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Lin WP, Mu X, Chen SH, He CJ, Li HH, Sun CW, Bian HN, Lai W, Huang ZF. [Clinical characteristics of 11 patients with Vibrio vulnificus infection and the establishment of a rapid diagnosis procedure for this disease]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2024; 40:266-272. [PMID: 38548397 DOI: 10.3760/cma.j.cn501225-20230803-00036] [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] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Objective: To analyze the clinical characteristics of patients with Vibrio vulnificus infection, share diagnosis and treatment experience, and establish a rapid diagnosis procedure for this disease. Methods: This study was a retrospective case series study. From January 2009 to November 2022, 11 patients with Vibrio vulnificus infection who met the inclusion criteria were admitted to the Department of Burns and Wound Repair of Guangdong Provincial People's Hospital Affiliated to Southern Medical University. The gender, age, time of onset of illness, time of admission, time of diagnosis, route of infection, underlying diseases, affected limbs, clinical manifestations and signs on admission, white blood cell count, hemoglobin, platelet count, C-reactive protein (CRP), alanine transaminase (ALT), aspartate transaminase (AST), creatinine, procalcitonin, albumin, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and blood sodium levels on admission, culture results and metagenomic next-generation sequencing (mNGS) results of pathogenic bacteria and the Vibrio vulnificus drug susceptibility test results during hospitalization, treatment methods, length of hospital stay, and outcomes of all patients were recorded. Comparative analysis was conducted on the admission time and diagnosis time of patients with and without a history of exposure to seawater/marine products, as well as the fatality ratio and amputation of limbs/digits ratio of patients with and without early adequate antibiotic treatment. For the survived patients with hand involvement, the hand function was assessed using Brunnstrom staging at the last follow-up. Based on patients' clinical characteristics and treatment conditions, a rapid diagnosis procedure for Vibrio vulnificus infection was established. Results: There were 7 males and 4 females among the patients, aged (56±17) years. Most of the patients developed symptoms in summer and autumn. The admission time was 3.00 (1.00, 4.00) d after the onset of illness, and the diagnosis time was 4.00 (2.00, 8.00) d after the onset of illness. There were 7 and 4 patients with and without a history of contact with seawater/marine products, respectively, and the admission time of these two types of patients was similar (P>0.05). The diagnosis time of patients with a history of contact with seawater/marine products was 2.00 (2.00, 5.00) d after the onset of illness, which was significantly shorter than 9.00 (4.25, 13.00) d after the onset of illness for patients without a history of contact with seawater/marine products (Z=-2.01, P<0.05). Totally 10 patients had underlying diseases. The affected limbs were right-hand in 8 cases, left-hand in 1 case, and lower limb in 2 cases. On admission, a total of 9 patients had fever; 11 patients had pain at the infected site, and redness and swelling of the affected limb, and 9 patients each had ecchymosis/necrosis and blisters/blood blisters; 6 patients suffered from shock, and 2 patients developed multiple organ dysfunction syndrome. On admission, there were 8 patients with abnormal white blood cell count, hemoglobin, and albumin levels, 10 patients with abnormal CRP, procalcitonin, and NT-proBNP levels, 5 patients with abnormal creatinine and blood sodium levels, and fewer patients with abnormal platelet count, ALT, and AST levels. During hospitalization, 4 of the 11 wound tissue/exudation samples had positive pathogenic bacterial culture results, and the result reporting time was 5.00 (5.00, 5.00) d; 4 of the 9 blood specimens had positive pathogenic bacterial culture results, and the result reporting time was 3.50 (1.25, 5.00) d; the mNGS results of 7 wound tissue/exudation or blood samples were all positive, and the result reporting time was 1.00 (1.00, 2.00) d. The three strains of Vibrio vulnificus detected were sensitive to 10 commonly used clinical antibiotics, including ciprofloxacin, levofloxacin, and amikacin, etc. A total of 10 patients received surgical treatment, 4 of whom had amputation of limbs/digits; all patients received anti-infection treatment. The length of hospital stay of 11 patients was (26±11) d, of whom 9 patients were cured and 2 patients died. Compared with that of the 6 patients who did not receive early adequate antibiotic treatment, the 5 patients who received early adequate antibiotic treatment had no significant changes in the fatality ratio or amputation of limbs/digits ratio (P>0.05). In 3 months to 2 years after surgery, the hand function of 8 patients was assessed, with results showing 4 cases of disabled hands, 2 cases of incompletely disabled hands, and 2 cases of recovered hands. When a patient had clinical symptoms of limb redness and swelling and a history of contact with seawater/marine products or a pre-examination triage RiCH score of Vibrio vulnificus sepsis ≥1, the etiological testing should be initiated immediately to quickly diagnose Vibrio vulnificus infection. Conclusions: Vibrio vulnificus infection occurs most frequently in summer and autumn, with clinical manifestations and laboratory test results showing obvious infection characteristics, and may be accompanied by damage to multiple organ functions. Both the fatality and disability ratios are high and have a great impact on the function of the affected limbs. Early diagnosis is difficult and treatment is easily delayed, but mNGS could facilitate rapid detection. For patients with red and swollen limbs accompanied by a history of contact with seawater/marine products or with a pre-examination triage RiCH score of Vibrio vulnificus sepsis ≥1, the etiological testing should be initiated immediately to quickly diagnose Vibrio vulnificus infection.
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Affiliation(s)
- W P Lin
- The First Department of General Surgery, the First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510062, China
| | - X Mu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - S H Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - C J He
- Department of Burns and Wound Repair, Shenzhen People's Hospital, the First Affiliated Hospital of Southern University of Science and Technology, the Second Clinical Medicine College of Jinan University, Shenzhen 518020, China
| | - H H Li
- Department of Burns and Wound Repair, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - C W Sun
- Department of Burns and Wound Repair, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - H N Bian
- Department of Burns and Wound Repair, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - W Lai
- Department of Burns and Wound Repair, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Z F Huang
- Department of Burns and Wound Repair, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
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Li HW, Qi SG, Wang SS, Yang SS, Chen SM, Li RR, Li XH, Liu SH, Yang JH, Li HH, Bao YH, Shi YT, Wang ZH, He Y, Liu M. [Effects of cognition-related lifestyles on early cognitive decline in community older adults in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:63-70. [PMID: 38228526 DOI: 10.3760/cma.j.cn112338-20230518-00310] [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] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Objective: To investigate the distribution characteristics of cognition-related lifestyles of elderly in communities and explore the integrated effects on early cognitive decline. Methods: The participants were from the Project of Prevention and Intervention of Neurodegenerative Disease for Elderly in China. A total of 2 537 older adults aged ≥60 years without dementia in the 2015 baseline survey and the 2017 follow-up survey were included. The information about their cognition-related lifestyles, including physical exercise, social interaction, leisure activity, sleep quality, smoking status, and alcohol consumption, were collected through questionnaire survey and the integrated scores were calculated. Multivariate logistic regression analysis was used to assess the association between integrated cognition-related lifestyle score and early cognitive decline. Results: In the 2 537 older adults surveyed, 28.7% had score of 5-6, while only 4.8% had high scores for all 6 healthy lifestyles. Significant differences in healthy lifestyle factor distributions were observed between men and women. Multivariate logistic regression model showed that the risks for early cognitive decline in the older adults who had lifestyle score of 4 and 5-6 were lower than that in those with lifestyle score of 0-3 (OR=0.683, 95%CI: 0.457-1.019; OR=0.623, 95%CI: 0.398-0.976; trend P=0.030). In the women, the risks for early cognitive decline was lower in groups with score of 4 and 5-6 than in group with score of 0-3 (OR=0.491, 95%CI: 0.297-0.812; OR=0.556, 95%CI: 0.332-0.929; trend P=0.024). Conclusion: Cognition-related healthy lifestyles are associated with significantly lower risk for early cognitive decline in the elderly, especially in women.
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Affiliation(s)
- H W Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - S G Qi
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - S S Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - S S Yang
- Department of Disease Prevention and Control, the First Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - S M Chen
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - R R Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - X H Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - S H Liu
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - J H Yang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China Department of anti Nuclear, Biological and Chemical medicine, Graduate School, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - H H Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Y H Bao
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Y T Shi
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China Department of anti Nuclear, Biological and Chemical medicine, Graduate School, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Z H Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y He
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China State Key Laboratory of Kidney Diseases, Beijing 100853, China
| | - M Liu
- Department of anti Nuclear, Biological and Chemical medicine, Graduate School, Chinese People's Liberation Army General Hospital, Beijing 100853, China
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Maurer M, Lumry WR, Li HH, Aygören-Pürsün E, Busse PJ, Jacobs J, Nurse C, Ahmed MA, Watt M, Yu M. Lanadelumab in Patients 2 to Less Than 12 Years Old With Hereditary Angioedema: Results From the Phase 3 SPRING Study. J Allergy Clin Immunol Pract 2024; 12:201-211.e6. [PMID: 37730089 DOI: 10.1016/j.jaip.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/16/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Symptoms of hereditary angioedema (HAE) often first occur during childhood, and HAE attacks in children can be severe and substantially affect health-related quality of life (HRQoL). However, there are no approved long-term prophylaxis treatments for children aged less than 6 years. OBJECTIVE The SPRING Study (NCT04070326) evaluated the safety, pharmacokinetics, and efficacy of lanadelumab and HRQoL in patients aged 2 to less than 12 years. METHODS Over 52 weeks of treatment, patients aged 2 to less than 6 years received lanadelumab 150 mg every 4 weeks (Q4W) and patients aged 6 to less than 12 years received 150 mg every 2 weeks (Q2W) but could switch to Q4W if they were attack-free for 26 weeks. RESULTS We enrolled 21 patients (aged 2 to less than 6 years: n = 4; aged 6 to less than 12 years: n = 17), 20 of whom completed the study. There were no reported serious treatment-emergent adverse events or discontinuations resulting from such events. Treatment-emergent adverse events were reported for 17 patients (81.0%). The most common TEAE was injection site pain. Overall systemic exposure was comparable for both age groups. The mean (SD) attack rate during treatment decreased by 94.8% from baseline (1.84 [1.53] to 0.08 [0.17] attacks/mo), and 16 (76.2%) patients were attack-free. The attack rate reduction in both age groups was similar during the first 26-week fixed-dosing treatment. Seven patients switched from Q2W to Q4W and remained attack-free. A large, clinically meaningful increase in the Pediatric Quality of Life Inventory Generic Core Scale Total Score and a large increase in the Pediatric Quality of Life Inventory Generic Core Scale-Family Impact Module Total Score from baseline to end of study (better HRQoL) were observed. CONCLUSIONS Findings support safety, efficacy, and improved HRQoL with lanadelumab 150 mg Q2W and Q4W regimens for the prevention of HAE attacks in patients aged 2 to less than 12 years.
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Affiliation(s)
- Marcus Maurer
- Institute of Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.
| | | | - H Henry Li
- Institute for Asthma and Allergy, Chevy Chase, Md
| | - Emel Aygören-Pürsün
- Department for Children and Adolescents, Angioedema Centre, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Paula J Busse
- Division of Allergy and Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Joshua Jacobs
- Allergy and Asthma Clinical Research, Walnut Creek, Calif
| | | | - Mariam A Ahmed
- Takeda Development Center Americas, Inc, Lexington, Mass
| | - Maureen Watt
- Takeda Development Center Americas, Inc, Lexington, Mass
| | - Ming Yu
- Takeda Development Center Americas, Inc, Lexington, Mass
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Fong PY, Tay ZY, Soh RY, Fook SMC, Li HH, Phua CQ. Should mild obstructive sleep apnoea be treated? A systematic review from the standpoint of disease progression. J Laryngol Otol 2023; 137:828-839. [PMID: 36380495 DOI: 10.1017/s0022215122002419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study was a systematic review to investigate the progression of untreated obstructive sleep apnoea in order to evaluate whether mild obstructive sleep apnoea should be treated from the standpoint of disease progression. METHOD The database search study outcomes that were collected included Apnea Hypopnea Index and Respiratory Disturbance Index. A meta-analysis of obstructive sleep apnoea severity over time intervals was performed. RESULTS A total of 17 longitudinal studies and 1 randomised, controlled trial were included for review. For patients with mild obstructive sleep apnoea, mean pre-study and post-study Apnea Hypopnea Index was 5.21 and 8.03, respectively, over a median interval of 53.1 months. In patients with moderate to severe obstructive sleep apnoea, mean pre-study and post-study Apnea Hypopnea Index was 28.9 and 30.3, respectively, over a median interval of 57.8 months. Predictors for disease progression in mild obstructive sleep apnoea are patients aged less than 60 years and those with a baseline body mass index less than 25. CONCLUSION Mild obstructive sleep apnoea progression is observed, but it does not appear to reach any clinically significant progression to moderate or severe obstructive sleep apnoea.
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Affiliation(s)
- P Y Fong
- Department of Otolaryngology, Sengkang General Hospital, Singapore
| | - Z Y Tay
- Department of Otolaryngology, Sengkang General Hospital, Singapore
| | - R Y Soh
- Sleep Medicine Unit, Sengkang General Hospital, Singapore
| | - S M C Fook
- Health Science Research Unit, Singapore General Hospital, Singapore
| | - H H Li
- Health Science Research Unit, Singapore General Hospital, Singapore
| | - C Q Phua
- Department of Otolaryngology, Sengkang General Hospital, Singapore
- Sleep Medicine Unit, Sengkang General Hospital, Singapore
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Craig TJ, Reshef A, Li HH, Jacobs JS, Bernstein JA, Farkas H, Yang WH, Stroes ESG, Ohsawa I, Tachdjian R, Manning ME, Lumry WR, Saguer IM, Aygören-Pürsün E, Ritchie B, Sussman GL, Anderson J, Kawahata K, Suzuki Y, Staubach P, Treudler R, Feuersenger H, Glassman F, Jacobs I, Magerl M. Efficacy and safety of garadacimab, a factor XIIa inhibitor for hereditary angioedema prevention (VANGUARD): a global, multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2023; 401:1079-1090. [PMID: 36868261 DOI: 10.1016/s0140-6736(23)00350-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Hereditary angioedema is a rare and potentially life-threatening genetic disease that is associated with kallikrein-kinin system dysregulation. Garadacimab (CSL312), a novel, fully-human monoclonal antibody that inhibits activated factor XII (FXIIa), is being studied for the prevention of hereditary angioedema attacks. The aim of this study was to evaluate the efficacy and safety of once-monthly subcutaneous administrations of garadacimab as prophylaxis for hereditary angioedema. METHODS VANGUARD was a pivotal, multicentre, randomised, double-blind, placebo-controlled, phase 3 trial that recruited patients (aged ≥12 years) with type I or type II hereditary angioedema across seven countries (Canada, Germany, Hungary, Israel, Japan, the Netherlands, and the USA). Eligible patients were randomly assigned (3:2) to receive garadacimab or placebo for 6 months (182 days) by an interactive response technology (IRT) system. Randomisation was stratified by age (≤17 years vs >17 years) and baseline attack rate (1 to <3 attacks per month vs ≥3 attacks per month) for the adult group. The randomisation list and code were kept by the IRT provider during the study, with no access by site staff and funding representatives. All patients and investigational site staff, and representatives from the funder (or their delegates) with direct interaction with the study sites or patients, were masked to treatment assignment in a double-blind fashion. Randomly assigned patients received a 400-mg loading dose of subcutaneous garadacimab as two 200-mg injections or volume-matched placebo on day 1 of the treatment period, followed by five additional self-administered (or caregiver-administered) monthly doses of 200-mg subcutaneous garadacimab or volume-matched placebo. The primary endpoint was the investigator-assessed time-normalised number of hereditary angioedema attacks (number of hereditary angioedema attacks per month) during the 6-month treatment period (day 1 to day 182). Safety was evaluated in patients who received at least one dose of garadacimab or placebo. The study is registered with the EU Clinical Trials Register, 2020-000570-25 and ClinicalTrials.gov, NCT04656418. FINDINGS Between Jan 27, 2021, and June 7, 2022, we screened 80 patients, 76 of whom were eligible to enter the run-in period of the study. Of 65 eligible patients with type I or type II hereditary angioedema, 39 were randomly assigned to garadacimab and 26 to placebo. One patient was randomly assigned in error and did not enter the treatment period (no dose of study drug received), resulting in 39 patients assigned to garadacimab and 25 patients assigned to placebo being included. 38 (59%) of 64 participants were female and 26 (41%) were male. 55 (86%) of 64 participants were White, six (9%) were Asian (Japanese), one (2%) was Black or African American, one (2%) was Native Hawaiian or Other Pacific Islander, and one (2%) was listed as other. During the 6-month treatment period (day 1 to day 182), the mean number of investigator-confirmed hereditary angioedema attacks per month was significantly lower in the garadacimab group (0·27, 95% CI 0·05 to 0·49) than in the placebo group (2·01, 1·44 to 2·57; p<0·0001), corresponding to a percentage difference in means of -87% (95% CI -96 to -58; p<0·0001). The median number of hereditary angioedema attacks per month was 0 (IQR 0·00-0·31) for garadacimab and 1·35 (1·00-3·20) for placebo. The most common treatment-emergent adverse events were upper-respiratory tract infections, nasopharyngitis, and headaches. FXIIa inhibition was not associated with an increased risk of bleeding or thromboembolic events. INTERPRETATION Monthly garadacimab administration significantly reduced hereditary angioedema attacks in patients aged 12 years and older compared with placebo and had a favourable safety profile. Our results support the use of garadacimab as a potential prophylactic therapy for the treatment of hereditary angioedema in adolescents and adults. FUNDING CSL Behring.
