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Erenso D, Tran L, Abualrob I, Bushra M, Hengstenberg J, Muhammed E, Endale I, Endale N, Endale E, Mayhut S, Torres N, Sheffield P, Vazquez C, Crogman H, Nichols C, Dang T, Hach EE. Observation of magnet-induced star-like radiation of a plasma created from cancer cells in a laser trap. Eur Biophys J 2024; 53:123-131. [PMID: 38451329 DOI: 10.1007/s00249-024-01701-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 10/06/2023] [Accepted: 01/20/2024] [Indexed: 03/08/2024]
Abstract
We present a new phenomenon resulting from the interaction of magnetic beads with cancer cells in a laser trap formed on a slide containing a depression 16.5 mm in diameter and 0.78 mm of maximum depth. This phenomenon includes the apparent formation and expansion of a dark bubble that attracts and incinerates surrounding matter when it explodes, which leads to a plasma emitting intense radiation that has the appearance of a star on a microscopic scale. We have observed the star-like phenomenon for more than 4 years, and the intensity depends on the laser's power. Measuring the laser power of the dark bubble shows the entrapment of electromagnetic energy as it expands.
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Affiliation(s)
- D Erenso
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA.
| | - L Tran
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - I Abualrob
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - M Bushra
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - J Hengstenberg
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - E Muhammed
- Department of Physics, Addis Ababa University, Addis Ababa, Ethiopia
| | - I Endale
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - N Endale
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - E Endale
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - S Mayhut
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - N Torres
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - P Sheffield
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - C Vazquez
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - H Crogman
- Department of Physics, California State University Dominguez Hills, Carson, CA, 90747, USA
| | - C Nichols
- Department of Physics, California State University Dominguez Hills, Carson, CA, 90747, USA
| | - T Dang
- Department of Physics, California State University Dominguez Hills, Carson, CA, 90747, USA
| | - E E Hach
- School of Physics and Astronomy, Rochester Institute of Technology, 85 Lomb Memorial Drive, Rochester, NY, 14623, USA
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Rali AS, Tran L, Balakrishna A, Senussi M, Kapur NK, Metkus T, Tedford RJ, Lindenfeld J. Guide to Lung-Protective Ventilation in Cardiac Patients. J Card Fail 2024:S1071-9164(24)00079-4. [PMID: 38513887 DOI: 10.1016/j.cardfail.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 03/23/2024]
Abstract
The incidence of acute respiratory insufficiency has continued to increase among patients admitted to modern-day cardiovascular intensive care units. Positive pressure ventilation (PPV) remains the mainstay of treatment for these patients. Alterations in intrathoracic pressure during PPV has distinct effects on both the right and left ventricles, affecting cardiovascular performance. Lung-protective ventilation (LPV) minimizes the risk of further lung injury through ventilator-induced lung injury and, hence, an understanding of LPV and its cardiopulmonary interactions is beneficial for cardiologists.
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Affiliation(s)
- Aniket S Rali
- Division of Cardiovascular Diseases, Vanderbilt University Medical Center, Nashville, TN.
| | - Lena Tran
- Division of Cardiovascular Diseases, Vanderbilt University Medical Center, Nashville, TN
| | - Aditi Balakrishna
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN
| | - Mourad Senussi
- Department of Medicine, Baylor St. Luke's Medical Center, Houston, TX
| | - Navin K Kapur
- Division of Cardiovascular Diseases, Tufts Medical Center, Boston, MA
| | - Thomas Metkus
- Departments of Medicine and Surgery, Divisions of Cardiology and Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ryan J Tedford
- Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC
| | - Joann Lindenfeld
- Division of Cardiovascular Diseases, Vanderbilt University Medical Center, Nashville, TN
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Bianchi A, Agosteo S, Bortot D, Cirrone GAP, Colautti P, La Tessa C, Mazzucconi D, Missiaggia M, Petringa G, Rosenfeld AB, Selva A, Tran L, Verona C, Verona Rinati G, Conte V. Microdosimetry of a 62-MeV clinical proton beam with five detectors. Radiat Prot Dosimetry 2023; 199:1968-1972. [PMID: 37819306 DOI: 10.1093/rpd/ncac231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/10/2022] [Accepted: 10/19/2022] [Indexed: 10/13/2023]
Abstract
In proton therapy, most treatment planning systems (TPS) use a fixed relative biological effectiveness (RBE) of 1.1 all along the depth-dose profile. Innovative TPS are now investigated considering the variability of RBE with radiation quality. New TPS need an experimental verification in the quality assurance (QA) routine in clinics, but RBE data are usually obtained with radiobiological measurements that are time consuming and not suitable for daily QA. Microdosimetry is a useful tool based on physical measurements which can monitor the radiation quality. Several microdosimeters are available in different research institutions, which could potentially be used for the QA in TPS. In this study, the response functions of five detectors in the same 62-MeV proton Spread Out Bragg Peak is compared in terms of spectral distributions and their average values and microdosimetric RBE. Their different response function has been commented and must be considered in the clinical practice.
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Affiliation(s)
- A Bianchi
- INFN-Laboratori Nazionali di Legnaro, 35020 Legnaro, Italy
| | - S Agosteo
- Politecnico di Milano, Dipartimento di Energia, 20156 Milano, Italy
- INFN-Milano, 20133 Milano, Italy
| | - D Bortot
- Politecnico di Milano, Dipartimento di Energia, 20156 Milano, Italy
- INFN-Milano, 20133 Milano, Italy
| | - G A P Cirrone
- INFN-Laboratori Nazionali del Sud, 95125 Catania, Italy
| | - P Colautti
- INFN-Laboratori Nazionali di Legnaro, 35020 Legnaro, Italy
| | - C La Tessa
- University of Trento, Dipartimento di Fisica, 38123 Povo, Trento, Italy
- Trento Institute of Fundamental Physics and Applications, 38123 Povo, Trento, Italy
| | - D Mazzucconi
- Politecnico di Milano, Dipartimento di Energia, 20156 Milano, Italy
- INFN-Milano, 20133 Milano, Italy
| | - M Missiaggia
- University of Trento, Dipartimento di Fisica, 38123 Povo, Trento, Italy
- Trento Institute of Fundamental Physics and Applications, 38123 Povo, Trento, Italy
| | - G Petringa
- INFN-Laboratori Nazionali del Sud, 95125 Catania, Italy
- ELI Beamlines Center, Institute of Physics, Czech Academy of Sciences, 252 41 Dolní Břežany, Czech Republic
| | - A B Rosenfeld
- Centre for Medical Radiation Physics, University of Wollongong, 2522 Wollongong, Australia
| | - A Selva
- INFN-Laboratori Nazionali di Legnaro, 35020 Legnaro, Italy
| | - L Tran
- Centre for Medical Radiation Physics, University of Wollongong, 2522 Wollongong, Australia
| | - C Verona
- INFN-Roma2, Dipartimento di Ingegneria Industriale, Università di Roma "Tor Vergata", 00133 Roma, Italy
| | - G Verona Rinati
- INFN-Roma2, Dipartimento di Ingegneria Industriale, Università di Roma "Tor Vergata", 00133 Roma, Italy
| | - V Conte
- INFN-Laboratori Nazionali di Legnaro, 35020 Legnaro, Italy
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Egelberg M, De Marchi T, Pekar G, Tran L, Bendahl P, Tullberg AS, Holmberg E, Karlsson P, Farnebo M, Killander F, Nimeús E. Low levels of WRAP53 predict decreased efficacy of radiotherapy and are prognostic for local recurrence and death from breast cancer: a long-term follow-up of the SweBCG91RT randomized trial. Mol Oncol 2023; 17:2029-2040. [PMID: 36975842 PMCID: PMC10552889 DOI: 10.1002/1878-0261.13426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/08/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Downregulation of the DNA repair protein WD40-encoding RNA antisense to p53 (WRAP53) has been associated with radiotherapy resistance and reduced cancer survival. The aim of this study was to evaluate WRAP53 protein and RNA levels as prognostic and predictive markers in the SweBCG91RT trial, in which breast cancer patients were randomized for postoperative radiotherapy. Using tissue microarray and microarray-based gene expression, 965 and 759 tumors were assessed for WRAP53 protein and RNA levels, respectively. Correlation with local recurrence and breast cancer-related death was assessed for prognosis, and the interaction between WRAP53 and radiotherapy in relation to local recurrence was assessed for radioresistance prediction. Tumors with low WRAP53 protein levels had a higher subhazard ratio (SHR) for local recurrence [1.76 (95% CI 1.10-2.79)] and breast cancer-related death [1.55 (1.02-2.38)]. Low WRAP53 RNA levels were associated with almost a three-fold decreased effect of radiotherapy in relation to ipsilateral breast tumor recurrence [IBTR; SHR 0.87 (95% CI 0.44-1.72)] compared with high RNA levels [0.33 (0.19-0.55)], with a significant interaction (P = 0.024). In conclusion, low WRAP53 protein is prognostic for local recurrence and breast cancer-related death. Low WRAP53 RNA is a potential marker for radioresistance.
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Affiliation(s)
- Moa Egelberg
- Division of Surgery, Department of Clinical Sciences Lund, Faculty of MedicineLund UniversitySweden
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Faculty of MedicineLund UniversitySweden
- Department of RadiologyKristianstad HospitalSweden
| | - Tommaso De Marchi
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Faculty of MedicineLund UniversitySweden
| | - Gyula Pekar
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Faculty of MedicineLund UniversitySweden
| | - Lena Tran
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Faculty of MedicineLund UniversitySweden
| | - Pär‐Ola Bendahl
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Faculty of MedicineLund UniversitySweden
| | - Axel Stenmark Tullberg
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University HospitalUniversity of GothenburgSweden
| | - Erik Holmberg
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University HospitalUniversity of GothenburgSweden
| | - Per Karlsson
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University HospitalUniversity of GothenburgSweden
| | - Marianne Farnebo
- Department of Bioscience and Nutrition & Department of Cell and Molecular BiologyKarolinska InstitutetStockholmSweden
| | - Fredrika Killander
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Faculty of MedicineLund UniversitySweden
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Faculty of MedicineSkåne University HospitalLundSweden
| | - Emma Nimeús
- Division of Surgery, Department of Clinical Sciences Lund, Faculty of MedicineLund UniversitySweden
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Faculty of MedicineLund UniversitySweden
- Division of Surgery, Department of Clinical Sciences Lund, Faculty of MedicineSkåne University HospitalLundSweden
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Stenmark Tullberg A, Sjöström M, Tran L, Niméus E, Killander F, Kovács A, Lundstedt D, Holmberg E, Karlsson P. Combining histological grade, TILs, and the PD-1/PD-L1 pathway to identify immunogenic tumors and de-escalate radiotherapy in early breast cancer: a secondary analysis of a randomized clinical trial. J Immunother Cancer 2023; 11:e006618. [PMID: 37208129 PMCID: PMC10201214 DOI: 10.1136/jitc-2022-006618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND The implementation of immunological biomarkers for radiotherapy (RT) individualization in breast cancer requires consideration of tumor-intrinsic factors. This study aimed to investigate whether the integration of histological grade, tumor-infiltrating lymphocytes (TILs), programmed cell death protein-1 (PD-1), and programmed death ligand-1 (PD-L1) can identify tumors with aggressive characteristics that can be downgraded regarding the need for RT. METHODS The SweBCG91RT trial included 1178 patients with stage I-IIA breast cancer, randomized to breast-conserving surgery with or without adjuvant RT, and followed for a median time of 15.2 years. Immunohistochemical analyses of TILs, PD-1, and PD-L1 were performed. An activated immune response was defined as stromal TILs ≥10% and PD-1 and/or PD-L1 expression in ≥1% of lymphocytes. Tumors were categorized as high-risk or low-risk using assessments of histological grade and proliferation as measured by gene expression. The risk of ipsilateral breast tumor recurrence (IBTR) and benefit of RT were then analyzed with 10 years follow-up based on the integration of immune activation and tumor-intrinsic risk group. RESULTS Among high-risk tumors, an activated immune infiltrate was associated with a reduced risk of IBTR (HR 0.34, 95% CI 0.16 to 0.73, p=0.006). The incidence of IBTR in this group was 12.1% (5.6-25.0) without RT and 4.4% (1.1-16.3) with RT. In contrast, the incidence of IBTR in the high-risk group without an activated immune infiltrate was 29.6% (21.4-40.2) without RT and 12.8% (6.6-23.9) with RT. Among low-risk tumors, no evidence of a favorable prognostic effect of an activated immune infiltrate was seen (HR 2.0, 95% CI 0.87 to 4.6, p=0.100). CONCLUSIONS Integrating histological grade and immunological biomarkers can identify tumors with aggressive characteristics but a low risk of IBTR despite a lack of RT boost and systemic therapy. Among high-risk tumors, the risk reduction of IBTR conferred by an activated immune infiltrate is comparable to treatment with RT. These findings may apply to cohorts dominated by estrogen receptor-positive tumors.
