and Molecular Biology, Virginia Commonwealth University, Richmond, Virginia; and
| | - Y Huang
- Departments of Emergency Medicine and Physiology and Biophysics, Virginia Commonwealth University, Richmond, Virginia
| | - C A Smith
- Department of Biochemistry and Molecular Biology, Virginia Commonwealth University, Richmond, Virginia; and
| | - R W Barbee
- Departments of Emergency Medicine and Physiology and Biophysics, Virginia Commonwealth University, Richmond, Virginia
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Liu X, Painter RE, Enesa K, Holmes D, Whyte G, Garlisi CG, Monsma FJ, Rehak M, Craig FF, Smith CA. High-throughput screening of antibiotic-resistant bacteria in picodroplets. Lab Chip 2016; 16:1636-43. [PMID: 27033300 DOI: 10.1039/c6lc00180g] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
The prevalence of clinically-relevant bacterial strains resistant to current antibiotic therapies is increasing and has been recognized as a major health threat. For example, multidrug-resistant tuberculosis and methicillin-resistant Staphylococcus aureus are of global concern. Novel methodologies are needed to identify new targets or novel compounds unaffected by pre-existing resistance mechanisms. Recently, water-in-oil picodroplets have been used as an alternative to conventional high-throughput methods, especially for phenotypic screening. Here we demonstrate a novel microfluidic-based picodroplet platform which enables high-throughput assessment and isolation of antibiotic-resistant bacteria in a label-free manner. As a proof-of-concept, the system was used to isolate fusidic acid-resistant mutants and estimate the frequency of resistance among a population of Escherichia coli (strain HS151). This approach can be used for rapid screening of rare antibiotic-resistant mutants to help identify novel compound/target pairs.
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Affiliation(s)
- X Liu
- Sphere Fluidics Limited, The Jonas Webb Building, Babraham Research Campus, Babraham, Cambridge, CB22 3AT, UK.
| | - R E Painter
- Merck Research Labs, Merck & Co., Inc., 2015 Galloping Hill Road, K15, Kenilworth, NJ07033, USA
| | - K Enesa
- Sphere Fluidics Limited, The Jonas Webb Building, Babraham Research Campus, Babraham, Cambridge, CB22 3AT, UK.
| | - D Holmes
- Sphere Fluidics Limited, The Jonas Webb Building, Babraham Research Campus, Babraham, Cambridge, CB22 3AT, UK.
| | - G Whyte
- School of Engineering & Physical Sciences, Institute of Biological Chemistry, Biophysics & Bioengineering, Heriot-Watt University, Edinburgh, EH14 4AS, UK
| | - C G Garlisi
- Merck Research Labs, Merck & Co., Inc., 2015 Galloping Hill Road, K15, Kenilworth, NJ07033, USA
| | - F J Monsma
- Merck Research Labs, Merck & Co., Inc., 2015 Galloping Hill Road, K15, Kenilworth, NJ07033, USA
| | - M Rehak
- Sphere Fluidics Limited, The Jonas Webb Building, Babraham Research Campus, Babraham, Cambridge, CB22 3AT, UK.
| | - F F Craig
- Sphere Fluidics Limited, The Jonas Webb Building, Babraham Research Campus, Babraham, Cambridge, CB22 3AT, UK.
| | - C A Smith
- Sphere Fluidics Limited, The Jonas Webb Building, Babraham Research Campus, Babraham, Cambridge, CB22 3AT, UK.
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40
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Smith CA, Freeman ML. Preclinical Advances in Combined-Modality Cancer Immunotherapy With Radiation Therapy. Int J Radiat Oncol Biol Phys 2016; 94:11-14. [DOI: 10.1016/j.ijrobp.2015.07.2282] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 07/24/2015] [Indexed: 11/25/2022]
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Stevens B, Maxson J, Tyner J, Smith CA, Gutman JA, Robinson W, Jordan CT, Lee CK, Swisshelm K, Tobin J, Wei Q, Schowinsky J, Rinella S, Lee HG, Pollyea DA. Clonality of neutrophilia associated with plasma cell neoplasms: report of a SETBP1 mutation and analysis of a single institution series. Leuk Lymphoma 2015; 57:927-34. [PMID: 26389776 DOI: 10.3109/10428194.2015.1094697] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A rare but well-known association between plasma cell neoplasms and neutrophilia is known to exist. Whether the neutrophilia is secondary to the plasma cell neoplasm or this convergence represents two independent clonal disorders is unclear. We reviewed five consecutive cases from a single institution over a 3-year period, applying molecular, cytogenetic and cytokine-profiling approaches to determine whether neutrophilia associated with plasma cell neoplasms represents a reactive or clonal process. We report, for the first time, the occurrence of a SETBP1 mutation in two cases, as well as changes in G-CSF and IL-6 in SETBP1 wild type vs. mutated patients that are supportive of a hypothesis that neutrophilia associated with plasma cell neoplasms may sometimes be reactive and may sometimes represent a second clonal entity. Finally, using an ex vivo drug screening platform we report the potential efficacy of the multi-kinase inhibitor dasatinib in select patients.
