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Persaud D, Bryson Y, Nelson BS, Tierney C, Cotton MF, Coletti A, Jao J, Spector SA, Mirochnick M, Capparelli EV, Costello D, Szewczyk J, Nicodimus N, Stranix-Chibanda L, Kekitiinwa AR, Korutaro V, Reding C, Carrington MN, Majji S, Yin DE, Jean-Philippe P, Chadwick EG. HIV-1 reservoir size after neonatal antiretroviral therapy and the potential to evaluate antiretroviral-therapy-free remission (IMPAACT P1115): a phase 1/2 proof-of-concept study. Lancet HIV 2024; 11:e20-e30. [PMID: 38061376 PMCID: PMC11094801 DOI: 10.1016/s2352-3018(23)00236-9] [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: 04/20/2023] [Revised: 08/23/2023] [Accepted: 09/11/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Infants born with HIV-1 require lifelong antiretroviral therapy (ART). We aimed to assess whether very early ART in neonates might restrict HIV-1 reservoirs, an important step towards ART-free remission. METHODS IMPAACT P1115 is an ongoing, phase 1/2, proof-of-concept study in which infants were enrolled at 30 research clinics in 11 countries (Brazil, Haiti, Kenya, Malawi, South Africa, Tanzania, Thailand, Uganda, the USA, Zambia, and Zimbabwe) into two cohorts. Infants at least 34 weeks' gestational age at high risk for in-utero HIV-1 with either untreated maternal HIV-1 (cohort 1) or who were receiving pre-emptive triple antiretroviral prophylaxis outside of the study (maternal ART permissible; cohort 2) were included. All infants initiated treatment within 48 h of life. Cohort 1 initiated three-drug nevirapine-based ART, and cohort 2 initiated three-drug nevirapine-based prophylaxis then three-drug nevirapine-based ART following HIV diagnosis by age 10 days. We added twice-daily coformulated oral ritonavir 75 mg/m2 and lopinavir 300 mg/m2 from 14 days of life and 42 weeks postmenstrual age. We discontinued nevirapine 12 weeks after two consecutive plasma HIV-1 RNA levels below limit of detection. We tracked virological suppression, safety outcomes, and meeting a predetermined biomarker profile at age 2 years (undetectable RNA since week 48, HIV-1 antibody-negative, HIV-1 DNA not detected, and normal CD4 count and CD4 percentage) to assess qualification for analytical treatment interruption. This study is registered with ClinicalTrials.gov, NCT02140255. FINDINGS Between Jan 23, 2015, and Dec 14, 2017, 440 infants were included in cohort 1 and 20 were included in cohort 2. 54 of these infants (34 from cohort 1 and 20 from cohort 2) had confirmed in-utero HIV-1 and were enrolled to receive study ART. 33 (61%) of 54 infants were female and 21 (39%) were male. The estimated probability of maintaining undetectable plasma RNA through to 2 years was 33% (95% CI 17-49) in cohort 1 and 57% (28-78) in cohort 2. Among infants maintaining protocol-defined virological control criteria through to study week 108, seven of 11 (64%, 95% CI 31-89) in cohort 1 and five of seven (71%, 29-96) in cohort 2 had no detected HIV-1 DNA. Ten of 12 (83%, 52-100) in cohort 1 and all seven (100%, 59-100) in cohort 2 tested HIV-1 antibody-negative at week 108. Among 54 infants initiated on very early ART, ten (19%; six in cohort 1 and four in cohort 2) met all criteria for possible analytical treatment interruption. Reversible grade 3 or 4 adverse events occurred in 15 (44%) of 34 infants in cohort 1 and seven (35%) of 20 infants in cohort 2. INTERPRETATION Very early ART for in-utero HIV-1 can achieve sustained virological suppression in association with biomarkers indicating restricted HIV-1 reservoirs by age 2 years, which might enable potential ART-free remission. FUNDING National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institute of Mental Health.
