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Torrance B, Panier H, Cadar A, Martin D, Lorenzo E, Bartley J, Haynes L. P16-EXPRESSING SENESCENT CELLS ARE A DOUBLE-EDGED SWORD IN SHAPING IMMUNE RESPONSES WITH AGE. Innov Aging 2022. [PMCID: PMC9766413 DOI: 10.1093/geroni/igac059.2940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Aging results in the accumulation of senescent cells which can cause dysfunction in many contexts but the effects on immune responses remain unclear. Here, we aimed to probe the effects of clearing senescent cells in aged mice on the immune response to influenza infection. We utilized a powerful p16 trimodality reporter mouse model (p16-3MR): under the control of the p16 promoter, these mice express cassettes encoding luciferase, RFP, and herpesvirus thymidine kinase (HSV-TK). p16 is commonly upregulated in senescent cells so this model allows us to selectively delete those cells by treating with ganciclovir (GCV), which will induce apoptosis in cells expressing HSV-TK. We hypothesized that while p16-expressing senescent cells may exacerbate dysfunctional responses to a primary infection, they may play a protective role in resolving inflammation and fostering memory cell generation. We found that deletion of p16-expressing cells enhanced viral clearance and decreased infiltration of pro-inflammatory flu-specific CD8 T cells during the primary response to infection. Conversely, at 30 days post infection, there were fewer flu-specific CD8 memory T cells and lower amounts of anti-viral antibodies in the lungs of GCV treated mice. We also observed perturbations in memory T cell trafficking in GCV treated mice. Furthermore, GCV treated mice were unable to mount an effective memory response and were unable to control viral load following a heterosubtypic challenge. This suggests that targeting senescent cells may potentiate primary responses while limiting the ability to form durable and protective immune memory with age.
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Affiliation(s)
| | - Hunter Panier
- UConn Health, Farmington, Connecticut, United States
| | - Andreia Cadar
- UConn Health, Farmington, Connecticut, United States
| | | | - Erica Lorenzo
- UConn Health, Farmington, Connecticut, United States
| | - Jenna Bartley
- UConn Health, Farmington, Connecticut, United States
| | - Laura Haynes
- UConn Health, Farmington, Connecticut, United States
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Bartley J. Recruitment Challenges and Strategies for Multimodal Intervention Trials. Innov Aging 2021. [PMCID: PMC8679452 DOI: 10.1093/geroni/igab046.1144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Determining ways to improve hip fracture recovery in older adults is important, however recruitment of this target population into clinical trials is challenging. Multimodal interventions that target multiple mechanisms of recovery may improve outcomes, but each component presents unique recruitment barriers. While exercise interventions have been shown to be beneficial for hip fracture recovery, offering exercise following completion of conventional physical therapy can be viewed as a burdensome time commitment. Hormone replacement therapy may hold promise for overcoming anabolic resistance, but concern about adverse side effects can also deter participation. STEP-HI is a multisite trial testing whether exercise and testosterone can improve hip fracture recovery in older women. In this talk, recruitment barriers experienced in STEP-HI and strategies employed to overcome these barriers will be discussed. Strategies include: partnering with hospitals, skilled nursing facilities and orthopedic surgeons. providing talks and education materials; and featuring past participant testimonials in recruitment materials.
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Affiliation(s)
- Jenna Bartley
- Center on Aging, UConn Health, Farmington, Connecticut, United States
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Binder EF, Christensen JC, Stevens-Lapsley J, Bartley J, Berry SD, Dobs AS, Fortinsky RH, Hildreth KL, Kiel DP, Kuchel GA, Marcus RL, McDonough CM, Orwig D, Sinacore DR, Schwartz RS, Volpi E, Magaziner J, Schechtman KB. A multi-center trial of exercise and testosterone therapy in women after hip fracture: Design, methods and impact of the COVID-19 pandemic. Contemp Clin Trials 2021; 104:106356. [PMID: 33716173 PMCID: PMC9119796 DOI: 10.1016/j.cct.2021.106356] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Up to 75% of hip fracture patients never recover to their pre-fracture functional status. Supervised exercise that includes strength training can improve functional recovery after hip fracture. The role of testosterone replacement for augmenting the effects of exercise in older women after hip fracture is unknown. METHODS The Starting Testosterone and Exercise after Hip Injury (STEP-HI) Study is a 6-month Phase 3 multicenter randomized placebo-controlled trial designed to compare supervised exercise (EX) plus 1% testosterone topical gel, with EX plus placebo gel, and with enhanced usual care (EUC). Female hip fracture patients age ≥ 65 years are being recruited from clinical centers across the United States. Participants are community dwelling and enrolled within 24 weeks after surgical repair of the fracture. The EX intervention is a center-based program of progressive resistance training. The EUC group receives a home exercise program and health education. Participants receive dietary counseling, calcium and vitamin D. The primary outcome is the Six Minute Walk Distance. Secondary outcomes include physical performance measures, self-reported function and quality of life, and dual energy x-ray absorptiometry measures of body composition and bone mineral density. RESULTS Enrollment, interventions, and follow-up are ongoing. We describe the impact of the coronavirus disease 2019 pandemic on the trial, including modifications made to allow continuation of the interventions and outcome data collection using remote video and audio technology. CONCLUSIONS Results from the STEP-HI study are expected to have important clinical and public health implications for management of the growing population of hip fracture patients.
