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Durrant FG, Gutierrez JA, Nguyen SA, Nathan CAO, Newman JG. Sexual history of patients with human papillomavirus positive and negative oropharyngeal cancer: A systematic review and meta-analysis. Head Neck 2024. [PMID: 38477218 DOI: 10.1002/hed.27733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 02/25/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Increased sexual activity is associated with higher human papillomavirus (HPV) rates; however, there is a lack of analysis comparing the sexual history of patients with HPV positive and HPV negative oropharyngeal cancer (OPC). METHODS In this meta-analysis, PubMed, Scopus, and CINAHL were searched for articles that included patients with OPC and reported information regarding HPV status and either history of oral sex, number of sexual partners, or sexually transmitted infections (STI). RESULTS A total of 11 studies were included with 3296 patients with OPC. Patients with HPV positive OPC were more likely than patients with HPV negative OPC to report a history of oral sex (92%, 95% CI: 87.0-97.0 vs. 74.5%, 95% CI: 50.6-98.4, p < 0.0001), higher mean number of sexual partners (18.4 partners, 95% CI: 1.5-35.4 vs. 7.2 partners, 95% CI: 1.0-13.4, p < 0.0001), and more frequent history of STI (23.7%, 95% CI: 18.4-29.0 vs. 8.8%, 95% CI: 4.7-12.8, p = 0.0001). CONCLUSIONS Compared to patients with HPV negative OPC, our analysis shows a larger proportion of patients with HPV positive OPC had participated in oral sex, had a higher number of sexual partners, and had a higher proportion of STI history.
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Affiliation(s)
- Frederick G Durrant
- Department of Otolaryngology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Jorge A Gutierrez
- Department of Otolaryngology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Shaun A Nguyen
- Department of Otolaryngology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Cherie-Ann O Nathan
- Department of Otolaryngology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Jason G Newman
- Department of Otolaryngology, Medical University of South Carolina, Charleston, South Carolina, USA
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Gutierrez JA, Barth JL, Schlosser RJ, Edwards TS, Smith TL, Soler ZM. Utilization of RNA sequencing to investigate olfactory dysfunction in chronic rhinosinusitis without nasal polyps: A pilot study. World J Otorhinolaryngol Head Neck Surg 2024; 10:29-36. [PMID: 38560035 PMCID: PMC10979044 DOI: 10.1002/wjo2.123] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/31/2023] [Accepted: 06/13/2023] [Indexed: 04/04/2024] Open
Abstract
Objectives Prior research on olfactory dysfunction in chronic rhinosinusitis (CRS) has focused on patients with polyps and suggests that direct inflammation of the olfactory cleft mucosa plays a contributory role. The purpose of this study was to evaluate gene expression in superior turbinate mucosal specimens, comparing normosmic and dysosmic CRS patients without polyps (CRSsNP). Methods Tissue samples were obtained from the superior turbinates of patients with CRSsNP at the time of endoscopic sinus surgery. Samples subsequently underwent RNA sequencing and functional analysis to investigate biological pathways associated with differentially expressed genes between dysosmic (n = 7) and normosmic (n = 4) patients. Results Differential gene expression analysis comparing dysosmic and normosmic CRSsNP patients showed upregulation of 563 genes and downregulation of 327 genes. Using stringent criteria for multiple comparisons, one upregulated gene (Immediate Early Response 3 [IER3]) had an false discovery rate (FDR) correction adjusted P value considered statistically significant (P < 0.001, fold change 2.69). Reactome functional analysis revealed eight biological pathways significantly different between dysosmic and normosmic patients (P < 0.05, FDR correction) including IL-4 and IL-13 signaling, IL-10 signaling, and rhodopsin-like receptors. Conclusions RNA sequencing of the superior turbinates in patients with CRSsNP can provide valuable information regarding biological pathways and genes involved in olfactory dysfunction. This study supports literature suggesting that Type 2 inflammation may play a role in olfactory dysfunction in at least some patients with CRSsNP. This study also prompts questions regarding the role of IL-10, rhodopsin-like receptors, and IER3 in the pathogenesis of olfactory dysfunction.
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Affiliation(s)
- Jorge A. Gutierrez
- Department of Otolaryngology–Head and Neck SurgeryMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Jeremy L. Barth
- Department of Regenerative Medicine & Cell BiologyMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Rodney J. Schlosser
- Department of Otolaryngology–Head and Neck SurgeryMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Thomas S. Edwards
- Department of Otolaryngology–Head and Neck SurgeryMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Timothy L. Smith
- Department of Otolaryngology–Head and Neck SurgeryOregon Health & Science UniversityPortlandOregonUSA
| | - Zachary M. Soler
- Department of Otolaryngology–Head and Neck SurgeryMedical University of South CarolinaCharlestonSouth CarolinaUSA
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Gutierrez JA, Shannon CM, Nguyen SA, Meyer TA, Lambert PR. Comparison of Quality of Life Outcomes for Percutaneous Versus Transcutaneous Implantable Hearing Devices: A Systematic Review and Meta-analysis. Otol Neurotol 2024; 45:e129-e136. [PMID: 38270194 DOI: 10.1097/mao.0000000000004111] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
OBJECTIVE To compare quality of life (QOL) outcomes of percutaneous and transcutaneous bone conduction devices (pBCD and tBCD, respectively). DATABASES REVIEWED Pubmed, Scopus, CINAHL. METHODS A systematic review was performed searching for English language articles from inception to March 15, 2023. Studies reporting QOL outcomes measured using a validated tool following implantation of either pBCDs or tBCDs were considered for inclusion. QOL outcomes included scores for Glasgow Benefit Inventory, Glasgow Children's Benefit Inventory, Abbreviated Profile of Hearing Aid Benefit, and the Speech, Spatial, and Qualities of Hearing Scale. A meta-analysis of continuous measures was performed. RESULTS A total of 52 articles with 1,469 patients were included. Six hundred eighty-nine patients were implanted with pBCDs, and the remaining 780 were implanted with tBCDs. Average Glasgow Benefit Inventory scores for the tBCD group (33.0, 95% confidence interval [22.7-43.3]) were significantly higher than the pBCD group (30.9 [25.2-36.6]) (Δ2.1 [1.4-2.8], p < 0.0001). Mean Glasgow Children's Benefit Inventory scores (Δ3.9 [2.0-5.8], p = 0.0001) and mean gain in Abbreviated Profile of Hearing Aid Benefit scores (Δ5.6 [4.8-6.4], p < 0.0001) were significantly higher among patients implanted with tBCDs than those implanted with pBCDs. Patients implanted with tBCDs also had significantly higher gains on the Speech (Δ1.1 [0.9-1.3], p < 0.0001), Spatial (Δ0.8 [0.7-0.9], p < 0.0001), and Qualities of Hearing (Δ1.2 [1.1-1.3], p < 0.0001) portions of the Speech, Spatial, and Qualities of Hearing Scale than those implanted with pBCDs. CONCLUSIONS Patients implanted with transcutaneous devices had better QOL outcomes than those implanted with percutaneous devices.
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Affiliation(s)
- Jorge A Gutierrez
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
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4
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Gill AS, Tullis B, Mace JC, Massey C, Pandrangi VC, Gutierrez JA, Ramakrishnan VR, Beswick DM, Soler ZM, Smith TL, Alt JA. Health care disparities and chronic rhinosinusitis: Does neighborhood disadvantage impact outcomes in sinonasal disease? Int Forum Allergy Rhinol 2024. [PMID: 38367249 DOI: 10.1002/alr.23337] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/04/2024] [Accepted: 01/30/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE Socioeconomic status (SES) is linked to health outcomes but has not been well studied in patients with chronic rhinosinusitis (CRS). The area deprivation index (ADI) is a comprehensive measure of geographic SES that ranks neighborhood disadvantage. This investigation used ADI to understand the impact of neighborhood disadvantage on CRS treatment outcomes. METHODS A total of 642 study participants with CRS were prospectively enrolled and self-selected endoscopic sinus surgery (ESS) or continued appropriate medical therapy as treatment. The 22-item SinoNasal Outcome Test (SNOT-22) and Medical Outcomes Study Questionnaire Short-Form 6-D (SF-6D) health utility value scores were recorded pre- and post-treatment. Using residence zip codes, national ADI scores were retrospectively assigned to patients. Spearman's correlation coefficients (Rs) and Cramer's V effect size (φc ) with 95% confidence interval (CI) were calculated. RESULTS A history of ESS was associated with significantly worse ADI scores compared to no history of ESS (φc = 0.18; 95% CI: 0.10, 0.25; p < 0.001). Baseline total SNOT-22 (Rs = 0.14; 95% CI: 0.06, 0.22; p < 0.001) and SF-6D values (Rs = -0.20; 95% CI: -0.27, -0.12; p < 0.001) were significantly negatively correlated with national ADI rank. No significant correlations between ADI and within-subject improvement, or achievement of >1 minimal clinically important difference, in SNOT-22 or SF-6D scores after treatment were found. CONCLUSIONS Geographic socioeconomic deprivation was associated with worse baseline disease severity and history of prior surgical intervention. However, ADI did not correlate with improvement in disease-specific outcomes. The impact of socioeconomic deprivation on outcomes in CRS requires further investigation.
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Affiliation(s)
- Amarbir S Gill
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Benton Tullis
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Jess C Mace
- Division of Rhinology and Sinus Surgery/Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University (OHSU), Portland, Oregon, USA
| | - Conner Massey
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Vivek C Pandrangi
- Division of Rhinology and Sinus Surgery/Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University (OHSU), Portland, Oregon, USA
| | - Jorge A Gutierrez
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Vijay R Ramakrishnan
- Department of Otolaryngology-Head and Neck Surgery, University of Indiana, Indianapolis, Indiana, USA
| | - Daniel M Beswick
- Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, California, USA
| | - Zachary M Soler
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Timothy L Smith
- Division of Rhinology and Sinus Surgery/Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University (OHSU), Portland, Oregon, USA
| | - Jeremiah A Alt
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
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Gutierrez JA, Khan S, Chapurin N, Schlosser RJ, Soler ZM. Factors Impacting Follow-Up Care in Allergic Fungal Rhinosinusitis. Otolaryngol Head Neck Surg 2024; 170:577-585. [PMID: 37925622 DOI: 10.1002/ohn.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 09/18/2023] [Accepted: 10/10/2023] [Indexed: 11/05/2023]
Abstract
OBJECTIVE The purpose of this study was to analyze barriers to medical care and follow-up in patients with allergic fungal rhinosinusitis (AFRS). STUDY DESIGN Cross-sectional questionnaire-based study with retrospective chart review. SETTING Tertiary Medical Center. METHODS Subjects with AFRS and chronic rhinosinusitis with nasal polyps (CRSwNP) were prospectively recruited for completion of the Barriers to Care Questionnaire (BCQ) and formal chart review. RESULTS Fifty-nine AFRS and 51 CRSwNP patients participated. AFRS patients were more likely to be lost to follow-up within 6 months of surgery (35.6% vs 17.7%, P = 0.04) and no-show at least 1 appointment (20.3% vs 5.9%, P = 0.03) compared to CRSwNP patients. Men with AFRS were more likely to have only a single follow-up visit (37.0% vs 3.1%, P < 0.001) and be lost to follow-up (66.7% vs 9.4%, P < 0.001) than women. There were no significant differences in the BCQ between groups; however, rate of questionnaire completion was lower in the AFRS group than the CRS group (62.7% vs 80.4%, P = 0.042). AFRS patients who did not complete the BCQ were more likely to be male (63.6% vs 35.1%, P = 0.034), lost to follow-up (77.3% vs 10.8%, P < 0.0001), and have a single follow-up visit (40.9% vs 5.4%, P < 0.0001). Younger age was associated with increased likelihood of having a single follow-up visit (odds ratio 1.143, 95% CI 1.022-1.276). CONCLUSION Young, male AFRS patients are more frequently lost to follow-up after surgery and less likely to complete questionnaires assessing barriers to care. Further investigation is needed to assess barriers to follow-up in these at-risk groups.