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Affiliation(s)
- Deborah Persaud
- Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Yvonne Bryson
- University of California Los Angeles, Los Angeles, CA, USA
| | - Bryan S Nelson
- Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Camlin Tierney
- Harvard T H Chan School of Public Health, Boston, MA, USA
| | | | | | - Jennifer Jao
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Stephen A Spector
- University of California San Diego School of Medicine, La Jolla, CA, USA
| | | | | | - Diane Costello
- University of California Los Angeles, Los Angeles, CA, USA
| | - Joseph Szewczyk
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicol Nicodimus
- University of Zimbabwe, Clinical Trials Research Centre, Harare, Zimbabwe
| | | | | | - Violet Korutaro
- Baylor College of Medicine Children's Foundation, Kampala, Uganda
| | - Christina Reding
- Frontier Science and Technology Research Foundation, Amherst, NY, USA
| | - Mary N Carrington
- Frederick National Laboratory for Cancer Research and Laboratory of Integrative Cancer Immunology National Cancer Institute, MD, USA
| | - Sai Majji
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Dwight E Yin
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Patrick Jean-Philippe
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Ellen G Chadwick
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Lahlouh M, Chenoune Y, Blanc R, Piotin M, Escalard S, Fahed R, Szewczyk J, Passat N. Automated Aortic Anatomy Analysis: from Image to Clinical Indicators. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-5. [PMID: 38082844 DOI: 10.1109/embc40787.2023.10340921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Most cerebrovascular diseases (including strokes and aneurysms) are treated endovascularly with catheters that are navigated from the groin through the vessels to the brain. Many patients have complex anatomy of the aortic arch and supra-aortic vessels, which can make it difficult to select the best catheters for navigation, resulting in longer procedures and more complications or failures. To this end, we propose a framework dedicated to the analysis of the aortic arch and supra-aortic trunks. This framework can automatically compute anatomical and geometrical features from meshes segmented beforehand via CNN-based pipeline. These features such as arch type, tortuosity and angulations describe the navigational difficulties encountered during catheterization. Quantitative and qualitative validation was performed by experienced neuroradiologists, leading to reliable vessel characterization.Clinical relevance- This method allows clinicians to determine the type and the anatomy of the aortic arch and its supra-aortic trunks before endovascular procedures. This is essential in interventional neuroradiology, such as navigation with catheters in this complex area.
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Huang Y, Dhummakupt A, Khetan P, Nilles T, Zhou W, Mudvari P, Szewczyk J, Chen YH, Boritz E, Ji H, Agwu A, Persaud D. Immune activation and exhaustion marker expression on T-cell subsets in ART-treated adolescents and young adults with perinatal HIV-1 infection as correlates of viral persistence. Front Immunol 2023; 14:1007626. [PMID: 37033916 PMCID: PMC10076634 DOI: 10.3389/fimmu.2023.1007626] [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] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
HIV-1 infection in memory CD4+ T cells forms a latent reservoir that is a barrier to cure. Identification of immune biomarkers that correlate with HIV-1 reservoir size may aid with evaluating efficacy of HIV-1 eradication strategies, towards ART-free remission and cure. In adults living with non-perinatal HIV-1, the immune exhaustion marker PD-1 on central memory CD4+ T cells (Tcm) correlates with measures of HIV-1 reservoir size. Immune correlates of HIV-1 are less defined in adolescents and young adults with perinatal HIV-1. With multi-parameter flow cytometry, we examined immune activation (CD69, CD25, HLA-DR), and exhaustion (PD-1, TIGIT, TIM-3 and LAG-3) markers on CD4+ T cell subsets (naïve (Tn), central memory (Tcm), and the combination (Ttem) of transitional (Ttm) and effector memory (Tem) cells, in 10 adolescents and young adults living with perinatal HIV-1 (median age 15.9 years; median duration of virologic suppression 7.0 years), in whom HIV-1 reservoir size was measured with the Intact Proviral HIV-1 DNA Assay (IPDA) and an enhanced Tat/Rev limiting dilution assay (TILDA). RNA-seq was also performed on the unstimulated CD4+ T cells. The median total HIV-1 DNA concentration in memory CD4+ T cells was 211.90 copies per million CD4+ T cells. In the 7 