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Affiliation(s)
- Ellen F Binder
- Division of Geriatrics and Nutritional Science, Washington University School of Medicine in St. Louis, St. Louis, MO, United States of America.
| | - Jesse C Christensen
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States of America
| | - Jennifer Stevens-Lapsley
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Denver, CO, United States of America
| | - Jenna Bartley
- UConn Center on Aging, University of Connecticut, Farmington, CT, United States of America
| | - Sarah D Berry
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Isreal Deasconess Medical Center and Harvard Medical School, Boston, MA, United States of America
| | - Adrian S Dobs
- Department of Medicine, Johns Hopkins Medicine, Baltimore, MD, United States of America
| | - Richard H Fortinsky
- UConn Center on Aging, University of Connecticut, Farmington, CT, United States of America
| | - Kerry L Hildreth
- Division of Geriatrics, University of Colorado Anschutz Medical Campus, Denver, CO, United States of America
| | - Douglas P Kiel
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Isreal Deasconess Medical Center and Harvard Medical School, Boston, MA, United States of America
| | - George A Kuchel
- UConn Center on Aging, University of Connecticut, Farmington, CT, United States of America
| | - Robin L Marcus
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States of America
| | - Christine M McDonough
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Denise Orwig
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - David R Sinacore
- Department of Physical Therapy, High Point University, High Point, NC, United States of America
| | - Robert S Schwartz
- Division of Geriatrics, University of Colorado Anschutz Medical Campus, Denver, CO, United States of America
| | - Elena Volpi
- Sealy Center on Aging, University of Texas Medical Branch at Galveston, Galveston, TX, United States of America
| | - Jay Magaziner
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Kenneth B Schechtman
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, MO, United States of America
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Coll PP, Costello VW, Kuchel GA, Bartley J, McElhaney JE. The Prevention of Infections in Older Adults: Vaccination. J Am Geriatr Soc 2019; 68:207-214. [PMID: 31613000 DOI: 10.1111/jgs.16205] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 12/13/2022]
Abstract
All living beings are at risk for experiencing infections; humans are no exception. The prestige and credibility of modern medicine is built in large part on achievements in preventing and treating infectious diseases. For most of human history, there was little that could be done to prevent and treat infections. Millions of humans, of all ages, have died from infections; and in some parts of the world, infection-related deaths remain common. Advances in preventing and treating infectious diseases include improved sanitization, sterilization, pasteurization, immunization, and antibiotics. Vaccination has played a major role in the prevention of lethal diseases, such as smallpox, diphtheria, cholera, and influenza. Because of developing or waning immune function, the young and the old are at particularly high risk of experiencing infections. Influenza and pneumonia remain common causes of death in older adults. Influenza, in particular, has the potential to result in premature mortality for all age groups, including those who are older and particularly those who live in congregate settings. Vaccination is important in promoting healthy aging. J Am Geriatr Soc 68:207-214, 2019.
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Affiliation(s)
- Patrick P Coll
- Department of Family Medicine and Center on Aging, University of Connecticut Health Center, Farmington, Connecticut
| | - Victoria W Costello
- Center on Aging, University of Connecticut Health Center, Farmington, Connecticut
| | - George A Kuchel
- Center on Aging, University of Connecticut Health Center, Farmington, Connecticut
| | - Jenna Bartley
- Center on Aging, University of Connecticut Health Center, Farmington, Connecticut
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Keilich S, Bartley J, Haynes L. MECHANISMS OF INFLUENZA-INDUCED DISABILITY WITH AGING. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | - L Haynes
- Univerisity of Connecticut School of Medicine
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Telalbasic S, Gruber TM, Bartley J, Barinoff J, Sehouli J, Mechsner S. Adenomyosis uteri und Kinderwunsch. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- S Telalbasic
- Charité – Universitätsmedizin Berlin, Gynäkologie, Berlin, Deutschland
| | - TM Gruber
- Charité – Universitätsmedizin Berlin, Gynäkologie, Berlin, Deutschland
| | - J Bartley
- Kinderwunsch Berlin, Berlin, Deutschland
| | - J Barinoff
- Charité – Universitätsmedizin Berlin, Gynäkologie, Berlin, Deutschland
| | - J Sehouli
- Charité – Universitätsmedizin Berlin, Gynäkologie, Berlin, Deutschland
| | - S Mechsner
- Charité – Universitätsmedizin Berlin, Gynäkologie, Berlin, Deutschland
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Affiliation(s)
- D E White
- BioDesign Lab, Auckland University of Technology, Auckland, NEW ZEAL
| | - J Bartley
- Department of Physiology, University of Auckland, Auckland, NEW ZEAL
| | - A J Campbell
- WellSleep Centre, University of Otago, Welington, NEW ZEAL
| | - A M Neill
- WellSleep Centre, University of Otago, Welington, NEW ZEAL
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Maeffet J, Bartley J. Verwendung einer App zur Begleitung des zu Hause durchgeführten medikamentösen Schwangerschaftsabbruchs: eine geplante prospektiv randomisierte Studie. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1622759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
