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Fu Y, Pickford R, Galper J, Phan K, Wu P, Li H, Kim YB, Dzamko N, Halliday GM, Kim WS. A protective role of ABCA5 in response to elevated sphingomyelin levels in Parkinson's disease. NPJ Parkinsons Dis 2024; 10:20. [PMID: 38212656 PMCID: PMC10784510 DOI: 10.1038/s41531-024-00632-2] [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: 09/15/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024] Open
Abstract
Parkinson's disease (PD) is a chronic neurodegenerative disorder that affects the motor system. Increasing evidence indicates that lysosomal dysfunction is pivotal in the pathogenesis of PD, typically characterized by dysregulation of sphingolipids in lysosomes. ATP-binding cassette subfamily A member 5 (ABCA5) is a lysosomal transporter that mediates the removal of excess sphingomyelin from lysosomes. We therefore investigated whether the expression levels of ABCA5 are associated with sphingomyelin levels and α-synuclein pathology in PD. Firstly, we undertook a comprehensive assessment of the six sphingolipid classes that are part of the lysosomal salvage pathway in the disease-affected amygdala and disease-unaffected visual cortex using liquid chromatography-mass spectrometry. We found that sphingomyelin levels were significantly increased in PD compared to controls and correlated with disease duration only in the amygdala, whereas, the five other sphingolipid classes were slightly altered or unaltered. Concomitantly, the expression of ABCA5 was upregulated in the PD amygdala compared to controls and correlated strongly with sphingomyelin levels. Using neuronal cells, we further verified that the expression of ABCA5 was dependent on cellular levels of sphingomyelin. Interestingly, sphingomyelin levels were strongly associated with α-synuclein in the amygdala and were related to α-synuclein expression. Finally, we revealed that sphingomyelin levels were also increased in PD plasma compared to controls, and that five identical sphingomyelin species were increased in both the brain and the plasma. When put together, these results suggest that in regions accumulating α-synuclein in PD, ABCA5 is upregulated to reduce lysosomal sphingomyelin levels potentially as a protective measure. This process may provide new targets for therapeutic intervention and biomarker development for PD.
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Affiliation(s)
- YuHong Fu
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Russell Pickford
- Bioanalytical Mass Spectrometry Facility, University of New South Wales, Sydney, NSW, Australia
| | - Jasmin Galper
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Katherine Phan
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Ping Wu
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Hongyun Li
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Young-Bum Kim
- Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Nicolas Dzamko
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Glenda M Halliday
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Woojin Scott Kim
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.
- School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia.
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2
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Phan K, Gomez YH, Gorgui J, El-Messidi A, Gagnon R, Abenhaim HA, Rahme E, Daskalopoulou SS. Arterial stiffness for the early prediction of pre-eclampsia compared with blood pressure, uterine artery Doppler and angiogenic biomarkers: a prospective cohort study. BJOG 2023. [PMID: 36807704 DOI: 10.1111/1471-0528.17430] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 01/20/2023] [Accepted: 02/07/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVE Our aim was to evaluate the ability of arterial stiffness parameters to predict pre-eclampsia early compared with peripheral blood pressure, uterine artery Doppler and established angiogenic biomarkers. DESIGN Prospective cohort study. SETTING Tertiary care antenatal clinics in Montreal, Canada. POPULATION Women with singleton high-risk pregnancies. METHODS In the first trimester, arterial stiffness was measured by applanation tonometry, along with peripheral blood pressure and serum/plasma angiogenic biomarkers; uterine artery Doppler was measured in the second trimester. The predictive ability of different metrics was assessed through multivariate logistic regression. MAIN OUTCOME MEASURES Arterial stiffness (carotid-femoral pulse wave velocity, carotid-radial pulse wave velocity) and wave reflection (augmentation index, reflected wave start time), peripheral blood pressure, ultrasound indices of velocimetry and circulating angiogenic biomarker concentrations. RESULTS In this prospective study, among 191 high-risk pregnant women, 14 (7.3%) developed pre-eclampsia. A first-trimester 1 m/s increase in carotid-femoral pulse wave velocity was associated with 64% increased odds (P < 0.05), and a 1-millisecond increase in time to wave reflection with 11% decreased odds for pre-eclampsia (P < 0.01). The area under the curve of arterial stiffness, blood pressure, ultrasound indices and angiogenic biomarkers was 0.83 (95% confidence interval [CI] 0.74-0.92), 0.71 (95% CI 0.57-0.86), 0.58 (95% CI 0.39-0.77), and 0.64 (95% CI 0.44-0.83), respectively. With a 5% false-positive rate, blood pressure had a sensitivity of 14% for pre-eclampsia and arterial stiffness a sensitivity of 36%. CONCLUSIONS Arterial stiffness predicted pre-eclampsia earlier and with greater ability than blood pressure, ultrasound indices or angiogenic biomarkers.
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Affiliation(s)
- K Phan
- Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Y H Gomez
- Division of Internal Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - J Gorgui
- Division of Internal Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - A El-Messidi
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
| | - R Gagnon
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
| | - H A Abenhaim
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
| | - E Rahme
- Division of Clinical Epidemiology, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - S S Daskalopoulou
- Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada.,Division of Internal Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
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3
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Phan K, He Y, Bhatia S, Pickford R, McDonald G, Mazumder S, Timmins HC, Hodges JR, Piguet O, Dzamko N, Halliday GM, Kiernan MC, Kim WS. Multiple pathways of lipid dysregulation in amyotrophic lateral sclerosis. Brain Commun 2022; 5:fcac340. [PMID: 36632187 PMCID: PMC9825811 DOI: 10.1093/braincomms/fcac340] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/02/2022] [Accepted: 12/12/2022] [Indexed: 12/27/2022] Open
Abstract
Amyotrophic lateral sclerosis is a rapidly progressing neurodegenerative disease characterized by the degeneration of motor neurons and loss of various muscular functions. Dyslipidaemia is prevalent in amyotrophic lateral sclerosis with aberrant changes mainly in cholesterol ester and triglyceride. Despite this, little is known about global lipid changes in amyotrophic lateral sclerosis or in relation to disease progression. The present study incorporated a longitudinal lipidomic analysis of amyotrophic lateral sclerosis serum with a comparison with healthy controls using advanced liquid chromatography-mass spectrometry. The results established that diglyceride, the precursor of triglyceride, was enriched the most, while ceramide was depleted the most in amyotrophic lateral sclerosis compared with controls, with the diglyceride species (18:1/18:1) correlating significantly to neurofilament light levels. The prenol lipid CoQ8 was also decreased in amyotrophic lateral sclerosis and correlated to neurofilament light levels. Most interestingly, the phospholipid phosphatidylethanolamine and its three derivatives decreased with disease progression, in contrast to changes with normal ageing. Unsaturated lipids that are prone to lipid peroxidation were elevated with disease progression with increases in the formation of toxic lipid products. Furthermore, in vitro studies revealed that phosphatidylethanolamine synthesis modulated TARDBP expression in SH-SY5Y neuronal cells. Finally, diglyceride, cholesterol ester and ceramide were identified as potential lipid biomarkers for amyotrophic lateral sclerosis diagnosis and monitoring disease progression. In summary, this study represents a longitudinal lipidomics analysis of amyotrophic lateral sclerosis serum and has provided new insights into multiple pathways of lipid dysregulation in amyotrophic lateral sclerosis.