participants with subtype B HIV-1 infection, the median intact proviral DNA load was 7.96 copies per million CD4+ T cells. Levels of HLA-DR and TIGIT on the Ttem were correlated with total HIV-1 DNA (r=0.76, p=0.015) and (r=0.72, p=0.023), respectively, but not with intact proviral load or induced reservoir size. HIV-1 DNA load was also positively correlated with transcriptional clusters associated with HLA-DR expression by RNA-seq. In contrast, PD-1 expression on Tcm was inversely correlated with total HIV-1 DNA (r=-0.67, p=0.039). Reservoir size by IPDA and TILDA were correlated (r=0.81, p=0.036). Thus, in this cohort of youths with long-standing treated perinatal infection, HLA-DR and TIGIT on Ttem were the key correlates of HIV-1 infected cell frequencies by total HIV-1 DNA, and not PD-1. Total HIV-1 DNA was negatively correlated with PD-1 expressing Tcm. These differences in longstanding perinatal HIV-1 infection compared with adult infection requires further study in larger cohorts.
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Affiliation(s)
- Yuyang Huang
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Adit Dhummakupt
- Department of Pediatric Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Priya Khetan
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Tricia Nilles
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Weiqiang Zhou
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Prakriti Mudvari
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, United States
| | - Joseph Szewczyk
- Department of Pediatric Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Ya Hui Chen
- Department of Pediatric Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Eli Boritz
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, United States
| | - Hongkai Ji
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Allison Agwu
- Department of Pediatric Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Deborah Persaud
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- Department of Pediatric Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- *Correspondence: Deborah Persaud,
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Badrou A, Tardif N, Even A, Chaudet P, Lescanne N, Szewczyk J, Gravouil A, Hamila N, Bel-Brunon A. Characterization of Surgical Tools for Specific Endovascular Navigation. Cardiovasc Eng Technol 2022; 13:751-763. [PMID: 35237938 DOI: 10.1007/s13239-022-00612-8] [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] [Received: 06/07/2021] [Accepted: 02/02/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE The aim of this work was to mechanically characterize a specific active guidewire and catheters that are commercially available, for further implementation into numerical simulation of endovascular navigation towards complex targets. METHODS For the guidewire, 3-point bending tests and bending with added masses were used to obtain the Young moduli of its various components. To study its behavior, the guidewire was activated under "ideal" conditions and its performance was investigated. As for the various catheters, they were measured and 3-point bending tests were conducted to determine their mechanical properties. RESULTS & CONCLUSION The Young moduli of the shaft and the distal tip of the guidewire were determined. We defined a suitable current intensity to activate the guidewire related to an optimal curvature. Then, the time of activation/deactivation was measured at 1.7 s. On the flip side, parts of the catheters were considered either elastic or viscoelastic. In all cases, the rigidity gradients along the various catheters were highlighted. The characterization of the aforementioned surgical tools provides the opportunity to simulate the endovascular nagivation process.
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Affiliation(s)
- A Badrou
- Univ Lyon, INSA Lyon, CNRS, LaMCoS, UMR5259, 69621, Villeurbanne, France
| | - N Tardif
- Univ Lyon, INSA Lyon, CNRS, LaMCoS, UMR5259, 69621, Villeurbanne, France
| | - A Even
- Univ Lyon, INSA Lyon, CNRS, LaMCoS, UMR5259, 69621, Villeurbanne, France
| | - P Chaudet
- Univ Lyon, INSA Lyon, CNRS, LaMCoS, UMR5259, 69621, Villeurbanne, France
| | - N Lescanne
- BaseCamp Vascular (BCV), 75005, Paris, France
| | - J Szewczyk
- BaseCamp Vascular (BCV), 75005, Paris, France
- Sorbonne Université, CNRS, INSERM, Institut des Systèmes Intelligents et de Robotique, ISIR, ISIR - AGATHE, 75005, Paris, France
| | - A Gravouil
- Univ Lyon, INSA Lyon, CNRS, LaMCoS, UMR5259, 69621, Villeurbanne, France
| | - N Hamila
- Ecole Nationale d'Ingénieurs de Brest, ENIB, UMR CNRS 6027, IRDL, 29200, Brest, France
| | - A Bel-Brunon
- Univ Lyon, INSA Lyon, CNRS, LaMCoS, UMR5259, 69621, Villeurbanne, France.
