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Mirnezami AH, Drami I, Glyn T, Sutton PA, Tiernan J, Behrenbruch C, Guerra G, Waters PS, Woodward N, Applin S, Charles SJ, Rose SA, Denys A, Pape E, van Ramshorst GH, Baker D, Bignall E, Blair I, Davis P, Edwards T, Jackson K, Leendertse PG, Love-Mott E, MacKenzie L, Martens F, Meredith D, Nettleton SE, Trotman MP, van Hecke JJM, Weemaes AMJ, Abecasis N, Angenete E, Aziz O, Bacalbasa N, Barton D, Baseckas G, Beggs A, Brown K, Buchwald P, Burling D, Burns E, Caycedo-Marulanda A, Chang GJ, Coyne PE, Croner RS, Daniels IR, Denost QD, Drozdov E, Eglinton T, Espín-Basany E, Evans MD, Flatmark K, Folkesson J, Frizelle FA, Gallego MA, Gil-Moreno A, Goffredo P, Griffiths B, Gwenaël F, Harris DA, Iversen LH, Kandaswamy GV, Kazi M, Kelly ME, Kokelaar R, Kusters M, Langheinrich MC, Larach T, Lydrup ML, Lyons A, Mann C, McDermott FD, Monson JRT, Neeff H, Negoi I, Ng JL, Nicolaou M, Palmer G, Parnaby C, Pellino G, Peterson AC, Quyn A, Rogers A, Rothbarth J, Abu Saadeh F, Saklani A, Sammour T, Sayyed R, Smart NJ, Smith T, Sorrentino L, Steele SR, Stitzenberg K, Taylor C, Teras J, Thanapal MR, Thorgersen E, Vasquez-Jimenez W, Waller J, Weber K, Wolthuis A, Winter DC, Brangan G, Vimalachandran D, Aalbers AGJ, Abdul Aziz N, Abraham-Nordling M, Akiyoshi T, Alahmadi R, Alberda W, Albert M, Andric M, Angeles M, Antoniou A, Armitage J, Auer R, Austin KK, Aytac E, Baker RP, Bali M, Baransi S, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brunner M, Bui A, Burgess A, Burger JWA, Campain N, Carvalhal S, Castro L, Ceelen W, Chan KKL, Chew MH, Chok AK, Chong P, Christensen HK, Clouston H, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Damjanovic L, Davies M, Davies RJ, Delaney CP, de Wilt JHW, Deutsch C, Dietz D, Domingo S, Dozois EJ, Duff M, Egger E, Enrique-Navascues JM, Espín-Basany E, Eyjólfsdóttir B, Fahy M, Fearnhead NS, Fichtner-Feigl S, Fleming F, Flor B, Foskett K, Funder J, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Giner F, Ginther N, Glover T, Golda T, Gomez CM, Harris C, Hagemans JAW, Hanchanale V, Harji DP, Helbren C, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Holmström A, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Jenkins JT, Jourand K, Kaffenberger S, Kapur S, Kanemitsu Y, Kaufman M, Kelley SR, Keller DS, Kersting S, Ketelaers SHJ, Khan MS, Khaw J, Kim H, Kim HJ, Kiran R, Koh CE, Kok NFM, Kontovounisios C, Kose F, Koutra M, Kraft M, Kristensen HØ, Kumar S, Lago V, Lakkis Z, Lampe B, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Loria A, Lynch AC, Mackintosh M, Mantyh C, Mathis KL, Margues CFS, Martinez A, Martling A, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, McArthur DR, McCormick JJ, McGrath JS, McPhee A, Maciel J, Malde S, Manfredelli S, Mikalauskas S, Modest D, Morton JR, Mullaney TG, Navarro AS, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, O’Dwyer ST, Paarnio K, Pappou E, Park J, Patsouras D, Peacock O, Pfeffer F, Piqeur F, Pinson J, Poggioli G, Proud D, Quinn M, Oliver A, Radwan RW, Rajendran N, Rao C, Rasheed S, Rasmussen PC, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Seifert G, Selvasekar C, Shaban M, Shaikh I, Shida D, Simpson A, Skeie-Jensen T, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Spasojevic M, Steffens D, Stocchi L, Stylianides NA, Swartling T, Sumrien H, Swartking T, Takala H, Tan EJ, Taylor D, Tejedor P, Tekin A, Tekkis PP, Thaysen HV, Thurairaja R, Toh EL, Tsarkov P, Tolenaar J, Tsukada Y, Tsukamoto S, Tuech JJ, Turner G, Turner WH, Tuynman JB, Valente M, van Rees J, van Zoggel D, Vásquez-Jiménez W, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weiser MR, Westney OL, Wheeler JMD, Wild J, Wilson M, Yano H, Yip B, Yip J, Yoo RN, Zappa MA. The empty pelvis syndrome: a core data set from the PelvEx collaborative. Br J Surg 2024; 111:znae042. [PMID: 38456677 PMCID: PMC10921833 DOI: 10.1093/bjs/znae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/15/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Empty pelvis syndrome (EPS) is a significant source of morbidity following pelvic exenteration (PE), but is undefined. EPS outcome reporting and descriptors of radicality of PE are inconsistent; therefore, the best approaches for prevention are unknown. To facilitate future research into EPS, the aim of this study is to define a measurable core outcome set, core descriptor set and written definition for EPS. Consensus on strategies to mitigate EPS was also explored. METHOD Three-stage consensus methodology was used: longlisting with systematic review, healthcare professional event, patient engagement, and Delphi-piloting; shortlisting with two rounds of modified Delphi; and a confirmatory stage using a modified nominal group technique. This included a selection of measurement instruments, and iterative generation of a written EPS definition. RESULTS One hundred and three and 119 participants took part in the modified Delphi and consensus meetings, respectively. This encompassed international patient and healthcare professional representation with multidisciplinary input. Seventy statements were longlisted, seven core outcomes (bowel obstruction, enteroperineal fistula, chronic perineal sinus, infected pelvic collection, bowel obstruction, morbidity from reconstruction, re-intervention, and quality of life), and four core descriptors (magnitude of surgery, radiotherapy-induced damage, methods of reconstruction, and changes in volume of pelvic dead space) reached consensus-where applicable, measurement of these outcomes and descriptors was defined. A written definition for EPS was agreed. CONCLUSIONS EPS is an area of unmet research and clinical need. This study provides an agreed definition and core data set for EPS to facilitate further research.
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West CT, West MA, Mirnezami AH, Drami I, Denys A, Glyn T, Sutton PA, Tiernan J, Behrenbruch C, Guerra G, Waters PS, Woodward N, Applin S, Charles SJ, Rose SA, Pape E, van Ramshorst GH, Aalbers AGJ, Abdul AN, Abecasis N, Abraham-Nordling M, Akiyoshi T, Alahmadi R, Alberda W, Albert M, Andric M, Angeles M, Angenete E, Antoniou A, Armitage J, Auer R, Austin KK, Aytac E, Aziz O, Bacalbasa N, Baker RP, Bali M, Baransi S, Baseckas G, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brown K, Brunner M, Buchwald P, Bui A, Burgess A, Burger JWA, Burling D, Burns E, Campain N, Carvalhal S, Castro L, Caycedo-Marulanda A, Ceelen W, Chan KKL, Chang GJ, Chew MH, Chok AK, Chong P, Christensen HK, Clouston H, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Coyne PE, Croner RS, Damjanovic L, Daniels IR, Davies M, Davies RJ, Delaney CP, de Wilt JHW, Denost QD, Deutsch C, Dietz D, Domingo S, Dozois EJ, Drozdov E, Duff M, Egger E, Eglinton T, Enrique-Navascues JM, Espín-Basany E, Evans MD, Eyjólfsdóttir B, Fahy M, Fearnhead NS, Fichtner-Feigl S, Flatmark K, Fleming F, Flor B, Folkesson J, Foskett K, Frizelle FA, Funder J, Gallego MA, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Gil-Moreno A, Giner F, Ginther N, Glover T, Goffredo P, Golda T, Gomez CM, Griffiths B, Gwenaël F, Harris C, Harris DA, Hagemans JAW, Hanchanale V, Harji DP, Helbren C, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Holmström A, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Iversen LH, Jenkins JT, Jourand K, Kaffenberger S, Kandaswamy GV, Kapur S, Kanemitsu Y, Kaufman M, Kazi M, Kelley SR, Keller DS, Kelly ME, Kersting S, Ketelaers SHJ, Khan MS, Khaw J, Kim H, Kim HJ, Kiran R, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kose F, Koutra M, Kraft M, Kristensen HØ, Kumar S, Kusters M, Lago V, Lakkis Z, Lampe B, Langheinrich MC, Larach T, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Loria A, Lydrup ML, Lyons A, Lynch AC, Mackintosh M, Mann C, Mantyh C, Mathis KL, Margues CFS, Martinez A, Martling A, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, McArthur DR, McCormick JJ, McDermott FD, McGrath JS, McPhee A, Maciel J, Malde S, Manfredelli S, Mikalauskas S, Modest D, Monson JRT, Morton JR, Mullaney TG, Navarro AS, Neeff H, Negoi I, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, O’Dwyer ST, Paarnio K, Palmer G, Pappou E, Park J, Patsouras D, Peacock A, Pellino G, Peterson AC, Pfeffer F, Piqeur F, Pinson J, Poggioli G, Proud D, Quinn M, Oliver A, Quyn A, Radwan RW, Rajendran N, Rao C, Rasheed S, Rasmussen PC, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rothbarth J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Saklani A, Sammour T, Sayyed R, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Seifert G, Selvasekar C, Shaban M, Shaikh I, Shida D, Simpson A, Skeie-Jensen T, Smart NJ, Smart P, Smith JJ, Smith T, Solbakken AM, Solomon MJ, Sørensen MM, Spasojevic M, Steele SR, Steffens D, Stitzenberg K, Stocchi L, Stylianides NA, Swartling T, Sumrien H, Swartking T, Takala H, Tan EJ, Taylor C, Taylor D, Tejedor P, Tekin A, Tekkis PP, Teras J, Thanapal MR, Thaysen HV, Thorgersen E, Thurairaja R, Toh EL, Tsarkov P, Tolenaar J, Tsukada Y, Tsukamoto S, Tuech JJ, Turner G, Turner WH, Tuynman JB, Valente M, van Rees J, van Zoggel D, Vásquez-Jiménez W, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weber K, Weiser MR, Westney OL, Wheeler JMD, Wild J, Wilson M, Wolthuis A, Yano H, Yip B, Yip J, Yoo RN, Zappa MA, Winter DC. Empty pelvis syndrome: PelvEx Collaborative guideline proposal. Br J Surg 2023; 110:1730-1731. [PMID: 37757457 PMCID: PMC10805575 DOI: 10.1093/bjs/znad301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