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Affiliation(s)
- Jorge A Gutierrez
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Sofia Khan
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Nikita Chapurin
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Rodney J Schlosser
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Zachary M Soler
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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Gutierrez JA, Shannon CM, Nguyen SA, Meyer TA, Lambert PR. Comparison of Transcutaneous and Percutaneous Implantable Hearing Devices for the Management of Congenital Aural Atresia: A Systematic Review and Meta-Analysis. Otol Neurotol 2024; 45:1-10. [PMID: 38085758 DOI: 10.1097/mao.0000000000004061] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
OBJECTIVE To compare audiometric outcomes, complications, and revisions required for percutaneous (pBCD) versus transcutaneous (tBCD) implantable bone-conduction devices for the treatment of hearing loss associated with congenital aural atresia (CAA).Databases Reviewed.PubMed, Scopus, CINAHL. METHODS A systematic review was performed searching for English language articles from inception to December 14, 2022. Studies reporting audiometric outcomes or complications for either pBCDs or tBCDs for the treatment of CAA were selected for inclusion. A meta-analysis of single means and meta-analysis of proportions with comparison (Δ) of weighted proportions was conducted. RESULTS A total of 56 articles with 756 patients were selected for inclusion. One hundred ninety patients were implanted with pBCDs, whereas the remaining 566 were implanted with tBCDs. Mean pure-tone audiometry improvement in the pBCD group (39.1 ± 1.1 dB) was significantly higher than in the tBCD group (34.6 ± 1.6 dB; Δ4.5 dB; 95% confidence interval, 4.2-4.7 dB; p < 0.0001). The average improvement in speech reception threshold was 38.6 ± 2.5 dB in the percutaneous group as compared with 32.7 ± 1.6 dB in the transcutaneous group (Δ5.9 dB [5.3-6.5 dB], p < 0.0001). Overall complication rates for patients implanted with pBCDs and tBCDs were 29.0% (15.7-44.4%) and 9.4% (6.5%-13.0%), respectively (Δ19.6% [12.0-27.7%], p < 0.0001). CONCLUSIONS Patients with CAA implanted with pBCDs had significantly better audiometric outcomes than those implanted with tBCDs. However, complication rates were significantly higher among the pBCD group.
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Affiliation(s)
- Jorge A Gutierrez
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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Gutierrez JA, Shannon CM, Chapurin N, Schlosser RJ, Soler ZM. Challenges to medication adherence with intranasal corticosteroid irrigations. Int Forum Allergy Rhinol 2024; 14:32-40. [PMID: 37314391 DOI: 10.1002/alr.23210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/03/2023] [Accepted: 06/08/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND The purpose of this study was to investigate real-world adherence to intranasal corticosteroid irrigations using pharmacy data and assess factors associated with low adherence. METHODS Patients undergoing treatment with corticosteroid irrigations for any diagnosis during a 2-year period were prospectively recruited. Subjects completed a one-time set of questionnaires including the Barriers to Care Questionnaire (BCQ), 22-item Sino-Nasal Outcome Test (SNOT-22), and a questionnaire assessing their experience with corticosteroid irrigations. Pharmacy data was used to calculate the medication possession ratio (MPR), a measure of medication adherence graded from 0 to 1. RESULTS Seventy-one patients were enrolled. Patient diagnoses included chronic rhinosinusitis (CRS) without nasal polyps (n = 37), CRS with nasal polyps (n = 24), or a non-CRS diagnosis, most commonly chronic rhinitis (n = 10). The MPR for the overall group was 0.44 ± 0.33. Just 9.9% of patients had a perfect MPR of 1. Despite low MPR, only 19.7% of patients reported problems taking the medication when directly asked. Lower education resulted in lower MPR (unstandardized B = 0.065, p = 0.046). Increasing BCQ score, indicating higher barriers to care, was associated with lower MPR (unstandardized B = -0.010, p = 0.033). The lower the MPR, the worse the patient SNOT-22 scores (unstandardized B = -15.980, p = 0.036). CONCLUSION Adherence to corticosteroid irrigations was low and patients underreported issues with their medication. Education and barriers to care were associated with lower adherence, which, in turn, was associated with worse sinonasal quality of life.
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Affiliation(s)
- Jorge A Gutierrez
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Christian M Shannon
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Nikita Chapurin
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Rodney J Schlosser
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Zachary M Soler
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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Gutierrez JA, Cabrera CI, Stout A, Mowry SE. Tympanoplasty in the Setting of Complex Middle Ear Pathology: A Systematic Review. Ann Otol Rhinol Laryngol 2023; 132:1453-1466. [PMID: 36951041 DOI: 10.1177/00034894231159000] [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: 03/24/2023]
Abstract
OBJECTIVE To assess the prognostic factors for anatomic and hearing success after tympanoplasty in the setting of complex middle ear pathology. METHODS A systematic review was performed in January 2022. English-language articles describing outcome data for tympanoplasty repair variables including underlying pathology, perforation location, smoking status, graft technique, reconstruction material, anatomic success, and hearing success were extracted. Articles were included when tympanosclerosis, retraction pockets, adhesions, cholesteatoma, chronic suppurative otitis media, anterior perforations, and smoking were included. Underlying pathology, perforation location, smoking status, graft technique, reconstruction material, anatomic success, and hearing success were extracted. Any factors analyzed as potential indicators of success were sought out. RESULTS Data sources included PubMed, OVID, Cochrane, Web of Science, Scopus, and manual search of bibliographies. Ninety-three articles met final criteria, which accounted for 6685 patients. Fifty articles presented data on both anatomic and hearing outcomes, 32 articles presented data on anatomic outcomes only, and 11 articles presented data on hearing outcomes only. This systematic review found that adhesions and tympanosclerosis were prognostic factors for poorer hearing. Additionally, smoking and tympanosclerosis may be predictive of anatomic failure; however, the significance of this finding was mixed in included studies. This analysis is significantly limited by both the heterogeneity within the patients and the lack of controls. CONCLUSION Adhesions and tympanosclerosis were prognostic factors for poorer hearing. Clearly documented methods and outcomes for the included pathologies could lead to more definitive conclusions regarding prognostic factors for success. LEVEL OF EVIDENCE 3B.
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Affiliation(s)
- Jorge A Gutierrez
- Department of Otolaryngology-Head and Neck Surgery, Case Western Reverse University School of Medicine, Cleveland, OH, USA
| | - Claudia I Cabrera
- Department of Otolaryngology-Head and Neck Surgery, Case Western Reverse University School of Medicine, Cleveland, OH, USA
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Amber Stout
- Medical Core Library, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Sarah E Mowry
- Department of Otolaryngology-Head and Neck Surgery, Case Western Reverse University School of Medicine, Cleveland, OH, USA
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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Black JH, Buckley D, Velezis M, Eldrup-Jorgensen J, Serratore ND, Gutierrez JA, Whatley E, Marmor RA, Bertges DJ, Tcheng JE, Royce S, Malone M, Farb A, Secemsky EA, Parikh SA, Smale J, Jaff MR, White R, Wilgus RW, Krucoff MW. Consensus minimum core data elements adapted to peripheral vascular intervention in the drug-eluting era: Consensus report from the Registry Assessment of Peripheral Interventional Devices (RAPID) Pathways "LEAN" working group. J Vasc Surg 2023; 78:1313-1321. [PMID: 37524153 DOI: 10.1016/j.jvs.2023.07.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/28/2023] [Accepted: 07/22/2023] [Indexed: 08/02/2023]
Abstract
Registry Assessment of Peripheral Interventional Devices (RAPID) initiated the Pathways Program to provide a transparent, collaborative forum in which to pursue insights into multiple unresolved questions on benefit-risk of paclitaxel-coated devices, including understanding the basis of the mortality signal, without a demonstrable potential biological mechanism, and whether the late mortality signal could be artifact intrinsic to multiple independent prospective randomized data sources that did not prespecify death as a long-term end point. In response to the directive, the LEAN-Case Report Form working group focused on enhancements to the RAPID Phase I Minimum Core Data set through the addition of key clinical modifiers that would be more strongly linked to longer-term mortality outcomes after peripheral arterial disease intervention in the drug-eluting device era, with the goal to have future mortality signals more accurately examined.
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Affiliation(s)
- James H Black
- Johns Hopkins University School of Medicine, Baltimore, MD.
| | - Donna Buckley
- Office of Cardiovascular Devices, Food and Drug Administration, Silver Spring, MD
| | - Martha Velezis
- Office of Cardiovascular Devices, Food and Drug Administration, Silver Spring, MD
| | | | | | - Jorge A Gutierrez
- Duke University Medical Center/Duke Clinical Research Institute, Durham, NC
| | - Eleni Whatley
- Office of Cardiovascular Devices, Food and Drug Administration, Silver Spring, MD
| | | | | | - James E Tcheng
- Duke University Medical Center/Duke Clinical Research Institute, Durham, NC
| | - Sara Royce
- Office of Cardiovascular Devices, Food and Drug Administration, Silver Spring, MD
| | - Misti Malone
- Office of Cardiovascular Devices, Food and Drug Administration, Silver Spring, MD
| | - Andrew Farb
- Office of Cardiovascular Devices, Food and Drug Administration, Silver Spring, MD
| | - Eric A Secemsky
- Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, MA
| | | | - Joshua Smale
- Becton, Dickinson and Company, Franklin Lakes, NJ
| | | | | | - Rebecca W Wilgus
- Duke University Medical Center/Duke Clinical Research Institute, Durham, NC
| | - Mitchell W Krucoff
- Duke University Medical Center/Duke Clinical Research Institute, Durham, NC
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Gutierrez JA, Durrant FG, Nguyen SA, Chapurin N, Schlosser RJ, Soler ZM. Association between Social Determinants of Health and Allergic Fungal Rhinosinusitis: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2023; 169:1101-1113. [PMID: 37293865 DOI: 10.1002/ohn.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/17/2023] [Accepted: 05/01/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Some previous studies have shown an increased prevalence of allergic fungal rhinosinusitis (AFRS) among young, black patients with poor access to health care; however, results have been mixed. The purpose of this study was to investigate the relationship between social determinants of health and AFRS. DATA SOURCES PubMed, Scopus, CINAHL. REVIEW METHODS A systematic review was performed searching for articles published from date of inception to September 29, 2022. English language articles describing the relationship between social determinants of health (i.e., race, insurance status) and AFRS as compared to chronic rhinosinusitis (CRS) were selected for inclusion. A Meta-analysis of proportions with comparison (Δ) of weighted proportions was conducted. RESULTS A total of 21 articles with 1605 patients were selected for inclusion. The proportion of black patients among AFRS, chronic rhinosinusitis with nasal polyps (CRSwNP), and chronic rhinosinusitis without nasal polyps (CRSsNP) groups was 58.0% [45.3%-70.1%], 23.8% [14.1%-35.2%], and 13.0% [5.1%-24.0%], respectively. This was significantly higher among the AFRS population compared to both the CRSwNP population (Δ34.2% [28.4%-39.6%], p < .0001) and the CRSsNP population (Δ44.9% [38.4%-50.6%], p < .0001). The proportion of patients who were either uninsured or covered by Medicaid among the AFRS, CRSwNP, and CRSsNP populations was 31.5% [25.4%-38.1%], 8.6% [0.7%-23.8%], and 5.0% [0.3%-14.8%], respectively. This was significantly higher among the AFRS group than the CRSwNP group (Δ22.9% [15.3%-31.1%], p < .0001) and the CRSsNP group (Δ26.5% [19.1%-33.4%], p < .0001). CONCLUSION This study confirms that AFRS patients are more likely to be Black and either uninsured or on subsidized insurance than their CRS counterparts.