| | - J Bartley
- Kinderwunschzentrum an der Gedächtniskirche, Berlin
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Bartley J, Keilich S, Kuchel G, Haynes L. INFLUENZA-INDUCED MUSCLE DEGRADATION: A PATHWAY TO AGE-ASSOCIATED DISABILITY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J. Bartley
- UConn Health Center, Farmington, Connecticut
| | | | - G. Kuchel
- UConn Health Center, Farmington, Connecticut
| | - L. Haynes
- UConn Health Center, Farmington, Connecticut
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Lee B, Diaz GA, Rhead W, Lichter-Konecki U, Feigenbaum A, Berry SA, Le Mons C, Bartley J, Longo N, Nagamani SC, Berquist W, Gallagher RC, Harding CO, McCandless SE, Smith W, Schulze A, Marino M, Rowell R, Coakley DF, Mokhtarani M, Scharschmidt BF. Glutamine and hyperammonemic crises in patients with urea cycle disorders. Mol Genet Metab 2016; 117:27-32. [PMID: 26586473 PMCID: PMC4915945 DOI: 10.1016/j.ymgme.2015.11.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/10/2015] [Accepted: 11/10/2015] [Indexed: 12/30/2022]
Abstract
UNLABELLED Blood ammonia and glutamine levels are used as biomarkers of control in patients with urea cycle disorders (UCDs). This study was undertaken to evaluate glutamine variability and utility as a predictor of hyperammonemic crises (HACs) in UCD patients. METHODS The relationships between glutamine and ammonia levels and the incidence and timing of HACs were evaluated in over 100 adult and pediatric UCD patients who participated in clinical trials of glycerol phenylbutyrate. RESULTS The median (range) intra-subject 24-hour coefficient of variation for glutamine was 15% (8-29%) as compared with 56% (28%-154%) for ammonia, and the correlation coefficient between glutamine and concurrent ammonia levels varied from 0.17 to 0.29. Patients with baseline (fasting) glutamine values >900 μmol/L had higher baseline ammonia levels (mean [SD]: 39.6 [26.2]μmol/L) than patients with baseline glutamine ≤ 900 μmol/L (26.6 [18.0]μmol/L). Glutamine values >900 μmol/L during the study were associated with an approximately 2-fold higher HAC risk (odds ratio [OR]=1.98; p=0.173). However, glutamine lost predictive significance (OR=1.47; p=0.439) when concomitant ammonia was taken into account, whereas the predictive value of baseline ammonia ≥ 1.0 upper limit of normal (ULN) was highly statistically significant (OR=4.96; p=0.013). There was no significant effect of glutamine >900 μmol/L on time to first HAC crisis (hazard ratio [HR]=1.14; p=0.813), but there was a significant effect of baseline ammonia ≥ 1.0 ULN (HR=4.62; p=0.0011). CONCLUSIONS The findings in this UCD population suggest that glutamine is a weaker predictor of HACs than ammonia and that the utility of the predictive value of glutamine will need to take into account concurrent ammonia levels.
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Affiliation(s)
- B Lee
- Baylor College of Medicine, Houston, TX, USA.
| | - G A Diaz
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - W Rhead
- The Medical College of Wisconsin, Milwaukee, WI, USA
| | | | | | - S A Berry
- Univ. of Minnesota, Minneapolis, MN, USA
| | - C Le Mons
- National Urea Cycle Disorders Foundation, Pasadena, CA, USA
| | - J Bartley
- Miller Children's Hospital, Long Beach, CA, USA
| | - N Longo
- Univ. of UT, Salt Lake City, UT, USA
| | | | | | | | | | - S E McCandless
- Case Western Reserve Univ. Medical Center, Cleveland, OH, USA
| | - W Smith
- Maine Medical Ctr., Portland, ME, USA
| | - A Schulze
- The Hospital for Sick Children, Univ. of Toronto, Canada
| | - M Marino
- Oregon Health Sciences, Portland, OR, USA
| | - R Rowell
- MED Technical Consulting, Inc., Union City, CA, USA
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Bartley J, Hopkins J, Haynes L. Influenza infection results in upregulation of inflammatory and atrophy genes in murine skeletal muscle (VIR5P.1146). The Journal of Immunology 2015. [DOI: 10.4049/jimmunol.194.supp.148.14] [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] [Indexed: 01/03/2023]
Abstract
Abstract
Though influenza is a respiratory infection, myalgia is a common symptom and associations with acute myositis and rhabdomyolysis have been noted. It is currently unclear if these symptoms are secondary due to the systemic response or if muscle may contribute to inflammation. Further, the effect of influenza on muscle damage and potential repair is not well established. We aimed to determine the expression level of select myokines, atrophy, and myogenic markers in skeletal muscle during influenza infection. Young C57BL/6 mice were inoculated with Pr8 influenza virus (IN, 500 EID50) and sacrificed 7 or 15 days post infection (DPI) or were uninfected (n=4/group). Gastrocnemius gene expression was analyzed via RT-qPCR. Myostatin, IL4, IL6, IL6 receptor alpha, Ubiquitin B, Ubiquitin C, Foxo1, Atrogin-1, and MuRF-1 gene expression was upregulated 7 DPI indicating increased inflammation, protein degradation, and atrophy. Expression of positive regulators of muscle growth and maintenance (Igf-1, MyoD, and Mef2C) was downregulated at this time as well. At 15 DPI Atrogin-1 and MuRF-1 were downregulated though upregulation of myogenic markers did not occur. Our results indicate influenza infection is associated with muscle-localized inflammation, protein degradation, and atrophy that is resolved by day 15 post infection. It is known that influenza infection in the elderly leads to increased disability and loss of independence; it is likely muscle atrophy is a contributing factor.