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Nguyen DVA, Girerd C, Boyer Q, Rougeot P, Lehmann O, Tavernier L, Szewczyk J, Rabenorosoa K. A Hybrid Concentric Tube Robot for Cholesteatoma Laser Surgery. IEEE Robot Autom Lett 2022. [DOI: 10.1109/lra.2021.3128685] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Powell L, Dhummakupt A, Siems L, Singh D, Le Duff Y, Uprety P, Jennings C, Szewczyk J, Chen Y, Nastouli E, Persaud D. Clinical validation of a quantitative HIV-1 DNA droplet digital PCR assay: Applications for detecting occult HIV-1 infection and monitoring cell-associated HIV-1 dynamics across different subtypes in HIV-1 prevention and cure trials. J Clin Virol 2021; 139:104822. [PMID: 33930698 PMCID: PMC8212401 DOI: 10.1016/j.jcv.2021.104822] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 12/18/2020] [Accepted: 04/06/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND In HIV-1-exposed infants, nucleic acid testing (NAT) is required to diagnose infection since passively transferred maternal antibodies preclude antibody testing. The sensitivity of clinical NAT assays is lowered with infant antiretroviral prophylaxis and, with empiric very early antiretroviral treatment of high-risk infants, thereby impacting early infant diagnosis. Similarly, adult HIV-1 infections acquired under pre-exposure prophylaxis may occur at low levels, with undetectable plasma viremia and indeterminate antibody tests, for which HIV-1 DNA testing maybe a useful adjunct. Cell-associated HIV-1 DNA concentrations are also used to monitor HIV-1 persistence in viral reservoirs with relevance to HIV-1 cure therapeutics, particularly in perinatal infections. OBJECTIVES We clinically validated an HIV-1 DNA quantitative assay using droplet digital PCR (ddPCR), across different HIV-1 subtypes. STUDY DESIGN The analytical sensitivity and specificity of an HIV-1 DNA ddPCR assay was determined using serial dilutions of a plasmid containing HIV-1 LTR-gag spiked into peripheral blood mononuclear cells (PBMCs), with MOLT-4 cells or PBMCs infected with different HIV-1 subtypes (A, B and C), and U1 cells spiked into PBMCs. Inter- and intra-run variability were used to determine assay precision. RESULTS The HIV-1 LTR-gag ddPCR assay was reliable and reproducible, and exhibited high analytical specificity with sensitivity to near single copy level, across multiple HIV-1 subtypes, and a limit of detection of 4.09 copies/million PBMCs. CONCLUSIONS This assay has applications for detecting occult HIV-1-infection in the setting of combination and long-acting regimens used for HIV-1 prevention, across different HIV-1 subtypes, in infants and adults, and in HIV-1 cure interventions.