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Affiliation(s)
- Jorge A Gutierrez
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Frederick G Durrant
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Nikita Chapurin
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Rodney J Schlosser
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Zachary M Soler
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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Khan S, Gutierrez JA, Chapurin N, Nguyen SA, Soler ZM, Schlosser RJ. The impact of race on olfaction: A systematic review and meta-analysis. Int Forum Allergy Rhinol 2023; 13:2063-2072. [PMID: 37183309 DOI: 10.1002/alr.23184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/24/2023] [Accepted: 05/11/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Many studies have identified a higher degree of Olfactory Dysfunction (OD) in Black patients compared to White patients. This study aims to analyze olfactory outcomes in different races. METHODS The PubMed, Scopus, and CINAHL databases were searched from inception to September 5, 2022, for English-language articles documenting self-reported and psychophysical OD stratified by race. A meta-analysis of proportions, comparison of weighted proportions, and comparison of means were performed in MedCalc 20.218. In the quantitative analysis, 79,297 patients were included, comprising 79.3% Whites, 16.1% Blacks, and 4.6% Hispanics. RESULTS A total of 14 studies were meta-analyzed. The prevalence of self-reported OD in Hispanic, White, and Black patients was 19.5% (95% CI, 16.6% to 22.6%), 17.2% (95% CI, 10.5% to 25.0%), and 13.9% (95% CI, 9.3% to 19.2%), respectively (p < 0.0007). The prevalence of psychophysical OD in Black, White, and Hispanic patients was 30.3% (95% CI, 24.2% to 36.9%), 24.2% (95% CI, 20.1% to 28.5%), and 18.4% (95% CI, 16.3% to 20.7%), respectively (p < 0.0001). Blacks reported a greater extent of unrecognized OD compared to Whites, with a difference of 16.5% (95% CI, 15.0% to 17.9%) versus 5.8% (95% CI, 3.4% to 8.0%), respectively (p < 0.0001). Hispanic rates of self-reported OD and psychophysical OD were not statistically different. CONCLUSIONS Our findings suggest that Blacks have the highest rate of psychophysical OD and are more likely to underreport their awareness compared to Whites.
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Affiliation(s)
- Sofia Khan
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Endoscopic Skull Base Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Jorge A Gutierrez
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Endoscopic Skull Base Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Nikita Chapurin
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Endoscopic Skull Base Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Endoscopic Skull Base Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Zachary M Soler
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Endoscopic Skull Base Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Rodney J Schlosser
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Endoscopic Skull Base Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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Gutierrez JA, Shannon CM, Nguyen SA, Labadie RF, White DR. The Impact of Surgical Indication on Posttonsillectomy Hemorrhage: A Systematic Review and Meta-Analysis. Otolaryngol Head Neck Surg 2023; 169:780-791. [PMID: 37003296 DOI: 10.1002/ohn.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/16/2023] [Accepted: 03/13/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE To investigate the impact of the surgical indication on posttonsillectomy bleed rates. DATA SOURCES PubMed, Scopus, CINAHL. REVIEW METHODS A systematic review was performed searching for articles published from the date of inception to July 6, 2022. English language articles describing posttonsillectomy hemorrhage rates in pediatric patients (age ≤ 18) stratified by indication were selected for inclusion. A meta-analysis of proportions with comparison (Δ) of weighted proportions was conducted. All studies were assessed for risk of bias. RESULTS A total of 72 articles with 173,970 patients were selected for inclusion. The most common indications were chronic/recurrent tonsillitis (CT/RT), obstructive sleep apnea/sleep-disordered breathing (OSA/SDB), and adenotonsillar hypertrophy (ATH). Posttonsillectomy hemorrhage rates for CT/RT, OSA/SDB, and ATH were 3.57%, 3.69%, and 2.72%, respectively. Patients operated on for a combination of CT/RT and OSA/SDB had a bleed rate of 5.99% which was significantly higher than those operated on for CT/RT alone (Δ2.42%, p = .0006), OSA/SDB alone (Δ2.30%, p = .0016), and ATH alone (Δ3.27%, p < .0001). Additionally, those operated on for a combination of ATH and CT/RT had a hemorrhage rate of 6.93%, significantly higher than those operated on for CT/RT alone (Δ3.36%, p = .0003), OSA/SDB alone (Δ3.01%, p = .0014), and ATH alone (Δ3.98%, p < .0001). CONCLUSION Patients operated on for multiple indications had significantly higher rates of posttonsillectomy hemorrhage than those operated on for a single surgical indication. Better documentation of patients with multiple indications would help further characterize the magnitude of the compounding effect described here.
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Affiliation(s)
- Jorge A Gutierrez
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Christian M Shannon
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Robert F Labadie
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - David R White
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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Shannon CM, Gutierrez JA, Nguyen SA, Meyer TA, Lambert PR. Comparison of Outcomes of Surgery Versus Implantable Device for the Treatment of Hearing Loss Associated With Congenital Aural Atresia: A Systematic Review and Meta-Analysis. Otol Neurotol 2023; 44:758-766. [PMID: 37464461 DOI: 10.1097/mao.0000000000003950] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
OBJECTIVE To compare audiometric outcomes, complications, and revisions required for implantable bone-conduction devices (BCDs) versus atresia surgery for the treatment of hearing loss associated with congenital aural atresia. DATABASES REVIEWED PubMed, Scopus, CINAHL. METHODS Databases were searched for English articles from inception to July 1, 2022, for studies reporting audiometric outcomes or complications for either BCDs or atresia surgery for the treatment of congenital aural atresia. Main outcome measures included pure-tone audiometry, air-bone gap, speech reception threshold, associated complications, and rates of revision for each treatment option. RESULTS We identified 973 abstracts, of which 89 were selected for data extraction and analysis. A total of 2,611 patients were included, 1,901 in the atresia surgery group and 710 in the BCDs group. A meta-analysis of single means was conducted for age and audiometric outcomes, and a meta-analysis of proportions was conducted for complications and revisions. The average short-term improvement in pure-tone audiometry for the BCDs group was 34.4 ± 1.6 dB compared with 22.4 ± 1.5 dB for the atresia surgery group, representing a significant difference (12.0 dB; 95% confidence interval, 11.9-12.2; p < 0.0001). A smaller proportion of complications were reported in the devices group (16.9%) compared with the atresia surgery group (45.7%). In addition, a smaller proportion of cases in the devices group required some degree of revision (17.8%) compared with the atresia surgery group (23.0%). CONCLUSIONS This study demonstrates that implantable BCDs have significantly better audiometric outcomes as well as a lower rate of complications and revisions required compared with atresia surgery.
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Affiliation(s)
- Christian M Shannon
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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Garza FAF, Garza JIO, Espinosa-Uribe A, Carranza-Cantú ER, Gutierrez JA. National Survey of COVID-19 Infections Among Head Surgical Specialists Regarding Orthopedic Foot and Ankle Surgeons in Mexico. Foot & Ankle Orthopaedics 2022. [PMCID: PMC8795579 DOI: 10.1177/2473011421s00200] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Category: Other Introduction/Purpose: The health contingency due to COVID19 has represented an unprecedented state
of health contingency with implications for the economy and public health.
There is a concern in the medical community regarding the risk of contagion
of COVID19. Recently, the occupational risk of contagion by COVID19 has been
described in surgical specialties that involve proximity to the face and
airway of the patient Ophthalmology and Otorhinolaryngology and head and
neck surgery (ENT). A possibility has been raised that Foot and Ankle joint
surgeons have some occupational protection due to the distance greater than
1m with respect to the patient's airway during surgical activities. The
objective of this study is to compare COVID-19 infections referred by
different surgical specialties and subspecialties. Methods: An observational, cross-sectional, and descriptive study will be carried out
in which a survey will be applied to 134 surgical specialists divided into 3
groups (ophthalmology, ENT, and orthopedic surgeons performing foot and
ankle surgery) during the months of August to September 2020.Percentage
prevalences of each variable to be evaluated will be obtained, likewise, a
Chi- square test will be applied to determine statistical differences
between the proportions of referred positivity in the 3 groups. This
research study was reviewed by our institution and hospital research ethics
committee. All participants gave their informed consent at the time of
conducting the survey, as well as allowing the use of their responses for
the purposes of this project. Results: A total of 134 surveys pertaining to 30, 69, and 35 Mexican ophthalmology,
ENT, and orthopedic surgeons who perform foot and ankle surgery respectively
were evaluated. The geographical distribution of the surveys is identified
in figure 1. After the statistical analysis, non-significant statistical
differences (p> 0.32) were documented in the proportion of infections
between ophthalmologists or ENTs, with respect to the proportion of
infections referred by COVID-19 in the group of Orthopedic foot and ankle
surgeons surveyed. Conclusion: When analyzing the results of this survey-type study, it is possible to
establish that the statistically non-significant differences between the
proportions of infections of the groups of specialists evaluated could
suggest that the working distance with respect to the patient's airway is
not a protective factor for contagion. by COVID-19. Preventive strategies,
as well as the vaccination of health personnel involved in patient care, are
essential.
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Gutierrez JA, Silber JJ, Falcone RD, Correa NM. Modified reverse micelle method as facile way to obtain several gold nanoparticle morphologies. J Mol Liq 2021. [DOI: 10.1016/j.molliq.2021.115709] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Gutierrez JA, Japas ML, Silber JJ, Falcone RD, Correa NM. Is it Necessary for the Use of Fluorinated Compounds to Formulate Reverse Micelles in a Supercritical Fluid? Searching the Best Cosurfactant to Create "Green" AOT Reverse Micelle Media. Langmuir 2021; 37:445-453. [PMID: 33373249 DOI: 10.1021/acs.langmuir.0c03093] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Herein, we report the effect of employing two different alcohols, such as n-pentanol and 2,2,3,3,4,4,5,5-octafluoro pentanol (from now on F-pentanol), into 1,4-bis-2-ethylhexylsulfosuccinate (AOT) reverse micelles (RMs), to determine the interfacial activity and establish the best candidate to act as a cosurfactant in supercritical RMs. Dynamic light scattering (DLS), Fourier transform infrared (FT-IR), and fluorescence emission spectroscopy allowed us to determine and understand the behavior of alkanols in RMs. As a result, we found interesting displacements of alkanol molecules within the RMs, suggesting that the electrostatic interaction between SO3- and Na+ weakens because of new interactions of n-pentanol with SO3- through H-bonds, changing the curvature of the micellar interface. According to FT-IR and DLS studies, F-pentanol forms a RM polar core interacting through intermolecular H-bonds, suggesting no perturbations of the AOT RM interface. Hence, n-pentanol was selected as a cosurfactant to form supercritical RMs, which is confirmed by red edge excitation shift studies, using C343 as a molecular probe. Herein, we were able to create RMs under supercritical conditions without the presence of modified surfactants, fluorinated or multitailed compounds, which, to the best of our knowledge, was not shown before.
