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Nguyen E, Cui Z, Kokaraki G, Carlson J, Liu Y. Transferable and Interpretable Treatment Effectiveness Prediction for Ovarian Cancer via Multimodal Deep Learning. AMIA Annu Symp Proc 2024; 2023:550-558. [PMID: 38222355 PMCID: PMC10785847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Ovarian cancer, a potentially life-threatening disease, is often difficult to treat. There is a critical need for innovations that can assist in improved therapy selection. Although deep learning models are showing promising results, they are employed as a "black-box" and require enormous amounts of data. Therefore, we explore the transferable and interpretable prediction of treatment effectiveness for ovarian cancer patients. Unlike existing works focusing on histopathology images, we propose a multimodal deep learning framework which takes into account not only large histopathology images, but also clinical variables to increase the scope of the data. The results demonstrate that the proposed models achieve high prediction accuracy and interpretability, and can also be transferred to other cancer datasets without significant loss of performance.
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Affiliation(s)
- Emily Nguyen
- Computer Science Department, University of Southern California, Los Angeles, CA, U.S.A
| | - Zijun Cui
- Computer Science Department, University of Southern California, Los Angeles, CA, U.S.A
| | - Georgia Kokaraki
- Keck School of Medicine, University of Southern California, Los Angeles, CA, U.S.A
| | - Joseph Carlson
- Keck School of Medicine, University of Southern California, Los Angeles, CA, U.S.A
| | - Yan Liu
- Computer Science Department, University of Southern California, Los Angeles, CA, U.S.A
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2
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Jamieson A, Vermij L, Kramer CJ, Jobsen JJ, Jürgemlienk-Schulz I, Lutgens L, Mens JW, Haverkort MA, Slot A, Nout RA, Oosting J, Carlson J, Howitt BE, Ip PP, Lax SF, McCluggage WG, Singh N, McAlpine JN, Creutzberg CL, Horeweg N, Gilks CB, Bosse T. Clinical Behavior and Molecular Landscape of Stage I p53-Abnormal Low-Grade Endometrioid Endometrial Carcinomas. Clin Cancer Res 2023; 29:4949-4957. [PMID: 37773079 PMCID: PMC10690141 DOI: 10.1158/1078-0432.ccr-23-1397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/09/2023] [Accepted: 09/25/2023] [Indexed: 09/30/2023]
Abstract
PURPOSE The clinical significance of the p53-abnormal (p53abn) molecular subtype in stage I low-grade endometrioid endometrial carcinoma (EEC) is debated. We aimed to review pathologic and molecular characteristics, and outcomes of stage I low-grade p53abn EEC in a large international cohort. EXPERIMENTAL DESIGN Previously diagnosed stage I p53abn EC (POLE-wild-type, mismatch repair-proficient) low-grade EEC from Canadian retrospective cohorts and PORTEC-1&2 trials were included. Pathology review was performed by six expert gynecologic pathologists blinded to p53 status. IHC profiling, next-generation sequencing, and shallow whole-genome sequencing was performed. Kaplan-Meier method was used for survival analysis. RESULTS We identified 55 stage I p53abn low-grade EEC among 3,387 cases (2.5%). On pathology review, 17 cases (31%) were not diagnosed as low-grade EEC by any pathologists, whereas 26 cases (47%) were diagnosed as low-grade EEC by at least three pathologists. The IHC and molecular profile of the latter cases were consistent with low-grade EEC morphology (ER/PR positivity, patchy p16 expression, PIK3CA and PTEN mutations) but they also showed features of p53abn EC (TP53 mutations, many copy-number alterations). These cases had a clinically relevant risk of disease recurrence (5-year recurrence-free survival 77%), with pelvic and/or distant recurrences observed in 12% of the patients. CONCLUSIONS A subset of p53abn EC is morphologically low-grade EEC and exhibit genomic instability. Even for stage I disease, p53abn low-grade EEC are at substantial risk of disease recurrence. These findings highlight the clinical relevance of universal p53-testing, even in low-grade EEC, to identify women at increased risk of recurrence.
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Affiliation(s)
- Amy Jamieson
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of British Columbia, Vancouver, Canada
| | - Lisa Vermij
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Claire J.H. Kramer
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jan J. Jobsen
- Department of Radiation Oncology, Medisch Spectrum Twente, Enschede, the Netherlands
| | - Ina Jürgemlienk-Schulz
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Jan Willem Mens
- Department of Radiation Oncology, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Annerie Slot
- Radiotherapeutic Institute Friesland, Leeuwarden, the Netherlands
| | - Remi A. Nout
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jan Oosting
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Joseph Carlson
- Department of Pathology, University of Southern California, Los Angeles
| | - Brooke E. Howitt
- Department of Pathology, Stanford University School of Medicine, Palo Alto
| | - Philip P.C. Ip
- Department of Pathology, University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Sigurd F. Lax
- Department of Pathology, Hospital Graz II, Medical University of Graz, Graz, and Johannes Kepler University, Linz, Austria
| | - W. Glenn McCluggage
- Department of Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom
| | - Naveena Singh
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Jessica N. McAlpine
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of British Columbia, Vancouver, Canada
| | - Carien L. Creutzberg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Nanda Horeweg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - C. Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Tjalling Bosse
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
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3
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Åkerlund E, Gudoityte G, Moussaud-Lamodière E, Lind O, Bwanika HC, Lehti K, Salehi S, Carlson J, Wallin E, Fernebro J, Östling P, Kallioniemi O, Joneborg U, Seashore-Ludlow B. The drug efficacy testing in 3D cultures platform identifies effective drugs for ovarian cancer patients. NPJ Precis Oncol 2023; 7:111. [PMID: 37907613 PMCID: PMC10618545 DOI: 10.1038/s41698-023-00463-z] [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: 03/27/2023] [Accepted: 10/06/2023] [Indexed: 11/02/2023] Open
Abstract
Most patients with advanced ovarian cancer (OC) relapse and progress despite systemic therapy, pointing to the need for improved and tailored therapy options. Functional precision medicine can help to identify effective therapies for individual patients in a clinically relevant timeframe. Here, we present a scalable functional precision medicine platform: DET3Ct (Drug Efficacy Testing in 3D Cultures), where the response of patient cells to drugs and drug combinations are quantified with live-cell imaging. We demonstrate the delivery of individual drug sensitivity profiles in 20 samples from 16 patients with ovarian cancer in both 2D and 3D culture formats, achieving over 90% success rate in providing results six days after operation. In this cohort all patients received carboplatin. The carboplatin sensitivity scores were significantly different for patients with a progression free interval (PFI) less than or equal to 12 months and those with more than 12 months (p < 0.05). We find that the 3D culture format better retains proliferation and characteristics of the in vivo setting. Using the DET3Ct platform we evaluate 27 tailored combinations with results available 10 days after operation. Notably, carboplatin and A-1331852 (Bcl-xL inhibitor) showed an additive effect in four of eight OC samples tested, while afatinib and A-1331852 led to synergy in five of seven OC models. In conclusion, our 3D DET3Ct platform can rapidly define potential, clinically relevant data on efficacy of existing drugs in OC for precision medicine purposes, as well as provide insights on emerging drugs and drug combinations that warrant testing in clinical trials.
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Affiliation(s)
- Emma Åkerlund
- Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - Greta Gudoityte
- Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | | | - Olina Lind
- Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | | | - Kaisa Lehti
- Department of Biomedical Laboratory Science, Norwegian University of Science and Technology NTNU, Trondheim, Norway
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Sahar Salehi
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Department of Pelvic Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
- Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden
| | - Joseph Carlson
- Department of Pathology and Laboratory Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - Emelie Wallin
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
- Department of Pelvic Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Josefin Fernebro
- Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden
- Department of Pelvic Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Päivi Östling
- Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - Olli Kallioniemi
- Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Ulrika Joneborg
- Department of Pelvic Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
- Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden
| | - Brinton Seashore-Ludlow
- Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
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4
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Sreedasyam A, Plott C, Hossain MS, Lovell J, Grimwood J, Jenkins J, Daum C, Barry K, Carlson J, Shu S, Phillips J, Amirebrahimi M, Zane M, Wang M, Goodstein D, Haas F, Hiss M, Perroud PF, Jawdy S, Yang Y, Hu R, Johnson J, Kropat J, Gallaher S, Lipzen A, Shakirov E, Weng X, Torres-Jerez I, Weers B, Conde D, Pappas M, Liu L, Muchlinski A, Jiang H, Shyu C, Huang P, Sebastian J, Laiben C, Medlin A, Carey S, Carrell A, Chen JG, Perales M, Swaminathan K, Allona I, Grattapaglia D, Cooper E, Tholl D, Vogel J, Weston DJ, Yang X, Brutnell T, Kellogg E, Baxter I, Udvardi M, Tang Y, Mockler T, Juenger T, Mullet J, Rensing S, Tuskan G, Merchant S, Stacey G, Schmutz J. JGI Plant Gene Atlas: an updateable transcriptome resource to improve functional gene descriptions across the plant kingdom. Nucleic Acids Res 2023; 51:8383-8401. [PMID: 37526283 PMCID: PMC10484672 DOI: 10.1093/nar/gkad616] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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] [Received: 10/19/2022] [Revised: 06/21/2023] [Accepted: 07/11/2023] [Indexed: 08/02/2023] Open
Abstract
Gene functional descriptions offer a crucial line of evidence for candidate genes underlying trait variation. Conversely, plant responses to environmental cues represent important resources to decipher gene function and subsequently provide molecular targets for plant improvement through gene editing. However, biological roles of large proportions of genes across the plant phylogeny are poorly annotated. Here we describe the Joint Genome Institute (JGI) Plant Gene Atlas, an updateable data resource consisting of transcript abundance assays spanning 18 diverse species. To integrate across these diverse genotypes, we analyzed expression profiles, built gene clusters that exhibited tissue/condition specific expression, and tested for transcriptional response to environmental queues. We discovered extensive phylogenetically constrained and condition-specific expression profiles for genes without any previously documented functional annotation. Such conserved expression patterns and tightly co-expressed gene clusters let us assign expression derived additional biological information to 64 495 genes with otherwise unknown functions. The ever-expanding Gene Atlas resource is available at JGI Plant Gene Atlas (https://plantgeneatlas.jgi.doe.gov) and Phytozome (https://phytozome.jgi.doe.gov/), providing bulk access to data and user-specified queries of gene sets. Combined, these web interfaces let users access differentially expressed genes, track orthologs across the Gene Atlas plants, graphically represent co-expressed genes, and visualize gene ontology and pathway enrichments.
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Affiliation(s)
| | | | - Md Shakhawat Hossain
- Division of Plant Science and Technology, C.S. Bond Life Science Center, University of Missouri, Columbia, MO, USA
| | - John T Lovell
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
- Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Jane Grimwood
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
| | - Jerry W Jenkins
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
| | - Christopher Daum
- Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Kerrie Barry
- Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Joseph Carlson
- Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Shengqiang Shu
- Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Jeremy Phillips
- Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Mojgan Amirebrahimi
- Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Matthew Zane
- Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Mei Wang
- Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - David Goodstein
- Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Fabian B Haas
- Plant Cell Biology, Faculty of Biology, University of Marburg, Karl-von-Frisch-Str, Marburg, Germany
| | - Manuel Hiss
- Plant Cell Biology, Faculty of Biology, University of Marburg, Karl-von-Frisch-Str, Marburg, Germany
| | - Pierre-François Perroud
- Plant Cell Biology, Faculty of Biology, University of Marburg, Karl-von-Frisch-Str, Marburg, Germany
| | - Sara S Jawdy
- Center for Bioenergy Innovation, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - Yongil Yang
- Center for Bioenergy Innovation, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - Rongbin Hu
- Center for Bioenergy Innovation, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - Jenifer Johnson
- Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Janette Kropat
- Department of Chemistry and Biochemistry and Institute for Genomics and Proteomics, University of California, Los Angeles, CA, USA
| | - Sean D Gallaher
- Department of Chemistry and Biochemistry and Institute for Genomics and Proteomics, University of California, Los Angeles, CA, USA
| | - Anna Lipzen
- Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Eugene V Shakirov
- Department of Integrative Biology, University of Texas at Austin, Austin, TX, USA
| | - Xiaoyu Weng
- Department of Integrative Biology, University of Texas at Austin, Austin, TX, USA
| | | | - Brock Weers
- Department of Biochemistry and Biophysics, Texas A&M University, College Station, TX, USA
| | - Daniel Conde
- Centro de Biotecnología y Genómica de Plantas, Universidad Politécnica de Madrid, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA-CSIC), Madrid, Spain
| | - Marilia R Pappas
- Laboratório de Genética Vegetal, EMBRAPA Recursos Genéticos e Biotecnologia, EPQB Final W5 Norte, Brasília, Brazil
| | - Lifeng Liu
- Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Andrew Muchlinski
- Department of Biological Sciences, Virginia Tech, Blacksburg, VA, USA
| | - Hui Jiang
- Donald Danforth Plant Science Center, St. Louis, MO, USA
| | - Christine Shyu
- Donald Danforth Plant Science Center, St. Louis, MO, USA
| | - Pu Huang
- Donald Danforth Plant Science Center, St. Louis, MO, USA
| | - Jose Sebastian
- Donald Danforth Plant Science Center, St. Louis, MO, USA
| | - Carol Laiben
- Donald Danforth Plant Science Center, St. Louis, MO, USA
| | - Alyssa Medlin
- Donald Danforth Plant Science Center, St. Louis, MO, USA
| | - Sankalpi Carey
- Donald Danforth Plant Science Center, St. Louis, MO, USA
| | - Alyssa A Carrell
- Biosciences Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - Jin-Gui Chen
- Biosciences Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - Mariano Perales
- Centro de Biotecnología y Genómica de Plantas, Universidad Politécnica de Madrid, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA-CSIC), Madrid, Spain
- Departamento de Biotecnología-Biología Vegetal, Escuela Técnica Superior de Ingeniería Agronómica, Alimentaria y de Biosistemas, Universidad Politécnica de Madrid, Madrid, Spain
| | | | - Isabel Allona
- Centro de Biotecnología y Genómica de Plantas, Universidad Politécnica de Madrid, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA-CSIC), Madrid, Spain
- Departamento de Biotecnología-Biología Vegetal, Escuela Técnica Superior de Ingeniería Agronómica, Alimentaria y de Biosistemas, Universidad Politécnica de Madrid, Madrid, Spain
| | - Dario Grattapaglia
- Laboratório de Genética Vegetal, EMBRAPA Recursos Genéticos e Biotecnologia, EPQB Final W5 Norte, Brasília, Brazil
| | | | - Dorothea Tholl
- Department of Biological Sciences, Virginia Tech, Blacksburg, VA, USA
| | - John P Vogel
- Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - David J Weston
- Biosciences Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - Xiaohan Yang
- Center for Bioenergy Innovation, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | | | | | - Ivan Baxter
- Donald Danforth Plant Science Center, St. Louis, MO, USA
| | | | | | - Todd C Mockler
- Donald Danforth Plant Science Center, St. Louis, MO, USA
| | - Thomas E Juenger
- Department of Integrative Biology, University of Texas at Austin, Austin, TX, USA
| | - John Mullet
- Department of Biochemistry and Biophysics, Texas A&M University, College Station, TX, USA
| | - Stefan A Rensing
- Plant Cell Biology, Faculty of Biology, University of Marburg, Karl-von-Frisch-Str, Marburg, Germany
| | - Gerald A Tuskan
- Center for Bioenergy Innovation, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - Sabeeha S Merchant
- Department of Chemistry and Biochemistry and Institute for Genomics and Proteomics, University of California, Los Angeles, CA, USA
| | - Gary Stacey
- Division of Plant Science and Technology, C.S. Bond Life Science Center, University of Missouri, Columbia, MO, USA
| | - Jeremy Schmutz
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
- Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
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Petersons A, Carlson J, Mathieson W. Improving Yields in Multi-analyte Extractions by Utilizing Post-homogenized Tissue Debris. J Histochem Cytochem 2023; 71:273-288. [PMID: 37119238 PMCID: PMC10227881 DOI: 10.1369/00221554231172823] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/06/2023] [Indexed: 05/01/2023] Open
Abstract
In multi-analyte extractions, tissue is typically homogenized in a lysis buffer, and then DNA, RNA, and protein are purified from the supernatant. However, yields are typically lower than in dedicated, single-analyte extractions. In a two-part experiment, we assessed whether yields could be improved by revisiting the normally discarded, post-homogenized tissue debris. We initially performed additional homogenizations, each followed by a simultaneous extraction. These yielded no additional RNA, 13% additional DNA (which became progressively more degraded), and 161.7% additional protein (which changed in proteome when analyzed using SDS-PAGE). We then digested post-homogenized tissue debris from a simultaneous extraction using proteinase K and extracted DNA using silica spin columns or alcohol precipitation. An average additional DNA yield of 27.1% (silica spin columns) or 203.9% (alcohol precipitation) was obtained with/without compromising DNA integrity (assessment by long-range PCR, DNA Integrity Numbers, and size at peak fluorescence of electropherogram). Validation using a cohort of 65 tissue blocks returned an average additional DNA yield of 31.6% (silica columns) and 54.8% (alcohol precipitation). Users can therefore refreeze the homogenized remnants of tissue blocks rather than disposing of them and then perform additional DNA extractions if yields in the initial multi-analyte extractions were low.