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Fahy MR, Kelly ME, Aalbers AGJ, Abdul Aziz N, Abecasis N, Abraham-Nordling M, Akiyoshi T, Alberda W, Albert M, Andric M, Angeles MA, Angenete E, Antoniou A, Auer R, Austin KK, Aytac E, Aziz O, Bacalbasa N, Baker RP, Bali M, Baransi S, Baseckas G, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Beynon J, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brunner M, Buchwald P, Bui A, Burgess A, Burger JWA, Burling D, Burns E, Campain N, Carvalhal S, Castro L, Caycedo-Marulanda A, Ceelan W, Chan KKL, Chang GJ, Chang M, Chew MH, Chok AY, Chong P, Clouston H, Codd M, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Coyne PE, Croner RS, Damjanovich L, Daniels IR, Davies M, Delaney CP, de Wilt JHW, Denost Q, Deutsch C, Dietz D, Domingo S, Dozois EJ, Drozdov E, Duff M, Eglinton T, Enriquez-Navascues JM, Espín-Basany E, Evans MD, Eyjólfsdóttir B, Fearnhead NS, Ferron G, Flatmark K, Fleming FJ, Flor B, Folkesson J, Frizelle FA, Funder J, Gallego MA, Gargiulo M, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Gil-Moreno A, Giner F, Ginther DN, Glyn T, Glynn R, Golda T, Griffiths B, Harris DA, Hagemans JAW, Hanchanale V, Harji DP, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Iversen LH, Jenkins JT, Jourand K, Kaffenberger S, Kandaswamy GV, Kapur S, Kanemitsu Y, Kazi M, Kelley SR, Keller DS, Ketelaers SHJ, Khan MS, Kiran RP, Kim H, Kim HJ, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kose F, Koutra M, Kristensen HØ, Kroon HM, Kumar S, Kusters M, Lago V, Lampe B, Lakkis Z, Larach JT, Larkin JO, Larsen SG, Larson DW, Law WL, Lee PJ, Limbert M, Loria A, Lydrup ML, Lyons A, Lynch AC, Maciel J, Manfredelli S, Mann C, Mantyh C, Mathis KL, Marques CFS, Martinez A, Martling A, Mehigan BJ, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, Mikalauskas S, McArthur DR, McCormick JJ, McCormick P, McDermott FD, McGrath JS, Malde S, Mirnezami A, Monson JRT, Navarro AS, Negoi I, Neto JWM, Ng JL, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, Nugent T, Oliver A, O’Dwyer ST, O’Sullivan NJ, Paarnio K, Palmer G, Pappou E, Park J, Patsouras D, Peacock O, Pellino G, Peterson AC, Pinson J, Poggioli G, Proud D, Quinn M, Quyn A, Rajendran N, Radwan RW, Rajendran N, Rao C, Rasheed S, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rothbarth J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Saklani A, Sammour T, Sayyed R, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Selvasekar C, Shaikh I, Simpson A, Skeie-Jensen T, Smart NJ, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Sorrentino L, Steele SR, Steffens D, Stitzenberg K, Stocchi L, Stylianides NA, Swartling T, Spasojevic M, Sumrien H, Sutton PA, Swartking T, Takala H, Tan EJ, Taylor C, Tekin A, Tekkis PP, Teras J, Thaysen HV, Thurairaja R, Thorgersen EB, Toh EL, Tsarkov P, Tsukada Y, Tsukamoto S, Tuech JJ, Turner WH, Tuynman JB, Valente M, van Ramshorst GH, van Zoggel D, Vasquez-Jimenez W, Vather R, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Urrejola G, Wakeman C, Warrier SK, Wasmuth HH, Waters PS, Weber K, Weiser MR, Wheeler JMD, Wild J, Williams A, Wilson M, Wolthuis A, Yano H, Yip B, Yip J, Yoo RN, Zappa MA, Winter DC. Minimum standards of pelvic exenterative practice: PelvEx Collaborative guideline. Br J Surg 2022; 109:1251-1263. [PMID: 36170347 DOI: 10.1093/bjs/znac317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/18/2022] [Accepted: 08/18/2022] [Indexed: 12/31/2022]
Abstract
This document outlines the important aspects of caring for patients who have been diagnosed with advanced pelvic cancer. It is primarily aimed at those who are establishing a service that adequately caters to this patient group. The relevant literature has been summarized and an attempt made to simplify the approach to management of these complex cases.
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Kelly ME, Aalbers AGJ, Abdul Aziz N, Abecasis N, Abraham‐Nordling M, Akiyoshi T, Alberda W, Albert M, Andric M, Angenete E, Antoniou A, Auer R, Austin KK, Aziz O, Baker RP, Bali M, Baseckas G, Bebington B, Bednarski BK, Beets GL, Berg PL, Beynon J, Biondo S, Boyle K, Bordeianou L, Bremers AB, Brunner M, Buchwald P, Bui A, Burgess A, Burger JWA, Burling D, Burns E, Campain N, Carvalhal S, Castro L, Caycedo‐Marulanda A, Chan KKL, Chang GJ, Chew MH, Chong PC, Christensen HK, Clouston H, Codd M, Collins D, Colquhoun A, Corr A, Coscia M, Coyne PE, Creavin B, Croner RS, Damjanovic L, Daniels IR, Davies M, Davies RJ, Delaney CP, Denost Q, Deutsch C, Dietz D, Domingo S, Dozois EJ, Duff M, Eglinton T, Enrique‐Navascues JM, Espin‐Basany E, Evans MD, Fearnhead NS, Flatmark K, Fleming F, Frizelle FA, Gallego MA, Garcia‐Granero E, Garcia‐Sabrido JL, Gentilini L, George ML, Ghouti L, Giner F, Ginther N, Glynn R, Golda T, Griffiths B, Harris DA, Hagemans JAW, Hanchanale V, Harji DP, Helewa RM, Heriot AG, Hochman D, Hohenberger W, Holm T, Hompes R, Jenkins JT, Kaffenberger S, Kandaswamy GV, Kapur S, Kanemitsu Y, Kelley SR, Keller DS, Khan MS, Kiran RP, Kim H, Kim HJ, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kristensen HØ, Kroon HM, Kusters M, Lago V, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Lydrup ML, Lyons A, Lynch AC, Mantyh C, Mathis KL, Margues CFS, Martling A, Meijerink WJHJ, Merkel S, Mehta AM, McArthur DR, McDermott FD, McGrath JS, Malde S, Mirnezami A, Monson JRT, Morton JR, Mullaney TG, Negoi I, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, O’Connell PR, O’Dwyer ST, Palmer G, Pappou E, Park J, Patsouras D, Pellino G, Peterson AC, Poggioli G, Proud D, Quinn M, Quyn A, Radwan RW, van Ramshorst GH, Rasheed S, Rasmussen PC, Regenbogen SE, Renehan A, Rocha R, Rochester M, Rohila J, Rothbarth J, Rottoli M, Roxburgh C, Rutten HJT, Ryan ÉJ, Safar B, Sagar PM, Sahai A, Saklani A, Sammour T, Sayyed R, Schizas AMP, Schwarzkopf E, Scripcariu V, Selvasekar C, Shaikh I, Hellawell G, Shida D, Simpson A, Smart NJ, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Steele SR, Steffens D, Stitzenberg K, Stocchi L, Stylianides NA, Sumrien H, Sutton PA, Swartking T, Taylor C, Tekkis PP, Teras J, Thurairaja R, Toh EL, Tsarkov P, Tsukada Y, Tsukamoto S, Tuech JJ, Turner WH, Tuynman JB, Vasquez‐Jimenez W, Verhoef C, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weber K, Weiser MR, Wheeler JMD, Wild J, Wilson M, de Wilt JHW, Wolthuis A, Yano H, Yip B, Yip J, Yoo RN, van Zoggel D, Winter DC. Simultaneous pelvic exenteration and liver resection for primary rectal cancer with synchronous liver metastases: results from the PelvEx Collaborative. Colorectal Dis 2020; 22:1258-1262. [PMID: 32294308 DOI: 10.1111/codi.15064] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/24/2020] [Indexed: 02/08/2023]
Abstract
AIM At presentation, 15-20% of patients with rectal cancer already have synchronous liver metastases. The aim of this study was to determine the surgical and survival outcomes in patients with advanced rectal cancer who underwent combined pelvic exenteration and liver (oligometastatic) resection. METHOD Data from 20 international institutions that performed simultaneous pelvic exenteration and liver resection between 2007 and 2017 were accumulated. Primarily, we examined perioperative outcomes, morbidity and mortality. We also assessed the impact that margin status had on survival. RESULTS Of 128 patients, 72 (56.2%) were men with a median age of 60 years [interquartile range (IQR) 15 years]. The median size of the liver oligometastatic deposits was 2 cm (IQR 1.8 cm). The median duration of surgery was 406 min (IQR 240 min), with a median blood loss of 1090 ml (IQR 2010 ml). A negative resection margin (R0 resection) was achieved in 73.5% of pelvic exenterations and 66.4% of liver resections. The 30-day mortality rate was 1.6%, and 32% of patients had a major postoperative complication. The 5-year overall survival for patients in whom an R0 resection of both primary and metastatic disease was achieved was 54.6% compared with 20% for those with an R1/R2 resection (P = 0.006). CONCLUSION Simultaneous pelvic exenteration and liver resection is feasible, with acceptable morbidity and mortality. Simultaneous resection should only be performed where an R0 resection of both pelvic and hepatic disease is anticipated.
