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Novick D. Conversation with Dr. Daniela Novick. J Interferon Cytokine Res 2023; 43:539-543. [PMID: 37878764 DOI: 10.1089/jir.2023.29057.int] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023] Open
Affiliation(s)
- Daniela Novick
- Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot, Israel
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Nozawa K, Terada M, Onishi M, Ozaki Y, Takano T, Fakhouri W, Novick D, Haro JM, Faris LH, Kawaguchi T, Tanizawa Y, Tsurutani J. Real-world treatment patterns and outcomes of abemaciclib for the treatment of HR + , HER2- metastatic breast cancer patients in Japan. Breast Cancer 2023:10.1007/s12282-023-01461-6. [PMID: 37217763 DOI: 10.1007/s12282-023-01461-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/08/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION This study described, in routine clinical practice in Japan, the patient characteristics, treatment patterns, and outcomes of female patients with HR + /HER2- metastatic breast cancer (MBC) who started abemaciclib treatment. METHODS Clinical charts were reviewed for patients starting abemaciclib in 12/2018-08/2021 with a minimum of 3 months follow-up data post-abemaciclib initiation regardless of abemaciclib discontinuation. Patient characteristics, treatment patterns, and tumor response were descriptively summarized. Kaplan-Meier curves estimated progression-free survival (PFS). RESULTS 200 patients from 14 institutions were included. At abemaciclib initiation, median age was 59 years, and the Eastern Cooperative Oncology Group performance status score was 0/1/2 for 102/68/5 patients (58.3/38.9/2.9%), respectively. Most had an abemaciclib starting dose of 150 mg (92.5%). The percentage of patients receiving abemaciclib as 1st, 2nd, or 3rd line treatment was 31.5%, 25.8%, and 25.2%, respectively. The most frequent endocrine therapy drugs used with abemaciclib were fulvestrant (59%) and aromatase inhibitors (40%). Evaluation of tumor response was available for 171 patients, 30.4% of whom had complete/partial response. Median PFS was 13.0 months (95% CI 10.1-15.8 months). CONCLUSIONS In a routine clinical practice setting in Japan, patients with HR + , HER2- MBC appear to benefit from abemaciclib treatment in terms of treatment response and median PFS, with the results broadly reflecting the evidence demonstrated in clinical trials.
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Affiliation(s)
- K Nozawa
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - M Terada
- Department of Breast Surgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - M Onishi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Y Ozaki
- Department of Breast Medical Oncology, Breast Oncology Center, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - T Takano
- Department of Breast Medical Oncology, Breast Oncology Center, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - W Fakhouri
- Eli Lilly and Company, Indianapolis, IN, USA
| | - D Novick
- Eli Lilly and Company, Indianapolis, IN, USA
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - L H Faris
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - T Kawaguchi
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Y Tanizawa
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Junji Tsurutani
- Advanced Cancer Translational Research Institute, Showa University, Tokyo, Japan.
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Huber R, Novick D, Hu G. Editorial: Termination of pro-inflammatory signaling and its dysregulation in autoimmune diseases. Front Immunol 2023; 14:1174996. [PMID: 36969258 PMCID: PMC10036856 DOI: 10.3389/fimmu.2023.1174996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/12/2023] Open
Affiliation(s)
- René Huber
- Institute of Clinical Chemistry, Hannover Medical School, Hannover, Germany
- *Correspondence: René Huber, ; Daniela Novick, ; Guochang Hu,
| | - Daniela Novick
- Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot, Israel
- *Correspondence: René Huber, ; Daniela Novick, ; Guochang Hu,
| | - Guochang Hu
- Department of Anesthesiology, University of Illinois College of Medicine, Chicago, IL, United States
- Department of Pharmacology and Regenerative Medicine, University of Illinois College of Medicine, Chicago, IL, United States
- *Correspondence: René Huber, ; Daniela Novick, ; Guochang Hu,
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Novick D. A natural goldmine of binding proteins and soluble receptors simplified their translation to blockbuster drugs, all in one decade. Front Immunol 2023; 14:1151620. [PMID: 36875111 PMCID: PMC9980337 DOI: 10.3389/fimmu.2023.1151620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 02/03/2023] [Indexed: 02/18/2023] Open
Abstract
Human urinary proteins are a goldmine of natural proteins a feature that simplifies their translation to biologics. Combining this goldmine together with the ligand-affinity-chromatography (LAC) purification method, proved a winning formula in their isolation. LAC specificity, efficiency, simplicity and inherent indispensability in the search for predictable and unpredictable proteins, is superior to other separation techniques. Unlimited amounts of recombinant cytokines and monoclonal antibodies (mAb) accelerated the "triumph". My approach concluded 35 years of worldwide pursuit for Type I IFN receptor (IFNAR2) and advanced the understanding of the signal transduction of this Type of IFN. TNF, IFNγ and IL-6 as baits enabled the isolation of their corresponding soluble receptors and N-terminal amino acid sequence of the isolated proteins facilitated the cloning of their cell surface counterparts. IL-18, IL-32, and heparanase as the baits yielded the corresponding unpredictable proteins: the antidote IL-18 Binding Protein (IL-18BP), the enzyme Proteinase 3 (PR3) and the hormone Resistin. IFNβ proved beneficial in Multiple Sclerosis and is a blockbuster drug, Rebif®. TNF mAbs translated into Remicade® to treat Crohn's disease. Enbrel® based on TBPII is for Rheumatoid Arthritis. Both are blockbusters. Tadekinig alfa™, a recombinant IL-18BP, is in phase III clinical study for inflammatory and autoimmune diseases. Seven years of continuous compassionate use of Tadekinig alfa™ in children born with mutations (NLRC4, XIAP) proved life-saving and is an example of tailored made medicine. IL-18 is a checkpoint biomarker in cancer and IL-18BP is planned recently to target cytokine storms resulting from CAR-T treatment and in COVID 19.
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Affiliation(s)
- Daniela Novick
- Molecular Genetics, The Weizmann Institute of Science, Rehovot, Israel
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Volfovitch Y, Tsur AM, Gurevitch M, Novick D, Rabinowitz R, Mandel M, Achiron A, Rubinstein M, Shoenfeld Y, Amital H. The intercorrelations between blood levels of ferritin, sCD163, and IL-18 in COVID-19 patients and their association to prognosis. Immunol Res 2022; 70:817-828. [PMID: 36222965 PMCID: PMC9555272 DOI: 10.1007/s12026-022-09312-w] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is associated with immune dysregulation, severe respiratory failure, and multiple organ dysfunction caused by a cytokine storm involving high blood levels of ferritin and IL-18. Furthermore, there is a resemblance between COVID-19 and macrophage activation syndrome (MAS) characterized by high concentrations of soluble CD163 (sCD163) receptor and IL-18. High levels of ferritin, IL-18, and sCD163 receptor are associated with “hyperferritinemic syndrome”, a family of diseases that appears to include COVID-19. In this retrospective cohort study, we tested the association and intercorrelations in the serum levels of ferritin, sCD163, and IL-18 and their impact on the prognosis of COVID-19. We analyzed data of 70 hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The levels of sCD163, ferritin, and IL-18 were measured and the correlation of these parameters with the respiratory deterioration and overall 30-day survival was assessed. Among the 70 patients, 60 survived 30 days from hospitalization. There were substantial differences between the subjects who were alive following 30 days compared to those who expired. The differences were referring to lymphocyte and leukocyte count, CRP, D-dimer, ferritin, sCD163, and IL-18. Results showed high levels of IL-18 (median, 444 pg/mL in the survival group compared with 916 pg/mL in the mortality group, p-value 8.54 × 10–2), a statistically significant rise in levels of ferritin (median, 484 ng/mL in the survival group compared with 1004 ng/mL in the mortality group p-value, 7.94 × 10–3), and an elevated value of in sCD163 (mean, 559 ng/mL in the survival group compared with 840 ng/mL in the mortality group, p-value 1.68 × 10–2). There was no significant correlation between the rise of ferritin and the levels sCD163 or IL-18. Taken together, sCD163, ferritin, and IL-18 were found to correlate with the severity of COVID-19 infection. Although these markers are associated with COVID-19 and might contribute to the cytokine storm, no intercorrelation was found among them. It cannot be excluded though that the results depend on the timing of sampling, assuming that they play distinct roles in different stages of the disease course. The data represented herein may provide clinical benefit in improving our understanding of the pathological course of the disease. Furthermore, measuring these biomarkers during the disease progression may help target them at the right time and refine the decision-making regarding the requirement for hospitalization.