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Affiliation(s)
- Brett Stevens
- a Division of Hematology , University of Colorado , Aurora , CO , USA
| | - Julia Maxson
- b Clinical Research Division , Fred Hutchinson Cancer Research Center , Seattle , WA , USA ;,c Division of Oncology , Oregon Health Science University , Portland , OR , USA
| | - Jeffrey Tyner
- c Division of Oncology , Oregon Health Science University , Portland , OR , USA
| | - Clayton A Smith
- a Division of Hematology , University of Colorado , Aurora , CO , USA
| | - Jonathan A Gutman
- a Division of Hematology , University of Colorado , Aurora , CO , USA
| | - William Robinson
- a Division of Hematology , University of Colorado , Aurora , CO , USA
| | - Craig T Jordan
- a Division of Hematology , University of Colorado , Aurora , CO , USA
| | | | - Karen Swisshelm
- e Department of Pathology , University of Colorado , Aurora , CO , USA
| | - Jennifer Tobin
- f School of Pharmacy, University of Colorado , Aurora , CO , USA
| | - Qi Wei
- g Department of Pediatrics , University of Colorado , Aurora , CO , USA
| | | | - Sean Rinella
- a Division of Hematology , University of Colorado , Aurora , CO , USA
| | - Hea Gie Lee
- a Division of Hematology , University of Colorado , Aurora , CO , USA
| | - Daniel A Pollyea
- a Division of Hematology , University of Colorado , Aurora , CO , USA
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Peterson JF, Aggarwal N, Smith CA, Gollin SM, Surti U, Rajkovic A, Swerdlow SH, Yatsenko SA. Integration of microarray analysis into the clinical diagnosis of hematological malignancies: How much can we improve cytogenetic testing? Oncotarget 2015; 6:18845-62. [PMID: 26299921 PMCID: PMC4662459 DOI: 10.18632/oncotarget.4586] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [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: 06/15/2015] [Accepted: 07/21/2015] [Indexed: 12/14/2022] Open
Abstract
Purpose To evaluate the clinical utility, diagnostic yield and rationale of integrating microarray analysis in the clinical diagnosis of hematological malignancies in comparison with classical chromosome karyotyping/fluorescence in situ hybridization (FISH). Methods G-banded chromosome analysis, FISH and microarray studies using customized CGH and CGH+SNP designs were performed on 27 samples from patients with hematological malignancies. A comprehensive comparison of the results obtained by three methods was conducted to evaluate benefits and limitations of these techniques for clinical diagnosis. Results Overall, 89.7% of chromosomal abnormalities identified by karyotyping/FISH studies were also detectable by microarray. Among 183 acquired copy number alterations (CNAs) identified by microarray, 94 were additional findings revealed in 14 cases (52%), and at least 30% of CNAs were in genomic regions of diagnostic/prognostic significance. Approximately 30% of novel alterations detected by microarray were >20 Mb in size. Balanced abnormalities were not detected by microarray; however, of the 19 apparently “balanced” rearrangements, 55% (6/11) of recurrent and 13% (1/8) of non-recurrent translocations had alterations at the breakpoints discovered by microarray. Conclusion Microarray technology enables accurate, cost-effective and time-efficient whole-genome analysis at a resolution significantly higher than that of conventional karyotyping and FISH. Array-CGH showed advantage in identification of cryptic imbalances and detection of clonal aberrations in population of non-dividing cancer cells and samples with poor chromosome morphology. The integration of microarray analysis into the cytogenetic diagnosis of hematologic malignancies has the potential to improve patient management by providing clinicians with additional disease specific and potentially clinically actionable genomic alterations.