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Gur Kabul E, Basakci Calik B, Akar B, Bali M, Ekici Tekin Z, Otar Yener G, Yuksel S. SAT0626-HPR EXPLORING THE RELATION BETWEEN PAIN AND ACTIVITY AND PARTICIPATION BASED ON ICF IN CHILDREN AND ADOLESCENTS WITH JUVENIL IDIOPATIK ARTRIT: A PILOT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Functional limitation and inactivation are the most important problems in children with Juvenil Idiopatik Artrit (JIA).Objectives:The aim of this study was to link and allocate items of Childhood Health Assessment Questionnaire (CHAQ) with activity and participation based on International Classification of Functioning, Disability and Health (ICF). The other aim was to examine the relationship between the pain and activity and participation determined on the basis of CHAQ with Juvenil Idiopatik Artrit (JIA).Methods:Thirty-seven children and adolescents (26 girls, 11 boys, mean age=11.75±4.04 years) were included. The mean BMI of the participants was 19.61±4.52 kg / cm2. Inclusion criteria: To be diagnosed with JIA according to ILAR classification. Being in the 6-18 age range. To be stable in drug use for at least 3 months or longer. Exclusion criteria:The presence of another disease. Intraarticularsteroid injection or surgery in any joint in last 3 months. Evaluations were made by the same pediatric rheumatologist and physiotherapist (PT) by face to face interview method. Pain was evaluated by use of Numeric Rating Scale (NRS) (0=no, 10=worst) and disability by CHAQ. As CHAQ score increases, disability increases. CHAQ has 8 categories. The highest score for any question determines the score for that category. The items of CHAQ were linked with ICF codes and allocated with the ICF components by three PT. Original scoring of CHAQ allocated to ICF components was used in order to calculate scores of activity and participation in accordance with clinical data for 37 JIA. The 20th item in the “Reach” category is not included in the calculation as it contains the body function component of ICF. The data was analyzed using Pearson’s correlation coefficient.Results:Mean score of NRS was 3.52±2.34. Mean activity and participation score of CHAQ was 0.51±0.58, 0.70±1.10, respectively. Based on expert distinction, activity and participation categories of ICF were covered 24 and 5 items of CHAQ, respectively. Pain had moderate correlation with activity (r=0.595; p=0.002) and participation (r=0.604; p=0.001) for CHAQ. Activity had high correlation with participation (r=0.702; p=0.000).Conclusion:Pain in children and adolescents with JIA is an important parameter affecting activity and participation. Pain should be evaluated in all aspects due to the limitation of both activity and participation. CHAQ largely contains the activity component of ICF. The development of new questionnaire is needed to assess the participation of JIA children and adolescents in more detail.References:[1]Schanberg LE. Widespread pain in children: when is it pathologic? Arthritis Rheum 2003;48:2402-2405.Table 1.Linking and allocating items of CHAQItemsICF CodeICF ComponentDRESSING & GROOMINGDress, including tying shoelaces and doing buttons?d5402AShampoo his/her hair?d5100ARemove socks?d5403ACut fingernails?d520AARISINGStand up from a low chair or floor?d4103AGet in and out of bed or stand up in crib?d4100AEATINGCut his /her own meat?d550ALift a cup or glass to mouth?d4402AOpen a new cereal box?d440AWALKINGWalk outdoors on flat ground?d450AClimb up five steps?d4551AHYGIENEWash and dry entire body?d510ATake a tub bath?dd410AGet on and off the toilet or potty chair?d4103ABrush teeth?d5201AComb/brush hair?d5202AREACHReach and get down a heavy object from just above his/her head?d4452ABend down to pick up clothing or a piece of paper from the floor?d4105APull on a sweater over his/her head?d5400ATurn neck to look back over shoulder?b7101Body FunctionGRIPWrite or scribble with pen or pencil?d170AOpen car doors?d4450AOpen jars which have been previously opened?d4453ATurn faucets on and off?d4402APush open a door when he/she to turn a door knob?d4453AACTIVITIESRun errands and shop?d6200PGet in and out of car or toy car or school?d4702PRide bike or tricycle?d4750PDo household choresd6402PRun and play?d9201PA:Activity, P:ParticipationDisclosure of Interests:None declared
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Gur Kabul E, Basakci Calik B, Bali M, Otar Yener G, Ekici Tekin Z, Yuksel S. AB0985 THE EFFECT OF GENDER ON CHILDREN AND ADOLESCENTS WITH FAMILIAL MEDITERRANEAN FEVER. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:In the literature, it was reported that children with with Familial Mediterranean fever (FMF) have lower functional capacity and muscle strength than healthy children. With reduced functional capacity, daily activities are negatively affected. The individual starts to adopt an inactive lifestyle and decreases in muscle strength are observed. A vicious circle occurs and results in exacerbation of symptoms and worse quality of life.Objectives:The aim of this study is to investigate the effect of gender on dynamic muscular endurance, physical activity and quality of life with FMF.Methods:Forty-eight children and adolescents (26 girls, 22 boys, mean age=12.43±3.04 years, age range=7-18 years) were included. Exclusion criteria:The presence of another disease. Intraarticularsteroid injection or surgery in any joint in the last 3 months. Evaluations were made by the same pediatric rheumatologist and physiotherapist by face to face interview method. Dynamic muscle endurance was evaluated by use of curl up test (30 sec), push up test (30 sec) and one-legged stationary hop test (15 sec); physical activity level by Physical Activity Questionnaire and quality of life by Pediatric Quality of Life Inventory (PedsQL) 3.0 Arthritis Module. Physical Activity Questionnaire contains nine items and evaluates physical activities in last seven days and frequency of these activities. As score increases, level of physical activity increases. In this study, child and parent forms of PedsQL were used to evaluate the quality of life. High scores mean high quality of life. Independent Samples Test was used in the analysis because the data fit the normal distribution.Results:Difference was significant in Physical Activity Questionnaire (p=0.028) in favor of girl gender whereas in child form (p=0.017) and parent form (p=0.040) of PedsQL (p=0.003) in favor of boy gender.Conclusion:We see that the physical activity are lower in children and adolescents with FMF who have a gender of girls and, accordingly, lower quality of life. Therefore, we believe that these individuals should increase their physical activities.References:[1]Gualano B, S´a Pinto AL, Perondi B, Leite Prado DM, Omori C, Almeida RT, Sallum AM, Silva CA. Evidence for prescribing exercise as treatment in pediatric rheumatic diseases. Autoimmun Rev 2010;9(8):569-573.[2]Alayli G, Durmus D, Ozkaya O, Sen HE, Nalcacioglu H, Bilgici A, Kuru O. Functional Capacity, Strength, and Quality of Life in Children and Youth With Familial Mediterranean Fever. Pediatric Physical Therapy 2014;26(3):347-352.Table 1.Demographic characteristicsVariablesGirls (n=26)Boys (n=22)M±SDM±SDAge (years)12.96±2.9111.86±3.24Body weight (kg)42.76±12.5540.17±11.89Height (m)1.50±0.131.48±0.15BMI (kg/m2)18.25±2.9017.85±3.39Age of onset (years)7.57±4.077.22±3.99Dose of colchicine (per day)1.18±0.601.63±0.68Duration of treatment (years)5.30±2.904.61±3.34C-reactive protein (mg/dl)0.88±2.281.25±2.91Pras et al severity score6.35±2.685.31±2.60n (%)n (%)FMF in the family (Yes/No)4(15.4)/16(61.5)12(54.5)/10(45.5)Arthritis (Yes/No)9(34.6)/17(65.4)6(27.3)/16 (72.7)Arthralgia (Yes/No)20(76.9)/6(23.1)14(63.6)/ 8(36.4)Knee (Yes/No)6(23.1)/20(76.9)7(31.8)/15 (68.2)Elbow (Yes/No)1(3.8)/25(96.2)0(0)/22(100)Ankle (Yes/No)6(23.1)/20(76.9)7(31.8)/15(68.2)Hand (Yes/No)1(3.8)/25(96.2)1(4.5)/21(95.5)Table 2.Comparison of data in terms of genderVariablesGirls (n=26)Boys (n=22)p*M±SDM±SDCurl Up Test (repeat)10.70±3.5812.80±3.660.075Push Up Test (repeat)10.55±5.0611.75±6.290.511One-legged Stationary Hop Test (repeat)37.60±12.7435.35±6.020.480Physical Activity Questionnaire16.93±5.7020.70±5.770.028PedsQL- child form19.15±13.4810.68±9.380.017PedsQL- parent form22.30±17.8513.04±11.060.040Disclosure of Interests:None declared