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Affiliation(s)
- Laura Powell
- Johns Hopkins University, School of Medicine, Department of Pediatrics, Division of Infectious Diseases, Baltimore, MD, United States
| | - Adit Dhummakupt
- Johns Hopkins University, School of Medicine, Department of Pediatrics, Division of Infectious Diseases, Baltimore, MD, United States
| | - Lilly Siems
- Johns Hopkins University, School of Medicine, Department of Pediatrics, Division of Infectious Diseases, Baltimore, MD, United States
| | - Dolly Singh
- Johns Hopkins University, School of Medicine, Department of Pediatrics, Division of Infectious Diseases, Baltimore, MD, United States
| | - Yann Le Duff
- Center for AIDS Reagents, National Institute for Biological Standards and Controls, England, UK
| | - Priyanka Uprety
- Department of Pathology and Laboratory Medicine, Robert Wood Johnson University Hospital, Rutgers University, New Brunswick, NJ, United States
| | - Cheryl Jennings
- Rush University Medical Center, Department of Molecular Pathogens and Immunity, Chicago, IL, United States
| | - Joseph Szewczyk
- Johns Hopkins University, School of Medicine, Department of Pediatrics, Division of Infectious Diseases, Baltimore, MD, United States
| | - Ya Chen
- Johns Hopkins University, School of Medicine, Department of Pediatrics, Division of Infectious Diseases, Baltimore, MD, United States
| | - Eleni Nastouli
- Department of Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health and Francis Crick Institute, London, UK
| | - Deborah Persaud
- Johns Hopkins University, School of Medicine, Department of Pediatrics, Division of Infectious Diseases, Baltimore, MD, United States; Departments of Molecular Microbiology and Immunology and International Health, Johns Hopkins Bloomberg School of Public Health, United States.
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Abstract
Bacterial lipoproteins are a very diverse group of proteins characterized by the presence of an N-terminal lipid moiety that serves as a membrane anchor. Lipoproteins have a wide variety of crucial functions, ranging from envelope biogenesis to stress response. In Gram-negative bacteria, lipoproteins can be targeted to various destinations in the cell, including the periplasmic side of the cytoplasmic or outer membrane, the cell surface or the external milieu. The sorting mechanisms have been studied in detail in Escherichia coli, but exceptions to the rules established in this model bacterium exist in other bacteria. In this chapter, we will present the current knowledge on lipoprotein sorting in the cell. Our particular focus will be on the surface-exposed lipoproteins that appear to be much more common than previously assumed. We will discuss the different targeting strategies, provide numerous examples of surface-exposed lipoproteins and discuss the techniques used to assess their surface exposure.
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Affiliation(s)
- J Szewczyk
- WELBIO, Brussels, Belgium; de Duve Institute, Université catholique de Louvain, Brussels, Belgium
| | - J-F Collet
- WELBIO, Brussels, Belgium; de Duve Institute, Université catholique de Louvain, Brussels, Belgium.
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Vanthournhout L, Herman B, Duisit J, Château F, Szewczyk J, Lengelé B, Raucent B. Requirements analysis and preliminary design of a robotic assistant for reconstructive microsurgery. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2015:4926-4930. [PMID: 26737397 DOI: 10.1109/embc.2015.7319497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Microanastomosis is a microsurgical gesture that involves suturing two very small blood vessels together. This gesture is used in many operations such as avulsed member auto-grafting, pediatric surgery, reconstructive surgery - including breast reconstruction by free flap. When vessels have diameters smaller than one millimeter, hand tremors make movements difficult to control. This paper introduces our preliminary steps towards robotic assistance for helping surgeons to perform microanastomosis in optimal conditions, in order to increase gesture quality and reliability even on smaller diameters. A general needs assessment and an experimental motion analysis were performed to define the requirements of the robot. Geometric parameters of the kinematic structure were then optimized to fulfill specific objectives. A prototype of the robot is currently being designed and built in order to providing a sufficient increase in accuracy without prolonging the duration of the procedure.