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Affiliation(s)
- Jorge A Gutierrez
- Programa de Seguridad y Salud en el Trabajo, Universidad del Quindío, Carrera 15 Calle 12 Norte, C.P. 630004 Armenia, Colombia
| | - M Laura Japas
- Gerencia Química, Centro Atómico Constituyentes-CNEA, AV. Gral. Paz 1499, Pcia, de Buenos Aires B1650KNA, San Martín, Argentina
| | - Juana J Silber
- Instituto para el Desarrollo Agroindustrial y de la Salud, IDAS, (CONICET-UNRC), Departamento de Química, Universidad Nacional de Río Cuarto, Agencia Postal # 3. C.P. X5804BYA Río Cuarto, Argentina
| | - R Darío Falcone
- Instituto para el Desarrollo Agroindustrial y de la Salud, IDAS, (CONICET-UNRC), Departamento de Química, Universidad Nacional de Río Cuarto, Agencia Postal # 3. C.P. X5804BYA Río Cuarto, Argentina
| | - N Mariano Correa
- Instituto para el Desarrollo Agroindustrial y de la Salud, IDAS, (CONICET-UNRC), Departamento de Química, Universidad Nacional de Río Cuarto, Agencia Postal # 3. C.P. X5804BYA Río Cuarto, Argentina
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Luna MA, Gutierrez JA, Cobo Solis AK, Molina PG, Correa NM. Vehiculization of noscapine in large unilamellar vesicles. Study of its protective role against lipid peroxidation by electrochemical techniques. J Electroanal Chem (Lausanne) 2019. [DOI: 10.1016/j.jelechem.2018.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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Uribe PA, Ortiz CC, Centeno DA, Castillo JJ, Blanco SI, Gutierrez JA. Self-assembled Pt screen printed electrodes with a novel peroxidase Panicum maximum and zinc oxide nanoparticles for H2O2 detection. Colloids Surf A Physicochem Eng Asp 2019. [DOI: 10.1016/j.colsurfa.2018.10.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lawitz E, Poordad F, Gutierrez JA, Kakuda TN, Picchio G, Beets G, Vandevoorde A, Van Remoortere P, Jacquemyn B, Luo D, Ouwerkerk-Mahadevan S, Vijgen L, Van Eygen V, Beumont M. Simeprevir, daclatasvir and sofosbuvir for hepatitis C virus-infected patients with decompensated liver disease. J Viral Hepat 2017; 24:287-294. [PMID: 27878906 DOI: 10.1111/jvh.12645] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 10/04/2016] [Indexed: 01/08/2023]
Abstract
Approximately three million individuals in the United States are chronically infected with hepatitis C virus (HCV). Chronic HCV infection may lead to the development of compensated as well as decompensated liver cirrhosis. The Phase II IMPACT study was conducted in HCV genotype 1- or 4-infected cirrhotic patients with portal hypertension or decompensated liver disease and assessed for the first time the combination of the three direct-acting antivirals simeprevir, daclatasvir and sofosbuvir. Treatment-naïve or treatment-experienced adults with Child-Pugh (CP) score <7 (CP A) and evidence of portal hypertension, or CP score 7-9 (CP B), received 12 weeks of simeprevir 150 mg, daclatasvir 60 mg and sofosbuvir 400 mg, once daily. The primary efficacy endpoint was sustained virologic response 12 weeks after end of treatment (SVR12). Pharmacokinetics and safety were also assessed. Overall, 40 patients were enrolled (CP A: 19; CP B: 21). All 40 patients achieved SVR12. At week 8, the mean pharmacokinetic exposure to simeprevir, sofosbuvir, daclatasvir and GS-331007 (sofosbuvir metabolite) was 2.2-, 1.5-, 1.2- and 1.2-fold higher in patients with CP B than CP A, respectively. Grade 1/2 adverse events (AEs) occurred in 26 of 40 (65%) patients. One CP B patient had a Grade 3 AE (gastrointestinal haemorrhage), which was reported as a serious AE but not considered related to study drugs. Treatment for 12 weeks with simeprevir, daclatasvir and sofosbuvir was generally safe and well tolerated, and resulted in 100% of cirrhotic patients with portal hypertension or decompensated liver disease achieving SVR12.
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Affiliation(s)
- E Lawitz
- Texas Liver Institute, University of Texas Health Science Center, San Antonio, TX, USA
| | - F Poordad
- Texas Liver Institute, University of Texas Health Science Center, San Antonio, TX, USA
| | - J A Gutierrez
- Texas Liver Institute, University of Texas Health Science Center, San Antonio, TX, USA
| | | | - G Picchio
- Janssen Research & Development LLC, Raritan, NJ, USA
| | - G Beets
- Janssen Pharmaceutica NV, Beerse, Belgium
| | | | | | | | - D Luo
- Janssen Research & Development LLC, Titusville, NJ, USA
| | | | - L Vijgen
- Janssen Pharmaceutica NV, Beerse, Belgium
| | | | - M Beumont
- Janssen Research & Development LLC, Beerse, Belgium
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Gutierrez JA, Cruz J, Rondón P, Jones N, Ortiz C. Small gold nanocomposites obtained in reverse micelles as nanoreactors. Effect of surfactant, optical properties and activity against Pseudomonas aeruginosa. NEW J CHEM 2016. [DOI: 10.1039/c6nj02259f] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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]
Abstract
High antibacterial convergence of an antimicrobial synthetic peptide and small gold nanoparticles against Pseudomonas aeruginosa.
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Affiliation(s)
- Jorge A. Gutierrez
- Escuela de Química
- Universidad Industrial de Santander
- Bucaramanga
- Colombia
| | - Jenniffer Cruz
- Escuela de Química
- Universidad Industrial de Santander
- Bucaramanga
- Colombia
| | - Paola Rondón
- Escuela de Química
- Universidad Industrial de Santander
- Bucaramanga
- Colombia
| | - Nathalia Jones
- Escuela de Microbiología
- Universidad Industrial de Santander
- Bucaramanga
- Colombia
| | - Claudia Ortiz
- Escuela de Microbiología
- Universidad Industrial de Santander
- Bucaramanga
- Colombia
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Gutierrez JA, Lawitz EJ, Poordad F. Interferon-free, direct-acting antiviral therapy for chronic hepatitis C. J Viral Hepat 2015; 22:861-70. [PMID: 26083155 DOI: 10.1111/jvh.12422] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 03/11/2015] [Indexed: 12/13/2022]
Abstract
The treatment environment for chronic hepatitis C has undergone a revolution, particularly in genotype 1. Gone are interferon-based therapy and its associated tolerability challenges, inadequate response rates and numerous baseline factors that affect response to therapy. New and emerging treatment regimens employ all-oral combinations of direct-acting antiviral agents, and results of clinical trials suggest that these regimens routinely achieve cure rates >90%, even in patients who failed prior interferon-based triple therapy. In 2015, three all-oral FDA-approved regiments will be available for genotype 1 (sofosbuvir /ledipasvir, sofosbuvir/simeprevir, and paritaprevir/r/ombitasvir/dasabuvir). Furthermore, new treatment combinations appear to be more tolerable and require shorter duration of therapy. We provide an overview of the classes of direct-acting antiviral agents (DAAs), the clinical factors affecting their integration into combination therapies and recent findings from trials of such combination therapies in patients with genotype 1 HCV infection.
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Affiliation(s)
- J A Gutierrez
- The Texas Liver Institute, University of Texas Health Science Center, San Antonio, TX, USA
| | - E J Lawitz
- The Texas Liver Institute, University of Texas Health Science Center, San Antonio, TX, USA
| | - F Poordad
- The Texas Liver Institute, University of Texas Health Science Center, San Antonio, TX, USA
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Thomas SL, Schultz CR, Mouzon E, Golembieski WA, Lemke N, Poisson LM, Gutierrez JA, Cottingham S, Rempel SA. Abstract 2363: Loss of Sparc in p53-null astrocytes alters collagen deposition and promotes macrophage activation and tumor phagocytosis. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-2363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Both the induction of SPARC expression and the loss of the p53 tumor suppressor gene are changes that occur early in glioma development. Therefore, the upregulation of SPARC may cooperate with the loss of p53 to enhance cell survival and inhibit apoptosis during glioma formation. This study determined whether the loss of Sparc in astrocytes that are null for p53 (p53-null/Sparc-null) would result in reduced cell survival and tumor formation and increased tumor immunogenicity in an in vivo xenograft brain tumor model. In vitro, the loss of Sparc in p53-null astrocytes resulted in an increase in cell proliferation (15-33%, p<0.01); however, there was an inhibition of growth in soft agar. Intracranial xenografts of p53-null/Sparc-wt and p53-null/Sparc-null astrocytes were assessed for tumor size, proliferation rate, and SPARC expression. At 7 days post-implantation, Sparc-null astrocytes produced significantly smaller tumors (Wilcoxon rank-sum test p = 0.0091, median = 0.709mm2 for Sparc-wt and 0.240mm2 for Sparc-null) with a significantly lower MIB-1 proliferation index (Wilcoxon rank-sum test p = 0.0345, median = 8.6% for Sparc-wt and 0.4% for Sparc-null). By CD68 and periodic acid Schiff +/- diastase staining of xenograft tumors, it was found that Sparc-null tumors had a massive infiltration of microglia/macrophages with a phagocytic appearance compared to the activated, but non-phagocytic, microglia/macrophages present within the Sparc-wt tumors. The loss of Sparc in astrocytes and the resulting increase in microglia/macrophage activation lead to an alteration in the tumor microenvironment with increased collagen deposition and altered collagen structure at both 7 and 50 days post-implantation as assessed by picrosirius red and polarized light microscopy. Sparc-null tumors had increased collagen deposition with a long fiber structure compared to the small bundles of collagen present in Sparc-wt tumors. Our results indicate that the loss of p53 by deletion/mutation in the early stages of glioma formation may cooperate with the induction of SPARC to potentiate cancer cell survival and escape from immune surveillance.