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Affiliation(s)
- Jess F Peterson
- Pittsburgh Cytogenetics Laboratory, Center for Medical Genetics and Genomics, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA.,Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.,Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Nidhi Aggarwal
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Clayton A Smith
- Department of Medicine, Division of Hematology, University of Colorado, Denver, CO
| | - Susanne M Gollin
- Pittsburgh Cytogenetics Laboratory, Center for Medical Genetics and Genomics, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA.,Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.,Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Urvashi Surti
- Pittsburgh Cytogenetics Laboratory, Center for Medical Genetics and Genomics, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA.,Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.,Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Aleksandar Rajkovic
- Pittsburgh Cytogenetics Laboratory, Center for Medical Genetics and Genomics, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA.,Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.,Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Steven H Swerdlow
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Svetlana A Yatsenko
- Pittsburgh Cytogenetics Laboratory, Center for Medical Genetics and Genomics, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA.,Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Pollyea DA, Gutman JA, Gore L, Smith CA, Jordan CT. Targeting acute myeloid leukemia stem cells: a review and principles for the development of clinical trials. Haematologica 2015; 99:1277-84. [PMID: 25082785 DOI: 10.3324/haematol.2013.085209] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Despite an increasingly rich understanding of its pathogenesis, acute myeloid leukemia remains a disease with poor outcomes, overwhelmingly due to disease relapse. In recent years, work to characterize the leukemia stem cell population, the disease compartment most difficult to eliminate with conventional therapy and most responsible for relapse, has been undertaken. This, in conjunction with advances in drug development that have allowed for increasingly targeted therapies to be engineered, raises the hope that we are entering an era in which the leukemia stem cell population can be eliminated, resulting in therapeutic cures for acute myeloid leukemia patients. For these therapies to become available, they must be tested in the setting of clinical trials. A long-established clinical trials infrastructure has been employed to shepherd new therapies from proof-of-concept to approval. However, due to the unique features of leukemia stem cells, drugs that are designed to specifically eliminate this population may not be adequately tested when applied to this model. Therefore, in this review article, we seek to identify the relevant features of acute myeloid leukemia stem cells for clinical trialists, discuss potential strategies to target leukemia stem cells, and propose a set of guidelines outlining the necessary elements of clinical trials to allow for the successful testing of stem cell-directed therapies.
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Affiliation(s)
- Daniel A Pollyea
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO
| | - Jonathan A Gutman
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO
| | - Lia Gore
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Clayton A Smith
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO
| | - Craig T Jordan
- Division of Hematology, University of Colorado School of Medicine, Aurora, CO
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Smith CA, Richardson SM, Eagle MJ, Rooney P, Board T, Hoyland JA. The use of a novel bone allograft wash process to generate a biocompatible, mechanically stable and osteoinductive biological scaffold for use in bone tissue engineering. J Tissue Eng Regen Med 2014; 9:595-604. [PMID: 24945627 DOI: 10.1002/term.1934] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [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: 01/29/2014] [Revised: 04/29/2014] [Accepted: 05/21/2014] [Indexed: 01/02/2023]
Abstract
Fresh-frozen biological allograft remains the most effective substitute for the 'gold standard' autograft, sharing many of its osteogenic properties but, conversely, lacking viable osteogenic cells. Tissue engineering offers the opportunity to improve the osseointegration of this material through the addition of mesenchymal stem cells (MSCs). However, the presence of dead, immunogenic and potentially harmful bone marrow could hinder cell adhesion and differentiation, graft augmentation and incorporation, and wash procedures are therefore being utilized to remove the marrow, thereby improving the material's safety. To this end, we assessed the efficiency of a novel wash technique to produce a biocompatible, biological scaffold void of cellular material that was mechanically stable and had osteoinductive potential. The outcomes of our investigations demonstrated the efficient removal of marrow components (~99.6%), resulting in a biocompatible material with conserved biomechanical stability. Additionally, the scaffold was able to induce osteogenic differentiation of MSCs, with increases in osteogenic gene expression observed following extended culture. This study demonstrates the efficiency of the novel wash process and the potential of the resultant biological material to serve as a scaffold in bone allograft tissue engineering.