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Affiliation(s)
- Timothy J Craig
- Allergy, Asthma and Immunology, Department of Medicine and Pediatrics, Penn State University, Hershey, PA, USA.
| | - Avner Reshef
- Allergy, Immunology & Angioedema Center, Barzilai University Hospital, Ashkelon, Israel
| | - H Henry Li
- Institute for Asthma and Allergy, Chevy Chase, MD, USA
| | | | - Jonathan A Bernstein
- University of Cincinnati, Department of Internal Medicine Division of Rheumatology, Allergy and Immunology and the Bernstein Clinical Research Center Cincinnati, Cincinnati, OH, USA
| | - Henriette Farkas
- Department of Internal Medicine and Haematology, Hungarian Angioedema Center of Reference and Excellence, Semmelweis University, Budapest, Hungary
| | - William H Yang
- Ottawa Allergy Research Corporation, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Erik S G Stroes
- Department of Vascular Medicine, Amsterdam UMC, Amsterdam, Netherlands
| | - Isao Ohsawa
- Department of Nephrology, Saiyu Soka Hospital, Saitama, Japan
| | - Raffi Tachdjian
- Division of Allergy & Clinical Immunology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Michael E Manning
- Allergy, Asthma & Immunology Associates, Ltd, Internal Medicine, UA College of Medicine, Phoenix, Phoenix, AZ, USA
| | | | | | - Emel Aygören-Pürsün
- Klinikum der Johann Wolfgang-Goethe Universität, Klinik für Kinder- und Jugendmedizin, Frankfurt, Germany
| | - Bruce Ritchie
- Division of Hematology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Gordon L Sussman
- Gordon Sussman Clinical Research Inc and Department of Clinical Immunology and Allergy, St Michael's Hospital, Toronto, ON, Canada
| | | | - Kimito Kawahata
- St Marianna University School of Medicine, Kawasaki-shi, Kanagawa, Japan
| | - Yusuke Suzuki
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Petra Staubach
- Department of Dermatology and Allergy, University Medical Center, Mainz, Germany
| | - Regina Treudler
- University Leipzig Medical Faculty, Department of Dermatology, Venereology and Allergology, Leipzig Interdisciplinary Center for Allergology-CAC, Leipzig, Germany
| | | | | | | | - Markus Magerl
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Frauhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
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6
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Aygören-Pürsün E, Zanichelli A, Cohn DM, Cancian M, Hakl R, Kinaciyan T, Magerl M, Martinez-Saguer I, Stobiecki M, Farkas H, Kiani-Alikhan S, Grivcheva-Panovska V, Bernstein JA, Li HH, Longhurst HJ, Audhya PK, Smith MD, Yea CM, Maetzel A, Lee DK, Feener EP, Gower R, Lumry WR, Banerji A, Riedl MA, Maurer M. An investigational oral plasma kallikrein inhibitor for on-demand treatment of hereditary angioedema: a two-part, randomised, double-blind, placebo-controlled, crossover phase 2 trial. Lancet 2023; 401:458-469. [PMID: 36774155 DOI: 10.1016/s0140-6736(22)02406-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/09/2022] [Accepted: 11/16/2022] [Indexed: 02/11/2023]
Abstract
BACKGROUND Guidelines recommend effective on-demand therapy for all individuals with hereditary angioedema. We aimed to assess the novel oral plasma kallikrein inhibitor, sebetralstat, which is in development, for on-demand treatment of hereditary angioedema attacks. METHODS In this two-part phase 2 trial, individuals with type 1 or 2 hereditary angioedema aged 18 years or older were recruited from 25 sites, consisting of specialty outpatient centres, across nine countries in Europe and the USA. Individuals were eligible if they had experienced at least three hereditary angioedema attacks in the past 93 days, were not on prophylactic therapy, and had access to and the ability to self-administer conventional attack treatment. In part 1 of the trial, participants were given a single 600 mg open-label oral dose of sebetralstat to assess safety, pharmacokinetics, and pharmacodynamics of the dose. Part 2 was a randomised, double-blind, placebo-controlled, two-sequence, two-period (2 × 2) crossover trial; participants were randomly assigned (1:1) to either sequence 1, in which they were given a single dose of 600 mg of sebetralstat to treat the first eligible attack and a second dose of placebo to treat the second eligible attack, or sequence 2, in which they were given placebo to treat the first eligible attack and then 600 mg of sebetralstat to treat the second eligible attack. Participants and investigators were masked to treatment assignment. The primary endpoint was time to use of conventional attack treatment within 12 h of study drug administration, which was assessed in all participants who were randomly assigned to treatment and who received study drug for two attacks during part 2 of the study. Safety was assessed in all participants who received at least one dose of study drug, starting in part 1. This study is registered with ClinicalTrials.gov, NCT04208412, and is completed. FINDINGS Between July 2, 2019, and Dec 8, 2020, 84 individuals were screened and 68 were enrolled in part 1 and received sebetralstat (mean age 38·3 years [SD 13·2], 37 [54%] were female, 31 [46%] were male, 68 [100%] were White). 42 (62%) of 68 participants completed pharmacokinetic assessments. Sebetralstat was rapidly absorbed, with a geometric mean plasma concentration of 501 ng/mL at 15 min. In a subset of participants (n=6), plasma samples obtained from 15 min to 4 h after study drug administration had near-complete protection from ex vivo stimulated generation of plasma kallikrein and cleavage of high-molecular-weight kininogen. In part 2, all 68 participants were randomly assigned to sequence 1 (n=34) or sequence 2 (n=34). 53 (78%) of 68 participants treated two attacks (25 [74%] in the sequence 1 group and 28 [82%] in the sequence 2 group). Time to use of conventional treatment within 12 h of study drug administration was significantly longer with sebetralstat versus placebo (at quartile 1: >12 h [95% CI 9·6 to >12] vs 8·0 h [3·8 to >12]; p=0·0010). There were no serious adverse events or adverse event-related discontinuations. INTERPRETATION Oral administration of sebetralstat was well tolerated and led to rapid suppression of plasma kallikrein activity, resulting in increased time to use of conventional attack treatment and faster symptom relief versus placebo. Based on these results, a phase 3 trial to evaluate the efficacy and safety of two dose levels of sebetralstat in adolescent and adult participants with hereditary angioedema has been initiated (NCT05259917). FUNDING KalVista Pharmaceuticals.
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Affiliation(s)
- Emel Aygören-Pürsün
- Department for Children and Adolescents, University Hospital Frankfurt, Frankfurt, Germany
| | - Andrea Zanichelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Operative Unit of Medicine, IRCCS Policlinico San Donato, Milan, Italy
| | - Danny M Cohn
- Amsterdam UMC, Department of Vascular Medicine, University of Amsterdam, Amsterdam, Netherlands
| | - Mauro Cancian
- Department of Systems Medicine, University Hospital of Padua, Padua, Italy
| | - Roman Hakl
- Department of Clinical Immunology and Allergology, St Anne's University Hospital, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tamar Kinaciyan
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Markus Magerl
- Institute of Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | | | - Marcin Stobiecki
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Krakow, Poland
| | - Henriette Farkas
- Hungarian Angioedema Center of Reference and Excellence, Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
| | - Sorena Kiani-Alikhan
- Barts Health NHS Trust, Department of Immunology, GA(2)LEN/HAEi Angioedema Centre of Reference and Excellence, London, UK
| | - Vesna Grivcheva-Panovska
- PHI University Clinic of Dermatology, School of Medicine, University Saints Cyril and Methodius, Skopje, North Macedonia
| | - Jonathan A Bernstein
- University of Cincinnati College of Medicine and Bernstein Clinical Research Center, Cincinnati, OH, USA
| | - H Henry Li
- Institute for Asthma and Allergy, Chevy Chase, MD, USA
| | - Hilary J Longhurst
- Department of Immunology, Auckland District Health Board and University of Auckland, Auckland, New Zealand
| | | | | | | | - Andreas Maetzel
- KalVista Pharmaceuticals, Cambridge, MA, USA; Institute of Health Policy, Management & Evaluation, University of Toronto, ON, Canada
| | | | | | | | | | - Aleena Banerji
- Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, MA, USA
| | - Marc A Riedl
- Division of Rheumatology, Allergy and Immunology, University of California, San Diego, La Jolla, CA, USA
| | - Marcus Maurer
- Institute of Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
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Aygören-Pürsün E, Manning M, Fain O, Desai B, Tomita D, Johnston D, Li HH, Kiani-Alikhan S. Long-term HAE Prophylaxis with Berotralstat Is Well Tolerated and Effective: Analysis for the APeX-S Study. J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.406] [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: 02/05/2023]
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Chiao J, Wan L, Yu JJ, Hou S, Qian Z, Yu J, Sun J, Sun A, Chi A, Tran R, Joseph K, Battad D, Li HH. SARS-CoV-2 Antibody Semi-Quantitative Levels Is Important In The Management Of COVID-19 Vaccinations In Immunodeficiency Disorder Patients. J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.083] [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: 02/05/2023]
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Liu JJ, Xu XX, Sun LJ, Yuan CX, Kaneko K, Sun Y, Liang PF, Wu HY, Shi GZ, Lin CJ, Lee J, Wang SM, Qi C, Li JG, Li HH, Xayavong L, Li ZH, Li PJ, Yang YY, Jian H, Gao YF, Fan R, Zha SX, Dai FC, Zhu HF, Li JH, Chang ZF, Qin SL, Zhang ZZ, Cai BS, Chen RF, Wang JS, Wang DX, Wang K, Duan FF, Lam YH, Ma P, Gao ZH, Hu Q, Bai Z, Ma JB, Wang JG, Wu CG, Luo DW, Jiang Y, Liu Y, Hou DS, Li R, Ma NR, Ma WH, Yu GM, Patel D, Jin SY, Wang YF, Yu YC, Hu LY, Wang X, Zang HL, Wang KL, Ding B, Zhao QQ, Yang L, Wen PW, Yang F, Jia HM, Zhang GL, Pan M, Wang XY, Sun HH, Xu HS, Zhou XH, Zhang YH, Hu ZG, Wang M, Liu ML, Ong HJ, Yang WQ. Observation of a Strongly Isospin-Mixed Doublet in ^{26}Si via β-Delayed Two-Proton Decay of ^{26}P. Phys Rev Lett 2022; 129:242502. [PMID: 36563237 DOI: 10.1103/physrevlett.129.242502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 10/10/2022] [Accepted: 11/03/2022] [Indexed: 06/17/2023]
Abstract
β decay of proton-rich nuclei plays an important role in exploring isospin mixing. The β decay of ^{26}P at the proton drip line is studied using double-sided silicon strip detectors operating in conjunction with high-purity germanium detectors. The T=2 isobaric analog state (IAS) at 13 055 keV and two new high-lying states at 13 380 and 11 912 keV in ^{26}Si are unambiguously identified through β-delayed two-proton emission (β2p). Angular correlations of two protons emitted from ^{26}Si excited states populated by ^{26}P β decay are measured, which suggests that the two protons are emitted mainly sequentially. We report the first observation of a strongly isospin-mixed doublet that deexcites mainly via two-proton decay. The isospin mixing matrix element between the ^{26}Si IAS and the nearby 13 380-keV state is determined to be 130(21) keV, and this result represents the strongest mixing, highest excitation energy, and largest level spacing of a doublet ever observed in β-decay experiments.
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Affiliation(s)
- J J Liu
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - X X Xu
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Department of Physics, The University of Hong Kong, Hong Kong, China
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou 516003, China
| | - L J Sun
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai 200240, China
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - C X Yuan
- Sino-French Institute of Nuclear Engineering and Technology, Sun Yat-Sen University, Zhuhai 519082, China
| | - K Kaneko
- Department of Physics, Kyushu Sangyo University, Fukuoka 813-8503, Japan
| | - Y Sun
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413, China
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai 200240, China
| | - P F Liang
- Department of Physics, The University of Hong Kong, Hong Kong, China
| | - H Y Wu
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, Peking University, Beijing 100871, China
| | - G Z Shi
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - C J Lin
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413, China
- College of Physics and Technology & Guangxi Key Laboratory of Nuclear Physics and Technology, Guangxi Normal University, Guilin 541004, China
| | - J Lee
- Department of Physics, The University of Hong Kong, Hong Kong, China
| | - S M Wang
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Institute of Modern Physics, Fudan University, Shanghai 200433, China
- Shanghai Research Center for Theoretical Nuclear Physics, NSFC and Fudan University, Shanghai 200438, China
| | - C Qi
- KTH Royal Institute of Technology, SE-100 44, Stockholm, Sweden
| | - J G Li
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - H H Li
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Latsamy Xayavong
- Department of Physics, Faculty of Natural Sciences, National University of Laos, Vientiane 01080, Laos
| | - Z H Li
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, Peking University, Beijing 100871, China
| | - P J Li
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Y Y Yang
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - H Jian
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Y F Gao
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - R Fan
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - S X Zha
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - F C Dai
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - H F Zhu
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - J H Li
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Z F Chang
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - S L Qin
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Z Z Zhang
- Sino-French Institute of Nuclear Engineering and Technology, Sun Yat-Sen University, Zhuhai 519082, China
| | - B S Cai
- Sino-French Institute of Nuclear Engineering and Technology, Sun Yat-Sen University, Zhuhai 519082, China
| | - R F Chen
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - J S Wang
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- College of Science, Huzhou University, Huzhou 313000, China
| | - D X Wang
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413, China
| | - K Wang
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - F F Duan
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, Lanzhou University, Lanzhou 730000, China
| | - Y H Lam
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - P Ma
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Z H Gao
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, Lanzhou University, Lanzhou 730000, China
| | - Q Hu
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Z Bai
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - J B Ma
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - J G Wang
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - C G Wu
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, Peking University, Beijing 100871, China
| | - D W Luo
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, Peking University, Beijing 100871, China
| | - Y Jiang
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, Peking University, Beijing 100871, China
| | - Y Liu
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, Peking University, Beijing 100871, China
| | - D S Hou
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - R Li
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - N R Ma
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413, China
| | - W H Ma
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Institute of Modern Physics, Fudan University, Shanghai 200433, China
| | - G M Yu
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Fundamental Science on Nuclear Safety and Simulation Technology Laboratory, Harbin Engineering University, Harbin 150001, China
| | - D Patel
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Department of Physics, Sardar Vallabhbhai National Institute of Technology, Surat 395007, India
| | - S Y Jin
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Y F Wang
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Physics and Astronomy, Yunnan University, Kunming 650091, China
| | - Y C Yu
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Physics and Astronomy, Yunnan University, Kunming 650091, China
| | - L Y Hu
- Fundamental Science on Nuclear Safety and Simulation Technology Laboratory, Harbin Engineering University, Harbin 150001, China
| | - X Wang
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, Peking University, Beijing 100871, China
| | - H L Zang
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, Peking University, Beijing 100871, China
| | - K L Wang
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - B Ding
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Q Q Zhao
- Department of Physics, The University of Hong Kong, Hong Kong, China
| | - L Yang
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413, China
| | - P W Wen
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413, China
| | - F Yang
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413, China
| | - H M Jia
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413, China
| | - G L Zhang
- School of Physics, Beihang University, Beijing 100191, China
| | - M Pan
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413, China
- School of Physics, Beihang University, Beijing 100191, China
| | - X Y Wang
- School of Physics, Beihang University, Beijing 100191, China
| | - H H Sun
- Department of Nuclear Physics, China Institute of Atomic Energy, Beijing 102413, China
| | - H S Xu
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou 516003, China
| | - X H Zhou
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou 516003, China
| | - Y H Zhang
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou 516003, China
| | - Z G Hu
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou 516003, China
| | - M Wang
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou 516003, China
| | - M L Liu
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - H J Ong
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- RCNP, Osaka University, Osaka 567-0047, Japan
| | - W Q Yang
- CAS Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
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10
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Liu XG, Chen L, Li HH, Hu YK, Xiong YH, Huang W, Su SS, Qi SH. [Research advances on the application of natural and recombinant collagen in wound repair]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2022; 38:978-982. [PMID: 36299212 DOI: 10.3760/cma.j.cn501120-20211123-00394] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Collagen is a macromolecular protein constituting the extracellular matrix of animal connective tissue, which has been widely used and developed in fields of biomedicine, tissue engineering, food, and cosmetics. Due to its advantages such as abundant sources and good biocompatibility, low immunogenicity, and degradability, collagen can be used as a dressing or tissue engineering scaffold for wound repair. According to the source of materials, collagen can be divided into natural collagen and recombinant collagen. Natural collagen is mainly extracted directly from mammals and fish; recombinant collagen is obtained based on genetic engineering technology, and its sources include recombinant expression systems of microorganisms, animals, and plants. This paper summarizes the sources of collagen, and the roles, advantages, and disadvantages of different sources of collagen in wound repair, the particularity and superiority of collagen combined with three-dimensional printing technology in wound repair, the impact of market norms of China's collagen industry on the field of wound repair, and explains the precautions for the development of collagen-related products, aiming to provide new ideas for selecting a suitable source of collagen for wound repair.