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Affiliation(s)
- Ala Petersons
- Integrated Biobank of Luxembourg, Dudelange,
Luxembourg
- Laboratoire National de Santé, Dudelange,
Luxembourg
| | - Joseph Carlson
- Karolinska University Hospital, Radiumhemmet,
Stockholm, Sweden
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Qian J, Roman LD, Rajpara S, Neuman M, Khetan V, Craig DW, Carlson J, Carpten JD. Abstract 6082: Assessing difference in the tumor and immune microenvironment of BRCA1/2 mutated versus BRCA wild type high grade serous ovarian cancers. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-6082] [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: 04/07/2023]
Abstract
Abstract
Ovarian cancer (OvCa) is the deadliest gynecological malignancy in the United States. Surgery and chemotherapy are the primary treatments for OvCa, but 80% of late-stage OvCa patients experience chemo-resistant recurrence, which necessitates the development of new treatment strategies. The genomic diversity within a tumor and the interactions among various cell types within its microenvironment are considered key factors contributing to therapeutic efficacy. Specifically, women who harbor germline BRCA1 or BRCA2 mutations are at increased risk of developing high grade serous ovarian cancer (HGSC). To understand the genomic consequences, including somatic alterations, associated with defective DNA repair, tumor DNA and RNA was isolated from fresh frozen OCT embedded sections from 15 HGSC patients with BRCA1/2 mutation and 10 without any alterations in the BRCA genes (BRCA-wt). Whole exome sequencing (WES) and total RNA-seq was performed to determine the association of homologous recombination (HR) DNA repair gene defects with tumor mutation burden (TMB), neoantigen load (NL), and immunological assessment of tumor microenvironment. TMB was calculated from mutation rates of somatic WES. Germline exome analysis was used to validate inherited BRCA mutations. To identify the somatic mutations, somatic single nucleotide variants and InDels were detected using Strelka. TP53 mutations were most common with several other genes showing only modest mutation frequency. Mutation signatures were also detected with maftools and compared to the COSMIC mutational signature database. BRCA-mutated samples displayed a unique mutational signature associated with defects in HR DNA repair pathway. We also observed heterogeneity in copy number variation profiles amongst cases, as determined by the tool Sequenza. Furthermore, gene set enrichment analysis indicated differential enrichment of P53 pathway, MAPK pathway, and PTEN pathway, in addition to numerous pathways related to immune cell signaling and immune response. RNA-seq data was analyzed with CIBERSORTx and revealed different proportions of 22 immune effector cell types that accompany tumor cells within the HGSC microenvironment. Additional analyses are underway, including measuring differences in NL in BRCA-mutated versus BRCA-wt cases. This work will represent a significant advancement in our fundamental knowledge regarding the complexities of the TME and effective immunological responses in OvCa.
Citation Format: Jing Qian, Lynda D. Roman, Seeta Rajpara, Monica Neuman, Varun Khetan, David W. Craig, Joseph Carlson, John D. Carpten. Assessing difference in the tumor and immune microenvironment of BRCA1/2 mutated versus BRCA wild type high grade serous ovarian cancers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6082.
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Affiliation(s)
- Jing Qian
- 1Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Lynda D. Roman
- 1Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Seeta Rajpara
- 1Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Monica Neuman
- 1Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Varun Khetan
- 1Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - David W. Craig
- 1Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Joseph Carlson
- 1Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - John D. Carpten
- 1Keck School of Medicine, University of Southern California, Los Angeles, CA
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Chastant AJ, Long W, Carlson J. FD&C Yellow #6 hypersensitivity unveiled in a patient treated with ChloraPrep™ Hi-Lite Orange. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00538-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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8
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Penna GD, Carlson J. PEANUT COMPONENT TESTING: NOT THE ONLY COMPONENT. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chastant A, Carlson J. FD&C YELLOW #6 HYPERSENSITIVITY UNVEILED IN A PATIENT TREATED WITH CHLORAPREP™ HI-LITE ORANGE. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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10
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Hein N, Carlson J. VENOM IMMUNOTHERAPY: SELECTIVE DESENSITIZATION. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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11
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Svensson A, Carlson J, Jensen HK, Dahlberg P, Bundgaard H, Christensen AH, Boonstra MJ, Svendsen JH, Cadrin Tourigny J, Te Riele ASJ, Platonov PG. Arrhythmogenic right ventricular cardiomyopathy – evolution of electrocardiographic markers during long-term follow-up prior to ascertainment of diagnosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1754] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Depolarization and repolarization abnormalities are part of the diagnostic Task Force Criteria of 2010 (TFC2010) for arrhythmogenic right ventricular cardiomyopathy (ARVC). These abnormalities are thought to be progressive but have also been described as dynamic and sometimes reversible. Evolution of ECG abnormalities prior to clinical ARVC diagnosis is poorly studied.
Objective
To assess the evolution of ECG depolarization and repolarization characteristics in patients with ARVC prior to diagnosis and to identify markers of disease progression at a preclinical stage.
Methods
353 patients with definite ARVC from Sweden, Denmark, the Netherlands and Canada with at least one 12-lead digital ECG (65% males, 67% probands, 56% mutation carriers, median age at diagnosis 42 [IQR 29–53] years and median age at first ECG 44 [30–55] years) were included. Digital ECGs were extracted from regional ECG archives. ECGs with left bundle branch block, ventricular pacing or recorded either prior to 15 years of age or after heart transplantation were excluded. Remaining 6,871 ECGs were digitally processed and automatically analysed using the Glasgow algorithm. Median values for overall QRS duration, terminal activation delay (TAD) in lead V1 as well as amplitudes of QRS-T-components in precordial leads per patient per year were used for analyses and graphically represented using Lowess smoothing with cubic splines (Figure 1). Blue lines indicate smoothed conditional mean with 95% confidence interval (shadow). Time “0” (red line) indicates the time when TFC2010 were fulfilled for definite diagnosis.
A database of 18,564 anonymized digital ECGs (58% males, median age at latest ECG 41 years [IQR 32–52]) who were in contact with health care during 2020–2021 was processed using the same exclusion criteria and signal-processing methodology as in the ARVC group and used as a reference (black line).
Results
TAD in lead V1 and overall QRS duration demonstrated a significant increase years before ARVC diagnosis, and significant reductions were seen in QRS-T voltages measured as R wave amplitude, QRS amplitude (the absolute sum of R wave and S wave), and T wave amplitude (Table 1 and Figure 1). The changes were seen in all precordial leads, not only the right-sided, and visually diverging from the controls.
Conclusion
Development of the ARVC ECG phenotype started several years before diagnosis and continued afterwards. QRS duration and TAD increased, QRS voltages decrease, and T wave amplitude decreased eventually leading to T wave inversion. These changes might be visually assessed but also measured with available ECG software. These findings may be clinically useful in the screening and follow-up of ARVC relatives.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Governmental funding of clinical research (ALF), Region Ostergotland, Sweden.The Swedish Heart-Lung Foundation.
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Affiliation(s)
- A Svensson
- Department of Cardiology, Department of Medical, Health and Caring Sciences, Linkoping University , Linkoping , Sweden
| | - J Carlson
- Department of Cardiology, Clinical Sciences, Lund University , Lund , Sweden
| | - H K Jensen
- Aarhus University Hospital, Department of Clinical Medicine, Aarhus University Hospital , Aarhus , Denmark
| | - P Dahlberg
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg , Gothenburg , Sweden
| | - H Bundgaard
- Rigshospitalet - Copenhagen University Hospital, Department of Clinical Medicine University of Copenhagen , Copenhagen , Denmark
| | - A H Christensen
- Gentofte University Hospital, Department of Clinical Medicine University of Copenhagen , Copenhagen , Denmark
| | - M J Boonstra
- Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University , Utrecht , The Netherlands
| | - J H Svendsen
- Rigshospitalet - Copenhagen University Hospital, Department of Clinical Medicine University of Copenhagen , Copenhagen , Denmark
| | - J Cadrin Tourigny
- Cardiovascular Genetics Center, Montreal Heart Center, Montreal, Quebec, Canada , Montreal , Canada
| | - A S J Te Riele
- Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University , Utrecht , The Netherlands
| | - P G Platonov
- Arrhythmia Clinic, Skane University Hospital Lund and, Department of Cardiology, Clinical Sciences, Lund University , Lund , Sweden
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12
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Bolton E, Bezecny J, Han D, Carlson J, Mengden Koon S, Berry EG. Localized myxedema histologically mimicking spindle cell lipoma. Dermatol Online J 2022; 28. [DOI: 10.5070/d328357787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 11/08/2022] Open
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13
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Åkerlund E, Gudoityte G, Lamodiere EM, Carlson J, Wallin E, Fernebro J, Kallioniemi O, Östling P, Joneborg U, Seashore-Ludlow B. Abstract 1890: Development of the drug efficacy testing in ex vivo 3D cultures (DETECT) platform and its application to functional precision medicine in ovarian cancer. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-1890] [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
Many ovarian cancer (OC) patients receiving chemotherapy relapse with acquired resistance, hence novel treatment allocation strategies are urgently needed. 3D cell culture models and organoid technologies have emerged as exciting tools to study cancer. Despite the advances, there is a need for protocols that can quickly generate patient-relevant 3D models for high-throughput drug screening and for diagnostic drug sensitivity testing. Ideally, such methods should be cost-effective, provide multi-parametric data to reveal distinct phenotypes, have single cell resolution to reveal heterogeneity and cell interactions, meet diagnostic timeframes and be miniaturized to allow the analysis of many drugs and combinations with small numbers of primary tumor cells. Here, we aimed to develop a robust technology for high-throughput ex vivo drug sensitivity testing for functional precision medicine using OC tissue and ascites samples (mostly high-grade serous carcinoma) from patients. We present a scalable drug screening platform: DETECT (Drug Efficacy Testing in Ex-vivo 3D Cultures), where tumor-derived patient cells can be rapidly screened within one week from sampling. Using this information patient-specific drug combinations are subsequently designed and tested with these data available within 9 days. This is much faster than with most screening protocols for organoids and PDC models where many weeks or months are required for establishment of the models and expansion of the required numbers of cells. We have currently tested the efficacy of 58 selected chemo- and targeted drugs in 5 doses using high content imaging and then a complete dose-matrix of 3 combinations at step 2. We report robust drug screening data in 15 out of 18 OC patient samples, which has resulted in a functional taxonomy of patient samples and a taxonomy of drugs based on their efficacy across patient samples. Some of the most common responses were seen for the BCL-XL inhibitor A-1331852 (9/15 patients), Topotecan (7), Dactinomycin (7), Omipalisib (6) and Omacetaxine (6). All but 2 drugs showed efficacy in at least one OC sample, suggesting heterogeneity and opportunities to make use of unique drug response patterns. Combination screening revealed that Carboplatin and A-1331852, a BCL-XL inhibitor, showed increased efficacy in 3 of the 5 tested patient samples. In conclusion, our 3D HT-drug testing assay DETECT with a combination screening capability could in the future be useful for guiding individualized treatment in a clinical setting as well as for identifying existing and emerging drugs and drug combinations for repurposing in OC.
Citation Format: Emma Åkerlund, Greta Gudoityte, Elisabeth Moussaud Lamodiere, Joseph Carlson, Emelie Wallin, Josefin Fernebro, Olli Kallioniemi, Päivi Östling, Ulrika Joneborg, Brinton Seashore-Ludlow. Development of the drug efficacy testing in ex vivo 3D cultures (DETECT) platform and its application to functional precision medicine in ovarian cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1890.
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Affiliation(s)
- Emma Åkerlund
- 1Karolinska Institutet/Science for Life Laboratory, Stockholm, Sweden
| | - Greta Gudoityte
- 1Karolinska Institutet/Science for Life Laboratory, Stockholm, Sweden
| | | | | | | | | | - Olli Kallioniemi
- 1Karolinska Institutet/Science for Life Laboratory, Stockholm, Sweden
| | - Päivi Östling
- 1Karolinska Institutet/Science for Life Laboratory, Stockholm, Sweden
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14
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Wallin E, Falconer H, Carlson J, Haglund C, Koskela LR, Rådestad AF. Objective and subjective assessment of bladder function after robot-assisted laparoscopic radical hysterectomy for early stage cervical cancer. J Minim Invasive Gynecol 2022; 29:1075-1082. [PMID: 35654357 DOI: 10.1016/j.jmig.2022.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022]
Abstract
STUDY OBJECTIVE To examine whether objective bladder function following robot-assisted radical hysterectomy (RRH) for early-stage cervical cancer is correlated with subjective patient-reported outcomes as well as quality of life during the first year after RRH. DESIGN Prospective observational study SETTING: Karolinska University Hospital, Sweden PATIENTS: Women with early stage cervical cancer (FIGO stage IA2-IB1) between July 2017 and May 2019 were assessed for eligibility. INTERVENTIONS Robotic radical hysterectomy (RRH) MEASUREMENTS AND MAIN RESULTS: Subjective bladder function was evaluated with the Female Lower Urinary Tract Symptoms and Urinary Incontinence Quality of Life modules of the International Consultation on Incontinence Questionnaire. Objective urinary function was characterized with urodynamic tests and the nerves ablated at RRH were quantified by using immunohistochemical staining of biopsies from the resected paracervix, vesico-uterine and sacro-uterine ligaments. Twenty-seven women were included for analysis at baseline, two weeks, three months and 12 months after surgery. RRH caused hypotonia of the urinary bladder (p<.05). Patient reported outcomes of voiding and filling dysfunction were most significant 2 weeks after surgery (p<.05) but for most of the women bladder function recovered within 3 months. No correlations were found with either subjective nor objective urinary function and the number of ablated nerves. CONCLUSION For the majority of women, objective and subjective urinary bladder dysfunction recovered within 3 months after RRH. The absence of correlation between functional outcomes and ablated autonomous nerves suggest that other underlying causes play a significant role. Early detection of bladder overextension after RRH is paramount and the role of postoperative bladder catherization needs further investigation.