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Affiliation(s)
- C A Smith
- Centre for Tissue Injury and Repair, University of Manchester, UK
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Omotehara T, Smith CA, Mantani Y, Kobayashi Y, Tatsumi A, Nagahara D, Hashimoto R, Hirano T, Umemura Y, Yokoyama T, Kitagawa H, Hoshi N. Spatiotemporal expression patterns of doublesex and mab-3 related transcription factor 1 in the chicken developing gonads and Mullerian ducts. Poult Sci 2014; 93:953-8. [PMID: 24706973 DOI: 10.3382/ps.2013-03672] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 01/23/2023] Open
Abstract
Sex of birds is genetically determined by the inheritance of sex chromosomes (ZZ for male and ZW for female), and the Z-linked gene named doublesex and mab-3 related transcription factor 1 (DMRT1) is a candidate sex-determining gene in avian species. However, the mechanisms underlying sex determination in birds are not yet understood, and the expression patterns of the DMRT1 protein in urogenital tissues have not been identified. In the current study, we used immunohistochemistry to investigate the detailed expression patterns of the DMRT1 protein in the urogenital systems (including Müllerian ducts) in male and female chicken embryos throughout embryonic development. Gonadal somatic cells in the male indifferent gonads showed stronger expressions of DMRT1 compared with those in the female indifferent gonads well before the presumptive period of the sex determination, and Sertoli cells forming testicular cords expressed DMRT1 in the testes after sex determination. Germ cells expressed DMRT1 equally in males and females after sex determination. The expression was continuous in males, but in females it gradually disappeared from the germ cells in the central part of the cortex of the left ovary toward both edges. The DMRT1 was also detected in the tubal ridge, which is a precursor of the Müllerian duct, and at the mesenchyme and outermost coelomic epithelium of the Müllerian duct in both sexes. Strong expression was observed in the males, but it was restricted to coelomic epithelium after the regression of the duct started. Thus, we observed the detailed spatiotemporal expression patterns of DMRT1 in the developing chicken urogenital systems throughout embryonic development, suggesting its various roles in the development of urogenital tissues in the chicken embryo.
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Affiliation(s)
- T Omotehara
- Department of Animal Science, Graduate School of Agricultural Science, Kobe University, Kobe, Hyogo 657-8501, Japan
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Levett KM, Smith CA, Dahlen HG, Bensoussan A. Acupuncture and acupressure for pain management in labour and birth: a critical narrative review of current systematic review evidence. Complement Ther Med 2014; 22:523-40. [PMID: 24906592 DOI: 10.1016/j.ctim.2014.03.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 02/27/2014] [Accepted: 03/30/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Reviews of maternity services highlight the need for a reduction of medical interventions for women with low risk pregnancies and births to prevent the potential cascade of interventions and their associated risks. Complementary medicines (CM) such as acupuncture and acupressure have claimed to be effective in reducing interventions in labour; however, systematic reviews of evidence to date are conflicting. AIMS To examine current evidence from systematic reviews on the topic of acupuncture and acupressure for pain management in labour and birth, and to evaluate the methodological and treatment frameworks applied to this evidence. METHODS A search limited to systematic reviews of the MEDLINE, CINAHL, PUBMED, EMBASE and Cochrane databases was performed in December 2013 using the keywords 'CAM', 'alternative medicine', 'complementary medicine', 'complementary therapies', 'traditional medicine', 'Chinese Medicine', 'Traditional Chinese Medicine', 'acupuncture', 'acupressure', cross-referenced with 'childbirth', 'birth', labo*r', and 'delivery'. The quality of the evidence is also evaluated in the context of study design. RESULTS The RCTs included in these systematic reviews differed in terms of study designs, research questions, treatment protocols and outcome measures, and yielded some conflicting results. It may be inappropriate to include these together in a systematic review, or pooled analysis, of acupuncture for labour with an expectation of an overall conclusion for efficacy. Trials of acupuncture and acupressure in labour show promise, but further studies are required. CONCLUSION The use of current systematic reviews of the evidence for acupuncture and acupressure for labour and birth may be misleading. Appropriate methods and outcome measures for investigation of acupuncture and acupressure treatment should more carefully reflect the research question being asked. The use of pragmatic trials designs with woman-centred outcomes may be appropriate for evaluating the effectiveness of these therapies.