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Affiliation(s)
- Yuval Volfovitch
- Department of Medicine 'B', Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Avishai M Tsur
- Department of Medicine 'B', Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,The Israel Defense Forces Medical Corps, Ramat Gan, Israel.,Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
| | - Michael Gurevitch
- Department of Medicine 'B', Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Daniela Novick
- Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot, Israel
| | - Roy Rabinowitz
- Department of Molecular Genetics and Biochemistry, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mathilda Mandel
- Department of Medicine 'B', Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Anat Achiron
- Department of Medicine 'B', Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Menachem Rubinstein
- Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot, Israel
| | - Yehuda Shoenfeld
- Department of Medicine 'B', Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia.,Ariel University, Ariel, Israel.,Zabludowicz Center for Autoimmune Diseases, H. Sheba Medical Center, Tel Hashomer, Israel
| | - Howard Amital
- Department of Medicine 'B', Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
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Rajan N, Wei A, Cheng R, Novick D, Szende A, Baik R, Colman S. PCN106 Treatment Patterns and Health Resource Utilization in Patients with Hepatocellular Cancer (HCC) Following Failure of Sorafenib in Real World Setting in Taiwan. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Baig A, Loya M, Novick D, Shah S. Abstract No. 530 The role of chest radiographs post computed tomography–guided lung biopsy with gelatinous foam slurry: is it necessary? J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Novick D, Torres T, Laredo F. PCN31 BURDEN OF DISEASE FOR ADVANCED BREAST CANCER IN MEXICO. Value Health Reg Issues 2019. [DOI: 10.1016/j.vhri.2019.08.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Novick D, Dinarello CA. IL-18 binding protein reverses the life-threatening hyperinflammation of a baby with the NLRC4 mutation. J Allergy Clin Immunol 2017; 140:316. [PMID: 28457594 DOI: 10.1016/j.jaci.2017.02.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 02/04/2017] [Accepted: 02/27/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Daniela Novick
- Weizmann Institute of Science, Molecular Genetics, Rehovot, Israel.
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Goren A, Novick D, Barros BR, Laks J, Dueñas H, Kahle-Wrobleski K. Impact of Caregiving for Patients with Alzheimer's Disease and Dementia on Psychiatric and Clinical Comorbidities in Brazil. Value Health 2014; 17:A402. [PMID: 27200965 DOI: 10.1016/j.jval.2014.08.921] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- A Goren
- Kantar Health, New York, NY, USA
| | - D Novick
- Eli Lilly and Company, Windlesham, UK
| | - B R Barros
- Eli Lilly do Brasil Ltda, São Paulo, Brazil
| | - J Laks
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - H Dueñas
- Eli Lilly de Mexico, Mexico City, Mexico
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Gorbounova VA, Bychkov MB, Vladimirova LY, Levchenko EV, Karpenko TD, Mamontov OY, Burmistrov V, Novick D, Rajan N, Sholokhova E, Solovyenko Y, Tjulandin SA. Characteristics of Patients with Pleural Mesothelioma in the Russian Federation. Value Health 2014; 17:A617. [PMID: 27202164 DOI: 10.1016/j.jval.2014.08.2178] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- V A Gorbounova
- N. N. Blokhin Russian Cancer Research Center, Moscow, Russia
| | - M B Bychkov
- N. N. Blokhin Russian Cancer Research Center, Moscow, Russia
| | - L Y Vladimirova
- Rostov Scientific Research Oncological Institute, Rostov-on-Don, Russia
| | - E V Levchenko
- N. N. Petrov Research Oncology Institute, Saint-Petersburg, Russia
| | - T D Karpenko
- N. N. Blokhin Russian Cancer Research Center, Moscow, Russia
| | - O Y Mamontov
- N. N. Petrov Research Oncology Institute, Saint-Petersburg, Russia
| | | | - D Novick
- Eli Lilly Holdings Limited, Windlesham, UK
| | - N Rajan
- Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia
| | | | | | - S A Tjulandin
- N. N. Blokhin Russian Cancer Research Center, Moscow, Russia
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Novick D, Montgomery W, Treuer T, Aguado J, Kraemer S, Haro JM. Comparative Effectiveness in Terms of Treatment Discontinuation of Orodispersable Versus. Standard Oral Olanzapine Tablets in Non-Adherent Patients: Results from a 1-Year European Outpatient Observational Study. Value Health 2014; 17:A766. [PMID: 27202812 DOI: 10.1016/j.jval.2014.08.287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- D Novick
- Eli Lilly Holdings Limited, Windlesham, UK
| | - W Montgomery
- Eli Lilly Australia Pty Ltd,, West Ryde, Australia
| | - T Treuer
- Eli Lilly & Company, Budapest, Hungary
| | - J Aguado
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - S Kraemer
- Eli Lilly and Company Ltd, Bad Homburg, Germany
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
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Novick D, Jihyung Hong J, Montgomery W, Dueñas H, Elfatarany G, Haro JM. Predictors Pf Remission in the Treatment of Depression in the Middle East: Real-World Evidence From A 6-Month Prospective Observational Study. Value Health 2014; 17:A454. [PMID: 27201258 DOI: 10.1016/j.jval.2014.08.1240] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- D Novick
- Eli Lilly Holdings Limited, Windlesham, UK
| | | | | | - H Dueñas
- Eli Lilly de Mexico, Mexico City, Mexico
| | - G Elfatarany
- Eli Lilly & Company, Saudi, Riyadh, Saudi Arabia
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
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Novick D, Montgomery W, Treuer T, Aguado J, Kraemer S, Haro JM. Relationship of Insight with Medication Adherence and the Impact on Outcomes in Patients with Schizophrenia and Bipolar Disorder: Results From A 1-Year European Outpatient Observational Study. Value Health 2014; 17:A455. [PMID: 27201259 DOI: 10.1016/j.jval.2014.08.1243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- D Novick
- Eli Lilly Holdings Limited, Windlesham, UK
| | | | - T Treuer
- Eli Lilly & Company, Budapest, Hungary
| | - J Aguado
- Parc Sanitari Sant Joan de Deu, CIBERSAM, Sant Boi de Llobregat, Spain
| | - S Kraemer
- Eli Lilly and Company Ltd, Bad Homburg, Germany
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
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Novick D, Montgomery W, Aguado J, Dueñas H, Haro JM. Symtomatic Factors in Patients With Major Depressive Disorder (MDD): Results from an Observational Study. Value Health 2014; 17:A543. [PMID: 27201753 DOI: 10.1016/j.jval.2014.08.1753] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- D Novick
- Eli Lilly Holdings Limited, Windlesham, UK
| | | | - J Aguado
- Parc Sanitari Sant Joan de Deu, CIBERSAM, Sant Boi de Llobregat, Spain
| | - H Dueñas
- Eli Lilly de Mexico, Mexico City, Mexico
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
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Abstract
In an attempt to isolate a heparanase receptor, postulated to mediate non-enzymatic functions of the heparanase protein, we utilized human urine collected from healthy volunteers. Affinity chromatography of this rich protein source on immobilized heparanase revealed resistin as a heparanase binding protein. Co-immunoprecipitation and ELISA further confirmed the interaction between heparanase and resistin. Importantly, we found that heparanase potentiates the bioactivity of resistin in its standard bioassay in which monocytic human leukemia cell line, THP1, differentiates into adherent macrophage-like foam cells. It is thus conceivable that this newly identified complex of heparanase and resistin exerts a stimulatory effect also in various inflammatory conditions known to be affected by the two proteins.