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Ciecko-Michalska I, Binder M, Wyczesany M, Szewczyk J, Senderecka M, Wojcik J, Dziedzic T, Slowik A, Mach T. Electrophysiological correlates of attentional processes in patients with liver cirrhosis without minimal or clinically-overt hepatic encephalopathy. J Physiol Pharmacol 2012; 63:339-346. [PMID: 23070082] [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] [Received: 12/23/2011] [Accepted: 06/21/2012] [Indexed: 06/01/2023]
Abstract
Liver cirrhosis is often accompanied by a spectrum of cognitive deficits, labelled hepatic encephalopathy (HE). The precise specification of cognitive impairment associated with HE has not been yet elucidated. The aim of this study was an attempt to examine cortical function in cirrhotic patients using EEG event-related potentials during a demanding task involving selective attention. We compared group of 30 patients with liver cirrhosis without minimal or overt HE with education-, age- and sex-matched 29 non-cirrhotic controls. Both groups performed an attentional blink (AB) task, which requires detecting and identifying two target characters in a longer series of rapidly and sequentially presented characters. EEG signals from 32 electrodes were measured and then analyzed in the paradigm of event-related potentials (ERP). Though the groups did not differ in the detection rate of the target stimuli, ERP waveforms revealed two group differences of component amplitudes. The first difference was related to the waveform amplitude within the 200-400 ms after first target in the right frontal region (frontocentral N2 component). Moreover, in patient group this amplitude positively correlated with the blood plasma level of alkaline phosphatase and gamma-glutamyl transpeptidase. The second amplitude difference was observed in the midline parieto-occipital regions within the 400-600 ms after the first target (P3b component). The AB task and ERP analysis allowed to find differences in cortical functioning in cirrhotic patients even without overt cognitive deficits. Our finding demonstrates that liver dysfunction can influence cortical processing associated with detecting and categorizing stimulus change.
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Affiliation(s)
- I Ciecko-Michalska
- Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Cracow, Poland.
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Ciecko-Michalska I, Wojcik J, Wyczesany M, Binder M, Szewczyk J, Senderecka M, Dziedzic T, Slowik A, Mach T. Cognitive evoked response potentials in patients with liver cirrhosis without diagnosis of minimal or overt hepatic encephalopathy. A pilot study. J Physiol Pharmacol 2012; 63:271-276. [PMID: 22791641] [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] [Received: 12/22/2011] [Accepted: 06/18/2012] [Indexed: 06/01/2023]
Abstract
Liver cirrhosis is often accompanied by cognitive deficits called minimal hepatic encephalopathy (MHE) when it is observed to a moderate extent. In the present study, brain activity and cognitive functioning were examined in patients with liver cirrhosis without MHE or overt clinical hepatic encephalopathy. A battery of neuropsychological tests and event related potentials (ERPs) were used. Moreover, an additional n-back task was administered with two difficulty levels (1- and 2-back). This task was designed to engage cognitive processes of storage and manipulation of information in working memory. The participants have to decide whether the letter shown was the same as a target (congruence condition). No significant differences were found in the performance of either the neuropsychological tests or the n-back task. However, the expected effects of decreased performance as well as a decrease in P3 amplitude with difficulty level were identified. The interaction of group x congruence condition was also observed in the P2 component time window. These results may indicate group differences manifesting in early stages of information processing in working memory. It confirms that the patients whose neuropsychological performance is within the normal range can still reveal subtle changes in CNS functioning visible in ERP research. The study confirms the usability of the ERP method in diagnosis of neurocognitive functions in patients with liver cirrhosis, which seems to be more sensitive than neuropsychological tests.