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Affiliation(s)
- X G Liu
- Department of Burn and Wound Repair, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510062, China
| | - L Chen
- Department of Burn and Wound Repair, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510062, China
| | - H H Li
- School of Biomedical Engineering, Sichuan University, Chengdu 610065, China
| | - Y K Hu
- Department of Burn and Wound Repair, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510062, China
| | - Y H Xiong
- Department of Burn and Wound Repair, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510062, China
| | - W Huang
- Department of Burn and Wound Repair, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510062, China
| | - S S Su
- Sun Yat-sen University-Yixian Group Skin Health Precision Research Joint Laboratory, Yue Keli Skin Regeneration Laboratory, Guangzhou 510275, China
| | - S H Qi
- Department of Burn and Wound Repair, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510062, China
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Craig TJ, Zaragoza-Urdaz RH, Li HH, Yu M, Ren H, Juethner S, Anderson J. Effectiveness and safety of lanadelumab in ethnic and racial minority subgroups of patients with hereditary angioedema: results from phase 3 studies. Allergy Asthma Clin Immunol 2022; 18:85. [PMID: 36153561 PMCID: PMC9508782 DOI: 10.1186/s13223-022-00721-y] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/21/2022] [Indexed: 11/10/2022]
Abstract
Background The COVID-19 pandemic has highlighted disparities in healthcare, particularly in the United States, even though disparities have existed since the organization of the modern healthcare system. Recruitment of patients from racial and ethnic minority groups is often minimal in phase 3 clinical trials, and is further exacerbated in the case of trials for rare diseases such as hereditary angioedema (HAE). This can lead to a gap in the understanding of minority patients’ experiences with these diseases and their response to potential treatment options. Methods We reviewed data from phase 3 double-blind (HELP) and open-label extension (HELP OLE) trials of lanadelumab, a monoclonal antibody developed for long-term prophylaxis against attacks of HAE. Efficacy (attack rate reduction) and safety (adverse events) results from White patients were compared descriptively to those from Hispanic/Latino patients, Black/African Americans, and other minority Americans. Results Not surprisingly, few minorities were recruited across both studies: 9.5% Black, 2.4% Asian, and 7.1% Hispanic/Latino versus 88.1% White and 91.7% non-Hispanic/non-Latino received lanadelumab in HELP, and 4.7% Black, 0.9% Asian, 0.9% other, and 6.1% Hispanic/Latino versus 93.4% White and 93.4% non-Hispanic/non-Latino were enrolled in HELP OLE. Although these studies were conducted in the United States, Canada, Europe, and Jordan, all minorities were from the United States. Despite the number of minority patients being far less than expected for the population, there was no evidence that either efficacy or adverse event profiles differed between ethnic or racial groups. Conclusions The HELP and HELP OLE studies described herein recruited far fewer minorities than would be ideal to represent these populations. However, evidence suggests that the effectiveness and tolerance of lanadelumab are similar between the groups. Nonetheless, the disparity in recruitment into research for minorities has significant room for improvement. Trial registration NCT02586805, registered 26 October 2015, https://clinicaltrials.gov/ct2/show/record/NCT02586805. NCT02741596, registered 18 April 2016, https://clinicaltrials.gov/ct2/show/NCT02741596.
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Li HH, Liu HZ, Li QL, Bi RY, Zhu SS. [A comparative study of the upper airway changes of idiopathic condylar resorption and anterior open bite patients after bilateral temporomandibular joint prostheses surgery and bimaxillary orthognathic surgery]. Zhonghua Kou Qiang Yi Xue Za Zhi 2022; 57:708-715. [PMID: 35790510 DOI: 10.3760/cma.j.cn112144-20220401-00150] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To evaluate the 2-dimension and 3-dimension changes of upper airway of patients who were diagnosed with idiopathic condylar resorption (ICR) and anterior open bite as well as received bilateral temporomandibular joint (TMJ) prostheses replacement or bimaxillary orthognathic surgery. Methods: This study is a retrospective study. Seventeen patients diagnosed as ICR and anterior open bite in Department of Orthognathic and TMJ surgery, West China Hospital of Sichuan University were selected (January 2018 to December 2021) and divided into bilateral TMJ protheses replacement group (group R, n=8) and orthognathic group (group O, n=9), according to which surgery they have performed. In order to compare variation of upper airway before and after surgery in different dimensions and sections within the same group or between groups, Spiral computed tomography data were obtained before (1 month) and after operation (10 to 12 months) to measure the total volume of airway (VT), the maximum sagittal area (MSA), the maximum cross-sectional area (MACA), the minimum cross-sectional area (MICA), the area of the most posterior plane(PPA), the area of soft-palate plane (SPA), the area of the most posterior point of tongue base plane (PTA), the area of the root of epiglottis plane (EA), the oropharyngeal airway volume (VO), the glossopharyngeal airway volume (VG) and the laryngeal airway volume (VL). Wilcoxon signed-rank test were used to complete statistical analyses for VO (T2),SPA (T2),ΔMSA,ΔMACA in group R as well as PTA (T1),EA (T2) in group O. Statistical analyses of other items were performed with student's t test. Results: VT, VO, VG, VL, MSA, MACA, MIC, PPA, PTA and EA of group R (T2) were significantly increased after TMJ prosthesis with Lefort I osteotomy (P<0.05). Meanwhile the VT, VO, VG, MSA, MACA, MICA, PPA and SPA of group O (T2) were significantly increased (P<0.05). There were significant difference in ΔVT and ΔVL between group R [(6 854.80±3 197.82) mm3, (2 252.85±1 527.96) mm3] and group O [(3 367.91±3 124.62) mm3, (413.21±1 244.44) mm3](t=2.27, P=0.038; t=2.74, P=0.015). Conclusions: Bilateral temporomandibular joint (TMJ) prostheses replacement and bimaxillary orthognathic surgery can both enlarge the areas and volumes of upper airway in patients who suffer from ICR and anterior open bite. Compared with bimaxillary orthognathic surgery, bilateral temporomandibular joint prostheses replacement plays a more pronounced role in enlargement and reconstruction of middle-inferior section of upper airway.
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Affiliation(s)
- H H Li
- Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Chengdu 610041, China
| | - H Z Liu
- Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Chengdu 610041, China
| | - Q L Li
- Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Chengdu 610041, China
| | - R Y Bi
- Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Chengdu 610041, China
| | - S S Zhu
- Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Chengdu 610041, China
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Qi P, Chen YK, Cui RL, Heng RJ, Xu S, He XY, Yue AM, Kang JK, Li HH, Zhu YX, Wang C, Chen YL, Hu K, Yin YY, Xuan LX, Song Y. [Overexpression of NAT10 induced platinum drugs resistance in breast cancer cell]. Zhonghua Zhong Liu Za Zhi 2022; 44:540-549. [PMID: 35754228 DOI: 10.3760/cma.j.cn112152-20211231-00986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To observe the platinum drugs resistance effect of N-acetyltransferase 10 (NAT10) overexpression in breast cancer cell line and elucidate the underlining mechanisms. Methods: The experiment was divided into wild-type (MCF-7 wild-type cells without any treatment) group, NAT10 overexpression group (H-NAT10 plasmid transfected into MCF-7 cells) and NAT10 knockdown group (SH-NAT10 plasmid transfected into MCF-7 cells). The invasion was detected by Transwell array, the interaction between NAT10 and PARP1 was detected by co-immunoprecipitation. The impact of NAT10 overexpression or knockdown on the acetylation level of PARP1 and its half-life was also determined. Immunostaining and IP array were used to detect the recruitment of DNA damage repair protein by acetylated PARP1. Flow cytometry was used to detect the cell apoptosis. Results: Transwell invasion assay showed that the number of cell invasion was 483.00±46.90 in the NAT10 overexpression group, 469.00±40.50 in the NAT10 knockdown group, and 445.00±35.50 in the MCF-7 wild-type cells, and the differences were not statistically significant (P>0.05). In the presence of 10 μmol/L oxaliplatin, the number of cell invasion was 502.00±45.60 in the NAT10 overexpression group and 105.00±20.50 in the NAT10 knockdown group, both statistically significant (P<0.05) compared with 219.00±31.50 in wild-type cells. In the presence of 10 μmol/L oxaliplatin, NAT10 overexpression enhanced the binding of PARP1 to NAT10 compared with wild-type cells, whereas the use of the NAT10 inhibitor Remodelin inhibited the mutual binding of the two. Overexpression of NAT10 induced PARP1 acetylation followed by increased PARP1 binding to XRCC1, and knockdown of NAT10 expression reduced PARP1 binding to XRCC1. Overexpression of NAT10 enhanced PARP1 binding to LIG3, while knockdown of NAT10 expression decreased PARP1 binding to LIG3. In 10 μmol/L oxaliplatin-treated cells, the γH2AX expression level was 0.38±0.02 in NAT10 overexpressing cells and 1.36±0.15 in NAT10 knockdown cells, both statistically significant (P<0.05) compared with 1.00±0.00 in wild-type cells. In 10 μmol/L oxaliplatin treated cells, the apoptosis rate was (6.54±0.68)% in the NAT10 overexpression group and (12.98±2.54)% in the NAT10 knockdown group, both of which were statistically significant (P<0.05) compared with (9.67±0.37)% in wild-type cells. Conclusion: NAT10 overexpression enhances the binding of NAT10 to PARP1 and promotes the acetylation of PARP1, which in turn prolongs the half-life of PARP1, thus enhancing PARP1 recruitment of DNA damage repair related proteins to the damage sites, promoting DNA damage repair and ultimately the survival of breast cancer cells.
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Affiliation(s)
- P Qi
- Department of Head and Neck Breast, Xinxiang Central Hospital, the Fourth Affiliated Hospital of Xinxiang Medical College, Xinxiang 453000, China
| | - Y K Chen
- College of Pharmacology, Xinxiang Medical University, Xinxiang 453000, China
| | - R L Cui
- College of Pharmacology, Xinxiang Medical University, Xinxiang 453000, China
| | - R J Heng
- Department of Head and Neck Breast, Xinxiang Central Hospital, the Fourth Affiliated Hospital of Xinxiang Medical College, Xinxiang 453000, China
| | - S Xu
- Department of Head and Neck Breast, Xinxiang Central Hospital, the Fourth Affiliated Hospital of Xinxiang Medical College, Xinxiang 453000, China
| | - X Y He
- Department of Head and Neck Breast, Xinxiang Central Hospital, the Fourth Affiliated Hospital of Xinxiang Medical College, Xinxiang 453000, China
| | - A M Yue
- Department of Head and Neck Breast, Xinxiang Central Hospital, the Fourth Affiliated Hospital of Xinxiang Medical College, Xinxiang 453000, China
| | - J K Kang
- College of Pharmacology, Xinxiang Medical University, Xinxiang 453000, China
| | - H H Li
- College of Pharmacology, Xinxiang Medical University, Xinxiang 453000, China
| | - Y X Zhu
- College of Pharmacology, Xinxiang Medical University, Xinxiang 453000, China
| | - C Wang
- College of Pharmacology, Xinxiang Medical University, Xinxiang 453000, China
| | - Y L Chen
- College of Pharmacology, Xinxiang Medical University, Xinxiang 453000, China
| | - K Hu
- College of Pharmacology, Xinxiang Medical University, Xinxiang 453000, China
| | - Y Y Yin
- College of Pharmacology, Xinxiang Medical University, Xinxiang 453000, China
| | - L X Xuan
- Department of Breast, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences &Peking Union Medical College, Beijing 100021, China
| | - Y Song
- College of Pharmacology, Xinxiang Medical University, Xinxiang 453000, China
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Li HH, Zhu H, Wang YP, Zhan HW, Li JF, Wang LH, Wang QY, Ma QC, Liu CH, Jiang J, Tian Z, Pan XH. [A case report of cardiac amyloidosis diagnosed by myocardial biopsy guided by intracardiac ultrasound]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:75-77. [PMID: 35045619 DOI: 10.3760/cma.j.cn112148-20211202-01039] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- H H Li
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - H Zhu
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Y P Wang
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - H W Zhan
- Department of Nuclear Medicine, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - J F Li
- Department of Pathology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - L H Wang
- Department of Radiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Q Y Wang
- Department of Radiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Q C Ma
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - C H Liu
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - J Jiang
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Z Tian
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - X H Pan
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
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Deng H, Cui H, Cao B, Liu GB, Song LQ, Li HH, Zhao RY, Chen L, Wei B. [Analysis of influence factors for short-term recurrence of retroperitoneal liposarcoma after complete resection]. Zhonghua Wai Ke Za Zhi 2022; 60:52-56. [PMID: 34954947 DOI: 10.3760/cma.j.cn112139-20210401-00154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To examine the influence factors of short-term recurrence after complete surgical resection of retroperitoneal liposarcoma. Methods: The clinicopathological data of retroperitoneal liposarcoma at Department of General Surgery, the First Medical Center, People's Liberation Army General Hospital from January 1, 2000 to January 31, 2020 were retrospectively analyzed. There were 60 males and 31 females, aged (52.1±9.9) years (range: 30 to 84 years). Tumor recurrence within 12 months after complete resection was defined as short-term recurrence, and tumor recurrence more than 12 months was defined as non-short-term recurrence. The t test, rank-sum test, χ2 test and Fisher exact test were conducted for inter-group comparison. Logistic regression analysis was used to analyze the independent influence factors for the short-term recurrence of retroperitoneal liposarcoma after complete resection. The Kaplan-Meier curve was used to calculate the recurrence-free survival, and the Log-rank test was adopted for the comparison between the groups. Results: The univariate analysis results showed that irregular tumor morphology, multiple pathological subtypes, pathological scores>3, and multiple primary tumors are influence factors for short-term recurrence after complete resection of retroperitoneal liposarcoma (χ2: 4.422 to 7.773, all P<0.05). Regression analysis of the above risk factors showed that multiple primary tumors was the independent risk factor (OR=2.918, 95%CI: 1.127 to 7.556, P=0.027). In the short-term recurrence group, Kaplan-Meier curve analysis showed that patients with multiple primary tumors had a shorter median recurrence time than patients with unifocal tumor (6 months vs. 9 months, P=0.028). Conclusions: Multiple primary tumor is an independent risk factor for short-term recurrence after complete resection of retroperitoneal liposarcoma. It suggests that the frequency of follow-up after surgery should be increased for such patients.
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Affiliation(s)
- H Deng
- Medical School of People's Liberation Army, Beijing 100853, China
| | - H Cui
- Department of General Surgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
| | - B Cao
- Medical School of People's Liberation Army, Beijing 100853, China
| | - G B Liu
- Department of General Surgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
| | - L Q Song
- Department of General Surgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
| | - H H Li
- Medical School of People's Liberation Army, Beijing 100853, China
| | - R Y Zhao
- Medical School of People's Liberation Army, Beijing 100853, China
| | - L Chen
- Department of General Surgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
| | - B Wei
- Department of General Surgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
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16
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Li HH, Xu XJ. [Treatment advances in pediatric relapsed and refractory Langerhans cell histiocytosis]. Zhonghua Er Ke Za Zhi 2021; 59:993-996. [PMID: 34711040 DOI: 10.3760/cma.j.cn112140-20210421-00331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- H H Li
- Department of Hematology-Oncology, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - X J Xu
- Department of Hematology-Oncology, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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Anderson J, Levy DS, Lumry W, Koochaki P, Lanar S, Henry Li H. Letting the patients speak: an in-depth, qualitative research-based investigation of factors relevant to health-related quality of life in real-world patients with hereditary angioedema using subcutaneous C1 inhibitor replacement therapy. Allergy Asthma Clin Immunol 2021; 17:60. [PMID: 34176500 PMCID: PMC8237414 DOI: 10.1186/s13223-021-00550-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 05/01/2021] [Indexed: 11/16/2022] Open
Abstract
Background While many studies of effective hereditary angioedema (HAE) therapy have demonstrated improved health-related quality of life (HRQoL) using validated instruments, specific reasons behind the improved scores have never been investigated using qualitative methods. A non-interventional, qualitative research study was designed to investigate the reasons for improvements in HRQoL while using effective prophylaxis, in this case subcutaneous C1INH (C1INH[SC]) replacement therapy. Methods Adult patients with HAE-C1INH type 1 or 2 who had been using C1INH(SC) for ≥ 3 consecutive months were recruited through four HAE specialty practices in the US to participate in a 60-min phone interview performed by a trained qualitative research specialist (ICON plc) using a semi-structured interview guide with open-ended questions developed with the Angioedema Quality of Life (AE-QoL) items in mind. Interview transcripts were analyzed using thematic analysis methods to identify concepts (specific symptoms/impacts) and themes (higher-level categories grouping related concepts). A cross-mapping exercise was performed between interview-identified concepts and items included in the AE-QoL. Results Fourteen patients were interviewed and included in the analysis (age range, 28–82 years [mean 47.5 years]; 64% female; 93% white). In 10 interviews, patients mentioned having no or nearly no HAE attacks, no longer feeling limited by HAE, less HAE-related anxiety/worry and depression, an improved ability to travel, fewer emergency room/hospital visits, and ease of administration of C1INH(SC), including not requiring assistance from others. Other commonly expressed concepts included: increased feelings of confidence, independence, optimism, and normalcy; less absence from work/school; better productivity; improved sleep and energy; healthier family relationships; and improved cognition. While all AE-QoL items emerged from patient interviews, a number of identified concepts were not addressed by the AE-QoL, including sensitivity to various potential attack-triggers (e.g., stress/anxiety, sports), attack frequency, not having to cancel social plans, improvements in ability to perform day-to-day tasks, and a lower burden from medical visits. Conclusions From these interviews, a large number of common themes and concepts emerged: a greater sense of freedom and normalcy, increased productivity, and improved interpersonal relationships while using convenient and effective prophylaxis. These findings provide insights into real-world experiences and the many facets of HRQoL that are important to patients with HAE-C1INH. Supplementary Information The online version contains supplementary material available at 10.1186/s13223-021-00550-5.