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Kroon HM, Dudi-Venkata N, Bedrikovetski S, Thomas M, Kelly M, Aalbers A, Abdul Aziz N, Abraham-Nordling M, Akiyoshi T, Alberda W, Andric M, Antoniou A, Austin K, Baker R, Bali M, Baseckas G, Bednarski B, Beets G, Berg P, Beynon J, Biondo S, Bordeianou L, Brunner M, Buchwald P, Burger J, Burling D, Campain N, Chan K, Chang G, Chew M, C Chong P, Christensen H, Codd M, Colquhoun A, Corr A, Coscia M, Coyne P, Creavin B, Damjanovic L, Daniels I, Davies M, Davies R, de Wilt J, Denost Q, Dietz D, Dozois E, Duff M, Eglinton T, Enriquez-Navascues J, Evans M, Fearnhead N, Frizelle F, Garcia-Granero E, Garcia-Sabrido J, Gentilini L, George M, Glynn R, Golda T, Griffiths B, Harris D, Evans M, Hagemans J, Harji D, Heriot A, Hohenberger W, Holm T, Jenkins J, Kapur S, Kanemitsu Y, Kelley S, Keller D, Kim H, Koh C, Kok N, Kokelaar R, Kontovounisios C, Kusters M, Larson D, Law W, Laurberg S, Lee P, Lydrup M, Lynch A, Mantyh C, Mathis K, Martling A, Meijerink W, Merkel S, Mehta A, McDermott F, McGrath J, Mirnezami A, Morton J, Mullaney T, Mesquita-Neto J, Nielsen M, Nieuwenhuijzen G, Nilsson P, O'Connell P, Palmer G, Patsouras D, Pellino G, Poggioli G, Quinn M, Quyn A, Radwan R, Rasheed S, Rasmussen P, Regenbogen S, Rocha R, Rothbarth J, Roxburgh C, Rutten H, Ryan É, Sagar P, Saklani A, Schizas A, Schwarzkopf E, Scripcariu V, Shaikh I, Shida D, Simpson A, Smart N, Smith J, Solomon M, Sørensen M, Steele S, Steffens D, Stocchi L, Stylianides N, Tekkis P, Taylor C, Tsarkov P, Tsukamoto S, Turner W, Tuynman J, van Ramshorst G, van Zoggel D, Vasquez-Jimenez W, Verhoef C, Verstegen M, Wakeman C, Warrier S, Wasmuth H, Weiser M, Wheeler J, Wild J, Yip J, Winter D, Sammour T. Palliative pelvic exenteration: A systematic review of patient-centered outcomes. Eur J Surg Oncol 2019; 45:1787-1795. [DOI: 10.1016/j.ejso.2019.06.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/02/2019] [Accepted: 06/07/2019] [Indexed: 12/13/2022] Open
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Khakoo S, Carter P, Valeri N, Shaikh R, Jones T, Begum R, Rana I, Picchia S, Bali M, Brown G, Wotherspoon A, Terlizzo M, von Loga K, Ahmed I, Watkins D, Chau I, Starling N, Tait D, Hubank M, Cunningham D. Circulating tumour DNA (ctDNA) as a tool to assess response and guide therapy adaptation in rectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy303.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kutlay S, Kurultak I, Nergizoglu G, Erturk S, Karatan O, Azevedo P, Pinto CT, Pereira CM, Marinho A, Vanmassenhove J, Hoste E, Glorieux G, Dhondt A, Vanholder R, Van Biesen W, Rei S, Aleksandrova I, Kiselev V, Ilynskiy M, Berdnikov G, Marchenkova L, Vanmassenhove J, Hoste E, Glorieux G, Dhondt A, Vanholder R, Van Biesen W, Daher EF, Vieira APF, Souza JB, Falcao FS, Costa CR, Fernandes AACS, Mota RMS, Lima RSA, Silva Junior GB, Ulusal Okyay G, Erten Y, Er R, Aybar M, Inal S, Tekbudak M, Aygencel G, Onec K, Bali M, Sindel S, Soto K, Fidalgo P, Papoila AL, Vanmassenhove J, Hoste E, Glorieux G, Dhondt A, Vanholder R, Van Biesen W, Lentini P, Zanoli L, Granata A, Contestabile A, Basso A, Berlingo G, de Cal M, Pellanda V, Dell'Aquila R, Fortrie G, Stads S, van Bommel J, Zietse R, Betjes MG, Berrada A, Arias C, Riera M, Orfila MA, Rodriguez E, Barrios C, Peruzzi L, Chiale F, Camilla R, Martano C, Cresi F, Bertino E, Coppo R, Klimenko A, Villevalde S, Efremovtseva M, Kobalava Z, Pipili C, Ioannidou S, Kokkoris S, Poulaki S, Tripodaki ES, Parisi M, Papastylianou A, Nanas S, Wang YN, Cheng H, Chen YP, Wen Z, Li X, Shen P, Zou Y, Lu Y, Ma X, Chen Y, Ren H, Chen X, Chen N, Yue T, Cheng H, Chen YP, Elmamoun S, Wodeyar H, Goldsmith C, Abraham A, Wootton A, Ahmed S, Hill C, Curtis S, Miller A, Hine T, Stevens KK, Patel RK, Mark PB, Delles C, Jardine AG, Wilflingseder J, Heinzel A, Mayer P, Perco P, Kainz A, Mayer B, Oberbauer R, Huang TM, Wu VC, Park DJ, Bae EJ, Kang YJ, Cho HS, Chang SH, Lentini P, Zanoli L, Granata A, Contestabile A, Berlingo G, Basso A, Pellanda V, de Cal M, Stramana R, Cognolato D, Baiocchi M, Dell'Aquila R, Chiella BM, Pilla C, Balbinotto A, Antunes VH, Heglert A, Collares FM, Thome FS, Gjyzari A, Thereska N, Xhango O, Xue J, Chen MC, Wang L, Chen YJ, Sun XZ, An WS, Kim ES, Son YK, Kim SE, Kim KH, Oh YJ, Tsai HB, Ko WJ, Chao CT, Fortrie G, Stads S, Aarnoudse AJL, Zietse R, Betjes MG, Peride I, Radulescu D, Niculae A, Ciocalteu A, Checherita AI, Kao CC, Wang CY, Lai CF, Huang TM, Chen HH, Wu VC, Ko WJ, Wu KD, Klaus F, Goldani JC, Cantisani G, Zanotelli ML, Carvalho L, Klaus D, Garcia VD, Keitel E, Hussaini SM, Rao PN, Kul A, Ye N, Zhang Y, Cheng H, Chen YP, Baines R, Westacott R, Trew J, Kirtley J, Selby N, Carr S, Xu G, Steffgen J, Blaschke S, Brun-Schulte-Wissing N, Pagel P, Huber F, Mapes J, Jaehnige A, Pestel S, Deray G, Rouviere O, Bacigalupo L, Maes B, Hannedouche T, Vrtovsnik F, Rigothier C, Billiouw JM, Campioni P, Marti-Bonmati L, Gao YM, Li D, Cheng H, Chen YP, Woo S, Lee J, Noh H, Kwon SH, Han DC, Hetherington L, Valluri A, McQuarrie E, Fleming S, Geddes C, Bell S, MacKinnon B, Bell S, Patton A, Sneddon J, Donnan P, Vadiveloo T, Marwick C, Bennie M, Davey P, Yasuda H, Tsuji N, Tsuji T, Iwakura T, Ohashi N, Kato A, Fujigaki Y, Sasaki S, Kawarazaki H, Shibagaki Y, Kimura K, Lingaraju U, Rajanna S, Radhakrishnan H, Parekh A, Sreedhar CG, Sarvi R, Rainone F, Merlino L, Ritchie JP, Kalra PA, Daher EF, Vieira APF, Jacinto CN, Abreu KLS, Silva Junior GB, Neves M, Baptista JP, Rodrigues L, Pinho J, Teixeira L, Pimentel J, Gonzalez Sanchidrian S, Rangel Hidalgo G, Cebrian Andrada C, Deira Lorenzo J, Marin Alvarez J, Garcia-Bernalt Funes V, Gallego Dominguez S, Labrador Gomez P, Castellano Cervino I, Novillo Santana R, Gomez-Martino Arroyo J, Kim Y, Choi BS, Kim YO, Yoon SA, Lin MC, Wu VC, Ko WJ, Wu KD, Wang WJ, Melo MJ, Lopes JA, Raimundo M, Fragoso A, Antunes F, Martin-Moreno PL, Varo N, Restituto P, Sayon-Orea C, Garcia-Fernandez N, Leite Filho NCV, Souza LEO, Cavalcante RM, Silva Junior GB, Morais BM, Leite TT, Silva SL, Kubrusly M, Daher EF, Jung YS, Kim YN, Shin HS, Rim H, Bentall A, Al-Baaj F, Williamson S, Cheshire S, Jelakovic M, Ivkovic V, Laganovic M, Karanovic S, Pecin I, Premuzic V, Vukovic Lela I, Vrdoljak A, Fucek M, Cvitkovic A, Juric D, Bozina N, Bitunjac M, Leko N, Abramovic Baric M, Matijevic V, Jelakovic B, Ullah A, Exarchou K, Archer T, Anijeet H, Brown R, Ahmed S, Zhang Y, Ye N, Cheng H, Cheng YP, Rocha JCG, Gushiken da Silva T, de Castro PF, Kioroglo PS, Branco Martins JP, Tzanno-Martins C, Biesenbach P, Luf F, Fleischmann E, Grunberger T, Druml W, Gaipov A, Turkmen K, Toker A, Solak Y, Cicekler H, Ucar R, Kilicaslan A, Gormus N, Tonbul HZ, Yeksan M, Turk S, Monteburini T, Cenerelli S, Santarelli S, Boggi R, Tazza L, Bossola M, Ferraresi M, Merlo I, Giovinazzo G, Quercia AD, Gai M, Leonardi G, Anania P, Guarena C, Cantaluppi V, Pacitti A, Biancone L, Hissa PNG, Daher EDF, Liborio AB, Thereza BMF, Mendes CCP, Sousa ARO. AKI - human studies. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gill N, Kaur A, Arora R, Dhawan V, Bali M. Synthetic Studies of Novel Azaflavanone Derivatives and its Biological Activities. ACTA ACUST UNITED AC 2012. [DOI: 10.3923/crc.2012.88.98] [Citation(s) in RCA: 8] [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: 11/15/2022]
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Bali M, Akabas MH. Gating-induced conformational rearrangement of the γ-aminobutyric acid type A receptor β-α subunit interface in the membrane-spanning domain. J Biol Chem 2012; 287:27762-70. [PMID: 22730325 DOI: 10.1074/jbc.m112.363341] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
GABA(A) receptors mediate fast inhibitory synaptic transmission. The transmembrane ion channel is lined by a ring of five α helices, M2 segments, one from each subunit. An outer ring of helices comprising the alternating M1, M3, and M4 segments from each subunit surrounds the inner ring and forms the interface with the lipid bilayer. The structural rearrangements that follow agonist binding and culminate in opening of the ion pore remain incompletely characterized. Propofol and other intravenous general anesthetics bind at the βM3-αM1 subunit interface. We sought to determine whether this region undergoes conformational changes during GABA activation. We measured the reaction rate of p-chloromercuribenzenesulfonate (pCMBS) with cysteines substituted in the GABA(A) receptor α1M1 and β2M3 segments. In the presence of GABA, the pCMBS reaction rate increased significantly in a cluster of residues in the extracellular third of the α1M1 segment facing the β2M3 segment. Mutation of the β2M2 segment 19' position, R269Q, altered the pCMBS reaction rate with several α1M1 Cys, some only in the resting state and others only in the GABA-activated state. Thus, β2R269 is charged in both states. GABA activation induced disulfide bond formation between β2R269C and α1I228C. The experiments demonstrate that α1M1 moves in relationship to β2M2R269 during gating. Thus, channel gating does not involve rigid body movements of the entire transmembrane domain. Channel gating causes changes in the relative position of transmembrane segments both within a single subunit and relative to the neighboring subunits.