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Affiliation(s)
- Jenna Bartley
- 1University of Connecticut Health Center, Farmington, CT
| | - Jake Hopkins
- 1University of Connecticut Health Center, Farmington, CT
| | - Laura Haynes
- 1University of Connecticut Health Center, Farmington, CT
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Bartley J, Munoz C, Kunces L, Saenz C, Creighton B, Freidenreich D, Lee E, Maresh C, Volek J. Influence of Habitual Carbohydrate Intake on Exercise‐Induced Inflammation in Ultra‐Endurance Athletes. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.lb668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Carl Maresh
- KinesiologyThe Ohio State UniversityColumbusOHUnited States
| | - Jeff Volek
- KinesiologyThe Ohio State UniversityColumbusOHUnited States
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Munoz C, McKenzie A, Bartley J, Kunces L, Creighton B, Varanoske A, Armstrong L, Maresh C, Lee E. NFAT5 Expression in Circulating PBMCs is a Potential Biomarker of Whole‐body Dehydration and Stress. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.675.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Colleen Munoz
- KinesiologyUniversity of ConnecticutStorrsCTUnited States
| | - Amy McKenzie
- KinesiologyUniversity of ConnecticutStorrsCTUnited States
| | - Jenna Bartley
- KinesiologyUniversity of ConnecticutStorrsCTUnited States
| | - Laura Kunces
- KinesiologyUniversity of ConnecticutStorrsCTUnited States
| | | | | | | | - Carl Maresh
- Human Sciences The Ohio State UniversityColumbusOHUnited States
| | - Elaine Lee
- KinesiologyUniversity of ConnecticutStorrsCTUnited States
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Mokhtarani M, Diaz GA, Rhead W, Berry SA, Lichter-Konecki U, Feigenbaum A, Schulze A, Longo N, Bartley J, Berquist W, Gallagher R, Smith W, McCandless SE, Harding C, Rockey DC, Vierling JM, Mantry P, Ghabril M, Brown RS, Dickinson K, Moors T, Norris C, Coakley D, Milikien DA, Nagamani SC, Lemons C, Lee B, Scharschmidt BF. Elevated phenylacetic acid levels do not correlate with adverse events in patients with urea cycle disorders or hepatic encephalopathy and can be predicted based on the plasma PAA to PAGN ratio. Mol Genet Metab 2013; 110:446-53. [PMID: 24144944 PMCID: PMC4108288 DOI: 10.1016/j.ymgme.2013.09.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 09/29/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Phenylacetic acid (PAA) is the active moiety in sodium phenylbutyrate (NaPBA) and glycerol phenylbutyrate (GPB, HPN-100). Both are approved for treatment of urea cycle disorders (UCDs) - rare genetic disorders characterized by hyperammonemia. PAA is conjugated with glutamine in the liver to form phenylacetyleglutamine (PAGN), which is excreted in urine. PAA plasma levels ≥ 500 μg/dL have been reported to be associated with reversible neurological adverse events (AEs) in cancer patients receiving PAA intravenously. Therefore, we have investigated the relationship between PAA levels and neurological AEs in patients treated with these PAA pro-drugs as well as approaches to identifying patients most likely to experience high PAA levels. METHODS The relationship between nervous system AEs, PAA levels and the ratio of plasma PAA to PAGN were examined in 4683 blood samples taken serially from: [1] healthy adults [2], UCD patients of ≥ 2 months of age, and [3] patients with cirrhosis and hepatic encephalopathy (HE). The plasma ratio of PAA to PAGN was analyzed with respect to its utility in identifying patients at risk of high PAA values. RESULTS Only 0.2% (11) of 4683 samples exceeded 500 μg/ml. There was no relationship between neurological AEs and PAA levels in UCD or HE patients, but transient AEs including headache and nausea that correlated with PAA levels were observed in healthy adults. Irrespective of population, a curvilinear relationship was observed between PAA levels and the plasma PAA:PAGN ratio, and a ratio>2.5 (both in μg/mL) in a random blood draw identified patients at risk for PAA levels>500 μg/ml. CONCLUSIONS The presence of a relationship between PAA levels and reversible AEs in healthy adults but not in UCD or HE patients may reflect intrinsic differences among the populations and/or metabolic adaptation with continued dosing. The plasma PAA:PAGN ratio is a functional measure of the rate of PAA metabolism and represents a useful dosing biomarker.
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Affiliation(s)
- M Mokhtarani
- Hyperion Therapeutics, 601 Gateway Blvd., Suite 200, South San Francisco, CA 94080, USA.
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Bartley J, Jülicher A, Hotz B, Mechsner S, Hotz H. Epithelial to mesenchymal transition (EMT) seems to be regulated differently in endometriosis and the endometrium. Arch Gynecol Obstet 2013; 289:871-81. [PMID: 24170160 DOI: 10.1007/s00404-013-3040-4] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 09/19/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE Epithelial-mesenchymal transition (EMT) endows cells with migratory and invasive properties, a prerequisite for the establishment of endometriotic lesions. However, the role EMT might play in the pathophysiology of endometriosis is still unknown. Therefore, we examined five recognized markers for EMT in endometrium and endometriosis: E-cadherin, N-cadherin, Twist, Snail and Slug. METHODS Immunohistochemistry was used for peritoneal, ovarian and rectovaginal endometriotic lesions (n = 27) and endometrium (n = 13). Reverse transcription polymerase chain reaction was applied to tissue samples and primary cell cultures of endometriotic lesions (n = 9) and endometrium (n = 8). RESULTS In endometriosis and endometrium E-cadherin, N-cadherin, Twist, Snail and Slug were expressed on protein and mRNA level. E-cadherin expression was strong in epithelial cells, but single E-cadherin-negative cells were frequently present in endometriosis. In endometriosis N-cadherin, Twist and Snail expression were upregulated in comparison with endometrium. The expression of E- and N-cadherin was inversely correlated, while that of N-cadherin and Twist was positively correlated. CONCLUSION This study strongly suggests that EMT may be regulated differently in endometriosis and the endometrium. Future research should further elucidate the regulation of EMT in the endometrium and endometriosis.