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Affiliation(s)
- John Anderson
- Clinical Research Center of Alabama, Birmingham, AL, USA.
| | | | | | | | | | - H Henry Li
- Institute for Asthma and Allergy, Chevy Chase, MD, USA
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18
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Maurer M, Aygören-Pürsün E, Banerji A, Bernstein JA, Balle Boysen H, Busse PJ, Bygum A, Caballero T, Castaldo AJ, Christiansen SC, Craig T, Farkas H, Grumach AS, Hide M, Katelaris CH, Li HH, Longhurst H, Lumry WR, Magerl M, Martinez-Saguer I, Riedl MA, Zhi Y, Zuraw B. Consensus on treatment goals in hereditary angioedema: A global Delphi initiative. J Allergy Clin Immunol 2021; 148:1526-1532. [PMID: 34048855 DOI: 10.1016/j.jaci.2021.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 05/06/2021] [Accepted: 05/19/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Hereditary angioedema (HAE) is a rare, life-threatening genetic disorder characterized by recurrent episodes of subcutaneous or submucosal angioedema. The ultimate goals of treatment for HAE remain ill-defined. OBJECTIVES The aim of this Delphi process was to define the goals of HAE treatment and to examine which factors should be considered when assessing disease control and normalization of the patient's life. METHODS The Delphi panel comprised 23 participants who were selected based on involvement with scientific research on HAE or coauthorship of the most recent update and revision of the World Allergy Organization/European Academy of Allergy and Clinical Immunology guideline on HAE. The process comprised 3 rounds of voting. The final round aimed to aggregate the opinions of the expert panel and to achieve consensus. RESULTS Two direct consensus questions were posed in round 2, based on the responses received in round 1, and the panel agreed that the goals of treatment are to achieve total control of the disease and to normalize the patient's life. For the third round of voting, 21 statements were considered, with the participants reaching consensus on 18. It is clear from the wide-ranging consensus statements that the burdens of disease and treatment should be considered when assessing disease control and normalization of patients' lives. CONCLUSIONS The ultimate goal for HAE treatment is to achieve no angioedema attacks. The availability of improved treatments and disease management over the last decade now makes complete control of HAE a realistic possibility for most patients.
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Affiliation(s)
- Marcus Maurer
- Angioedema Center of Reference and Excellence, Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Emel Aygören-Pürsün
- Department of Children and Adolescents, University Hospital Frankfurt, Frankfurt, Germany
| | - Aleena Banerji
- Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Department of Medicine, Harvard Medical School, Boston, Mass
| | - Jonathan A Bernstein
- Department of Medicine, Division of Immunology/Allergy Section, University of Cincinnati, Cincinnati, Ohio
| | | | - Paula J Busse
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Anette Bygum
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark; Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Teresa Caballero
- Allergy Department, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research, Centre for Biomedical Network Research on Rare Diseases, Madrid, Spain
| | | | - Sandra C Christiansen
- US HAE Association Angioedema Center, Department of Medicine, University of California, San Diego, La Jolla, Calif
| | - Timothy Craig
- Department of Medicine, Pediatrics and Graduate Studies, Penn State University, Hershey, Pa
| | - Henriette Farkas
- Hungarian Angioedema Center of Reference and Excellence, Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
| | - Anete S Grumach
- Clinical Immunology, Faculdade de Medicina, Centro Universitário Saude ABC, São Paulo, Brazil
| | - Michihiro Hide
- Department of Dermatology, Hiroshima University, Hiroshima, Japan
| | - Constance H Katelaris
- Department of Medicine, Campbelltown Hospital and Western Sydney University, Campbelltown, Australia
| | - H Henry Li
- Institute for Asthma and Allergy, Chevy Chase, Md
| | - Hilary Longhurst
- Auckland City Hospital, Auckland, New Zealand; University College Hospital, London, United Kingdom
| | - William R Lumry
- Department of Internal Medicine, Allergy/Immunology Division, Southwestern Medical School, University of Texas, Dallas, Tex; Allergy and Asthma Research Association Research Center, Dallas, Tex
| | - Markus Magerl
- Angioedema Center of Reference and Excellence, Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Marc A Riedl
- US HAE Association Angioedema Center, Department of Medicine, University of California, San Diego, La Jolla, Calif
| | - Yuxiang Zhi
- Department of Allergy and Clinical Immunology, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, National Clinical Research Center for Immunologic Disease, Beijing, China
| | - Bruce Zuraw
- US HAE Association Angioedema Center, Department of Medicine, University of California, San Diego, La Jolla, Calif; San Diego Veterans Affairs Healthcare, San Diego, Calif
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Mohamed Afif A, Anthony APM, Jamaruddin S, Su'aidi SU, Li HH, Low ASC, Cheong EHT. Diagnostic accuracy of Doppler ultrasound for detecting hepatic artery stenosis after liver transplantation. Clin Radiol 2021; 76:708.e19-708.e25. [PMID: 33902885 DOI: 10.1016/j.crad.2021.02.032] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/17/2021] [Indexed: 12/25/2022]
Abstract
AIM To evaluate the diagnostic accuracy of Doppler ultrasound (DUS) in detecting hepatic artery stenosis (HAS) after liver transplantation using computed tomography angiography (CTA) as the reference standard. MATERIALS AND METHODS This study included data from January 2005 to November 2017, where DUS of the hepatic artery of living and deceased donor liver grafts were compared with the reference standard, CTA. DUS parameters, such as intrahepatic artery (IHA) peak systolic velocity (PSV), resistive index (RI), systolic acceleration time (SAT); and extrahepatic artery (EHA) PSV were taken. The optimum cut-off was estimated using area under the receiver operating characteristic curve (AUC). Multivariable logistic regression analysis was developed to predict HAS. RESULTS Ninety-nine liver transplant cases were retrieved, 50 met the inclusion criteria where nine patients had significant HAS. HAS patients had a significantly low IHAPSV with a cut-off of 35.1 cm/s (sensitivity 53.8%, specificity 78.4%, AUC 0.701). IHARI had a significantly low RI with a cut-off 0.585 (sensitivity 86.7%, specificity 85.4%, AUC 0.913). The IHASAT cut-off was 0.045 seconds (sensitivity 80%, specificity 91.4%, AUC 0.857). The EHAPSV cut-off was 197.4 cm/s (sensitivity 50%, specificity 99.1%, AUC 0.648). The prediction model using DUS parameters IHARI and IHASAT demonstrated good discrimination with an AUC of 0.930 (95% CI: 0.843, 1.000; sensitivity 93.3%, specificity 88%). CONCLUSION A prediction model using the DUS parameters IHARI and IHASAT showed good diagnostic accuracy of 88.6% for monitoring liver transplant patients. If validated externally, this DUS model could be utilised to diagnose HAS in liver transplant recipients.
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Affiliation(s)
- A Mohamed Afif
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
| | - A P M Anthony
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - S Jamaruddin
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - S U Su'aidi
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - H H Li
- Department of Health Serviced Research Unit, Singapore General Hospital, Singapore
| | - A S C Low
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - E H T Cheong
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
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Bork K, Anderson JT, Caballero T, Craig T, Johnston DT, Li HH, Longhurst HJ, Radojicic C, Riedl MA. Assessment and management of disease burden and quality of life in patients with hereditary angioedema: a consensus report. Allergy Asthma Clin Immunol 2021; 17:40. [PMID: 33875020 PMCID: PMC8056543 DOI: 10.1186/s13223-021-00537-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hereditary angioedema (HAE) is a rare disease characterized by unpredictable, potentially life-threatening attacks, resulting in significant physical and emotional burdens for patients and families. To optimize care for patients with HAE, an individualized management plan should be considered in partnership with the physician, requiring comprehensive assessment of the patient's frequency and severity of attacks, disease burden, and therapeutic control. Although several guidelines and consensus papers have been published concerning the diagnosis and treatment of HAE, there has been limited specific clinical guidance on the assessment of disease burden and quality of life (QoL) in this patient population. Practical guidance is critical in supporting effective long-term clinical management of HAE and improving patient outcomes. The objective of this review is to provide evidence-based guidelines for an individualized assessment of disease burden and QoL in patients with HAE. METHODS A consensus meeting was held on February 29, 2020, consisting of 9 HAE experts from the United States and Europe with extensive clinical experience in the treatment of HAE. Consensus statements were developed based on a preliminary literature review and discussions from the consensus meeting. RESULTS Final statements reflect the consensus of the expert panel and include the assessment of attack severity, evaluation of disease burden, and long-term clinical management of HAE caused by C1-esterase inhibitor deficiency. Patient-reported outcome measures for assessing HAE attack severity and frequency are available and valuable tools; however, attack frequency and severity are insufficient markers of disease severity unless they are evaluated in the broader context of the effect on an individual patient's QoL. QoL assessments should be individualized for each patient and minimally, they should address the interference of HAE with work, school, social, family, and physical activity, along with access to and burden of HAE treatment. Advances in HAE therapies offer the opportunity for comprehensive, individualized treatment plans, allowing patients to achieve minimal attack burden with reduced disease and treatment burden. CONCLUSION This consensus report builds on existing guidelines by expanding the assessment of disease burden and QoL measures for patients with HAE.
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Affiliation(s)
- Konrad Bork
- Department of Dermatology, University Medical Center, Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany.
| | - John T Anderson
- Clinical Research Center of Alabama, 504 Brookwood Boulevard, Suite 250, Birmingham, AL, 35209, USA
| | - Teresa Caballero
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPaz), Biomedical Research Network on Rare Diseases (CIBERER, U754), Paseo Castellana 261, 28406, Madrid, Spain
| | - Timothy Craig
- Department of Medicine and Pediatrics, Penn State University, 200 Campus Drive, Suite 1300, Entrance 4, Hershey, University Park, PA, 17033, USA
| | - Douglas T Johnston
- Asthma and Allergy Specialists, 8405 Providence Road, Suite 300, Charlotte, NC, 28277, USA
| | - H Henry Li
- Institute for Asthma and Allergy, 2 Wisconsin Circle, Suite 250, Chevy Chase, MD, 20815, USA
| | - Hilary J Longhurst
- Addenbrookes Hospital, Cambridge Universities NHS Foundation Trust, Cambridge and University College Hospital London, Cambridge, CB2 0QQ, UK
| | - Cristine Radojicic
- Division of Allergy and Clinical Immunology, Department of Medicine, Duke University, 1821 Hillandale Rd, Durham, NC, 27705, USA
| | - Marc A Riedl
- University of California San Diego, 8899 University Center Ln, San Diego, CA, 92122, USA
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Lumry WR, Weller K, Magerl M, Banerji A, Longhurst HJ, Riedl MA, Lewis HB, Lu P, Devercelli G, Jain G, Maurer M, Hébert J, Ritchie B, Sussman G, Yang WH, Martinez‐Saguer I, Staubach P, Cicardi M, Shennak M, Zaragoza‐Urdaz RH, Anderson J, Baptist AP, Bernstein JA, Boggs PB, Busse PJ, Craig T, Davis‐Lorton M, Gierer S, Gower RG, Harris D, Hong DI, Jacobs J, Johnston DT, Li HH, Lockey RF, Lugar P, Manning ME, McNeil DL, Melamed I, Mostofi T, Nickel T, Otto WR, Petrov AA, Radojicic C, Rehman SM, Schwartz LB, Shapiro R, Sher E, Smith AM, Soteres D, Tachdjian R, Wedner HJ, Weinstein ME, Zafra H. Impact of lanadelumab on health-related quality of life in patients with hereditary angioedema in the HELP study. Allergy 2021; 76:1188-1198. [PMID: 33258114 PMCID: PMC8247292 DOI: 10.1111/all.14680] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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: 06/22/2020] [Revised: 11/01/2020] [Accepted: 11/14/2020] [Indexed: 01/20/2023]
Abstract
Background An objective of the phase 3 HELP Study was to investigate the effect of lanadelumab on health‐related quality of life (HRQoL) in patients with hereditary angioedema (HAE). Methods Patients with HAE‐1/2 received either lanadelumab 150 mg every 4 weeks (q4wks; n = 28), 300 mg q4wks (n = 29), 300 mg every 2 weeks (q2wks; n = 27), or placebo (n = 41) for 26 weeks (days 0–182). The Angioedema Quality of Life Questionnaire (AE‐QoL) was administered monthly, consisting of four domain (functioning, fatigue/mood, fears/shame, nutrition) and total scores. The generic EQ‐5D‐5L questionnaire was administered on days 0, 98, and 182. Comparisons were made between placebo and (a) all lanadelumab‐treated patients and (b) individual lanadelumab groups for changes in scores (day 0–182) and proportions achieving the minimal clinically important difference (MCID, −6) in AE‐QoL total score. Results Compared with the placebo group, the lanadelumab total group demonstrated significantly greater improvements in AE‐QoL total and domain scores (mean change, −13.0 to −29.3; p < 0.05 for all); the largest improvement was in functioning. A significantly greater proportion of the lanadelumab total group achieved the MCID (70% vs 37%; p = 0.001). The lanadelumab 300 mg q2wks group had the highest proportion (81%; p = 0.001) and was 7.2 times more likely to achieve the MCID than the placebo group. Mean EQ‐5D‐5L scores at day 0 were high in all groups, indicating low impairment, with no significant changes at day 182. Conclusion Patients with HAE‐1/2 experienced significant and clinically meaningful improvements in HRQoL measured by AE‐QoL following lanadelumab treatment in the HELP Study.
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Affiliation(s)
- William R. Lumry
- Allergy Asthma Research Associates Research Center Dallas TX USA
| | - Karsten Weller
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
| | - Markus Magerl
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
| | - Aleena Banerji
- Division of Rheumatology, Allergy and Immunology Massachusetts General HospitalHarvard Medical School Boston MA USA
| | - Hilary J. Longhurst
- Addenbrooke’s Hospital Cambridge University Hospitals NHS Foundation TrustCambridge, and University College London Hospitals London UK
| | - Marc A. Riedl
- Division of Rheumatology Allergy & Immunology University of California San Diego La Jolla CA USA
| | | | - Peng Lu
- Takeda Pharmaceutical Company Limited Lexington MA USA
| | | | - Gagan Jain
- Takeda Pharmaceutical Company Limited Lexington MA USA
| | - Marcus Maurer
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
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Li HH, Liu XB, Kong MJ, Gao F, Wang LH, Lin XP, Hu YH, Jiang J, Pu ZX, Zhao J, Zhou QJ, Wen CJ, Wang JA. [A case report of Impella-assisted treatment for severe aortic regurgitation during the perioperative period of transcatheter aortic valve replacement]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:179-181. [PMID: 33611906 DOI: 10.3760/cma.j.cn112148-20200309-00177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- H H Li
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X B Liu
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - M J Kong
- Department of Cardiac Surgery, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - F Gao
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - L H Wang
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X P Lin
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Y H Hu
- Department of Intensive Care Unit, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - J Jiang
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Z X Pu
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - J Zhao
- Department of Anesthesiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Q J Zhou
- Department of Radiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - C J Wen
- Department of Cardiovascular Intervention Center, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - J A Wang
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
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Lumry WR, Zuraw B, Cicardi M, Craig T, Anderson J, Banerji A, Bernstein JA, Caballero T, Farkas H, Gower RG, Keith PK, Levy DS, Li HH, Magerl M, Manning M, Riedl MA, Lawo JP, Prusty S, Machnig T, Longhurst H. Long-term health-related quality of life in patients treated with subcutaneous C1-inhibitor replacement therapy for the prevention of hereditary angioedema attacks: findings from the COMPACT open-label extension study. Orphanet J Rare Dis 2021; 16:86. [PMID: 33588897 PMCID: PMC7885603 DOI: 10.1186/s13023-020-01658-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 12/22/2020] [Indexed: 12/13/2022] Open
Abstract
Background Long-term prophylaxis with subcutaneous C1-inhibitor (C1-INH[SC]; HAEGARDA, CSL Behring)
in patients with hereditary angioedema (HAE) due to C1-INH deficiency (C1-INH-HAE) was evaluated in an open-label extension follow-up study to the international, double-blind, placebo-controlled COMPACT study. The current analysis evaluated patient-reported health-related quality of life (HRQoL) data from 126 patients in the open-label extension study randomized to treatment with C1-INH(SC) 40 IU/kg (n = 63) or 60 IU/kg (n = 63) twice weekly for 52 weeks. HRQoL was evaluated at the beginning of the open-label study and at various time points using the European Quality of Life-5 Dimensions Questionnaire (EQ-5D), the Hospital Anxiety and Depression Scale (HADS), the Work Productivity and Activity Impairment Questionnaire (WPAI), and the Treatment Satisfaction Questionnaire for Medication. The disease-specific Angioedema Quality of Life Questionnaire (AE-QoL) and HAE quality of life questionnaire (HAE-QoL) instruments were administered in a subset of patients. Statistical significance was determined by change-from-baseline 95% confidence intervals (CIs) excluding zero. No adjustment for multiplicity was done.