Citation Format: Stacey L. Thomas, Chad R. Schultz, Ezekiell Mouzon, William A. Golembieski, Nancy Lemke, Laila M. Poisson, Jorge A. Gutierrez, Sandra Cottingham, Sandra A. Rempel. Loss of Sparc in p53-null astrocytes alters collagen deposition and promotes macrophage activation and tumor phagocytosis. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 2363. doi:10.1158/1538-7445.AM2015-2363
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Gutierrez JA, Karwatowska-Prokopczuk E, Murphy SA, Belardinelli L, Farzaneh-Far R, Walker G, Morrow DA, Scirica BM. Effects of Ranolazine in Patients With Chronic Angina in Patients With and Without Percutaneous Coronary Intervention for Acute Coronary Syndrome: Observations From the MERLIN-TIMI 36 Trial. Clin Cardiol 2015; 38:469-75. [PMID: 26059896 DOI: 10.1002/clc.22425] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 04/21/2015] [Accepted: 04/22/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Ranolazine, a piperazine derivative with anti-ischemic effects, reduces the frequency of angina and improves exercise performance in patients with chronic angina. The effects of ranolazine in patients with established ischemic heart disease and chronic angina undergoing percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS) is not well described. We hypothesized that ranolazine would reduce ischemic events, regardless of revascularization. METHODS We examined the 1-year incidence of recurrent cardiovascular (CV) events in the subgroup of patients with prior chronic angina (n = 3565) enrolled in the randomized, double-blind, placebo-controlled Metabolic Efficiency with Ranolazine for Less Ischemia in Non-ST-Elevation ACS (MERLIN)-Thrombolysis In Myocardial Infarction (TIMI) 36 trial who did or did not have a PCI within 30 days of the index event. RESULTS Ranolazine reduced the risk of recurrent ischemia following admission regardless of whether patients had (hazard ratio [HR], 0.69; 95% confidence interval [CI] 0.51-0.92] or did not have PCI (HR, 0.81; 95% CI, 0.66-0.99; P interaction = 0.39). CV death, myocardial infarction, and recurrent ischemia were similarly lower with ranolazine in the PCI group (HR, 0.71; 95% CI, 0.55-0.91) vs the non-PCI group (HR, 0.91; 95% CI, 0.78-1.06; P interaction = 0.10), with a nominally significant decrease in CV death (HR, 0.39; 95% CI, 0.16-0.93) in the PCI group vs no difference in the non-PCI group (HR, 1.19; 95% CI, 0.89-1.59; P interaction = 0.02). CONCLUSIONS In patients with chronic angina, ranolazine reduced recurrent ischemic events, regardless of whether patients did or did not receive PCI within 30 days of a non-ST-segment ACS.
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Affiliation(s)
- Jorge A Gutierrez
- TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
| | | | - Sabina A Murphy
- TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
| | | | | | | | - David A Morrow
- TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Benjamin M Scirica
- TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
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Gutierrez JA, Alejandra Luna M, Mariano Correa N, Silber JJ, Darío Falcone R. The impact of the polar core size and external organic media composition on micelle–micelle interactions: the effect on gold nanoparticle synthesis. NEW J CHEM 2015. [DOI: 10.1039/c5nj01126d] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
An easy way to modulate reverse micelles as nanoreactors to produce different kinds of gold nanoparticles.
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Affiliation(s)
- Jorge A. Gutierrez
- Departamento de Química
- Universidad Nacional de Río Cuarto
- Río Cuarto
- Argentina
| | - M. Alejandra Luna
- Departamento de Química
- Universidad Nacional de Río Cuarto
- Río Cuarto
- Argentina
| | - N. Mariano Correa
- Departamento de Química
- Universidad Nacional de Río Cuarto
- Río Cuarto
- Argentina
| | - Juana J. Silber
- Departamento de Química
- Universidad Nacional de Río Cuarto
- Río Cuarto
- Argentina
| | - R. Darío Falcone
- Departamento de Química
- Universidad Nacional de Río Cuarto
- Río Cuarto
- Argentina
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Gish RG, Gutierrez JA, Navarro-Cazarez N, Giang K, Adler D, Tran B, Locarnini S, Hammond R, Bowden S. A simple and inexpensive point-of-care test for hepatitis B surface antigen detection: serological and molecular evaluation. J Viral Hepat 2014; 21:905-8. [PMID: 24779356 PMCID: PMC4263238 DOI: 10.1111/jvh.12257] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 03/02/2014] [Indexed: 12/09/2022]
Abstract
Early identification of chronic hepatitis B is important for optimal disease management and prevention of transmission. Cost and lack of access to commercial hepatitis B surface antigen (HBsAg) immunoassays can compromise the effectiveness of HBV screening in resource-limited settings and among marginalized populations. High-quality point-of-care (POC) testing may improve HBV diagnosis in these situations. Currently available POC HBsAg assays are often limited in sensitivity. We evaluated the NanoSign(®) HBs POC chromatographic immunoassay for its ability to detect HBsAg of different genotypes and with substitutions in the 'a' determinant. Thirty-seven serum samples from patients with HBV infection, covering HBV genotypes A-G, were assessed for HBsAg titre with the Roche Elecsys HBsAg II quantification assay and with the POC assay. The POC assay reliably detected HBsAg at a concentration of at least 50 IU/mL for all genotypes, and at lower concentrations for some genotypes. Eight samples with substitutions in the HBV 'a' determinant were reliably detected after a 1/100 dilution. The POC strips were used to screen serum samples from 297 individuals at risk for HBV in local clinical settings (health fairs and outreach events) in parallel with commercial laboratory HBsAg testing (Quest Diagnostics EIA). POC testing was 73.7% sensitive and 97.8% specific for detection of HBsAg. Although the POC test demonstrated high sensitivity over a range of genotypes, false negatives were frequent in a clinical setting. Nevertheless, the POC assay offers advantages for testing in both developed and resource-limited countries due to its low cost (0.50$) and immediately available results.
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Affiliation(s)
- R G Gish
- Hepatitis B FoundationDoylestown, PA, USA
| | - J A Gutierrez
- Transplant Hepatology, University of Miami HospitalMiami, FL, USA
| | - N Navarro-Cazarez
- Division of Gastroenterology, University of California at San DiegoSan Diego, CA, USA
| | - K Giang
- Skaggs School of Pharmacy, University of California at San DiegoSan Diego, CA, USA
| | - D Adler
- Skaggs School of Pharmacy, University of California at San DiegoSan Diego, CA, USA
| | - B Tran
- Skaggs School of Pharmacy, University of California at San DiegoSan Diego, CA, USA
| | - S Locarnini
- Victorian Infectious Diseases Reference LaboratoryNorth Melbourne, VIC, Australia
| | - R Hammond
- Victorian Infectious Diseases Reference LaboratoryNorth Melbourne, VIC, Australia
| | - S Bowden
- Victorian Infectious Diseases Reference LaboratoryNorth Melbourne, VIC, Australia
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26
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Gutierrez JA, Falcone RD, Lopez‐Quintela MA, Buceta D, Silber JJ, Correa NM. On the Investigation of the Droplet–Droplet Interactions of Sodium 1,4‐Bis(2‐ethylhexyl) Sulfosuccinate Reverse Micelles upon Changing the External Solvent Composition and Their Impact on Gold Nanoparticle Synthesis (Eur. J. Inorg. Chem. 27/2014). Eur J Inorg Chem 2014. [DOI: 10.1002/ejic.201490138] [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: 11/08/2022]
Affiliation(s)
- Jorge A. Gutierrez
- Departamento de Química, Universidad Nacional de Río Cuarto, Agencia Postal # 3, C. P. X5804BYA Río Cuarto, Argentina, http://gso‐unrc.blogspot.com.ar/ www.unrc.edu.ar
| | - R. Dario Falcone
- Departamento de Química, Universidad Nacional de Río Cuarto, Agencia Postal # 3, C. P. X5804BYA Río Cuarto, Argentina, http://gso‐unrc.blogspot.com.ar/ www.unrc.edu.ar
| | - M. Arturo Lopez‐Quintela
- Facultad de Química, Departamento de Química‐Física, Laboratorio de Nanotecnología y Magnetismo (NANOMAG), Universidad de Santiago de Compostela, C. P. 15782 Santiago de Compostela, Spain
| | - David Buceta
- Facultad de Química, Departamento de Química‐Física, Laboratorio de Nanotecnología y Magnetismo (NANOMAG), Universidad de Santiago de Compostela, C. P. 15782 Santiago de Compostela, Spain
| | - Juana J. Silber
- Departamento de Química, Universidad Nacional de Río Cuarto, Agencia Postal # 3, C. P. X5804BYA Río Cuarto, Argentina, http://gso‐unrc.blogspot.com.ar/ www.unrc.edu.ar
| | - N. Mariano Correa
- Departamento de Química, Universidad Nacional de Río Cuarto, Agencia Postal # 3, C. P. X5804BYA Río Cuarto, Argentina, http://gso‐unrc.blogspot.com.ar/ www.unrc.edu.ar
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Wyles DL, Gutierrez JA. Importance of HCV genotype 1 subtypes for drug resistance and response to therapy. J Viral Hepat 2014; 21:229-40. [PMID: 24597691 DOI: 10.1111/jvh.12230] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 12/12/2013] [Indexed: 12/11/2022]
Abstract
The treatment for patients infected with hepatitis C virus (HCV) genotype 1 has undergone major changes with the availability of direct-acting antivirals. Triple therapy, containing telaprevir or boceprevir, first-wave NS3 protease inhibitors, in combination with peginterferon and ribavirin, improved rates of sustained virologic response compared with peginterferon and ribavirin alone in patients with HCV genotype 1. However, the development of drug-resistant variants is a concern. In patients treated with telaprevir or boceprevir, different patterns of resistance are observed for the two major HCV genotype 1 subtypes, 1a and 1b. Genotype 1b is associated with a lower rate of resistant variant selection and better response to triple therapy compared with genotype 1a. Similar subtype-specific patterns have been observed for investigational direct-acting antivirals, including second-wave NS3 protease inhibitors, NS5A inhibitors and non-nucleoside NS5B inhibitors. This review explores resistance to approved and investigational direct-acting antivirals for the treatment of HCV, focusing on the differences between genotype 1a and genotype 1b. Finally, given the importance of HCV genotype 1 subtype on resistance and treatment outcomes, clinicians must also be aware of the tests currently available for genotype subtyping and their limitations.