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Affiliation(s)
- Daniela Novick
- Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot, Israel
- * E-mail: (DN); (IV)
| | - Sara Barak
- Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot, Israel
| | - Neta Ilan
- Cancer and Vascular Biology Research Center, The Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Israel Vlodavsky
- Cancer and Vascular Biology Research Center, The Rappaport Faculty of Medicine, Technion, Haifa, Israel
- * E-mail: (DN); (IV)
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Peng X, Sun P, Novick D, Andrews J, Sun S. Real-world comparison of health care utilization between duloxetine and pregabalin initiators with fibromyalgia. J Pain Res 2014; 7:37-46. [PMID: 24470771 PMCID: PMC3891762 DOI: 10.2147/jpr.s51636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives To compare health care utilization of duloxetine initiators and pregabalin initiators among fibromyalgia patients in a real-world setting. Methods A retrospective cohort study was conducted based on a US national commercial health claims database (2006–2009). Fibromyalgia patients who initiated duloxetine or pregabalin in 2008, aged 18–64 years, and who maintained continuous health insurance coverage 1 year before and 1 year after initiation were assigned to duloxetine or pregabalin cohorts on the basis of their initiated agent. Patients who had pill coverage of the agents over the course of 90 days preceding the initiation were excluded. The two comparative cohorts were constructed using propensity score greedy match methods. Descriptive analysis and paired t-test were performed to compare health care utilization rates in the postinitiation year and the changes of these rates from the preinitiation year to the postinitiation year. Results Both matched cohorts (n=1,265 pairs) had a similar mean initiation age (49–50 years), percentage of women (87%–88%), and prevalence of baseline comorbid conditions (neuropathic pain other than diabetic peripheral neuropathic pain, low back pain, cardiovascular disease, hypertension, headache or migraine, and osteoarthritis). In the preinitiation year, both cohorts had similar inpatient, outpatient, and medication utilization rates (inpatient, 15.7%–16.1%; outpatient, 100.0%; medication, 97.9%–98.7%). The utilization rates diverged in the postinitiation year, with the pregabalin cohort using more fibromyalgia-related inpatient care (3.2% versus 2.2%; P<0.05), any inpatient care (19.3% versus 16.8%; P<0.05), and fibromyalgia-related outpatient care (62.1% versus 51.8%; P<0.05). From the preinitiation period to the postinitiation period, the duloxetine cohort experienced decreases in certain utilization rates, whereas the pregabalin cohort had increases (percentage of patients with a fibromyalgia-related admission, −1.2% versus 0.4% [P<0.01]; number of fibromyalgia-related outpatient claims, −1.7 versus 4.7 [P<0.01]). Conclusion Fibromyalgia patients initiating pregabalin tended to consume more fibromyalgia-related inpatient and outpatient care in the first postinitiation year, whereas fibromyalgia patients initiating duloxetine tended to have lower utilization rates of fibromyalgia-related inpatient care in the postinitiation year than in the preinitiation year.
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Affiliation(s)
- X Peng
- Eli Lilly and Company, Indianapolis, IN, USA
| | - P Sun
- Kailo Research Group, Indianapolis, IN, USA
| | - D Novick
- Eli Lilly and Company, Indianapolis, IN, USA
| | - J Andrews
- Eli Lilly and Company, Indianapolis, IN, USA
| | - S Sun
- Kailo Research Group, Indianapolis, IN, USA
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Novick D, Montgomery W, Moneta V, Peng X, Brugnoli R, Haro J. EPA-1087 - Treatment patterns in asian patients with a major depressive episode. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78365-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Abstract
Together with IL-12 or IL-15, interleukin-18 (IL-18) plays a major role in the production of interferon-γ from T-cells and natural killer cells; thus, IL-18 is considered to have a major role in the Th1 response. However, without IL-12, IL-18 is proinflammatory in an IFNγ independent manner. IL-18 is a member of the IL-1 family of cytokines and similar to IL-1β, the cytokine is synthesized as an inactive precursor requiring processing by caspase-1 into an active cytokine. IL-18 is also present as an integral membrane protein but requires caspase-1 for full activity in order to induce IFNγ. Uniquely, unlike IL-1β, the IL-18 precursor is constitutively present in nearly all cells in healthy humans and animals. The activity of IL-18 is balanced by the presence of a high-affinity, naturally occurring IL-18 binding protein (IL-18BP). In humans, increased disease severity can be associated with an imbalance of IL-18 to IL-18BP such that the levels of free IL-18 are elevated in the circulation. Increasing number of studies have expanded the role of IL-18 in mediating inflammation in animal models of disease using the IL-18BP, IL-18 deficient mice, neutralization of IL-18 or deficiency in the IL-18 receptor alpha chain. A role for IL-18 has been implicated in several autoimmune diseases, myocardial function, emphysema, metabolic syndromes, psoriasis, inflammatory bowel disease, macrophage activation syndrome, sepsis and acute kidney injury, although paradoxically, in some models of disease, IL-18 is protective. The IL-18BP has been used safely in humans and clinical trials of IL-18BP as well as neutralizing anti-IL-18 antibodies are being tested in various diseases.
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Affiliation(s)
- Daniela Novick
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Soohyun Kim
- Department of Biomedical Science and Technology, Konkuk University, Seoul, Republic of Korea
| | - Gilles Kaplanski
- UMR-S1076, Aix Marseille Université, Campus Timone, Marseille, France; Service de Médecine Interne, Hôpital de la Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Charles A Dinarello
- Department of Medicine, University of Colorado Denver, Aurora, CO, United States; Department of Medicine, University Medical Center Nijmegen, Nijmegen, The Netherlands.
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Abstract
Interleukin-18 (IL-18) is a member of the IL-1 family of cytokines. Similar to IL-1β, IL-18 is synthesized as an inactive precursor requiring processing by caspase-1 into an active cytokine but unlike IL-1β, the IL-18 precursor is constitutively present in nearly all cells in healthy humans and animals. The activity of IL-18 is balanced by the presence of a high affinity, naturally occurring IL-18 binding protein (IL-18BP). In humans, increased disease severity can be associated with an imbalance of IL-18 to IL-18BP such that the levels of free IL-18 are elevated in the circulation. Increasing number of studies have expanded the role of IL-18 in mediating inflammation in animal models of disease using the IL-18BP, IL-18-deficient mice, neutralization of IL-18, or deficiency in the IL-18 receptor alpha chain. A role for IL-18 has been implicated in several autoimmune diseases, myocardial function, emphysema, metabolic syndromes, psoriasis, inflammatory bowel disease, hemophagocytic syndromes, macrophage activation syndrome, sepsis, and acute kidney injury, although in some models of disease, IL-18 is protective. IL-18 plays a major role in the production of interferon-γ from T-cells and natural killer cells. The IL-18BP has been used safely in humans and clinical trials of IL-18BP as well as neutralizing anti-IL-18 antibodies are in clinical trials. This review updates the biology of IL-18 as well as its role in human disease.
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Affiliation(s)
- Charles A Dinarello
- Department of Medicine, University of Colorado Denver , Aurora, CO , USA ; Department of Medicine, University Medical Center Nijmegen , Nijmegen , Netherlands
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Drucker I, Klajman A, Revel M, Manor Y, Ben-Efraim S, Novick D. Interleukin-6 and interleukin-6 receptor secretion by chronic lymphatic leukaemia and normal B lymphocytes: effect of PMA and PWM. Mediators Inflamm 2012; 6:147-53. [PMID: 18472849 PMCID: PMC2365853 DOI: 10.1080/09629359791857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Interleukin-6 (IL-6) and soluble interleukin-6 receptor (sIL-6R) were detected in supernatants of cultures of B chronic lymphatic leukaemia (CLL) lymphocytes. Phorbol-12-myristate 13 acetate (PMA) caused a decrease in the levels of IL-6 in 14 out of 16 cultures and an increase in levels of sIL6R in all 15 cases. The effect of pokeweed mitogen (PWM) was variable and not significant. The levels of IL-6 were below the detection limit (60 pg/ml) in sera of 13 CLL patients whereas sIL-6R was detected (13 ng/ml to 97 ng/ml) in the 13 sera. IL6 was not detected in cultures of unstimulated or stimulated with PMA or PWM normal human B cells. Levels of sIL-6R were minimal in cultures of normal B lymphocytes and were increased in PMA stimulated cultures. The results are consistent with the view that B-CLL cells produce spontaneously IL-6 which could act in an autocrine fashion to cause shedding of surface IL-6R and account for the correlation found between serum levels of sIL-6R and B-CLL lymphocyte numbers. The fall in levels of IL-6 in PMA stimulated CLL cultures might express masking or degradation of IL-6 after combination with the receptor.