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Affiliation(s)
- Axel Stenmark Tullberg
- Department of Oncology, University of Gothenburg Institute of Clinical Sciences, Goteborg, Sweden
| | - Martin Sjöström
- Department of Radiation Oncology, UCSF, San Francisco, California, USA
- Department of Clinical Sciences Lund, Oncology/Pathology and Surgery, Lund University, Lund, Sweden
| | - Lena Tran
- Department of Clinical Sciences Lund, Oncology/Pathology and Surgery, Lund University, Lund, Sweden
| | - Emma Niméus
- Department of Clinical Sciences Lund, Oncology/Pathology and Surgery, Lund University, Lund, Sweden
- Department of Surgery, Skåne University Hospital, Lund, Sweden
| | - Fredrika Killander
- Department of Clinical Sciences Lund, Oncology/Pathology and Surgery, Lund University, Lund, Sweden
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | - Anikó Kovács
- Department of Clinical Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Dan Lundstedt
- Department of Oncology, University of Gothenburg Institute of Clinical Sciences, Goteborg, Sweden
| | - Erik Holmberg
- Department of Oncology, University of Gothenburg Institute of Clinical Sciences, Goteborg, Sweden
| | - Per Karlsson
- Department of Oncology, University of Gothenburg Institute of Clinical Sciences, Goteborg, Sweden
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De Marchi T, Pyl PT, Sjöström M, Reinsbach SE, DiLorenzo S, Nystedt B, Tran L, Pekar G, Wärnberg F, Fredriksson I, Malmström P, Fernö M, Malmström L, Malmstöm J, Niméus E. Proteogenomics decodes the evolution of human ipsilateral breast cancer. Commun Biol 2023; 6:139. [PMID: 36732562 PMCID: PMC9894938 DOI: 10.1038/s42003-023-04526-6] [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: 08/06/2022] [Accepted: 01/24/2023] [Indexed: 02/04/2023] Open
Abstract
Ipsilateral breast tumor recurrence (IBTR) is a clinically important event, where an isolated in-breast recurrence is a potentially curable event but associated with an increased risk of distant metastasis and breast cancer death. It remains unclear if IBTRs are associated with molecular changes that can be explored as a resource for precision medicine strategies. Here, we employed proteogenomics to analyze a cohort of 27 primary breast cancers and their matched IBTRs to define proteogenomic determinants of molecular tumor evolution. Our analyses revealed a relationship between hormonal receptors status and proliferation levels resulting in the gain of somatic mutations and copy number. This in turn re-programmed the transcriptome and proteome towards a highly replicating and genomically unstable IBTRs, possibly enhanced by APOBEC3B. In order to investigate the origins of IBTRs, a second analysis that included primaries with no recurrence pinpointed proliferation and immune infiltration as predictive of IBTR. In conclusion, our study shows that breast tumors evolve into different IBTRs depending on hormonal status and proliferation and that immune cell infiltration and Ki-67 are significantly elevated in primary tumors that develop IBTR. These results can serve as a starting point to explore markers to predict IBTR formation and stratify patients for adjuvant therapy.
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Affiliation(s)
- Tommaso De Marchi
- Department of Clinical Sciences Lund, Division of Oncology, Lund University, Lund, Sweden.
| | - Paul Theodor Pyl
- grid.452834.c0000 0004 5911 2402Department of Laboratory Medicine, National Bioinformatics Infrastructure Sweden, Science for Life Laboratory, Lund, Sweden
| | - Martin Sjöström
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences Lund, Division of Oncology, Lund University, Lund, Sweden ,grid.266102.10000 0001 2297 6811Department of Radiation Oncology, University of California San Francisco, San Francisco, USA
| | - Susanne Erika Reinsbach
- grid.5371.00000 0001 0775 6028Department of Biology and Biological Engineering, National Bioinformatics Infrastructure Sweden, Science for Life Laboratory, Chalmers University of Technology, Gothenburg, Sweden
| | - Sebastian DiLorenzo
- grid.8993.b0000 0004 1936 9457National Bioinformatics Infrastructure Sweden, Uppsala University, Science for Life Laboratory, Department of Cell and Molecular Biology, Uppsala, Sweden
| | - Björn Nystedt
- grid.8993.b0000 0004 1936 9457National Bioinformatics Infrastructure Sweden, Uppsala University, Science for Life Laboratory, Department of Cell and Molecular Biology, Uppsala, Sweden
| | - Lena Tran
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences Lund, Division of Oncology, Lund University, Lund, Sweden
| | - Gyula Pekar
- grid.411843.b0000 0004 0623 9987Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Fredrik Wärnberg
- grid.8761.80000 0000 9919 9582Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Irma Fredriksson
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Department of Breast, Endocrine Tumors and Sarcoma, Karolinska University Hospital, Stockholm, Sweden
| | - Per Malmström
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences Lund, Division of Oncology, Lund University, Lund, Sweden ,grid.411843.b0000 0004 0623 9987Department of Haematology, Oncology, and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Mårten Fernö
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences Lund, Division of Oncology, Lund University, Lund, Sweden
| | - Lars Malmström
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences Lund, Division of Infection Medicine, Faculty of Medicine, Lund University, Lund, Sweden
| | - Johan Malmstöm
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences Lund, Division of Infection Medicine, Faculty of Medicine, Lund University, Lund, Sweden
| | - Emma Niméus
- Department of Clinical Sciences Lund, Division of Oncology, Lund University, Lund, Sweden. .,Department of Surgery, Skåne University Hospital, Lund, Sweden.
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7
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Tran L, Klainguti G, Hoeckele N, Kaeser PF. Torsional strabismus and vertical rectus muscle surgery in thyroid eye disease. J Fr Ophtalmol 2023; 46:49-56. [PMID: 36496294 DOI: 10.1016/j.jfo.2022.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/21/2022] [Accepted: 05/30/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE To assess the torsional component in patients with vertical strabismus due to thyroid eye disease (TED) and its course after vertical rectus muscle surgery. PATIENTS AND METHODS Retrospective chart review of patients undergoing vertical strabismus surgery for TED between 1998 and 2017, having undergone pre- and postoperative Harms tangent screen examination. RESULTS Forty patients (27 women) were identified. A torsional component was present in all patients. Thirty-three patients had a mean excyclotorsion of 4.5° in primary position, increasing to 8.2° in upgaze, associated with restricted elevation. Inferior rectus muscle recession (n=29) reduced the excyclotorsion in all cases. A 4.4° mean incyclotorsion was present in primary position in 7 cases, increasing to 7.1° in downgaze. Superior rectus muscle recession reduced the incyclotorsion in 5/6 cases. The torsional surgical dose-effect relationship was correlated with the amount of preoperative torsion. The field of binocular single vision improved from 6.5% preoperatively to 71.1% after surgery. CONCLUSIONS Ocular torsion is common in vertical strabismus secondary to TED and is significantly improved by vertical rectus muscle surgery alone. Surgery should be planned according to vertical deviation and motility limitation, and vertical rectus muscles surgery should be considered the first line of treatment, with selective oblique muscle surgery as a second-line option, which was unnecessary in our series.
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Affiliation(s)
- L Tran
- Hôpital ophtalmique Jules-Gonin, service d'ophtalmologie de l'université de Lausanne, 15, avenue de France, 1004 Lausanne, Switzerland
| | - G Klainguti
- Hôpital ophtalmique Jules-Gonin, service d'ophtalmologie de l'université de Lausanne, 15, avenue de France, 1004 Lausanne, Switzerland
| | - N Hoeckele
- Hôpital ophtalmique Jules-Gonin, service d'ophtalmologie de l'université de Lausanne, 15, avenue de France, 1004 Lausanne, Switzerland
| | - P-F Kaeser
- Hôpital ophtalmique Jules-Gonin, service d'ophtalmologie de l'université de Lausanne, 15, avenue de France, 1004 Lausanne, Switzerland.
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Gakis GP, Krikas A, Neofytou P, Tran L, Charitidis C. Modelling the biodistribution of inhaled gold nanoparticles in rats with interspecies extrapolation to humans. Toxicol Appl Pharmacol 2022; 457:116322. [PMID: 36414120 DOI: 10.1016/j.taap.2022.116322] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 10/05/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 11/21/2022]
Abstract
The increasing intentional and non-intentional exposure to nanoparticles (NPs) has raised the interest concerning their fate and biodistribution in the body of animals and humans after inhalation. In this context, Physiologically Based (pharmaco)Kinetic (PBK) modelling has emerged as an in silico approach that simulates the biodistribution kinetics of NPs in the body using mathematical equations. Due to restrictions in data availability, such models are first developed for rats or mice. In this work, we present the interspecies extrapolation of a PBK model initially developed for rats, in order to estimate the biodistribution of inhaled gold NPs (AuNPs) in humans. The extrapolation framework is validated by comparing the model results with experimental data from a clinical study performed on humans for inhaled AuNPs of two different sizes, namely 34 nm and 4 nm. The novelty of this work lies in the extrapolation of a PBK model for inhaled AuNPs to humans and comparison with clinical data. The extrapolated model is in good agreement with the experimental data, and provides insights for the mechanisms of inhaled AuNP translocation to the blood circulation, after inhalation. Finally, the biodistribution of the two sizes of AuNPs in the human body after 28 days post-exposure is estimated by the model and discussed.
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Affiliation(s)
- G P Gakis
- Research Lab of Advanced, Composite, Nano-Materials and Nanotechnology, Materials Science and Engineering Department, School of Chemical Engineering, National Technical University of Athens, Athens, Greece
| | - A Krikas
- Thermal Hydraulics and Multiphase Flow Laboratory, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - P Neofytou
- Thermal Hydraulics and Multiphase Flow Laboratory, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - L Tran
- Institute of Occupational Medicine, Edinburgh, UK
| | - C Charitidis
- Research Lab of Advanced, Composite, Nano-Materials and Nanotechnology, Materials Science and Engineering Department, School of Chemical Engineering, National Technical University of Athens, Athens, Greece.