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Affiliation(s)
- I Ciecko-Michalska
- Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Cracow, Poland
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Menudet JF, Zarhaee A, Solano B, Szewczyk J, Herman B, Rotinat C, Vidal C, Gayet B. Projet ID2U : instrument dextre à usage unique. Ing Rech Biomed 2011. [DOI: 10.1016/j.irbm.2011.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Szewczyk J. What do we really predict during language comprehension? Int J Psychophysiol 2008. [DOI: 10.1016/j.ijpsycho.2008.05.194] [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: 10/21/2022]
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Velázquez R, Pissaloux EE, Hafez M, Szewczyk J. Toward low-cost highly portable tactile displays with shape memory alloys. Appl Bionics Biomech 2007. [DOI: 10.1080/11762320701470517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Ciećko-Michalska I, Senderecka M, Szewczyk J, Panasiuk A, Słowik A, Wyczesany M, Binder M, Mach T. Event-related cerebral potentials for the diagnosis of subclinical hepatic encephalopathy in patients with liver cirrhosis. Adv Med Sci 2006; 51:273-7. [PMID: 17357325] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
PURPOSE Subclinical hepatic encephalopathy (SHE) seems to be a common problem in liver cirrhosis, however, studies assessing the pathogenesis of this disease remain unclear. Currently no gold standard exists for the diagnosis of this complex neuropsychiatric syndrome. The present study was undertaken firstly to examine the diagnostic usefulness of auditory event-related cerebral potentials (ERPs) in the detection of SHE, and secondly to compare it with that of the most validated psychometric test. MATERIAL AND METHODS 22 patients with liver cirrhosis without overt hepatic encephalopathy and 28 healthy controls were studied, using auditory ERPs. In addition they underwent a battery of neuropsychological and laboratory tests. RESULTS P300 latency analysis turned out that cirrhotics patients had significantly longer P300 latency than controls. The only neuropsychological test showing significant difference between clinical and control group was the similarities subtest of WAIS-R. CONCLUSIONS The results of the present study suggest that ERPs are more sensitive method than psychometric tests in detecting early changes in the brain function of patients with cirrhosis and for this reason this neurophysiological method should be applied in clinical practice.
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Affiliation(s)
- I Ciećko-Michalska
- Department of Gastroenterology, Hepatology and Infectiosus Diseases, Jagiellonian University, Kraków, Poland.
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Shen Z, Reed JR, Creighton M, Liu DQ, Tang YS, Hora DF, Feeney W, Szewczyk J, Bakhtiar R, Franklin RB, Vincent SH. Identification of novel metabolites of pioglitazone in rat and dog. Xenobiotica 2003; 33:499-509. [PMID: 12746106 DOI: 10.1080/0049825031000085951] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
1. Four new metabolites of pioglitazone were identified by liquid chromatography-mass spectrometry (LC-MS/MS) as being formed by hydroxylation (M-VII and M-VIII), opening of the thiazolidinedione ring (M-X) and by desaturation of the terminal ethyl side chain or tether ethoxy moiety (M-IX), respectively. The structure of one of the hydroxylated metabolites (M-VII) was confirmed by chemical modification using the Jones reaction. 2. Oxidative cleavage of the thiazolidinedione ring is a novel pathway not previously reported for pioglitazone. 3. The hydroxylated M-VII was detected in incubations with rat, dog and human liver and kidney microsomes, and in plasma from rats and dogs dosed orally with [(3)H]pioglitazone. 4. The carboxylic acid derivative of M-VII (M-V) and its taurine conjugate were the major radioactive components in dog bile.
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Affiliation(s)
- Z Shen
- Departments of Drug Metabolism, Merck Research Laboratories, Rahway, NJ 07065, USA.
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Hirst GC, Aquino C, Birkemo L, Croom DK, Dezube M, Dougherty RW, Ervin GN, Grizzle MK, Henke B, James MK, Johnson MF, Momtahen T, Queen KL, Sherrill RG, Szewczyk J, Willson TM, Sugg EE. Discovery of 1,5-benzodiazepines with peripheral cholecystokinin (CCK-A) receptor agonist activity (II): Optimization of the C3 amino substituent. J Med Chem 1996; 39:5236-45. [PMID: 8978852 DOI: 10.1021/jm9601664] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Analogs of the previously reported 1,5-benzodiazepine peripheral cholecystokinin (CCK-A) receptor agonist 1 were prepared which explore substitution and/or replacement of the C-3 phenyl urea moiety. Agonist efficacy on the isolated guinea pig gallbladder (GPGB) was retained with a variety of substituted ureas and amide analogs. Three compounds were identified which were orally active in the mouse gallbladder emptying assay (MGBE). The 2-indolamide (52) and N-(carboxymethyl)-2-indolamide (54) derivatives had improved affinity for the human CCK-A receptor but reduced agonist efficacy on the GPGB. Neither indolamide was orally active in a rat feeding assay. In contrast, the (3-carboxyphenyl)urea derivative (29, GW7854) had moderately increased affinity for the human CCK-B receptor but was a potent full agonist on the GPGB and was orally active in both the MGBE and rat feeding assays. GW7854 was a full agonist (EC50 = 60 nM) for calcium mobilization on CHO K1 cells expressing hCCK-A receptors and a potent antagonist of CCK-8 (pA2 = 9.1) on CHO K1 cells expressing hCCK-B receptors. GW7854 is a potent mixed CCK-A agonist/CCK-B antagonist which is orally active in two in vivo models of CCK-A-mediated agonist activity.