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Affiliation(s)
| | | | | | - Russell Pickford
- Bioanalytical Mass Spectrometry Facility, University of New South Wales, Sydney, NSW, Australia
| | - Gordon McDonald
- The University of Sydney, Sydney Informatics Hub, Sydney, NSW, Australia
| | - Srestha Mazumder
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
| | - Hannah C Timmins
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
| | - John R Hodges
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
| | - Olivier Piguet
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia,The University of Sydney, School of Psychology, Sydney, NSW, Australia
| | - Nicolas Dzamko
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia,The University of Sydney, School of Medical Sciences, Sydney, NSW, Australia
| | - Glenda M Halliday
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia,The University of Sydney, School of Medical Sciences, Sydney, NSW, Australia
| | - Matthew C Kiernan
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia,Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Woojin Scott Kim
- Correspondence to: W. S. Kim, Associate Professor Brain and Mind Centre, The University of Sydney Camperdown NSW 2050, Australia E-mail:
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Fu Y, He Y, Phan K, Bhatia S, Pickford R, Wu P, Dzamko N, Halliday GM, Kim WS. Increased unsaturated lipids underlie lipid peroxidation in synucleinopathy brain. Acta Neuropathol Commun 2022; 10:165. [DOI: 10.1186/s40478-022-01469-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/24/2022] [Indexed: 11/15/2022] Open
Abstract
AbstractLipid peroxidation is a process of oxidative degradation of cellular lipids that is increasingly recognized as an important factor in the pathogenesis of neurodegenerative diseases. We were therefore interested in the manifestation of lipid peroxidation in synucleinopathies, a group of neurodegenerative diseases characterized by the central pathology of α-synuclein aggregates, including Parkinson’s disease, multiple system atrophy, dementia with Lewy bodies and Alzheimer’s disease with Lewy bodies. We assessed lipid peroxidation products, lipid aldehydes, in the amygdala, a common disease-affected region in synucleinopathies, and in the visual cortex, a disease-unaffected region. We found that the levels of lipid aldehydes were significantly increased in the amygdala, but not in the visual cortex. We hypothesized that these increases are due to increases in the abundance of unsaturated lipids, since lipid aldehydes are formed from unsaturated lipids. We undertook a comprehensive analysis of membrane lipids using liquid chromatography-mass spectrometry and found that unsaturated phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine and sphingomyelin were specifically elevated in the amygdala and correlated with increases in lipid aldehydes. Furthermore, unsaturated phosphatidylethanolamine levels were associated with soluble α-synuclein. Put together, these results suggest that manifestation of lipid peroxidation is prevalent in synucleinopathies and is likely to be due to increases in unsaturated membrane lipids. Our findings underscore the importance of lipid peroxidation in α-synuclein pathology and in membrane structure maintenance.
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5
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Raiker R, Pakhchanian H, Phan K. 271 The association between primary focal hyperhidrosis and psychiatric illnesses. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.278] [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: 10/17/2022]
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6
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Fu Y, He Y, Phan K, Pickford R, Kim YB, Dzamko N, Halliday GM, Kim WS. Sex-specific lipid dysregulation in the Abca7 knockout mouse brain. Brain Commun 2022; 4:fcac120. [PMID: 35620166 PMCID: PMC9127619 DOI: 10.1093/braincomms/fcac120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/06/2022] [Accepted: 05/09/2022] [Indexed: 11/12/2022] Open
Abstract
Alzheimer’s disease is a devastating neurodegenerative disease that affects more women than men. The pathomechanism underlying the sex disparity, especially in the brain, is unclear. ABCA7 is one of the strongest susceptibility genes for Alzheimer’s disease. It mediates the transport of lipids across membranes and is associated with pathways related to amyloid-β neuropathology. However, the role of ABCA7 in the regulation of brain lipids is largely unknown. Sex-specific differences in the pathological link between brain lipid dysregulation and amyloid-β are also unknown. Here, we undertook quantitative discovery lipidomics of male and female Abca7 knockout (n = 52) and wild type (n = 35) mouse brain using sophisticated liquid chromatography/mass spectrometry. We identified 61 lipid subclasses in the mouse brain and found sex-specific differences in lipids that were altered with Abca7 deletion. The altered lipids belong to cellular pathways that control cell signalling, sterol metabolism, mitochondrial function and neuroprotection. We also investigated the relationship between lipids and amyloid-β levels in the Abca7 knockout mice and found elevated free cholesterol only in female mice that was significantly correlated with amyloid-β42 levels. In male Abca7 knockout mice, the neuroprotective ganglioside GD1a levels were elevated and inversely correlated with amyloid-β42 levels. Collectively, these results demonstrate that Abca7 deletion leads to sex-specific lipid dysregulation in the brain, providing insight into the underlying sex disparity in the aetiology of Alzheimer’s disease.
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Affiliation(s)
- YuHong Fu
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Ying He
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Katherine Phan
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Russell Pickford
- Bioanalytical Mass Spectrometry Facility, University of New South Wales, Sydney, NSW, Australia
| | - Young-Bum Kim
- Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Nicolas Dzamko
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Glenda M. Halliday
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales & Neuroscience Research Australia, Sydney, NSW, Australia
| | - Woojin Scott Kim
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales & Neuroscience Research Australia, Sydney, NSW, Australia
- Correspondence to: W. S. Kim Brain and Mind Centre The University of Sydney Camperdown, NSW 2050, Australia E-mail:
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7
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Katzeff JS, Bright F, Phan K, Kril JJ, Ittner LM, Kassiou M, Hodges JR, Piguet O, Kiernan MC, Halliday GM, Kim WS. Biomarker discovery and development for frontotemporal dementia and amyotrophic lateral sclerosis. Brain 2022; 145:1598-1609. [PMID: 35202463 PMCID: PMC9166557 DOI: 10.1093/brain/awac077] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/08/2022] [Accepted: 02/13/2022] [Indexed: 11/12/2022] Open
Abstract
Frontotemporal dementia refers to a group of neurodegenerative disorders characterized by behaviour and language alterations and focal brain atrophy. Amyotrophic lateral sclerosis is a rapidly progressing neurodegenerative disease characterized by loss of motor neurons resulting in muscle wasting and paralysis. Frontotemporal dementia and amyotrophic lateral sclerosis are considered to exist on a disease spectrum given substantial overlap of genetic and molecular signatures. The predominant genetic abnormality in both frontotemporal dementia and amyotrophic lateral sclerosis is an expanded hexanucleotide repeat sequence in the C9orf72 gene. In terms of brain pathology, abnormal aggregates of TAR-DNA-binding protein-43 are predominantly present in frontotemporal dementia and amyotrophic lateral sclerosis patients. Currently, sensitive and specific diagnostic and disease surveillance biomarkers are lacking for both diseases. This has impeded the capacity to monitor disease progression during life and the development of targeted drug therapies for the two diseases. The purpose of this review is to examine the status of current biofluid biomarker discovery and development in frontotemporal dementia and amyotrophic lateral sclerosis. The major pathogenic proteins implicated in different frontotemporal dementia and amyotrophic lateral sclerosis molecular subtypes and proteins associated with neurodegeneration and the immune system will be discussed. Furthermore, the use of mass spectrometry-based proteomics as an emerging tool to identify new biomarkers in frontotemporal dementia and amyotrophic lateral sclerosis will be summarized.
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Affiliation(s)
- Jared S Katzeff
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia.,The University of Sydney, School of Medical Sciences, Sydney, NSW, Australia
| | - Fiona Bright
- The University of Sydney, School of Medical Sciences, Sydney, NSW, Australia.,Dementia Research Centre and Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia
| | - Katherine Phan
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia.,The University of Sydney, School of Medical Sciences, Sydney, NSW, Australia
| | - Jillian J Kril
- The University of Sydney, School of Medical Sciences, Sydney, NSW, Australia.,Dementia Research Centre and Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia
| | - Lars M Ittner
- Dementia Research Centre and Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia
| | - Michael Kassiou
- The University of Sydney, School of Chemistry, Sydney, NSW, Australia
| | - John R Hodges
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
| | - Olivier Piguet
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia.,The University of Sydney, School of Psychology, Sydney, NSW, Australia
| | - Matthew C Kiernan
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia.,Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Glenda M Halliday
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia.,The University of Sydney, School of Medical Sciences, Sydney, NSW, Australia
| | - Woojin Scott Kim
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia.,The University of Sydney, School of Medical Sciences, Sydney, NSW, Australia
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8
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Phan K, He Y, Fu Y, Dzamko N, Bhatia S, Gold J, Rowe D, Ke YD, Ittner LM, Hodges JR, Piguet O, Kiernan MC, Halliday GM, Kim WS. Pathological manifestation of human endogenous retrovirus K in frontotemporal dementia. Commun Med (Lond) 2021; 1:60. [PMID: 35083468 PMCID: PMC8788987 DOI: 10.1038/s43856-021-00060-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/16/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Behavioral variant frontotemporal dementia (bvFTD) is a common form of younger-onset dementia with a proportion of cases overlapping pathologically and genetically with amyotrophic lateral sclerosis (ALS). Previous studies have identified that the human endogenous retrovirus K (HERV-K) is elevated in ALS serum and is associated with ALS TDP-43 pathology. In contrast, little is known about HERV-K changes in bvFTD. Here, we investigated the possible role of HERV-K in bvFTD. METHODS We measured the HERV-K env gene in sporadic bvFTD (N = 63), sporadic ALS (N = 89), and control (N = 21) serum by ddPCR. We also analyzed HERV-K env, by qPCR, and the HERV-K reverse transcriptase protein, by confocal immunofluorescence microscopy, in the disease-affected superior frontal cortex of bvFTD with TDP-43 pathology. RESULTS Here, we show that HERV-K env levels are significantly elevated (P = 3.5 × 10-6) in bvFTD compared to control serum, differentiating cases with an AUC value of 0.867. HERV-K env levels are also specifically elevated in the superior frontal cortex of bvFTD with TDP-43 pathology, with the HERV-K reverse transcriptase protein and TDP-43 deposit localized to the neuronal cytoplasm. Furthermore, in a neuronal cell line overexpression of TDP-43 induces HERV-K env transcription. CONCLUSIONS These results suggest that manifestation of HERV-K is associated with bvFTD TDP-43 pathology. Analysis of HERV-K in bvFTD may provide insight into an unrecognized but targetable perturbed pathology.