Results Mean baseline EQ-5D scores (Health State Value, 0.90; Visual Analog Scale, 81.32) were slightly higher (better) than United States population norms (0.825, 80.0, respectively) and mean HADS anxiety (5.48) and depression (2.88) scores were within “normal” range (0–7). Yet, patients using C1-INH(SC) 60 IU/kg demonstrated significant improvement from baseline to end-of-study on the EQ-5D Health State Value (mean change [95% CI], 0.07 [0.01, 0.12] and Visual Analog Scale (7.45 [3.29, 11.62]). In the C1-INH(SC) 60 IU/kg group, there were significant improvements in the HADS anxiety scale (mean change [95% CI], − 1.23 [− 2.08, − 0.38]), HADS depression scale (− 0.95 [− 1.57, − 0.34]), and WPAI-assessed presenteeism (mean change [95% CI], − 23.33% [− 34.86, − 11.81]), work productivity loss (− 26.68% [− 39.92, − 13.44]), and activity impairment (− 16.14% [− 26.36, − 5.91]). Clinically important improvements were achieved in ≥ 25% of patients for all domains except WPAI-assessed absenteeism (which was very low at baseline). Mean AE-QoL total score by visit ranged from 13.39 to 17.89 (scale 0–100; lower scores = less impairment). Mean HAE-QoL global scores at each visit (115.7–122.3) were close to the maximum (best) possible score of 135. Conclusions Long-term C1-INH(SC) replacement therapy in patients with C1-INH-HAE leads to significant and sustained improvements in multiple measures of HRQoL. Trial registration A Study to Evaluate the Long-term Clinical Safety and Efficacy of Subcutaneously Administered C1-esterase Inhibitor in the Prevention of Hereditary Angioedema, NCT02316353. Registered December 12, 2014, https://clinicaltrials.gov/ct2/show/NCT02316353.
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Affiliation(s)
- William R Lumry
- AARA Research Center, 10100 N. Central Expressway, Suite 100, Dallas, TX, 75231, USA.
| | - Bruce Zuraw
- Department of Medicine, UC San Diego, La Jolla, CA, USA
| | | | - Timothy Craig
- Penn State University College of Medicine, Hershey, PA, USA
| | - John Anderson
- Clinical Research Center of Alabama, Birmingham, AL, USA
| | | | - Jonathan A Bernstein
- University of Cincinnati College of Medicine and Bernstein Clinical Research Center, LLC, Cincinnati, OH, USA
| | - Teresa Caballero
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPaz), Biomedical Research Network On Rare Diseases (CIBERER U754), Madrid, Spain
| | - Henriette Farkas
- Hungarian Angioedema Reference Center, 3Rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | | | | | | | - H Henry Li
- Institute for Asthma and Allergy, Chevy Chase, MD, USA
| | - Markus Magerl
- Department of Dermatology and Allergy, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | | | - Marc A Riedl
- Division of Rheumatology, Allergy and Immunology, University of California, San Diego, La Jolla, CA, USA
| | | | | | - Thomas Machnig
- CSL Behring GmbH, Emil-von-Behring-Strasse 76, Marburg, Germany
| | - Hilary Longhurst
- University College Hospital, London, UK.,Auckland District Health Board, Auckland, New Zealand
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24
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Tang WY, Chen JM, Wang RR, Tan SL, Liu DM, Yu XY, Li HH, Zhang QF, Sheng YL, Xia WT. [Application of the Virtual Reality-Pattern Visual Evoked Potential in Forensic Visual Acuity Evaluation]. Fa Yi Xue Za Zhi 2021; 36:762-766. [PMID: 33550723 DOI: 10.12116/j.issn.1004-5619.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Indexed: 11/30/2022]
Abstract
Abstract Objective To explore a kind of visual evoked potential test equipment and method that is more suitable for the application of forensic clinical visual acuity evaluation. Methods Thirty-four volunteers (68 eyes) were selected, including 15 males and 19 females, aged between 20 and 40 years. Test lenses were placed before the tested eyes of volunteers to induce refractive myopia with insert method, and the diopter lenses were adjusted so that the visual acuity level of one eye of volunteers was above 0.8, and the visual acuity of the other eye was at moderate damage level (<0.3 and ≥0.1). The tests were carried out under the binocular simultaneous asynchronous stimulation mode (hereinafter referred to as "binocular mode") and monocular separate stimulation mode (hereinafter referred to as "monocular mode") of virtual reality-pattern visual evoked potential (VR-PVEP), and the amplitude of PVEP of volunteers under the two modes was compared at four spatial frequencies of 8×8, 16×16, 24×24 and 32×32. Results The differences in the amplitude of P100 wave between monocular and binocular modes at 8×8 spatial frequency had no statistical significance and the differences in amplitude of P100 wave between monocular and binocular modes at 16×16, 24×24, and 32×32 spatial frequencies had statistical significance (P<0.05). The amplitude of the same eye in monocular mode was higher than that in binocular mode. Through correlation analysis, it was found that the amplitude of P100 wave in monocular mode was moderately correlated with amplitude of P100 wave in binocular mode. Conclusion In forensic identification practice, VR-PVEP is helpful for overcoming the disturbance of poor fixation, and to increase the reliability of PVEP evaluation results. It can greatly shorten the detection time of PVEP and improve work efficiency.
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Affiliation(s)
- W Y Tang
- Basic Medical College of Jiamusi University, Jiamusi 154007, Heilongjiang Province, China
| | - J M Chen
- Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - R R Wang
- Shanghai NCC Electronic Corp., Ltd, Shanghai 200063, China
| | - S L Tan
- Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - D M Liu
- Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - X Y Yu
- Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - H H Li
- Shanghai NCC Electronic Corp., Ltd, Shanghai 200063, China
| | - Q F Zhang
- Shanghai NCC Electronic Corp., Ltd, Shanghai 200063, China
| | - Y L Sheng
- Basic Medical College of Jiamusi University, Jiamusi 154007, Heilongjiang Province, China
| | - W T Xia
- Basic Medical College of Jiamusi University, Jiamusi 154007, Heilongjiang Province, China.,Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
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Abstract
For the wounds caused by burns and other various reasons, the key of therapy is to close the open wounds in time by surgical operation. One of the most important methods is autologous skin grafting. However, for large area and long-term chronic trauma, the lack of autologous skin makes the treatment a huge challenge. For this reason, clinical medical workers have gradually developed miniature free skin grafting through continuous research. This paper reviews the relevant skin grafting techniques, including pinch free skin grafting, stamp free skin grafting, meek grafting, microne free skin grafting, etc.
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Affiliation(s)
- Z J Wang
- Burn Institute of PLA, Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai 200433, China
| | - H H Li
- Burn Institute of PLA, Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai 200433, China
| | - C Ben
- Burn Institute of PLA, Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai 200433, China
| | - H Lu
- Burn Institute of PLA, Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai 200433, China
| | - S H Zhu
- Burn Institute of PLA, Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai 200433, China
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26
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Johnston DT, Henry Li H, Craig TJ, Bernstein JA, Anderson J, Joseph K, Riedl MA. Androgen use in hereditary angioedema: A critical appraisal and approaches to transitioning from androgens to other therapies. Allergy Asthma Proc 2021; 42:22-29. [PMID: 33349293 DOI: 10.2500/aap.2021.42.200106] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: Hereditary angioedema (HAE) is a rare genetic disorder clinically characterized by recurrent attacks of subcutaneous and mucosal swelling. Attenuated androgens have been a prophylactic treatment option to reduce the frequency of HAE attacks for > 4 decades. However, the advent of effective on-demand treatments and highly effective, more tolerable, long-term prophylactic therapies has led to a decline in the use of attenuated androgens for the management of HAE in regions where newer therapies are available. A consensus about the best approach for discontinuing or tapering off attenuated androgen therapy does not exist. Objective: To develop a consensus on androgen tapering for patients with HAE. Methods: We sent an open-ended survey about androgen tapering to 21 physicians who treat HAE, 12 of whom responded. We reviewed the collective experience of the participating physicians in combination with results from a literature review on the topic. Results: The survey and literature review underscored potential concerns related to rapid androgen withdrawal in patients with HAE, including physician and patient concerns that the frequency and severity of attacks would abruptly worsen. In addition, discontinuation of attenuated androgens may have the potential for transient adverse effects, such as an increase in the rate of attacks or effects related to hormone withdrawal. Our survey showed that physicians often taper androgens to prevent increases in HAE attacks and possible withdrawal complications. Conclusion: Based on both experiences of the physicians who responded to our survey and reports in the endocrine literature, we provided recommendations for androgen tapering. However, we noted that the likelihood of adverse effects due to androgen withdrawal in patients with HAE is poorly understood and requires further study.
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Affiliation(s)
| | - H. Henry Li
- Institute for Asthma and Allergy, Chevy Chase, Maryland
| | - Timothy J. Craig
- Department of Medicine and Pediatrics, Penn State University, Hershey, Pennsylvania
| | - Jonathan A. Bernstein
- Allergy Section, Division of Immunology, Department of Internal Medicine, University of Cincinnati
| | - John Anderson
- Clinical Research Center of Alabama, Birmingham, Alabama
| | - Kusumam Joseph
- BioCryst Pharmaceuticals Inc., Durham, North Carolina; and
| | - Marc A. Riedl
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of California San Diego, La Jolla, California
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Riedl MA, Maurer M, Bernstein JA, Banerji A, Longhurst HJ, Li HH, Lu P, Hao J, Juethner S, Lumry WR, Hébert J, Ritchie B, Sussman G, Yang WH, Escuriola Ettingshausen C, Magerl M, Martinez‐Saguer I, Maurer M, Staubach P, Zimmer S, Cicardi M, Perego F, Wu MA, Zanichelli A, Al‐Ghazawi A, Shennak M, Zaragoza‐Urdaz RH, Ghurye R, Longhurst HJ, Zinser E, Anderson J, Banerji A, Baptist AP, Bernstein JA, Boggs PB, Busse PJ, Christiansen S, Craig T, Davis‐Lorton M, Gierer S, Gower RG, Harris D, Hong DI, Jacobs J, Johnston DT, Levitch ES, Li HH, Lockey RF, Lugar P, Lumry WR, Manning ME, McNeil DL, Melamed I, Mostofi T, Nickel T, Otto WR, Petrov AA, Poarch K, Radojicic C, Rehman SM, Riedl MA, Schwartz LB, Shapiro R, Sher E, Smith AM, Smith TD, Soteres D, Tachdjian R, Wedner HJ, Weinstein ME, Zafra H, Zuraw BL. Lanadelumab demonstrates rapid and sustained prevention of hereditary angioedema attacks. Allergy 2020; 75:2879-2887. [PMID: 32452549 PMCID: PMC7689768 DOI: 10.1111/all.14416] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/15/2020] [Accepted: 04/20/2020] [Indexed: 02/06/2023]
Abstract
Background Lanadelumab demonstrated efficacy in preventing hereditary angioedema (HAE) attacks in the phase 3 HELP Study. Objective To assess time to onset of effect and long‐term efficacy of lanadelumab, based on exploratory findings from the HELP Study. Methods Eligible patients with HAE type I/II received lanadelumab 150 mg every 4 weeks (q4wks), 300 mg q4wks, 300 mg q2wks, or placebo. Ad hoc analyses evaluated day 0‐69 findings using a Poisson regression model accounting for overdispersion. Least‐squares mean monthly HAE attack rate for lanadelumab was compared with placebo. Intrapatient comparisons for days 0‐69 versus steady state (days 70‐182) used a paired t test for continuous endpoints or Kappa statistics for categorical endpoints. Results One hundred twenty‐five patients were randomized and treated. During days 0‐69, mean monthly attack rate was significantly lower with lanadelumab (0.41‐0.76) vs placebo (2.04), including attacks requiring acute treatment (0.33‐0.61 vs 1.66) and moderate/severe attacks (0.31‐0.48 vs 1.33, all P ≤ .001). More patients receiving lanadelumab vs placebo were attack free (37.9%‐48.1% vs 7.3%) and responders (85.7%‐100% vs 26.8%). During steady state, the efficacy of lanadelumab vs placebo was similar or improved vs days 0‐69. Intrapatient differences were significant with lanadelumab 300 mg q4wks for select outcomes. Lanadelumab efficacy was durable—HAE attack rate was consistently lower vs placebo, from the first 2 weeks of treatment through study end. Treatment emergent adverse events were comparable during days 0‐69 and 70‐182. Conclusion Protection with lanadelumab started from the first dose and continued throughout the entire study period.
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Affiliation(s)
- Marc A. Riedl
- Division of Rheumatology, Allergy and Immunology University of California, San Diego San Diego CA USA
| | - Marcus Maurer
- Dermatological Allergology Allergie‐Centrum‐Charité Department of Dermatology and Allergy Charité – Universitätsmedizin Berlin Berlin Germany
| | - Jonathan A. Bernstein
- Division of Immunology/Allergy Section Department of Internal Medicine University of Cincinnati Cincinnati OH USA
- Bernstein Clinical Research Center Cincinnati OH USA
| | - Aleena Banerji
- Division of Rheumatology, Allergy and Immunology Department of Medicine Massachusetts General Hospital Harvard Medical School Boston MA USA
| | - Hilary J. Longhurst
- Addenbrooke's Hospital Cambridge University Hospitals NHS Foundation Trust, Cambridge and University College London Hospitals London UK
| | - H. Henry Li
- Institute for Asthma and Allergy, P.C. Chevy Chase MD USA
| | - Peng Lu
- Shire, a Takeda company Lexington MA USA
| | - James Hao
- Shire, a Takeda company Lexington MA USA
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Li QZ, Zhao HB, Ban N, Wang Q, Zhang JJ, Ding SN, Li HH, Zhou ZH. [Gastric adenocarcinoma with enteroblastic differentiation and elevated serum alpha fetoprotein]. Zhonghua Bing Li Xue Za Zhi 2020; 49:886-890. [PMID: 32892552 DOI: 10.3760/cma.j.cn112151-20191210-00791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the proportion and clinicopathological characteristics of gastric adenocarcinoma with enteroblastic differentiation (GAED) in gastric cancers showing an elevated serum alpha fetoprotein(AFP). Methods: A total of 724 resected gastric adenocarcinomas were collected from 2008 to 2018 at the 904 Hospital of Joint Service Support Force, and cases with pre-operative serum AFP>10 μg/L were screened. From the cases with elevated serum AFP, GAED cases were further evaluated based on morphology. Then the clincopathological features and immunohistochemical phenotypes of GAED were reviewed. In addition, the amplification of HER2 gene was detected with fluorescence in situ hybridization(FISH). When overall survival (OS) and progression-free survival (PFS) of GAED were analyzed, 289 cases ordinary gastric adenocarcinoma with normal serum AFP were employed as a control. Results: The percentage of GAED was 44% (11/25) in gastric cancers with elevated serum AFP. GAED was histologically tubular or papillary with clear cytoplasm, and some GAED cases showed cystadenoid structure similar to embryo sac (5 cases), homogeneous eosinophilic granules (4 cases) and intragland ulareosinophilic material (6 cases). All 11 GAED cases had lymph node metastasis. Liver metastasis and vascular thrombus were observed in 2 cases and 5 cases respectively. GAED was immunohistochemically positive for CDX2 (11/11), CD10 (8/11) and MUC2(3/11), which were intestinal epithelium differentiation markers. Meanwhile, primitive markers SALL4 (8/11), GPC3 (7/11) and AFP (5/11) were also expressed in GAED, and HER2 gene amplification was found in 3 cases (3/11) of GAED. Lastly, the PFS of GAED were significantly shorter than that of the control group (P=0.02), while OS was not statistically different between these two groups (P=0.99). Conclusions: Patients with GAED usually have a higher rate of elevated serum AFP in gastric adenocarcinoma, and the cancer exhibites features of both intestinal and primitive differentiation. As GAED is highly invasive, the prognosis of GAED may be poor. For GAED, the diagnosis of well-differentiated or moderately-differentiated adenocarcinoma should be avoided, because this diagnosis leads to underestimated malignant potential.