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Affiliation(s)
- G C Hirst
- Department of Medicinal Chemistry, Glaxo Wellcome Research and Development, Research Triangle Park, North Carolina 27709, USA
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Abstract
The article describes the case of meralgia paraesthetica, a disease not uncommon, of a bodybuilder. Extensive literature of meralgia paraesthetica shows us several reasons for the injury of the lateral cutaneous nerve of the thigh, but the genesis of the nerve-injury by strain in training is unusual. Diagnostics and therapy of that disease do not present any difficulty.
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Affiliation(s)
- J Szewczyk
- Krankenhaus für Sportverletzte Hellersen/Lüdenscheid
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Bakuła S, Zieliński D, Suchorzewska J, Szewczyk J, Wojtowicz A. [Hemoperfusion in treatment of severe food poisoning after eating sausage]. Pol Tyg Lek 1991; 46:177-9. [PMID: 1845742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- S Bakuła
- Kliniki Chorób Wewnetrznych i Ostrych Zatruć Instytutu Chorób Wewnetrznych
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Bakuła S, Nyka W, Szewczyk J, Zieliński D. [Severe poisoning with the organic solvent Nitro successfully treated with hemoperfusion]. Pol Tyg Lek 1989; 44:967-9. [PMID: 2487769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Dudkiewicz J, Szewczyk J, Zubrowski A, Sliwa P, Sitkiewicz M. [Clinical value of ultrasonographic assessment of fetal hypotrophy and the effects of its treatment]. Wiad Lek 1989; 42:939-44. [PMID: 2701040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The clinical usefulness was assessed of ultrasonography in the study of fetal hypotrophism determining the parameters BIP, THQ and placental parameters. Fetal growth was assessed and in case of hypotrophism adequate therapeutic management was undertaken. The study was carried out on 56 pregnant women referred for diagnosis and treatment of fetal hypotrophism in the period 1983-1985. The control group comprised 56 women with physiological pregnancy. The study was carried out with examinations at weekly intervals from the 24th week of pregnancy till labour using a Hellige-Panavista unit with a 2.5 MHz probe. The BIP and THQ dimensions were calculated a together with placental parameters. The oestriol level was determined in 24-hour urine. The underlying disease and fetal hypotrophism were treated. The most valuable indicator for the determination of asymmetrical and symmetrical type of hypotrophism and for its monitoring was the BIP/THQ index. Ultrasonography makes possible a rapid and accurate diagnosis of fetal condition and control of its treatment. Ultrasonographic observation of the placenta is a source of valuable information for the obstetrician. Oestriol determination is without any greater significance for monitoring of fetal hypotrophism.
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Dudkiewicz J, Sitkiewicz M, Kamiński K, Szewczyk J, Korzeniowska-Kumaszka E, Zubrowski A. [Value of determining alpha-amylase levels in the amniotic fluid for the evaluation of fetal maturity in normal pregnancy and in its various complications]. Wiad Lek 1987; 40:1596-9. [PMID: 3502514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Dudkiewicz J, Sitkiewicz M, Kamiński K, Szewczyk J, Korzeniowsa-Kumaszka E, Zubrowski A, Sliwa P. [Sources of alpha-amylase in the amniotic fluid in women]. Wiad Lek 1987; 40:1527-30. [PMID: 3502513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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