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Affiliation(s)
- D L Wyles
- Division of Infectious Diseases, University of California, San Diego, CA, USA
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Gutierrez JA, Falcone RD, Lopez-Quintela MA, Buceta D, Silber JJ, Correa NM. On the Investigation of the Droplet-Droplet Interactions of Sodium 1,4-Bis(2-ethylhexyl) Sulfosuccinate Reverse Micelles upon Changing the External Solvent Composition and Their Impact on Gold Nanoparticle Synthesis. Eur J Inorg Chem 2014. [DOI: 10.1002/ejic.201301612] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Santos MVC, Paiva MG, Macedo CRDP, Petrilli AS, Azeka E, Jatene IB, Castro Junior CG, Seber A, Miachon AS, Tanaka ACS, Castro MAS, Carvalho AC, Nars CCF, Terzian CN, Santos CCL, Guerra CCS, Silva DCB, Bassi DU, Feitosa FA, Hamamoto F, Szarf G, Lederman HM, Rigon Junior HJ, Mota ICF, Perrud JÁ, Soares Junior J, Gutierrez JA, Perin JPM, Catani LH, Tsai LY, Vianna LC, Santos MJ, Ishigai MMS, Diógenes MSB, Alves MTS, Piedade MTC, Parreiras M, Cypriano M, Negrini NS, Campos Filho O, Figueiredo PA, Novaes PE, Camargo PR, Maia OS, Petrilli R, Arduini RG, Gouveia RV, Teruya SBM, Moisés VA, Morais VLL. I Diretriz Brasileira de Cardio-Oncologia Pediátrica da Sociedade Brasileira de Cardiologia. Arq Bras Cardiol 2013; 100:1-68. [DOI: 10.5935/abc.2013s005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gutierrez JA, Falcone RD, Silber JJ, Correa NM. Role of the medium on the C343 inter/intramolecular hydrogen bond interactions. An absorption, emission, and 1HNMR investigation of C343 in benzene/n-heptane mixtures. J Phys Chem A 2010; 114:7326-30. [PMID: 20565101 DOI: 10.1021/jp102136e] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
C343, a common molecular probe utilized in solvation dynamics experiments, was studied in homogeneous media. Absorption, emission, and (1)HNMR spectroscopies were used to investigate the behavior of C343 in benzene and in benzene/n-heptane mixtures. We demonstrate the implications of the medium polarity, measured as the Kamlet-Taft polarity-polarizability (pi*) parameter, in the C343 inter/intramolecular hydrogen bond (H-bond) interactions and the role that this interaction plays in the dimerization process of the dye. In pure benzene, the dimer prevails because the intermolecular H-bond interaction is favored. On the other hand, as the n-heptane content increases the intramolecular H-bond is the strongest and the C343 monomer is favored. As the polarity of the medium decreases, the solvophobic interaction makes that C343 monomer species experiences a more complicated aggregation process beyond the simple monomer dimer equilibrium present in pure benzene. Thus, the addition of n-heptane to the mixture yields a C343 higher-order aggregates species. Thus, our work reveals the importance that the medium has on the behavior of a widespread dye used as chromophore for very different systems such as homogeneous and microheterogenous media. This is very important since the use of chromophores without understanding its chemistry can induce artifacts into the interpretation of solvation dynamics in heterogeneous environments, in particular, those provided by biological systems such as proteins. Considerable care in choosing and characterizing the system is required to analyze the results fully.
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Affiliation(s)
- Jorge A Gutierrez
- Department of Chemistry, National University of Rio Cuarto, Postal Agency #3, X5804BYA Río Cuarto, Argentina
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Katakowski M, Jiang F, Zheng X, Gutierrez JA, Szalad A, Chopp M. Tumorigenicity of cortical astrocyte cell line induced by the protease ADAM17. Cancer Sci 2009; 100:1597-604. [PMID: 19515085 DOI: 10.1111/j.1349-7006.2009.01221.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The metalloprotease ADAM17 (a.k.a. TACE) plays a pivotal role in the cleavage and activation of membrane-anchored receptor ligands. More recently, it has been revealed that ADAM17 is a potent sheddase of the epidermal growth factor (EGF) family of ligands and regulates epidermal growth factor receptor (EGFR) activity in a variety of tumors. EGFR is a key component of autonomous growth signaling in several tumors, and correlates with the malignancy grade of astrocytoma. In this study, we tested the hypothesis that over-expression of ADAM17 in cortical astrocytes derived from normal brain would induce a progression towards a malignant phenotype. Over-expression of human ADAM17 (hADAM17) in the CTX-TNA2 cortical astrocyte cell line resulted in non-adherent growth, increased proliferation, invasiveness, production of angiogenic factors, and expression of genes associated with immature and/or neoplastic cells. hADAM17 up-regulated EGFR and AKT phosphorylation, and increased proliferation and cell invasion were significantly dependent upon EGFR activity. When implanted in the nude mouse brain, CTX-TNA2 cells induced low histological grade, benign intraventricular gliomas. In contrast, the same astrocytes with hADAM17 formed large malignant gliomas. Taken together, these findings suggest that unregulated ADAM17 activity induces functional changes in astrocytes that significantly advance the malignant phenotype.
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Affiliation(s)
- Mark Katakowski
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USA
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Hartzfeld P, Elisevich K, Pace M, Smith B, Gutierrez JA. Characteristics and surgical outcomes for medial temporal post-traumatic epilepsy. Br J Neurosurg 2008; 22:224-30. [PMID: 18348018 DOI: 10.1080/02688690701818901] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A common post-traumatic location of epileptogenesis is the medial temporal lobe despite evidence of associated diffuse or remote cerebral injury. We undertook a review of post-traumatic medial temporal lobe epilepsy (MTLE) patients as part of an overall post-traumatic epilepsy population to assess the extent of cerebral injury sustained by this subpopulation and to establish whether surgical outcome differed from that of a non-traumatically-induced epilepsy population. A retrospective review of 57 patients operated for post-traumatic epilepsy (PTE) over a 10-year period (1993-2003) was undertaken with particular attention to those undergoing medial temporal resection. Preoperative magnetic resonance imaging (MRI) was assessed for the type and location of abnormalities. Postoperative outcomes were compared with those of patients with MTLE of non-traumatic origin operated by the same surgeon. Of the 57 patients operated, 30 cases underwent medial temporal lobe resection. The most common mechanism of injury was blunt trauma attributable to motor vehicle accidents with imaging abnormalities characterized by medial temporal sclerosis (MTS; 16 cases), T2/FLAIR hyperintensities (nine cases), periventricular gliosis (seven cases), diffuse cerebral atrophy (five cases) and focal encephalomalacia (three cases). Six patients had normal MRI studies. No significant differences in postoperative outcomes were found between post- and non-traumatic MTLE epilepsy groups. The presence of histopathological change in the medial temporal lobe varied greatly and provided no indication of a favourable postoperative outcome. Patients with post-traumatic medial temporal lobe epilepsy respond favourably to surgical treatment. In the case of medial temporal sclerosis, there is substantial variation of histopathological findings which correlate poorly with current imaging applications. The favourable outcomes obtained following surgery in this group attest to a commonality with other risk factors in the genesis of epilepsy in this location.
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Affiliation(s)
- P Hartzfeld
- Department of Neurosurgery, Henry Ford Health System, Detroit, Michigan 48202, USA
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Abstract
We present the imaging findings of a case of spinal pilomyxoid astrocytoma in a 29-year-old woman with history of neck and back pain and weakness of bilateral upper extremities. A contrast-enhanced magnetic resonance (MR) imaging study revealed an extensive intradural extramedullary lesion occupying most of the thecal sac extending from mid cervical up to the lumbosacral region with extensive contrast enhancement. Spinal pilomyxoid astrocytoma is rare with only three reported cases in pediatric population in the literature. This report illustrates the MR findings of an unusual case of intradural extramedullary spinal pilomyxoid tumor in an adult patient.
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Affiliation(s)
- Mishal Mendiratta-Lala
- Henry Ford Health Systems, Department of Radiology, 2799, West Grand Blvd, Detroit, Michigan 48202, USA
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Frank JA, McAuley DF, Gutierrez JA, Daniel BM, Dobbs L, Matthay MA. Differential effects of sustained inflation recruitment maneuvers on alveolar epithelial and lung endothelial injury. Crit Care Med 2005; 33:181-8; discussion 254-5. [PMID: 15644667 DOI: 10.1097/01.ccm.0000150663.45778.c4] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The role of recruitment maneuvers in mechanical ventilation for patients with the acute respiratory distress syndrome and acute lung injury remains uncertain in part due to a lack of data on the effects of specific recruitment maneuvers on lung injury severity. The primary objective of this study was to determine the effect of one type of recruitment maneuver--sustained inflation--on alveolar epithelial and lung endothelial injury in experimental acute lung injury. DESIGN Randomized experimental study. SETTING Academic research laboratory. SUBJECTS Forty-nine Sprague-Dawley rats. INTERVENTIONS Lung injury was induced in anesthetized, ventilated rats by instillation of acid (pH 1.5) into the airspaces. Rats were ventilated with a tidal volume of 6 mL/kg and a positive end-expiratory pressure of 5 cm H(2)O with or without a sustained inflation recruitment maneuver repeated every 30 mins. Each recruitment maneuver consisted of two 30-sec inflations to total lung capacity (30 cm H(2)O) 1 min apart. MEASUREMENTS AND MAIN RESULTS The use of recruitment maneuvers significantly improved oxygenation, compliance, end-expiratory lung volume, functional residual capacity, and deadspace fraction. Recruitment maneuvers reduced extravascular lung water and lung endothelial injury as measured by protein permeability (217 +/- 28 vs. 314 +/- 70 extravascular plasma equivalents [microL], p < .05). However, recruitment maneuvers did not prevent alveolar epithelial injury. Epithelial permeability and bronchoalveolar lavage RTI40 levels, a marker of type I cell injury, were similar with or without recruitment maneuvers. Recruitment maneuvers decreased epithelial fluid transport, a functional marker of epithelial injury. Recruitment maneuvers did not reduce markers of airspace inflammation. CONCLUSIONS Sustained inflation recruitment maneuvers improve respiratory mechanics and oxygenation and may protect the lung endothelium but do not reduce alveolar epithelial injury. Because of the differential effects of recruitment maneuvers on the lung endothelium and alveolar epithelium, the net effect in clinical acute lung injury may not be beneficial. Additional clinical studies will be needed to assess the net impact of recruitment maneuvers in patients with acute lung injury.
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Affiliation(s)
- James A Frank
- Cardiovascular Research Institute, University of California, San Francisco, USA
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Lee JW, Gonzalez RF, Chapin CJ, Busch J, Fineman JR, Gutierrez JA. Nitric oxide decreases surfactant protein gene expression in primary cultures of type II pneumocytes. Am J Physiol Lung Cell Mol Physiol 2005; 288:L950-7. [PMID: 15640287 DOI: 10.1152/ajplung.00210.2004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Inhaled nitric oxide (NO) is a selective pulmonary vasodilator effective in treating persistent pulmonary hypertension in newborns and in infants following congenital heart disease surgery. Recently, multiple in vivo and in vitro studies have shown a negative effect of NO on surfactant activity as well as surfactant protein gene expression. Although the relationship between NO and surfactant has been studied previously, the data has been hard to interpret due to the model systems used. The objective of the current study was to characterize the effect of NO on surfactant protein gene expression in primary rat type II pneumocytes cultured on a substratum that promoted the maintenance of type II cell phenotype. Exposure to a NO donor, S-nitroso-N-acetylpenicillamine (SNAP), decreased surfactant protein (SP)-A, (SP)-B, and (SP)-C mRNA levels in type II pneumocytes in a time- and dose-dependent manner. The effect was mediated in part by an increase in endothelin-1 secretion and a decrease in the intracellular messenger, phosphorylated ERK1/2 mitogen-activated protein kinases (MAPK). Exposing type II pneumocytes to endothelin-1 receptor antagonists PD-156707 or bosentan before exposure to SNAP partially prevented the decrease in surfactant protein gene expression. The results showed that NO mediated the decrease in surfactant protein gene expression at least in part through an increase in endothelin-1 secretion and a decrease in phosphorylated ERK1/2 MAPKs.
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Affiliation(s)
- Jae W Lee
- Dept. of Anesthesiology, University of California San Francisco, CA 94143, USA.