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Krikas A, Neofytou P, Gakis GP, Xiarchos I, Charitidis C, Tran L. Modeling of clearance, retention, and translocation of inhaled gold nanoparticles in rats. Inhal Toxicol 2022; 34:361-379. [PMID: 36053230 DOI: 10.1080/08958378.2022.2115592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective: The increasing exposure to gold nanoparticles (AuNPs), due to their wide range of applications, has led to the need for thorough understanding of their biodistribution, following exposure. The objective of this paper is to develop a PBK model in order to study the clearance, retention and translocation of inhaled gold nanoparticles in rats, providing a basis for the understanding of the absorption, distribution, metabolism and elimination (ADME) mechanisms of AuNPs in various organs.Materials and methods: A rat PBK computational model was developed, connected to a detailed respiratory model, including the olfactory, tracheobronchial, and alveolar regions. This model was coupled with a Multiple Path Particle Dosimetry (MPPD) model to appropriately simulate the exposure to AuNPs. Three existing in vivo experimental datasets from scientific literature for the biodistribution of inhaled AuNPs for different AuNP sizes and exposure scenarios were utilized for model calibration and validation.Results and Discussion: The model was calibrated using two individual datasets for nose only inhaled and intratracheally instilled AuNPs, while an independent dataset for nose only inhaled AuNPs was used as external validation. The overall fitting over the three datasets was proved acceptable as shown by the relevant statistical metrics. The influence of several physiological parameters is also studied via a sensitivity analysis, providing useful insights into the mechanisms of NP pharmacokinetics. The key aspects of the inhaled AuNPs biodistribution are discussed, revealing the key mechanisms for the AuNPs absorption routes, the AuNP uptake by secondary organs and the influence of the AuNP size on the translocation from the lungs to blood circulation.Conclusions: The model results together with the model sensitivity analysis clarified the key mechanisms for the inhaled AuNPs biodistribution to secondary organs. It was observed that nose-only inhaled AuNPs of smaller size can enter the blood circulation through secondary routes, such as absorption through the gastrointestinal (GI) lumen, showing that such translocations should not be underestimated in biodistribution modelling. Finally, the computational framework presented in this study can be used as a basis for a more wide investigation of inhaled nanoparticles biodistribution, including interspecies extrapolation of the resulting PBK model for the inhalation and subsequent biodistribution of AuNPs in humans.
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Affiliation(s)
- A Krikas
- Thermal Hydraulics and Multiphase Flow Laboratory, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - P Neofytou
- Thermal Hydraulics and Multiphase Flow Laboratory, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - G P Gakis
- Research Lab of Advanced, Composite, Nano-Materials and Nanotechnology, Materials Science and Engineering Department, School of Chemical Engineering, National Technical University of Athens, Athens, Greece
| | - I Xiarchos
- Research Lab of Advanced, Composite, Nano-Materials and Nanotechnology, Materials Science and Engineering Department, School of Chemical Engineering, National Technical University of Athens, Athens, Greece
| | - C Charitidis
- Research Lab of Advanced, Composite, Nano-Materials and Nanotechnology, Materials Science and Engineering Department, School of Chemical Engineering, National Technical University of Athens, Athens, Greece
| | - L Tran
- Institute of Occupational Medicine, Edinburgh, UK
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10
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Bhave P, Ahmed T, Lo SN, Shoushtari A, Zaremba A, Versluis JM, Mangana J, Weichenthal M, Si L, Lesimple T, Robert C, Trojanello C, Wicky A, Heywood R, Tran L, Batty K, Dimitriou F, Stansfeld A, Allayous C, Schwarze JK, Mooradian MJ, Klein O, Mehmi I, Roberts-Thomson R, Maurichi A, Yeoh HL, Khattak A, Zimmer L, Blank CU, Ramelyte E, Kähler KC, Roy S, Ascierto PA, Michielin O, Lorigan PC, Johnson DB, Plummer R, Lebbe C, Neyns B, Sullivan R, Hamid O, Santinami M, McArthur GA, Haydon AM, Long GV, Menzies AM, Carlino MS. Efficacy of anti-PD-1 and ipilimumab alone or in combination in acral melanoma. J Immunother Cancer 2022; 10:e004668. [PMID: 35793872 PMCID: PMC9260790 DOI: 10.1136/jitc-2022-004668] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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] [Accepted: 05/31/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Acral melanoma is a rare melanoma subtype with poor prognosis. Importantly, these patients were not identified as a specific subgroup in the landmark melanoma trials involving ipilimumab and the anti-programmed cell death protein-1 (PD-1) agents nivolumab and pembrolizumab. There is therefore an absence of prospective clinical trial evidence regarding the efficacy of checkpoint inhibitors (CPIs) in this population. Acral melanoma has lower tumor mutation burden (TMB) than other cutaneous sites, and primary site is associated with differences in TMB. However the impact of this on the effectiveness of immune CPIs is unknown. We examined the efficacy of CPIs in acral melanoma, including by primary site. METHODS Patients with unresectable stage III/IV acral melanoma treated with CPI (anti-PD-1 and/or ipilimumab) were studied. Multivariable logistic and Cox regression analyses were conducted. Primary outcome was objective response rate (ORR); secondary outcomes were progression-free survival (PFS) and overall survival (OS). RESULTS In total, 325 patients were included: 234 (72%) plantar, 69 (21%) subungual and 22 (7%) palmar primary sites. First CPI included: 184 (57%) anti-PD-1, 59 (18%) anti-PD-1/ipilimumab combination and 82 (25%) ipilimumab. ORR was significantly higher with initial anti-PD-1/ipilimumab compared with anti-PD-1 (43% vs 26%, HR 2.14, p=0.0004) and significantly lower with ipilimumab (15% vs 26%, HR 0.49, p=0.0016). Landmark PFS at 1 year was highest for anti-PD-1/ipilimumab at 34% (95% CI 24% to 49%), compared with 26% (95% CI 20% to 33%) with anti-PD-1 and 10% (95% CI 5% to 19%) with ipilimumab. Despite a trend for increased PFS, anti-PD-1/ipilimumab combination did not significantly improve PFS (HR 0.85, p=0.35) or OS over anti-PD-1 (HR 1.30, p=0.16), potentially due to subsequent therapies and high rates of acquired resistance. No outcome differences were found between primary sites. CONCLUSION While the ORR to anti-PD-1/ipilimumab was significantly higher than anti-PD-1 and PFS numerically higher, in this retrospective cohort this benefit did not translate to improved OS. Future trials should specifically include patients with acral melanoma, to help determine the optimal management of this important melanoma subtype.
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Affiliation(s)
- Prachi Bhave
- Sir Peter MacCallum Cancer Centre Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, New South Wales, Australia
| | - Tasnia Ahmed
- Melanoma Institute Australia, North Sydney, New South Wales, Australia
| | - Serigne N Lo
- Melanoma Institute Australia, North Sydney, New South Wales, Australia
| | - Alexander Shoushtari
- Medicine, Melanoma and Immunotherapeutics Service, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Anne Zaremba
- Dermatology, University Hospital Essen, Essen, Germany
| | - Judith M Versluis
- Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Joanna Mangana
- Dermatology, University Hospital Zürich, Zurich, Switzerland
| | - Michael Weichenthal
- Dermatology, University Hospital Schleswig-Holstein - Campus Kiel, Kiel, Germany
| | - Lu Si
- Melanoma and Sarcoma, Peking University Cancer Hospital, Beijing, China
| | - Thierry Lesimple
- Research and Medical Oncology, Centre Eugène Marquis, Rennes, France
| | | | - Claudia Trojanello
- Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione "G.Pascale", Napoli, Italy
| | - Alexandre Wicky
- Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Richard Heywood
- Christie NHS Foundation Trust and Division of Cancer Services, University of Manchester, Manchester, UK
| | - Lena Tran
- Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kathleen Batty
- Melanoma Institute Australia, North Sydney, New South Wales, Australia
| | - Florentia Dimitriou
- Melanoma Institute Australia, North Sydney, New South Wales, Australia
- Dermatology, University Hospital Zürich, Zurich, Switzerland
| | - Anna Stansfeld
- Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne, UK
| | - Clara Allayous
- Dermatology, Saint-Louis hospital, INSERM U976, AP-HP, Paris, France
| | - Julia K Schwarze
- Medical Oncology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel, Brussel, Belgium
| | - Meghan J Mooradian
- Medical Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Oliver Klein
- Medical Oncology, Olivia Newton John Cancer Centre, Austin Health, Melbourne, Victoria, Australia
- Medical Oncology, Warrnambool Hospital, Warrnambool, Victoria, Australia
- Medical Oncology, Peninsula Health, Melbourne, Victoria, Australia
| | - Inderjit Mehmi
- The Angeles Clinic and Research Institute, a Cedars-Sinai Affiliate, Los Angeles, California, USA
| | | | - Andrea Maurichi
- Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Hui-Ling Yeoh
- Medical Oncology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Adnan Khattak
- Medical Oncology, Fiona Stanley Hospital & Edith Cowan Univserity, Perth, Western Australia, Australia
| | - Lisa Zimmer
- Dermatology, University Hospital Essen, Essen, Germany
| | - Christian U Blank
- Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Egle Ramelyte
- Dermatology, University Hospital Zürich, Zurich, Switzerland
| | - Katharina C Kähler
- Dermatology, University Hospital Schleswig-Holstein - Campus Kiel, Kiel, Germany
| | | | - Paolo A Ascierto
- Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione "G.Pascale", Napoli, Italy
| | | | - Paul C Lorigan
- Christie NHS Foundation Trust and Division of Cancer Services, University of Manchester, Manchester, UK
| | - Douglas B Johnson
- Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ruth Plummer
- Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne, UK
| | - Celeste Lebbe
- Université de Paris, AP-HP Department of Dermatology, Hôpital Saint-Louis, Paris, France
| | - Bart Neyns
- Medical Oncology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel, Brussel, Belgium
| | - Ryan Sullivan
- Medical Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Omid Hamid
- The Angeles Clinic and Research Institute, a Cedars-Sinai Affiliate, Los Angeles, California, USA
| | - Mario Santinami
- Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Grant A McArthur
- Sir Peter MacCallum Cancer Centre Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew M Haydon
- Medical Oncology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Georgina V Long
- Melanoma Institute Australia, North Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Medical Oncology, Royal North Shore and Mater Hospitals, Sydney, New South Wales, Australia
| | - Alexander M Menzies
- Melanoma Institute Australia, North Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Medical Oncology, Royal North Shore and Mater Hospitals, Sydney, New South Wales, Australia
| | - Matteo S Carlino
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, New South Wales, Australia
- Melanoma Institute Australia, North Sydney, New South Wales, Australia
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Bui V, Hsu L, Sun A, Tran L, Shanbhag S, Chang L, Zhou W, Mehta N, Chen M. 401 Deepheartct: A Fully Automatic Hybrid Structure Segmentation Framework Based On Atlas, Reverse Ranking, And Convolutional Neural Network For Computed Tomography Angiography. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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12
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Tran L, Meng S, Wang P, Pan I, Yi T, Wang R, Jiao Z, Bai H. Abstract No. 240 Automated outcome prediction in mechanical thrombectomy for acute large vessel ischemic stroke using 3D convolutional neural networks applied to CT angiography. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.321] [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] Open
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13
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Patel P, Nallandhighal S, Scoville D, Tran L, Cotta B, Udager A, Rao A, Palapattu G, Dadhania V, Pitchiaya S, Salami S. Spatial transcriptomic profiling of prostate cancer reveals zone specific androgen receptor signaling and immune infiltration. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00509-7] [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: 11/04/2022]
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14
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Wang H, Crowley K, Tran L, Culbreth S, Marino K. 972: ROCURONIUM VERSUS SUCCINYLCHOLINE FOR RAPID SEQUENCE INTUBATION IN THE EMERGENCY DEPARTMENT. Crit Care Med 2022. [DOI: 10.1097/01.ccm.0000810212.82211.5e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Matrana D, Smith E, Marble M, Tran L, Meddaugh H, Heifner A, McKernan A, Wall L. M159 OMENN SYNDROME ASSOCIATED WITH DNA LIGASE 1. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.300] [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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16
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Tran L, Tuite M, Michaela Serpa S, Kunnirickal S, Esposito T, Pfau SE, Shah SM. Developing a multi-disciplinary program for routine acetylcholine vasoreactivity testing in the cardiac catheterization laboratory. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Of the patients who are referred for invasive coronary angiography 30–50% are found to have no obstructive coronary artery disease. Current ESC Guidelines for chronic coronary syndromes have a class IIa recommendation for intracoronary provocative testing with acetylcholine in patients with ischemia and no obstructive coronary artery disease (INOCA). However, there is limited guidance for pharmacy and nursing teams for the support of provocative testing in the cardiac catheterization laboratory.