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Affiliation(s)
- Katherine Phan
- grid.1013.30000 0004 1936 834XThe University of Sydney, Brain and Mind Centre, Sydney, NSW Australia ,grid.1013.30000 0004 1936 834XThe University of Sydney, School of Medical Sciences, Sydney, NSW Australia
| | - Ying He
- grid.1013.30000 0004 1936 834XThe University of Sydney, Brain and Mind Centre, Sydney, NSW Australia ,grid.1013.30000 0004 1936 834XThe University of Sydney, School of Medical Sciences, Sydney, NSW Australia
| | - YuHong Fu
- grid.1013.30000 0004 1936 834XThe University of Sydney, Brain and Mind Centre, Sydney, NSW Australia ,grid.1013.30000 0004 1936 834XThe University of Sydney, School of Medical Sciences, Sydney, NSW Australia
| | - Nicolas Dzamko
- grid.1013.30000 0004 1936 834XThe University of Sydney, Brain and Mind Centre, Sydney, NSW Australia ,grid.1013.30000 0004 1936 834XThe University of Sydney, School of Medical Sciences, Sydney, NSW Australia
| | - Surabhi Bhatia
- grid.1013.30000 0004 1936 834XThe University of Sydney, Brain and Mind Centre, Sydney, NSW Australia ,grid.1013.30000 0004 1936 834XThe University of Sydney, School of Medical Sciences, Sydney, NSW Australia
| | - Julian Gold
- grid.452312.30000 0004 0644 0381The University of Sydney, The Albion Centre, Sydney, NSW Australia
| | - Dominic Rowe
- grid.1004.50000 0001 2158 5405Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Yazi D. Ke
- grid.1004.50000 0001 2158 5405Dementia Research Centre and Department of Biomedical Sciences, Macquarie University, Sydney, NSW Australia
| | - Lars M. Ittner
- grid.1004.50000 0001 2158 5405Dementia Research Centre and Department of Biomedical Sciences, Macquarie University, Sydney, NSW Australia
| | - John R. Hodges
- grid.1013.30000 0004 1936 834XThe University of Sydney, Brain and Mind Centre, Sydney, NSW Australia
| | - Olivier Piguet
- grid.1013.30000 0004 1936 834XThe University of Sydney, Brain and Mind Centre, Sydney, NSW Australia ,grid.1013.30000 0004 1936 834XThe University of Sydney, School of Psychology, Sydney, NSW Australia
| | - Matthew C. Kiernan
- grid.1013.30000 0004 1936 834XThe University of Sydney, Brain and Mind Centre, Sydney, NSW Australia ,grid.413249.90000 0004 0385 0051Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, NSW Australia
| | - Glenda M. Halliday
- grid.1013.30000 0004 1936 834XThe University of Sydney, Brain and Mind Centre, Sydney, NSW Australia ,grid.1013.30000 0004 1936 834XThe University of Sydney, School of Medical Sciences, Sydney, NSW Australia
| | - Woojin Scott Kim
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia. .,The University of Sydney, School of Medical Sciences, Sydney, NSW, Australia.
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Lai B, Phan K, Lewis N, Shumack S. A rare case of vernal keratoconjunctivitis in a patient with atopic dermatitis treated with tralokinumab. J Eur Acad Dermatol Venereol 2021; 36:e343-e345. [PMID: 34807480 DOI: 10.1111/jdv.17824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/03/2021] [Accepted: 11/17/2021] [Indexed: 12/14/2022]
Affiliation(s)
- B Lai
- St George Dermatology and Skin Cancer Centre, Kogarah, NSW, Australia
| | - K Phan
- St George Dermatology and Skin Cancer Centre, Kogarah, NSW, Australia
| | - N Lewis
- Department of Ophthalmology, Royal North Shore Hospital, St Leonards, NSW, Australia.,University of Sydney Medical School, Sydney, NSW, Australia
| | - S Shumack
- St George Dermatology and Skin Cancer Centre, Kogarah, NSW, Australia.,University of Sydney Medical School, Sydney, NSW, Australia.,Department of Dermatology, Royal North Shore Hospital, St Leonards, NSW, Australia
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10
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He Y, Phan K, Bhatia S, Pickford R, Fu Y, Yang Y, Hodges JR, Piguet O, Halliday GM, Kim WS. Increased VLCFA-lipids and ELOVL4 underlie neurodegeneration in frontotemporal dementia. Sci Rep 2021; 11:21348. [PMID: 34725421 PMCID: PMC8560873 DOI: 10.1038/s41598-021-00870-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 12/29/2020] [Accepted: 10/18/2021] [Indexed: 12/22/2022] Open
Abstract
Rare, yet biologically critical, lipids that contain very long chain fatty acids (VLCFA-lipids) are synthesized in the brain by the enzyme ELOVL4. High levels of VLCFA-lipids are toxic to cells and excess VLCFA-lipids are actively removed by ABCD1 in an ATP-dependent manner. Virtually nothing is known about the impact of VLCFA-lipids in neurodegenerative diseases. Here, we investigated the possible role of VLCFA-lipids in frontotemporal dementia (FTD), which is a leading cause of younger-onset dementia. Using quantitative discovery lipidomics, we identified three VLCFA-lipid species that were significantly increased in FTD brain compared to controls, with strong correlations with ELOVL4. Increases in ELOVL4 expression correlated with significant decreases in the membrane-bound synaptophysin in FTD brain. Furthermore, increases in ABCD1 expression correlated with increases in VLCFA-lipids. We uncovered a new pathomechanism that is pertinent to understanding the pathogenesis of FTD.
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Affiliation(s)
- Ying He
- Brain and Mind Centre and School of Medical Sciences, The University of Sydney, Camperdown, Sydney, NSW, 2050, Australia
| | - Katherine Phan
- Brain and Mind Centre and School of Medical Sciences, The University of Sydney, Camperdown, Sydney, NSW, 2050, Australia
| | - Surabhi Bhatia
- Brain and Mind Centre and School of Medical Sciences, The University of Sydney, Camperdown, Sydney, NSW, 2050, Australia
| | - Russell Pickford
- Bioanalytical Mass Spectrometry Facility, University of New South Wales, Sydney, NSW, Australia
| | - YuHong Fu
- Brain and Mind Centre and School of Medical Sciences, The University of Sydney, Camperdown, Sydney, NSW, 2050, Australia
| | - Yue Yang
- Brain and Mind Centre and School of Medical Sciences, The University of Sydney, Camperdown, Sydney, NSW, 2050, Australia
| | - John R Hodges
- Brain and Mind Centre and School of Medical Sciences, The University of Sydney, Camperdown, Sydney, NSW, 2050, Australia
| | - Olivier Piguet
- Brain and Mind Centre and School of Psychology, The University of Sydney, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - Glenda M Halliday
- Brain and Mind Centre and School of Medical Sciences, The University of Sydney, Camperdown, Sydney, NSW, 2050, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Woojin Scott Kim
- Brain and Mind Centre and School of Medical Sciences, The University of Sydney, Camperdown, Sydney, NSW, 2050, Australia.
- Neuroscience Research Australia, Sydney, NSW, Australia.
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.
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11
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Ong CS, Oh L, Ghozy S, Dmytriw A, Mobbs R, Phan K, Dibas M, Faulkner H. 846 Dysphagia Rates in Single- And Multiple-Level Anterior Cervical Discectomy and Fusion Surgery: A Meta-Analysis. Br J Surg 2021. [DOI: 10.1093/bjs/znab258.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
To conduct a meta-analysis to assess dysphagia complicating single-level and multiple-level (≥2) anterior cervical discectomy and fusion (ACDF) surgery.
Method
Electronic searches were performed using four electronic databases from their inception to December 2017. Relevant studies reporting the rate of dysphagia as an endpoint for patients undergoing ACDF for degenerative disease, myelopathy, cervical canal stenosis or ossification of the posterior longitudinal ligament were identified according to prior inclusion and exclusion criteria. Statistical analysis was performed using a fixed effect model. P-scores were used to rank the levels of ACDF based on the rate of dysphagia. I2 was used to explore heterogeneity.
