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Mangan JM, Hedges KNC, Salerno MM, Tatum K, Bouwkamp B, Frick MW, McKenna L, Muzanyi G, Engle M, Coetzee J, Yvetot J, Elskamp M, Lamunu D, Tizora MET, Namutamba D, Chaisson RE, Swindells S, Nahid P, Dorman SE, Kurbatova E. Facilitators and barriers to adolescent participation in a TB clinical trial. Int J Tuberc Lung Dis 2024; 28:243-248. [PMID: 38659142 DOI: 10.5588/ijtld.23.0519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND The inclusion of adolescents in TB drug trials is essential for the development of safe, child-friendly regimens for the prevention and treatment of TB. TB Trials Consortium Study 31/AIDS Clinical Trials Group A5349 (S31/A5349) enrolled adolescents as young as 12 years old. We assessed investigator and coordinator described facilitators and barriers to adolescent recruitment, enrollment, and retention.METHODS Interviews were conducted with six investigators from sites that enrolled adolescent participants and six investigators from non-enrolling sites. Additionally, two focus groups were conducted with study coordinators from enrolling sites and two focus groups with non-enrolling sites. Discussions were transcribed, analyzed, summarized, and summaries were reviewed by Community Research Advisors Group members and research group representatives for content validity.RESULTS Investigators and coordinators attributed the successful enrollment of adolescents to the establishment and cultivation of external partnerships, flexibility to accommodate adolescents' schedules, staff engagement, recruitment from multiple locations, dedicated recruitment staff working onsite to access potential participants, creation of youth-friendly environments, and effective communications. Non-enrolling sites were mainly hindered by regulations. Suggestions for improvement in future trials focused on study planning and site preparations.CONCLUSION Proactive partnerships and collaboration with institutions serving adolescents helped identify and reduce barriers to their inclusion in this trial..
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Affiliation(s)
- J M Mangan
- Division of Tuberculosis Elimination, Centers for Disease Control, Atlanta, GA
| | - K N C Hedges
- Division of Tuberculosis Elimination, Centers for Disease Control, Atlanta, GA
| | - M M Salerno
- Bureau of Tuberculosis Control, New York City Department of Health and Mental Hygiene, New York, NY
| | - K Tatum
- Division of Tuberculosis Elimination, Centers for Disease Control, Atlanta, GA
| | - B Bouwkamp
- Division of Tuberculosis Elimination, Centers for Disease Control, Atlanta, GA, Oak Ridge Institute for Science and Education
| | - M W Frick
- Treatment Action Group, New York, NY, USA
| | - L McKenna
- Treatment Action Group, New York, NY, USA
| | - G Muzanyi
- Uganda-Case Western Reserve University Research Collaboration, Kampala, Uganda
| | - M Engle
- UTHSCSA & San Antonio Veterans Administration Medical Center, TX, USA
| | - J Coetzee
- Family Centre for Research with Ubuntu, University of Stellenbosch, Capetown, South Africa
| | - J Yvetot
- Les Centres GHESKIO, Port Au Prince, Haïti
| | - M Elskamp
- Bureau of Tuberculosis Control, New York City Department of Health and Mental Hygiene, New York, NY
| | - D Lamunu
- Uganda National Council for Science and Technology, Kampala, Uganda
| | - M E Theunissen Tizora
- Family Centre for Research with Ubuntu, University of Stellenbosch, Capetown, South Africa
| | - D Namutamba
- International Community of Women Living with HIV Eastern Africa, Bujumbura, Burundi
| | | | - S Swindells
- University of Nebraska Medical Center, Omaha, NE
| | - P Nahid
- UCSF Center for Tuberculosis, University of California, San Francisco, CA
| | - S E Dorman
- Medical University of South Carolina, Charleston, SC, USA
| | - E Kurbatova
- Division of Tuberculosis Elimination, Centers for Disease Control, Atlanta, GA
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Wu J, Carlock C, Tatum K, Shim J, Zhou C, Lou Y. Activation of Interleukin33-NFκB Axis in granulosa cells during atresia and its role in disposal of Atretic follicles. Biol Reprod 2024:ioae015. [PMID: 38271626 DOI: 10.1093/biolre/ioae015] [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] [Indexed: 01/27/2024] Open