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Affiliation(s)
- Q Z Li
- Department of Pathology, the 904 Hospital of Joint Service Support Force, PLA, Jiangsu Province, Wuxi 214044, China
| | - H B Zhao
- Department of Pathology, the 904 Hospital of Joint Service Support Force, PLA, Jiangsu Province, Wuxi 214044, China
| | - N Ban
- Department of Pathology, the 904 Hospital of Joint Service Support Force, PLA, Jiangsu Province, Wuxi 214044, China
| | - Q Wang
- Department of Pathology, the 904 Hospital of Joint Service Support Force, PLA, Jiangsu Province, Wuxi 214044, China
| | - J J Zhang
- Department of Pathology, the 904 Hospital of Joint Service Support Force, PLA, Jiangsu Province, Wuxi 214044, China
| | - S N Ding
- Department of Pathology, the 904 Hospital of Joint Service Support Force, PLA, Jiangsu Province, Wuxi 214044, China
| | - H H Li
- Department of Pathology, the 904 Hospital of Joint Service Support Force, PLA, Jiangsu Province, Wuxi 214044, China
| | - Z H Zhou
- Department of Pathology, the 904 Hospital of Joint Service Support Force, PLA, Jiangsu Province, Wuxi 214044, China
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Busse PJ, Christiansen SC, Riedl MA, Banerji A, Bernstein JA, Castaldo AJ, Craig T, Davis-Lorton M, Frank MM, Li HH, Lumry WR, Zuraw BL. US HAEA Medical Advisory Board 2020 Guidelines for the Management of Hereditary Angioedema. J Allergy Clin Immunol Pract 2020; 9:132-150.e3. [PMID: 32898710 DOI: 10.1016/j.jaip.2020.08.046] [Citation(s) in RCA: 130] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 08/28/2020] [Accepted: 08/29/2020] [Indexed: 01/29/2023]
Abstract
Scientific and clinical progress together with the development of effective novel therapeutic options has engendered multiple important changes in the diagnosis and management of hereditary angioedema (HAE). We now update and extend the 2013 United States Hereditary Angioedema Association Medical Advisory Board guidelines for the treatment and management of HAE. The guidelines are based on a comprehensive literature review with recommendations indicating both the strength of our recommendation and the quality of the underlying evidence. Guidelines are provided regarding the classification, diagnosis, on-demand treatment, prophylactic treatment, special considerations for women and children, development of a comprehensive management and monitoring plan, and assessment of burden of illness for both HAE due to C1 inhibitor deficiency and HAE with normal C1 inhibitor. Advances in HAE treatment now allow the development of management plans that can help many patients with HAE lead a normal life. Achieving this goal requires that physicians be familiar with the diagnostic and therapeutic transformations that have occurred in recent years.
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Affiliation(s)
- Paula J Busse
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Mount Sinai School of Medicine, New York, NY
| | - Sandra C Christiansen
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of California San Diego, La Jolla, Calif
| | - Marc A Riedl
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of California San Diego, La Jolla, Calif
| | - Aleena Banerji
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, Harvard Medical School, Boston, Mass
| | - Jonathan A Bernstein
- Division of Immunology, Rheumatology, and Allergy, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | - Timothy Craig
- Division of Allergy, Asthma, and Immunology, Department of Medicine, Pediatrics, and Graduate Studies, Pennsylvania State University, Hershey, Pa
| | - Mark Davis-Lorton
- Division of Rheumatology, Allergy and Clinical Immunology, Department of Medicine, NYU Winthrop Hospital, Mineola, NY
| | - Michael M Frank
- Department of Pediatrics, Duke University Medical Center, Durham, NC
| | - H Henry Li
- Medicine Service, Institute for Asthma and Allergy, Chevy Chase, Md
| | - William R Lumry
- Allergy and Asthma Research Associates Research Center, Dallas, Tex
| | - Bruce L Zuraw
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of California San Diego, La Jolla, Calif; San Diego Veterans Administration Healthcare, San Diego, Calif.
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Yang HJ, Li HH, Pang XR, Gao SF, Liang JB, Zheng X, Li DR, Wang YH, Yu XQ, Qian XQ, Yang XD, Chen WD. [Protective effect of recombinant adult serine protease inhibitor from Trichinella spiralis on sepsis-associated acute kidney injury in mice]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2020; 32:361-366. [PMID: 32935509 DOI: 10.16250/j.32.1374.2020122] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the protective effect of recombinant adult serine protease inhibitor from Trichinella spiralis (TsadSPI) on sepsis-associated acute kidney injury in mice. METHODS A total of 18 male BALB/c mice were randomly divided into the sham-operation group, the model group, and the TsadSPI treatment group, of 6 mice in each group. Sepsis-associated acute kidney injury was modeled in the model group and TsadSPI treatment group by cecal ligation puncture (CLP), while mice in the sham-operation group were only given exploratory laparotomy without ligation or perforation of the cecum. After 30 min of CLP, mice in the sham-operation group and the model group were intraperitoneally injected with PBS (100 μL), and mice in the TsadSPI treatment group were intraperitoneally injected with PBS (100 μL) containing TsadSPI (2 μg). At 12 h following modeling, the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine (Cr) and urea nitrogen (BUN) were measured to assess the liver and kidney functions, and the changes of the mouse kidney structure were observed using HE staining. In addition, the serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-10 and transforming growth factor (TGF)-β were measured using an enzyme-linked immunosorbent assay (ELISA), and the myeloid differentiation factor 88 (MyD88) and nuclear factor kappa-B (NF-κB) p65 expression was determined in kidney tissues using immunohistochemical staining. RESULTS At 12 h following CLP, there were significant differences in the serum levels of ALT (F = 41.031, P < 0.001), AST (F = 54.757, P < 0.001), Cr (F = 24.142, P < 0.001) and BUN (F = 214.849, P < 0.001) among the three groups, and higher levels of ALT, AST, Cr and BUN were measured in model group than in the sham-operation group (P < 0.001), while lower ALT, AST, Cr and BUN levels were found in the TsadSPI treatment group than in the model group (P < 0.001). HE staining showed severe mouse kidney injuries following CLP, and TsadSPI treatment resulted in remarkable alleviation of the injury. ELISA measured significant differences in the TNF-α (F = 47.502, P < 0.001) and IL-6 levels (F = 222.061, P < 0.001) among the three groups, and showed a remarkable reduction in the TNF-α and IL-6 levels in the TsadSPI treatment group as compared to those in the model group (P < 0.001). In addition, there were significant differences in serum IL-10 (F = 16.227, P < 0.001) and TGF-β levels (F = 52.092, P < 0.001) among the three groups, and higher IL-10 and TGF-β levels were seen in the TsadSPI treatment group than in the model group (P < 0.001). Immunohistochemical staining showed greater MyD88 expression and a higher nuclear positive rate of NF-κB p65 in kidney tissues in the model group than in the TsadSPI treatment group. CONCLUSIONS TsadSPI may reduce the MyD88 expression and nuclear positive rate of NF-κB p65 in mouse kidney tissues to up-regulate the expression of immunomodulatory factors and down-regulate the expression of pro-inflammatory cytokines, thereby protecting sepsis-associated acute kidney injury.
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Affiliation(s)
- H J Yang
- Department of Nephrology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China.,Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - H H Li
- Anhui Provincial Key Laboratory of Infection and Immunity, China.,Department of Basic Medicine, Bengbu Medical College, China
| | - X R Pang
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - S F Gao
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - J B Liang
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - X Zheng
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - D R Li
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - Y H Wang
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - X Q Yu
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - X Q Qian
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - X D Yang
- Anhui Provincial Key Laboratory of Infection and Immunity, China.,Department of Basic Medicine, Bengbu Medical College, China
| | - W D Chen
- Department of Nephrology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China
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Singh U, Lumry WR, Busse P, Wedner HJ, Banerji A, Craig TJ, Li HH, Tachdjian R, Jacobs JS, Riedl MA, Davis-Lorton M, Christiansen SC, Zuraw BL, Bernstein JA. Association Between Self-Reported Dental Hygiene Practices and Dental Procedure-Related Recurrent Angioedema Attacks in HAE Subjects: A Multicenter Survey. J Allergy Clin Immunol Pract 2020; 8:3162-3169.e5. [PMID: 32534150 DOI: 10.1016/j.jaip.2020.05.041] [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] [Key Words] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 05/01/2020] [Accepted: 05/20/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hereditary angioedema (HAE) symptoms may be triggered by dental procedures, thereby complicating dental care in individuals affected by the condition. OBJECTIVE This study investigated the self-perceived dental care needs, perceived susceptibility to acute angioedema (AE) attacks after dental procedures, and dental care behavior of patients with HAE. METHODS A self-administered semistructured web-based questionnaire was distributed to 250 adult patients with HAE (type 1 or 2; 88% type 1) and 256 matched non-HAE controls. Data were analyzed using stratified χ2 tests, logistic regression, and classification trees. RESULTS A total of 46.4% of HAE versus 55.5% of control patients had dental visits within 6 months (P = .04). Dental insurance was a barrier to seeking routine dental visits among both groups. However, significantly fewer patients with HAE had routine dental visits within 6 months despite having dental insurance compared with control patients (48% vs 60%, P = .01). Within the HAE group, a significantly greater number of patients with dental visits at intervals greater than 6 months had a history of recurrent postprocedural AE attacks (odds ratio [OR]: 3.9 [1.7, 8.8], P = .0005) and used antibacterial toothpaste more frequently than those without recurrent AE attacks (OR: 4.7 [1.5, 15.4], P = .005). CONCLUSIONS These data support the hypothesis that patients with HAE who are predisposed to having AE episodes in response to medical or physical trauma visit the dentist less and engage in specific oral hygiene practices more frequently than matched control patients and patients with HAE who reported that they were less likely to swell after a dental procedure.
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Affiliation(s)
- Umesh Singh
- Division of Immunology/Allergy, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - William R Lumry
- Allergy and Asthma Research Associates Research Center, Dallas, Texas
| | - Paula Busse
- Division of Clinical Immunology, Mount Sinai, New York, NY
| | - H James Wedner
- Allergy and Immunology, Washington University School of Medicine, St. Louis, Mo
| | - Aleena Banerji
- Division of Rheumatology, Department of Allergy & Immunology, Massachusetts General Hospital, Boston, Mass
| | - Timothy J Craig
- Department of Medicine and Pediatrics, Penn State University, Hershey, Pa
| | - H Henry Li
- Institute for Asthma and Allergy, PC, Chevy Chase, Md
| | - Raffi Tachdjian
- Division of Allergy and Immunology, UCLA School of Medicine, Los Angeles, Calif
| | - Joshua S Jacobs
- Allergy and Asthma Clinical Research, Inc., Walnut Creek, Calif
| | - Marc A Riedl
- Divison of Rheumatology, Allergy & Immunology, University of California, San Diego, La Jolla, Calif
| | | | - Sandra C Christiansen
- Divison of Rheumatology, Allergy & Immunology, University of California, San Diego, La Jolla, Calif
| | - Bruce L Zuraw
- Divison of Rheumatology, Allergy & Immunology, University of California, San Diego, La Jolla, Calif
| | - Jonathan A Bernstein
- Division of Immunology/Allergy, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.
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Ben C, Li HH, Liu T, Wang ZJ, Cheng DS, Zhu SH. [Advances in the research of artificial intelligence technology assisting the diagnosis of burn depth]. Zhonghua Shao Shang Za Zhi 2020; 36:244-246. [PMID: 32241051 DOI: 10.3760/cma.j.cn501120-20190403-00162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The early accurate diagnosis of burn depth is of great significance in determining the corresponding clinical intervention methods and judging the prognosis quality of burn patients. However, the current diagnostic method of burn depth still relies mainly on the empirical subjective judgment of clinicians, with low diagnostic accuracy. Especially for deep partial-thickness burn wounds, the error of early diagnosis is pretty big. In recent years, with the rapid development of artificial intelligence technology, deep learning algorithm combined with image analysis technology can better identify and analyze the information of medical images. This article reviews the research progress of artificial intelligence technology in the diagnosis of burn depth.
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Affiliation(s)
- C Ben
- Burn Institute of PLA, Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - H H Li
- Burn Institute of PLA, Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - T Liu
- Burn Institute of PLA, Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Z J Wang
- Burn Institute of PLA, Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - D S Cheng
- Burn Institute of PLA, Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - S H Zhu
- Burn Institute of PLA, Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China
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Yuan Y, Wang LY, Mei J, Cheng Y, Wang W, Chu L, Tang J, Li N, Li HH, He WX, Yang LL, Chen J, Bai YS, Wu Y, Liang JB, Sun SY, Zhang X, Yang XD. [Protective effect of excretory-secretory protein from adult Trichinella spiralis on ovalbumin-induced allergic rhinitis in mice]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2019; 31:504-509. [PMID: 31713379 DOI: 10.16250/j.32.1374.2019069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the protective effect of excretory-secretory protein (AES) from adult Trichinella spiralis on ovalbumin (OVA)-induced allergic rhinitis in mice. METHODS Eighteen female BALB/c mice were randomly divided into three groups, including the blank control group (Group A), OVA-induced rhinitis group (Group B) and AES treatment group (Group C). Mice in Group A were given PBS. Mice in Group B were intraperitoneally injected with antigen adjuvant suspension for systemic sensitization, once every other day for seven times; then, local excitation was intranasally induced with 5% OVA solution once a day for seven times to establish a mouse model of allergic rhinitis. In addition to induction of allergic rhinitis, mice in Group C were given 25 μg AES at baseline sensitization and local excitation. Following the final challenge, mice were observed for 30 min in each group, and the behavioral score was evaluated. The serum levels of IFN-γ, IL-4, IL-5, IL-10 and TGF-β were determined using an enzyme-linked immunosorbent assay in mice, and the pathological changes of mouse nasal mucosa were observed under a microscope. RESULTS There was a significant difference in the mouse behavioral scores among the three groups (F = 110.12, P < 0.01). The mouse behavioral score was significantly higher in Group B than in Group A (7.17 ± 0.75 vs. 1.33 ± 0.52, P < 0.01), and more remarkable pathological damages of mouse nasal mucosa were seen in Group B than in Group A, while the mouse behavioral score was significantly decreased in Group C than in Group B (P < 0.01), and the pathological damages of mouse nasal mucosa remarkably alleviated in Group C relative to Group B. There was a significant difference in serum IFN-γ level among the three groups (F = 7.50, P < 0.01) and the serum IFN-γ level in Group B was significantly lower than in group A and C (both P < 0.05). There were significant differences in serum IL-4 (F = 470.81, P < 0.01) and IL-5 levels (F =68.20, P < 0.01) among the three groups, and significantly greater serum IL-4 and IL-5 levels were detected in Group B than in Group A (P < 0.01), while significantly lower serum IL-4 and IL-5 levels were detected in Group C than in Group B (P < 0.01). There were significant differences in serum IL-10 (F = 174.91, P < 0.01) and TGF-β levels (F = 9.39, P < 0.01) among the three groups, and significantly greater serum IL-10 and TGF-β levels were seen in Group C than in Group B (both P < 0.05). CONCLUSIONS T. spiralis AES has a remarkable protective activity against OVA-induced allergic rhinitis in mice.
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Affiliation(s)
- Y Yuan
- Department of Basic Medical Sciences, Bengbu Medical College, Bengbu 233000, China.,Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - L Y Wang
- Department of Basic Medical Sciences, Bengbu Medical College, Bengbu 233000, China.,Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - J Mei
- The Second Affiliated Hospital of Bengbu Medical College, China
| | - Y Cheng
- Department of Pathogenic Infection and Immunity, Wuxi Medical School, Jiangnan University, China
| | - W Wang
- The First Affiliated Hospital of Bengbu Medical College, China
| | - L Chu
- The Second Affiliated Hospital of Bengbu Medical College, China
| | - J Tang
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - N Li
- Department of Basic Medical Sciences, Bengbu Medical College, Bengbu 233000, China
| | - H H Li
- Department of Basic Medical Sciences, Bengbu Medical College, Bengbu 233000, China
| | - W X He
- Department of Basic Medical Sciences, Bengbu Medical College, Bengbu 233000, China
| | - L L Yang
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - J Chen
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - Y S Bai
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - Y Wu
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - J B Liang
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - S Y Sun
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - X Zhang
- Anhui Provincial Key Laboratory of Infection and Immunity, China
| | - X D Yang
- Department of Basic Medical Sciences, Bengbu Medical College, Bengbu 233000, China.,Anhui Provincial Key Laboratory of Infection and Immunity, China
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Li HH, Zuraw B, Longhurst HJ, Cicardi M, Bork K, Baker J, Lumry W, Bernstein J, Manning M, Levy D, Riedl MA, Feuersenger H, Prusty S, Pragst I, Machnig T, Craig T. Subcutaneous C1 inhibitor for prevention of attacks of hereditary angioedema: additional outcomes and subgroup analysis of a placebo-controlled randomized study. Allergy Asthma Clin Immunol 2019; 15:49. [PMID: 31485239 PMCID: PMC6714075 DOI: 10.1186/s13223-019-0362-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 08/14/2019] [Indexed: 12/12/2022] Open
Abstract
Background Hereditary angioedema (HAE) is a debilitating disorder resulting from C1-esterase inhibitor (C1-INH) deficiency. In the COMPACT phase 3 study the prophylactic use of a subcutaneous C1 inhibitor (C1-INH [SC], HAEGARDA®, CSL Behring) twice weekly significantly reduced the frequency of acute edema attacks. Analysis of treatment effects by subgroups, onset of effect, and other exploratory analysis have not been reported. Methods This is a post hoc exploratory analysis on data from the randomized, placebo-controlled COMPACT study. 90 patients with C1-INH-HAE were randomized to 1 of 4 treatment sequences: C1-INH (SC) 40 or 60 IU/kg of body weight twice weekly for 16 weeks, preceded or followed by a placebo period. The pre-specified primary efficacy endpoint was the time-normalized number of HAE attacks, and pre-specified secondary efficacy endpoints were the percentage of patients with a certain treatment response (≥ 50% reduction on C1-INH (SC) versus placebo in the time-normalized number of attacks) and the time-normalized number of use of rescue medication. Pre-specified exploratory endpoints included severity of attacks, alone and combined with rescue medication use. Post hoc analyses included exploration of onset of effect and clinical assessment of patients with < 50% of response. Results Subgroup findings by various patient characteristics showed a consistent preventive effect of C1-INH (SC). In a post hoc analysis of attacks, the onset of the preventive effect within the first 2 weeks after treatment initiation in COMPACT showed that 10/43 patients (23%) experienced attacks of any severity with 60 IU/kg versus 34/42 patients (81%) with placebo. The need for rescue medication was tenfold lower with 60 IU/kg (35 treated attacks) versus placebo (358 treated attacks). A qualitative analysis of the 4 patients treated with 60 IU/kg and with < 50% reduction of attacks demonstrated a reduction in severity of attacks, rescue medication use, and symptom days which was considered a clinically meaningful treatment effect. Conclusions C1-INH (SC) prophylaxis demonstrated a preventive treatment effect with evidence of benefit within 2 weeks. A consistent treatment effect at recommended C1-INH (SC) dosing was evident in all subgroups of patients with type I/II HAE and by various measures of disease and treatment burden. Trial registration EU Clinical Trials Register, 2013-000916-10, Registered 10 December 2013, https://www.clinicaltrialsregister.eu/ctr-search/trial/2013-000916-10; ClinicalTrials.gov Register, NCT01912456, Registered 31 July 2013, https://clinicaltrials.gov/ct2/show/NCT01912456.