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Affiliation(s)
- Emelie Wallin
- Department of Women´s and Children´s Health and Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden and Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden.
| | - Henrik Falconer
- Department of Women´s and Children´s Health and Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden and Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Joseph Carlson
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Haglund
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Lotta Renström Koskela
- Department of Molecular Medicine and Surgery, Karolinska Institutet, and Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Angelique Flöter Rådestad
- Department of Women´s and Children´s Health and Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden and Department of Breast, Endocrine Tumours and Sarcoma, Karolinska University Hospital, Stockholm, Sweden
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15
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Marinko S, Platonov PG, Carlson J, Borgquist R. Longer left ventricular activation time is associated with lower mortality and risk of heart failure hospitalization in CRT recipients. Europace 2022. [DOI: 10.1093/europace/euac053.497] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): ALF Governmental Funding within the Swedish health care system
Introduction
Cardiac resynchronization therapy (CRT) is an established treatment for heart failure in selected patients. Longer QRS duration has been showed to correlate to clinical outcome, but measures global activation time, rather than the left ventricular dyssynchrony that CRT aims to correct. This study therefore evaluated the incremental value of using Left Ventricular Activation Time (LVAT) for prediction of outcome after CRT.
Methods
Medical records of 445 patients receiving CRT implants at a large-volume tertiary care center were retrospectively evaluated. Digital electrocardiograms (ECG) before and after CRT implantation were collected and ECG parameters were analysed in relation to a primary composite endpoint of time to heart failure hospitalisation or death from any cause. LVAT was defined as time from QRS onset to maximum positive deflection in lead V6 (Figure 1).
Results
Patients were followed for up to 6 years (median 2.7), during which 147 patients (33%) reached the primary endpoint (93 deaths and 103 heart failure hospitalisations). LVAT was measured pre-implant (median 71ms [58-88]) and post-implant (median 74ms [57-96]). There was no CRT-mediated reduction in LVAT (delta -2.3ms +/-31ms, p=0.27). When divided into quartiles, preoperative LVAT had a significant association with clinical outcome (HR 0.76 [0.64-0.90] per increasing quartile, p=0.001), also shown in a median-split Kaplan Meier curve (Figure 2, log rank p=0.001). Multivariate hazard ratio (adjusted for relevant clinical variables) was 0.83; [0.69-0.99]; p=0.047). There was an interaction between LVAT and ECG morphology (p=0.033), and when ECG groups were analysed separately, there was only a significant result for those with native left bundle branch block morphology. Post-implant LVAT, or change in LVAT, did not correlate with the primary endpoint (p=0.25 and p=0.38 respectively.
Conclusion
In CRT recipients, longer pre-implant LVAT was associated with lower risk of heart failure hospitalisation and death during a follow-up of up to 6 years. This association was mainly seen in patients with native LBBB prior to implant. No association was seen with post-CRT LVAT and clinical outcome. If confirmed in prospective trials, evaluation of preoperative LVAT may help optimise patient selection for CRT.
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Affiliation(s)
- S Marinko
- Lund University, Skane University Hospital, Department of Arrhythmias, Lund, Sweden
| | - PG Platonov
- Lund University, Skane University Hospital, Department of Arrhythmias, Lund, Sweden
| | - J Carlson
- Lund University, Cardiology, Lund, Sweden
| | - R Borgquist
- Lund University, Skane University Hospital, Department of Arrhythmias, Lund, Sweden
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16
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Bredeson JV, Lyons JB, Oniyinde IO, Okereke NR, Kolade O, Nnabue I, Nwadili CO, Hřibová E, Parker M, Nwogha J, Shu S, Carlson J, Kariba R, Muthemba S, Knop K, Barton GJ, Sherwood AV, Lopez-Montes A, Asiedu R, Jamnadass R, Muchugi A, Goodstein D, Egesi CN, Featherston J, Asfaw A, Simpson GG, Doležel J, Hendre PS, Van Deynze A, Kumar PL, Obidiegwu JE, Bhattacharjee R, Rokhsar DS. Chromosome evolution and the genetic basis of agronomically important traits in greater yam. Nat Commun 2022; 13:2001. [PMID: 35422045 PMCID: PMC9010478 DOI: 10.1038/s41467-022-29114-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 02/08/2022] [Indexed: 12/14/2022] Open
Abstract
The nutrient-rich tubers of the greater yam, Dioscorea alata L., provide food and income security for millions of people around the world. Despite its global importance, however, greater yam remains an orphan crop. Here, we address this resource gap by presenting a highly contiguous chromosome-scale genome assembly of D. alata combined with a dense genetic map derived from African breeding populations. The genome sequence reveals an ancient allotetraploidization in the Dioscorea lineage, followed by extensive genome-wide reorganization. Using the genomic tools, we find quantitative trait loci for resistance to anthracnose, a damaging fungal pathogen of yam, and several tuber quality traits. Genomic analysis of breeding lines reveals both extensive inbreeding as well as regions of extensive heterozygosity that may represent interspecific introgression during domestication. These tools and insights will enable yam breeders to unlock the potential of this staple crop and take full advantage of its adaptability to varied environments.
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Affiliation(s)
- Jessen V Bredeson
- Department of Molecular & Cell Biology, University of California, Berkeley, CA, 94720, USA
| | - Jessica B Lyons
- Department of Molecular & Cell Biology, University of California, Berkeley, CA, 94720, USA
- Innovative Genomics Institute, Berkeley, CA, USA
| | - Ibukun O Oniyinde
- International Institute of Tropical Agriculture, PMB 5320, Oyo Road, Ibadan, Nigeria
| | - Nneka R Okereke
- National Root Crops Research Institute (NRCRI), Umudike, Nigeria
| | - Olufisayo Kolade
- International Institute of Tropical Agriculture, PMB 5320, Oyo Road, Ibadan, Nigeria
| | - Ikenna Nnabue
- National Root Crops Research Institute (NRCRI), Umudike, Nigeria
| | | | - Eva Hřibová
- Institute of Experimental Botany of the Czech Academy of Sciences, Centre of the Region Haná for Biotechnological and Agricultural Research, Šlechtitelů 31, CZ-77900, Olomouc, Czech Republic
| | - Matthew Parker
- School of Life Sciences, University of Dundee, Dundee, UK
| | - Jeremiah Nwogha
- National Root Crops Research Institute (NRCRI), Umudike, Nigeria
| | | | | | - Robert Kariba
- World Agroforestry (CIFOR-ICRAF), Nairobi, Kenya
- African Orphan Crops Consortium, Nairobi, Kenya
| | - Samuel Muthemba
- World Agroforestry (CIFOR-ICRAF), Nairobi, Kenya
- African Orphan Crops Consortium, Nairobi, Kenya
| | - Katarzyna Knop
- School of Life Sciences, University of Dundee, Dundee, UK
| | | | - Anna V Sherwood
- School of Life Sciences, University of Dundee, Dundee, UK
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Antonio Lopez-Montes
- International Institute of Tropical Agriculture, PMB 5320, Oyo Road, Ibadan, Nigeria
- International Trade Center, Accra, Ghana
| | - Robert Asiedu
- International Institute of Tropical Agriculture, PMB 5320, Oyo Road, Ibadan, Nigeria
| | - Ramni Jamnadass
- World Agroforestry (CIFOR-ICRAF), Nairobi, Kenya
- African Orphan Crops Consortium, Nairobi, Kenya
| | - Alice Muchugi
- World Agroforestry (CIFOR-ICRAF), Nairobi, Kenya
- African Orphan Crops Consortium, Nairobi, Kenya
| | | | - Chiedozie N Egesi
- International Institute of Tropical Agriculture, PMB 5320, Oyo Road, Ibadan, Nigeria
- National Root Crops Research Institute (NRCRI), Umudike, Nigeria
- Cornell University, Ithaca, NY, 14850, USA
| | | | - Asrat Asfaw
- International Institute of Tropical Agriculture, PMB 5320, Oyo Road, Ibadan, Nigeria
| | - Gordon G Simpson
- School of Life Sciences, University of Dundee, Dundee, UK
- James Hutton Institute, Dundee, UK
| | - Jaroslav Doležel
- Institute of Experimental Botany of the Czech Academy of Sciences, Centre of the Region Haná for Biotechnological and Agricultural Research, Šlechtitelů 31, CZ-77900, Olomouc, Czech Republic
| | - Prasad S Hendre
- World Agroforestry (CIFOR-ICRAF), Nairobi, Kenya
- African Orphan Crops Consortium, Nairobi, Kenya
| | | | - Pullikanti Lava Kumar
- International Institute of Tropical Agriculture, PMB 5320, Oyo Road, Ibadan, Nigeria
| | - Jude E Obidiegwu
- National Root Crops Research Institute (NRCRI), Umudike, Nigeria.
| | - Ranjana Bhattacharjee
- International Institute of Tropical Agriculture, PMB 5320, Oyo Road, Ibadan, Nigeria.
| | - Daniel S Rokhsar
- Department of Molecular & Cell Biology, University of California, Berkeley, CA, 94720, USA.
- Innovative Genomics Institute, Berkeley, CA, USA.
- DOE Joint Genome Institute, Berkeley, CA, USA.
- Okinawa Institute of Science and Technology, Onna, Okinawa, Japan.
- Chan-Zuckerberg BioHub, 499 Illinois St., San Francisco, CA, 94158, USA.
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Chen Y, You S, Li J, Zhang Y, Kokaraki G, Epstein E, Carlson J, Huang WK, Haglund F. Follicular Helper T-Cell-Based Classification of Endometrial Cancer Promotes Precise Checkpoint Immunotherapy and Provides Prognostic Stratification. Front Immunol 2022; 12:788959. [PMID: 35069566 PMCID: PMC8777298 DOI: 10.3389/fimmu.2021.788959] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/10/2021] [Indexed: 12/21/2022] Open
Abstract
Despite the fact that management of EC is moving towards four TCGA-based molecular classifications, a pronounced variation in immune response among these molecular subtypes limits its clinical use. We aimed to investigate the determinant biomarker of ICI response in endometrial cancer (EC). We characterized transcriptome signatures associated with tumor immune microenvironment in EC. Two immune infiltration signatures were identified from the TCGA database (n = 520). The high- and low-infiltration clusters were compared for differences in patient clinical characteristics, genomic features, and immune cell transcription signatures for ICI prediction. A Lasso Cox regression model was applied to construct a prognostic gene signature. Time-dependent receiver operating characteristic curve, Kaplan-Meier curve, nomogram, and decision curve analyses were used to assess the prediction capacity. The efficacy of potential biomarker was validated by the Karolinska endometrial cancer cohort (n = 260). Immune signature profiling suggested that T follicular helper-like cells (Tfh) may be an important and favorable factor for EC; high Tfh infiltration showed potential for clinical use in the anti-PD-1 treatment. A Tfh Infiltration Risk Model (TIRM) established using eight genes was validated, and it outperformed the Immune Infiltration Risk Model. The TIRM had a stable prognostic value in combination with clinical risk factors and could be considered as a valuable tool in a clinical prediction model. We identified CRABP1 as an individual poor prognostic factor in EC. The Tfh-based classification distinguishes immune characteristics and predicts ICI efficacy. A nomogram based on Tfh-related risk score accurately predicted the prognosis of patients with EC, demonstrating superior performance to TCGA-based classification.
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Affiliation(s)
- Yi Chen
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Pathology and Cytology, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Shuwen You
- Department of Gynecology Oncology, Women’s Hospital of Zhejiang University, Hangzhou, China
| | - Jie Li
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yifan Zhang
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Pathology and Cytology, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Georgia Kokaraki
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Pathology and Cytology, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Elisabeth Epstein
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Obstetrics and Gynaecology, Södersjukhuset, Stockholm, Sweden
| | - Joseph Carlson
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
- Keck School of Medicine of University of Southern California, Los Angeles, CA, United States
| | - Wen-Kuan Huang
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Felix Haglund
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Pathology and Cytology, Karolinska University Hospital Solna, Stockholm, Sweden
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Petersen LG, Whittle RS, Lee JH, Sieker J, Carlson J, Finke C, Shelton CM, Petersen JCG, Diaz-Artiles A. Gravitational effects on intraocular pressure and ocular perfusion pressure. J Appl Physiol (1985) 2022; 132:24-35. [PMID: 34762525 DOI: 10.1152/japplphysiol.00546.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Changes in the gravitational vector by postural changes or weightlessness induce fluid shifts, impacting ocular hemodynamics and regional pressures. This investigation explores the impact of changes in the direction of the gravitational vector on intraocular pressure (IOP), mean arterial pressure at eye level (MAPeye), and ocular perfusion pressure (OPP), which is critical for ocular health. Thirteen subjects underwent 360° of tilt (including both prone and supine positions) at 15° increments. At each angle, steady-state IOP and MAPeye were measured, and OPP calculated as MAPeye - IOP. Experimental data were also compared to a six-compartment lumped-parameter model of the eye. Mean IOP, MAPeye, and OPP significantly increased from 0° supine to 90° head-down tilt (HDT) by 20.7 ± 1.7 mmHg (P < 0.001), 38.5 ± 4.1 mmHg (P < 0.001), and 17.4 ± 3.2 mmHg (P < 0.001), respectively. Head-up tilt (HUT) significantly decreased OPP by 16.5 ± 2.5 mmHg (P < 0.001). IOP was significantly higher in prone versus supine position for much of the tilt range. Our study indicates that OPP is highly gravitationally dependent. Specifically, data show that MAPeye is more gravitationally dependent than IOP, thus causing OPP to increase during HDT and to decrease during HUT. In addition, IOP was elevated in prone position compared with supine position due to the additional hydrostatic column between the base of the rostral globe to the mid-coronal plane, supporting the notion that hydrostatic forces play an important role in ocular hemodynamics. Changes in OPP as a function of changes in gravitational stress and/or weightlessness may play a role in the pathogenesis of spaceflight-associated neuro-ocular syndrome.NEW & NOTEWORTHY Maintaining appropriate ocular perfusion pressure (OPP) is critical for ocular health. We measured the relative changes in intraocular and mean arterial pressures during 360° tilt and calculated OPP, which was elevated during head-down tilt and decreased during head-up tilt. Experimental data are also explained by our computational model. We demonstrate that OPP is more gravitationally dependent than previously recognized and may be a factor in the overall patho-etiology behind the weightlessness-induced spaceflight-associated neuro-ocular syndrome.