Abstract
It has been previously shown that the cytokine interleukin33 (IL33) is required for two processes, i.e. autophagic digestion of granulosa cells and recruitment of macrophages into atretic follicles, for full disposal of atretic follicles. Now, this study shows that activation of IL33-ST2 (IL33 receptor)-NFκB axis in granulosa in early atretic follicles may regulate those two events. Injection of hCG has been shown to induce a transient peak of IL33 expression with synchronized atresia. In this model, IL33-independent expression of ST2 in granulosa cells was detected in early atretic follicles before macrophage invasion. The activation of NFκB pathway in ovaries was further demonstrated in vivo in Tg mice with luciferase-reporter for NFκB activation; the activation was microscopically localized to granulosa cells in early atretic follicles. Importantly, antibody blockage of IL33 or IL33 KO (Il33-/-) not only inhibited NFκB activity in ovaries, but also altered expression of two key genes, i.e. reduction in proinflammatory IL6 expression, and a surge of potential autophagy-inhibitory mTOR expression in atretic follicles. In contrast, apoptosis and other genes such as IL1β were not affected. In conclusion, in parallel to apoptosis, atresia signals also trigger activation of the IL33-ST2-NFκB pathway in granulosa, which leads to (1) down-regulated expression of mTOR that is a negative regulator of autophagy, and (2) up-regulated expression of proinflammatory IL6.
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Affiliation(s)
- Jean Wu
- Department of Diagnostic Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054
| | - Colin Carlock
- Department of Diagnostic Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054
| | - Kiana Tatum
- Department of Diagnostic Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054
| | - Junbo Shim
- Department of Diagnostic Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054
| | - Cindy Zhou
- Department of Diagnostic Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054
| | - Yahuan Lou
- Department of Diagnostic Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054
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Zhou C, Lou K, Tatum K, Funk J, Wu J, Bartkowiak T, Kagan D, Lou Y. Differentiating Glomerular Inflammation from Fibrosis in a Bone Marrow Chimera for Rat Anti-Glomerular Basement Membrane Glomerulonephritis. Am J Nephrol 2016; 42:42-53. [PMID: 26337665 DOI: 10.1159/000438929] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 07/20/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Many types of glomerulonephritis (GN) undergo tandem connected phases: inflammation and fibrosis. Fibrosis in human GNs leads to irreversible end-stage disease. This study investigated how these 2 phases were controlled. METHODS Using a rat anti-glomerular basement membrane GN model, we established bone marrow (BM) chimeras between GN-resistant Lewis (LEW) and GN-susceptible Wistar Kyoto (WKY) rats. Glomerular inflammation and fibrosis were compared between chimeras. RESULTS LEW's BM to WKY chimeras with or without co-transfer of host WKY's T cells were GN-resistant. On the other hand, WKY's BM to LEW (LEW(WKY)) chimeras developed glomerular inflammation and albuminuria upon immunization. Quantitative analysis showed that the number and composition of inflammatory cells in glomeruli of immunized LEW(WKY) chimeras were similar to those in immunized WKY rats at their inflammatory peak. Thus, glomerular inflammation was controlled by BM-derived non-T cell populations. However, unlike WKY rats, LEW(WKY) rats did not develop fibrosis until the end of experiments (84 days) in spite of persistent inflammation and albuminuria. CONCLUSION Inflammation alone was not sufficient to trigger fibrosis, suggesting a critical role of glomerular cells in the fibrotic process. As LEW(WKY) chimera allows us to separate glomerular inflammation from fibrosis, this model provides a useful tool to study how fibrosis is initiated following inflammation.