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Affiliation(s)
- Moez Bali
- Department of Physiology and Biophysics, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York 10461, USA
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McKinnon NK, Bali M, Akabas MH. Length and amino acid sequence of peptides substituted for the 5-HT3A receptor M3M4 loop may affect channel expression and desensitization. PLoS One 2012; 7:e35563. [PMID: 22539982 PMCID: PMC3335078 DOI: 10.1371/journal.pone.0035563] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Accepted: 03/20/2012] [Indexed: 11/18/2022] Open
Abstract
5-HT3A receptors are pentameric neurotransmitter-gated ion channels in the Cys-loop receptor family. Each subunit contains an extracellular domain, four transmembrane segments (M1, M2, M3, M4) and a 115 residue intracellular loop between M3 and M4. In contrast, the M3M4 loop in prokaryotic homologues is <15 residues. To investigate the limits of M3M4 loop length and composition on channel function we replaced the 5-HT3A M3M4 loop with two to seven alanine residues (5-HT3A-An = 2–7). Mutants were expressed in Xenopus laevis oocytes and characterized using two electrode voltage clamp recording. All mutants were functional. The 5-HT EC50's were at most 5-fold greater than wild-type (WT). The desensitization rate differed significantly among the mutants. Desensitization rates for 5-HT3A-A2, 5-HT3A-A4, 5-HT3A-A6, and 5-HT3A-A7 were similar to WT. In contrast, 5-HT3A-A3 and 5-HT3A-A5 had desensitization rates at least an order of magnitude faster than WT. The one Ala loop construct, 5-HT3A-A1, entered a non-functional state from which it did not recover after the first 5-HT application. These results suggest that the large M3M4 loop of eukaryotic Cys-loop channels is not required for receptor assembly or function. However, loop length and amino acid composition can effect channel expression and desensitization. We infer that the cytoplasmic ends of the M3 and M4 segments may undergo conformational changes during channel gating and desensitization and/or the loop may influence the position and mobility of these segments as they undergo gating-induced conformational changes. Altering structure or conformational mobility of the cytoplasmic ends of M3 and M4 may be the basis by which phosphorylation or protein binding to the cytoplasmic loop alters channel function.
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Affiliation(s)
- Nicole K. McKinnon
- Department of Physiology and Biophysics, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, United States of America
| | - Moez Bali
- Department of Physiology and Biophysics, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, United States of America
| | - Myles H. Akabas
- Department of Physiology and Biophysics, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, United States of America
- Departments of Neuroscience and Medicine, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, United States of America
- * E-mail:
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Gill N, Rani P, Arora R, Dhawan V, Bali M. Evaluation of Antioxidant, Antiinflammatory and Antiulcer Potential of Momordica charantia Methanolic Seed Extract. ACTA ACUST UNITED AC 2012. [DOI: 10.3923/rjphyto.2012.96.104] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Gill N, Singh S, Arora R, Bali M. Evaluation of Ethanolic Seed Extract of Lagenaria siceraria for Their Therapeutic Potential. J of Medical Sciences 2012. [DOI: 10.3923/jms.2012.78.84] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Van Laethem JL, Verslype C, Iovanna JL, Michl P, Conroy T, Louvet C, Hammel P, Mitry E, Ducreux M, Maraculla T, Uhl W, Van Tienhoven G, Bachet JB, Maréchal R, Hendlisz A, Bali M, Demetter P, Ulrich F, Aust D, Luttges J, Peeters M, Mauer M, Roth A, Neoptolemos JP, Lutz M. New strategies and designs in pancreatic cancer research: consensus guidelines report from a European expert panel. Ann Oncol 2012; 23:570-576. [PMID: 21810728 DOI: 10.1093/annonc/mdr351] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Although the treatment of pancreatic ductal adenocarcinoma (PDAC) remains a huge challenge, it is entering a new era with the development of new strategies and trial designs. Because there is an increasing number of novel therapeutic agents and potential combinations available to test in patients with PDAC, the identification of robust prognostic and predictive markers and of new targets and relevant pathways is a top priority as well as the design of adequate trials incorporating molecular-driven hypothesis. We presently report a consensus strategy for research in pancreatic cancer that was developed by a multidisciplinary panel of experts from different European institutions and collaborative groups involved in pancreatic cancer. The expert panel embraces the concept of exploratory early proof of concept studies, based on the prediction of response to novel agents and combinations, and randomised phase II studies permitting the selection of the best therapeutic approach to go forward into phase III, where the recommended primary end point remains overall survival. Trials should contain as many translational components as possible, relying on standardised tissue and blood processing and robust biobanking, and including dynamic imaging. Attention should not only be paid to the pancreatic cancer cells but also to microenvironmental factors and stem/stellate cells.
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Affiliation(s)
- J-L Van Laethem
- Gastrointestinal Cancer Unit, Hôpital Erasme, Université Libre de Bruxelles, Brussels.
| | - C Verslype
- Department of Hepatology, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium
| | - J L Iovanna
- Institut National de la Santé et de la Recherche Médicale, Marseille, France
| | - P Michl
- Department of Gastroenterology and Endocrinology, University of Marburg, Marburg, Germany
| | - T Conroy
- Nancy University and Department of Medical Oncology, Centre Alexis Vautrin, Nancy
| | - C Louvet
- Digestive Surgery Department, Institut Mutualiste Montsouris, Paris
| | - P Hammel
- Gastroenterology Department, Hôpital Beaujon, Clichy
| | - E Mitry
- Medical Oncology Department, Institut Curie, Hôpital René-Huguenin, Saint-Cloud
| | - M Ducreux
- Digestive Oncology Department, Institut G. Roussy, Villejuif, France
| | - T Maraculla
- Medical Oncology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - W Uhl
- Department of Surgery, St Josef-Hospital, Ruhr-University, Bochum, Germany
| | - G Van Tienhoven
- Department of Radiation Oncology, Academic Medical Centre, Amsterdam, The Netherlands
| | - J B Bachet
- Department of Gastroenterology, Hôpital Pitié Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - R Maréchal
- Department of Gastroenterology and Hepato-Pancreatology, Gastrointestinal Cancer Unit, Hôpital Universitaire Erasme, Brussels
| | - A Hendlisz
- Department of Gastroenterology, Institut J. Bordet, Brussels
| | - M Bali
- Department of Medical Imaging, Hôpital Erasme, Brussels, Belgium
| | - P Demetter
- Gastrointestinal Cancer Unit, Hôpital Erasme, Université Libre de Bruxelles, Brussels
| | - F Ulrich
- Department of General and Visceral Surgery, J. W. Goethe University Medical Center, Frankfurt
| | - D Aust
- Institute of Pathology, University Hospital Carl Gustav Carus, Dresden
| | - J Luttges
- Caritasklinik St Theresia, Saarbrücken, Germany
| | - M Peeters
- Department of Oncology, Universitair Ziekenhuis Antwerpen, Edegem
| | - M Mauer
- European Organisation for Research and Treatment of Cancer Headquarters, Brussels, Belgium
| | - A Roth
- Department of Surgery, Clinic for Visceral and Transplantation Surgery, Hôpital Universitaire de Genève, Geneva, Switzerland
| | - J P Neoptolemos
- Department of Surgery, University of Liverpool, Liverpool, UK
| | - M Lutz
- Caritasklinik St Theresia, Saarbrücken, Germany
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Pozdzik A, Brocheriou I, Depierreux M, Bali M, Deviere J, Nortier J. Néphrite tubulo-interstitielle chronique compliquant une pancréatite auto-immune au cours du syndrome d’hyper IgG4. Nephrol Ther 2012. [DOI: 10.1016/j.nephro.2011.07.422] [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: 10/14/2022]
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17
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Gill N, Dhawan S, Jain A, Arora R, Bali M. Antioxidant and Anti-Ulcerogenic Activity of Wild Punica granatum Ethanolic Seed Extract. ACTA ACUST UNITED AC 2012. [DOI: 10.3923/rjmp.2012.47.55] [Citation(s) in RCA: 8] [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: 11/15/2022]
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18
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Parikh RB, Bali M, Akabas MH. Structure of the M2 transmembrane segment of GLIC, a prokaryotic Cys loop receptor homologue from Gloeobacter violaceus, probed by substituted cysteine accessibility. J Biol Chem 2011; 286:14098-109. [PMID: 21362624 PMCID: PMC3077611 DOI: 10.1074/jbc.m111.221895] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [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: 01/15/2011] [Revised: 02/28/2011] [Indexed: 11/06/2022] Open
Abstract
GLIC is a homopentameric proton-gated, prokaryotic homologue of the Cys loop receptor family of neurotransmitter-gated ion channels. Recently, crystal structures of GLIC hypothesized to represent an open channel state were published. To explore the channel structure in functional GLIC channels, we tested the ability of p-chloromercuribenzenesulfonate to react with 30 individual cysteine substitution mutants in and flanking the M2 channel-lining segment in the closed state (pH 7.5) and in a submaximally activated state (pH 5.0). Nine mutants did not tolerate cysteine substitution and were not functional. From positions 10' to 27', p-chloromercuribenzenesulfonate significantly modified the currents at pH 7.5 and 5.0 in all mutants except H234C (11'), I235C (12'), V241C (18'), T243C (20'), L245C (22'), and Y250C (27'), which were not functional, except for 12'. Currents for P246C (23') and K247C (24') were only significantly altered at pH 5.0. The reaction rates were all >1000 m(-1) s(-1). The reactive residues were more accessible in the activated than in the resting state. We infer that M2 is tightly associated with the adjacent transmembrane helices at the intracellular end but is more loosely packed from 10' to the extracellular end than the x-ray structures suggest. We infer that the charge selectivity filter is in the cytoplasmic half of the channel. We also show that below pH 5.0, GLIC desensitizes on a time scale of minutes and infer that the crystal structures may represent a desensitized state.