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Affiliation(s)
- I Drucker
- Laboratory for Clinical Immunology Meir Hospital Kfar-Saba 44281 Israel
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Chiossone L, Audonnet S, Chetaille B, Chasson L, Farnarier C, Berda-Haddad Y, Jordan S, Koszinowski UH, Dalod M, Mazodier K, Novick D, Dinarello CA, Vivier E, Kaplanski G. Protection from inflammatory organ damage in a murine model of hemophagocytic lymphohistiocytosis using treatment with IL-18 binding protein. Front Immunol 2012; 3:239. [PMID: 22891066 PMCID: PMC3413989 DOI: 10.3389/fimmu.2012.00239] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [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: 10/14/2011] [Accepted: 07/17/2012] [Indexed: 01/25/2023] Open
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening condition due to the association of an infectious agent with lymphocyte cytotoxicity defects, either of congenital genetic origin in children or presumably acquired in adults. In HLH patients, an excess of lymphocyte or macrophage cytokines, such as IFN-γ and TNFα is present in serum. In animal models of the disease, IFN-γ and TNF-α have been shown to play a central pathogenic role. In humans, unusually high concentrations of IL-18, an inducer of IFN-γ, and TNF-α have been reported, and are associated with an imbalance between IL-18 and its natural inhibitor IL-18 binding protein (IL-18BP) resulting in an excess of free IL-18. Here we studied whether IL-18BP could reduce disease severity in an animal model of HLH. Mouse cytomegalovirus infection in perforin-1 knock-out mice induced a lethal condition similar to human HLH characterized by cytopenia with marked inflammatory lesions in the liver and spleen as well as the presence of hemophagocytosis in bone marrow. IL-18BP treatment decreased hemophagocytosis and reversed liver as well as spleen damage. IL-18BP treatment also reduced both IFN-γ and TNF-α production by CD8(+) T and NK cells, as well as Fas ligand expression on NK cell surface. These data suggest that IL-18BP is beneficial in an animal model of HLH and in combination with anti-infectious therapy may be a promising strategy to treat HLH patients.
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Affiliation(s)
- Laura Chiossone
- Centre d'Immunologie de Marseille-Luminy, INSERM, U 1104 Marseille, France
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Haro JM, Reed C, Gonzalez-Pinto A, Novick D, Bertsch J, Vieta E. 2-Year course of bipolar disorder type I patients in outpatient care: factors associated with remission and functional recovery. Eur Neuropsychopharmacol 2011; 21:287-93. [PMID: 20956071 DOI: 10.1016/j.euroneuro.2010.08.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Revised: 07/10/2010] [Accepted: 08/08/2010] [Indexed: 11/29/2022]
Abstract
EMBLEM is a 2-year, prospective, observational study that enrolled patients initiating/changing oral treatment for an acute manic/mixed episode. This paper analysed remission and functional recovery in 1656 patients who entered the 2-year long-term phase. Cox models identified variables significantly associated with achieving remission and functional recovery at 2years. Of these patients, 64% achieved remission and 34% achieved functional recovery. Patients with a higher CGI-BP overall score at baseline, who had depressive episodes in the year before inclusion and who had poor social functioning (work or social impairment, not living independently or without a spouse/partner) were less likely to achieve remission or recovery. Prescription of typical antipsychotics and prescription of antidepressants at the first visit of the long-term treatment phase (12weeks) were independent predictors of lower remission and recovery rates. In conclusion, functional recovery occurred in approximately half of those who achieved remission. Impairment of work and social functioning was consistently associated with lower remission and recovery rates.
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Affiliation(s)
- J M Haro
- Parc Sanitari Sant Joan De Deu-SSM, Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Sant Boi de Llobregat, Barcelona, Spain.
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González-Pinto A, Reed C, Novick D, Bertsch J, Haro JM. Assessment of medication adherence in a cohort of patients with bipolar disorder. Pharmacopsychiatry 2010; 43:263-70. [PMID: 20842617 DOI: 10.1055/s-0030-1263169] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION This study aimed to identify factors associated with medication adherence in bipolar disorder (BPD) patients. METHODS EMBLEM is a 2-year, prospective, observational study on the outcomes of BPD patients initiating or changing treatment for a manic/mixed episode. Data were collected at baseline, during the first 12 weeks of treatment (acute phase) and up to 24 months of follow-up (maintenance phase). Adherence was assessed by investigators at every visit. Repeated measures logistic regression analyses identified variables associated with adherence. RESULTS Of 1,831 patients included in the analysis, 76.6% were adherent and 23.4% were non-adherent with their BPD medication during the maintenance phase. Patients were more likely to be adherent if they had insight into their illness at week 12. Patients were less likely to be adherent if they had cannabis abuse/dependence during the acute phase, work impairment or higher CGI hallucinations/delusions at baseline DISCUSSION Psychotic symptoms, poor insight, cannabis abuse/dependence and work impairment are negatively related to medication adherence during maintenance therapy of bipolar disorder. Patients with these characteristics may need a different therapeutic approach.
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Affiliation(s)
- A González-Pinto
- CIBERSAM Stanley International Mood Disorders Research Centre, Hospital Santiago Apóstol, University of the Basque Country, Vitoria, Spain.
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Ascher-Svanum H, Peng X, Montgomery W, Faries DE, Lawson AH, Witte MM, Novick D, Jemiai N, Perrin E, McDonnell DP. Assessing the infrequent oral supplementation of olanzapine long-acting injection in the treatment of schizophrenia. Eur Psychiatry 2010; 26:313-9. [PMID: 20621454 DOI: 10.1016/j.eurpsy.2010.03.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Revised: 02/08/2010] [Accepted: 03/08/2010] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Adding another antipsychotic to a treatment regimen was previously used in evaluating the medication's efficacy. Supplementation of depot antipsychotics with oral antipsychotics is particularly meaningful because depot formulations are typically chosen for patients struggling with adherence to oral antipsychotics. This post-hoc analysis assessed supplementation of olanzapine long-acting injection (olanzapine-LAI) with oral olanzapine. SUBJECTS AND METHODS We used 12 months of data from an open-label, single-arm extension study of patients with schizophrenia or schizoaffective disorder (N=931) treated with olanzapine-LAI. The prevalence, duration, time to first supplementation, and best predictors of oral supplementation were assessed. RESULTS Oral supplementation occurred in 21% of patients for a median of 31 days with mean modal dose of 10.8 mg/day. Mean time to first supplementation was shorter for patients who were at least moderately ill at baseline compared to less ill patients (47 vs. 97 days, p<0.001). Best predictors of oral supplementation included a more severe illness profile at baseline, lower olanzapine-LAI dose prior to oral supplementation, supervised living arrangements, and being African-American. CONCLUSION Supplementation of olanzapine-LAI appears to be infrequent, of relatively short duration, and reserved for more severely ill patients who may require a targeted rescue medication due to signs of impending relapse.
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Affiliation(s)
- H Ascher-Svanum
- Lilly Corporate Center, DC 4133, Eli Lilly and Company, Indianapolis, IN 46285, USA.