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Carlock CI, Wu J, Zhou C, Tatum K, Adams HP, Tan F, Lou Y. Unique temporal and spatial expression patterns of IL-33 in ovaries during ovulation and estrous cycle are associated with ovarian tissue homeostasis. J Immunol 2014; 193:161-9. [PMID: 24860190 DOI: 10.4049/jimmunol.1400381] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Ovaries are among the most active organs. Frequently occurring events such as ovulation and ovarian atresia are accompanied with tissue destruction and repairing. Critical roles of immune cells or molecules in those events have been well recognized. IL-33 is a new member of the IL-1 cytokine gene family. Recent studies suggest its roles beyond immune responses. We systemically examined its expression in ovaries for its potential roles in ovarian functions. During ovulation, a high level of IL-33 was transiently expressed, making it the most significantly upregulated immune gene. During estrous cycle, IL-33 expression levels fluctuated along with numbers of ovarian macrophages and atresia wave. Cells with nuclear form of IL-33 (nIL-33(+) cells) were mostly endothelial cells of veins, either in the inner layer of theca of ovulating follicles during ovulation, or surrounding follicles during estrous cycle. Changes in number of nIL-33(+) cells showed a tendency similar to that in IL-33 mRNA level during estrous cycle. However, the cell number sharply declined before a rapid increase of macrophages and a surge of atresia. The decline in nIL-33(+) cell number was coincident with detection of higher level of the cytokine form of IL-33 by Western blot, suggesting a release of cytokine form of IL-33 before the surge of macrophage migration and atresia. However, IL-33 Ab, either by passive transfer or immunization, showed a limited effect on ovulation or atresia. It raises a possibility of IL-33's role in tissue homeostasis after ovarian events, instead of a direct involvement in ovarian functions.
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Affiliation(s)
- Colin I Carlock
- Department of Diagnostic Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054
| | - Jean Wu
- Department of Diagnostic Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054
| | - Cindy Zhou
- Department of Diagnostic Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054
| | - Kiana Tatum
- Department of Diagnostic Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054
| | - Henry P Adams
- Department of Genetics, University of Texas MD Anderson Cancer Center, Houston, TX 77030; and
| | - Filemon Tan
- Department of Internal Medicine, University of Texas School of Medicine at Houston, Houston, TX 77030
| | - Yahuan Lou
- Department of Diagnostic Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054;
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Tatum K, Das K, Zehr R, Strynar M, Lindstrom A, Delinsky A, Wambaugh J, Lau C. P26—Comparative pharmacokinetics of perfluorononanoic acid in rats and mice. Reprod Toxicol 2012. [DOI: 10.1016/j.reprotox.2011.11.060] [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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Veille JC, Hanson R, Steele L, Tatum K. M-mode echocardiographic evaluation of fetal and infant hearts: longitudinal follow-up study from intrauterine life to year one. Am J Obstet Gynecol 1996; 175:922-8. [PMID: 8885749 DOI: 10.1016/s0002-9378(96)80026-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Our purpose was to evaluate cardiac variables, including right and left end-diastolic and end-systolic dimensions by use of M-mode echocardiography during fetal, neonatal (transitional), and infancy periods to understand hemodynamic adaptation during these periods. STUDY DESIGN Fifty-three fetuses were enrolled in this study. Echocardiography evaluations were started as early as the sixteenth week of gestation and were repeated every 4 to 6 weeks until term, on postnatal days 1 and 2, and at 6 weeks, 6 months, and 12 months of age. End-diastolic and end-systolic measurements were made according to published standards. Mean and SEM for each of the end-diastolic and end-systolic measurements were calculated for each of 11 study periods. Data were analyzed by one-way analysis of variance, corrected for repeated measures, and in the case of right and left ventricular differences paired t tests were used for significance. RESULTS Left ventricular end-diastolic and end-systolic correlated positively with advancing age (R2 = 0.93, p < 0.0001), right ventricular end-diastolic also correlated with advancing age (R2 = = 0.361, p < 0.05), and right ventricular end-diastolic was significantly larger than left ventricular end-diastolic in utero (p < 0.01), whereas the opposite was true after birth (p < 0.0001). Heart rate significantly decreased with advancing age (p < 0.001), whereas ejection fraction for either the right or the left ventricle did not change significantly with advancing age. CONCLUSION This suggests that under basal conditions the ventricles can meet the increased demands in cardiac output by increasing ventricular dimensions without having to increase contractility reserve.
