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Tahri NB, Gravdehaug B, Bahrami N, Reitsma L. A woman in her fifties with a post-operative infection, generalised rash and organ failure. Tidsskr Nor Laegeforen 2024; 144:23-0623. [PMID: 38651709 DOI: 10.4045/tidsskr.23.0623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
Background Toxic shock syndrome (TSS) is a rare but potentially life-threatening disease caused by superantigen-producing Gram-positive bacteria such as Staphylococcus aureus and Streptococcus pyogenes. Staphylococcal TSS received special attention from 1978 to 1981, when an epidemic was observed associated with the use of hyper-absorbent tampons. Today the disease is rare and generally not related to menstruation, but can occur postpartum or in post-surgical wounds, intrauterine devices (IUDs), burns or other soft tissue injuries, mastitis or other focal infections. The annual incidence of staphylococcal TSS is around 0.5/100 000 and around 0.4/100 000 for streptococcal TSS. The mortality in menstrual-related cases is < 5 % and up to 22 % in non-menstrual related cases. Case presentation This article presents a case of a middle-aged woman who developed symptoms of toxic shock syndrome five days after elective breast cancer surgery, with high fever, multiorgan failure and a characteristic desquamation of the palms. Interpretation Toxic shock syndrome is a potentially lethal, toxin-mediated disease. Symptoms develop quickly, within hours. Early recognition and appropriate surgical management, intensive care and antibiotics are therefore important to reduce mortality and sequelae.
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Affiliation(s)
- Naima Borg Tahri
- Bryst- og endokrinkirurgisk avdeling, Akershus universitetssykehus
| | - Berit Gravdehaug
- Bryst- og endokrinkirurgisk avdeling, Akershus universitetssykehus
| | - Nazli Bahrami
- Bryst- og endokrinkirurgisk avdeling, Akershus universitetssykehus
| | - Laurens Reitsma
- Bryst- og endokrinkirurgisk avdeling, Akershus universitetssykehus
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2
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Alimoradi Z, Ghorbani S, Bahrami N, Griffiths M, Pakpour A. Socio-demographic predictors of dyadic sexual communication among Iranian married women. Sexologies 2021. [DOI: 10.1016/j.sexol.2021.09.003] [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]
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3
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Bahrami N, Jabeen S, Tahiri A, Sauer T, Ødegård HP, Geisler SB, Gravdehaug B, Reitsma LC, Selsås K, Kristensen V, Geisler J. Lack of cross-resistance between non-steroidal and steroidal aromatase inhibitors in breast cancer patients: the potential role of the adipokine leptin. Breast Cancer Res Treat 2021; 190:435-449. [PMID: 34554372 PMCID: PMC8558290 DOI: 10.1007/s10549-021-06399-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 09/11/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE The aromatase inactivator exemestane may cause clinical disease stabilization following progression on non-steroidal aromatase inhibitors like letrozole in patients with metastatic breast cancer, indicating that additional therapeutic effects, not necessarily related to estrogen-suppression, may be involved in this well-known "lack of cross-resistance". METHODS Postmenopausal women with ER positive, HER-2 negative, locally advanced breast cancer were enrolled in the NEOLETEXE-trial and randomized to sequential treatment starting with either letrozole (2.5 mg o.d.) or exemestane (25 mg o.d.) followed by the alternative aromatase inhibitor. Serum levels of 54 cytokines, including 12 adipokines were assessed using Luminex xMAP technology (multiple ELISA). RESULTS Serum levels of leptin were significantly decreased during treatment with exemestane (p < 0.001), regardless whether exemestane was given as first or second neoadjuvant therapy. In contrast, letrozole caused a non-significant increase in serum leptin levels in vivo. CONCLUSIONS Our findings suggest an additional and direct effect of exemestane on CYP-19 (aromatase) synthesis presumably due to effects on the CYP19 promoter use that is not present during therapy with the non-steroidal aromatase inhibitor letrozole. Our findings provide new insights into the influence of clinically important aromatase inhibitors on cytokine levels in vivo that contribute to the understanding of the clinically observed lack of cross-resistance between non-steroidal and steroidal aromatase inhibitors in breast cancer patients. TRIAL REGISTRATION Registered on March 23rd 2015 in the National trial database of Norway (Registration number: REK-SØ-84-2015).
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Affiliation(s)
- Nazli Bahrami
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway.,Department of Breast and Endocrine Surgery, Akershus University Hospital, Lørenskog, Norway
| | - Shakila Jabeen
- Department of Clinical Molecular Biology (EPIGEN), Akershus University Hospital, Lørenskog, Norway.,Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Andliena Tahiri
- Department of Clinical Molecular Biology (EPIGEN), Akershus University Hospital, Lørenskog, Norway.,Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Torill Sauer
- Department of Pathology, Akershus University Hospital, Lørenskog, Norway.,Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, University of Oslo, Oslo, Norway
| | | | | | - Berit Gravdehaug
- Department of Breast and Endocrine Surgery, Akershus University Hospital, Lørenskog, Norway
| | | | - Knut Selsås
- Department of Breast and Endocrine Surgery, Akershus University Hospital, Lørenskog, Norway
| | - Vessela Kristensen
- Department of Clinical Molecular Biology (EPIGEN), Akershus University Hospital, Lørenskog, Norway.,Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Jürgen Geisler
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway. .,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
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Reis J, Boavida J, Bahrami N, Lyngra M, Geitung JT. Breast sarcoidosis: Clinical features, imaging, and histological findings. Breast J 2020; 27:44-47. [PMID: 33034055 DOI: 10.1111/tbj.14075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 11/29/2022]
Abstract
Breast sarcoidosis is an extremely rare entity (about 1%). Conventional imaging significantly contributes to the detection of breast lesions, but it has been unable to establish a definite diagnosis. Histological examination should be mandatory, over imaging assessments, in order to confirm an early diagnosis and to avoid unjustified treatments. Malignancy should be excluded as a primary differential diagnosis. However, in the presence of granulomas, it is important to recognize other granulomatous disorders such as tuberculosis, Wegener's granulomatosis, or idiopathic granulomatous mastitis, since therapeutic strategies differ. This report clarifies the current clinical assessments and differential diagnosis of breast sarcoidosis.