Results
Ten studies were identified and included in the systematic review and meta-analysis, with a total of 4,018 patients identified; 2,362 patients underwent single-level ACDF, while 1,656 underwent multiple level (≥2 ACDF). The mean age ranged from 49.45 to 57.77 years. Mean follow-up time ranged from 2 days to 27.3 months. Overall, meta-analysis demonstrated a statistically significant higher dysphagia rate for multiple-level ACDF (6.6%) than for single-level ACDF (4%) (P heterogeneity =0.151, OR = 1.42, 95% CI: 1.05–1.91, I2=32%).
Conclusions
Dysphagia is a relatively common complication in the early postoperative period following ACDF and may cause patients significant discomfort and distress. This meta-analysis demonstrates a higher rate of dysphagia with multiple-level ACDF than with single-level ACDF at a period of 12–24 months.
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Affiliation(s)
- C S Ong
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - L Oh
- Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - S Ghozy
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
- Neurosurgery Department, El Sheikh Zayed Specialized Hospital, Giza, Egypt
| | - A Dmytriw
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - R Mobbs
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Neurospine Surgery Research Group, Prince of Wales Private Hospital, Sydney, Australia
- Department of Neurosurgery, Prince of Wales Hospital, Sydney, Australia
| | - K Phan
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Neurospine Surgery Research Group, Prince of Wales Private Hospital, Sydney, Australia
| | - M Dibas
- Sulaiman Al Rajhi Colleges, College of Medicine, Al Bukayriyah, Saudi Arabia
| | - H Faulkner
- Faculty of Medicine, University of New South Wales, Sydney, Australia
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12
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Ong CS, Choy WJ, Phan K, Diwan A, Mobbs R. 843 Annular Closure Device for Disc Herniation: Meta-Analysis of Clinical Outcome and Complications. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.937] [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: 11/13/2022]
Abstract
Abstract
Aim
To assist surgeons to determine a potential approach to reduce incidences of recurrent lumbar disc herniation and assess the current devices regarding their outcomes and complications.
Method
Four electronic full-text databases were systematically searched through September 2017. All results were pooled utilising meta-analysis with weighted mean difference and odds ratio as summary statistics.
Results
Four studies met inclusion criteria. Three studies reported the use of Barricaid (ACD) while one study reported the use of Anulex (AR). A total of 24 symptomatic reherniation were reported among 811 discectomies with ACD/AR as compared to 51 out of 645 in the control group (OR: 0.34; 95% CI: 0.20,0.56; I2 = 0%; P < 0.0001). Durotomies were lower among the ACD/AR patients with only 3 reported cases compared to 7 in the control group (OR: 0.54; 95% CI: 0.13, 2.23; I2 = 11%; P = 0.39). Similar outcomes for post-operative Oswestry Disability Index and visual analogue scale were obtained when both groups were compared.
Conclusions
Early results showed the use of Barricaid and Anulex devices are beneficial for short term outcomes demonstrating a reduction in symptomatic disc reherniation with low post-operative complication rates. Long-term studies are required to further investigate the efficacy of such devices.
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Affiliation(s)
- C S Ong
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - W J Choy
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- NeuroSpine Surgery Research Group, Prince of Wales Private Hospital, Sydney, Australia
| | - K Phan
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- NeuroSpine Surgery Research Group, Prince of Wales Private Hospital, Sydney, Australia
- Department of Neurosurgery, Prince of Wales Private Hospital, Sydney, Australia
| | - A Diwan
- Department of Orthopaedic Surgery, St. George & Sutherland Clinical School, University of New South Wales, New South Wales, Australia
| | - R Mobbs
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- NeuroSpine Surgery Research Group, Sydney, Australia
- Department of Neurosurgery, Prince of Wales Private Hospital, Sydney, Australia
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13
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Raiker R, Pakhchanian H, Phan K. LB751 COVID-19 complications in patients with Hidradenitis Suppurativa: A multicenter study. J Invest Dermatol 2021. [PMCID: PMC8374138 DOI: 10.1016/j.jid.2021.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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14
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Tonneau M, Phan K, Kazandjian S, Elkrief A, Panasci J, Richard C, Nolin-Lapalme A, El Sayed R, Ding L, Nair T, Malo J, Chandelier F, Kafi K, O'Brien J, Di Jorio L, Muanza T, Routy B. 1357P A deep radiomics approach to assess PD-L1 expression and clinical outcomes in patients with advanced non-small cell lung cancer treated with immune checkpoint inhibitors: A multicentric study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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15
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Phan K, Dehle F, Spiteri C, Toomeh E, Taylor C, Bohensky M. PCN85 Comparison of Observed LONG-TERM Overall Survival with Extrapolated Overall Survival for Pembrolizumab Monotherapy Assessed By Australian Reimbursement Authorities. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.135] [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: 10/23/2022]
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16
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Elkrief A, Phan K, Di Jorio L, Simpson R, Chassé M, Malo J, Richard C, Kosyakov M, Chandelier F, Kafi K, Routy B. 1394P Deep learning model to predict clinical outcomes in patients with advanced non-small cell lung cancer treated with immune checkpoint inhibitors. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1708] [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: 10/23/2022] Open
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17
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Phan K, Smith S. Lichen planopilaris and dyslipidaemia: systematic review and meta‐analysis. Clin Exp Dermatol 2020; 45:611-613. [DOI: 10.1111/ced.14190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/16/2020] [Accepted: 02/04/2020] [Indexed: 11/29/2022]
Affiliation(s)
- K. Phan
- Department of Dermatology Liverpool Hospital Liverpool Australia
| | - S.D. Smith
- Department of Dermatology Royal North Shore Hospital St Leonards Australia
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18
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Oh LJ, Phan K, Kim SW, Low TH, Gupta R, Clark JR. Elective neck dissection versus observation for early-stage oral squamous cell carcinoma: Systematic review and meta-analysis. Oral Oncol 2020; 105:104661. [PMID: 32244173 DOI: 10.1016/j.oraloncology.2020.104661] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [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: 12/04/2019] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Oral squamous cell carcinoma (OSCC) is the seventh most common cancer globally, and has been identified as a growing health concern. This study aims to evaluate the current literature comparing elective neck dissection to observation in the treatment of early-stage tongue SCC, focusing on nodal recurrence, overall survival, disease specific survival statistics from randomised controlled trials comparing the two interventions. METHODS Systematic review and meta-analysis was conducted according to PRISMA guidelines. The odds ratio (OR) was used as a summary statistic. RESULTS From 8 studies, there was a total of 372 cases of recurrence, 98 (15.1%) in END group and 274 (41.5%) in the Observation group. There was a significantly lower rate of recurrence in the END group compared to observation (OR 0.25, 95% CI 0.16-0.39, I2 = 54%, P < 0.00001). END was associated with higher overall survival rates when compared with observation (OR 1.95, 95% CI 1.40-2.73, I2 = 14%, P < 0.0001). END was also associated with higher disease-specific survival compared with observation (OR 1.88, 95% CI 1.21-2.93), I2 = 47%, P = 0.005), with no significant heterogeneity noted. CONCLUSIONS END was associated with significantly lower recurrence rates and higher overall and disease-specific survival compared to a conservative observation approach in early-stage oral SCC with clinically N0 neck.
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Affiliation(s)
- L J Oh
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia.
| | - K Phan
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - S W Kim
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - T H Low
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia
| | - R Gupta
- Central Clinical School, University of Sydney, Sydney, Australia; Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
| | - J R Clark
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia
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19
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Phan K, He Y, Pickford R, Bhatia S, Katzeff JS, Hodges JR, Piguet O, Halliday GM, Kim WS. Uncovering pathophysiological changes in frontotemporal dementia using serum lipids. Sci Rep 2020; 10:3640. [PMID: 32107421 PMCID: PMC7046653 DOI: 10.1038/s41598-020-60457-w] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 02/10/2020] [Indexed: 12/12/2022] Open
Abstract
Blood serum is enriched in lipids and has provided a platform to understand the pathogenesis of a number of human diseases with improved diagnosis and development of biomarkers. Understanding lipid changes in neurodegenerative diseases is particularly important because of the fact that lipids make up >50% of brain tissues. Frontotemporal dementia (FTD) is a common cause of early onset dementia, characterized by brain atrophy in the frontal and temporal regions, concomitant loss of lipids and dyslipidemia. However, little is known about the link between dyslipidemia and FTD pathophysiology. Here, we utilized an innovative approach – lipidomics based on mass spectrometry – to investigate three key aspects of FTD pathophysiology – mitochondrial dysfunction, inflammation, and oxidative stress. We analyzed the lipids that are intrinsically linked to neurodegeneration in serum collected from FTD patients and controls. We found that cardiolipin, acylcarnitine, lysophosphatidylcholine, platelet-activating factor, o-acyl-ω-hydroxy fatty acid and acrolein were specifically altered in FTD with strong correlation between the lipids, signifying pathophysiological changes in FTD. The lipid changes were verified by measurement of the common disease markers (e.g. ATP, cytokine, calcium) using conventional assays. When put together, these results support the use of lipidomics technology to detect pathophysiological changes in FTD.