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Affiliation(s)
- H Henry Li
- 1Institute for Asthma and Allergy, 2 Wisconsin Cir #250, Chevy Chase, MD 20815 USA
| | - Bruce Zuraw
- 2UC San Diego School of Medicine, 9500 Gilman Dr., Mail code 0732, La Jolla, CA 92093-0732 USA
| | | | - Marco Cicardi
- Ospedale Luigi Sacco/U.O. Medina Generale, Via G.B. Grassi, 74, 20157 Milan, Italy
| | - Konrad Bork
- 5Department of Dermatology, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - James Baker
- Baker Allergy, Asthma & Dermatology Research Center, LLC, 9495 SW Locust, Portland, OR 97223 USA
| | - William Lumry
- AARA Research Center, 10100 N Central Expressway, Suite 125, Dallas, TX 75231 USA
| | - Jonathan Bernstein
- 8Bernstein Clinical Research Center, LLC, 8444 Winton Road, Cincinnati, OH 45231 USA
| | - Michael Manning
- Medical Research of Arizona, 7514 E Monterey Way, Suite-1A, Scottsdale, AZ 85251 USA
| | - Donald Levy
- 705 West La Veta Avenue, Suite 101, Orange, CA 92868 USA
| | - Marc A Riedl
- 11University of California-San Diego School of Medicine, 8899 University Center Lane, Suite 230, La Jolla, CA 92122 USA
| | | | | | | | | | - Timothy Craig
- 13Department of Medicine and Pediatrics, Penn State University Allergy, Immunology and Respiratory Research, 500 University Drive H041, Hershey, PA 17033 USA
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Mao XY, Li HH, Jin F. [Some viewpoints about the local surgery on the de novo stage Ⅳ breast cancer]. Zhonghua Yi Xue Za Zhi 2019; 99:2485-2488. [PMID: 31484274 DOI: 10.3760/cma.j.issn.0376-2491.2019.32.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- X Y Mao
- Department of Breast Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
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Henry Li H, Riedl M, Kashkin J. Update on the Use of C1-Esterase Inhibitor Replacement Therapy in the Acute and Prophylactic Treatment of Hereditary Angioedema. Clin Rev Allergy Immunol 2019; 56:207-218. [PMID: 29909591 DOI: 10.1007/s12016-018-8684-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In the vast majority of patients with hereditary angioedema (HAE), angioedema attacks are due to the quantitative or functional deficiency of C1-esterase inhibitor (C1-INH), which leads to increased vascular permeability and unregulated release of bradykinin. Exogenous administration of C1-INH is a rational way to restore the concentration and functional activity of this protein, regulate the release of bradykinin, and attenuate or prevent subcutaneous and submucosal edema associated with HAE. Recent international guidelines for the management of HAE include C1-INH as an option for acute treatment of HAE. In addition, these guidelines recommend C1-INH as first-line treatment for long-term prophylaxis and as the therapy of choice for short-term/preprocedural prophylaxis. Several C1-INH products are available, with approved indications varying across regions. For the acute treatment of HAE, both plasma-derived and recombinant C1-INH formulations have been shown to be effective and well tolerated in adolescents and adults with HAE, with onset of relief within 30 min to a few hours. Plasma-derived C1-INH is approved for use in children, and recombinant C1-INH is being evaluated in this population. Intravenous (IV) and subcutaneous (SC) formulations of C1-INH have been approved for routine prophylaxis to prevent HAE attacks in adolescents and adults. Both formulations when administered twice weekly have been shown to reduce the frequency and severity of HAE attacks. The SC formulation of C1-INH obviates the need for repeated venous access and may facilitate self-administration of HAE prophylaxis at home, as recommended in HAE treatment guidelines. As with most rare diseases, the costs of HAE treatment are high; however, the development of additional acute and prophylactic medications for HAE may result in competitive pricing and help drive down the costs of HAE treatment.
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Affiliation(s)
- H Henry Li
- Institute for Asthma and Allergy, P.C., 2 Wisconsin Cir, Suite 250, Chevy Chase, MD, 20815, USA.
| | - Marc Riedl
- Division of Rheumatology, Allergy & Immunology, University of California, San Diego, 8899 University Center Lane, Suite 230, San Diego, CA, 92122, USA
| | - Jay Kashkin
- Allergy, Asthma and Immunology, 23-00 Route 208 South, Fair Lawn, NJ, 07410, USA
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Abstract
Hereditary angioedema is a very disabling and even life-threatening chronic condition. A timely and proper diagnosis of the condition is critical in disease management. Unfortunately, there is the potential for misdiagnosis when using the current laboratory diagnostic tools. Physicians should understand the limitations of each diagnostic assay and judiciously establish this life-altering diagnosis.
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Zhou N, Zheng MN, Li HH, Yu MH, Gong H, Yang J, Jiang GH. [Evaluation on follow-up intervention program in men who have sex with men in Tianjin]. Zhonghua Liu Xing Bing Xue Za Zhi 2019; 39:1228-1233. [PMID: 30293315 DOI: 10.3760/cma.j.issn.0254-6450.2018.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the behavior intervention program on men who have sex with men (MSM) in Tianjin. Methods: From April 2013 to September 2017, MSM were enrolled from MSM gathering places and through mobile internet to establish an open prospective cohort. Interventions were conducted in every follow-up meeting, while the changes of behaviors and HIV infection and syphilis incidences in the MSM before and after intervention were compared. Results: A total of 1 822 MSM were interviewed at baseline survey, with 1 007 eligible MSM were enrolled in the cohort. A total of 39 new cases of HIV infection were reported, and the cumulative observation time on cohort follow-up was 2 216.96 person-year, with the HIV incidence rate as 1.76 per 100 person-years. Among them, 934 MSM were sero-negative for syphilis in baseline survey. A total of 100 new cases of syphilis were reported, and the cumulative observation time of cohort follow-up was 1 959.94 person-year, the syphilis incidence rate was 5.10 per 100 person-years. With health education and intervention conducted, the awareness rate of AIDS related knowledge for MSM increased. Though the rate of anal sex increased after intervention, the rate of condom use in anal sex increased, too. The rate of condom use decreased after receiving more than 3 interventions. Data from the multivariate GEE analysis indicated that protective factors might be as follows: education level of college and above (aOR=0.81, 95%CI: 0.68-0.98), awareness of AIDS related knowledge (aOR=0.52, 95%CI: 0.36-0.75), ever receiving condom promotion and distribution in the past six months (aOR=0.60, 95%CI: 0.49-0.74), being recruited from mobile internet (aOR=0.85, 95%CI: 0.73-1.00) and times of cumulative intervention: one time (aOR=0.55, 95%CI: 0.45-0.66), two times (aOR=0.38, 95%CI: 0.30-0.49), three times (aOR=0.26, 95%CI: 0.20-0.35), four times and above (aOR=0.24, 95%CI: 0.17-0.33). Diagnoses of STDs in the past six months (aOR=1.43, 95%CI: 1.06-1.96), using rush-poppers (aOR=1.22, 95%CI: 1.02-1.47) might be risk factors. Conclusions: After continuous behavior intervention, the incidence of HIV infection and syphilis were at a low level in the MSM cohort in Tianjin. Their awareness rate of AIDS related knowledge and the rate of condom use increased. But there are still many risk factors influencing the unprotected anal sex in MSM. We should continuously carry out behavioral intervention programs to prevent unprotected anal sex among MSM.
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Affiliation(s)
- N Zhou
- Tianjin Center for Disease Control and Prevention, Tianjin 300011, China
| | - M N Zheng
- Tianjin Center for Disease Control and Prevention, Tianjin 300011, China
| | - H H Li
- Department of Epidemiology and Health Statistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - M H Yu
- Tianjin Center for Disease Control and Prevention, Tianjin 300011, China
| | - H Gong
- Tianjin Center for Disease Control and Prevention, Tianjin 300011, China
| | - J Yang
- Shenlan Public Health Counsel Service Center, Tianjin 300121, China
| | - G H Jiang
- Tianjin Center for Disease Control and Prevention, Tianjin 300011, China
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Huang WR, Gu ZY, Li HH, Bo J, Wang SH, Li F, Gao XN, Dou LP, Zhao Y, Jing Y, Zhu HY, Wang QS, Yu L, Gao CJ, Liu DH. [Clinical outcomes of peripheral blood stem cell transplantation for aggressive peripheral T-cell lymphoma]. Zhonghua Xue Ye Xue Za Zhi 2019; 39:729-733. [PMID: 30369182 PMCID: PMC7342247 DOI: 10.3760/cma.j.issn.0253-2727.2018.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
目的 研究外周血造血干细胞移植治疗外周T细胞淋巴瘤(PTCL)的疗效。 方法 回顾性分析解放军总医院血液科2007年6月至2017年6月接受外周血造血干细胞移植PTCL患者的临床资料。 结果 共有41例PTCL患者纳入研究,男30例,女11例,中位年龄38(13~57)岁。17例行自体外周血造血干细胞移植(auto-PBSCT),24例行异基因外周血造血干细胞移植(allo-PBSCT)。auto-PBSCT组ALK阳性间变大细胞淋巴瘤占47.1%(8/17),allo-PBSCT组NK/T细胞淋巴瘤和外周T细胞淋巴瘤-非特指型占66.7%(16/24)。auto-PBSCT组患者移植前疾病处于完全缓解(CR)状态者占58.8%(10/17),疾病进展(PD)状态者占11.8%(2/17);allo-PBSCT组移植前疾病状态为CR者8.3%(2/24),PD者45.8%(11/24)。auto-PBSCT组和allo-PBSCT组移植后2年总生存率、无病生存率差异均无统计学意义[(64.0±10.8)%对(53.5±9.7)%,P=0.543;(57.1±12.4)%对(53.5±10.6)%,P=0.701]。auto-PBSCT组6例死亡,5例死于复发;allo-PBSCT组12例死亡,其中5例死于复发,7例为移植相关死亡。 结论 auto-PBSCT和allo-PBSCT均是PTCL的有效治疗方法。
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Affiliation(s)
- W R Huang
- Department of Hematology, Chinese PLA General Hospital, Beijing 100853, China
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Anderson JT, Levy DS, Lumry WR, Koochaki P, Lanar S, Li HH. Exploring the Quality of Life Benefits of Subcutaneous C1-Inhibitor (C1-INH) Replacement Therapy Using Qualitative Research Methods. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.134] [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: 10/27/2022]
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Li HH, Craig TJ, Longhurst H, Cicardi M, Feuersenger H, Pragst I, Mycroft S. Long-term Safety of Subcutaneous C1-Inhibitor in the Prophylactic Treatment of Hereditary Angioedema. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.119] [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: 10/27/2022]
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Jacobs JS, Bernstein J, Davis-Lorton M, Li HH, Soteres DF, Nurse C, Paes K, Sexton DJ, Longhurst H. Increased Response to Higher Dose Lanadelumab in Hereditary Angioedema Patients: Exploratory Findings From the HELP and HELP OLE Studies. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Singh U, Banerji A, Busse PJ, Christiansen SC, Craig TJ, Davis-Lorton M, Jacobs JS, Li HH, Lumry WR, Riedl MA, Tachdjian R, Wedner HJ, Zuraw BL, Bernstein JA. A Questionnaire Survey Study To Determine Association of Dental Hygiene Practices in Hereditary Angioedema Subjects with The Incidence of Post-Procedural Angioedema Attacks. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.141] [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: 11/15/2022]
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Lumry WR, Martinez-Saguer I, Yang WH, Bernstein JA, Jacobs J, Moldovan D, Riedl MA, Johnston DT, Li HH, Tang Y, Schranz J, Lu P, Vardi M, Farkas H. Fixed-Dose Subcutaneous C1-Inhibitor Liquid for Prophylactic Treatment of C1-INH-HAE: SAHARA Randomized Study. J Allergy Clin Immunol Pract 2019; 7:1610-1618.e4. [PMID: 30682573 DOI: 10.1016/j.jaip.2019.01.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/12/2018] [Accepted: 01/06/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Hereditary angioedema (HAE) with C1 inhibitor deficiency (C1-INH) is characterized by swelling of subcutaneous and/or submucosal tissues. OBJECTIVE To evaluate efficacy/safety of fixed-dose subcutaneous plasma-derived C1-INH (pdC1-INH) liquid for HAE attack prevention (NCT02584959). METHODS Eligible patients were ≥12 years with ≥2 monthly attacks prescreening or pre-long-term prophylaxis. In a partial crossover design, 80% of patients were randomized to placebo or pdC1-INH liquid for 14 weeks and crossed over from active to placebo or vice versa for another 14 weeks. The remainder were randomized to pdC1-INH liquid for 28 weeks. The primary efficacy endpoint was normalized number of attacks (NNA) versus placebo. Key additional endpoints were the proportion of patients achieving NNA reduction ≥50%, attack severity, number of attack-free days, and safety. RESULTS Seventy-five patients were randomized and 58 (77%) completed the study. Mean age 41 years; 88% HAE type I. Least-squares means of NNA were reduced from 3.9 with placebo to 1.6 with pdC1-INH (from day 1; P < .0001). Most patients had ≥50% NNA reduction with pdC1-INH (from day 1, 78%). A total of 8.8% of placebo-treated patients were attack-free and 5.3%, 22.8%, and 63.2% had mild, moderate, and severe attacks, respectively; 37.5% of pdC1-INH-treated patients were attack-free and 8.9%, 26.8%, and 26.8% had mild, moderate, and severe attacks, respectively. Treatment-emergent adverse event rates were similar between groups (52% vs 56% for pdC1-INH crossover vs placebo, respectively). CONCLUSIONS Fixed-dose subcutaneous pdC1-INH liquid was superior to placebo in preventing HAE attacks and demonstrated a favorable safety profile.