Purpose
To demonstrate feasibility and safety of acetylcholine vasoreactivity testing in the cardiac catheterization laboratory.
Methods
The inpatient pharmacy developed an adapted protocol based on available evidence and facilitated a multi-disciplinary operational workflow for the assessment of vasospastic angina. 3mL acetylcholine aliquots of 1mcg/mL, 10 mcg/mL, 25 mcg/mL, 50 mcg/mL, and 100 mcg/mL were prepared by pharmacy following sterile compounding standards. The transition from provider or nursing staff compounding to pharmacy compounding provided quality assurance following United States Pharmacopeia compounding standards for improved sterility and patient safety, especially with a complicated micro-dilution recipe. Pharmacy supported the necessary guidance with optimized clinical decision support in the form of a customized order panel embedded in the electronic health record system and compounding software as another layer of standardization and quality assurance. Syringes were made available to the interventional cardiologist in the cardiac catheterization laboratory suite immediately prior to a scheduled case. Eleven orders of acetylcholine were placed with five dilution syringes per order (total 55 compounded syringes) from the customized acetylcholine provoked coronary vasospasm procedure order panel.
Results
From January 2020 to March 2021, 11 patients underwent acetylcholine vasoreactivity testing for clinical indications. One patient developed atrial fibrillation with a rapid ventricular rate during provocative testing of the right coronary artery which required elective cardioversion the following day. Of 11 patients, 9 were outpatients and 2 were inpatients. 1 patient received intravenous atropine and ondansetron due to profound bradycardia and nausea after 100mcg acetylcholine administration. No other safety events occurred.
Conclusion(s)
Provocative testing with intracoronary acetylcholine administration is safe and feasible. For clinical assessment, sterile compounding and customized order panels facilitate routine clinical assessment for patients with suspected vasospastic angina. Nursing protocols should include cardiac monitoring, medications to reverse adverse effects, and possible outcomes of provocative testing. We provide a practical description of our workflow for pharmacists, catheterization laboratory staff, and providers for routine acetylcholine provocation for the evaluation of INOCA.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- L Tran
- Yale New Haven Hospital, New Haven, United States of America
| | - M Tuite
- Yale New Haven Hospital, New Haven, United States of America
| | | | - S Kunnirickal
- Yale New Haven Hospital, New Haven, United States of America
| | - T Esposito
- Yale New Haven Hospital, New Haven, United States of America
| | - S E Pfau
- Yale New Haven Hospital, New Haven, United States of America
| | - S M Shah
- Yale New Haven Hospital, New Haven, United States of America
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Lisberg A, Liu B, Salehi-Rad R, Lee J, Tran L, Kostyantyn K, Lim R, Dumitras C, Jing Z, Abtin F, Suh R, Genshaft S, Fishbein G, Kaul A, Kahlon K, Ashouri S, Goldman J, Elashoff D, Garon E, Dubinett S. P11.01 Phase I Trial of in Situ Vaccination With Autologous CCL21-Modified Dendritic Cells (CCL21-DC) Combined With Pembrolizumab for Advanced NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.320] [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]
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18
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Bhave P, Ahmed T, Shoushtari A, Zaremba A, Versluis J, Mangana J, Weichenthal M, Si L, Lesimple T, Robert C, Trojaniello C, Wicky A, Heywood R, Tran L, Batty K, Stansfeld A, Lebbe C, Schwarze J, Mooradian M, Carlino M. 1047P Efficacy of checkpoint inhibitors (CPIs) in acral melanoma (AM). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Mansour MSI, Lindquist KE, Seidal T, Mager U, Mohlin R, Tran L, Hejny K, Holmgren B, Violidaki D, Dobra K, Dejmek A, Planck M, Brunnström H. PD-L1 Testing in Cytological Non-Small Cell Lung Cancer Specimens: A Comparison with Biopsies and Review of the Literature. Acta Cytol 2021; 65:501-509. [PMID: 34233336 DOI: 10.1159/000517078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/19/2021] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Programmed death-ligand 1 (PD-L1) expression is used for treatment prediction in non-small cell lung cancer (NSCLC). While cytology may be the only available material in the routine clinical setting, testing in clinical trials has mainly been based on biopsies. METHODS We included 2 retrospective cohorts of paired, concurrently sampled, cytological specimens and biopsies. Also, the literature on PD-L1 in paired cytological/histological samples was reviewed. Focus was on the cutoff levels ≥1 and ≥50% positive tumor cells. RESULTS Using a 3-tier scale, PD-L1 was concordant in 40/47 (85%) and 66/97 (68%) of the paired NSCLC cases in the 2 cohorts, with kappa 0.77 and 0.49, respectively. In the former cohort, all discordant cases had lower score in cytology. In both cohorts, concordance was lower in samples from different sites (e.g., biopsy from primary tumor and cytology from pleural effusion). Based on 25 published studies including about 1,700 paired cytology/histology cases, the median (range) concordance was 81-85% (62-100%) at cutoff 1% for a positive PD-L1 staining and 89% (67-100%) at cutoff 50%. CONCLUSIONS The overall concordance of PD-L1 between cytology and biopsies is rather good but with significant variation between laboratories, which calls for local quality assurance.
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Affiliation(s)
- Mohammed S I Mansour
- Department of Pathology and Cytology, Halland Hospital Halmstad, Halmstad, Sweden
- Division of Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | | | - Tomas Seidal
- Department of Pathology and Cytology, Halland Hospital Halmstad, Halmstad, Sweden
| | - Ulrich Mager
- Division of Respiratory and Internal Medicine, Department of Clinical Medicine, Halland Hospital Halmstad, Halmstad, Sweden
| | - Rikard Mohlin
- Department of Genetics and Pathology, Laboratory Medicine Region Skåne, Lund, Sweden
| | - Lena Tran
- Division of Oncology, Department of Clinical Sciences Lund, Lund University, Medicon Village, Lund, Sweden
| | - Kim Hejny
- Department of Pathology and Cytology, Halland Hospital Halmstad, Halmstad, Sweden
| | - Benjamin Holmgren
- Department of Pathology and Cytology, Halland Hospital Halmstad, Halmstad, Sweden
| | - Despoina Violidaki
- Department of Genetics and Pathology, Laboratory Medicine Region Skåne, Lund, Sweden
| | - Katalin Dobra
- Division of Clinical Pathology/Cytology, Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Annika Dejmek
- Department of Translational Medicine in Malmö, Lund University, Malmö, Sweden
| | - Maria Planck
- Division of Oncology, Department of Clinical Sciences Lund, Lund University, Medicon Village, Lund, Sweden
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund, Sweden
| | - Hans Brunnström
- Division of Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Genetics and Pathology, Laboratory Medicine Region Skåne, Lund, Sweden
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Bååth M, Jönsson JM, Westbom Fremer S, Martín de la Fuente L, Tran L, Malander S, Kannisto P, Måsbäck A, Honeth G, Hedenfalk I. MET Expression and Cancer Stem Cell Networks Impact Outcome in High-Grade Serous Ovarian Cancer. Genes (Basel) 2021; 12:742. [PMID: 34069138 PMCID: PMC8155853 DOI: 10.3390/genes12050742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/06/2021] [Accepted: 05/12/2021] [Indexed: 01/08/2023] Open
Abstract
Overexpression of the receptor tyrosine kinase MET has been linked to poor survival in several cancer types, and MET has been suggested to interact with stem cell networks. In vitro studies have further suggested a possible benefit of a combined treatment using PARP and MET inhibitors. We used a tissue microarray (TMA) with 130 samples of advanced-stage high-grade serous fallopian tube/ovarian cancer (HGSC) to investigate the prognostic value of MET protein expression alone and in combination with the stem cell factor SOX2. The possible synergistic effects of a PARP and MET inhibitor treatment were evaluated in two cell lines with BRCA1 or BRCA2 deficiency and in their BRCA1/2-proficient counterparts. Patients with tumors positive for MET had worse overall survival (log-rank test, p = 0.015) compared to patients with MET-negative tumors. The prognostic role of MET was even more prominent in the subgroup of patients with SOX2-negative tumors (p = 0.0081). No synergistic effects of the combined treatment with PARP and MET inhibitors were found in the cell lines examined. We conclude that MET expression could be used as a marker for OS in HGSC and that stemness should be taken into consideration when evaluating the mechanisms of this effect.
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Affiliation(s)
- Maria Bååth
- Division of Oncology, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, 223 81 Lund, Sweden; (M.B.); (J.-M.J.); (S.W.F.); (L.M.d.l.F.); (L.T.); (S.M.); (G.H.)
| | - Jenny-Maria Jönsson
- Division of Oncology, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, 223 81 Lund, Sweden; (M.B.); (J.-M.J.); (S.W.F.); (L.M.d.l.F.); (L.T.); (S.M.); (G.H.)
| | - Sofia Westbom Fremer
- Division of Oncology, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, 223 81 Lund, Sweden; (M.B.); (J.-M.J.); (S.W.F.); (L.M.d.l.F.); (L.T.); (S.M.); (G.H.)
- Department of Surgical Pathology, Division of Laboratory Medicine, Skåne University Hospital, 222 42 Lund, Sweden;
| | - Laura Martín de la Fuente
- Division of Oncology, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, 223 81 Lund, Sweden; (M.B.); (J.-M.J.); (S.W.F.); (L.M.d.l.F.); (L.T.); (S.M.); (G.H.)
| | - Lena Tran
- Division of Oncology, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, 223 81 Lund, Sweden; (M.B.); (J.-M.J.); (S.W.F.); (L.M.d.l.F.); (L.T.); (S.M.); (G.H.)
| | - Susanne Malander
- Division of Oncology, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, 223 81 Lund, Sweden; (M.B.); (J.-M.J.); (S.W.F.); (L.M.d.l.F.); (L.T.); (S.M.); (G.H.)
| | - Päivi Kannisto
- Division of Obstetrics and Gynaecology, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, 222 42 Lund, Sweden;
| | - Anna Måsbäck
- Department of Surgical Pathology, Division of Laboratory Medicine, Skåne University Hospital, 222 42 Lund, Sweden;
| | - Gabriella Honeth
- Division of Oncology, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, 223 81 Lund, Sweden; (M.B.); (J.-M.J.); (S.W.F.); (L.M.d.l.F.); (L.T.); (S.M.); (G.H.)
| | - Ingrid Hedenfalk
- Division of Oncology, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, 223 81 Lund, Sweden; (M.B.); (J.-M.J.); (S.W.F.); (L.M.d.l.F.); (L.T.); (S.M.); (G.H.)
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21
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De Marchi T, Pyl PT, Sjöström M, Klasson S, Sartor H, Tran L, Pekar G, Malmström J, Malmström L, Niméus E. Proteogenomic Workflow Reveals Molecular Phenotypes Related to Breast Cancer Mammographic Appearance. J Proteome Res 2021; 20:2983-3001. [PMID: 33855848 PMCID: PMC8155562 DOI: 10.1021/acs.jproteome.1c00243] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Indexed: 12/21/2022]
Abstract
Proteogenomic approaches have enabled the generat̲ion of novel information levels when compared to single omics studies although burdened by extensive experimental efforts. Here, we improved a data-independent acquisition mass spectrometry proteogenomic workflow to reveal distinct molecular features related to mammographic appearances in breast cancer. Our results reveal splicing processes detectable at the protein level and highlight quantitation and pathway complementarity between RNA and protein data. Furthermore, we confirm previously detected enrichments of molecular pathways associated with estrogen receptor-dependent activity and provide novel evidence of epithelial-to-mesenchymal activity in mammography-detected spiculated tumors. Several transcript-protein pairs displayed radically different abundances depending on the overall clinical properties of the tumor. These results demonstrate that there are differentially regulated protein networks in clinically relevant tumor subgroups, which in turn alter both cancer biology and the abundance of biomarker candidates and drug targets.