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Affiliation(s)
- Katherine Phan
- The University of Sydney, Brain and Mind Centre & Central Clinical School, Sydney, NSW, Australia
| | - Ying He
- The University of Sydney, Brain and Mind Centre & Central Clinical School, Sydney, NSW, Australia
| | - Russell Pickford
- Bioanalytical Mass Spectrometry Facility, University of New South Wales, Sydney, NSW, Australia
| | - Surabhi Bhatia
- The University of Sydney, Brain and Mind Centre & Central Clinical School, Sydney, NSW, Australia
| | - Jared S Katzeff
- The University of Sydney, Brain and Mind Centre & Central Clinical School, Sydney, NSW, Australia
| | - John R Hodges
- The University of Sydney, Brain and Mind Centre & Central Clinical School, Sydney, NSW, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Olivier Piguet
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia.,The University of Sydney, Brain and Mind Centre & School of Psychology, Sydney, NSW, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
| | - Glenda M Halliday
- The University of Sydney, Brain and Mind Centre & Central Clinical School, Sydney, NSW, Australia. .,ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia. .,The University of Sydney, Brain and Mind Centre & School of Psychology, Sydney, NSW, Australia. .,Neuroscience Research Australia, Sydney, NSW, Australia. .,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.
| | - Woojin Scott Kim
- The University of Sydney, Brain and Mind Centre & Central Clinical School, Sydney, NSW, Australia. .,Neuroscience Research Australia, Sydney, NSW, Australia. .,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.
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20
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Katzeff JS, Phan K, Purushothuman S, Halliday GM, Kim WS. Cross-examining candidate genes implicated in multiple system atrophy. Acta Neuropathol Commun 2019; 7:117. [PMID: 31340844 PMCID: PMC6651992 DOI: 10.1186/s40478-019-0769-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/14/2019] [Indexed: 12/26/2022] Open
Abstract
Multiple system atrophy (MSA) is a devastating neurodegenerative disease characterized by the clinical triad of parkinsonism, cerebellar ataxia and autonomic failure, impacting on striatonigral, olivopontocerebellar and autonomic systems. At early stage of the disease, the clinical symptoms of MSA can overlap with those of Parkinson's disease (PD). The key pathological hallmark of MSA is the presence of glial cytoplasmic inclusions (GCI) in oligodendrocytes. GCI comprise insoluble proteinaceous filaments composed chiefly of α-synuclein aggregates, and therefore MSA is regarded as an α-synucleinopathy along with PD and dementia with Lewy bodies. The etiology of MSA is unknown, and the pathogenesis of MSA is still largely speculative. Much data suggests that MSA is a sporadic disease, although some emerging evidence suggests rare genetic variants increase susceptibility. Currently, there is no general consensus on the susceptibility genes as there have been differences due to geographical distribution or ethnicity. Furthermore, many of the reported studies have been conducted on patients that were only clinically diagnosed without pathological verification. The purpose of this review is to bring together available evidence to cross-examine the susceptibility genes and genetic pathomechanisms implicated in MSA. We explore the possible involvement of the SNCA, COQ2, MAPT, GBA1, LRRK2 and C9orf72 genes in MSA pathogenesis, highlight the under-explored areas of MSA genetics, and discuss future directions of research in MSA.
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21
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Phan K, Sebaratnam DF. JAK inhibitors for alopecia areata: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2019; 33:850-856. [PMID: 30762909 DOI: 10.1111/jdv.15489] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 01/18/2019] [Indexed: 12/14/2022]
Abstract
There have been a number of case reports and small clinical trials reporting promising outcomes of Janus Kinase (JAK) inhibitors tofacitinib, ruxolitinib and baricitinib for alopecia areata (AA). The majority of the literature to date is based on small volume data, with a lack of definitive evidence or guidelines. To determine the expected response of AA to JAK inhibitor therapy and factors which influence response and recurrence rates. A systematic review and meta-analysis was performed according to PRISMA guidelines. From 30 studies and 289 cases, there were 72.4% responders, good responders 45.7% and partial responders 21.4%. Mean time to initial hair growth was 2.2 ± 6.7 months, and time to complete hair regrowth was 6.7 ± 2.2 months. All 37 recurrences occurred when treatment was ceased after 2.7 months. Oral route was significantly associated with response to treatment compared to topical therapy. No difference was found between paediatric and adult cases in proportion of responses. There is promising low-quality evidence regarding the effectiveness of JAK inhibitors in AA. Future large-sized randomized studies are required to confirm findings.
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Affiliation(s)
- K Phan
- Department of Dermatology, Liverpool Hospital, Sydney, NSW, Australia.,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - D F Sebaratnam
- Department of Dermatology, Liverpool Hospital, Sydney, NSW, Australia.,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.,Departments of Dermatology, Sydney Children's Hospitals' Network, Sydney, NSW, Australia
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22
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Dmytriw AA, Phan K, Moore JM, Pereira VM, Krings T, Thomas AJ. On Flow Diversion: The Changing Landscape of Intracerebral Aneurysm Management. AJNR Am J Neuroradiol 2019; 40:591-600. [PMID: 30894358 DOI: 10.3174/ajnr.a6006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/25/2019] [Indexed: 12/15/2022]
Abstract
Uptake of flow-diverting technology is rapidly outpacing the availability of clinical evidence. Most current usage is off-label, and the endovascular community is nearer the beginning than the end of the learning curve, given the number of devices in development. A comprehensive overview of technical specifications alongside key outcome data is essential both for clinical decision-making and to direct further investigations. Most-studied has been the Pipeline Embolization Device, which has undergone a transition to the Pipeline Flex for which outcome data are sparse or heterogeneous. Alternative endoluminal devices do not appear to be outperforming the Pipeline Embolization Device to date, though prospective studies and long-term data mostly are lacking, and between-study comparisons must be treated with caution. Nominal technical specifications may be unrelated to in situ performance, emphasizing the importance of correct radiologic sizing and device placement. Devices designed specifically for bifurcation aneurysms also lack long-term outcome data or have only recently become available for clinical use. There are no major studies directly comparing a flow-diverting device with standard coiling or microsurgical clipping. Data on flow-diverting stents are too limited in terms of long-term outcomes to reliably inform clinical decision-making. The best available evidence supports using a single endoluminal device for most indications. Recommendations on the suitability and choice of a device for bifurcation or ruptured aneurysms or for anatomically complex lesions cannot be made on the basis of current evidence. The appropriateness of flow-diverting treatment must be decided on a case-by-case basis, considering experience and the relative risks against standard approaches or observation.
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Affiliation(s)
- A A Dmytriw
- From the Department of Medical Imaging (A.A.D., V.M.P., T.K.), Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada .,Neurosurgical Service (A.A.D., K.P., J.M.M., A.J.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - K Phan
- Neurosurgical Service (A.A.D., K.P., J.M.M., A.J.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.,NeuroSpine Surgery Research Group (K.P.), Prince of Wales Private Hospital, Sydney, Australia
| | - J M Moore
- Neurosurgical Service (A.A.D., K.P., J.M.M., A.J.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - V M Pereira
- From the Department of Medical Imaging (A.A.D., V.M.P., T.K.), Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - T Krings
- From the Department of Medical Imaging (A.A.D., V.M.P., T.K.), Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - A J Thomas
- Neurosurgical Service (A.A.D., K.P., J.M.M., A.J.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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23
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Phan K, Charlton O, Smith SD. Hidradenitis suppurativa and diabetes mellitus: updated systematic review and adjusted meta-analysis. Clin Exp Dermatol 2019; 44:e126-e132. [PMID: 30730068 DOI: 10.1111/ced.13922] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a debilitating and distressing chronic inflammatory skin disease. There is also evolving evidence supporting the association between HS and cardiovascular risk factors, including smoking, obesity, hyperlipidaemia and metabolic syndrome. Notably, these are clinical features and risk factors that are closely associated with type 2 diabetes mellitus (DM). AIMS We performed a pooled adjusted meta-analysis of comparative studies to investigate the relationship between HS and DM. METHODS A systematic review and meta-analysis was performed according to recommended Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. OR was used as the summary effect size. RESULTS From pooled analysis of unadjusted data from 12 studies, we found a significantly higher proportion of DM in HS cases compared with non-HS healthy controls (16.1% vs. 15.7%; OR = 2.17; 95% CI 1.85-2.55; P < 0.001). Adjusted effect sizes from five studies were also pooled. A significantly higher proportion of DM was found for HS compared with healthy controls, although the effect size was attenuated compared with unadjusted analyses (OR 1.69; 95% CI 1.50-1.91; P < 0.001). CONCLUSIONS To our knowledge, our systematic review and meta-analysis is the first to pool adjusted effect sizes. We found that HS was associated with a 1.69-fold increased odds of diabetes; however, the absolute risk difference was small (16.1% vs. 15.7%) and is probably not clinically relevant. Treating clinicians should be aware of this association, but there may not be an urgent need to perform screening for impaired glucose tolerance or diabetes.