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Affiliation(s)
- J Bartley
- Department of Gynaecology, Endometriosis Research Centre Berlin, Charité Universitätsmedizin, Charitéplatz 1, 10117, Berlin, Germany,
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Mokhtarani M, Diaz GA, Rhead W, Lichter-Konecki U, Bartley J, Feigenbaum A, Longo N, Berquist W, Berry SA, Gallagher R, Bartholomew D, Harding CO, Korson MS, McCandless SE, Smith W, Vockley J, Bart S, Kronn D, Zori R, Cederbaum S, Dorrani N, Merritt JL, Sreenath-Nagamani S, Summar M, Lemons C, Dickinson K, Coakley DF, Moors TL, Lee B, Scharschmidt BF. Urinary phenylacetylglutamine as dosing biomarker for patients with urea cycle disorders. Mol Genet Metab 2012; 107:308-14. [PMID: 22958974 PMCID: PMC3608516 DOI: 10.1016/j.ymgme.2012.08.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 08/07/2012] [Accepted: 08/07/2012] [Indexed: 11/22/2022]
Abstract
UNLABELLED We have analyzed pharmacokinetic data for glycerol phenylbutyrate (also GT4P or HPN-100) and sodium phenylbutyrate with respect to possible dosing biomarkers in patients with urea cycle disorders (UCD). STUDY DESIGN These analyses are based on over 3000 urine and plasma data points from 54 adult and 11 pediatric UCD patients (ages 6-17) who participated in three clinical studies comparing ammonia control and pharmacokinetics during steady state treatment with glycerol phenylbutyrate or sodium phenylbutyrate. All patients received phenylbutyric acid equivalent doses of glycerol phenylbutyrate or sodium phenylbutyrate in a cross over fashion and underwent 24-hour blood samples and urine sampling for phenylbutyric acid, phenylacetic acid and phenylacetylglutamine. RESULTS Patients received phenylbutyric acid equivalent doses of glycerol phenylbutyrate ranging from 1.5 to 31.8 g/day and of sodium phenylbutyrate ranging from 1.3 to 31.7 g/day. Plasma metabolite levels varied widely, with average fluctuation indices ranging from 1979% to 5690% for phenylbutyric acid, 843% to 3931% for phenylacetic acid, and 881% to 1434% for phenylacetylglutamine. Mean percent recovery of phenylbutyric acid as urinary phenylacetylglutamine was 66.4 and 69.0 for pediatric patients and 68.7 and 71.4 for adult patients on glycerol phenylbutyrate and sodium phenylbutyrate, respectively. The correlation with dose was strongest for urinary phenylacetylglutamine excretion, either as morning spot urine (r = 0.730, p < 0.001) or as total 24-hour excretion (r = 0.791 p<0.001), followed by plasma phenylacetylglutamine AUC(24-hour), plasma phenylacetic acid AUC(24-hour) and phenylbutyric acid AUC(24-hour). Plasma phenylacetic acid levels in adult and pediatric patients did not show a consistent relationship with either urinary phenylacetylglutamine or ammonia control. CONCLUSION The findings are collectively consistent with substantial yet variable pre-systemic (1st pass) conversion of phenylbutyric acid to phenylacetic acid and/or phenylacetylglutamine. The variability of blood metabolite levels during the day, their weaker correlation with dose, the need for multiple blood samples to capture trough and peak, and the inconsistency between phenylacetic acid and urinary phenylacetylglutamine as a marker of waste nitrogen scavenging limit the utility of plasma levels for therapeutic monitoring. By contrast, 24-hour urinary phenylacetylglutamine and morning spot urine phenylacetylglutamine correlate strongly with dose and appear to be clinically useful non-invasive biomarkers for compliance and therapeutic monitoring.
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Affiliation(s)
- M Mokhtarani
- Hyperion Therapeutics, 601 Gateway Blvd, Suite 200, South San Francisco, CA 94080, USA.