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Affiliation(s)
- Tommaso De Marchi
- Division
of Surgery, Oncology, and Pathology, Department of Clinical Sciences, Lund University, Solvegatan 19, Lund SE-223 62, Sweden
| | - Paul Theodor Pyl
- Division
of Surgery, Oncology, and Pathology, Department of Clinical Sciences, Lund University, Solvegatan 19, Lund SE-223 62, Sweden
| | - Martin Sjöström
- Division
of Surgery, Oncology, and Pathology, Department of Clinical Sciences, Lund University, Solvegatan 19, Lund SE-223 62, Sweden
| | - Stina Klasson
- Department
Plastic and Reconstructive Surgery, Skåne
University Hospital, Inga Marie Nilssons gata 47, Malmö SE-20502, Sweden
| | - Hanna Sartor
- Division
of Diagnostic Radiology, Department of Translational Medicine, Skåne University Hospital, Entrégatan 7, Lund SE-22185, Sweden
| | - Lena Tran
- Division
of Surgery, Oncology, and Pathology, Department of Clinical Sciences, Lund University, Solvegatan 19, Lund SE-223 62, Sweden
| | - Gyula Pekar
- Division
of Oncology and Pathology, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund SE-22185, Sweden
| | - Johan Malmström
- Division
of Infection Medicine, Department of Clinical Sciences Lund, Faculty
of Medicine, Lund University, Klinikgatan 32, Lund SE-22184, Sweden
| | - Lars Malmström
- S3IT, University of Zurich, Winterthurerstrasse 190, Zurich CH-8057, Switzerland
- Institute
for Computational Science, University of
Zurich, Winterthurerstrasse 190, Zurich CH-8057, Switzerland
| | - Emma Niméus
- Division
of Surgery, Oncology, and Pathology, Department of Clinical Sciences, Lund University, Solvegatan 19, Lund SE-223 62, Sweden
- Department
of Surgery, Skåne University Hospital, Lund 222 42, Sweden
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Lisberg A, Liu B, Salehi-Rad R, Lee J, Tran L, Krysan K, Li R, Lin Y, Abtin F, Suh R, Oh S, Aberle D, Winter L, Wallace W, Elashoff D, Garon E, Sharma S, Dubinett S. P15.08 Phase I Trial of in situ Vaccination With Autologous CCL21-Modified Dendritic Cells (CCL21-DC) Combined With Pembrolizumab for Advanced NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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23
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Wynne R, Ferguson C, Williams-Spence J, Tran L, Reid C. Australian Risk Factors for 30-day Readmission After Isolated Coronary Artery Bypass Grafts. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.354] [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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24
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O'Brien J, Dawson L, Chowdhury E, Tran L, Baker R, Newcomb A, Smith J, Reid C, Duffy S. Long-term Outcomes in Indigenous Australians Following Coronary Artery Bypass Surgery. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.031] [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]
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25
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Conte V, Agosteo S, Bianchi A, Bolst D, Bortot D, Catalano R, Cirrone GAP, Colautti P, Cuttone G, Guatelli S, James B, Mazzucconi D, Rosenfeld AB, Selva A, Tran L, Petringa G. Microdosimetry of a therapeutic proton beam with a mini-TEPC and a MicroPlus-Bridge detector for RBE assessment. Phys Med Biol 2020; 65:245018. [PMID: 33086208 DOI: 10.1088/1361-6560/abc368] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Proton beams are widely used worldwide to treat localized tumours, the lower entrance dose and no exit dose, thus sparing surrounding normal tissues, being the main advantage of this treatment modality compared to conventional photon techniques. Clinical proton beam therapy treatment planning is based on the use of a general relative biological effectiveness (RBE) of 1.1 along the whole beam penetration depth, without taking into account the documented increase in RBE at the end of the depth dose profile, in the Bragg peak and beyond. However, an inaccurate estimation of the RBE can cause both underdose or overdose, in particular it can cause the unfavourable situation of underdosing the tumour and overdosing the normal tissue just beyond the tumour, which limits the treatment success and increases the risk of complications. In view of a more precise dose delivery that takes into account the variation of RBE, experimental microdosimetry offers valuable tools for the quality assurance of LET or RBE-based treatment planning systems. The purpose of this work is to compare the response of two different microdosimetry systems: the mini-TEPC and the MicroPlus-Bridge detector. Microdosimetric spectra were measured across the 62 MeV spread out Bragg peak of CATANA with the mini-TEPC and with the Bridge microdosimeter. The frequency and dose distributions of lineal energy were compared and the different contributions to the spectra were analysed, discussing the effects of different site sizes and chord length distributions. The shape of the lineal energy distributions measured with the two detectors are markedly different, due to the different water-equivalent sizes of the sensitive volumes: 0.85 μm for the TEPC and 17.3 μm for the silicon detector. When the Loncol's biological weighting function is applied to calculate the microdosimetric assessment of the RBE, both detectors lead to results that are consistent with biological survival data for glioma U87 cells. Both the mini-TEPC and the MicroPlus-Bridge detector can be used to assess the RBE variation of a 62 MeV modulated proton beam along its penetration depth. The microdosimetric assessment of the RBE based on the Loncol's weighting function is in good agreement with radiobiological results when the 10% biological uncertainty is taken into account.
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Affiliation(s)
- V Conte
- INFN Laboratori Nazionali di Legnaro, viale dell'Università 2 35020 Legnaro, Italy
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Igbinosa I, Lee K, Oakeson A, Riley E, Melchor S, Birdsong J, Tran L, Weng Y, Collins W, Abir G, Bianco Y, He Z, Desai M, Mathew R, Lee G, Ahuja N, Lyell D, Gibbs R, Aziz N. Health disparities among pregnant women with sars-cov-2 infection at a university medical center in northern California. Am J Obstet Gynecol 2020. [PMCID: PMC7683952 DOI: 10.1016/j.ajog.2020.08.138] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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27
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Zahradnik I, Pomorski M, Tran L, Kada W, De Marzi L, Tromson D, Barberet P, Pastuovic Z, Vohradsky J, Salvador S, Leterrier L, Prezado Y, Pourcher T, Herault J, Rosenfeld A. PH-0045: Characterization of proton, carbon and silicon ion beams using scCVD diamond-based microdosimeters. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00071-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Staaf J, Tran L, Söderlund L, Nodin B, Jirström K, Vidarsdottir H, Planck M, Mattsson JSM, Botling J, Micke P, Brunnström H. Diagnostic Value of Insulinoma-Associated Protein 1 (INSM1) and Comparison With Established Neuroendocrine Markers in Pulmonary Cancers. Arch Pathol Lab Med 2020; 144:1075-1085. [PMID: 31913660 DOI: 10.5858/arpa.2019-0250-oa] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2019] [Indexed: 11/06/2022]
Abstract
CONTEXT.— The diagnostic distinction of pulmonary neuroendocrine (NE) tumors from non-small cell lung carcinomas (NSCLCs) is clinically relevant for prognostication and treatment. Diagnosis is based on morphology and immunohistochemical staining. OBJECTIVE.— To determine the diagnostic value of insulinoma-associated protein 1 (INSM1), in comparison with established NE markers, in pulmonary tumors. DESIGN.— Fifty-four pulmonary NE tumors and 632 NSCLCs were stained for INSM1, CD56, chromogranin A, and synaptophysin. In a subset, gene expression data were available for analysis. Also, 419 metastases to the lungs were stained for INSM1. A literature search identified 39 additional studies with data on NE markers in lung cancers from the last 15 years. Seven of these included data on INSM1. RESULTS.— A positive INSM1 staining was seen in 39 of 54 NE tumors (72%) and 6 of 623 NSCLCs (1%). The corresponding numbers were 47 of 54 (87%) and 14 of 626 (2%) for CD56, 30 of 54 (56%) and 6 of 629 (1%) for chromogranin A, and 46 of 54 (85%) and 49 of 630 (8%) for synaptophysin, respectively. Analysis of literature data revealed that CD56 and INSM1 were the best markers for identification of high-grade NE pulmonary tumors when considering both sensitivity and specificity, while synaptophysin also showed good sensitivity. INSM1 gene expression was clearly associated with NE histology. CONCLUSIONS.— The solid data of both our and previous studies confirm the diagnostic value of INSM1 as a NE marker in pulmonary pathology. The combination of CD56 with INSM1 and/or synaptophysin should be the first-hand choice to confirm pulmonary high-grade NE tumors. INSM1 gene expression could be used to predict NE tumor histology.