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Affiliation(s)
- K Phan
- Department of Dermatology, Liverpool Hospital, Liverpool, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - O Charlton
- Department of Dermatology, Royal North Shore Hospital, St Leonards, Sydney, Australia
| | - S D Smith
- Department of Dermatology, Royal North Shore Hospital, St Leonards, Sydney, Australia.,Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia.,The Dermatology and Skin Cancer Centre, Gosford and St Leonards, Sydney, Australia
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24
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Ahmed RM, Phan K, Highton‐Williamson E, Strikwerda‐Brown C, Caga J, Ramsey E, Zoing M, Devenney E, Kim WS, Hodges JR, Piguet O, Halliday GM, Kiernan MC. Eating peptides: biomarkers of neurodegeneration in amyotrophic lateral sclerosis and frontotemporal dementia. Ann Clin Transl Neurol 2019; 6:486-495. [PMID: 30911572 PMCID: PMC6414477 DOI: 10.1002/acn3.721] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 11/25/2018] [Accepted: 12/21/2018] [Indexed: 12/12/2022] Open
Abstract
Objective Physiological changes potentially influence disease progression and survival along the Amyotrophic Lateral Sclerosis (ALS)-Frontotemporal dementia (FTD) spectrum. The peripheral peptides that regulate eating and metabolism may provide diagnostic, metabolic, and progression biomarkers. The current study aimed to examine the relationships and biomarker potential of hormonal peptides. Methods One hundred and twenty-seven participants (36 ALS, 26 ALS- cognitive, patients with additional cognitive behavioral features, and 35 behavioral variant FTD (bvFTD) and 30 controls) underwent fasting blood analyses of leptin, ghrelin, neuropeptide Y (NPY), peptide YY (PYY), and insulin levels. Relationships between endocrine measures, cognition, eating behaviors, and body mass index (BMI) were investigated. Biomarker potential was evaluated using multinomial logistic regression for diagnosis and correlation to disease duration. Results Compared to controls, ALS and ALS-cognitive had higher NPY levels and bvFTD had lower NPY levels, while leptin levels were increased in all patient groups. All groups had increased insulin levels and a state of insulin resistance compared to controls. Lower NPY levels correlated with increasing eating behavioral change and BMI, while leptin levels correlated with BMI. On multinomial logistic regression, NPY and leptin levels were found to differentiate between diagnosis. Reduced Neuropeptide Y levels correlated with increasing disease duration, suggesting it may be useful as a potential marker of disease progression. Interpretation ALS-FTD is characterized by changes in NPY and leptin levels that may impact on the underlying regional neurodegeneration as they were predictive of diagnosis and disease duration, offering the potential as biomarkers and for the development of interventional treatments.
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Affiliation(s)
- Rebekah M. Ahmed
- Memory and Cognition ClinicInstitute of Clinical NeurosciencesRoyal Prince Alfred HospitalSydneyNew South WalesAustralia
- Brain and Mind CentreSydney Medical SchoolThe University of SydneySydneyNew South WalesAustralia
- ARC Centre of Excellence in Cognition and its DisordersSydneyNew South WalesAustralia
| | - Katherine Phan
- Brain and Mind CentreSydney Medical SchoolThe University of SydneySydneyNew South WalesAustralia
| | | | - Cherie Strikwerda‐Brown
- Brain and Mind CentreSydney Medical SchoolThe University of SydneySydneyNew South WalesAustralia
- ARC Centre of Excellence in Cognition and its DisordersSydneyNew South WalesAustralia
- The University of SydneySchool of Psychology and Brain and Mind CentreSydneyNew South WalesAustralia
| | - Jashelle Caga
- Brain and Mind CentreSydney Medical SchoolThe University of SydneySydneyNew South WalesAustralia
| | - Eleanor Ramsey
- Brain and Mind CentreSydney Medical SchoolThe University of SydneySydneyNew South WalesAustralia
| | - Margaret Zoing
- Brain and Mind CentreSydney Medical SchoolThe University of SydneySydneyNew South WalesAustralia
| | - Emma Devenney
- Brain and Mind CentreSydney Medical SchoolThe University of SydneySydneyNew South WalesAustralia
| | - Woojin S. Kim
- Brain and Mind CentreSydney Medical SchoolThe University of SydneySydneyNew South WalesAustralia
| | - John R. Hodges
- Brain and Mind CentreSydney Medical SchoolThe University of SydneySydneyNew South WalesAustralia
- ARC Centre of Excellence in Cognition and its DisordersSydneyNew South WalesAustralia
| | - Olivier Piguet
- ARC Centre of Excellence in Cognition and its DisordersSydneyNew South WalesAustralia
- The University of SydneySchool of Psychology and Brain and Mind CentreSydneyNew South WalesAustralia
| | - Glenda M. Halliday
- Brain and Mind CentreSydney Medical SchoolThe University of SydneySydneyNew South WalesAustralia
| | - Matthew C. Kiernan
- Memory and Cognition ClinicInstitute of Clinical NeurosciencesRoyal Prince Alfred HospitalSydneyNew South WalesAustralia
- Brain and Mind CentreSydney Medical SchoolThe University of SydneySydneyNew South WalesAustralia
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Phan K, Kahlaee HR, Kim SH, Toh JWT. Laparoscopic vs. robotic rectal cancer surgery and the effect on conversion rates: a meta-analysis of randomized controlled trials and propensity-score-matched studies. Tech Coloproctol 2019; 23:221-230. [PMID: 30623315 DOI: 10.1007/s10151-018-1920-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 12/26/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND The usage of robotic surgery in rectal cancer is increasing, but there is an ongoing debate as to whether it provides any benefit. The aim of the present study was to determine if robotic surgery results in less conversion to an open operation than laparoscopic rectal cancer surgery. METHODS A meta-analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using Ovid Medline, PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, ACP Journal Club and Database of Abstracts of Review of Effectiveness. Included were randomized controlled trials (RCTs) and propensity-score-matched (PSM) studies comparing a robotic vs. laparoscopic approach to rectal cancer surgery. The primary endpoint was conversion to open. All statistical analyses and data synthesis were conducted using STATA/IC version 14·2, Windows 64 bit (StataCorp LP, College Station, TX, USA) RESULTS: Six hundred and twenty-one studies were identified through electronic database search. After application of selection criteria as per PRISMA and MOOSE criteria, six RCTs and five PSM articles were analyzed. From the six RCTs, 512 robotic and 519 laparoscopic cases were evaluated. There was a significantly lower rate of conversion for the robotic surgery arm (4.1% vs. 8.1%, OR 0.28; 95% CI 0.00-0.57). Of the five PSM studies, 2097 robotic and 3053 laparoscopic cases were evaluated. There was a significantly lower conversion to open rate found in the robotic surgery cohort (7.4% vs. 15.6%; OR 0.39; 95% CI 0.30-0.47). Pooled RCT and PSM data demonstrated significantly lower conversion rates for robotic surgery (6.7% vs. 14.5%; OR 0.38; 95% CI 0.30-0.46). CONCLUSIONS Robotic surgery for rectal cancer is associated with reduced conversion to open surgery compared to a laparoscopic approach.
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Affiliation(s)
- K Phan
- Division of Colorectal Surgery, Department of Surgery, Westmead Hospital, Sydney, NSW, Australia.,The University of Sydney, Westmead Clinical School, Sydney, NSW, Australia.,Division of Colorectal Surgery, Department of Surgery, Liverpool Hospital, Liverpool, Australia
| | - H R Kahlaee
- Department of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - S H Kim
- Division of Colorectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - J W T Toh
- Division of Colorectal Surgery, Department of Surgery, Westmead Hospital, Sydney, NSW, Australia. .,The University of Sydney, Westmead Clinical School, Sydney, NSW, Australia.