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David M, Berends L, Bartley J. Current Opinion of Obstetricians on the Prescription of Emergency Contraception: A German-American Comparison. Geburtshilfe Frauenheilkd 2012; 72:1004-1008. [PMID: 25258456 DOI: 10.1055/s-0032-1327992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 10/29/2012] [Accepted: 10/29/2012] [Indexed: 10/27/2022] Open
Abstract
Background: There are no current studies on the opinions of obstetricians and gynaecologists in Germany about emergency contraception (or post-coital contraception, morning-after pill). The opinions of a large group of physicians were collected using of a questionnaire and compared with the results of an American survey (n = 1154). Methods: A two-part questionnaire was used - part 1: sociodemographic data, part 2: 4 scenarios to illustrate the possible advantages and disadvantages of free access to emergency contraception as well as 4 indications and situations for which emergency contraception can be prescribed. Results: The response rate was 91.7 % (165/180 questionnaires). 63.9 % (103/161) of the German responding physicians were of the opinion that women with access to emergency contraception experienced unwanted pregnancies less frequently than those without access. Merely 26.2 % of the responding physicians supported the prescription-free availability of emergency contraception in apothecaries. The German-American comparison ultimately revealed only a few major differences, e.g., in answers to the question whether or not access to emergency contraception could reduce the number of unwanted pregnancies (89 vs. 64 %). Conclusions: The high rejection rate of free access to emergency contraception of almost 70 % in our surveyed group supports the current position published by the German Society for Gynaecology and Obstetrics (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe) and the German Professional Union of Gynaecologists (deutscher Berufsverband der Frauenärzte). Since other medical organisations, e.g., WHO, supported the prescription-free access to levonorgestrel formulations as emergency contraception a few years ago, it would be interesting to ask a larger sample of German gynaecologists and obstetricians about their opinions on emergency contraception.
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Affiliation(s)
- M David
- Klinik für Gynäkologie, Charité Campus Virchow-Klinikum, Berlin
| | - L Berends
- Klinik für Gynäkologie, Charité Campus Virchow-Klinikum, Berlin
| | - J Bartley
- Klinik für Gynäkologie und Institut für Sexualmedizin, Charité Campus B. Franklin und Charité Mitte, Berlin
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Bartley J. Das Syndrom polyzystischer Ovarien (PCO-Syndrom, PCOS) – neue Entwicklungen in Diagnostik und Therapie. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1295374] [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: 10/15/2022] Open
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Barcena de Arellano ML, Arnold J, Rüster C, Blöchle M, Bartley J, Mechsner S. Ist das Endometrium von Frauen mit Endometriose innerviert? Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1280486] [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: 10/18/2022] Open
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20
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Straube M, Barcena de Arellano ML, Bartley J, Vercellino GF, Mechsner S. Gibt es weitere Testverfahren die Endometriose-assoziierten endometrialen Veränderungen zu charakterisieren? Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1280489] [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: 10/18/2022] Open
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Carling P, Po J, Bartley J, Herwalt L. P11.03 Identifying opportunities to improve environmental hygiene in multiple healthcare venues. J Hosp Infect 2010. [DOI: 10.1016/s0195-6701(10)60111-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mechsner S, Infanger M, Ebert A, Schneider A, Bartley J. Bauchdeckenendometriose: Diagnostisches und therapeutisches Management. Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0029-1240924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Mechsner S, Weichbrodt M, Riedlinger WF, Bartley J, Schneider A, Köhler C. Endometriose in pelvinen Sentinel-Lymphknoten (SLK) von Patientinnen mit rektovaginaler Endometriose (EM). Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1238989] [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: 10/20/2022] Open
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Mechsner S, Weichbrodt M, Riedlinger W, Bartley J, Schneider A, Köhler C. Endometriose in pelvinen Sentinel-Lymphknoten (SLK) von Patientinnen mit rektovaginaler Endometriose (EM) – Pilot Studie. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1088637] [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: 10/19/2022] Open
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25
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Bartley J, Jülicher A, Herbel J, Ebert A. COX–2 und Neoangiogenese in Endometrioseläsionen. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1089079] [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: 10/19/2022] Open
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26
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Bartley J, Jülicher A, Mechsner S, Hotz B, Hotz H. Epitheliale mesenchymale Transition in Endometriose – Expression der Transcriptionsfaktoren Twist, Snail und Slug und der Zelladhäsionsmoleküle E-and N-Cadherin in Endometrioseläsionen. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1089228] [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: 10/19/2022] Open
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27
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Bauer PG, Riedlinger W, Bartley J, Kaufmann AM, Mechsner S. Charakterisierung von Endometriose-assoziierten lymphozytären Infiltraten. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1089225] [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: 10/18/2022] Open
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28
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Mechsner S, Weichbrodt M, Riedlinger WFJ, Bartley J, Kaufmann AM, Schneider A, Köhler C. Estrogen and progestogen receptor positive endometriotic lesions and disseminated cells in pelvic sentinel lymph nodes of patients with deep infiltrating rectovaginal endometriosis: a pilot study. Hum Reprod 2008; 23:2202-9. [PMID: 18635532 DOI: 10.1093/humrep/den259] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Deep infiltrating endometriosis (DIE) shows similarities to malignant diseases. A recent study involving DIE patients found endometriosis in mesorectal lymph nodes (LNs) after segmental bowel resection. However, it is unclear whether this observation is a local phenomenon or a sign of systemic disease. Therefore, we conducted a prospective study to investigate the occurrence of endometriosis in pelvic sentinel lymph nodes (SLNs) in patients with DIE. METHODS Fourteen patients underwent primary surgery for symptomatic DIE. Combined vaginal laparoscopic-assisted resection of the rectovaginal septum was performed. Dye was injected into the visible/palpable nodule. SLNs were removed from the iliac region. In order to identify endometriotic cells, immunohistochemical analysis of estrogen and progestogen receptors, CD10 and cytokeratin was performed. RESULTS In 12 out of 14 patients with DIE, SLNs were detected. The localization of the SLN followed the typical LN spread of the upper vagina. In three patients, we could detect typical endometriotic lesions in the LNs. Ten out of 12 (83.3%) SLNs showed disseminated estrogen and/or progestogen positive cells. CONCLUSIONS By using immunohistochemistry, we could demonstrate endometriotic lesions and endometriotic-like cells in pelvic SLNs of patients with DIE suggesting the potential for lymphatic spread of the disease.