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Affiliation(s)
- K M Levett
- National Institute for Complementary Medicine, University of Western Sydney, Penrith, New South Wales, Australia.
| | - C A Smith
- National Institute for Complementary Medicine, University of Western Sydney, Penrith, New South Wales, Australia.
| | - H G Dahlen
- School of Nursing and Midwifery, University of Western Sydney, Penrith, New South Wales, Australia.
| | - A Bensoussan
- National Institute for Complementary Medicine, University of Western Sydney, Penrith, New South Wales, Australia.
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Smith CA, Betts D. The practice of acupuncture and moxibustion to promote cephalic version for women with a breech presentation: implications for clinical practice and research. Complement Ther Med 2013; 22:75-80. [PMID: 24559820 DOI: 10.1016/j.ctim.2013.12.005] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 08/16/2013] [Accepted: 12/03/2013] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To examine what experienced acupuncture practitioners and researchers considered key aspects of treatment to promote cephalic version for women with a breech presentation, and to establish a treatment protocol through consensus to guide the self administration of moxa by pregnant women. METHODS AND DESIGN The Delphi method was used to seek the opinions of key informants. Sixteen English speaking international, Australian and New Zealand acupuncturists working in the area of pregnancy were invited to participate in the study. Participants were given a link to an online survey, and their views sought on treatment parameters guiding the treatment of breech presentation within a research setting. RESULTS Two rounds of the Delphi process were undertaken, 12 participants completed round one, and 10 completed round two. Eighty percent of participants agreed that moxa should commence between 34 and 35 weeks gestation. Ninety percent agreed to self administration of moxa by the woman, and use of smokeless and odourless sticks. Seventy percent agreed moxa should be applied for a minimum of 10 days, and be applied once a day for 30min. Monitoring safety was identified as an important outcome. Ninety percent agreed study clinical outcomes should assess side effects including burns, and maternal and foetal outcomes. CONCLUSION Findings from our study promote the clinical validity for a future research protocol, and highlight other areas for research to evaluate the role of acupuncture and moxibustion with normalising birth.
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Affiliation(s)
- C A Smith
- Centre for Complementary Medicine Research, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2750, Australia.
| | - D Betts
- Centre for Complementary Medicine Research, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2750, Australia
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Parise RA, Beumer JH, Clausen DM, Rigatti LH, Ziegler JA, Gasparetto M, Smith CA, Eiseman JL. Effects of the aldehyde dehydrogenase inhibitor disulfiram on the plasma pharmacokinetics, metabolism, and toxicity of benzaldehyde dimethane sulfonate (NSC281612, DMS612, BEN) in mice. Cancer Chemother Pharmacol 2013; 72:1195-204. [PMID: 24061865 DOI: 10.1007/s00280-013-2296-5] [Citation(s) in RCA: 6] [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: 04/03/2013] [Accepted: 09/07/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Benzaldehyde dimethane sulfonate (DMS612, NSC281612, BEN) is an alkylator with activity against renal cell carcinoma, currently in phase I trials. In blood, BEN is rapidly metabolized into its highly reactive carboxylic acid (BA), presumably the predominant alkylating species. We hypothesized that BEN is metabolized to BA by aldehyde dehydrogenase (ALDH) and aimed to increase BEN exposure in blood and tissues by inhibiting ALDH with disulfiram, thereby shifting BA production from blood to tissues. METHODS Female CD2F1 mice were dosed with 20 mg/kg BEN iv alone or 24 h after 300 mg/kg disulfiram ip. BEN, BA, and metabolites were quantitated in plasma and urine, and toxicities were assessed. RESULTS BEN had a plasma t½ <5 min and produced at least 12 products. The metabolite half-lives were <136 min. Disulfiram increased BEN plasma exposure 368-fold (AUC0-inf from 0.11 to 40.5 mg/L min), while plasma levels of BA remained similar. Urinary BEN excretion increased (1.0-1.5 % of dose), while BA excretion was unchanged. Hematocrit, white blood cell counts, and percentage lymphocytes decreased after BEN administration. Coadministration of disulfiram appeared to enhance these effects. Profound liver pathology was observed in mice treated with disulfiram and BEN. CONCLUSIONS BEN plasma concentrations increased after administration of disulfiram, suggesting that ALDH mediates the rapid metabolism of BEN in vivo, which may explain the increased toxicity seen with BEN after administration of disulfiram. Our results suggest that the coadministration of BEN with drugs that inhibit ALDH to patients that are ALDH deficient may cause liver damage.
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Affiliation(s)
- Robert A Parise
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, 15213, USA
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