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Affiliation(s)
- Lonnie G Petersen
- Mechanical and Aerospace Engineering, Jacobs School of Engineering, University of California, San Diego, California.,Department of Radiology, School of Medicine, University of California, San Diego, California
| | - Richard S Whittle
- Department of Aerospace Engineering, Texas A&M University, College Station, Texas
| | - Justin H Lee
- Department of Radiology, School of Medicine, University of California, San Diego, California
| | - Jeremy Sieker
- Department of Radiology, School of Medicine, University of California, San Diego, California
| | - Joseph Carlson
- Department of Aerospace Engineering, Texas A&M University, College Station, Texas
| | - Colton Finke
- Department of Aerospace Engineering, Texas A&M University, College Station, Texas
| | - Cody M Shelton
- Department of Aerospace Engineering, Texas A&M University, College Station, Texas
| | - Johan C G Petersen
- Department of Anesthesiology, UC-Health, University of California, San Diego, California
| | - Ana Diaz-Artiles
- Department of Aerospace Engineering, Texas A&M University, College Station, Texas.,Department of Health and Kinesiology, Texas A&M University, College Station, Texas
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Le T, Hajirawala M, Carlson J. M018 A CASE OF RECURRENT ANAPHYLAXIS DURING METRONIDAZOLE DESENSITIZATION. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hein N, Grieb H, Roddy T, Carlson J. M239 CHALLENGE CONFIRMED ATYPICAL FOOD PROTEIN-INDUCED ENTEROCOLITIS SYNDROME (FPIES) TO AVOCADO IN AN INFANT. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Baturova M, Demidova M, Carlson J, Erlinge D, Platonov P. Clinical risk factors and P wave indices in prediction of atrial fibrillation development during long-term follow-up after acute ST-segment elevation myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0456] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
In patients with high thromboembolic risk detection of atrial fibrillation (AF) is crucial for implementation of proper anticoagulation therapy, which highlights the need for identification of patients at risk for AF. P wave indices reflect atrial structural abnormalities linked to AF development.
Purpose
We aimed to assess the value of clinical risk factors and P wave indices in prediction of incident AF after acute ST-segment elevation myocardial infarction (STEMI) in patients undergoing primary percutaneous intervention (PCI).
Methods
Study sample comprised of 2277 consecutive patients with STEMI admitted to a tertiary care hospital for primary PCI from 2007 to 2010. SWEDEHEART registry was used as the source of information regarding clinical characteristics and events during index admission. Patients without known AF at discharge were included in the current study (n=1837, mean age 65±12 years, 30% females). AF in follow-up (median 9, interquartile range 25–75% (IQR) 7–10 years) was documented by linkage with the Swedish National Patient Register and Swedish Cause-of-Death Register. The closest available ECGs prior to STEMI (median 448, interquartile rate 25–75% 112–1390 days before STEMI) were extracted from the regional electronic ECG databases and automatically processed using Glasgow algorithm. P-wave duration, PR interval, P-wave frontal axis and P terminal force in lead V1 (PTF-V1) were assessed. PTF-V1 >40 mm*ms was considered abnormal.
Results
In follow-up incident AF was documented in 285 patients (15.4%). In univariate Cox regression analysis age, hypertension, history of myocardial infarction, heart failure, history of stroke, smoking status, P wave duration >120 ms, PR interval and abnormal PTF-V1 predicted the AF development during follow-up (Table). In multivariate Cox regression analysis in which significantly associated variables were included only age (hazard ratio (HR) 1.07, 95% CI 1.05–1.08, p<0.001) and abnormal PTF-V1 (HR 1.49, 95% CI 1.08–2.05, p=0.015, Figure) remained independent predictors of incident AF.
Conclusion
In patients with acute STEMI incident AF developed during long-term follow-up after discharge from hospital was strongly associated with age and atrial structural abnormalities reflected as abnormal PTF-V1 on pre-STEMI ECG which might serve as a tool in risk stratification of STEMI patients in regard to AF development.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Scholarship grant from Swedish Institute. Table 1Figure 1
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Affiliation(s)
- M Baturova
- St Petersburg state university, St Petersburg, Russia and Lund University, Lund, Sweden
| | - M.M Demidova
- National Medical and Research Almazov Center, St Petersburg, Russia and Lund University, Lund, Sweden
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - D Erlinge
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - P.G Platonov
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
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Baturova M, Demidova MM, Carlson J, Erlinge D, Platonov PG. ECG markers of atrial abnormalities are not associated with new onset atrial fibrillation in patients with acute ST-segment elevation myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1460] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
New onset AF is a known complication in patients with acute ST-segment elevation myocardial infarction (STEMI). However, whether new-onset AF is linked to atrial structural abnormalities or has different underlying mechanisms is not fully clarified.
Purpose
We aimed to assess the association of P wave indices as ECG markers of atrial structural abnormalities with new-onset AF in STEMI patients undergoing primary percutaneous intervention (PCI).
Methods
Study sample comprised of 2277 consecutive patients with STEMI admitted to a tertiary care hospital for primary PCI from 2007 to 2010. SWEDEHEART registry was used as the source of information regarding clinical characteristics and events during index admission, including new-onset AF. The closest available ECGs prior to STEMI (median 448, interquartile rate 25–75% 112–1390 days before STEMI) were extracted from the regional electronic ECG databases and automatically processed using Glasgow algorithm. Patients with sinus rhythm ECGs were included in the current analysis (n=1481, mean age 68±12 years, 33% females). P-wave duration, PR interval, P-wave frontal axis and P terminal force in lead V1 (PTF-V1) were assessed. PTF-V1 >40 mm*ms was considered abnormal.
Results
Paroxysmal AF prior to STEMI was known in 77 patients (5.2%). Among patients without pre-existing AF (n=1404), new-onset AF during hospital admission was identified in 102 patients (6.9%). Patients with new-onset AF were older than those without AF history (74±9 vs 67±12 years, p<0.001), but did not differ in regard to other clinical characteristics. In univariate logistic regression analysis P wave duration as continuous variable, P wave duration >120 ms and PR interval were significantly associated with new onset AF (Table 1). However, after adjustment for age both, P wave duration >120 ms (odds ratio (OR) 1.20, 95% CI 0.77–1.89, p=0.418) and PR interval (OR 1.01, 95% CI 1.00–1.01, p=0.068), failed to demonstrate the significant association with new onset AF while age (OR 1.06, 95% CI 1.04–1.08, p<0.001) remained an independent risk factor for AF development.
Conclusion
In patients with acute STEMI new onset AF developed during hospital admission is common and strongly associated with age. P wave indices failed to demonstrate the significant association with new onset AF thus indicating that atrial structural abnormalities are unlikely the underlying cause of AF development in acute STEMI.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Scholarship grant from Swedish Institute. Table 1
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Affiliation(s)
- M Baturova
- St Petersburg state university, St Petersburg, Russia and Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - M M Demidova
- National Medical and Research Almazov Center, St Petersburg, Russia and Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - D Erlinge
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - P G Platonov
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
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Ninou AH, Lehto J, Chioureas D, Stigsdotter H, Schelzig K, Åkerlund E, Gudoityte G, Joneborg U, Carlson J, Jonkers J, Seashore-Ludlow B, Gustafsson NMS. PFKFB3 Inhibition Sensitizes DNA Crosslinking Chemotherapies by Suppressing Fanconi Anemia Repair. Cancers (Basel) 2021; 13:cancers13143604. [PMID: 34298817 PMCID: PMC8306909 DOI: 10.3390/cancers13143604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 12/25/2022] Open
Abstract
Simple Summary DNA-damaging chemotherapeutics, such as platinum drugs, are cornerstones in cancer treatment. The efficacy of such treatment is intimately linked to the DNA repair capacity of the cancer cells, as DNA damage above a tolerable threshold culminates in cell death. Cancer cells often have deregulated DNA repair mechanisms, making them initially more sensitive to DNA-damaging chemotherapies. Unfortunately, over time, cancer cells often develop resistance to such treatments by rewiring their DNA damage response pathways. Here, we identify that targeting the recognized anti-cancer target 6-phosphofructo-2-kinase/fructose-2,6,-bisphophatase 3 (PFKFB3), commonly overexpressed in cancer, with the small molecule inhibitor KAN0438757, selectively sensitizes cancer cells to platinum drugs, including treatment-resistant cancer cells, while sparing normal cells. Mechanistically, PFKFB3 promotes tolerance to and the repair of platinum-induced DNA interstrand crosslinks (ICLs) through modulation of the Fanconi anemia (FA) DNA repair pathway. Thus targeting PFKFB3 opens up therapeutic possibilities to improve the efficacy of ICL-inducing cancer treatments. Abstract Replicative repair of interstrand crosslinks (ICL) generated by platinum chemotherapeutics is orchestrated by the Fanconi anemia (FA) repair pathway to ensure resolution of stalled replication forks and the maintenance of genomic integrity. Here, we identify novel regulation of FA repair by the cancer-associated glycolytic enzyme PFKFB3 that has functional consequences for replication-associated ICL repair and cancer cell survival. Inhibition of PFKFB3 displays a cancer-specific synergy with platinum compounds in blocking cell viability and restores sensitivity in treatment-resistant models. Notably, the synergies are associated with DNA-damage-induced chromatin association of PFKFB3 upon cancer transformation, which further increases upon platinum resistance. FA pathway activation triggers the PFKFB3 assembly into nuclear foci in an ATR- and FANCM-dependent manner. Blocking PFKFB3 activity disrupts the assembly of key FA repair factors and consequently prevents fork restart. This results in an incapacity to replicate cells to progress through S-phase, an accumulation of DNA damage in replicating cells, and fork collapse. We further validate PFKFB3-dependent regulation of FA repair in ex vivo cultures from cancer patients. Collectively, targeting PFKFB3 opens up therapeutic possibilities to improve the efficacy of ICL-inducing cancer treatments.
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Affiliation(s)
- Anna Huguet Ninou
- Science for Life Laboratory, Department of Oncology and Pathology, Karolinska Institutet, 171 21 Stockholm, Sweden; (A.H.N.); (J.L.); (D.C.); (H.S.); (K.S.); (E.Å.); (G.G.); (B.S.-L.)
- Kancera AB, Karolinska Science Park, 171 48 Solna, Sweden
| | - Jemina Lehto
- Science for Life Laboratory, Department of Oncology and Pathology, Karolinska Institutet, 171 21 Stockholm, Sweden; (A.H.N.); (J.L.); (D.C.); (H.S.); (K.S.); (E.Å.); (G.G.); (B.S.-L.)
- Kancera AB, Karolinska Science Park, 171 48 Solna, Sweden
| | - Dimitrios Chioureas
- Science for Life Laboratory, Department of Oncology and Pathology, Karolinska Institutet, 171 21 Stockholm, Sweden; (A.H.N.); (J.L.); (D.C.); (H.S.); (K.S.); (E.Å.); (G.G.); (B.S.-L.)
| | - Hannah Stigsdotter
- Science for Life Laboratory, Department of Oncology and Pathology, Karolinska Institutet, 171 21 Stockholm, Sweden; (A.H.N.); (J.L.); (D.C.); (H.S.); (K.S.); (E.Å.); (G.G.); (B.S.-L.)
| | - Korbinian Schelzig
- Science for Life Laboratory, Department of Oncology and Pathology, Karolinska Institutet, 171 21 Stockholm, Sweden; (A.H.N.); (J.L.); (D.C.); (H.S.); (K.S.); (E.Å.); (G.G.); (B.S.-L.)
| | - Emma Åkerlund
- Science for Life Laboratory, Department of Oncology and Pathology, Karolinska Institutet, 171 21 Stockholm, Sweden; (A.H.N.); (J.L.); (D.C.); (H.S.); (K.S.); (E.Å.); (G.G.); (B.S.-L.)
| | - Greta Gudoityte
- Science for Life Laboratory, Department of Oncology and Pathology, Karolinska Institutet, 171 21 Stockholm, Sweden; (A.H.N.); (J.L.); (D.C.); (H.S.); (K.S.); (E.Å.); (G.G.); (B.S.-L.)
| | - Ulrika Joneborg
- Department of Women’s and Children’s Health, Karolinska Institutet, 171 21 Stockholm, Sweden;
| | - Joseph Carlson
- Department of Oncology and Pathology, Karolinska Institutet, 171 76 Stockholm, Sweden;
- Department of Pathology and Laboratory Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Jos Jonkers
- Oncode Institute and Division of Molecular Pathology, The Netherlands Cancer Institute, 1066CX Amsterdam, The Netherlands;
| | - Brinton Seashore-Ludlow
- Science for Life Laboratory, Department of Oncology and Pathology, Karolinska Institutet, 171 21 Stockholm, Sweden; (A.H.N.); (J.L.); (D.C.); (H.S.); (K.S.); (E.Å.); (G.G.); (B.S.-L.)
| | - Nina Marie Susanne Gustafsson
- Science for Life Laboratory, Department of Oncology and Pathology, Karolinska Institutet, 171 21 Stockholm, Sweden; (A.H.N.); (J.L.); (D.C.); (H.S.); (K.S.); (E.Å.); (G.G.); (B.S.-L.)
- Correspondence:
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24
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Lovell JT, Bentley NB, Bhattarai G, Jenkins JW, Sreedasyam A, Alarcon Y, Bock C, Boston LB, Carlson J, Cervantes K, Clermont K, Duke S, Krom N, Kubenka K, Mamidi S, Mattison CP, Monteros MJ, Pisani C, Plott C, Rajasekar S, Rhein HS, Rohla C, Song M, Hilaire RS, Shu S, Wells L, Webber J, Heerema RJ, Klein PE, Conner P, Wang X, Grauke LJ, Grimwood J, Schmutz J, Randall JJ. Four chromosome scale genomes and a pan-genome annotation to accelerate pecan tree breeding. Nat Commun 2021; 12:4125. [PMID: 34226565 PMCID: PMC8257795 DOI: 10.1038/s41467-021-24328-w] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/07/2021] [Indexed: 02/06/2023] Open
Abstract
Genome-enabled biotechnologies have the potential to accelerate breeding efforts in long-lived perennial crop species. Despite the transformative potential of molecular tools in pecan and other outcrossing tree species, highly heterozygous genomes, significant presence-absence gene content variation, and histories of interspecific hybridization have constrained breeding efforts. To overcome these challenges, here, we present diploid genome assemblies and annotations of four outbred pecan genotypes, including a PacBio HiFi chromosome-scale assembly of both haplotypes of the 'Pawnee' cultivar. Comparative analysis and pan-genome integration reveal substantial and likely adaptive interspecific genomic introgressions, including an over-retained haplotype introgressed from bitternut hickory into pecan breeding pedigrees. Further, by leveraging our pan-genome presence-absence and functional annotation database among genomes and within the two outbred haplotypes of the 'Lakota' genome, we identify candidate genes for pest and pathogen resistance. Combined, these analyses and resources highlight significant progress towards functional and quantitative genomics in highly diverse and outbred crops.