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Affiliation(s)
| | - Moez Bali
- From the Departments of Physiology & Biophysics
| | - Myles H. Akabas
- From the Departments of Physiology & Biophysics
- Neuroscience, and
- Medicine, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York 10461
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19
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20
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Bali M, Akabas MH. Rigid Motion Near the GABAA Receptor α1 Subunit First Transmembrane Segment Revealed by pCMBS- Reactivity in Cysteine-Substituted Mutants During Channel Activation. Biophys J 2011. [DOI: 10.1016/j.bpj.2010.12.1712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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21
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Gill N, Bajwa J, Sharma P, Dhiman K, Sood S, Sharma P, Singh B, Bali M. Evaluation of Antioxidant and Antiulcer Activity of Traditionally Consumed Cucumis melo Seeds. ACTA ACUST UNITED AC 2010. [DOI: 10.3923/jpt.2011.82.89] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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22
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Gill N, Bajwa J, Dhiman K, Sharma P, Sood S, Sharma P, Singh B, Bali M. Evaluation of Therapeutic Potential of Traditionally Consumed Cucumis melo Seeds. ACTA ACUST UNITED AC 2010. [DOI: 10.3923/ajps.2011.86.91] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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23
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Sood S, Muthuraman A, Gill N, Bali M, Sharma P. Effect of Citrus karna Peel Extract on Stress Induced Peptic Ulcer in Rat. ACTA ACUST UNITED AC 2010. [DOI: 10.3923/jbs.2010.231.236] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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24
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McKinnon N, Bali M, Akabas MH. Length and Composition of the 5HT3A Receptor M3M4 Loop Effects Channel Expression and Desensitization. Biophys J 2010. [DOI: 10.1016/j.bpj.2009.12.698] [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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25
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Parikh RB, Bali M, Akabas MH. M2 Segment Accessibility in The Prokaryotic Proton-Gated Cys-loop Receptor Channel from Gloeobacter Violaceus in Closed and Open States. Biophys J 2010. [DOI: 10.1016/j.bpj.2009.12.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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26
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Gill N, Garg M, Bansal R, Sood S, Muthuraman A, Bali M, Sharma P. Evaluation of Antioxidant and Antiulcer Potential of Cucumis sativum L.
Seed Extract in Rats. ACTA ACUST UNITED AC 2009. [DOI: 10.3923/ajcn.2009.131.138] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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27
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Sood S, Bansal S, Muthuraman A, Gill N, Bali M. Therapeutic Potential of Citrus medica L. Peel Extract in Carrageenan Induced Inflammatory Pain in Rat. ACTA ACUST UNITED AC 2009. [DOI: 10.3923/rjmp.2009.123.133] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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28
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Parikh R, Bali M, Akabas MH. Identification Of Channel-lining Residues In The Prokaryotic Proton-gated Cys-loop Receptor Ion Channel From Gloeobacter Violaceus. Biophys J 2009. [DOI: 10.1016/j.bpj.2008.12.780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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29
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Jansen M, Bali M, Akabas MH. Modular design of Cys-loop ligand-gated ion channels: functional 5-HT3 and GABA rho1 receptors lacking the large cytoplasmic M3M4 loop. J Gen Physiol 2008; 131:137-46. [PMID: 18227272 PMCID: PMC2213565 DOI: 10.1085/jgp.200709896] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2007] [Accepted: 01/09/2008] [Indexed: 01/14/2023] Open
Abstract
Cys-loop receptor neurotransmitter-gated ion channels are pentameric assemblies of subunits that contain three domains: extracellular, transmembrane, and intracellular. The extracellular domain forms the agonist binding site. The transmembrane domain forms the ion channel. The cytoplasmic domain is involved in trafficking, localization, and modulation by cytoplasmic second messenger systems but its role in channel assembly and function is poorly understood and little is known about its structure. The intracellular domain is formed by the large (>100 residues) loop between the alpha-helical M3 and M4 transmembrane segments. Putative prokaryotic Cys-loop homologues lack a large M3M4 loop. We replaced the complete M3M4 loop (115 amino acids) in the 5-hydroxytryptamine type 3A (5-HT(3A)) subunit with a heptapeptide from the prokaryotic homologue from Gloeobacter violaceus. The macroscopic electrophysiological and pharmacological characteristics of the homomeric 5-HT(3A)-glvM3M4 receptors were comparable to 5-HT(3A) wild type. The channels remained cation-selective but the 5-HT(3A)-glvM3M4 single channel conductance was 43.5 pS as compared with the subpicosiemens wild-type conductance. Coexpression of hRIC-3, a protein that modulates expression of 5-HT(3) and acetylcholine receptors, significantly attenuated 5-HT-induced currents with wild-type 5-HT(3A) but not 5-HT(3A)-glvM3M4 receptors. A similar deletion of the M3M4 loop in the anion-selective GABA-rho1 receptor yielded functional, GABA-activated, anion-selective channels. These results imply that the M3M4 loop is not essential for receptor assembly and function and suggest that the cytoplasmic domain may fold as an independent module from the transmembrane and extracellular domains.
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Affiliation(s)
- Michaela Jansen
- Department of Physiology and Biophysics, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY 10461, USA
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30
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Abstract
For many general anesthetics, their molecular basis of action involves interactions with GABA(A) receptors. Anesthetics produce concentration-dependent effects on GABA(A) receptors. Low concentrations potentiate submaximal GABA-induced currents. Higher concentrations directly activate the receptors. Functional effects of anesthetics have been characterized, but little is known about the conformational changes they induce. We probed anesthetic-induced conformational changes in the M2 membrane-spanning, channel-lining segment using disulfide trapping between engineered cysteines. Previously, we showed that oxidation by copper phenanthroline in the presence of GABA of the M2 6' cysteine mutants, alpha(1)T261Cbeta(1)T256C and alpha(1)beta(1)T256C resulted in formation of an intersubunit disulfide bond between the adjacent beta-subunits that significantly increased the channels' spontaneous open probability. Oxidation in GABA's absence had no effect. We examined the effect on alpha(1)T261Cbeta(1)T256C and on alpha(1)beta(1)T256C of oxidation by copper phenanthroline in the presence of potentiating and directly activating concentrations of the general anesthetics propofol, pentobarbital, and isoflurane. Oxidation in the presence of potentiating concentration of anesthetics had little effect. Oxidation in the presence of directly activating anesthetic concentrations significantly increased the channels' spontaneous open probability. We infer that activation by anesthetics and GABA induces a similar conformational change at the M2 segment 6' position that is related to channel opening.
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Affiliation(s)
- Ayelet Rosen
- Department of Physiology and Biophysics, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York 10461, USA
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31
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Abstract
Considerable controversy surrounds the location of the closed channel gate in members of the Cys-loop receptor family of neurotransmitter-gated ion channels that includes the GABAA, glycine, acetylcholine, and 5-HT3 receptors. Cysteine-accessibility studies concluded that the gate is near the cytoplasmic end of the channel in acetylcholine and GABAA receptors but in the middle of the 5-HT3A receptor channel. Zn2+ accessibility studies in a chimeric 5-HT3-ACh receptor suggested the gate is near the channel's cytoplasmic end. In the 4-Å resolution structure of the acetylcholine receptor closed state determined by cryoelectron microscopy, the narrowest region, inferred to be the gate, is in the channel's midsection from 9' to 14' but the M1–M2 loop residues at the channel's cytoplasmic end were not resolved in that structure. We used blocker trapping experiments with picrotoxin, a GABAA receptor open channel blocker, to determine whether a gate exists at a position more extracellular than the picrotoxin binding site, which is in the vicinity of α1Val257 (2') near the channel's cytoplasmic end. We show that picrotoxin can be trapped in the channel after removal of GABA. By using the state-dependent accessibility of engineered cysteines as reporters for the channel's structural state we infer that after GABA washout, with picrotoxin trapped in the channel, the channel appears to be in the closed state. We infer that a gate exists between the picrotoxin binding site and the channel's extracellular end, consistent with a closed channel gate in the middle of the channel. Given the homology with acetylcholine and 5-HT3 receptors there is probably a similar gate in those channels as well. This does not preclude the existence of an additional gate at a more cytoplasmic location.