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Kim WS, He Y, Phan K, Ahmed RM, Rye KA, Piguet O, Hodges JR, Halliday GM. Altered High Density Lipoprotein Composition in Behavioral Variant Frontotemporal Dementia. Front Neurosci 2018; 12:847. [PMID: 30487733 PMCID: PMC6246632 DOI: 10.3389/fnins.2018.00847] [Citation(s) in RCA: 13] [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: 09/20/2018] [Accepted: 10/29/2018] [Indexed: 11/13/2022] Open
Abstract
Frontotemporal dementia (FTD) is a common cause of early onset dementia with behavioral variant FTD (bvFTD) being the most common form. bvFTD is characterized clinically by behavioral and personality changes, eating abnormalities, and pathologically, by systemic lipid dysregulation that impacts on survival. As lipoprotein metabolism is at the core of lipid dysregulation, here, we analyzed the composition, both proteins and lipids, of the two major lipoprotein classes in blood – high density lipoproteins (HDLs) and low density lipoproteins (LDLs). Fasted plasmas from bvFTD and Alzheimer’s disease (AD) patients and controls were fractionated using fast protein liquid chromatography (FPLC) and samples analyzed by lipid assays, ELISA and western blotting. We found that apolipoprotein A-I (apoA-I) and apolipoprotein A-II (apoA-II) levels in HDLs were decreased in bvFTD compared to controls, whereas apolipoprotein B (apoB) levels in LDLs were unaltered. We also found that cholesterol and triglyceride levels in FPLC fractions were altered in bvFTD compared to controls. The apoB:apoA-I ratio and the standard lipid ratios were significantly increased in bvFTD compared to AD and controls. Furthermore, we found that plasma apolipoprotein C-I and paraoxonase 1 levels were significantly altered in bvFTD and AD, respectively, compared controls. This study represents the first apolipoprotein analysis of bvFTD, and our results suggest altered HDL function and elevated cardiovascular disease risk in bvFTD.
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Affiliation(s)
- Woojin Scott Kim
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
| | - Ying He
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Katherine Phan
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Rebekah M Ahmed
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Kerry-Anne Rye
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Olivier Piguet
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia.,School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - John R Hodges
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Glenda M Halliday
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
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Shepard P, Akagi K, Everett S, Hassan I, Osborne A, Tan M, Schroth C, Aase D, Passi H, Proescher E, Greenstein J, Walters R, Krage M, Phan K. A - 66The Polytrauma Triad: Impact of PTSD Symptom Clusters on Cognitive Complaints in Post-9/11 Veterans. Arch Clin Neuropsychol 2018. [DOI: 10.1093/arclin/acy061.66] [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: 11/12/2022] Open
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Choi J, Luc J, Escrivà EM, Phan K, Rizvi S, Patel S, Entwistle J, Morris R, Massey H, Tchantchaleishvili V. Impact of Concomitant Mitral Valve Surgery for Mitral Regurgitation During LVAD Implantation: Systematic Review and Meta-Analysis. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.168] [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: 11/29/2022] Open
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Tchantchaleishvili V, Luc J, Phan K, Dunlay S, Maltais S, Stulak J. Management and Outcomes of LVAD Thrombosis: A Systematic Review and Meta-Analysis. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Phan K, Ferenci T. The fitness costs and trade-off shapes associated with the exclusion of nine antibiotics by OmpF porin channels. ISME J 2017; 11:1472-1482. [PMID: 28072422 DOI: 10.1038/ismej.2016.202] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/20/2016] [Accepted: 12/01/2016] [Indexed: 02/01/2023]
Abstract
The trade-off relationship between antibiotic exclusion and nutrient access across the Gram-negative outer membrane is determined by structural constraints in porin channels. The precise nutritional cost of exclusion is unknown for different antibiotics, as are the shapes of the nutrition-susceptibility trade-off. Using a library of 10 engineered isogenic Escherichia coli strains with structural modifications of OmpF porin expressed at a constant level, susceptibilities were measured for nine antibiotics and the nutritional fitness costs estimated by competitions in chemostats. Different antibiotics exhibited a remarkably varied range of geometries in the nutrition-susceptibility trade-off, including convex, concave and sigmoidal trade-off shapes. The trade-off patterns predict the possibility of adaptations in contributing to antibiotic resistance; exclusion of amoxicillin or trimethoprim in ompF mutants can occur with little loss of fitness whereas kanamycin and streptomycin exclusion has a high cost. Some individual OmpF changes even allow positive correlations (trade-ups), resulting in increased fitness and decreased susceptibility specifically to cephalexin or ciprofloxacin. The surprising plasticity of the nutrition-exclusion relationship means that there are no generalisable rules that apply to decreasing susceptibility for all antibiotics. The protein changes are exquisitely specific in determining nutritional fitness and adaptive outcomes in a structural constraint trade-off.
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Affiliation(s)
- Katherine Phan
- School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Thomas Ferenci
- School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales, Australia
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Yudi M, Clark D, Tsang D, Jelinek M, Kalten K, Joshi S, Phan K, Nasis A, Amerena J, MacIsaac A, Arunothayaraj S, Si S, Reid C, Farouque O. SMARTphone-based, Early Cardiac REHABilitation in Patients with Acute Coronary Syndromes [SMART-REHAB Trial]: A Randomised Controlled Trial. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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32
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Zentner D, Phan K, Gibson R, Sood S, Gorelik A, Grigg L, Nicoll A. Fontan-Associated Liver Disease (FALD)–Results from Shear Wave Elastography. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.651] [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: 11/26/2022]
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Huo Y, Phan K, Zhao D, Rao P, Phan S, Mortimer A. Endovascular therapy including thrombectomy for acute ischemic stroke: a systematic review and meta-analysis with trial sequential analysis. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.259] [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] Open
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34
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Huo Y, Phan K, Jia F, Phan S, Mortimer A. A systematic review and meta-analysis of stent-assisted coiling versus coiling-only in treatment of intracranial aneurysm. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.303] [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] Open
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35
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Phan K, Xie A, Tsai YC, Kumar N, La Meir M, Yan TD. Biatrial ablation vs. left atrial concomitant surgical ablation for treatment of atrial fibrillation: a meta-analysis. Europace 2015; 17:38-47. [PMID: 25336669 DOI: 10.1093/europace/euu220] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
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36
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Phan K, Medi C, Yan T. Thoracoscopic surgical ablation versus catheter ablation for atrial fibrillation: systematic review and meta-analysis. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.333] [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: 10/23/2022]
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37
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Sohn KY, Phan K, Hill S, Worster A, You J, Oremus M, Devereaux P, Jaffe A, Kavsak P. Comparison of angiogenic growth factors assays using a research mulitplex platform versus clinical platforms in patients with chest pain. Clin Biochem 2011. [DOI: 10.1016/j.clinbiochem.2011.06.061] [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: 11/16/2022]
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38
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Huang Y, Sohn KY, Phan K, Dhesy-Thind S, Hill S, Hirte H, Hotte S, Worster A, Kavsak P. NT-proBNP measurement using a multiplex platform in cancer and chest pain populations. Clin Biochem 2011. [DOI: 10.1016/j.clinbiochem.2011.06.032] [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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Ferenci T, Galbiati HF, Betteridge T, Phan K, Spira B. The constancy of global regulation across a species: the concentrations of ppGpp and RpoS are strain-specific in Escherichia coli. BMC Microbiol 2011; 11:62. [PMID: 21439067 PMCID: PMC3074542 DOI: 10.1186/1471-2180-11-62] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 03/25/2011] [Indexed: 12/21/2022] Open
Abstract
Background Sigma factors and the alarmone ppGpp control the allocation of RNA polymerase to promoters under stressful conditions. Both ppGpp and the sigma factor σS (RpoS) are potentially subject to variability across the species Escherichia coli. To find out the extent of strain variation we measured the level of RpoS and ppGpp using 31 E. coli strains from the ECOR collection and one reference K-12 strain. Results Nine ECORs had highly deleterious mutations in rpoS, 12 had RpoS protein up to 7-fold above that of the reference strain MG1655 and the remainder had comparable or lower levels. Strain variation was also evident in ppGpp accumulation under carbon starvation and spoT mutations were present in several low-ppGpp strains. Three relationships between RpoS and ppGpp levels were found: isolates with zero RpoS but various ppGpp levels, strains where RpoS levels were proportional to ppGpp and a third unexpected class in which RpoS was present but not proportional to ppGpp concentration. High-RpoS and high-ppGpp strains accumulated rpoS mutations under nutrient limitation, providing a source of polymorphisms. Conclusions The ppGpp and σS variance means that the expression of genes involved in translation, stress and other traits affected by ppGpp and/or RpoS are likely to be strain-specific and suggest that influential components of regulatory networks are frequently reset by microevolution. Different strains of E. coli have different relationships between ppGpp and RpoS levels and only some exhibit a proportionality between increasing ppGpp and RpoS levels as demonstrated for E. coli K-12.