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Hong J, Novick D, Haro J, Knapp M. PW01-181 - Economic consequences of medication nonadherence in the treatment of schizophrenia: 36-month results from the SOHO (schizophrenia outpatient health outcomes) study. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)71588-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Novick D, Brugnoli R, Haro J, Rossi A, Bortolomasi M, Frediani S, Borgherini G. PW01-254 - Risk factors for suicide in the observational schizophrenia outpatient health outcomes (SOHO) study. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)71661-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Novick D, Ascher-Svanum H, Zhu B, Brnabic A, Stauffer V, Peng X, Karagianis J, Perrin E. The Number Needed to Treat for All-Cause Medication Discontinuation in the Treatment of Schizophrenia: Consistency Across World Geographies and Study Designs. Pharmacopsychiatry 2009; 43:81-5. [DOI: 10.1055/s-0029-1242816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Karagianis J, Novick D, Pecenak J, Haro JM, Dossenbach M, Treuer T, Montgomery W, Walton R, Lowry AJ. Worldwide-Schizophrenia Outpatient Health Outcomes (W-SOHO): baseline characteristics of pan-regional observational data from more than 17,000 patients. Int J Clin Pract 2009; 63:1578-88. [PMID: 19780867 DOI: 10.1111/j.1742-1241.2009.02191.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To describe the Worldwide-Schizophrenia Outpatient Health Outcomes (W-SOHO) patient population at study entry, focusing on illness burden and prescribing practices across regions. METHODS The SOHO study was a 3-year, prospective, observational study designed to assess costs and outcomes associated with antipsychotic use in outpatients initiating or changing antipsychotic (with an emphasis on olanzapine compared with other antipsychotics). SOHO was conducted in 10 European countries and 27 other countries as Intercontinental SOHO (IC-SOHO). Data from all countries have been pooled to produce the W-SOHO dataset. MAIN OUTCOMES MEASURES Clinical Global Impression-Schizophrenia (CGI-SCH) severity scores, psychotropic medication use, adverse events, social interaction, housing and employment status, self-perceived health state (EuroQoL EQ-5D scale and Visual Analogue Scale, EQ-VAS), and reasons for initiation/change of antipsychotic. RESULTS The W-SOHO database comprises 17,384 patients from six regions; East Asia (n = 1223), Central and Eastern Europe (n = 2175), Northern Europe (n = 4291), Southern Europe (n = 5788), Latin America (n = 2566), North Africa and the Middle East (n = 1341). Overall, patients were 38 +/- 13 years old (mean +/- SD), moderately ill (mean CGI-SCH overall score of 4.4 +/- 1.0) with a median duration of illness of 7 years (interquartile range 1-16 years); 43% were female, 10% were receiving antipsychotic medication for the first time. Adverse events were prevalent across all regions; on average, 50% (range 41-59%) of patients taking antipsychotics exhibited extrapyramidal symptoms at baseline, and 62% (34-67%) of patients reported sexual dysfunction in the previous month. On average, only 19% (16-23%) of patients were in paid employment and as many as 69% were living in dependent housing. CONCLUSIONS Despite inherent diversity in these patients and the health care systems supporting them, there are striking cross-regional similarities in baseline characteristics for most measures. Not all countries are represented; regional comparisons may not be valid outside of the countries studied.
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Affiliation(s)
- J Karagianis
- Clinical Research, Eli Lilly Canada Inc., Toronto, ON, Canada M1N 2E8.
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Favilli F, Anzilotti C, Martinelli L, Quattroni P, De Martino S, Pratesi F, Neumann D, Beermann S, Novick D, Dinarello CA, Boraschi D, Migliorini P. IL-18 activity in systemic lupus erythematosus. Ann N Y Acad Sci 2009; 1173:301-9. [PMID: 19758166 DOI: 10.1111/j.1749-6632.2009.04742.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Interleukin-18 (IL-18) is an inflammation-related cytokine that plays a central role both in innate defense reactions and in Th1 activation and specific immune responses. Increased levels of IL-18 can be detected in biological fluids and organs of individuals affected by several autoimmune pathologies, as well as in autoimmune animal models. In this review, the role of IL-18 in systemic lupus erythematosus (SLE) is critically examined, including its possible role in the pathogenesis of disease. In SLE, increased levels of IL-18 have been found in serum/plasma of affected persons, which positively correlated with disease severity. The possibility that circulating IL-18 levels are predictive of renal damage has been proposed, suggesting that IL-18 may be a prognostic marker of renal involvement useful to identify patients at risk of renal failure. The evaluation of urinary levels of free active IL-18 indeed suggests a correlation with the degree of renal involvement. The possible pathogenic role of IL-18 in lupus has been studied in a mouse model of progressive disease, which makes possible the identification, at the level of the different affected organs, of IL-18 changes preceding disease development and those appearing after disease onset. It can be concluded that IL-18 has a multifaceted role in autoimmune lupus, being apparently involved both in the effector phases of the late organ damage and, in some organs, in the initial pathogenic events. Therapeutic strategies targeting IL-18 in autoimmunity are under development.
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Affiliation(s)
- Flavia Favilli
- National Research Council, Institute of Biomedical Technologies, Pisa, Italy.
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Novick D, Elbirt D, Miller G, Dinarello CA, Rubinstein M, Sthoeger ZM. High circulating levels of free interleukin-18 in patients with active SLE in the presence of elevated levels of interleukin-18 binding protein. J Autoimmun 2009; 34:121-6. [PMID: 19699611 DOI: 10.1016/j.jaut.2009.08.002] [Citation(s) in RCA: 65] [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: 06/26/2009] [Revised: 08/06/2009] [Accepted: 08/07/2009] [Indexed: 11/30/2022]
Abstract
Systemic Lupus Erythematosus (SLE) is an autoimmune disease characterized by the production of autoantibodies particularly to nuclear antigens and by an abnormal production of proinflammatory cytokines. In the present study, we measured the levels of the proinflammatory cytokine IL-18 and its natural inhibitor, the IL-18 binding protein (IL-18BP), in sera of SLE patients at various stages of the disease. This is the first study to present IL-18BP levels in sera of SLE patients as well as the calculated, biologically active, free IL-18 concentrations that are most probably more relevant to the pathology of SLE. Sera from 48 unselective SLE patients (total of 195 samples) were obtained longitudinally with a mean follow-up period of 11.1 +/- 8.9 years and were compared to sera from 100 healthy volunteers. Circulating levels of IL-18, IL-18BP and free IL-18 in the SLE patients were significantly higher than the levels of healthy controls (5 fold, 6 fold and 3 fold for IL-18, IL-18BP and free IL-18, respectively) and correlated with disease activity as scored by SLEDAI-2K. Furthermore, these levels during active disease (SLEDAI-2K > or = 6) were higher compared to the levels measured in the sera of the same patients during remission or during mild disease (SLEDAI-2K 0-5). The high levels of IL-18 and IL-18BP in sera of active SLE patients suggest their possible role in the pathogenesis and course of the disease. However, despite the elevated levels of IL-18BP during active disease, free IL-18 remained more than 2 fold higher than the levels in healthy controls suggesting a potential benefit of administration of exogenous IL-18BP as a novel therapeutic approach for active SLE.
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Affiliation(s)
- Daniela Novick
- Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot, Israel
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Novick D, Gonzalez-Pinto A, Haro JM, Bertsch J, Reed C, Perrin E, Tohen M. Translation of Randomised Controlled Trial Findings into Clinical Practice: Comparison of Olanzapine and Valproate in the EMBLEM Study. Pharmacopsychiatry 2009; 42:145-52. [DOI: 10.1055/s-0028-1128115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Suarez D, Haro JM, Novick D, Perrin E, Ochoa S, Naber D. Reasons and Outcomes of Olanzapine Dose Adjustments in the Outpatient Treatment of Schizophrenia. Pharmacopsychiatry 2009; 42:135-40. [PMID: 19585391 DOI: 10.1055/s-0028-1112127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Novick D, Suarez D, Haro J, Haddad P. Adherence with Antipsychotic Treatment Medication in Outpatients with Schizophrenia: 36- Month Results from the Schizophrenia Outpatients Health Outcomes (soho) Study. Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)71250-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Objective:To assess frequency and baseline factors associated with adherence with antipsychotic medication during long-term treatment in outpatients with schizophrenia.Methods:SOHO is a 3-year, prospective, observational study that included 10 972 patients changing or starting a new antipsychotic medication Treatment adherence during 4 weeks prior to the visit was assessed at each visit by participating psychiatrists as:•the patient has not been prescribed medication;•the patient almost always adheres;•the patient adheres half of the time; and•the patient never adheres to antipsychotic medication.Logistic regression models were fitted to analyze the baseline factors associated to compliance during follow-up.Results:6731 patients with at most one missing visit were analysed. Data from the missing visit were imputed from the previous visit; 71.2% were considered to be adherent and 28.8% non-adherent over the 3-year follow-up period. the strongest predictor of medication adherence during follow-up was adherence at baseline (OR = 4.01, 95% CI: 3.46-4.64). other baseline predictors of adherence included not using antipsychotics in the previous 4 weeks, receiving treatment for first time, being socially active, and a higher body mass index. Baseline predictors of non-adherence were alcohol dependence, substance abuse, hospitalisation in previous 6 months, living independently housing and having hostile behaviours.Conclusions:Alcohol dependence, substance abuse and living independently were associated with non-adherence. Previous adherence, being socially active and receiving medication for the first time was associated with better adherence. Limitation: medication adherence was assessed by the psychiatrist through a single item question.