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Affiliation(s)
- Moez Bali
- Department of Physiology, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY 10461, USA
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32
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Abstract
Based on the Torpedo acetylcholine receptor structure, Unwin and colleagues (Miyazawa et al., 2003; Unwin, 2005) hypothesized that the transduction of agonist binding to channel gate opening involves a "pin-into-socket" interaction between alphaV46 at the tip of the extracellular beta1-beta2 loop and the transmembrane M2 segment and M2-M3 loop. We mutated to cysteine the aligned positions in the 5-HT3A and 5-HT3B subunit beta1-beta2 loops K81 and Q70, respectively. The maximal 5-HT-activated currents in receptors containing 5-HT3A/K81C or 5-HT3B/Q70C were markedly reduced compared with wild type. Desensitization of wild-type currents involved fast and slow components. Mutant currents desensitized with only the fast time constant. Reaction with several methanethiosulfonate reagents potentiated currents to wild-type levels, but reaction with other more rigid thiol-reactive reagents caused inhibition. Single-channel conductances of wild type, K81C, and K81C after modification were similar. We tested the proximity of K81C to the M2-M3 loop by mutating M2-M3 loop residues to cysteine in the K81C background. Disulfide bonds formed in 5-HT3A/K81C/A304C and 5-HT3A/K81C/I305C when coexpressed with 5-HT3B. We conclude that in the resting state, K81 is not in a hydrophobic pocket as suggested by the pin-into-socket hypothesis. K81 interacts with the extracellular end of M2 and plays a critical role in channel opening and in the return from fast desensitization. We suggest that during channel activation, beta1-beta2 loop movement moves M2 and the M2-M3 loop so that the M2 segments rotate/translate away from the channel axis, thereby opening the lumen. Recovery from fast desensitization requires the interaction between K81 and the extracellular end of M2.
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Affiliation(s)
- David C Reeves
- Department of Physiology and Biophysics, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York 10461, USA
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33
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Abstract
When endoscopic therapy is used for the treatment of patients with painful chronic pancreatitis, extracorporeal shock wave lithotripsy (ESWL) can be proposed as a first-line approach when obstructive ductal stone(s) induce upstream dilation of the main pancreatic duct. Stone fragmentation by ESWL is followed by endoscopic ductal drainage using pancreatic sphincterotomy, fragmented stone(s) extraction, and pancreatic stenting in case of ductal stricture. After completion of endoscopic pancreatic ductal drainage, long-term clinical benefit can be expected for two thirds of the patients. Best clinical results are associated with absence or cessation of smoking and with early treatment in the course of chronic pancreatitis, while alcohol abuse increases the risks of diabetes, steatorrhea and mortality. The complications of chronic pancreatitis are mainly the development of pseudocyst secondary to the downstream ductal obstruction, and biliary obstruction caused by fibrotic changes in the head of the pancreas. Successful endoscopic pseudocyst drainage is currently obtained in most patients, and carries a low complication rate. Biliary stenting is a safe and effective technique for the short-term treatment of symptomatic bile duct stricture due to chronic pancreatitis, but permanent resolution is obtained in only 25% of cases. In conclusion, endoscopic management is now considered to be the preferred interventional treatment of chronic pancreatitis, for patients selected on the basis of the anatomical changes caused by the disease. This treatment is generally safe, minimally invasive, often effective for years, does not prevent further surgery, and can be repeated.
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Affiliation(s)
- M Delhaye
- Medicosurgical Department of Gastroenterology, Erasme University Hospital, Brussels, Belgium.
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34
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Abstract
The GABAA receptor is a target of many general anesthetics. The low affinity of general anesthetics has complicated the search for the location of anesthetic binding sites. Attention has focused on two pairs of residues near the extracellular ends of the M2 and M3 membrane-spanning segments, alpha1Ser270/beta2Asn265 (15' M2) and alpha1Ala291/beta2Met286 (M3). In the 4-A resolution acetylcholine receptor structure, the aligned positions are separated by approximately 10 A. To determine whether these residues are part of a binding site for propofol, an intravenous anesthetic, we probed propofol's ability to protect cysteines substituted for these residues from modification by the sulfhydryl-specific reagent p-chloromercuribenzenesulfonate (pCMBS-). pCMBS- reacted with cysteines substituted at the four positions in the absence and presence of GABA. Because propofol binding induces conformational change in the GABAAreceptor, we needed to establish a reference state of the receptor to compare reaction rates in the absence and presence of propofol. We compared reaction rates in the presence of GABA with those in the presence of propofol +GABA. The GABA concentration was reduced to give a similar fraction of the maximal GABA current in both conditions. Propofol protected, in a concentration-dependent manner, the cysteine substituted for beta2Met286 from reaction with pCMBS-. Propofol did not protect the cysteine substituted for the aligned alpha1 subunit position or the 15' M2 segment Cys mutants in either subunit. We infer that propofol may bind near the extracellular end of the betasubunit M3 segment.
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Affiliation(s)
- Moez Bali
- Department of Physiology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY 10461, USA
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35
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Yousefi S, Ma XZ, Singla R, Zhou YC, Sakac D, Bali M, Liu Y, Sahai BM, Branch DR. HIV-1 infection is facilitated in T cells by decreasing p56lck protein tyrosine kinase activity. Clin Exp Immunol 2003; 133:78-90. [PMID: 12823281 PMCID: PMC1808751 DOI: 10.1046/j.1365-2249.2003.02187.x] [Citation(s) in RCA: 20] [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] [Indexed: 11/20/2022] Open
Abstract
Several studies have suggested an important role for the protein tyrosine kinase p56lck (Lck) in HIV infection; however, the exact nature of this role remains unclear. Using a series of well characterized Jurkat-derived cell lines having a wide range of Lck kinase activity, our results showed that, while the entry of HIV-1 into these cell lines was similar, the kinetics of virus production by these cells were very different. Cells expressing a kinase-inactive Lck showed accelerated viral replication, whereas, cells expressing Lck with normal or elevated enzymatic activity showed a delay in virus replication that was proportional to the initial level of endogenous Lck activity. The cell line having the highest initial Lck kinase activity showed the slowest rate of productive HIV-1 infection. Analysis of 2-LTR circles revealed that this inhibitory effect of Lck was not due to inhibition of reverse transcription of HIV-1 genome or migration of the proviral DNA into the nuclei. This affect of Lck was confirmed in additional studies that used either the S1T cell line lacking completely Lck or where the Lck activity was altered in Jurkat cells prior to infection. S1T cells showed a 3- to 12-fold increase in the level of infection compared to Jurkat cells despite similar CD4 and chemokine coreceptor expression and cell doubling times. Pretreatment of Jurkat with an antisense lck oligodeoxynucleotide inhibited the synthesis of functional Lck and facilitated the viral replication by the cells as did expressing a dominant-negative mutant Lck which increased the productive infection>3-fold. Conversely, whereas IL-16 had no affect on productive infection in S1T cells that lack Lck, IL-16 pretreatment of Jurkat cells resulted in an immediate (within 5 min) and sustained and gradual (over 5 h) increase in Lck activity that resulted in a reduction of HIV-1 replication that paralleled the increasing Lck kinase activity. These results show that the enzymatic activity of Lck kinase can affect viral replication, that a lack of, or decreased Lck activity facilitates viral replication. Conversely, Lck can mediate a delay in HIV-1 infection that is proportional to the initial endogenous Lck enzyme activity.
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Affiliation(s)
- S Yousefi
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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36
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Derici U, Arinsoy T, Ataoglu O, Bali M, Eroglu A, Goker B, Sindel S. Localized Castleman's disease and nephrotic syndrome not responsive to resection plus colchicine therapy. Ann Hematol 2002; 81:399-401. [PMID: 12185513 DOI: 10.1007/s00277-002-0486-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2001] [Accepted: 05/07/2002] [Indexed: 10/27/2022]
Abstract
We describe one patient with localized Castleman's disease (CD) of the mixed hyaline vascular and plasma cell type located at the mesentery of the small bowel, associated with systemic amyloidosis and nephrotic syndrome. A true nephrotic syndrome has rarely been reported in patients with CD. In the literature, it has been suggested that clinical and laboratory manifestations generally improved after surgical resection of the tumor. However, in our case, clinical and laboratory findings did not regress after operation followed by colchicine therapy.
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Affiliation(s)
- U Derici
- Department of Nephrology, Gazi University Faculty of Medicine, 06510 Besevler-Ankara, Turkey.
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37
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Abstract
The almost ubiquitously expressed ClC-2 chloride channel is activated by hyperpolarization and osmotic cell swelling. Osmotic swelling also activates a different class of outwardly rectifying chloride channels, and several reports point to a link between protein tyrosine phosphorylation and activation of these channels. This study examines the possibility that transforming growth factor-α (TGF-α) modulates ClC-2 activity in human colonic epithelial (T84) cells. TGF-α (0.17 nM) irreversibly inhibited ClC-2 current in nystatin-perforated whole cell patch-clamp experiments, whereas a superimposed reversible activation of the current was observed at 8.3 nM TGF-α. Both effects required activation of the intrinsic epidermal growth factor receptor (EGFR) tyrosine kinase activity, of phosphoinositide 3-kinase, and of protein kinase C. With microspectrofluorimetry of the pH-sensitive fluorescent dye 2′,7′-bis(2-carboxyethyl)-5(6)-carboxyfluorescein, TGF-α was shown to reversibly alkalinize T84 cells at 8.3 nM but not at 0.17 nM, suggesting that 8.3 nM TGF-α-induced alkalinization activates ClC-2 current. This study indicates that ClC-2 channels are targets for EGFR signaling in epithelial cells.