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Affiliation(s)
- Johan Staaf
- Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, Lund, Sweden (Staaf, Nodin, Jirström, Vidarsdottir, Planck, Brunnström)
| | - Lena Tran
- Department of Genetics and Pathology, Division of Laboratory Medicine, Region Skåne, Lund, Sweden (Tran, Söderlund, Jirström, Brunnström)
| | - Linnea Söderlund
- Department of Genetics and Pathology, Division of Laboratory Medicine, Region Skåne, Lund, Sweden (Tran, Söderlund, Jirström, Brunnström)
| | - Björn Nodin
- Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, Lund, Sweden (Staaf, Nodin, Jirström, Vidarsdottir, Planck, Brunnström)
| | - Karin Jirström
- Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, Lund, Sweden (Staaf, Nodin, Jirström, Vidarsdottir, Planck, Brunnström).,Department of Genetics and Pathology, Division of Laboratory Medicine, Region Skåne, Lund, Sweden (Tran, Söderlund, Jirström, Brunnström)
| | - Halla Vidarsdottir
- Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, Lund, Sweden (Staaf, Nodin, Jirström, Vidarsdottir, Planck, Brunnström).,Department of Surgery, Helsingborg Hospital, Helsingborg, Sweden (Vidarsdottir)
| | - Maria Planck
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund, Sweden (Planck)
| | - Johanna S M Mattsson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden (Mattsson, Botling, Micke)
| | - Johan Botling
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden (Mattsson, Botling, Micke)
| | - Patrick Micke
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden (Mattsson, Botling, Micke)
| | - Hans Brunnström
- Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, Lund, Sweden (Staaf, Nodin, Jirström, Vidarsdottir, Planck, Brunnström).,Department of Genetics and Pathology, Division of Laboratory Medicine, Region Skåne, Lund, Sweden (Tran, Söderlund, Jirström, Brunnström)
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Zhu J, Tran L, Zheng F, James J, Guthridge J, Chong B. 717 Enhanced molecular signatures in cutaneous lupus erythematosus patients support distinct pathogenic pathways in African American patients. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.730] [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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Merrill JT, Guthridge J, Zack D, Foster P, Burington B, Tran L, Smith M, James JA. SAT0187 DISCRIMINATION OF SYSTEMIC LUPUS (SLE) PATIENTS WITH CLINICAL RESPONSE TO OBEXELIMAB (XMAB®5871) BASED ON A PATTERN OF IMMUNOLOGIC MARKERS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:We recently reported Phase 2 SLE trial results of obexelimab, an FcγRIIb agonist (suppressor of B cell activation). Obexelimab did not meet the primary endpoint (% of patients without flare at Day 225) (p=0.183) but other endpoints such as time to flare (p=0.025) were met.Objectives:1. To assign SLE patients to phenotypic subsets based on patterns of gene expression in immune-related pathways.12. To explore the association of immune patterns and clinical response to obexelimab.Methods:This analysis included 71 of the 104 participants in the obexelimab study, those who either completed the protocol or terminated for disease flare, if there were adequate blood samples (biomarker subset). At screening, patients were assigned to clusters based on 41 SLE co-expression signature modules from the Human Immune Phenotyping Consortium via unsupervised random forest and K-means clustering.2Other markers of SLE disease were also examined. TheBOLD3study design mandated withdrawal of background immunosuppressants, supporting less ambiguous pharmacodynamic analysis as the trial progressed.Results:Immune pathway expression patterns of 7 patient clusters (Fig 1a) confirmed our prior characterization of 200 non-overlapping SLE patients.2The biomarker subset retained a trend of longer time to first flare in patients receiving obexelimab (n=38) vs placebo (n=33) (Fig1b, HR 0.61, p=0.11). A smaller set of only Clusters 3 and 6 demonstrated marked increased time to flare in the obexelimab group (n=13) compared to placebo (n=14) (Fig 1c, HR 0.22, p=0.025). Obexelimab had no effect on other clusters (Fig 1d). The responder clusters shared low expression of inflammation modules (p < 0.001) compared to other clusters and high expression of T Cell, immune response, cell cycle, mitochondrial modules (all p < 0.001) and B Cell modules (p=0.006). We therefore sorted patients by these specific features regardless of cluster assignment. Figure 2 shows significant impact of obexelimab on time to flare in 64 patients with B Cell pathway activation (HR 0.5, p=0.038), although less robust by itself than found in Clusters 3 and 6. In a group with high B or plasma cell modules but low inflammation (n=46), treatment effect increased (HR 0.35, p=0.019). Between Screening and Baseline, as brief steroids were given and background treatments withdrawn, expression of B Cell and Plasma Cell pathways increased. Both then decreased after treatment with obexelimab but not placebo (p< 0.0001 and p< 0.001 respectively), an effect not seen with other immune pathway modules.Conclusion:Precision medicine for SLE has been hampered by heterogenous immune signals with variable expression. Clustering of patients by gene co-expression pathways enabled an efficient, hierarchical array that reduplicated results of a prior SLE cohort, suggesting these are not random phenotypes. Of these 7 reproducible SLE subsets, the combination of clusters 3 and 6 distinguished an obexelimab responder population of 27 out of 71 subjects (38%) with high expression of B and T Cell modules and cell activation pathways. Focus on the defining features shared by these clusters revealed specific factors associated with response, enabling inclusion of some patients from other clusters in an optimized responder population of 46/71 (65% of subjects). B Cell and Plasma Cell pathways demonstrated mechanism-related pharmacodynamic effects of obexelimab. Lack of responders with high expression of inflammation modules could implicate inhibitory factors to obexelimab within inflammatory pathways, potentially targetable by complementary treatments.References:[1]Banchereau Cell 165:1548 2016[2]Lu ACR Abstract #2977 2017[3]Merrill Arthritis Rheumatol 69: 1257 2017Disclosure of Interests: :Joan T Merrill Grant/research support from: Xencor, Bristol Myers Squibb, Glaxo Smith Kline, Consultant of: Xencor, Abbvie, UCB, Glaxo Smith Kline, EMD Serono, Astellas, Remegen, Celgene/Bristol Myers Squibb, Exagen, Astra Zeneca, Amgen, Jannsen, Servier, ILTOO, Daitchi Sankyo, Lilly, Paid instructor for: Abbvie, Bristol Myers Squibb, Joel Guthridge Grant/research support from: Xencor, Bristol Myers Squibb, DXterity, Debra Zack Shareholder of: Xencor, Employee of: Xencor, Paul Foster Shareholder of: Xencor Inc, Employee of: Xencor Inc, Bart Burington Shareholder of: Xencor Inc, Employee of: Xencor Inc, Ly Tran: None declared, Miles Smith: None declared, Judith A. James Grant/research support from: Progentec Diagnostics, Inc, Consultant of: Abbvie, Novartis, Jannsen
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Tran L, Jeon B, Chasens E. 0829 Sleep, Chronic Pain, and Global Health in Adults Ages 65 or Older. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.825] [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] Open
Abstract
Abstract
Introduction
Understanding the association of sleep and pain in older adults can help improve their global health. The purpose of the study was to describe the associations between sleep, chronic pain, and global health in adults ages 65 or older.
Methods
This study was a secondary analysis of data from adults over 65 years in the 2015 Sleep in America Poll - Sleep and Pain by the National Sleep Foundation (NSF). The survey included demographics (age, race, marital status, education), sleep (duration, quality, insomnia symptoms), and pain (type [none, chronic, fleeting], intensity, location). Global health derived from general health, physical health, mental health, and quality of life with a potential range of 4-20; higher score=better health. The survey also queried fatigue and stress.
Results
The sample (N=248) was 65-91 years (mean age=72.8±5.9), male (53.6%), White (82.7%), married (65.7%), and with post-highschool education (54.4%). Average sleep duration was 425±74 minutes. “No pain” was reported by 38.7% of the sample (n=96), “fleeting pain” by 32.7% (n= 81), and “chronic pain” by 28.6% (n=71). The most common locations for chronic pain were shoulder or neck (63.2%) and back (69.4%). Average global health score was 9.8±2.9. There was no significant difference in time in bed, sleep duration, bedtime, or wake-up time between groups. Persons with chronic pain had higher average pain intensity, worst pain intensity, and current pain; they reported significantly lower sleep quality with significantly more restlessness, trouble staying asleep, and worry about getting a good night sleep (all p-values<.02), there was no significant difference in difficulty falling asleep compared to persons with no pain. Persons with chronic pain had significantly worse general health, physical health, mental health, global health, fatigue, and stress (all p-values<.02); but no significant difference in quality of life compared to persons with no pain.
Conclusion
We conclude that chronic pain has a significant negative impact on sleep and global health in the sample of adults ages 65 or older from the 2015 Sleep in America Poll - Sleep and Pain by the NSF.
Support
Undergraduate Research Mentoring Program, University of Pittsburgh School of Nursing.
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Affiliation(s)
- L Tran
- University of Pittsburgh School of Nursing, Pittsburgh, PA
| | - B Jeon
- University of Pittsburgh School of Nursing, Pittsburgh, PA
| | - E Chasens
- University of Pittsburgh School of Nursing, Pittsburgh, PA
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Aljarod T, Tran L, Al Ikhwan M, Prasad B. 0640 Initial Sleep Center Evaluation and Follow Up Improves Positive Airway Pressure (PAP) Therapy Adherence When Compared to Direct Referrals Without Sleep Physician Follow Up: A Retrospective Study. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.636] [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] Open
Abstract
Abstract
Introduction
Obstructive sleep apnea (OSA) affects 26% of adults and positive airway pressure (PAP) is the gold-standard of therapy. Factors affecting PAP adherence—use >4 hours in a 24-hour period—have been studied extensively. We compared of the three months (or other time frame) PAP adherence between patients seen by a sleep specialist prior to OSA diagnosis versus patients referred directly for OSA testing by non-sleep specialist providers. The goal of the study was to understand the impact of sleep consultation on PAP adherence.
Methods
Direct referral (DR) patients underwent polysomnography (PSG) and received PAP devices prior to the sleep clinic visit. In contrast, sleep center patients (SC) had a sleep clinic visit with a sleep physician or APRN prior to PSG.
Eighty-four patients were included in this study, 42 DR and 42 SC patients. Exclusion criteria were age <18 years old, absence of baseline PSG, and lack of 90-day compliance data. Covariates included demographics, body mass index (BMI), AHI, nadir oxygen saturation, demographics, and Epworth Sleepiness Scale (ESS) score. Objective PAP adherence for first 90 days was the primary outcome.
Results
Age (p=0.1), ESS (p=0.3), BMI (p=0.6), and AHI (p=0.9) were not significantly different between the groups. SC patients had greater PAP adherence (4.77 hours, 95%CI: 4.1 to 5.4) compared to DR patients (3.61 hours, 95%CI: 2.88 to 4.33, p=0.02). SC patients were also 8 times more likely to follow up in clinic within 1 year of starting PAP treatment (Likelihood Ratio 8.25, p=0.004).
Conclusion
While possibly more time-efficient for patients, direct referrals may ultimately result in lower PAP adherence due to missed opportunities for receiving education about OSA and PAP therapy. This is consistent with findings from a previous meta-analysis demonstrating that educational interventions improve PAP adherence. Moving forward, we will continue encouraging directly referred patients to follow up in the sleep center after PSG.
Support
None
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Affiliation(s)
- T Aljarod
- University of Illinois at chicago, Chicago, IL
| | - L Tran
- Universitry of Illinois at Chicago, Chicago, IL
| | - M Al Ikhwan
- University of Illinois at Chicago, Chicago, IL
| | - B Prasad
- University of Illinois at Chicago, Chicago, IL
- University of Illinois at Chicago, Chicago, IL
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Williams H, Tarallo C, Tran L, Griswold L, Bailey C, Patel K, Ghamande S, Rungruang B. Factors Influencing Survival and Survivorship Outcomes in Vulvar Cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2019.11.061] [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: 10/24/2022]
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Salehi-Rad R, Li R, Lim R, Tran L, Abascal J, Ong S, Liu B, Dubinett S. A35 Dendritic Cell in Situ Vaccination Potentiates Anti-PD-1 Efficacy and Induces Immunoediting in a Murine Model of NSCLC. J Thorac Oncol 2020. [DOI: 10.1016/j.jtho.2019.12.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Brunnström H, Staaf J, Tran L, Söderlund L, Nodin B, Jirström K, Vidarsdottir H, Planck M, Mattsson J, Botling J, Micke P. MA18.05 Diagnostic Difference Between Neuroendocrine Markers in Pulmonary Cancers: A Comprehensive Study and Review of the Literature. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.649] [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: 10/25/2022]
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Vakil H, Tran L, Lewis GD, Cykowski MD, Butler EB, Teh BS. Biopsy proven metastatic meningioma: A case report and review of the literature. Rep Pract Oncol Radiother 2019; 24:528-532. [PMID: 31516399 DOI: 10.1016/j.rpor.2019.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/21/2019] [Accepted: 08/11/2019] [Indexed: 11/18/2022] Open
Abstract
Meningiomas are the most common type of benign tumor found in the brain and are typically benign, slow-growing lesions. The current standard of care consists of surgical resection and subsequent postoperative radiotherapy to prevent local recurrence. Because of their indolent nature, meningiomas are rarely found to spread extracranially and develop distant metastases. We present the clinical, imaging, and pathologic features of a patient who had meningioma with multiple local recurrences, who was incidentally found to have metastatic disease in the lungs. In addition, we discuss details of this case in the context of the previously reported literature.
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Affiliation(s)
- Haris Vakil
- Department of Radiation Oncology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
| | - Lena Tran
- Department of Radiation Oncology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
| | - Gary D Lewis
- Department of Radiation Oncology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Matthew D Cykowski
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Edward Brian Butler
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Bin S Teh
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX 77030, USA
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Vakil H, Tran L, Lewis GD, Teh BS. Biopsy Proven Metastatic Meningioma: A Case Report and Review of the Literature. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/s0360-3016(19)30469-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Stark JH, Wool E, Tran L, Robinson E, Chemelski M, Weibel D, Huang WT, Kochhar S, Hardy JR, Bailey S, Galiwango E, Kajungu D. Assessing feasibility of resources at health facilities in Uganda to diagnose pregnancy and neonatal outcomes. Int Health 2019; 11:128-135. [PMID: 30252056 DOI: 10.1093/inthealth/ihy066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/27/2018] [Accepted: 09/13/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Standardized case definitions for obstetric and neonatal outcomes were developed by the Global Alignment of Immunization Safety Assessment in Pregnancy (GAIA) project. These definitions can facilitate comparable assessment of maternal immunization safety surveillance and research. This study assessed the capabilities of health centers (HC) in Uganda to implement these definitions in a low income country, which has not been explored. METHODS Healthcare practitioners at 15 government-accredited health centers and one government-funded district hospital in the Iganga-Mayuge Health and Demographic Surveillance Site (IMHDSS) in Uganda were interviewed about the facility's clinical diagnostic and laboratory capabilities. Five obstetric and five neonatal case definitions were evaluated. Definitions with the highest diagnostic certainty were designated as level 1, while definitions that decreased in certainty were designated as level 2 or 4. HCs were evaluated on diagnostic and laboratory capabilities to apply the GAIA definitions. RESULTS Higher-level facilities in the IMHDSS demonstrated the ability to diagnose more specific levels of the GAIA obstetric and neonatal outcomes than lower-level facilities. Furthermore, for the neonatal outcome assessment, there was an increased ability to diagnose outcomes moving from GAIA level 1 to level 3. CONCLUSIONS The ability of health centers to implement globally standardized definitions is promising for implementation of standardized data collection methods for global vaccine safety surveillance and research.