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Affiliation(s)
- John T. Lovell
- grid.417691.c0000 0004 0408 3720Genome Sequencing Center, HudsonAlpha Institute for Biotechnology, Huntsville, AL USA
| | - Nolan B. Bentley
- grid.264756.40000 0004 4687 2082Department of Horticultural Science, Texas A&M University, College Station, TX USA
| | - Gaurab Bhattarai
- grid.213876.90000 0004 1936 738XInstitute of Plant Breeding, Genetics & Genomics, University of Georgia, Athens, GA USA
| | - Jerry W. Jenkins
- grid.417691.c0000 0004 0408 3720Genome Sequencing Center, HudsonAlpha Institute for Biotechnology, Huntsville, AL USA
| | - Avinash Sreedasyam
- grid.417691.c0000 0004 0408 3720Genome Sequencing Center, HudsonAlpha Institute for Biotechnology, Huntsville, AL USA
| | - Yanina Alarcon
- grid.419447.b0000 0004 0370 5663Noble Research Institute, Ardmore, OK USA
| | - Clive Bock
- USDA Southeastern Fruit and Tree Nut Research Laboratory, Byron, GA USA
| | - Lori Beth Boston
- grid.417691.c0000 0004 0408 3720Genome Sequencing Center, HudsonAlpha Institute for Biotechnology, Huntsville, AL USA
| | - Joseph Carlson
- grid.451309.a0000 0004 0449 479XDOE Joint Genome Institute, Berkeley, CA USA
| | - Kimberly Cervantes
- grid.24805.3b0000 0001 0687 2182Department of Entomology, Plant Pathology and Weed Science, New Mexico State University, Las Cruces, NM USA
| | - Kristen Clermont
- grid.507314.4USDA-ARS Food Processing and Sensory Quality Research, New Orleans, LA USA
| | - Sara Duke
- USDA-ARS Plains Area Administrative Office, College Station, TX USA
| | - Nick Krom
- grid.419447.b0000 0004 0370 5663Noble Research Institute, Ardmore, OK USA
| | - Keith Kubenka
- USDA Pecan Breeding and Genetics, College Station, TX USA
| | - Sujan Mamidi
- grid.417691.c0000 0004 0408 3720Genome Sequencing Center, HudsonAlpha Institute for Biotechnology, Huntsville, AL USA
| | | | - Maria J. Monteros
- grid.419447.b0000 0004 0370 5663Noble Research Institute, Ardmore, OK USA
| | - Cristina Pisani
- USDA Southeastern Fruit and Tree Nut Research Laboratory, Byron, GA USA
| | - Christopher Plott
- grid.417691.c0000 0004 0408 3720Genome Sequencing Center, HudsonAlpha Institute for Biotechnology, Huntsville, AL USA
| | - Shanmugam Rajasekar
- grid.134563.60000 0001 2168 186XArizona Genomics Institute, University of Arizona, Tucson, AZ USA
| | - Hormat Shadgou Rhein
- grid.24805.3b0000 0001 0687 2182Department of Entomology, Plant Pathology and Weed Science, New Mexico State University, Las Cruces, NM USA
| | - Charles Rohla
- grid.419447.b0000 0004 0370 5663Noble Research Institute, Ardmore, OK USA
| | - Mingzhou Song
- grid.24805.3b0000 0001 0687 2182Department of Computer Science, New Mexico State University, Las Cruces, NM USA
| | - Rolston St. Hilaire
- grid.24805.3b0000 0001 0687 2182Plant and Environmental Sciences, New Mexico State University, Las Cruces, NM USA
| | - Shengqiang Shu
- grid.451309.a0000 0004 0449 479XDOE Joint Genome Institute, Berkeley, CA USA
| | - Lenny Wells
- grid.213876.90000 0004 1936 738XDepartment of Horticulture, University of Georgia-Tifton Campus, Tifton, GA USA
| | - Jenell Webber
- grid.417691.c0000 0004 0408 3720Genome Sequencing Center, HudsonAlpha Institute for Biotechnology, Huntsville, AL USA
| | - Richard J. Heerema
- grid.24805.3b0000 0001 0687 2182Department of Computer Science, New Mexico State University, Las Cruces, NM USA
| | - Patricia E. Klein
- grid.264756.40000 0004 4687 2082Department of Horticultural Science, Texas A&M University, College Station, TX USA
| | - Patrick Conner
- grid.213876.90000 0004 1936 738XDepartment of Horticulture, University of Georgia-Tifton Campus, Tifton, GA USA
| | - Xinwang Wang
- USDA Pecan Breeding and Genetics, College Station, TX USA
| | - L. J. Grauke
- USDA Pecan Breeding and Genetics, College Station, TX USA
| | - Jane Grimwood
- grid.417691.c0000 0004 0408 3720Genome Sequencing Center, HudsonAlpha Institute for Biotechnology, Huntsville, AL USA
| | - Jeremy Schmutz
- grid.417691.c0000 0004 0408 3720Genome Sequencing Center, HudsonAlpha Institute for Biotechnology, Huntsville, AL USA ,grid.451309.a0000 0004 0449 479XDOE Joint Genome Institute, Berkeley, CA USA
| | - Jennifer J. Randall
- grid.24805.3b0000 0001 0687 2182Department of Entomology, Plant Pathology and Weed Science, New Mexico State University, Las Cruces, NM USA
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25
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Vermij L, Singh N, Leon-Castillo A, Horeweg N, Oosting J, Carlson J, Smit V, Gilks B, Bosse T. Performance of a HER2 testing algorithm specific for p53-abnormal endometrial cancer. Histopathology 2021; 79:533-543. [PMID: 33835523 PMCID: PMC8518500 DOI: 10.1111/his.14381] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/30/2021] [Accepted: 04/07/2021] [Indexed: 11/28/2022]
Abstract
Aims Human epidermal growth factor receptor 2 (HER2) amplification in endometrial cancer (EC) is almost completely confined to the p53‐abnormal (p53abn) molecular subtype and independent of histological subtype. HER2 testing should therefore be molecular subtype‐directed. However, the most optimal approach for HER2 testing in EC has not been fully established. Therefore, we developed an EC‐specific HER2 immunohistochemistry (IHC) scoring method and evaluated its reproducibility and performance to establish an optimal diagnostic HER2 testing algorithm for p53abn EC. Methods and results HER2 IHC slides of 78 p53abn EC were scored by six gynaecopathologists according to predefined EC‐specific IHC scoring criteria. Interobserver agreement was calculated using Fleiss’ kappa and the first‐order agreement coefficient (AC1). The consensus IHC score was compared with HER2 dual in‐situ hybridisation (DISH) results. Sensitivity and specificity were calculated. A substantial interobserver agreement was found using three‐ or two‐tiered scoring [κ = 0.675, 95% confidence interval (CI) = 0.633–0.717; AC1 = 0.723, 95% CI = 0.643–0.804 and κ = 0.771, 95% CI = 0.714–0.828; AC1 = 0.774, 95% CI = 0.684–0.865, respectively]. Sensitivity and specificity for the identification of HER2‐positive EC was 100 and 97%, respectively, using a HER2 testing algorithm that recommends DISH in all cases with moderate membranous staining in >10% of the tumour (IHC+). Performing DISH on all IHC‐2+ and ‐3+ cases yields a sensitivity and specificity of 100%. Conclusions Our EC‐specific HER2 IHC scoring method is reproducible. A screening strategy based on IHC scoring on all cases with subsequent DISH testing on IHC‐2+/‐3+ cases has perfect test accuracy for identifying HER2‐positive EC.
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Affiliation(s)
- Lisa Vermij
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Naveena Singh
- Department of Pathology, Barts Health NHS Trust, London, UK
| | - Alicia Leon-Castillo
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Nanda Horeweg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jan Oosting
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Joseph Carlson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Vincent Smit
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Tjalling Bosse
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
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27
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Van Steenkiste G, Carlson J, Decloedt A, Vera L, Buhl R, Platonov PG, van Loon G. Relationship between atrial fibrillatory rate based on analysis of a modified base-apex surface electrocardiogram analysis and the results of transvenous electrical cardioversion in horses with spontaneous atrial fibrillation. J Vet Cardiol 2021; 34:73-79. [PMID: 33611234 DOI: 10.1016/j.jvc.2021.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 12/31/2020] [Accepted: 01/05/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To compare the atrial fibrillatory rate (AFR) derived from a local right atrial intracardiac recording (RA-FR) and from a single-lead surface electrocardiogram (ECG) during atrial fibrillation (AF) and to evaluate the correlation with transvenous electrical cardioversion (TVEC) threshold (in Joules), number of shocks and cardioversion success rate in horses. ANIMALS ECGs and clinical records of horses with AF treated by TVEC. Horses were included if a simultaneous recording of the right atrial intracardiac electrogram and a modified base-apex ECG were available. MATERIALS AND METHODS Clinical records of horses with AF treated by TVEC were reviewed. Three-minute long episodes of simultaneous electrograms and surface ECG during AF were selected for analysis and compared using Bland-Altman analysis. The mean RA-FR was measured from the deflections on the intracardiac electrogram, while the AFR was extracted from the surface ECG using spatiotemporal QRS and T-wave cancellation. RESULTS Seventy-three horses satisfied the inclusion criteria. The mean difference between RA-FR and AFR was -13 fibrillations per minute (fpm), the 95% limits of agreement were between -66 and 40 fpm, and there was a moderate (ρ = 0.65) correlation between RA-FR and AFR (p < 0.001). Neither RA-FR nor AFR appeared to influence the TVEC cardioversion threshold or the number of TVEC shocks applied. CONCLUSIONS The AFR may allow non-invasive long-term monitoring of AF dynamics. Neither RA-FR nor AFR could be used to predict the minimal defibrillation threshold for TVEC.
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Affiliation(s)
- G Van Steenkiste
- Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
| | - J Carlson
- Department of Cardiology, Lund University, 21185 Lund, Sweden
| | - A Decloedt
- Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - L Vera
- Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - R Buhl
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Højbakkegaard Allé 5, 2630 Taastrup, Denmark
| | - P G Platonov
- Arrhythmia Clinic, Skåne University Hospital and Department of Cardiology, Clinical Sciences, Lund University, 21185 Lund, Sweden
| | - G van Loon
- Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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28
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Svensson A, Carlson J, Sherina V, Bundgaard H, Svendsen J, Platonov P. Progressive ECG changes over time in arrhythmogenic right ventricular cardiomyopathy precede diagnosis and continue – indices of disease substrate development? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2106] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Depolarization and repolarization abnormalities are common in arrhythmogenic right ventricular cardiomyopathy (ARVC), and are included in the diagnostic 2010 Task Force criteria (TFC2010). However, first ARVC symptoms commonly occur before ECG abnormalities reach the diagnostic thresholds and the time course of ECG abnormalities during initial phase of the disease remains obscure. Regional digital ECG archives allow computerized signal-processing and assessment of ECG phenotype during different disease phases, including the time prior to ascertainment of ARVC diagnosis.
Purpose
We aimed to assess the natural course of ECG characteristics associated with ARVC, hypothesizing that ARVC is a progressive disease and that ECG parameters progress over time due to disease substrate development.
Methods
Definite ARVC patients with at least one digital ECG recruited in three tertiary care hospitals in Sweden and Denmark were included (n=102, 66% males, 68% probands, 52% carrying a pathogenic genetic variant, 74% ICD carriers and 25% physically active >4 hours/week). Median age at diagnosis was 41 years (IQR 30–55). 12-lead digital ECGs were extracted from the regional ECG archives, containing all recordings in the hospital catchment areas since 1988. After excluding ECGs with heart rate <40 or >100/min, left bundle branch block or ventricular pacing, and those recorded prior to 14 years of age, the remaining 2067 ECGs were digitally processed and automatically analyzed using the Glasgow algorithm (median 3 [IQR 0–9] ECGs prior to diagnosis and 6 [IQR 2–14] ECGs during follow-up). Overall QRS duration as well as the right precordial lead indices exemplified by the lead V2 (terminal activation delay [TAD], area under the T-wave [T-wave area] and R-prime amplitude) were calculated and graphically represented using generalized additive model (GAM) with cubic splines (Figure 1). A median value for each measurement per patient per year was used for analysis. Blue line indicates smoothed conditional mean with 95% confidence interval (shadow). Time “0” (red line) indicates the time when TFC2010 criteria were fulfilled.
Results
Marked and consistent changes are seen in all studied depolarization and repolarization parameters over 10 years preceding ARVC diagnosis and continue afterwards. TAD demonstrates gradual increase, while T-wave area demonstrates consistent decrease over time before and after diagnosis indicating amplitude reduction and transition to T-wave inversion. The R-prime curve indicates that the terminal part of QRS complex demonstrate abnormalities first late in the course of the disease (Figure 1).
Conclusion
Electrocardiographic ARVC phenotype appears to become detectable long before the time of ARVC diagnosis indicating the progressive nature of ARVC and may explain arrhythmic events that may occur during the subclinical phase before ECG criteria are fulfilled.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Svensson
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - J Carlson
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden
| | - V Sherina
- Research Statistics, Biostatistics, GSK, Upper Providence, PA, United States of America
| | - H Bundgaard
- Unit for Inherited Cardiac Diseases, the Heart Center, National University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - J.H Svendsen
- Department of Cardiology, Rigshospitalet, University of Copenhagen and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - P.G Platonov
- Department of Cardiology, Clinical Sciences, Lund University, Arrhythmia Clinic, Skane University Hospital, Lund, Sweden
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Baturova M, Demidova M, Carlson J, Erlinge D, Platonov P. Impact of new onset atrial fibrillation on long-term prognosis in patients with acute ST-segment elevation myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0493] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
New onset AF is a known complication in patients with acute ST-segment elevation myocardial infarction (STEMI). However, whether new-onset AF affects the long-term prognosis to the same extent as pre-existing AF is not fully clarified and prescription of oral anticoagulants (OAC) in patients with new-onset AF remains a matter of debates.
Purpose
We aimed to assess the impact of new-onset AF in STEMI patients undergoing primary percutaneous intervention (PCI) on outcome during long-term follow-up in comparison with pre-existing AF and to evaluate effect of OAC therapy in patients with new-onset AF on survival.
Methods
Study sample comprised of 2277 consecutive patients with STEMI admitted to a tertiary care hospital for primary PCI from 2007 to 2010 (age 66±12 years, 70% male). AF prior to STEMI was documented by record linkage with the Swedish National Patient Register and review of ECGs obtained from the digital archive containing ECGs recorded in the hospital catchment area since 1988. SWEDEHEART registry was used as the source of information regarding clinical characteristics and events during index admission, including new-onset AF and OAC at discharge. All-cause mortality was assessed using the Swedish Cause-of-Death Register 8 years after discharge.