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Lambert M, Naber D, Schacht A, Wagner T, Hundemer HP, Karow A, Huber CG, Suarez D, Haro JM, Novick D, Dittmann RW, Schimmelmann BG. Rates and predictors of remission and recovery during 3 years in 392 never-treated patients with schizophrenia. Acta Psychiatr Scand 2008; 118:220-9. [PMID: 18699954 DOI: 10.1111/j.1600-0447.2008.01213.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Few studies have prospectively examined remission and recovery as well as their predictors in schizophrenia simultaneously. Aims of the study were to identify remission and recovery rates as well as their predictors in schizophrenia. METHOD 392 never-treated patients with schizophrenia were assessed over 3 years. Combined remission and recovery required concurrent achievement of symptomatic and functional remission as well as adequate quality of life for at least 6 and 24 months respectively. Predictors were analysed using stepwise logistic regression models. RESULTS At 3 years, remission rates for symptoms, functioning and subjective wellbeing were 60.3%, 45.4% and 57.0%; recovery rates were 51.7%, 35.0% and 44.3%. Of those, 28.1% were in combined remission and 17.1% in combined recovery. Predictors mainly included the baseline functional status and early remission within the first 3 months. CONCLUSION The proportion of patients who met combined remission or recovery criteria is low. Early treatment adaptations in case of early non-remission are mandatory.
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Affiliation(s)
- M Lambert
- Psychosis Early Detection and Intervention Centre, Centre for Psychosocial Medicine, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Werman A, Korba BE, Alkahe B, Finkelshtein D, Bujanover S, Novick D, Vinocour E, Rubinstein M. 54 A soluble form of the LDL receptor inhibits hepatitis B virus replication in vitro. Cytokine 2008. [DOI: 10.1016/j.cyto.2008.07.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Novick D, Elbirt D, Dinarello CA, Rubinstein M, Sthoeger ZM. Interleukin-18 binding protein in the sera of patients with Wegener's granulomatosis. J Clin Immunol 2008; 29:38-45. [PMID: 18594952 DOI: 10.1007/s10875-008-9217-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2008] [Accepted: 06/05/2008] [Indexed: 12/24/2022]
Abstract
INTRODUCTION In the present study, we examined the levels of the pro-inflammatory cytokine IL-18 and its natural inhibitor, the IL-18 binding protein (IL-18BP), in sera of Wegener's granulomatosis (WG) patients at various stages of the disease. PATIENTS AND METHODS Sera from eight consecutive biopsy-proven systemic WG patients (four men and four women; age at diagnosis 58.4 +/- 13.8 years) were obtained longitudinally with a follow-up period of 55.2 +/- 30 months. Sera obtained from 50 healthy subjects were used as controls. RESULTS AND DISCUSSION Serum levels of IL-18, IL-18BP, and free IL-18 obtained during an active phase of the disease (Birmingham Vasculitis Activity Score, BVAS > 10) were more than twofold higher than levels in the same patients during inactive disease stages (BVAS < 5; P < 0.002; P < 0.006, and P < 0.03 for IL-18, IL-18BP, and free IL-18, respectively). During inactive stages, the levels of these markers were comparable to those of healthy controls. The elevated levels of IL-18 and IL-18BP in sera during active stages of disease suggest a possible role in the pathogenesis and course of the WG. CONCLUSION Despite the elevated IL-18BP levels during active disease, free IL-18 remained higher than in the inactive disease stages, suggesting a potential benefit of administration of exogenous IL-18BP as a novel therapeutic approach for active WG.
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Affiliation(s)
- D Novick
- Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot, Israel.
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Haro JM, Novick D, Suarez D, Ochoa S, Roca M. Predictors of the course of illness in outpatients with schizophrenia: a prospective three year study. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:1287-92. [PMID: 18502012 DOI: 10.1016/j.pnpbp.2008.04.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2007] [Revised: 03/25/2008] [Accepted: 04/02/2008] [Indexed: 11/25/2022]
Abstract
The course of schizophrenia includes a combination of periods of remission and relapse. Previous studies focused on simple dichotomous outcomes and did not take into account the complexity of the course. Using data from a large 3-year follow-up study of schizophrenia, we described the different courses of schizophrenia. Of the 5950 patients with complete 3-year data, 38.7% never achieved remission (prolonged course), 15.7% achieved remission but relapsed and 45.7% achieved and maintained remission (persistent remission). Females, patients with better social functioning at baseline (living independently, in paid employment, socially active or having a spouse or partner) and with a shorter duration of illness had a more favourable course. Patients prescribed risperidone, quetiapine or depot typicals at the baseline visit were more likely to have a prolonged course than patients who started olanzapine. The results show that description of the long-term outcome of schizophrenia cannot be summarized with just one outcome variable.
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Affiliation(s)
- J M Haro
- Sant Joan de Déu-SSM, Fundació Sant Joan de Déu, CIBER-SAM, Spain.
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Haro JM, Ciudad A, Alonso J, Bousoño M, Suárez D, Novick D, Gilaberte I. [Remission and relapse in the outpatient treatment of patients with schizophrenia. Outcomes at 3 years]. Actas Esp Psiquiatr 2008; 36:187-196. [PMID: 18461495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Three year data collected in the frame of the SOHO study within Spain were used to evaluate antipsychotic treatment outcomes by analyzing remission and relapse as well as the factors influencing them. METHODS The SOHO was a prospective, long-term, observational study of the outcomes of schizophrenia treatment in ambulatoty who initiated therapy or who changed to a new antipsychotic drug performed in 10 European countries, with a focus on olanzapine. This article reports the attainment of international schizophrenia clinical remission and relapse criteria and the associated correlates in these patients. RESULTS AND CONCLUSIONS A total of 2,020 patients were recruited in Spain. Almost 2/3 (60.1%) of the patients met the criteria for clinical remission. Factors that influence the likelihood of remission were identified, such as gender, baseline clinical and/or functional status, time since treatment initiation, treatment with olanzapine versus oral typical antipsychotics, duration of treatment, gender or the need for concomitant anxiolytics. Relapse occurred in 18.7% of patients. Treatment with quetiapine or the prescription of anticholinergics was associated with a greater risk of relapse. CONCLUSIONS These results highlight some prognostic factors of the course of schizophrenia and underscore the importance of the antipsychotic choice and its maintenance to achieve favorable long-term clinical outcomes in routine practice.
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Affiliation(s)
- J M Haro
- Fundacion San Juan de Dios, Barcelona, Spain.