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Affiliation(s)
- S Mechsner
- Department of Gynecology, Endometriosis Research Center Charité, Charité, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.
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Goh C, Taufiq-Yap Y, Hutchings G, Dummer N, Bartley J. Influence of Bi–Fe additive on properties of vanadium phosphate catalysts for n-butane oxidation to maleic anhydride. Catal Today 2008. [DOI: 10.1016/j.cattod.2007.10.059] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Qin N, Bartley J, Wang JC, Warburton P. A neocentromere derived from a supernumerary marker deleted from the long arm of chromosome 6. Cytogenet Genome Res 2007; 119:154-7. [DOI: 10.1159/000109633] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2006] [Accepted: 05/18/2007] [Indexed: 11/19/2022] Open
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31
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Zanetti-Dällenbach R, Bartley J, Holzgreve W, Wight E. Differenzialdiagnose inflammatorisches Mammakarzinom: Brustödem nach Thrombose der V. brachiocephalica. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-965678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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32
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Wedhorn M, Halis G, Mechsner S, Cordes A, Parlayan S, Rohne J, Bartley J, Ebert AD. Endometriose-Report: Die operative Häufigkeit der Endometriose in 22 Berliner Frauenkliniken im Jahre 2001. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-989193] [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: 10/19/2022] Open
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33
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Juelicher A, Bartley J, Hotz B, Arndt M, Hotz H, Ebert AD. Die Rolle von Twist beim invasiven Wachstum der Endometriose. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-989157] [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: 10/19/2022] Open
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34
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Mangler M, Medrano N, Lanowska M, Bartley J, Schneider A, Köhler C. Präoperative Diagnostik eines Darmbefalls bei rektovaginaler Endometriose. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-989169] [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: 10/19/2022] Open
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35
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Kaiser A, Bartley J, Loddenkemper C, Schneider A, Ebert AD, Mechsner S. Untersuchungen zur klinischen Bedeutung Endometriose-assoziierter Nervenfasern (EM-aNF) in peritonealen Endometrioseläsionen (pEM). Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-989158] [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: 10/19/2022] Open
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36
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West A, Bartley J, Loddenkemper C, Ebert AD, Mechsner S. Klinische Relevanz der Oxytocin-Rezeptor (OTR) Expression in peritonealen Endometrioseherden (pEM). Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-989194] [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: 10/19/2022] Open
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37
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Mechsner S, Loddenkemper C, Beutler C, Thode J, Bartley J, Schwarz J, Ebert AD. Die Rolle des Oxytocin Rezeptors (OTR) und Vasopressin Rezeptors (VPR) in der Pathogenese der Adenomyosis uteri (AM)-assoziierten Dysmenorrhoe. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952712] [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: 10/20/2022] Open
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38
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Schwarz J, mechsner S, Bartley J, Thode J, Ebert AD. Interaktionen zwischen Endometriose- und Nervenzellen. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952214] [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: 10/20/2022] Open
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39
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Thode J, Mechsner S, Schwarz J, Bartley J, Beutler C, Ebert AD. Untersuchungen zur endokrinen Regulation der epidermal growth factor receptor (EGFR) Familie im Endometriose in vitro-Modell. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952714] [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: 10/20/2022] Open
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40
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West A, Mechsner S, Beutler C, Thode J, Bartley J, Ebert AD. Untersuchungen zur zyklusabhängigen Oxytocin-Rezeptor-Expression (OTR) im Endometrium und in peritonealen Endometrioseherden. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952715] [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: 10/20/2022] Open
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41
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Jülicher A, Hotz B, Arndt M, Bartley J, Ritz JP, Ebert AD. Die Rolle von TWIST beim invasiven Wachstum der Endometriose. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952711] [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: 10/20/2022] Open
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42
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Bühling K, Bartley J, Lübbert H. Einsatz oraler Antidiabetika in der Therapie des Kinderwunsches, des Gestationsdiabetes und zur Prävention des Typ-2-Diabetes. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-923772] [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: 10/24/2022] Open
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43
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Taufiq-Yap YH, Hasbi ARM, Hussein MZ, Hutchings GJ, Bartley J, Dummer N. Synthesis of Vanadium Phosphate Catalysts by Hydrothermal Method for Selective Oxidation of n-butane to Maleic Anhydride. Catal Letters 2006. [DOI: 10.1007/s10562-005-9627-z] [Citation(s) in RCA: 10] [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: 10/25/2022]
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Abstract
Endometriosis is considered a chronic disease of women during their reproductive phase, which resembles many signs of malignancy. So far, therapeutic options for endometriosis-associated pain and infertility are unsatisfactory and often lead to recurrence of disease after termination of treatment. Angiogenesis seems to play an important role in the pathogenesis of endometriosis. The use of angiogenesis inhibitors may add an important new tool to well-established treatment schedules. Therefore, it is very important to thoroughly investigate the role of angiogenesis in endometriosis with respect to the female reproductive system.