Results
AF prior to STEMI was documented in 177 patients (8%). Among patients without pre-existing AF (n=2100), new-onset AF was identified in 151 patients (7%). Patients with new-onset AF were older than those without AF history (74±9 vs 65±12 years, p<0.001), but did not differ in regard to other clinical characteristics. Among 2149 STEMI survivors discharged alive, 523 (24%) died during 8 years of follow-up. OAC was prescribed at discharge in 45 (32%) patients with new onset AF and in 49 (31%) patients with pre-existing AF, p=0.901. In a univariate analysis, both new-onset AF (HR 2.18, 95% CI 1.70–2.81, p<0.001) and pre-existing AF (HR 2.80, 95% CI 2.25–3.48, p<0.001) were associated with all-cause mortality, Figure 1. After adjustment for age, gender, cardiac failure, diabetes, BMI and smoking history, new-onset AF remained an independent predictor of all-cause mortality (HR 1.40, 95% CI 1.02–1.92, p=0.037). OAC prescribed at discharge in patients with new-onset AF was not significantly associated with survival (univariate HR 0.86, 95% CI 0.50–1.50, p=0.599).
Conclusion
New-onset AF developed during hospital admission with STEMI is common and independently predicts all-cause mortality during long-term follow-up after STEMI with risk estimates similar to pre-existing AF. The effect of OAC on survival in patients with new-onset AF is inconclusive as only one third of them received OAC therapy at discharge.
Kaplan-Meier survival curve
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M.A Baturova
- Saint-Petersburg state university, Saint Petersburg, Russian Federation
| | - M.M Demidova
- National Medical and Research Almazov Centre, Saint Petersburg, Russian Federation
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - D Erlinge
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - P.G Platonov
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
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30
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Jacobsson J, Carlson J, Reitan C, Borgquist R, Platonov P. Interatrial Block Predicts Atrial Fibrillation and Total Mortality in Patients with Cardiac Resynchronization Therapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1088] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Interatrial block (IAB) and abnormal P-wave terminal force in lead V1 (PTFV1) are electrocardiographic (ECG) abnormalities associated with new-onset atrial fibrillation (AF) and death. However, their prognostic importance has not been proven in CRT recipients with advanced heart failure (HF).
Purpose
To assess if IAB and abnormal PTFV1 are associated with new-onset AF or death in CRT recipients.
Methods
CRT recipients without AF history before CRT implantation were included (n=210, median age 67 years, 80% male, 55% ischemic heart disease, 70% NYHA Class III/IV, median LVEF 25%, 51% CRT-P). Automated analysis of P-wave duration (PWD) and morphology classified patients as having either No IAB (PWD <120ms), Partial IAB (pIAB: PWD ≥120 ms, positive P waves in leads II and aVF) or Advanced IAB (aIAB: PWD ≥120 ms and biphasic or negative P wave in leads II or aVF). PTFV1 >0.04 mm·s was considered abnormal. Cox regression analyses adjusted for age, NYHA Class, ischemic etiology of HF, LBBB, LVEF and CRT-P vs. CRT-D were performed to assess the impact of IAB and abnormal PTFV1 on the primary endpoint new-onset AF, death or heart transplant (HTx) and the secondary endpoint death or HTx at 5 years of follow up.
Results
IAB was found in 45% (34% pIAB and 11% aIAB) and was associated with both the primary (HR 1.9, 95% CI 1.2–2.9, p=0.004) and the secondary (HR 2.1, 95% CI 1.2–3.4, p=0.006) endpoints. Abnormal PTFV1 was not associated with outcome. See Forest plot for adjusted HRs for individual P-wave indices.
Conclusions
IAB is associated with new-onset AF and death in CRT recipients and may be helpful in risk stratification in the context of HF management. Abnormal PTFV1 did not demonstrate any prognostic value in the setting of CRT-treated patients with advanced HF.
Forest plot
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Swedish Heart and Lung Foundation
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Affiliation(s)
- J Jacobsson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - C Reitan
- Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm, Sweden
| | - R Borgquist
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - P.G Platonov
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
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Demidova M, Ulfarsson A, Carlson J, Erlinge D, Platonov P. Early monomorphic ventricular tachycardia is associated with increased long-term mortality in STEMI. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1783] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Malignant ventricular arrhythmias occurring early during ST-elevation myocardial infarction (STEMI) are known to markedly contribute to increased in-hospital mortality, but not to influence the long-term prognosis. However recent data advocate differential approach to the type of arrhythmia and indicate long-term hazard of monomorphic ventricular tachycardia (VT).
Purpose
We aimed to evaluate the prognostic value of monomorphic VT compared to non-monomorphic VT or ventricular fibrillation (VF) during the first 48 hours of STEMI in non-selected cohort of STEMI patients admitted for primary PCI.
Methods
Consecutive STEMI patients admitted to a tertiary care hospital for primary PCI during 2007–2010 were included. The Swedish national SWEDEHEART registry was used for assessment of clinical characteristics and the presence of VT/VF during index admission. The occurrence and type of VT/VF during the first 48 hours from symptom onset were verified in medical records. Information on all-cause mortality endpoint 8 years after STEMI was obtained from the Swedish Cause of Death Register.
Results
In total, 2277 patients were included (age 66±12 years, 70% male). Early monomorphic VT during index STEMI was documented in 35 (1.5%) and non-monomorphic VT or VF – in 115 (5.1%) patients. Patients with monomorphic VT had similar clinical characteristics compared to those with non-monomorphic VT/VF with a trend of higher prevalence of history of myocardial infarction by index admission among those with monomorphic VT (31% vs 21%, p=0.256). In total, 22 (63%) patients with monomorphic VT and 43 (37%) with non-monomorphic VT/VF died by 8 years of follow up (p=0.011). Monomorphic VT was associated with a higher risk of all-cause mortality compared to non-monomorphic VT/VF in a univariate analysis (HR 2.03, 95% CI 1.21–3.39, p=0.007) and after adjustment for age and history of myocardial infarction (HR 1.74, 95% CI 1.02–2.97, p=0.041) (Figure).
Conclusion
Monomorphic VT during the first 48 hours of STEMI is associated with a higher risk of all-cause mortality compared to non-monomorphic VT/VF and deserves further studies in order to refine risk stratification strategies.
Survival after STEMI by VT/VF <48 hours
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): The Swedish Heart-Lung Foundation
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Affiliation(s)
- M Demidova
- Lund University, Lund, Sweden and National Medical Research Centre, Saint Petersburg, Russian Federation
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Grieb A, Carlson J. M170 A POSTPARTUM PUZZLE OF RECURRENT URTICARIA. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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33
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Yang C, Zhang Y, Chen Y, Ragaller F, Liu M, Corvigno S, Dahlstrand H, Carlson J, Chen Z, Näsman A, Waraky A, Lin Y, Larsson O, Haglund F. Nuclear IGF1R interact with PCNA to preserve DNA replication after DNA-damage in a variety of human cancers. PLoS One 2020; 15:e0236291. [PMID: 32701997 PMCID: PMC7377393 DOI: 10.1371/journal.pone.0236291] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/01/2020] [Indexed: 12/18/2022] Open
Abstract
Nuclear IGF1R has been linked to poor outcome in cancer. We recently showed that nuclear IGF1R phosphorylates PCNA and increases DNA damage tolerance. In this paper we aimed to describe this mechanism in cancer tissue as well as in cancer cell lines. In situ proximity ligation assay identified frequent IGF1R and PCNA colocalization in many cancer types. IGF1R/PCNA colocalization was more frequently increased in tumor cells than in adjacent normal, and more prominent in areas with dysplasia and invasion. However, the interaction was often lost in tumors with poor response to neoadjuvant treatment and most metastatic lesions. In two independent cohorts of serous ovarian carcinomas and oropharyngeal squamous cell carcinomas, stronger IGF1R/PCNA colocalization was significantly associated with a higher overall survival. Ex vivo irradiation of ovarian cancer tissue acutely induced IGF1R/PCNA colocalization together with γH2AX-foci formations. In vitro, RAD18 mediated mono-ubiquitination of PCNA during replication stress was dependent on IGF1R kinase activity. DNA fiber analysis revealed that IGF1R activation could rescue stalled DNA replication forks, but only in cancer cells with baseline IGF1R/PCNA interaction. We believe that the IGF1R/PCNA interaction is a basic cellular mechanism to increase DNA stress tolerance during proliferation, but that this mechanism is lost with tumor progression in conjunction with accumulated DNA damage and aberrant strategies to tolerate genomic instability. To exploit this mechanism in IGF1R targeted therapy, IGF1R inhibitors should be explored in the context of concomitant induction of DNA replication stress as well as in earlier clinical stages than previously tried.
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Affiliation(s)
- Chen Yang
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of General Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Precise Diagnosis and Treatment of Gastrointestinal Tumor, Changsha, Hunan, China
| | - Yifan Zhang
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Yi Chen
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Franziska Ragaller
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
- Heidelberg University and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Mingzhi Liu
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Sara Corvigno
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Hanna Dahlstrand
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Joseph Carlson
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Zihua Chen
- Department of General Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Precise Diagnosis and Treatment of Gastrointestinal Tumor, Changsha, Hunan, China
| | - Anders Näsman
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Ahmed Waraky
- Department of Laboratory Medicine, Gothenburg University, Gothenburg, Sweden
| | - Yingbo Lin
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Olle Larsson
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Felix Haglund
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
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34
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Brown C, Kaji A, Fantegrossi A, Carlson J, April M, Kilgo R, Walls R. Video versus augmented direct laryngoscopy in adult emergency department intubations. Br J Anaesth 2020. [DOI: 10.1016/j.bja.2020.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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35
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Dawkins WG, Carlson J, van Kolck U, Gezerlis A. Clustering of Four-Component Unitary Fermions. Phys Rev Lett 2020; 124:143402. [PMID: 32338952 DOI: 10.1103/physrevlett.124.143402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 03/13/2020] [Indexed: 06/11/2023]
Abstract
Ab initio nuclear physics tackles the problem of strongly interacting four-component fermions. The same setting could foreseeably be probed experimentally in ultracold atomic systems, where two- and three-component experiments have led to major breakthroughs in recent years. Both due to the problem's inherent interest and as a pathway to nuclear physics, in this Letter we study four-component fermions at unitarity via the use of quantum Monte Carlo methods. We explore novel forms of the trial wave function and find one which leads to a ground state of the eight-particle system whose energy is almost equal to that of two four-particle systems. We investigate the clustering properties involved and also extrapolate to the zero-range limit. In addition to being experimentally testable, our results impact the prospects of developing nuclear physics as a perturbation around the unitary limit.
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Affiliation(s)
- William G Dawkins
- Department of Physics, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - J Carlson
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - U van Kolck
- Institut de Physique Nucléaire, CNRS-IN2P3, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay, France
- Department of Physics, University of Arizona, Tucson, Arizona 85721, USA
| | - Alexandros Gezerlis
- Department of Physics, University of Guelph, Guelph, Ontario N1G 2W1, Canada
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36
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Cruz A, Carlson J. M358 SUCCESSFUL OFF-LABEL USE OF OMALIZUMAB IN THE TREATMENT OF A PATIENT WITH SYSTEMIC MASTOCYTOSIS. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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37
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Stålberg K, Bjurberg M, Borgfeldt C, Carlson J, Dahm-Kähler P, Flöter-Rådestad A, Hellman K, Hjerpe E, Holmberg E, Kjølhede P, Marcickiewicz J, Rosenberg P, Tholander B, Åvall-Lundqvist E, Högberg T. Lymphovascular space invasion as a predictive factor for lymph node metastases and survival in endometrioid endometrial cancer - a Swedish Gynecologic Cancer Group (SweGCG) study. Acta Oncol 2019; 58:1628-1633. [PMID: 31373248 DOI: 10.1080/0284186x.2019.1643036] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: The aim of this study is to evaluate the impact of lymphovascular space invasion (LVSI) on the risk of lymph node metastases and survival in endometrioid endometrial adenocarcinoma.Material and methods: As regard the study design, this is a cohort study based on prospectively recorded data. Patients with endometrioid endometrial adenocarcinoma registered in the Swedish Quality Registry for Gynecologic Cancer 2010-2017 with FIGO stages I-III and verified nodal status were identified (n = 1587). LVSI together with established risk factors, namely DNA ploidy, FIGO grade, myometrial invasion and age, were included in multivariable regression analyses with lymph node metastases as the dependent variable. Associations between the risk factors and overall and relative survival were included in multivariable models. Estimates of risk ratios (RR), hazard ratios (HR), excess mortality rate ratios (EMR), and 95% confidence intervals (95% CI) were calculated.Results: The presence of LVSI presented the strongest association with lymph node metastases (RR = 5.46, CI 3.69-8.07, p < .001) followed by deep myometrial invasion (RR = 1.64, CI 1.13-2.37). In the multivariable survival analyses, LVSI (EMR = 7.69, CI 2.03-29.10,) and non-diploidy (EMR = 3.23, CI 1.25-8.41) were associated with decreased relative survival. In sub-analyses including only patients with complete para-aortic and pelvic lymphadenectomy and negative lymph nodes (n = 404), only LVSI (HR = 2.50, CI 1.05-5.98) was associated with a worsened overall survival.Conclusion: This large nationwide study identified LVSI as the strongest independent risk factor for lymph node metastases and decreased survival in patients with endometrioid adenocarcinomas. Moreover, decreased overall survival was also seen in patients with LVSI-positive tumors and negative lymph nodes, indicating that hematogenous dissemination might also be important.
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Affiliation(s)
- Karin Stålberg
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Maria Bjurberg
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital Lund, Lund, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Christer Borgfeldt
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Obstetrics and Gynecology, Skåne University Hospital, Lund, Sweden
| | - Joseph Carlson
- Department of Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Pernilla Dahm-Kähler
- Department of Obstetrics and Gynecology, Sahlgrenska Academy at Göteborg University, Sahgrenska University Hospital, Göteborg, Sweden
| | | | - Kristina Hellman
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology and Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Elisabet Hjerpe
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology and Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Erik Holmberg
- Department of Oncology, Sahlgrenska Academy, Institute of Clinical Sciences, Goteborg, Sweden
- Sahlgrenska University Hospital, Regionalt Cancercentrum Väst, Goteborg, Sweden
| | - Preben Kjølhede
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden
- Department of Clinical and Experimental Medicine, Linköping University, Linkoping, Sweden
| | - Janusz Marcickiewicz
- Regionalt cancercentrum vast, Goteborg, Sweden
- Department of Obstetrics and Gynecology, Hallands Hospital Varberg, Varberg, Sweden
| | - Per Rosenberg
- Department of Clinical and Experimental Medicine, Linköping University, Linkoping, Sweden
- Department of Clinical Oncology, Linköping University, Linkoping, Sweden
| | - Bengt Tholander
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Elisabeth Åvall-Lundqvist
- Department of Clinical and Experimental Medicine, Linköping University, Linkoping, Sweden
- Department of Clinical Oncology, Linköping University, Linkoping, Sweden
| | - Thomas Högberg
- Department of Cancer Epidemiology, Lund University, Lund, Sweden
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Marklund A, Sjövall A, Blomqvist L, Carlson J, Rodriguez-Wallberg KA. Endometriosis, the great imitator - a successful case of fertility preservation in a woman receiving sterilizing treatment due to a diagnosis of rectosigmoid carcinoma. Gynecol Endocrinol 2019; 35:945-948. [PMID: 31248302 DOI: 10.1080/09513590.2019.1633298] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Bowels are the most common site of extrapelvic endometriosis. Still, colonic endometriosis often presents a diagnostic challenge, mimicking a broad spectrum of diseases including primary colonic malignancy. For women of fertile age, the consequences of endometriosis being misdiagnosed as colorectal cancer may include loss of fertility. We hereby present a case of endometriosis mimicking rectosigmoid adenocarcinoma in a young woman, where fertility preservation prior to the start of antineoplastic treatments turned out to be of crucial importance for the woman's future attempts to achieve a pregnancy and livebirth.