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Affiliation(s)
- James H Stark
- Worldwide Safety and Regulatory, Pfizer, New York, NY, USA.,College of Global Public Health, New York University, New York, NY, USA
| | - Eve Wool
- College of Global Public Health, New York University, New York, NY, USA.,Northwell Health Solutions, Population Health Management, Manhasset, NY, USA
| | - Lena Tran
- College of Global Public Health, New York University, New York, NY, USA.,Lucile Packard Children's Hospital Stanford, Stanford Children's Health, Palo Alto, CA, USA
| | - Elizabeth Robinson
- College of Global Public Health, New York University, New York, NY, USA.,New York University, School of Medicine, New York, NY, USA
| | - Meaghan Chemelski
- College of Global Public Health, New York University, New York, NY, USA.,Maine Medical Center Research Institute, Clinical Trials Office, Scarborough, ME, USA
| | - Daniel Weibel
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Wan-Ting Huang
- Office of Preventive Medicine, Taiwan Centers for Disease Control, Taipei, Taiwan
| | - Sonali Kochhar
- Global Healthcare Consulting; Department of Global Health, University of Washington, Seattle, WA, USA; Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Janet R Hardy
- ECC Population Health Group and University of South Florida, Tampa, FL, USA
| | - Steven Bailey
- Worldwide Safety and Regulatory, Pfizer, New York, NY, USA
| | - Edward Galiwango
- Makerere University Centre for Health and Population Research, Iganga Mayuge Health and Demographic Surveillance Site, Iganga, Uganda
| | - Dan Kajungu
- Makerere University Centre for Health and Population Research, Iganga Mayuge Health and Demographic Surveillance Site, Iganga, Uganda
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Debrot E, Tran L, Chartier L, Bolst D, Guatelli S, Vandevoorde C, de Kock E, Beukes P, Symons J, Nieto-Camero J, Prokopovich DA, Chiriotti S, Parisi A, De Saint-Hubert M, Vanhavere F, Slabbert J, Rosenfeld AB. SOI microdosimetry and modified MKM for evaluation of relative biological effectiveness for a passive proton therapy radiation field. Phys Med Biol 2018; 63:235007. [PMID: 30468682 DOI: 10.1088/1361-6560/aaec2f] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
With more patients receiving external beam radiation therapy with protons, it becomes increasingly important to refine the clinical understanding of the relative biological effectiveness (RBE) for dose delivered during treatment. Treatment planning systems used in clinics typically implement a constant RBE of 1.1 for proton fields irrespective of their highly heterogeneous linear energy transfer (LET). Quality assurance tools that can measure beam characteristics and quantify or be indicative of biological outcomes become necessary in the transition towards more sophisticated RBE weighted treatment planning and for verification of the Monte Carlo and analytical based models they use. In this study the RBE for the CHO-K1 cell line in a passively delivered clinical proton spread out Bragg peak (SOBP) is determined both in vitro and using a silicon-on-insulator (SOI) microdosimetry method paired with the modified microdosimetric kinetic model. The RBE along the central axis of a SOBP with 2 Gy delivered at the middle of the treatment field was found to vary between 1.11-1.98 and the RBE for 10% cell survival between 1.07-1.58 with a 250 kVp x-ray reference radiation and between 1.19-2.34 and 0.95-1.41, respectively, for a Co60 reference. Good agreement was found between RBE values calculated from the SOI-microdosimetry-MKM approach and in vitro. A strong correlation between proton lineal energy and RBE was observed particularly in the distal end and falloff of the SOBP.
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Affiliation(s)
- E Debrot
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, Australia
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Vidarsdottir H, Tran L, Nodin B, Jirström K, Planck M, Jönsson P, Mattsson JSM, Botling J, Micke P, Brunnström H. Immunohistochemical profiles in primary lung cancers and epithelial pulmonary metastases. Hum Pathol 2018; 84:221-230. [PMID: 30389437 DOI: 10.1016/j.humpath.2018.10.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/30/2018] [Accepted: 10/01/2018] [Indexed: 12/25/2022]
Abstract
Correct diagnosis of pulmonary tumors is essential for treatment decision and often relies on immunohistochemical markers. We stained tissue microarrays from resected primary lung cancer (n = 665) and pulmonary metastases (n = 425) for CK7, CK20, CDX2, CK5, p40, p63, TTF-1, napsin A, GATA3, and PAX8 to systematically assess the diagnostic value of these markers. Primary lung adenocarcinomas expressed TTF-1 in 90% and napsin A in 84% of the cases, whereas 10% were positive for p63, 7% for CDX2, 2% for CK20, and 2% for GATA3. Only 68% of the lung adenocarcinomas were positive for CK7, TTF-1, and napsin A and negative for all other markers. Primary lung squamous cell carcinomas expressed CK5, p40, and p63 in 94%-97% of cases, whereas 44% were positive for CK7, 20% for GATA3, 7% for CDX2, and 3% for TTF-1. Rare cases expressed PAX8, CK20, or napsin A. Pulmonary metastases of colorectal cancer were positive for CK20 in 83% and CDX2 in 99% of the cases. Rare cases expressed CK7, p63, or PAX8, whereas 4% expressed TTF-1. Pulmonary metastases of renal cell carcinomas were positive for PAX8 in 74%, napsin A in 7%, and CK7 in 7% of the cases. Pulmonary metastases of breast cancer were positive for GATA3 in 93% and CK7 in 78% of the cases, whereas 15% expressed CK5. Information on expression and patterns of immunohistochemical markers facilitates histopathological diagnostics. Evidently, unusual immune profiles occur and may lead to incorrect diagnosis.
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Affiliation(s)
- Halla Vidarsdottir
- Department of Surgery, Helsingborg Hospital, SE-251 87, Helsingborg, Sweden; Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, SE-221 00 Lund, Sweden
| | - Lena Tran
- Department of Genetics and Pathology, Division of Laboratory Medicine, Region Skåne, SE-221 85 Lund, Sweden
| | - Björn Nodin
- Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, SE-221 00 Lund, Sweden
| | - Karin Jirström
- Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, SE-221 00 Lund, Sweden; Department of Genetics and Pathology, Division of Laboratory Medicine, Region Skåne, SE-221 85 Lund, Sweden
| | - Maria Planck
- Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, SE-221 00 Lund, Sweden; Department of Respiratory Medicine and Allergology, Skåne University Hospital, SE-221 85 Lund, Sweden
| | - Per Jönsson
- Department of Clinical Sciences Lund, Division of Thoracic Surgery, Lund University, SE-221 00 Lund, Sweden
| | - Johanna S M Mattsson
- Department of Immunology, Genetics and Pathology, Uppsala University, SE-751 85 Uppsala, Sweden
| | - Johan Botling
- Department of Immunology, Genetics and Pathology, Uppsala University, SE-751 85 Uppsala, Sweden
| | - Patrick Micke
- Department of Immunology, Genetics and Pathology, Uppsala University, SE-751 85 Uppsala, Sweden
| | - Hans Brunnström
- Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, SE-221 00 Lund, Sweden; Department of Genetics and Pathology, Division of Laboratory Medicine, Region Skåne, SE-221 85 Lund, Sweden.
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Vidarsdottir H, Tran L, Nodin B, Jirström K, Planck M, Mattsson JSM, Botling J, Micke P, Jönsson P, Brunnström H. Comparison of Three Different TTF-1 Clones in Resected Primary Lung Cancer and Epithelial Pulmonary Metastases. Am J Clin Pathol 2018; 150:533-544. [PMID: 30169783 DOI: 10.1093/ajcp/aqy083] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Immunohistochemical staining against thyroid transcription factor 1 (TTF-1) is often used to distinguish lung adenocarcinoma from squamous cell carcinoma and pulmonary metastasis. METHODS TTF-1 expression was examined using the antibody clones 8G7G3/1, SPT24, and SP141 on tissue microarrays from 665 cases of resected lung cancers and 428 pulmonary metastases. RESULTS Most lung adenocarcinomas, 89%, 93%, and 93%, were positive with TTF-1 clones 8G7G3/1, SPT24, and SP141, respectively. The corresponding figures for lung squamous cell carcinomas were 0%, 6%, and 8%. In total, five (2%), 19 (7%), and 21 (8%) of the pulmonary metastases from colorectal adenocarcinomas were positive with clones 8G7G3/1, SPT24, and SP141, respectively. Other TTF-1-positive pulmonary metastases (n = 8) were thyroid, urothelial, pancreatic, small bowel, and cervix carcinomas. CONCLUSIONS TTF-1 expression in lung cancer and pulmonary metastases differs between clones, with 8G7G3/1 being more specific but less sensitive compared with SPT24 and SP141.
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Affiliation(s)
- Halla Vidarsdottir
- Department of Surgery, Helsingborg Hospital, Helsingborg, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Division of Oncology and Pathology, Lund University, Lund, Sweden
| | - Lena Tran
- Department of Genetics and Pathology, Laboratory Medicine, Lund, Sweden
| | - Björn Nodin
- Division of Oncology and Pathology, Lund University, Lund, Sweden
| | - Karin Jirström
- Division of Oncology and Pathology, Lund University, Lund, Sweden
- Department of Genetics and Pathology, Laboratory Medicine, Lund, Sweden
| | - Maria Planck
- Division of Oncology and Pathology, Lund University, Lund, Sweden
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | - Johanna S M Mattsson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Johan Botling
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Patrick Micke
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Per Jönsson
- Division of Thoracic Surgery, Lund University, Lund, Sweden
- Department of Thoracic Surgery, Skåne University Hospital, Lund, Sweden
| | - Hans Brunnström
- Division of Oncology and Pathology, Lund University, Lund, Sweden
- Department of Genetics and Pathology, Laboratory Medicine, Lund, Sweden
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Torrey H, Khodadoust M, Tran L, Baum D, Defusco A, Kim YH, Faustman DL. Targeted killing of TNFR2-expressing tumor cells and T regs by TNFR2 antagonistic antibodies in advanced Sézary syndrome. Leukemia 2018; 33:1206-1218. [PMID: 30356161 PMCID: PMC6756055 DOI: 10.1038/s41375-018-0292-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [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: 04/25/2018] [Revised: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 01/08/2023]
Abstract
Sézary syndrome (SS) is a rare form of cutaneous T-cell lymphoma often refractory to treatment. SS is defined as adenopathy, erythroderma with high numbers of atypical T cells. This offers an opportunity for new interventions and perhaps antibody-based therapeutic by virtue of its high expression of the TNFR2 oncogene on the tumor cells and on T-regulatory cells (Tregs). Potent human-directed TNFR2 antagonistic antibodies have been created that preferentially target the TNFR2 oncogene and tumor-infiltrating TNFR2+ Tregs. Here we test the therapeutic potential of TNFR2 antagonists on freshly isolated lymphocytes from patients with Stage IVA SS and from healthy controls. SS patients were on a variety of end-stage multi-drug therapies. Baseline burden Treg/T effector (Teff) ratios and the responsiveness of tumor and infiltrating Tregs to TNFR2 antibody killing was studied. We show dose-escalating concentrations of a dominant TNFR2 antagonistic antibody killed TNFR2+ SS tumor cells and thus restored CD26- subpopulations of lymphocyte cell numbers to normal. The abundant TNFR2+ Tregs of SS subjects are also killed with TNFR2 antagonism. Beneficial and rapid expansion of Teff was observed. The combination of Treg inhibition and Teff expansion brought the high Treg/Teff ratio to normal. Our findings suggest a marked responsiveness of SS tumor cells and Tregs, to targeting with TNFR2 antagonistic antibodies. These results show TNFR2 antibodies are potent and efficacious in vitro.