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Novick D, Rubinstein M. Corrigendum to “The tale of soluble receptors and binding proteins: From bench to bedside” [Cytokine Growth Factor Rev. 18 (2007) 525–33]. Cytokine Growth Factor Rev 2008. [DOI: 10.1016/j.cytogfr.2007.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Schuepbach D, Novick D, Haro J, Reed C, Boeker H, Noda S, Angst J, Hell D. Determinants of Voluntary vs. Involuntary Admission in Bipolar Disorder and the Impact of Adherence. Pharmacopsychiatry 2008; 41:29-36. [DOI: 10.1055/s-2007-993213] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Leach ST, Messina I, Lemberg DA, Novick D, Rubenstein M, Day AS. Local and systemic interleukin-18 and interleukin-18-binding protein in children with inflammatory bowel disease. Inflamm Bowel Dis 2008; 14:68-74. [PMID: 17879274 DOI: 10.1002/ibd.20272] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Interleukin-18 (IL-18) is increased in the inflamed mucosa of patients with Crohn's disease (CD). The balance between this pleiotropic proinflammatory cytokine and its natural inhibitor, IL-18-binding protein (IL-18BP), may contribute to the pathogenesis of inflammatory bowel disease (IBD). METHODS Serum and mucosal biopsies were collected from children with IBD, from children with celiac disease, and from controls. Biopsies were maintained in culture for 24 hours, and supernatant was collected. Serum and supernatant IL-18 and IL-18BPa concentrations were measured by immunoassay. Disease activity score (PCDAI) and standard serum inflammatory markers (albumin, platelets, ESR, and CRP) were recorded. RESULTS Serum IL-18 was greater in children with CD (537 pg/mL) than in controls (335 pg/mL; P < 0.05) but not in children with ulcerative colitis (UC) or IBD type unclassified (IBDU). Mucosal IL-18 was greater in children with CD and UC/IBDU than in controls (P < 0.01). Serum IL-18BPa was increased in children with CD compared with that in controls (3.9 versus 2.6 ng/mL; P < 0.05), but was not elevated in children with UC/IBDU. Furthermore, calculated free-serum IL-18 was elevated in CD, but not UC/IBDU, compared with that in controls (P = 0.001). Total and free-serum IL-18 were elevated in severe CD relative to in mild/moderate disease. CONCLUSIONS IL-18, produced in the colons of children with IBD, may contribute to local inflammatory changes. Systemic IL-18 level may be a useful indicator of gut inflammation. Furthermore, free IL-18 is greatly elevated in children with CD, suggesting that compensatory increases in IL-18BPa are insufficient. Further exploration of the role of this cytokine in the pathogenesis of IBD is now required.
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Affiliation(s)
- Steven T Leach
- School of Women's and Children's Health, University of New South Wales, Australia
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Thompson SR, Novick D, Stock CJ, Sanders J, Brull D, Cooper J, Woo P, Miller G, Rubinstein M, Humphries SE. Free Interleukin (IL)-18 levels, and the impact of IL18 and IL18BP genetic variation, in CHD patients and healthy men. Arterioscler Thromb Vasc Biol 2007; 27:2743-9. [PMID: 17951325 DOI: 10.1161/atvbaha.107.149245] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate free interleukin-18 (fIL-18) levels, and variation within the IL-18 system genes, in heart surgery patients, and healthy men. METHODS AND RESULTS fIL-18 was calculated from IL-18 and IL-18 binding protein (BP) levels, in 421 healthy men and 196 post-coronary artery bypass graft (CABG) patients. After surgery, fIL-18 peaked at 6 hours (from 117 to 331 pg/mL) but fell to below presurgery levels at 24 hours (99 pg/mL), because of changes in total IL-18 and IL-18BP. fIL-18 24 hours postsurgery was significantly higher in those who suffered a major complication after surgery (125 versus 80 pg/mL, P<0.01). Baseline total IL-18 was also higher in healthy men who went on to suffer an MI over 17 years of prospective study (276 versus 240 pg/mL, P=0.01). Tagging SNPs for IL18 (n=5) and IL18BP (n=3) were determined, in both studies the IL18 HapIII haplotype (frequency 30%) was associated with 36% lower baseline fIL-18 levels before surgery (P<0.01), and 7% lower in healthy men (P=0.04). The frequency of HapIII was lower in CABG patients than in healthy men (20.7 versus 29.8%, P<0.01). CONCLUSIONS IL-18 levels, which are determined in part by variation in IL18, play a role in CHD development and postsurgery outcome.
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Affiliation(s)
- Simon R Thompson
- Cardiovascular Genetics, Rayne Institute, University College London, WC1E 6JF, UK.
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Abstract
Our approach of isolating proteins from a rich source of human proteins by ligand-affinity-chromatography enabled rapid and efficient isolation of not only soluble receptors corresponding to cell-associated receptors, but also independent binding-proteins and associated enzymes. No other approach would yield the latter. During the early 80's we prepared the tools and the infrastructure that enabled the subsequent 20 years of achievements. Thus we described eight soluble receptors (R) and binding proteins (BP) for various cytokines including the IL-6R, IFN-gammaR, TNFRI, TNFRII, LDLR, IFN-alpha/betaR, IL-18BP and IL-32BP identified as Proteinase 3. The isolation of the soluble IFN-alpha/beta receptor led to the cloning of its long sought cell surface ligand binding counterpart. We have established the concept that soluble receptors and binding proteins are normal constituents of body fluids in healthy individuals and that the levels of these biomarkers are modulated in various pathological situations. Each of these proteins contributed to basic science, one of them serves as a basis for therapy and some others are in various stages of clinical development.
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Affiliation(s)
- Daniela Novick
- Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot 76100, Israel.
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Hurgin V, Novick D, Werman A, Dinarello CA, Rubinstein M. 59 Antiviral and Immunoregulatory Activities of IFN-gamma Depend on Constitutively Expressed IL-1 alpha. Cytokine 2007. [DOI: 10.1016/j.cyto.2007.07.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Neff GW, Kemmer N, Zacharias VC, Kaiser T, Duncan C, McHenry R, Jonas M, Novick D, Williamson C, Hess K, Thomas M, Buell J. Analysis of hospitalizations comparing rifaximin versus lactulose in the management of hepatic encephalopathy. Transplant Proc 2007; 38:3552-5. [PMID: 17175328 DOI: 10.1016/j.transproceed.2006.10.107] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2006] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Patients with end-stage liver disease often develop hepatic encephalopathy. The loss in cognitive abilities results in marked economic loss to the patient and health care community. We report hospital admission rates and economic impact of patients with end-stage liver disease suffering from hepatic encephalopathy. METHODS The medical records were reviewed involving liver transplant patients started on lactulose or rifaximin therapy after presenting with stage 2 hepatic encephalopathy from January 2004 to November 2005. Information collected included demographics, hospitalizations required for hepatic encephalopathy, economic data, and Model for End-stage Liver Disease (MELD) score. RESULTS Thirty-nine patients met study criteria: 24 patients treated with lactulose (group one) and 15 with rifaximin (group two). Group one included 18 men and six women of mean age 48 (range 39 to 58), average MELD 14 (range 10 to 19). Group two included 10 men and five women of mean age 47 (range 42 to 58), average MELD 15 (range 10 to 19). Group one patients required 19 hospitalizations overall: three patients with three hospitalizations, four patients with two hospitalizations, and two patients required one hospitalization. Total drug cost per month was 50 dollars(group one) and 620 dollars(group two). The average annual cost of hospitalization, emergency room visit, and drug per patient treated was 13,284.96 dollars for a total of 318,839 dollars (range 5005 dollars to 26,255 dollars, including drug cost and hospital care). Group two required three hospitalizations, all three with one visit. The average annual cost of hospitalization, emergency room visit, and drug per patient treated was 7958.13 dollars for a total of 119,372 dollars (range 6005 dollars to 19,255 dollars, including drug cost and hospital care). The total cost of therapy per patient per year was 13,285 dollars (group one) versus 7958 dollars (group two). The average length of stay was shorter in group two [3.5 days (range 3 to 4)] versus group 1 [5.0 days (range 3 to 10); P < .0001]. CONCLUSION These pilot data demonstrate the marked difference in economic costs for the treatment of hepatic encephalopathy. The results also show that in comparative groups, the economic gains are quickly lost when using lactulose.
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Affiliation(s)
- G W Neff
- Department of Medicine, University of Cincinnati, Cincinnati, Ohio 45267-0595, USA.
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Hurgin V, Novick D, Werman A, Dinarello CA, Rubinstein M. Antiviral and immunoregulatory activities of IFN-gamma depend on constitutively expressed IL-1alpha. Proc Natl Acad Sci U S A 2007; 104:5044-9. [PMID: 17360358 PMCID: PMC1817830 DOI: 10.1073/pnas.0611608104] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
IFN-gamma induces its immunoregulatory activities by activating genes mainly through the Jak-STAT signaling pathway. Here we show that what was considered to be intrinsic IFN-gamma activities depend largely on the basal level of NF-kappaB, which is maintained by constitutively expressed IL-1alpha. The IL-1 receptor antagonist and antibodies to IL-1alpha, but not to IL-1beta, inhibited the antiviral activity of IFN-gamma by 90%, whereas no inhibition of type I IFN activity was observed. Similarly, the induction of many genes by IFN-gamma, including HLA-DR, ICAM-1, IL-18BP, and genes mediating its antiviral activity, greatly depended on basal IL-1alpha. Furthermore, IFN-gamma induced serum IL-18 binding protein in wild-type mice but not in IL-1alpha/beta double-deficient mice. Thus, constitutively expressed IL-1alpha is critical for numerous IFN-gamma activities.