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Affiliation(s)
- Anna Marklund
- Department of Oncology-Pathology, Karolinska Institutet , Stockholm , Sweden
- Department of Obstetrics and Gynecology, Södersjukhuset , Stockholm , Sweden
| | - Annika Sjövall
- Centre of Digestive Diseases, Karolinska University Hospital , Stockholm , Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm , Sweden
| | - Lennart Blomqvist
- Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm , Sweden
- Department of Imaging and Physiology, Karolinska University Hospital , Stockholm , Sweden
| | - Joseph Carlson
- Department of Oncology-Pathology, Karolinska Institutet , Stockholm , Sweden
- Department of Clinical Pathology, Karolinska University Hospital , Stockholm , Sweden
| | - Kenny A Rodriguez-Wallberg
- Department of Oncology-Pathology, Karolinska Institutet , Stockholm , Sweden
- Department of Reproductive Medicine, Division of Gynecology and Reproduction, Karolinska University Hospital , Stockholm , Sweden
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39
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Jacobsson JKD, Reitan C, Borgquist R, Carlson J, Platonov PP. P5683Incremental hazard associated with the degree of advanced intaratrial block in cardiac resynchronization therapy treated heart failure patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Advanced Inter Atrial Block (aIAB) reflects a disruption of the electrical signal between the atria and develops gradually. It has been predictive of atrial fibrillation and death in patients with Cardiac Resynchronization Therapy (CRT). A higher number of inferior ECG leads demonstrating biphasic P waves was proposed as a measure of aIAB severity, however its prognostic importance has not been proven.
Purpose
To assess if aIAB is associated with poor prognosis in CRT recipients and to see if there is a dose-response relationship between the aIAB severity and the outcome.
Methods
CRT recipients with sinus rhythm on digitally stored preoperative ECG were included (n=565, median age 70 years, 82% male, 55% ischemic heart failure [HF] etiology, 54% CRT-P, 70% left bundle branch block [LBBB]). Automated analysis of P-wave duration [PWD] and morphology in leads II, aVF and III assessed as positive, negative or biphasic +/− was performed and patients classified as having either No IAB (PWD <120ms), Partial IAB (pIAB, PWD ≥120 ms, positive P-waves in inferior leads), aIAB (PWD ≥120 ms and biphasic p-waves in one of the inferior leads). aIAB patients were further stratified by the presence of biphasic P waves in only one (aIAB-1) or more (aIAB-2) inferior leads. Extreme aIAB was defined as biphasic P waves in lead II and negative in leads III and aVF. Cox regression analyses adjusted for age, gender, NYHA class, ischemic HF etiology, left ventricular ejection fraction, LBBB, CRT-P versus CRT-D and PWD were performed to assess the impact of aIAB and its types on the endpoint hospitalization for HF or death at 5 years of follow up.
Results
Advanced IAB was observed in 65 patients (10 with aIAB-1, 53 with aIAB-2 and 2 with extreme aIAB) and pIAB in 151. No clinically relevant significant differences in baseline characteristics were observed between groups. Compared to the NoIAB group, aIAB-2 and extreme aIAB independently predicted the combined endpoint with adjusted HR=1.82 (95% CI 1.14–2.90, p-value 0.012) and HR=4.70 (95% CI 1.10–20.16, p-value 0.037), respectively.
Conclusion
Advanced IAB is associated with HF admissions or death from any cause in HF patients treated with CRT. Our findings indicate dose-response relationship between the severity of aIAB and the outcome.
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Affiliation(s)
| | - C Reitan
- Lund University, Department of Cardiology, Lund, Sweden
| | - R Borgquist
- Lund University, Department of Cardiology, Lund, Sweden
| | - J Carlson
- Lund University, Department of Cardiology, Lund, Sweden
| | - P P Platonov
- Lund University, Department of Cardiology, Lund, Sweden
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40
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Demidova MM, Carlson J, Erlinge D, Platonov PG. P2661Ventricular fibrillation during acute STEMI is not associated with early repolarization pattern on ECG recorded prior to the index ischemic episode. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0981] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Generally considered as benign, ECG early repolarization (ER) pattern was recently claimed to be an indicator of increased susceptibility to fatal arrhythmias during acute ischemia. The victims of sudden cardiac death have been reported to have high prevalence of ER comparing with survivors of acute coronary event.
We aimed to test the association between the ER pattern on resting ECG recorded prior to ST-elevation myocardial infarction (STEMI) and the risk of ventricular fibrillation (VF) during acute phase of STEMI in non-selected population of STEMI patients.
Methods
For STEMI patients admitted to a tertiary care hospital for primary PCI during 2007–2010 (n=2286), all ECGs recorded prior to the date of admission with STEMI were extracted from a digital archive. The latest ECG recorded prior to the index STEMI was used for analysis.
After excluding ECGs with paced rhythm and intraventricular blocks with QRS duration ≥120ms, the remaining ECGs were processed using the Glasgow algorithm allowing automatic ER detection. The association between ER-pattern on historical ECG and VF during the first 48 hours of STEMI was tested using logistic regression.
Results
Historical ECGs were available for 1584 patients; 124 of them were excluded due to a paced rhythm or wide QRS, leaving 1460 patients available for analysis (age 68±12 years, 67% male). The time from historical ECG to STEMI was 16 (IQR 4–49) months. ER pattern was present on historical ECG in 272 of 1460 (18.6%) (ER+ group), among them in 90 (33%) – in inferior leads, in 116 (43%) – in lateral leads, in 66 (24%) – both in inferior and lateral leads.
ER+ patients were younger both at the time of historical ECG (64±13 vs 66±19; p=0.041) and at the time of STEMI (67±12 vs 68±12; p=0.033), and had lower heart rate on historical ECG (68±12 vs 73±15; p<0.001) than ER- patients. ER+ and ER- groups did not differ regarding clinical characteristics and conventional ECG measurements. The course of STEMI was complicated by VF in 106 patients (17 of them from ER+ group). The occurrence of VF during STEMI was not associated with ER-pattern on historical ECG (OR 0.875 95% CI 0.518–1.479; p=0.618). There was no association of ER pattern with VF before reperfusion (OR 0.54 95% CI 0.25–1.21; p=0.135) or reperfusion VF (OR 1.28 95% CI 0.55–3.01; p=0.569). No association was observed with regard to localization (inferior or lateral) of ER-pattern either.
Conclusion
In a non-selected population of STEMI patients the presence of ER-pattern on ECG recorded prior to the acute coronary event was not associated with VF during the first 48 hours of STEMI.
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Affiliation(s)
- M M Demidova
- Lund University, Lund, Sweden and National Medical Research Centre, Saint Petersburg, Russian Federation
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Baturova MA, Svensson A, Svendsen JH, Bundgaard H, Carlson J, Meurling C, Astrom Aneq M, Platonov PG. P5653Atrial fibrillation in arrhythmogenic right ventricular cardiomyopathy and its association with left atrial volume index. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0596] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recent studies in arrhythmogenic right ventricular cardiomyopathy (ARVC) support atrial involvement in the disease progression and consider atrial fibrillation (AF) as one of the primary manifestations of ARVC. We aimed to assess clinical factors, components of 2010 Task Force criteria (TFC2010) and echocardiographic characteristics of atria associated with AF in the Scandinavian cohort of ARVC patients.
Methods
Study sample comprised of 106 definite ARVC patients by TFC2010 from three tertiary care centers participating in the Nordic ARVC Registry (33% females, median age at ARVC diagnosis 41 years [IQR 30–54 years]). No concomitant diseases were observed in 90 patients (85%) while 16 patients had one or more comorbidities: hypertension (n=6), diabetes mellitus (n=5), coronary artery disease (n=5) or congestive heart failure (n=9). AF was included in the registry protocol as a pre-specified clinical event and verified by processing of the electronic ECG databases which contains all ECG recordings from the involved hospitals catchment areas (earliest ECG from 1988). Left (LA) and right atrial (RA) dimensions were obtained by revisiting cardiac ultrasound examinations performed at the time of ARVC diagnosis. Association between AF and clinical characteristics was assessed using multivariable logistic regression analysis adjusted for age and gender.
Results
AF was diagnosed in 29 patients (27%) at a median age of 53 (IQR 38–63) years, 7 females (24%). Median time from ARVC diagnosis to AF onset was 8 (IQR 2–12) years. AF was univariately associated with right ventricular structural abnormalities meeting the definition of major imaging criterion by 2010TFC, ventricular tachycardia (VT) with superior axis (major criterion) and LA volume index. Significantly associated variables were included in a multivariate model, in which LA volume index (OR=1.07, 95% CI 1.01–1.14, p=0.021) and superior axis VT (OR=7.45, 95% CI 1.82–30.55, p=0.005) remained independently associated with AF. In receiver operating characteristic (ROC) curve analysis, LA volume index was significantly associated with AF (AUC=0.703, p=0.005) and with superior axis VT (AUC=0.703, p=0.021). AF was not associated with either RA volume index (univariate OR=1.03, 95% CI 0.99–1.06, p=0.203) or left ventricular ejection fraction (OR=0.97, 95% CI 0.92–1.03, p=0.299).
Conclusion
In patients with ARVC,AF is primarily associated with LA structural abnormalities without indication of RA involvement and is strongly associated with ventricular arrhythmias thus indicating parallel development of atrial and ventricular arrhythmic substrate.
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Affiliation(s)
- M A Baturova
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden, Research Park, St.Petersburg State University, St.Petersburg, Russian Federation
| | - A Svensson
- Linkoping University, Department of Cardiology and Department of Medical and Health Sciences, Linkoping, Sweden
| | - J H Svendsen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, The Heart Centre, Copenhagen, Denmark
| | - H Bundgaard
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, The Heart Centre, Copenhagen, Denmark
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - C Meurling
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - M Astrom Aneq
- Linkoping University, Department of Clinical Physiology and Department of Medical and Health Sciences, Linkoping, Sweden
| | - P G Platonov
- Lund University, Department of cardiology, Clinical Sciences, Arrhythmia Clinic, Skåne University Hospital, Lund, Sweden
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Platonov PG, Carlson J, Castrini I, Svensson A, Christiansen MK, Gilljam T, Madsen T, Hansen J, Astrom MA, Haagua K, Jensen HK, Edvardsen T, Svendsen JH. P2247Pregnancies and childbirth in women with arrhythmogenic right ventricular cardiomyopathy are associated with low risk of ventricular arrhythmias. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0725] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is associated with a risk of ventricular arrhythmias (VA) and sudden cardiac death (SCD). Even though female patients with ARVC are considered to be at lower risk of VA, the impact of pregnancy and child birth on the arrhythmic risk and development of arrhythmic substrate in the context of ARVC remains insufficiently studied.
Objective
To assess the risk of VA in relation to childbirth in women with ARVC and the impact of multiple pregnancies on progression of arrhythmic manifestations of the disease.
Methods
The study included 186 females with definite ARVC (n=107, 70 probands) or unaffected mutation-carriers (n=79) with median age at the end of follow up of 48 (IQR 34–60) years. Seventeen women had 1, 59 had 2 and 29 had ≥3 child births by the age of 40 years. VA was defined as ventricular tachycardia, appropriate ICD therapy, aborted cardiac arrest or SCD. Proportions of patients who experienced VA by the age of 40 years were compared between nulliparous women (n=81) and those with reported child births (n=105). VA-free survival after accomplished pregnancies was assessed for women ≥40 years of age (n=119). Cumulative probability of VA for each pregnancy (n=230) was assessed from conception through 2 years after child birth and compared between those that occurred before ARVC diagnosis (Pre-Ds, n=164), after it (Post-Ds, n=11) and in unaffected mutation carriers (No-Ds, n=55).
Results
The nulliparous women had lower age at ARVC diagnosis (37 vs 44, p=0.023) and more often had VA before the age of 40 (31% vs 13%, p=0.003) while the number of child births was not related to the prevalence of VA (18% among women with 1 childbirth, 12% in those with 2 and 14% in those with 3 or more, ns). Three women suffered SCD before the age of 40. VA-free survival after 40 years did not differ between nulliparous and those who gave birth (Figure A). Only four pregnancy-related events were documented (Figure B): 1 in the Post-Ds group and three in the Pre-Ds group. No pregnancy-related events were reported in the unaffected mutation carriers.
Conclusion
In this Scandinavian cohort of women with ARVC we observed no indication of an increased VA risk either associated with pregnancies or during long-term follow up after the last child birth.
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Affiliation(s)
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | | | | | | | - T Gilljam
- Sahlgrenska Academy, Gothenburg, Sweden
| | - T Madsen
- Aalborg University Hospital, Aalborg, Denmark
| | - J Hansen
- Gentofte University Hospital, Gentofte, Denmark
| | | | - K Haagua
- University of Oslo, Oslo, Norway
| | - H K Jensen
- Aarhus University Hospital, Aarhus, Denmark
| | | | - J H Svendsen
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
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Eranti A, Carlson J, Kentta TV, Holmqvist F, Holkeri A, Haukilahti MA, Kerola T, Aro AL, Rissanen H, Noponen K, Seppanen T, Knekt P, Huikuri HV, Junttila MJ, Platonov PG. 3056Orthogonal P wave morphology, traditional P wave indices, and the risk of atrial fibrillation in the general population. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0023] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
A substantial portion of the risk of atrial fibrillation (AF) remains unexplained by the established risk markers. However, accurate assessment of AF risk would be beneficial, especially among stroke patients and subjects with symptoms attributable to arrhythmia.
Purpose
To study the associations of P-wave indices with AF risk in the general population.
Methods
Electrocardiograms, including orthogonal leads, of 7217 Finnish subjects aged over 30 years who took part in the baseline examinations of the Mini-Finland Health Survey in 1978–80, were digitized. P-wave duration, third-degree interatrial block (IAB), and P terminal force (PTF) were assessed manually. PTF was considered abnormal when the amplitude of the negative terminal part of the P wave in lead V1 was ≥0.1mV and duration ≥40ms. Third-degree IAB was defined as P-wave duration ≥120ms and the presence of ≥2 +/− biphasic P-waves in the inferior leads. Orthogonal P-wave morphology, which is related to left atrial breakthrough site and affected by atrial fibrosis (1 being considered benign, 2 borderline, and 3 shown to be associated with adverse events), was assessed with an automated algorithm, and ascertained manually. Subjects were followed 10 years for AF hospitalization and mortality. The risk of AF associated with P wave parameters was assessed using Cox proportional hazards models. Model discrimination improvement was quantified by the change in C index, integrated discrimination improvement (IDI), and continuous net reclassification improvement (cNRI).