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Affiliation(s)
- H Torrey
- Massachusetts General Hospital and Harvard Medical School, Building 149, 13th Street, Rm 3602, 02129, Boston, MA, USA
| | - M Khodadoust
- Stanford University School of Medicine/Cancer Institute, 94305, Palo Alto, CA, USA
| | - L Tran
- Massachusetts General Hospital and Harvard Medical School, Building 149, 13th Street, Rm 3602, 02129, Boston, MA, USA
| | - D Baum
- Massachusetts General Hospital and Harvard Medical School, Building 149, 13th Street, Rm 3602, 02129, Boston, MA, USA
| | - A Defusco
- Massachusetts General Hospital and Harvard Medical School, Building 149, 13th Street, Rm 3602, 02129, Boston, MA, USA
| | - Y H Kim
- Stanford University School of Medicine/Cancer Institute, 94305, Palo Alto, CA, USA
| | - D L Faustman
- Massachusetts General Hospital and Harvard Medical School, Building 149, 13th Street, Rm 3602, 02129, Boston, MA, USA.
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Litton E, Bass F, Delaney A, Hillis G, Marasco S, McGuinness S, Myles PS, Reid CM, Smith JA, Bagshaw SM, Keri-Anne Cowdrey HB, Frengley R, Ferrier J, Gilder E, Henderson S, Larobina M, Merthens J, Morgan M, Navarra L, Rudas M, Turner L, Reid K, Wise M, Young N, Young P, McGiffin D, Duncan J, Kaczmarek M, Seevanayagam S, Shaw M, Shardey G, Skillington P, Chorley T, Baker L, Zhang B, Bright C, Baker R, Canning N, Gilfillan, Kruger R, Fayers T, Kyte M, Doran C, Smith J, Baxter H, Seah P, Scaybrook S, James A, Goodwin K, Dignan R, Hewitt N, Gerrard K, Curtis L, Smith J, Baxter H, Tiruvoipati R, Broukal N, Wolfenden H, Muir, Worthington M, Wong C, Tatoulis J, Wynne R, Marshman D, Sze D, Wilson M, Turner L, Passage J, Kolybaba M, Fermanis G, Newbon P, Passage J, Kolybaba M, Newcomb A, Mack J, Duve K, Jansz P, Hunter T, Bissaker P, Dennis N, Burke N, Yadav S, Cooper K, Chard R, Halaka M, Tran L, Huq M, Billah B, Reid CM. Six-Month Outcomes After High-Risk Coronary Artery Bypass Graft Surgery and Preoperative Intra-aortic Balloon Counterpulsation Use: An Inception Cohort Study. J Cardiothorac Vasc Anesth 2018; 32:2067-2073. [DOI: 10.1053/j.jvca.2018.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Indexed: 11/11/2022]
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Wu NC, Wong E, Acca B, Birkmeier J, Tran L, Zhao S, Wong W, Chu VC, Ho K, Malek M, Lu C, Ge G, David K, Quigley NB, Beqaj SS, Davenport S, Weidler J, Bates M, Press M. Abstract P2-03-03: A multicenter clinical study of Xpert® breast cancer STRAT4 demonstrates high concordance with central lab ER, PgR, HER2, and Ki67 IHC and HER2 FISH tests in FFPE breast tumor tissues. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-03-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The Xpert® Breast Cancer STRAT4 (STRAT4) is a CE-IVD marked, semi-quantitative, cartridge-based RT-qPCR assay for the detection of ESR1, PGR, ERBB2 (HER2), and MKi67 mRNAs from formalin fixed, paraffin embedded (FFPE) breast tumors. The assay is fast (< 2 hrs), reproducible, robust, and easy to perform.
The aim of this multicenter clinical study was to assess the performance characteristics of the STRAT4 assay relative to central lab immunohistochemistry (IHC) for ER, PgR, HER2, and Ki67 and to fluorescence in situ hybridization (FISH) for HER2 gene amplification.
Methods: A total of 200 archived primary invasive breast cancer FFPE blocks were sourced from Indivumed for this study. From each block, twelve (12) adjacent tissue sections (4-µm thickness) on slides were prepared for pathological H&E confirmation to define tumor area, and for testing by STRAT4, IHC (ER, PgR, HER2,Ki67), and HER2 FISH. Standard STRAT4 lysate preparation using a single unstained slide per specimen and testing on N=84, N=68, and N=48 samples was performed at 3 independent sites, respectively (2 US and 1 EU). A single slide from each specimen was also processed using the recommended concentrated lysate procedure for STRAT4 testing at Cepheid. All IHC and FISH testing was performed by a central academic reference laboratory in the US. For a given sample, STRAT4 data generated using the standard lysate procedure was included for concordance analysis when all target gene test results were valid. In cases where the standard lysate preparation yielded indeterminate test results for any target, data from the concentrated lysate preparation was used for the data analysis. Receiver Operating Characteristic (ROC) analysis, overall percent agreement (OPA), positive percent agreement (PPA), and negative percent agreement (NPA) between STRAT4 and IHC (IHC/FISH for HER2) were determined for ESR1,PGR, ERBB2, and MKi67.
Results: Of the 200 samples tested by STRAT4, all samples generated valid results for ESR1 and ERBB2, 199 of 200 samples were valid for PGR, and 198 of 200 samples were valid for MKi67 using the standard or concentrated lysate preparation protocol. One sample failed to generate results for both ER and PgR IHC. Twelve samples failed to yield HER2 FISH results.
The STRAT4 success rate and results concordance with IHC were comparable across study sites. OPA between STRAT4 and IHC was 97% for ESR1, 88.9% for PGR, 93.3% for HER2 (92.4% for IHC and FISH), and 90.7% for MKi67 (excluding IHC 10-20% staining). Areas under the ROC curves were 0.9922 for ESR1, 0.9509 for PGR, 0.9958 for ERBB2, and 0.9395 for MKi67.
Conclusion: STRAT4 measurements for ESR1, PGR, ERBB2 and MKi67 mRNA expression are robust and highly concordant with IHC (IHC/FISH for HER2). The technical portion of the assay is easily performed in < 2 hrs including hands-on time using standard FFPE tissue sections. Xpert STRAT4 offers local pathology labs an alternative to centralized, subjective IHC/FISH tests that require a higher level of expertise. Further investigations correlating STRAT4 markers directly with clinical outcomes in independent cohorts are in progress.
Citation Format: Wu NC, Wong E, Acca B, Birkmeier J, Tran L, Zhao S, Wong W, Chu VC, Ho K, Malek M, Lu C, Ge G, David K, Quigley NB, Beqaj SS, Davenport S, Weidler J, Bates M, Press M. A multicenter clinical study of Xpert® breast cancer STRAT4 demonstrates high concordance with central lab ER, PgR, HER2, and Ki67 IHC and HER2 FISH tests in FFPE breast tumor tissues [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-03-03.
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Affiliation(s)
- NC Wu
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - E Wong
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - B Acca
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - J Birkmeier
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - L Tran
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - S Zhao
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - W Wong
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - VC Chu
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - K Ho
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - M Malek
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - C Lu
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - G Ge
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - K David
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - NB Quigley
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - SS Beqaj
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - S Davenport
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - J Weidler
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - M Bates
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - M Press
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
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Evans M, Choi K, Ogurek I, Tran L, Howard D. 102: A systematic review of case reports of organ damage secondary to intrauterine device perforation. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.12.121] [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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Dieleman J, Peelen L, Coulson T, Tran L, Reid C, Smith J, Myles P, Pilcher D. Age and other perioperative risk factors for postoperative systemic inflammatory response syndrome after cardiac surgery. Br J Anaesth 2017; 119:637-644. [DOI: 10.1093/bja/aex239] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2017] [Indexed: 02/05/2023] Open
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Vandevoorde C, Beukes P, Miles X, de Kock E, Symons J, Nieto-Camero J, Tran L, Chartier L, Debrot E, Propokovic D, Chiriotti S, Parisi A, De Saint-Hubert M, Vanhavere F, Rozenfeld A, Slabbert J. Assessment of out-of-field DNA damage and the impact of neutron RBE on secondary cancer risk in paediatric proton therapy. Phys Med 2017. [DOI: 10.1016/s1120-1797(17)30314-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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O’Connor E, Jackson R, Tran L, Lakshminarayanan B. WITHDRAWN: A late diagnosis of a complicated Meckel’s diverticulum - The first case of an enterocolic fistula secondary to a Meckel’s diverticulum in a paediatric patient and review of the literature. Journal of Pediatric Surgery Case Reports 2017. [DOI: 10.1016/j.epsc.2017.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Coulson TG, Bailey M, Reid CM, Tran L, Mullany DV, Smith JA, Pilcher D. The association between peri-operative acute risk change (ARC) and long-term survival after cardiac surgery. Anaesthesia 2017; 72:1467-1475. [DOI: 10.1111/anae.13967] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2017] [Indexed: 01/23/2023]
Affiliation(s)
- T. G. Coulson
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - M. Bailey
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - C. M. Reid
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
- School of Public Health; Curtin University; Perth Western Australia Australia
| | - L. Tran
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - D. V. Mullany
- Critical Care Research Group; University of Queensland; Brisbane Queensland Australia
| | - J. A. Smith
- Department of Surgery; Monash University; Melbourne Victoria Australia
| | - D. Pilcher
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
- Department of Intensive Care; The Alfred Hospital; Melbourne Victoria Australia
- ANZICS Centre for Outcome and Resource Evaluation; Carlton, Melbourne Victoria Australia
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Hattay P, Prusator DK, Tran L, Greenwood-Van Meerveld B. Psychological stress-induced colonic barrier dysfunction: Role of immune-mediated mechanisms. Neurogastroenterol Motil 2017; 29. [PMID: 28300333 DOI: 10.1111/nmo.13043] [Citation(s) in RCA: 16] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/09/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Evidence suggests that patients with irritable bowel syndrome (IBS) exhibit increases in gut permeability and alterations in tight junction (TJ) protein expression. Although psychological stress worsens IBS symptoms, the mechanisms by which stress enhances gut permeability and affects TJ protein expression remain to be determined. Here, we test the hypothesis that chronic intermittent psychological stress activates the release of proinflammatory cytokines to alter TJ proteins and promotes increased gut permeability. METHODS Male Fischer-344 rats were subjected to 1 hour of water avoidance stress (WAS) or SHAM stress per day for 7 days. Following the stress protocol, colonic permeability was measured via transepithelial electrical resistance (TEER) and macromolecular flux of horseradish peroxidase (HRP). In tissue isolated from rats exposed to the WAS or SHAM stress, TJ proteins claudin-2, junctional adhesion molecule-A (JAM-A) and zonula occluden-1 (ZO-1) were measured via Western blotting, histological appearance of the colonic segments was assessed via hematoxylin and eosin staining, and an inflammatory cytokine panel was quantified via quantitative reverse transcription-polymerase chain reaction. KEY RESULTS Repetitive daily exposure to WAS decreased the TEER, increased the macromolecular flux of HRP, and altered the expression of claudin-2, JAM-A and ZO-1 proteins within colonic tissue compared to SHAM controls. In the absence of a histologically defined inflammation, the cytokine profiles of WAS-treated animals revealed an increase in interleukin-1β and tumor necrosis factor (TNF)-α. Subsequent analysis revealed a significant positive correlation between TNF-α and expression of TJ protein claudin-2. CONCLUSIONS & INFERENCES Our findings suggest that chronic stress increases colonic permeability via sub-inflammatory cytokine-mediated remodeling of TJ protein expression.
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Affiliation(s)
- P Hattay
- Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - D K Prusator
- Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - L Tran
- Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - B Greenwood-Van Meerveld
- Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,VA Medical Center, Oklahoma City, OK, USA.,Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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