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Affiliation(s)
- Vladimir Hurgin
- *Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot 76100, Israel; and
| | - Daniela Novick
- *Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot 76100, Israel; and
| | - Ariel Werman
- *Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot 76100, Israel; and
| | - Charles A. Dinarello
- Department of Medicine, University of Colorado Health Sciences Center, Denver, CO 80262
| | - Menachem Rubinstein
- *Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot 76100, Israel; and
- To whom correspondence should be addressed. E-mail:
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Abstract
IL-32, a recently discovered proinflammatory cytokine with four isoforms, induces IL-1beta, TNF-alpha, IL-6, and chemokines. Here, we used ligand (IL-32alpha) affinity chromatography in an attempt to isolate an IL-32alpha soluble receptor or binding protein. Recombinant IL-32alpha was covalently immobilized on agarose, and preparations of concentrated crude human urinary proteins were applied for chromatographic separation. A specific 30-kDa protein eluted from the column during acid washing and was identified by mass spectrometry as proteinase 3 (PR3) and confirmed by N-terminal microsequencing. PR3, a neutrophil granule serine protease, exists in a soluble or membrane form and is the major autoantigen for autoantibodies in the systemic vasculitic disease, Wegener's granulomatosis. The affinity of IL-32alpha to PR3 was determined by surface plasmon resonance. The dissociation constants were 2.65 +/- 0.4 nM for urinary PR3 and 1.2 +/- 0.05 nM for neutrophil-derived PR3. However, irreversible inactivation of PR3 enzymatic activity did not significantly change binding to the cytokine. Nevertheless, limited cleavage of IL-32 yielded products consistent with PR3 enzyme activity. Moreover, after limited cleavage by PR3, IL-32alpha was more active than intact IL-32alpha in inducing macrophage inflammatory protein-2 in mouse macrophages and IL-8 in human peripheral blood mononuclear cells. We suggest that PR3 is a specific IL-32alpha binding protein, independent of its enzymatic activity. However, limited cleavage of IL-32alpha by PR3 enhances activities of the cytokine. Therefore, specific inhibition of PR3 activity to process IL-32 or neutralization of IL-32 by inactive PR3 or its fragments may reduce the consequences of IL-32 in immune regulated diseases.
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Affiliation(s)
- Daniela Novick
- *Department of Molecular Genetics and
- To whom correspondence may be addressed. E-mail:
| | | | - Tania Azam
- Department of Medicine, University of Colorado Health Sciences Center, Denver, CO 80262
| | - Aharon Rabinkov
- Unit of Biological Services, The Weizmann Institute of Science, Rehovot 76100, Israel, and
| | - Charles A. Dinarello
- Department of Medicine, University of Colorado Health Sciences Center, Denver, CO 80262
- To whom correspondence may be addressed. E-mail: or
| | - Soo-Hyun Kim
- Department of Medicine, University of Colorado Health Sciences Center, Denver, CO 80262
- To whom correspondence may be addressed. E-mail: or
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Neumayr G, Ludwiczek O, Hoertnagl H, Pfister R, Mitterbauer G, Moschen A, Novick D, Rubinstein M, Tilg H. The Impact of Prolonged Strenuous Endurance Exercise on Interleukin 18 and Interleukin 18 Binding Protein in Recreational Cyclists. Int J Sports Med 2005; 26:836-40. [PMID: 16320167 DOI: 10.1055/s-2005-837466] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Interleukin 18 (IL-18) is an important pro-inflammatory cytokine in the early phase of human immune response to microbial infections. The influence of strenuous exercise on the intrinsic balance of IL-18 and its endogenous antagonist IL-18 binding protein (IL-18 BP) is unknown, but could be of major relevance for the athlete's immune function empirically and epidemiologically proven to be altered after exhaustive exertion. To study the effect of strenuous marathon cycling on the interaction of IL-18 and IL-18 BP we investigated 37 male, healthy, and well-trained amateur cyclists participating in the Otztaler Radmarathon in Tyrol (distance: 230 km; cumulative altitude difference: 5500 m). IL-18 was measured by a commercially available ELISA-Kit and IL-18 BP by a novel IL-18 BP ELISA method. Free, unbound IL-18 was calculated according to a standard equation. The mean plasma level of IL-18 was 142.27 +/- 21.85 pg/ml pre-race, remained nearly unchanged (124.35 +/- 13.16 pg/ml; p = 1.0) immediately after competition (mean race time 9 h 38 min), but declined significantly 24 h afterward (62.92 +/- 6.80 pg/ml; p = 0.002). The plasma levels of IL-18 BP increased considerably immediately after and kept on rising for the following 24 h (pre-race: 1.51 +/- 0.20 ng/ml; immediately post-race: 3.84 +/- 0.26 ng/ml, p < 0.001; 24 h post-race: 4.33 +/- 0.42 ng/ml, p < 0.001). Therefore, the calculated free IL-18 was 122.06 +/- 16.79 pg/ml pre-race, declined to 82.86 +/- 8.59 (p = 0.05) immediately post-race and to 39.17 +/- 3.76 pg/ml 24 h post-race (p < 0.001). The respective percentages of this post-exercise reduction in free IL-18 plasma levels were 32 % and 68 %. The present study reveals an exercise-induced significant decline in free IL-18 accompanied by an immediate up-regulation of IL-18 BP and decreased IL-18 in marathon cyclists. This down-regulation of free IL-18 may (i) limit the magnitude and duration of a too excessive inflammatory response to the exercise-induced tissue damage and (ii) on the other hand contribute to the elevated susceptibility to infection in athletes undergoing exhaustive exercise.
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Affiliation(s)
- G Neumayr
- Institute of Sports Medicine, University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
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Mazodier K, Marin V, Novick D, Farnarier C, Robitail S, Schleinitz N, Veit V, Paul P, Rubinstein M, Dinarello CA, Harlé JR, Kaplanski G. Severe imbalance of IL-18/IL-18BP in patients with secondary hemophagocytic syndrome. Blood 2005; 106:3483-9. [PMID: 16020503 PMCID: PMC1895045 DOI: 10.1182/blood-2005-05-1980] [Citation(s) in RCA: 162] [Impact Index Per Article: 8.5] [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: 05/17/2005] [Accepted: 07/10/2005] [Indexed: 12/27/2022] Open
Abstract
Hemophagocytic syndrome (HPS) is characterized by an uncontrolled and poorly understood activation of T-helper 1 (Th-1) lymphocytes and macrophages. We studied 20 patients with HPS secondary to infections, autoimmune disease, lymphoma, or cancer and observed that the concentrations of serum interleukin 18 (IL-18), a strong inducer of Th-1 responses, interferon gamma (IFN-gamma) production, and stimulation of macrophages and natural killer (NK) cells were highly increased in HPS but not in control patients. In contrast, concentrations of its natural inhibitor, the IL-18 binding protein (IL-18BP), were only moderately elevated, resulting in a high level of biologically active free IL-18 in HPS (4.6-fold increase compared with controls; P < .001). Free IL-18 but not IL-12 concentrations significantly correlated with clinical status and the biologic markers of HPS such as anemia (P < .001), hypertriglyceridemia, and hyperferritinemia (P < .01) and also with markers of Th-1 lymphocyte or macrophage activation, such as elevated concentrations of IFN-gamma and soluble IL-2 and tumor necrosis factor alpha (TNF-alpha) receptor concentrations. Despite high IL-18 elevation, in vitro NK-cell cytotoxicity was severely impaired in HPS patients, in part due to NK-cell lymphopenia that was observed in a majority of patients but also secondary to an intrinsic NK-cell functional deficiency. We concluded that a severe IL-18/IL-18BP imbalance results in Th-1 lymphocyte and macrophage activation, which escapes control by NK-cell cytotoxicity and may allow for secondary HPS in patients with underlying diseases.
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Affiliation(s)
- Karin Mazodier
- Service de Médecine Interne, Hôpital de la Conception, Marseille, France
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