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Affiliation(s)
- J C Veille
- Department of Obstetrics and Gynecology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC, USA
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Veille JC, Tatum K, Zaccaro D. Maternal right hypogastric artery blood flow during normal pregnancy and 6 weeks postpartum. J Soc Gynecol Investig 1996; 3:191-198. [PMID: 8796830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
OBJECTIVE To document and quantify the temporal hemodynamic changes occurring in the pelvic circulation in normal human pregnancy, and to compare these changes with those found 6 weeks postpartum. METHODS Thirty-three patients had color pulsed Doppler evaluation of the right hypogastric artery six times during pregnancy and once 6 weeks postpartum. Pulsed Doppler waveforms were digitized to assess the time velocity integral (area under the Doppler curve = TVI) and the peak flow velocity (maximum velocity = PFV). The diameter of the vessel was determined during systole using high-resolution two-dimensional ultrasound from a longitudinal plane. A quantitative estimate of the blood flow through this vessel was calculated by multiplying the TVI by the calculated cross-sectional area of the vessel. RESULTS The cross-sectional area and the indexed volume of blood flow per minute of the hypogastric artery were significantly greater during pregnancy compared with the postpartum value. The estimated vascular resistance index was significantly decreased during pregnancy. Time velocity integral was significantly lower at the initial study compared with the postpartum value. CONCLUSION The hypogastric artery undergoes significant hemodynamic changes during pregnancy when compared to the postpartum period. Furthermore, the pelvic circulation displays these changes early in gestation.
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Affiliation(s)
- J C Veille
- Department of Obstetrics and Gynecology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27157, USA
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Abstract
OBJECTIVE Our purpose was to longitudinally quantify human fetal renal blood flow. STUDY DESIGN Twenty-two normal fetuses underwent a color-pulsed Doppler evaluation of the renal artery. The Doppler waveforms were digitized to assess the velocity-time integral. The size of the vessel was determined during systole with color high-resolution two-dimensional ultrasonography. Renal blood flow was estimated by multiplying the time-velocity integral (i.e., area under the curve) by the area of the renal artery. The combined cardiac output was calculated by adding right and left inflow Doppler-derived volumes. RESULTS Renal artery size, peak flow velocity, time-velocity integral, and renal blood flow significantly increased with advancing gestational age. The resistivity indexes, such as the systolic/diastolic ratio or the Pourcelot index of the fetal renal artery, did not significantly change with advancing gestational age. The pulsatility index, however, was correlated with gestational age. The percentage of the combined cardiac output to the fetal kidney remained constant throughout gestation. CONCLUSIONS Color pulsed Doppler can be used to visualize small and deep vascular structures in the human fetus. Renal blood flow increased with advancing gestational age. This increase seems to be related to the increase in the combined cardiac output.
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Affiliation(s)
- J C Veille
- Department of Obstetrics and Gynecology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157
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Abstract
OBJECTIVES We attempted to quantify noninvasively blood flow of the middle cerebral artery in human fetuses during five distinct periods. STUDY DESIGN Twenty normal fetuses had color pulsed Doppler ultrasonography of the middle cerebral artery. A total of 68 studies were successfully done and are reported. The Doppler sample was placed as parallel to the direction of the vessel flow as possible. All waveforms were recorded on a strip chart at a preset speed of 100 mm/sec. Six Doppler waveforms were digitized for the time velocity integral (area under the curve is equal to time velocity integral) and averaged. Middle cerebral blood flow was obtained by multiplying the time velocity integral of the Doppler curve by the cross-sectional area of the vessel. The combined cardiac output was obtained by adding the right and left ventricular outputs, which were obtained by multiplying the time velocity integrals by the area of the corresponding annuli. Analysis of variance for repeated measurements was used to determine significance. RESULTS The diameter of the middle cerebral artery, the time velocity integral, and the peak flow velocity of the Doppler waveform increased significantly with advancing gestational age. Blood flow to the middle cerebral artery ranged from 23 ml/min at 19 weeks to 133 ml/min at term. Resistivity index values were not correlated with advancing gestational age. The percent of the cardiac output to one of the two middle cerebral arteries remained constant throughout gestation with a range between 3% and 7%. CONCLUSIONS (1) Time velocity integral, peak flow velocity, diameter, and blood flow of the middle cerebral artery increased significantly with gestational age; (2) the percent of the total cardiac output to the middle cerebral artery does not significantly change with gestational age.
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Affiliation(s)
- J C Veille
- Department of Obstetrics and Gynecology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157
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