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Affiliation(s)
| | | | - William H Yang
- Ottawa Allergy Research Corporation, University of Ottawa Medical School, Ottawa, Ontario, Canada
| | | | - Joshua Jacobs
- Allergy and Asthma Clinical Research, Walnut Creek, Calif
| | - Dumitru Moldovan
- MediQuest Medical Center, Sangeorgiu de Mures, Târgu Mureș, Romania
| | | | | | - H Henry Li
- Institute for Asthma and Allergy, Chevy Chase, Md
| | | | | | - Peng Lu
- Shire, now part of Takeda, Lexington, Mass
| | | | - Henriette Farkas
- Hungarian Angioedema Reference Center, Semmelweis University, Budapest, Hungary
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Banerji A, Riedl MA, Bernstein JA, Cicardi M, Longhurst HJ, Zuraw BL, Busse PJ, Anderson J, Magerl M, Martinez-Saguer I, Davis-Lorton M, Zanichelli A, Li HH, Craig T, Jacobs J, Johnston DT, Shapiro R, Yang WH, Lumry WR, Manning ME, Schwartz LB, Shennak M, Soteres D, Zaragoza-Urdaz RH, Gierer S, Smith AM, Tachdjian R, Wedner HJ, Hebert J, Rehman SM, Staubach P, Schranz J, Baptista J, Nothaft W, Maurer M. Effect of Lanadelumab Compared With Placebo on Prevention of Hereditary Angioedema Attacks: A Randomized Clinical Trial. JAMA 2018; 320:2108-2121. [PMID: 30480729 PMCID: PMC6583584 DOI: 10.1001/jama.2018.16773] [Citation(s) in RCA: 148] [Impact Index Per Article: 24.7] [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: 11/14/2022]
Abstract
IMPORTANCE Current treatments for long-term prophylaxis in hereditary angioedema have limitations. OBJECTIVE To assess the efficacy of lanadelumab, a fully human monoclonal antibody that selectively inhibits active plasma kallikrein, in preventing hereditary angioedema attacks. DESIGN, SETTING, AND PARTICIPANTS Phase 3, randomized, double-blind, parallel-group, placebo-controlled trial conducted at 41 sites in Canada, Europe, Jordan, and the United States. Patients were randomized between March 3, 2016, and September 9, 2016; last day of follow-up was April 13, 2017. Randomization was 2:1 lanadelumab to placebo; patients assigned to lanadelumab were further randomized 1:1:1 to 1 of the 3 dose regimens. Patients 12 years or older with hereditary angioedema type I or II underwent a 4-week run-in period and those with 1 or more hereditary angioedema attacks during run-in were randomized. INTERVENTIONS Twenty-six-week treatment with subcutaneous lanadelumab 150 mg every 4 weeks (n = 28), 300 mg every 4 weeks (n = 29), 300 mg every 2 weeks (n = 27), or placebo (n = 41). All patients received injections every 2 weeks, with those in the every-4-week group receiving placebo in between active treatments. MAIN OUTCOME AND MEASURES Primary efficacy end point was the number of investigator-confirmed attacks of hereditary angioedema over the treatment period. RESULTS Among 125 patients randomized (mean age, 40.7 years [SD, 14.7 years]; 88 females [70.4%]; 113 white [90.4%]), 113 (90.4%) completed the study. During the run-in period, the mean number of hereditary angioedema attacks per month in the placebo group was 4.0; for the lanadelumab groups, 3.2 for the every-4-week 150-mg group; 3.7 for the every-4-week 300-mg group; and 3.5 for the every-2-week 300-mg group. During the treatment period, the mean number of attacks per month for the placebo group was 1.97; for the lanadelumab groups, 0.48 for the every-4-week 150-mg group; 0.53 for the every-4-week 300-mg group; and 0.26 for the every-2-week 300-mg group. Compared with placebo, the mean differences in the attack rate per month were -1.49 (95% CI, -1.90 to -1.08; P < .001); -1.44 (95% CI, -1.84 to -1.04; P < .001); and -1.71 (95% CI, -2.09 to -1.33; P < .001). The most commonly occurring adverse events with greater frequency in the lanadelumab treatment groups were injection site reactions (34.1% placebo, 52.4% lanadelumab) and dizziness (0% placebo, 6.0% lanadelumab). CONCLUSIONS AND RELEVANCE Among patients with hereditary angioedema type I or II, treatment with subcutaneous lanadelumab for 26 weeks significantly reduced the attack rate compared with placebo. These findings support the use of lanadelumab as a prophylactic therapy for hereditary angioedema. Further research is needed to determine long-term safety and efficacy. TRIAL REGISTRATION EudraCT Identifier: 2015-003943-20; ClinicalTrials.gov Identifier: NCT02586805.
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Affiliation(s)
- Aleena Banerji
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Marc A. Riedl
- Division of Rheumatology, Allergy & Immunology, University of California, San Diego
| | - Jonathan A. Bernstein
- Department of Internal Medicine/Allergy Section Cincinnati, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Marco Cicardi
- Department of Biomedical and Clinical Sciences, Luigi Sacco, University of Milan, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Bruce L. Zuraw
- Division of Rheumatology, Allergy & Immunology, University of California, San Diego
| | - Paula J. Busse
- Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Markus Magerl
- Department of Dermatology and Allergy, Dermatological Allergology, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | | | - Mark Davis-Lorton
- Rheumatology Allergy and Immunology, NYU Winthrop Hospital, Mineola, New York
| | - Andrea Zanichelli
- Department of Biomedical and Clinical Sciences, Luigi Sacco, University of Milan, ASST Fatebenefratelli Sacco, Milan, Italy
| | - H. Henry Li
- Institute for Asthma and Allergy, Chevy Chase, Maryland
| | - Timothy Craig
- Department of Medicine and Pediatrics, Pennsylvania State University, Allergy, Asthma, and Immunology, Hershey
| | - Joshua Jacobs
- Allergy and Asthma Clinical Research, Walnut Creek, California
| | | | - Ralph Shapiro
- Immunology Department, Midwest Immunology Clinic, Plymouth, Minnesota
| | - William H. Yang
- Ottawa Allergy Research Corporation and University of Ottawa Medical School, Ottawa, Ontario, Canada
| | - William R. Lumry
- Allergy Asthma Research Associates Research Center, Dallas, Texas
| | | | - Lawrence B. Schwartz
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Virginia Commonwealth University, Richmond
| | | | - Daniel Soteres
- Asthma and Allergy Associates PC, Colorado Springs, Colorado
| | | | - Selina Gierer
- Division of Allergy, Clinical Immunology & Rheumatology, University of Kansas Medical Center, Kansas City
| | | | - Raffi Tachdjian
- AIRE Medical of Los Angeles, University of California, Los Angeles
| | - H. James Wedner
- Division of Allergy and Immunology, Washington University, St Louis, Missouri
| | - Jacques Hebert
- Centre de Recherche Appliqué en Allergie de Québec, Quebec, Canada
| | | | - Petra Staubach
- Department of Dermatology, University Medicine Mainz, Mainz, Germany
| | | | | | | | - Marcus Maurer
- Department of Dermatology and Allergy, Dermatological Allergology, Charité—Universitätsmedizin Berlin, Berlin, Germany
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Li HH, Mycroft S, Christiansen S, Wood DN, Feuersenger H, Pawaskar D, Jacobs I. Subcutaneous C1-esterase inhibitor to prevent hereditary angioedema attacks: Safety findings from the COMPACT trial. Allergy Asthma Proc 2018; 39:365-370. [PMID: 30107868 DOI: 10.2500/aap.2018.39.4164] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The first subcutaneous (SC) C1-esterase inhibitor concentrate (C1-INH) was approved by the U.S. Food and Drug Administration in June 2017 as routine prophylaxis to prevent hereditary angioedema attacks in adolescents and adults at a dose of 60 IU/kg twice weekly based on the phase III Clinical Study for Optimal Management of Preventing Angioedema With Low-volume Subcutaneous C1-Inhibitor Replacement Therapy (COMPACT) trial. OBJECTIVE This article aimed to evaluate the relationship of the C1-INH (SC) dose regimens tested in the COMPACT trial (40 IU/kg and 60 IU/kg twice weekly) and the occurrence of adverse events (AEs). METHODS Patients were instructed to record any AEs in their e-diary daily. Safety and tolerability were assessed based on reported AEs, including injection-site reactions (ISRs); unsolicited AEs (AEs other than ISRs); serious AEs; thrombotic, thromboembolic, anaphylactic, hypersensitivity, sepsis, and bacteremia events; inhibitory antibodies to C1-INH; and clinically significant abnormalities in laboratory assessments. Information on ISRs was specifically solicited. RESULTS No relationship between the dose of C1-INH (SC) and the incidence of ISRs or unsolicited AEs was observed. The proportion of injections followed by at least one ISR was 12% with C1-INH (SC) 40 IU/kg versus 5% with 60 IU/kg and 6% with placebo. No ISRs were serious or led to treatment discontinuation, and all resolved. There were no anaphylaxis, thromboembolic, sepsis, or bacteremia events reported during treatment with C1-INH (SC). All hypersensitivity AEs were nonserious, and the majority were assessed as being unrelated to treatment. No inhibitory antibodies to C1-INH were observed. CONCLUSION C1-INH (SC) is safe and well tolerated with no dose-dependent safety concerns, as demonstrated in the COMPACT trial.Clinical trial NCT01912456, <ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">www.clinicaltrials.gov</ext-link>.
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Affiliation(s)
- H. Henry Li
- From the Institute for Asthma and Allergy, P.C., Chevy Chase, Maryl
| | | | - Sandra Christiansen
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of California San Diego, La Jolla, California
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Pawaskar D, Tortorici MA, Zuraw B, Craig T, Cicardi M, Longhurst H, Li HH, Lumry WR, Martinez-Saguer I, Jacobs J, Bernstein JA, Riedl MA, Katelaris CH, Keith PK, Feussner A, Sidhu J. Population pharmacokinetics of subcutaneous C1-inhibitor for prevention of attacks in patients with hereditary angioedema. Clin Exp Allergy 2018; 48:1325-1332. [PMID: 29998524 DOI: 10.1111/cea.13220] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 06/06/2018] [Accepted: 06/17/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Long-term prophylaxis with subcutaneous (SC) administration of a highly concentrated plasma-derived C1-esterase inhibitor (C1-INH) formulation was recently approved by the Food and Drug Administration for hereditary angioedema (HAE) attack prevention. OBJECTIVE To characterize the population pharmacokinetics of C1-INH (SC) (HAEGARDA® ; CSL Behring) in healthy volunteers and HAE patients, and assess the variability and influence of covariates on pharmacokinetics. METHODS C1-INH functional activity data obtained after administration of various C1-INH (intravenous; IV) and C1-INH (SC) doses from 1 study in healthy volunteers (n = 16) and 2 studies in subjects with HAE (n = 108) were pooled to develop a population pharmacokinetic model (NONMEM v7.2). Pharmacokinetic parameters derived from steady-state simulations based on the final model were also evaluated. RESULTS C1-INH functional activity following C1-INH (SC) administration was described by a linear one-compartment model with first-order absorption and elimination, with inter-individual variability in all parameters tested. The mean population bioavailability of C1-INH (SC), and pharmacokinetic parameters for clearance (CL), volume of distribution, and absorption rate were estimated to be ~43%, 1.03 mL/hour/kg, 0.05 L/kg and 0.0146 hour-1 , respectively. The effect of bodyweight on CL of C1-INH functional activity was included in the final model, estimated to be 0.74. Steady-state simulations of C1-INH functional activity vs time profiles in 1000 virtual HAE patients revealed higher minimum functional activity (Ctrough ) levels after twice-weekly dosing with 40 IU/kg (~40%) and 60 IU/kg (~48%) compared with 1000 IU IV (~30%). Based on the population pharmacokinetic model, the median time to peak concentration was ~59 hours and the median apparent plasma half-life was ~69 hours. CONCLUSIONS AND CLINICAL RELEVANCE Twice-weekly bodyweight-adjusted dosing of C1-INH (SC) exhibits linear pharmacokinetics and dose-dependent increases in Ctrough levels at each dosing interval. In this analysis, SC dosing led to maintenance of higher Ctrough levels than IV dosing.
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Affiliation(s)
| | | | - Bruce Zuraw
- Department of Medicine, University of California San Diego and San Diego VA Healthcare, La Jolla, California
| | - Timothy Craig
- Department of Medicine, Pediatrics and Graduate Studies, Penn State University, Hershey, Pennsylvania
| | - Marco Cicardi
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università Degli Studi Di Milano, Milan, Italy
| | - Hilary Longhurst
- Addenbrookes Hospital, Cambridge Universities NHS Foundation Trust, Cambridge, UK
| | - H Henry Li
- Institute for Asthma and Allergy, Chevy Chase, Maryland
| | - William R Lumry
- AARA Research CenterAllergy and Asthma Specialists, Dallas, Texas
| | | | - Joshua Jacobs
- Allergy and Asthma Clinical Research Walnut Creek, Walnut Creek, California
| | - Jonathan A Bernstein
- Department of Immunology/Allergy, University of Cincinnati College of Medicine and Bernstein Clinical Research Center, Cincinnati, Ohio
| | - Marc A Riedl
- Department of Medicine, Division of Rheumatology, Allergy & Immunology, University of California San Diego, San Diego, California
| | - Constance H Katelaris
- Department of Medicine, Campbelltown Hospital, Western Sydney University, Sydney, New South Wales, Australia
| | - Paul K Keith
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Liu T, Li HH, Sheng JJ, Zhu SH. [Advances in the research of delivery system of growth factor and the gene for promoting wound healing]. Zhonghua Shao Shang Za Zhi 2018; 34:566-569. [PMID: 30157565 DOI: 10.3760/cma.j.issn.1009-2587.2018.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Growth factors play critical roles in the process of wound healing. Application of growth factor locally is a good way of promoting wound healing, while it is easy to be hydrolyzed in wounds and its efficacy has dose- and time-dependent manner. Therefore, appropriate growth factor delivery system is needed to assist it to function in wounds. In addition to delivering growth factor directly to wounds, viral and non-viral vectors can be used for gene transfection of growth factor in wounds. The gene can be transformed to growth factor to promote wound healing by transcription and translation. This article reviews the advances in the research of delivery system of growth factor and the gene for promoting wound healing.
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Affiliation(s)
- T Liu
- Department of Burn Surgery, Institute of Burns, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China
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Li HH, Bao ZX, Liu XB, Zhu SH. [Advances in the research of application of artificial intelligence in burn field]. Zhonghua Shao Shang Za Zhi 2018; 34:246-248. [PMID: 29690744 DOI: 10.3760/cma.j.issn.1009-2587.2018.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Artificial intelligence has been able to automatically learn and judge large-scale data to some extent. Based on database of a large amount of burn data and in-depth learning, artificial intelligence can assist burn surgeons to evaluate burn surface, diagnose burn depth, guide fluid supply during shock stage, and predict prognosis, with high accuracy. With the development of technology, artificial intelligence can provide more accurate information for burn surgeons to make clinical diagnosis and treatment strategies.
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Affiliation(s)
- H H Li
- Department of Burn Surgery, Institute of Burns, the first affiliated Hospital of Naval Medical University, Shanghai 200433, China
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Dong HY, Wang B, Li HH, Shan L, Jia FY. [Correlation between serum 25-hydroxyvitamin D level and core symptoms of autism spectrum disorder in children]. Zhonghua Er Ke Za Zhi 2018; 55:916-919. [PMID: 29262471 DOI: 10.3760/cma.j.issn.0578-1310.2017.12.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the relationship between serum 25-hydroxyvitamin D levels and core symptoms of autism spectrum disorder (ASD) in children. Method: In this cross-sectional study, ASD children 4 to 6 years of age who were diagnosed in Department of Developmental and Behavioral Pediatrics, First Hospital of Jilin university from January to May 2017 were assigned to ASD group, and children for routine growth and development assessment in Jilin province were assigned to control group. The two groups were well matched for age and sex, and none of them had received vitamin D supplementation. Serum 25-hydroxyvitamin D levels were measured by HPLC-MS/MS method. The patients of the ASD group were assessed with autism behavior checklist (ABC), childhood autism rating scale (CARS), social response scale (SRS), and autism treatment evaluation checklist (ATEC). The levels of vitamin D were divided into normal(>0.03 ng/L), insufficient (0.01-0.03 ng/L) and deficient (<0.01 ng/L). Levels of serum vitamin D between the two groups were compared by two independent sample t-test, and the difference in the percentages of normal, insufficient and deficient levels of vitamin D was tested by chi-square test, and correlations between vitamin D levels and the total scores or subscales of ABC, CARS, SRS and ATEC were analyzed by Pearson correlation analysis. Result: The 87 subjects in the ASD group included 75 males and 12 females, with a mean (±SD) age of (4.7±0.7) years. The 301 subjects in the control group included 249 males and 52 females, with a mean (±SD) age of (4.8±0.8) years. Serum vitamin D level in ASD children was significantly lower than that of the control group ( (0.021±0.008) vs. (0.036±0.016) ng/L, t=-8.17, P<0.01), and the between-group percentage difference of normal, insufficient and deficient levels of vitamin D was statistically significant (12 (14%) vs. 186 (62%) , 67 (77%) vs. 113 (37%) , 8 (9%) vs. 2 (1%) , χ(2)=72.1, P<0.01). There were negative correlations between serum vitamin D level in ASD children and total ABC score or ABC subscale scores (body behavior, self-care, language and social interaction)(r=-0.531,-0.397,-0.283,-0.248,-0.262, P=0.000, 0.000, 0.007, 0.020, 0.014). There were negative correlations between serum vitamin D level in ASD children and total CARS score and CARS subscale scores (imitation, nonverbal communication and general impression) (r=-0.352, -0.216, -0.248, -0.216, P=0.001, 0.046, 0.021, 0.046). There were negative correlations between serum vitamin D level in ASD children and SRS behavior subscale or ATEC social interaction subscale (r=-0.536, P=0.005, r=-0.400, P=0.014). Conclusion: Serum 25-hydroxyvitamin D level in children with ASD is obviously lower than that in the healthy control group, and there are negative correlations between vitamin D levels and core symptoms of ASD. Trial registration Chinese Clinical Trial Registry, ChiCTR-CCC-13004498.
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Affiliation(s)
- H Y Dong
- Department of Developmental and Behavioral Pediatrics, First Hospital of Jilin University, Changchun 130021, China
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