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Lee JW, Ovadia B, Azakie A, Salas S, Goerke J, Fineman JR, Gutierrez JA. Increased pulmonary blood flow does not alter surfactant protein gene expression in lambs within the first week of life. Am J Physiol Lung Cell Mol Physiol 2004; 286:L1237-43. [PMID: 14751849 DOI: 10.1152/ajplung.00271.2003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Neonates and infants with congenital heart disease with increased pulmonary blood flow suffer morbidity from poor oxygenation and decreased lung compliance. In a previous experiment involving 4-wk-old lambs with pulmonary hypertension secondary to increased pulmonary blood flow following an in utero placement of an aortopulmonary vascular graft, we found a decrease in surfactant protein (SP)-A gene expression as well as a decrease in SP-A and SP-B protein contents. To determine the timing of these changes, the objective of the present study was to characterize the effect of increased pulmonary blood flow and pulmonary hypertension on SP-A, -B, and -C gene expressions and protein contents within the first week of life. Of eight fetal lambs that underwent the in utero placement of the shunt, there was no difference in the expression of SP-A, -B, and -C mRNA levels or SP-A and -B protein contents compared with age-matched controls. The results showed that, in this model of congenital heart disease with pulmonary hypertension and increased pulmonary blood flow, the effect of the shunt on SP gene expression and protein content was not apparent within the first week of life.
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Affiliation(s)
- Jae W Lee
- Department of Anesthesiology, University of California, CA 94143, USA.
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Abstract
A 79-year-old female presented with difficulty ambulating and was found to have weakness and hyperreflexia in the lower extremities. Magnetic resonance imaging (MRI) revealed a large T8-T9 intraspinal tumor. She underwent a thoracic laminectomy, and excision of an intradural extramedullary lesion. The surgical specimen was soft, black tissue that consisted of a moderately cellular, deeply pigmented tumor. The neoplastic cells proved to be melanocytic, and were devoid of overt features of anaplasia, i.e., prominent nuclear pleomorphism, necrosis, significant mitotic activity, and high proliferation indices. Four months postoperatively, MRI demonstrated focal areas of enhancement in the conus medullaris and in the fourth ventricle, indicating leptomeningeal spread. Subsequently, the patient underwent whole brain radiation. On repeat imaging, there was nodular enhancement of the fourth ventricle and throughout the spinal cord. Despite chemotherapy and radiation therapy, the disease advanced and the patient expired. Meningeal melanocytoma is a rare, histologically benign tumor with good prognosis. However, local aggressive behavior has been recorded, especially in cases of subtotal gross resection. On a literature review, there was one case of cranial posterior fossa meningeal melanocytoma with associated lesions in both suprarenal glands and the left kidney, but there were no cases with distant metastasis. In this report, we present an unusual case of spinal meningeal melanocytoma with diffuse spread throughout the craniospinal axis that proved to be fatal.
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Affiliation(s)
- Ali Bydon
- Hermelin Brain Tumor Center, Henry Ford Hospital, Detroit, MI 48202, USA.
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Stuart RB, Ovadia B, Suzara VV, Ross PA, Thelitz S, Fineman JR, Gutierrez JA. Inhaled nitric oxide increases surfactant protein gene expression in the intact lamb. Am J Physiol Lung Cell Mol Physiol 2003; 285:L628-33. [PMID: 12765879 DOI: 10.1152/ajplung.00264.2002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Inhaled nitric oxide (iNO) is used to treat a number of disease processes. Although in vitro data suggest that nitric oxide (NO) alters surfactant protein gene expression, the effects in vivo have not been studied. The objective of this study was to evaluate the effects of iNO on surfactant protein (SP)-A, -B, and -C gene expression in the intact lamb. Thirteen 4-wk-old lambs were mechanically ventilated with 21% oxygen and received iNO at 40 ppm (n = 7) or vehicle gas (n = 6) for 24 h. Peripheral lung biopsies were obtained at 0, 12, and 24 h and analyzed for surfactant mRNA, protein, and total DNA content. Inhaled NO increased SP-A and SP-B mRNA content by 80% from 0 to 12 h and by 78 and 71%, respectively, from 0 to 24 h. There was an increase in SP-A and SP-B protein content by 45% from 0 to 12 h, and a decrease by 70 and 65%, respectively, from 0 to 24 h. DNA content was unchanged. The mechanisms and physiological effects of these findings warrant further investigation.
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Affiliation(s)
- Regan B Stuart
- Dept. of Pediatrics, Univ. of California, San Francisco, 505 Parnassus M680, Box 0106, San Francisco, California 94143-0106, USA.
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Yoshizawa J, Chapin CJ, Sbragia L, Ertsey R, Gutierrez JA, Albanese CT, Kitterman JA. Tracheal occlusion stimulates cell cycle progression and type I cell differentiation in lungs of fetal rats. Am J Physiol Lung Cell Mol Physiol 2003; 285:L344-53. [PMID: 12679321 DOI: 10.1152/ajplung.00281.2002] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Fetal tracheal occlusion (TO) has been reported to stimulate lung growth but decreases number and maturation of type II cells, effects that vary with gestational age and duration of TO. We examined effects of a novel method of TO (unipolar microcautery to seal the trachea) produced at 19.5-20 days (d) of gestation in fetal rats; fetuses were delivered at term, 22 d. Controls were sham operated and unoperated littermates. TO increased wet lung weight but not dry lung weight or lung DNA and protein. To evaluate further the effects of TO, we examined the cell cycle regulators, cyclins D1 and A, in fetal lungs. Cyclin D1 increased with TO (P < 0.005). TO also increased expression of the type I epithelial cell marker RTI40 (mRNA and protein). TO decreased mRNA for surfactant proteins (SP)-A and -C but did not affect protein levels of SP-A and -B and of RTII70, a type II epithelial cell marker. We conclude that TO by microcautery, even of short duration, has diverse pulmonary effects including stimulating increased levels of cyclin D1 with probable cell cycle progression, type I cell differentiation, and possibly inhibiting type II cell function.
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Affiliation(s)
- Jyoji Yoshizawa
- Department of Veteran Affairs, University of California, San Francisco, CA 94118, USA
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40
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Abstract
We have previously reported that mechanical distention of alveolar epithelial type II cells in culture favored the expression of the type I cell phenotype and inhibited the expression of the type II cell phenotype. The objective of the present study was to investigate the effects of continuous mechanical contraction on the expression of specific markers for the type I and type II cell phenotypes in cultured alveolar type II cells. Type II cells were mechanically contracted in culture at varying amplitudes and times. Cells were analyzed for mRNA and protein content of markers of the type I (RTI40) and type II (surfactant proteins [SPs] A, B, and C) phenotypes. Continuous contraction of culture membrane surface area by 25% for a duration of 4 h resulted in an 83% increase in SP-A, a 42% increase in SP-B, and a 230% increase in SP-C, in comparison with controls. After 12 h of contraction, RTI40 mRNA content decreased to 59% of control levels. A minimal contraction of 20% of culture membrane surface area was required to modulate expression of the type II cell markers. In summary, mechanical contraction favors expression of the type II cell phenotype and inhibits expression of the type I cell phenotype in a time- and amplitude-dependent manner.
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Affiliation(s)
- Jorge A Gutierrez
- Department of Pediatrics, University of California, San Francisco, CA 94118, USA.
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41
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Abstract
Currently, no published methods describe the extraction of high molecular weight genomic DNA from ixodid ticks (Acari: Ixodidae) and commonly used methods of extraction are not well adapted for use with members of this family. A method for extraction of minimally degraded genomic DNA from ixodid ticks that can be completed in one or two days is described. The method produces DNA which is of sufficient size (>24 kb) for use in Southern analysis and which is readily digestible by restriction endonucleases. Southern analysis using a cytochrome P450 gene probe, demonstrates the success of our method with genomic DNA extracted from two species of Ixodidae, the lone star tick, Amblyomma americanum (Linnaeus) and the cattle fever tick, Boophilus microplus (Canestrini).
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Affiliation(s)
- C A Hill
- Department of Biological Sciences, University of Notre Dame, PO Box 369, Notre Dame, IN 46556-0369, U.S.A.
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42
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Quinn TP, Schlueter M, Soifer SJ, Gutierrez JA. Cyclic mechanical stretch induces VEGF and FGF-2 expression in pulmonary vascular smooth muscle cells. Am J Physiol Lung Cell Mol Physiol 2002; 282:L897-903. [PMID: 11943652 DOI: 10.1152/ajplung.00044.2001] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.9] [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: 12/20/2022] Open
Abstract
Vascular endothelial growth factor (VEGF) and basic (b) fibroblast growth factor (FGF-2/bFGF) are involved in vascular development and angiogenesis. Pulmonary artery smooth muscle cells express VEGF and FGF-2 and are subjected to mechanical forces during pulsatile blood flow. The effect of stretch on growth factor expression in these cells is not well characterized. We investigated the effect of cyclic stretch on the expression of VEGF and FGF-2 in ovine pulmonary artery smooth muscle cells. Primary confluent cells from 6-wk-old lambs were cultured on flexible silicon membranes and subjected to cyclic biaxial stretch (1 Hz; 5-25% stretch; 4-48 h). Nonstretched cells served as controls. Expression of VEGF and FGF-2 was determined by Northern blot analysis. Cyclic stretch induced expression of both VEGF and FGF-2 mRNA in a time- and amplitude-dependent manner. Maximum expression was found at 24 h and 15% stretch (VEGF: 1.8-fold; FGF-2: 1.9-fold). These results demonstrate that mechanical stretch regulates VEGF and FGF-2 gene expression, which could play a role in pulmonary vascular development or in postnatal pulmonary artery function or disease.
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MESH Headings
- Animals
- Cell Survival/physiology
- Cells, Cultured
- Chronic Disease
- Endothelial Growth Factors/analysis
- Endothelial Growth Factors/genetics
- Fibroblast Growth Factor 2/analysis
- Fibroblast Growth Factor 2/genetics
- Gene Expression/physiology
- Hypertension, Pulmonary/physiopathology
- Lymphokines/analysis
- Lymphokines/genetics
- Muscle Fibers, Skeletal/chemistry
- Muscle Fibers, Skeletal/physiology
- Muscle, Smooth, Vascular/chemistry
- Muscle, Smooth, Vascular/cytology
- Muscle, Smooth, Vascular/physiology
- Pulmonary Artery/cytology
- RNA, Messenger/analysis
- Sheep
- Stress, Mechanical
- Vascular Endothelial Growth Factor A
- Vascular Endothelial Growth Factors
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Affiliation(s)
- Timothy P Quinn
- Department of Pediatrics, University of California San Francisco, San Francisco, California 94143, USA.
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43
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Frank JA, Gutierrez JA, Jones KD, Allen L, Dobbs L, Matthay MA. Low tidal volume reduces epithelial and endothelial injury in acid-injured rat lungs. Am J Respir Crit Care Med 2002; 165:242-9. [PMID: 11790662 DOI: 10.1164/ajrccm.165.2.2108087] [Citation(s) in RCA: 227] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Using a rat model of acid-induced lung injury, we tested the hypothesis that tidal volume reduction at the same level of PEEP (10 cm H(2)O) would diminish the degree of pulmonary edema by attenuating injury to the alveolar epithelial and endothelial barriers. Tidal volume reduction from 12 to 6 to 3 ml/kg significantly reduced the rate of lung water accumulation from 690 microl/h to 310 microl/h to 210 microl/h. Ventilation with either 6 or 3 ml/kg reduced endothelial injury equally as measured by plasma vWf:Ag and permeability to albumin. Plasma RTI40, a marker of type I epithelial cell injury, decreased 46% when tidal volume was reduced from 12 to 6 ml/kg and decreased an additional 33% with 3 ml/kg (p < 0.05). The rate of alveolar epithelial fluid clearance was significantly faster in the 3-ml/kg group (24 +/- 7%/h) compared with 6 ml/kg (15 +/- 11%/h) and 12 ml/kg (3 +/- 6%/h). We conclude that low tidal volume ventilation protects both the alveolar epithelium and the endothelium in this model of acute lung injury. The additional decrease in pulmonary edema with a tidal volume of 3 ml/kg is partly accounted for by greater protection of the alveolar epithelium.