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Affiliation(s)
- M Bali
- Institut National de la Santé et de la Recherche Médicale U. 467, Faculté de Médecine Necker, 156, rue de Vaugirard, 75730 Paris Cedex 15, France
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Clain J, Fritsch J, Lehmann-Che J, Bali M, Arous N, Goossens M, Edelman A, Fanen P. Two mild cystic fibrosis-associated mutations result in severe cystic fibrosis when combined in cis and reveal a residue important for cystic fibrosis transmembrane conductance regulator processing and function. J Biol Chem 2001; 276:9045-9. [PMID: 11118444 DOI: 10.1074/jbc.m008979200] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The number of complex cystic fibrosis transmembrane conductance regulator (CFTR) genotypes identified as having double-mutant alleles with two mutations inherited in cis has been growing. We investigated the structure-function relationships of a severe cystic fibrosis (CF)-associated double mutant (R347H-D979A) to evaluate the contribution of each mild mutation to the phenotype. CFTR mutants expressed in HeLa cells were analyzed for protein biosynthesis and Cl(-) channel activity. Our data show that R347H is associated with mild defective Cl(-) channel activity and that the D979A defect leads to misprocessing. The mutant R347H-D979A combines both defects for a dramatic decrease in Cl(-) current. To decipher the molecular mechanism of this phenotype, single and double mutants with different charge combinations at residues 347 and 979 were constructed as charged residues were involved in this complex genotype. These studies revealed that residue 979, located in the third cytoplasmic loop, is critical for CFTR processing and Cl(-) channel activity highlighting the role of charged residues. These results have also important implications for CF, as they show that two mutations in cis can act in concert to alter dramatically CFTR function contributing to the wide phenotypic variability of CF disease.
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Affiliation(s)
- J Clain
- INSERM U.468, Hôpital Henri Mondor, 94010 Créteil, INSERM U.467, Faculté de Médecine Necker, 75015 Paris, and CNRS UPR.1524, Hôpital Saint Vincent dePaul, 75674 Paris, France
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39
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Abstract
Though feedforward activation (FA) is a little known principle of control in metabolic networks, there is one well-known example; namely, the activation of pyruvate kinase (PK) by fructose-1,6-biphosphate (FBP) in glycolysis. The effects of this activation on the enzyme's kinetics are well characterised, but its possible role in glycolytic control has not been determined, and, experimentally, there is as yet no direct way of modifying the enzyme to remove just the FBP activation without affecting other aspects of the enzyme's kinetics. Given this limitation, we used a detailed numerical simulation of human erythrocyte glycolysis to simulate the effects of selective removal of the activation of PK by FBP on steady-state metabolite concentrations and on the dynamic response of glycolytic flux to a sudden increase of the cell's demand for ATP. Our modelling results predict that in the absence of FA steady-state levels of metabolites within the activation loop, i.e. from FBP to phosphoenolpyruvate, would be four- to thirteen-fold higher than normal, whereas levels of ATP and metabolites outside the loop, i.e. glucose-6-phosphate, fructose-6-phosphate and pyruvate, would be lower than normal. Existing clinical evidence in a patient with haemolytic anaemia, correlated with a lack of activation of PK by FBP (Paglia D.E., Valentine W.N., Holbrook C.T., Brockway R., Blood (1983) 62 972-979), is consistent with this prediction. In response to changing demand for ATP, the model predicts that the corresponding change of glycolytic flux would entail changes of metabolite concentrations in the absence of FA, but that in its presence the levels of metabolites within the activation loop remain essentially unperturbed. Thus, our results suggest that by stabilising metabolite pools in the face of variable glycolytic flux, FA may serve to avoid perturbations of the oxygen affinity of haemoglobin (sensitive to the levels of 2,3-phosphoglycerate) and of cell osmolality that would otherwise occur during variations in the cell's demand for ATP. In addition, by significantly raising the steady-state setpoint of intermediate metabolite pools, the productivity index (ratio of glycolytic flux to total metabolites in the pathway) of glycolysis would fall almost four-fold in the absence of forward activation.
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Affiliation(s)
- M Bali
- Inserm U. 467, Necker Faculty of Medicine, University Paris-V, 156, rue de Vaugirard, 75730 Paris, France
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Dumlu S, Bali M, Yilmaz M, Sindel S, Arinsoy T, Tuncer C, Hasanoglu E. Prevalence of gallstone disease in hemodialysis patients. Nephron Clin Pract 2000; 78:347-8. [PMID: 9546703 DOI: 10.1159/000044952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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41
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Chang H, Voralia M, Bali M, Sher GD, Branch DR. Irreversible loss of donor blood leucocyte activation may explain a paucity of transfusion-associated graft-versus-host disease from stored blood. Br J Haematol 2000; 111:146-56. [PMID: 11091195 DOI: 10.1046/j.1365-2141.2000.02330.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Transfusion-associated graft-versus-host disease (TA-GVHD) is usually a fatal outcome of blood transfusion therapy, caused by viable leucocytes contained in the donor blood. Most cases of TA-GVHD occur when less than 4-d-old blood is transfused. We therefore examined the molecular changes that occur during storage that may account for the paucity of TA-GVHD following infusion of older blood. Leucocyte number and viability were essentially unchanged from freshly obtained blood, but the expression of cell-surface lymphocyte activation antigens (CD3, CD4, CD28, CD2, CD45) decreased rapidly within the first 24 h and continued to fall to less than 20% of original levels by d 9 of storage at 4 degrees C. The decrease in CD antigen expression directly correlated with a decreasing ability to induce activation of the T-lymphocyte cellular signal transduction pathway. As a result, cells became less responsive in a mixed lymphocyte culture (MLC) by d 3, with abrogation of the MLC responsiveness by d 5. Donor leucocytes stored for 4 d or less at 4 degrees C were able to partially re-express CD antigens and reconstitute their signalling pathway when placed at 37 degrees C. whereas those stored for more than 4 d were not. These irreversible changes result from a permanent downregulation of donor cell protein synthesis. These findings provide a mechanism to explain the paucity of TA-GVHD following transfusion of blood that is more than 4 d-old. Further study may show that aged blood provides additional assurances for the prevention of TA-GVHD; however, use of aged blood should not replace current protocols using irradiation.
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Affiliation(s)
- H Chang
- Department of Medicine, University of Toronto, Ontario, Canada
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Bülent Tiras M, Noyan V, Süer O, Bali M, Edali N, Yildirim M. Adenomatoid tumor of the uterus in a patient with chronic renal failure. Eur J Obstet Gynecol Reprod Biol 2000; 92:205-7. [PMID: 10996682 DOI: 10.1016/s0301-2115(99)00290-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A case of adenomatoid tumor of the uterus in a 34-year-old patient, who had received a renal transplant and was undergoing immunosuppresive therapy is presented. At surgery, there were a total of eight nodular intramural and subserous masses thought to be leiomyoma nodules, and tumor excision was unusually, hardly performed because the nodules were strictly adherent to the myometrium. All the specimens yielded the same pathological diagnosis - adenomatoid tumor. This case is unusual because of the multiple nodular pattern and its association with the immunocompromised status of the patient. Although adenomatoid tumors have not been shown to recur, we are in doubt in our case, because the uterus is still intact and the immunocompromised status of the patient might have a role in the extensive growth and also in the possibility of recurrence.
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Affiliation(s)
- M Bülent Tiras
- Department of Obstetrics and Gynecology, Gazi University, School of Medicine, Besevler, Ankara, Turkey
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Sucak GT, Bali M, Karakan T, Haznedar R. Bilateral spontaneous perinephric hematoma: evaluation with CT and angiography and successful conservative treatment. Nephron Clin Pract 2000; 86:237-8. [PMID: 11015019 DOI: 10.1159/000045768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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44
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Tondelier D, Brouillard F, Lipecka J, Labarthe R, Bali M, Costa de Beauregard MA, Torossi T, Cougnon M, Edelman A, Baudouin-Legros M. Aspirin and some other nonsteroidal anti-inflammatory drugs inhibit cystic fibrosis transmembrane conductance regulator protein gene expression in T-84 cells. Mediators Inflamm 1999; 8:219-27. [PMID: 10704076 PMCID: PMC1781806 DOI: 10.1080/09629359990388] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Cystic fibrosis (CF) is caused by mutations in the CF gene, which encodes CF transmembrane conductance regulator protein (CFTR), a transmembrane protein that acts as a cAMP-regulated chloride channel The disease is characterized by inflammation but the relationship between inflammation, abnormal transepithelial ion transport, and the clinical manifestations of CF are uncertain. The present study was undertaken to determine whether three nonsteroidal anti-inflammatory drugs (NSAIDs) (aspirin, ibuprofen, and indomethacin) modulate CFTR gene expression in T-84 cells. Treatment with NSAIDs reduced CFTR transcripts, and decreased cAMP-stimulated anion fluxes, an index of CFTR function. However, the two phenomena occurred at different concentrations of both drugs. The results indicate that NSAIDs can regulate both CFTR gene expression and the function of CFTR-related chloride transport, and suggest that NSAIDs act via multiple transduction pathways.
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Affiliation(s)
- D Tondelier
- INSERM U. 467, Faculté de Médecine Necker-Enfants Malades, Paris, France
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Duranay M, Bali M, Sahin M, Yakinci G, Vurgun N, Dilmen U. Parvovirus B19 infection and unresponsiveness to erythropoietin therapy in haemodialysis patients. Nephrol Dial Transplant 1998; 13:779-80. [PMID: 9550669 DOI: 10.1093/ndt/13.3.779] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- M Duranay
- Department of Nephrology, University of Inonü, Malatya, Turkey
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Affiliation(s)
- T Arinsoy
- Nephrology and Pathology Department, Gazi University Hospital, Ankara, Turkey
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47
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Kayhan B, Ali Z, Sindel S, Arinsoy T, Bali M, Yamaç K. Thrombocytopenia with a myeloma kidney. Nephron Clin Pract 1997; 77:122-4. [PMID: 9380233 DOI: 10.1159/000190263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Duranay M, Erbilen M, Bali M, Sahin M, Ateş K, Hasanoğlu A, Yakinci G. Treatment of hemodialysis ascites with continuous ambulatory peritoneal dialysis. Nephron Clin Pract 1996; 73:327-8. [PMID: 8773371 DOI: 10.1159/000189067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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50
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Doğan I, Unal S, Sindel S, Tunçer C, Arinsoy T, Bali M, Kandilci U, Hasanoğlu E. Esophageal motor dysfunction in chronic renal failure. Nephron Clin Pract 1996; 72:346-7. [PMID: 8684564 DOI: 10.1159/000188879] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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