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Affiliation(s)
- Thomas Ferenci
- School of Molecular and Microbial Biosciences, The University of Sydney, NSW, Australia
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40
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Levert M, Zamfir O, Clermont O, Bouvet O, Lespinats S, Hipeaux MC, Branger C, Picard B, Saint-Ruf C, Norel F, Balliau T, Zivy M, Le Nagard H, Cruvellier S, Chane-Woon-Ming B, Nilsson S, Gudelj I, Phan K, Ferenci T, Tenaillon O, Denamur E. Molecular and evolutionary bases of within-patient genotypic and phenotypic diversity in Escherichia coli extraintestinal infections. PLoS Pathog 2010; 6:e1001125. [PMID: 20941353 PMCID: PMC2947995 DOI: 10.1371/journal.ppat.1001125] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Accepted: 08/31/2010] [Indexed: 12/22/2022] Open
Abstract
Although polymicrobial infections, caused by combinations of viruses, bacteria, fungi and parasites, are being recognised with increasing frequency, little is known about the occurrence of within-species diversity in bacterial infections and the molecular and evolutionary bases of this diversity. We used multiple approaches to study the genomic and phenotypic diversity among 226 Escherichia coli isolates from deep and closed visceral infections occurring in 19 patients. We observed genomic variability among isolates from the same site within 11 patients. This diversity was of two types, as patients were infected either by several distinct E. coli clones (4 patients) or by members of a single clone that exhibit micro-heterogeneity (11 patients); both types of diversity were present in 4 patients. A surprisingly wide continuum of antibiotic resistance, outer membrane permeability, growth rate, stress resistance, red dry and rough morphotype characteristics and virulence properties were present within the isolates of single clones in 8 of the 11 patients showing genomic micro-heterogeneity. Many of the observed phenotypic differences within clones affected the trade-off between self-preservation and nutritional competence (SPANC). We showed in 3 patients that this phenotypic variability was associated with distinct levels of RpoS in co-existing isolates. Genome mutational analysis and global proteomic comparisons in isolates from a patient revealed a star-like relationship of changes amongst clonally diverging isolates. A mathematical model demonstrated that multiple genotypes with distinct RpoS levels can co-exist as a result of the SPANC trade-off. In the cases involving infection by a single clone, we present several lines of evidence to suggest diversification during the infectious process rather than an infection by multiple isolates exhibiting a micro-heterogeneity. Our results suggest that bacteria are subject to trade-offs during an infectious process and that the observed diversity resembled results obtained in experimental evolution studies. Whatever the mechanisms leading to diversity, our results have strong medical implications in terms of the need for more extensive isolate testing before deciding on antibiotic therapies. We investigated whether an infection is a site of pathogen within-species diversity. Our results indicate that there is indeed extensive diversity during human extraintestinal infections by Escherichia coli. This diversity was of two types, not mutually exclusive, as we found that patients were infected either by several distinct E. coli clones or by members of a single clone that exhibit micro-heterogeneity. The high degree of phenotypic diversity, including antibiotic resistance, suggests that there is no uniform selection pressure leading to a single fitter clone during an infection. We discuss a possible mechanism and a mathematical model that explains these unexpected results. Our data suggest that the evolution of diversity in the course of an infection and in in vitro experimental evolution in the absence of host immune selective pressure may have many parallels. Whatever the mechanisms leading to diversity, our results have strong medical implications in terms of the need for more extensive isolate testing before deciding on antibiotic therapies.
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Affiliation(s)
- Maxime Levert
- INSERM U722 and Université Paris 7 Denis Diderot, Faculté de Médecine, Site Xavier Bichat, Paris, France
| | - Oana Zamfir
- INSERM U722 and Université Paris 7 Denis Diderot, Faculté de Médecine, Site Xavier Bichat, Paris, France
| | - Olivier Clermont
- INSERM U722 and Université Paris 7 Denis Diderot, Faculté de Médecine, Site Xavier Bichat, Paris, France
| | - Odile Bouvet
- INSERM U722 and Université Paris 7 Denis Diderot, Faculté de Médecine, Site Xavier Bichat, Paris, France
| | - Sylvain Lespinats
- INSERM U722 and Université Paris 7 Denis Diderot, Faculté de Médecine, Site Xavier Bichat, Paris, France
| | - Marie Claire Hipeaux
- Assistance Publique - Hôpitaux de Paris, Hôpital Louis Mourier, Laboratoire de Microbiologie, Colombes, France
| | - Catherine Branger
- INSERM U722 and Université Paris 7 Denis Diderot, Faculté de Médecine, Site Xavier Bichat, Paris, France
- Assistance Publique - Hôpitaux de Paris, Hôpital Louis Mourier, Laboratoire de Microbiologie, Colombes, France
| | - Bertrand Picard
- INSERM U722 and Université Paris 7 Denis Diderot, Faculté de Médecine, Site Xavier Bichat, Paris, France
| | - Claude Saint-Ruf
- INSERM U1001 and Université Paris 5 René Descartes, Faculté de Médecine, Paris, France
| | - Françoise Norel
- Unité de Génétique Moléculaire and CNRS URA2172, Institut Pasteur, Paris, France
| | - Thierry Balliau
- CNRS UMR 0320/UMR8120 Génétique Végétale, Plate-Forme de Protéomique PAPPSO, Gif-sur-Yvette, France
| | - Michel Zivy
- CNRS UMR 0320/UMR8120 Génétique Végétale, Plate-Forme de Protéomique PAPPSO, Gif-sur-Yvette, France
| | - Hervé Le Nagard
- INSERM U738 and Université Paris 7 Denis Diderot, Faculté de Médecine, Site Xavier Bichat, Paris, France
| | - Stéphane Cruvellier
- Laboratoire de Génomique Comparative, CNRS UMR8030, Institut de Génomique, CEA, Genoscope, Evry, France
| | - Béatrice Chane-Woon-Ming
- Laboratoire de Génomique Comparative, CNRS UMR8030, Institut de Génomique, CEA, Genoscope, Evry, France
| | - Susanna Nilsson
- Department of Mathematics, Imperial College, London, United Kingdom
| | - Ivana Gudelj
- Department of Mathematics, Imperial College, London, United Kingdom
| | - Katherine Phan
- School of Molecular Bioscience, University of Sydney, Sydney, New South Wales, Australia
| | - Thomas Ferenci
- School of Molecular Bioscience, University of Sydney, Sydney, New South Wales, Australia
| | - Olivier Tenaillon
- INSERM U722 and Université Paris 7 Denis Diderot, Faculté de Médecine, Site Xavier Bichat, Paris, France
| | - Erick Denamur
- INSERM U722 and Université Paris 7 Denis Diderot, Faculté de Médecine, Site Xavier Bichat, Paris, France
- * E-mail:
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Schofer MD, Quante M, Peterlein CD, Timmesfeld N, Phan K, Fuchs-Winkelmann S. [Operative and follow-up treatment of rotator cuff tears--the current situation]. Z Orthop Unfall 2009; 147:321-6. [PMID: 19551583 DOI: 10.1055/s-2008-1039224] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM The aim of this study was to evaluate the current situation of rotator cuff repair and follow-up treatment in German hospitals. METHODS An evaluated survey, enquiring about the year 2006, was sent to all 777 German orthopaedic and/or trauma surgery departments. The hospitals were chosen using the official index of hospitals from the German Federal Statistical Office. RESULTS 44 % of the surveys were sent back, whereby 40 % were of use. Within the 309 departments, 26 % of the total number of 59,957 shoulder operations were rotator cuff repairs. Mini-open was the operation method in 49 %, open in 29 % and arthroscopic in 22 % of cases. Regarding the operational methods, there were differences between the departments and level of care. The arthroscopic technique was used sometimes in 48 % of the departments, whereas 52 % never used it. Specialised shoulder departments employed the total arthroscopic procedure more often. A set follow-up treatment occurred in 79 % of departments. CONCLUSION Rotator cuff repair is mainly carried out using the mini-open method, which is nowadays regarded as gold standard.
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Affiliation(s)
- M D Schofer
- Orthopädie und Rheumatologie, Universitätsklinikum Marburg, Marburg, Germany.
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Liberzon I, Phan K, Khan S, Abelson J. Role of the GABAA Receptor in Anxiety: Evidence from animal models, molecular and clinical psychopharmacology, and brain imaging studies. Curr Neuropharmacol 2003. [DOI: 10.2174/1570159033477071] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Desrosiers P, Carlson E, Chandler W, Chau H, Cong P, Doolen R, Freitag C, Lin S, Masui C, Wu E, Crevier T, Mullins D, Song L, Lou R, Zhan J, Tangkilisan A, Ung Q, Phan K. High throughput screening techniques for pre-formulation: salt selection and polymorph studies. Acta Crystallogr A 2002. [DOI: 10.1107/s0108767302085446] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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