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Affiliation(s)
- C M Becker
- Deutsches Endometriose Kompetenz-und Experten-Netzwerk, Frauenklinik und Poliklinik, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin
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Ebert AD, Bartley J, David M, Schweppe KW. [Aromatase inhibitors--theoretical concept and present experiences in the treatment of endometriosis]. ACTA ACUST UNITED AC 2003; 125:247-51. [PMID: 14505258 DOI: 10.1055/s-2003-42517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The medical treatment of endometriosis needs to be optimized. Therapeutic management strategies of endometriosis-associated pain or recurrent disease is primarily aimed at downregulating the ovarian function or at antagonizing the effect of estrogen in ectopic endometrial implants. In this context, basic research is delivering powerful tools for the possible development of new, specific treatment modalities. Recently, aromatase overexpression has been detected in endometriotic tissue. Aromatase (p450arom) is responsible for conversion of C19 androgens to estrogen in several human tissues. Aromatase activity gives rise to local estrogen biosynthesis, which, in turn, stimulates prostaglandin E(2) production by upregulation of cyclooxygenase-2 (COX-2), thus establishing a positive feedback cycle. Another abnormality in endometriosis, i. e. the deficiency in 17 beta-hydroxysteroiddehydrogenase type-II (17 beta-HSD-Type-II) expression, impairs the inactivation of estradiol to estrone. In contrast to the eutopic endometrium, these molecular aberrations collectively favour accumulation of increasing amounts of local estradiol and prostaglandin E(2) in endometriosis. In several human cell lines, prostaglandin and estrogen concentrations are associated with proliferation, migration, angiogenesis, apoptosis resistance, and even invasiveness. Consequently, aromatase and COX-2 are promising new therapeutic targets. In summary, specific aromatase inhibitors (such as Letrozole, Anastrozol or Exemestan) or selective COX-2 inhibitors (e.g. Celecoxib, Rofecoxib) are of great interest to be studied in clinical trials in premenopausal woman with endometriosis to extend the spectrum of currently available treatment options.
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Affiliation(s)
- A D Ebert
- Deutsches Endometriose Kompetenz- und Experten-Netzwerkes and Endometriosezentrum Berlin, Frauenklinik und Poliklinik, Charité-Universitätsmedizin Berlin.
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Krämer T, Buchwald J, Fichtner I, Heine B, Bartley J, Mechsner S, Beutler C, Salomon DS, Ebert AD. Charakterisierung der Cyclooxygenase-2 (COX-2)-Expression sowie der Expressionsmuster der EGF-Rezeptoren (HER-1, -2, -3 und -4) in humanen Mammakarzinomen nach Xenotransplantation auf (nu/nu)-Nacktmäuse. Geburtshilfe Frauenheilkd 2003. [DOI: 10.1055/s-2003-815245] [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: 10/20/2022] Open
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Bartley J, Mechsner S, Beutler C, Thode J, Loddenkemper C, Halis G, Ebert AD. Klinische Relevanz der Cyclooxygenase-2 (COX-2)-Expression in peritonealen, ovariellen und rectovaginalen Endometrioseherden (EMH) – from bench to bedsite? Geburtshilfe Frauenheilkd 2003. [DOI: 10.1055/s-2003-815128] [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: 10/20/2022] Open
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Mechsner S, Bartley J, Beutler C, Loddenkemper C, Thode J, Lange J, Halis G, Ebert AD. Klinische Relevanz der Expression des Oxytocin-Rezeptors (OTR) in glatten Muskelzellen peritonealer und ovarieller Endometrioseläsionen. Geburtshilfe Frauenheilkd 2003. [DOI: 10.1055/s-2003-815210] [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: 10/20/2022] Open
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49
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Krämer T, Buchwald J, Fichtner I, Heine B, Bartley J, Mechsner S, Beutler C, Salomon DS, Ebert AD. Charakterisierung der Cyclooxygenase-2 (COX-2)-Expression sowie der Expressionsmuster der EGF-Rezeptoren (HER-1, -3 und -4) in invasiv-duktalen Mammakarzinomen (IDMCa). Geburtshilfe Frauenheilkd 2003. [DOI: 10.1055/s-2003-815244] [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: 10/20/2022] Open
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Bartley J, Mechsner S, Beutler C, Halis G, Lange J, Ebert AD. COX-2-Expression in extragenitalen Endometrioseläsionen als neuer Therapieansatz? ACTA ACUST UNITED AC 2003; 125:252-5. [PMID: 14505259 DOI: 10.1055/s-2003-42279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Extragenital endometriosis is a rare form of endometriosis. Due to its invasive and metastatic properties it resembles some features of malignant tumours. Cyclooxygenase (COX)-2 is a rate-limiting enzyme in the biosynthesis of prostaglandins and is mainly expressed in inflammatory and malignant processes. In this study we investigated the COX-2 expression in extragenital endometriosis. MATERIAL AND METHODS Tissue was obtained of 13 women with rectal and vaginal endometriosis, scar endometriosis and endometriosis of the omentum majus. The COX-2 expression was investigated by immunohistochemistry. RESULTS In the glandular epithelium a COX-2 overexpression was found in all cases and in the stroma a weak to moderate COX-2 expression was found in half of the cases. A hormonal therapy at the time of surgery had no influence on the COX-2 expression in extragenital endometriosis. CONCLUSION The high COX-2 expression in extragenital endometriosis is believed to be strongly correlated with the pathological abnormalities this of disease.
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Affiliation(s)
- J Bartley
- Deutsches Endometriose Kompetenz- und Experten-Netzwerk, Frauenklinik, Charité-Universitätsmedizin Berlin, FU Berlin
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