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Affiliation(s)
- James A Frank
- Cardiovascular Research Institute and the Department of Medicine, University of California, San Francisco, San Francisco, California 94143-0130, USA.
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44
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Gutierrez JA, Parry AJ, McMullan DM, Chapin CJ, Fineman JR. Decreased surfactant proteins in lambs with pulmonary hypertension secondary to increased blood flow. Am J Physiol Lung Cell Mol Physiol 2001; 281:L1264-70. [PMID: 11597919 DOI: 10.1152/ajplung.2001.281.5.l1264] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Infants with increased pulmonary blood flow secondary to congenital heart disease suffer from tachypnea, dyspnea, and recurrent pulmonary infections. We have recently established a model of pulmonary hypertension secondary to increased pulmonary blood flow in lambs after in utero placement of an aortopulmonary vascular graft. The purpose of the present study was to utilize our animal model to determine the effects on the expression of surfactant proteins A (SP-A), B (SP-B), and C (SP-C). At age 4 wk, SP-A mRNA content in lambs decreased to 61.4 +/- 8% of age-matched control value (n = 5; P < 0.05). In addition, SP-A protein content was decreased to 50 +/- 12% of control value (n = 6; P < 0.0001). Although we did not observe statistically significant changes in SP-B mRNA content, SP-B protein was decreased to 74 +/- 25% of control value (n = 4; P < 0.02). There was no difference in SP-C mRNA. These data show that in a model of congenital heart disease with pulmonary hypertension secondary to increased pulmonary blood flow, there is a decrease in SP-A gene expression as well as a decrease in SP-A and SP-B protein contents.
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Affiliation(s)
- J A Gutierrez
- Department of Pediatrics, University of California, San Francisco, California 94143, USA.
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45
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Abstract
Physical forces play an important role in modulating lung development, growth, compliance, differentiation and metabolism. Both tonic distension and phasic changes in volume occur during development and after birth. Morphometric studies have shown that alveolar epithelial cells are distended during lung expansion from functional residual capacity. In both in vivo and in vitro model systems, mechanical distension stimulates surfactant secretion. Drawing on the results of developmental anomalies and experiments in vivo, we and others have generated the underlying hypothesis that mechanical distension promotes expression of the type I cell phenotype and inhibits expression that of the type II; contraction has the opposite effects. The results of recent experiments, using both cultured type II cells from adult rodents and fetal lung explant tissue to test this hypothesis, provide support. The molecular and biochemical mechanisms by which physical forces affect lung functions are currently under investigation.
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Affiliation(s)
- L G Dobbs
- Cardiovascular Research Institute, University of California San Francisco: LH Campus, 3333 California Street; Suite 150, San Francisco, CA 94118, USA.
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46
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McGovern KJ, Blanchard TG, Gutierrez JA, Czinn SJ, Krakowka S, Youngman P. gamma-Glutamyltransferase is a Helicobacter pylori virulence factor but is not essential for colonization. Infect Immun 2001; 69:4168-73. [PMID: 11349094 PMCID: PMC98487 DOI: 10.1128/iai.69.6.4168-4173.2001] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The contribution of glutamyl transpeptidase (GGT) (gamma-glutamyltransferase [EC 2. 3. 2. 2]) to Helicobacter pylori virulence was investigated in piglets and mice using GGT-deficient isogenic strains. All animals became colonized. However, the bacterial load was significantly lower for mutant bacteria than for parent strains. These results suggest that GGT activity provides an advantage to H. pylori in colonization.
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Affiliation(s)
- K J McGovern
- Millennium Pharmaceuticals, Inc., Cambridge, Massachusetts, USA
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47
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Hill CA, Gutierrez JA. Analysis of the expressed genome of the lone star tick, Amblyomma americanum (Acari: Ixodidae) using an expressed sequence tag approach. Microb Comp Genomics 2001; 5:89-101. [PMID: 11087176 DOI: 10.1089/10906590050179774] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
An expressed sequence tag (EST) approach was used to study the genome of two developmental stages of the lone star tick, Amblyomma americanum. cDNA libraries were constructed from the larval and adult stages of A. americanum. In total, 1942 ESTs were sequenced (1462 adult ESTs and 480 larval ESTs) and analyzed using bioinformatic programs. Contig assembly using the CAPII program revealed 11% and 15% redundancy of sequences in the larval and adult ESTs, respectively. Of the 1942 ESTs, 1738 sequences were considered quality sequences and of these, 771 or approximately 44.4% of the sequences were putatively identified based on amino acid identity using the protein Basic Local Alignment Search Tool (BLAST) algorithm. Putatively identified sequences were classified according to their predicted gene function. In total, 967 sequences, or 55.6% of the quality sequences, had limited or no protein similarity to previously identified gene products. Sequences lacking protein homology were analyzed using an automated sequence annotation system for predicted protein characteristics such as open reading frames, signal peptides, protein motifs, and transmembrane regions. In this paper we describe the sequencing of the largest number of ESTs obtained from an arachnid species to date and the subsequent detailed analysis of these sequences.
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Affiliation(s)
- C A Hill
- Elanco Animal Health, A Division of Eli Lilly and Company, Greenfield, Indiana 46140, USA.
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48
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Menon PM, Gutierrez JA, Rempel SA. A study of SPARC and vitronectin localization and expression in pediatric and adult gliomas: high SPARC secretion correlates with decreased migration on vitronectin. Int J Oncol 2000; 17:683-93. [PMID: 10995878 DOI: 10.3892/ijo.17.4.683] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [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: 11/06/2022] Open
Abstract
SPARC is a secreted glycoprotein that interacts with extracellular matrix (ECM) proteins to promote de-adhesion of cells from the matrix, thereby inducing a biological state conducive to cell migration. We have demonstrated that SPARC is highly expressed in gliomas (grades II-IV) and promotes glioma invasion in vitro. Therefore, the protein itself or its mechanisms of action might become therapeutic targets to arrest glioma invasion. Vitronectin is an ECM protein found in the blood vessel basement membranes and may promote glioma invasion along these structures. It binds to SPARC in vitro. However, it is not known whether SPARC and vitronectin colocalize and/or interact to contribute to brain tumor cell migration in vivo. In this study, we immuno-histochemically determined if the grade I juvenile pilocytic astrocytomas (JPAs) also express SPARC, if vitronectin is expressed in grades I, II, and IV astrocytomas, and if the proteins colocalize in brain tumors in vivo. We performed western blot analyses to determine if different grades of tumors had different intracellular and/or secreted levels of SPARC and vitronectin. We performed migration assays to determine whether vitronectin is a permissive substrate for glioma migration, and whether the extent of migration correlates with the level of secreted SPARC. Our data demonstrated that JPAs expressed SPARC and secreted significantly higher levels than glioblastomas multiforme (GBMs). Vitronectin was absent from well-preserved tumor but present in areas of disrupted tumor, such as degeneration and/or necrosis. SPARC and vitronectin colocalized only in regions of angiogenesis. We observed that the extent of migration on vitronectin inversely correlated with the level of secreted SPARC: the higher the level, the lesser the migration. These data suggest that the outcome of SPARC - ECM interactions may depend on local SPARC concentrations. The high levels of SPARC secreted by the JPAs, paradoxically, may be more prohibitive for migration on vitronectin than the lower levels secreted by the GBMs. This may account, in part, for the lack of JPA invasion into brain tissue along blood vessel membranes.
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Affiliation(s)
- P M Menon
- Molecular Neuro-Oncology Laboratory, Hermelin Brain Tumor Center, Detroit, MI 48202, USA
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49
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Haider S, Nafziger D, Gutierrez JA, Brar I, Mateo N, Fogle J. Progressive multifocal leukoencephalopathy and idiopathic CD4+lymphocytopenia: a case report and review of reported cases. Clin Infect Dis 2000; 31:E20-2. [PMID: 11049808 DOI: 10.1086/318120] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [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: 11/03/2022] Open
Abstract
Progressive multifocal leukoencephalopathy (PML) is a well recognized demyelinating neurological disorder caused by JC virus. Idiopathic CD4(+) lymphocytopenia (ICL) is a syndrome first described by the Centers for Disease Control and Prevention as a CD4(+) count <300 cells/mm(3) or a CD4(+) count that is <20% of the total T cell count on 2 occasions, with no evidence of human immunodeficiency virus (HIV) infection on testing, and absence of any defined immunodeficiency or therapy that depresses the levels of CD4(+) T cells. To the best of our knowledge, this is the third reported case of PML and ICL, and also the first reported case of the use of cidofovir to treat PML in a patient not infected with human immunodeficiency virus.
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Affiliation(s)
- S Haider
- Division of Infectious Diseases, Henry Ford Hospital, Detroit, MI 48202, USA.
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50
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Gutmann DH, Donahoe J, Perry A, Lemke N, Gorse K, Kittiniyom K, Rempel SA, Gutierrez JA, Newsham IF. Loss of DAL-1, a protein 4.1-related tumor suppressor, is an important early event in the pathogenesis of meningiomas. Hum Mol Genet 2000; 9:1495-500. [PMID: 10888600 DOI: 10.1093/hmg/9.10.1495] [Citation(s) in RCA: 145] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Meningiomas are common nervous system tumors, whose molecular pathogenesis is poorly understood. To date, the most frequent genetic alteration detected in these tumors is loss of heterozygosity (LOH) on chromosome 22q. This finding led to the identification of the neurofibromatosis 2 (NF2) tumor suppressor gene on 22q12, which is inactivated in 40% of sporadic meningiomas. The NF2 gene product, merlin (or schwannomin), is a member of the protein 4.1 family of membrane-associated proteins, which also includes ezrin, radixin and moesin. Recently, we identified another protein 4.1 gene, DAL-1 (differentially expressed in adenocarcinoma of the lung) located on chromosome 18p11.3, which is lost in approximately 60% of non-small cell lung carcinomas, and exhibits growth-suppressing properties in lung cancer cell lines. Given the homology between DAL-1 and NF2 and the identification of significant LOH in the region of DAL-1 in lung, breast and brain tumors, we investigated the possibility that loss of expression of DAL-1 was important for meningioma development. In this report, we demonstrate DAL-1 loss in 60% of sporadic meningiomas using LOH, RT-PCR, western blot and immunohistochemistry analyses. Analogous to merlin, we show that DAL-1 loss is an early event in meningioma tumorigenesis, suggesting that these two protein 4.1 family members are critical growth regulators in the pathogenesis of meningiomas. Furthermore, our work supports the emerging notion that membrane-associated alterations are important in the early stages of neoplastic transformation and the study of such alterations may elucidate the mechanism of tumorigenesis shared by other tumor types.
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Affiliation(s)
- D H Gutmann
- Departments of Neurology and Neuropathology, Washington University School of Medicine, St Louis, MO 63110, USA.
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