Results
There were 5489 subjects (47.8% male, mean age 50.5 years) with a readable ECG, sinus rhythm, no missing data, and a predefined orthogonal P-wave morphology. Type 3 orthogonal P morphology (n=216, multivariate adjusted HR [maHR] 3.01, 95% confidence interval [CI] 1.66–5.45, p<0.001), P-wave duration ≥120ms (n=752, maHR 1.67, 95% CI 1.06–2.64, p=0.027), and third-degree IAB (n=103, maHR 3.18, 95% CI 1.66–6.13, p=0.001) were independently associated with the risk of AF in separate models. PTF did not independently predict AF. Subjects presenting with both Type 1 orthogonal P-wave morphology and P-wave duration <110ms (n=2074) were at low risk of AF (maHR 0.46, 95% CI 0.26–0.83, p=0.006) when compared to the rest of the subjects. The inclusion of variables combining orthogonal P-wave morphology and P-wave duration to a multivariate model including conventional AF risk factors improved C index from 0.815 to 0.832 (change 0.017, 95% CI 0.001–0.033), IDI was 0.012 (95% CI 0.006–0.051), and cNRI was 0.220 (95% CI 0.048–0.357).
Conclusions
P-wave indices and orthogonal P-wave morphology can be used to identify subjects at high and low risk for AF and possibly direct extensive AF screening protocols towards high-risk subjects in the general population in order to decrease the risk of cardioembolic stroke. However, more research is needed in this topic.
Acknowledgement/Funding
Finnish Medical Foundation, Onni and Hilja Tuovinen's Foundation, Orion Research Foundation, Paavo Nurmi's Foundation, Veritas Foundation
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Affiliation(s)
- A Eranti
- North Karelia Central Hospital, Heart Center, Joensuu, Finland
| | - J Carlson
- Lund University, Clinical Sciences, Department of Cardiology, Lund, Sweden
| | - T V Kentta
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu, Finland
| | - F Holmqvist
- Lund University, Clinical Sciences, Department of Cardiology, Lund, Sweden
| | - A Holkeri
- Helsinki University Central Hospital, Heart and Lung Center, Division of Cardiology, Helsinki, Finland
| | - M A Haukilahti
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu, Finland
| | - T Kerola
- Paijat-Hame Central Hospital, Department of Internal Medicine, Lahti, Finland
| | - A L Aro
- Helsinki University Central Hospital, Heart and Lung Center, Division of Cardiology, Helsinki, Finland
| | - H Rissanen
- National Institute for Health and Welfare (THL), Department of Public Health Solutions, Helsinki, Finland
| | - K Noponen
- University of Oulu, Center for Machine Vision and Signal Analysis, Oulu, Finland
| | - T Seppanen
- University of Oulu, Center for Machine Vision and Signal Analysis, Oulu, Finland
| | - P Knekt
- National Institute for Health and Welfare (THL), Department of Public Health Solutions, Helsinki, Finland
| | - H V Huikuri
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu, Finland
| | - M J Junttila
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu, Finland
| | - P G Platonov
- Lund University, Clinical Sciences, Department of Cardiology, Lund, Sweden
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Verner E, Johnston A, Pati N, Hawkes E, Lee H, Cochrane T, Cheah C, Filshie R, Purtill D, Enjeti A, Brown C, Murphy N, Curnow J, Cake S, Carlson J, Butcher B, Trotman J. SAFETY ANALYSIS OF AUSTRALASIAN LEUKAEMIA & LYMPHOMA GROUP NHL29: A PHASE II STUDY OF IBRUTINIB, RITUXIMAB AND MINI-CHOP IN VERY ELDERLY PATIENTS WITH NEWLY DIAGNOSED DLBCL. Hematol Oncol 2019. [DOI: 10.1002/hon.63_2630] [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: 11/12/2022]
Affiliation(s)
- E.K. Verner
- Haematology; Concord Repatriation General Hospital; Concord Australia
| | | | - N. Pati
- Haematology; Canberra Hospital; Canberra Australia
| | - E. Hawkes
- Medical Oncology; Eastern Health; Box Hill Australia
| | - H. Lee
- Haematology; Flinders Medical Centre; Adelaide Australia
| | - T. Cochrane
- Haematology; Gold Coast University Hospital; Southport Australia
| | - C.Y. Cheah
- Haematology; Sir Charles Gairdner Hospital; Perth Australia
| | - R. Filshie
- Haematology; St Vincent's Hospital; Fitzroy Australia
| | - D. Purtill
- Haematology; Fiona Stanley Hospital; Murdoch Australia
| | - A.K. Enjeti
- Haematology; Calvary Mater Hospital; Newcastle Australia
| | - C. Brown
- Haematology; Royal Prince Alfred Hospital; Camperdown Australia
| | - N. Murphy
- Haematology; Royal Hobart Hospital; Hobart Australia
| | - J. Curnow
- Haematology; Westmead Hospital; Westmead Australia
| | - S. Cake
- Trial Centre; Australasian Leukaemia and Lymphoma Group; Richmond Australia
| | - J. Carlson
- Trial Centre; Australasian Leukaemia and Lymphoma Group; Richmond Australia
| | - B.E. Butcher
- Biostatistics & Medical Writing; WriteSource Medical Pty Ltd; Lane Cove Australia
| | - J. Trotman
- Medicine; University of Sydney; Camperdown Australia
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Barajas A, Pelaez T, González O, Usall J, Iniesta R, Arteaga M, Jackson C, Baños I, Sánchez B, Dolz M, Obiols JE, Haro JM, Ochoa S, Arranz B, Arteaga M, Asensio R, Autonell J, Baños I, Bañuelos M, Barajas A, Barceló M, Blanc M, Borrás M, Busquets E, Carlson J, Carral V, Castro M, Corbacho C, Coromina M, Dachs I, De Miquel L, Dolz M, Domenech MD, Elias M, Espezel I, Falo E, Fargas A, Foix A, Fusté M, Godrid M, Gómez D, González O, Granell L, Gumà L, Haro JM, Herrera S, Huerta E, Lacasa F, Mas N, Martí L, Martínez R, Matalí J, Miñambres A, Muñoz D, Muñoz V, Nogueroles R, Ochoa S, Ortiz J, Pardo M, Planella M, Pelaez T, Peruzzi S, Rivero S, Rodriguez MJ, Rubio E, Sammut S, Sánchez M, Sánchez B, Serrano E, Solís C, Stephanotto C, Tabuenca P, Teba S, Torres A, Urbano D, Usall J, Vilaplana M, Villalta V. Predictive capacity of prodromal symptoms in first-episode psychosis of recent onset. Early Interv Psychiatry 2019; 13:414-424. [PMID: 29116670 DOI: 10.1111/eip.12498] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 07/16/2017] [Accepted: 08/20/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Both the nature and number of a wide range of prodromal symptoms have been related to the severity and type of psychopathology in the psychotic phase. However, at present there is an incomplete picture focused mainly on the positive pre-psychotic dimension. AIM To characterize the prodromal phase retrospectively, examining the number and nature of prodromal symptoms as well as their relationship with psychopathology at the onset of first-episode psychosis. METHODS Retrospective study of 79 patients experiencing a first-episode psychosis of less than 1 year from the onset of full-blown psychosis. All patients were evaluated with a comprehensive battery of instruments including socio-demographic and clinical questionnaire, IRAOS interview, PANSS, stressful life events scale (PERI) and WAIS/WISC (vocabulary subtest). Bivariate associations and multiple regression analysis were performed. RESULTS Regression models revealed that several prodromal dimensions of IRAOS (delusions, affect, language, behaviour and non-hallucinatory disturbances of perception) predicted the onset of psychosis, with positive (22.4% of the variance) and disorganized (25.6% of the variance) dimensions being the most widely explained. CONCLUSION In addition to attenuated positive symptoms, other symptoms such as affective, behavioural and language disturbances should also be considered in the definitions criteria of at-high-risk people.
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Affiliation(s)
- Ana Barajas
- Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Esplugues de Llobregat, Barcelona, Spain.,Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain.,Department of Clinical and Psychology, School of Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Trinidad Pelaez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Olga González
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Judith Usall
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Raquel Iniesta
- Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Maria Arteaga
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Chris Jackson
- Birmingham Early Intervention Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - Iris Baños
- Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Bernardo Sánchez
- Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Esplugues de Llobregat, Barcelona, Spain
| | - Montserrat Dolz
- Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Esplugues de Llobregat, Barcelona, Spain
| | - Jordi E Obiols
- Department of Clinical and Psychology, School of Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Josep M Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | | | - Susana Ochoa
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
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Baturova MA, Lindgren A, Shubik YV, Carlson J, Platonov PG. Interatrial block in prediction of all-cause mortality after first-ever ischemic stroke. BMC Cardiovasc Disord 2019; 19:37. [PMID: 30744701 PMCID: PMC6371419 DOI: 10.1186/s12872-019-1015-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 02/04/2019] [Indexed: 12/25/2022] Open
Abstract
Background Interatrial block (IAB) is an ECG indicator of atrial fibrosis related to atrial remodeling and thrombus formation thus leading to embolic stroke and increasing mortality. We aimed to assess weather IAB predicted all-cause mortality during 10 years after ischemic stroke. Methods The study sample comprised 235 patients (median age 74 (interquartile range 25–75% 65–81) years, 95 female) included in the Lund Stroke Register in 2001–2002, who had sinus rhythm ECGs at stroke admission. IAB was defined as a P-wave duration ≥120 ms without = partial IAB (n = 56) or with = advanced IAB (n = 41) biphasic morphology (±) in the inferior ECG leads. All-cause mortality was assessed via linkage with the Swedish Causes of Death Register. Results During follow-up 126 patients died (54%). Advanced IAB, but not partial, was associated with all-cause mortality in univariate Cox regression analysis (hazard ratio (HR) 1.98, 95% CI 1.27–3.09, p = 0.003). After adjustment for age, gender, severity of stroke measured by NIHSS scale and smoking status in patients without additional comorbidities advanced IAB independently predicted all-cause mortality (HR 7.89, 95% CI 2.01–30.98, p = 0.003), while in patients with comorbidities it did not (HR 1.01 95% CI 0.59–1.72, p = 0.966). Conclusion Advanced IAB predicted all-cause mortality after ischemic stroke, but mostly in patients without additional cardiovascular comorbidities.
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Affiliation(s)
- M A Baturova
- Department of Cardiology, Clinical Sciences, Lund University, SE-221 85, Lund, Sweden. .,Research Park, St Petersburg State University, Peterhof, Botanicheskaya, 17, St Petersburg, Russia.
| | - A Lindgren
- Department of Cardiology, Clinical Sciences, Lund University, SE-221 85, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Y V Shubik
- Cardiology research, clinical and educational center, St. Petersburg State University, Universitetskaya Embankment, 7/9, St. Petersburg, Russia
| | - J Carlson
- Department of Cardiology, Clinical Sciences, Lund University, SE-221 85, Lund, Sweden
| | - P G Platonov
- Department of Cardiology, Clinical Sciences, Lund University, SE-221 85, Lund, Sweden.,Arrythmia Clinic, Skåne University Hospital, SE-221 85, Lund, Sweden
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Keränen A, Ghazi S, Carlson J, Papadogiannakis N, Lagerstedt-Robinson K, Lindblom A. Testing strategies to reduce morbidity and mortality from Lynch syndrome. Scand J Gastroenterol 2018; 53:1535-1540. [PMID: 30572730 DOI: 10.1080/00365521.2018.1542453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Lynch syndrome (LS) has an autosomal dominant inheritance pattern and is associated with increased risk for colorectal cancer (CRC) and other cancers. Various strategies are used to identify patients at risk and offer surveillance and preventive programs, the cost effectiveness of which is much dependent on the prevalence of LS in a population. Universal testing (UT) is proposed as an effective measure, targeting all newly diagnosed CRC patients under a certain age. MATERIALS AND METHODS LS cases were identified in a cohort of 572 consecutive CRC patients. Immunohistochemistry was performed in 539 cases, using antibodies against mismatch repair proteins MLH1, PMS2, MSH2, and MSH6. Microsatellite instability and gene mutation screening were performed in 57 cases. RESULTS In total 11 pathogenic variants were detected, identifying LS in 1.9% of new CRC cases. Comparing the results with current clinical methods, 2 pathogenic variants were found with Amsterdam criteria and 9 when using either Bethesda guidelines or our institution's prior clinical criteria. Pathogenic variants in MSH6 were the most common in our series. We also found different outcomes using different age cut offs. CONCLUSION Our study demonstrates that UT of tumors before age on onset at 75 years would most likely be cost-efficient and essentially equivalent to applying the Bethesda guidelines or our institution's prior clinical criteria on all new CRC.
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Affiliation(s)
- Anne Keränen
- a Department of Laboratory Medicine, Division of Pathology , Karolinska Institutet , Karolinska University Hospital, Stockholm , Sweden
| | - Sam Ghazi
- a Department of Laboratory Medicine, Division of Pathology , Karolinska Institutet , Karolinska University Hospital, Stockholm , Sweden
| | - Joseph Carlson
- a Department of Laboratory Medicine, Division of Pathology , Karolinska Institutet , Karolinska University Hospital, Stockholm , Sweden
| | - Nikos Papadogiannakis
- a Department of Laboratory Medicine, Division of Pathology , Karolinska Institutet , Karolinska University Hospital, Stockholm , Sweden
| | - Kristina Lagerstedt-Robinson
- b Department of Molecular Medicine and Surgery , and Department of Clinical Genetics, Karolinska Institutet, Karolinska University Hospital, Solna , Stockholm , Sweden
| | - Annika Lindblom
- b Department of Molecular Medicine and Surgery , and Department of Clinical Genetics, Karolinska Institutet, Karolinska University Hospital, Solna , Stockholm , Sweden
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Cruz A, Montelibano L, Carlson J, Aung T. CHLORHEXIDINE: AN INCREASINGLY RECOGNIZED CAUSE OF PERI-OPERATIVE ANAPHYLAXIS. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Devlin V, Carlson J. HYPEREOSINOPHILIC SYNDROME: EXPLORING DIAGNOSTIC DILEMMA. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Carlson B, Jones K, Carlson J, Craft M, Benbrook D, Coleman-Jackson R, Hershey L. CEREBRAL OXYGENATION AND SLEEP DISORDERED BREATHING IN ADULTS WITH MILD COGNITIVE IMPAIRMENT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B Carlson
- Fran and Earl Ziegler College of Nursing and Donald W. Reynolds Center for Geriatric Nursing Excellence, University of Oklahoma Health Sciences Center
| | - K Jones
- Department of Pulmonary, Critical Care, and Sleep Medicine, College of Medicine, The University of Oklahoma Health Sciences Center
| | - J Carlson
- Fran and Earl Ziegler College of Nursing, The University of Oklahoma Health Sciences Center
| | - M Craft
- The Fran and Earl Ziegler College of Nursing and Donald W. Reynolds Center for Geriatric Nursing Excellence, The University of Oklahoma Health Sciences Center
| | - D Benbrook
- Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Oklahoma Health Sciences Center
| | - R Coleman-Jackson
- Department of Neurology, University of Oklahoma Health Sciences Center
| | - L Hershey
- Department of Neurology, University of Oklahoma Health Sciences Center
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