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Affiliation(s)
- Joana Reis
- Department of Diagnostic Imaging and Intervention, Akershus University Hospital (AHUS), Lorenskog, Norway.,Institute of Clinical Medicine, Campus AHUS, University of Oslo, Lorenskog, Norway
| | - Joao Boavida
- Department of Diagnostic Imaging and Intervention, Akershus University Hospital (AHUS), Lorenskog, Norway
| | - Nazli Bahrami
- Department of Breast & Endocrine Surgery, Akershus University Hospital (AHUS), Lorenskog, Norway.,Department of Oncology, Akershus University Hospital (AHUS), Lorenskog, Norway
| | - Marianne Lyngra
- Department of Pathology, Akershus University Hospital (AHUS), Lorenskog, Norway
| | - Jonn Terje Geitung
- Department of Diagnostic Imaging and Intervention, Akershus University Hospital (AHUS), Lorenskog, Norway.,Institute of Clinical Medicine, Campus AHUS, University of Oslo, Lorenskog, Norway
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Bahrami N, Chang G, Kanaya N, Sauer T, Park D, Loeng M, Gravdehaug B, Chen S, Geisler J. Changes in serum estrogenic activity during neoadjuvant therapy with letrozole and exemestane. J Steroid Biochem Mol Biol 2020; 200:105641. [PMID: 32151708 DOI: 10.1016/j.jsbmb.2020.105641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/21/2020] [Accepted: 02/22/2020] [Indexed: 12/29/2022]
Abstract
The aromatase inhibitors (AIs), letrozole (Femar®/Femara®) and exemestane (Aromasin®), are widely used to treat estrogen receptor (ER) positive breast cancer in postmenopausal patients. In the setting of metastatic breast cancer, these drugs may be used after another causing new responses in selected patients after progressing on the first choice. The precise explanation for this "lack of cross resistance" is still missing. NEOLETEXE is a neoadjuvant, randomized, open-label, cross-over trial. Postmenopausal patients with ER-positive, HER-2 negative, locally advanced breast cancer were enrolled. All patients were randomized to treatment starting with either letrozole or exemestane for at least 2 months followed by another 2 months on the alternative AI. The total estrogenic activities in blood samples were determined using the AroER tri-screen assay developed in the Chen laboratory. Using this highly sensitive assay, estrogenic activity was detected at three time points for all patients. Importantly, a significantly higher total estrogenic activity was found during therapy with exemestane compared to letrozole in 21 out of 26 patients. When letrozole was included in the AroER tri-screen assay, the estrogenic activities in most samples collected during exemestane treatment were further reduced, suggesting that low levels of androgens remained in specimens obtained after exemestane treatment. Our results suggest the AroER tri-screen to be a very sensitive method to estimate the overall estrogen-mediated activity in human samples even during therapy with highly potent aromatase inhibitors. In the present study, serum estrogen activity was significantly higher during exemestane therapy when compared to letrozole therapy.
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Affiliation(s)
- Nazli Bahrami
- Department of Oncology, Akershus University Hospital (AHUS), Lørenskog, Norway; Department of Breast and Endocrine Surgery, Akershus University Hospital, Lørenskog, Norway
| | - Gregory Chang
- Department of Cancer Biology, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Noriko Kanaya
- Department of Cancer Biology, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Torill Sauer
- Department of Pathology, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Campus AHUS, Norway
| | - Daehoon Park
- Department of Pathology, Akershus University Hospital, Lørenskog, Norway
| | - Marie Loeng
- Department of Oncology, Akershus University Hospital (AHUS), Lørenskog, Norway
| | - Berit Gravdehaug
- Department of Breast and Endocrine Surgery, Akershus University Hospital, Lørenskog, Norway
| | - Shiuan Chen
- Department of Cancer Biology, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Jürgen Geisler
- Department of Oncology, Akershus University Hospital (AHUS), Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Campus AHUS, Norway.
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Vaske C, Parulkar R, Bahrami N, Sauer T, Lüders T, Lorentzen A, Gravdehaug B, Kristensen V, Geisler J. Abstract P6-04-07: Time-course DNA and RNA profiling reveals down regulation of all members of the sulfotransferase A1 subfamily during neoadjuvant therapy with aromatase inhibitors. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p6-04-07] [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
Background. The NEO-LET-EXE trial examines the neoadjuvant and sequential administration of the aromatase inhibitor (AI) letrozole (Femar/Femara) and the aromatase inactivator exemestane (Aromasin). Although both drugs nearly completely inhibit aromatase, resistance to both is developed with time. However, when used sequentially in patients with metastatic breast cancer (MBC), in some patients after switching to the alternative drug after progressing on the first choice, new responses may appear. The mechanism behind this clinical observation is not known. The solution may lead us potentially to a novel strategy to treat hormonal dependent breast cancer.Material. Postmenopausal patients suffering from strongly estrogen receptor (ER) positive (>50%), HER-2 negative locally advanced breast cancer (LABC) may be enrolled. Age: 18+ (no upper limit). Present accrual and target accrual: 55 out of planned 100 patients have been enrolled so far. The last patient is expected to enter the trial in Q4 2020. We report here results from a scientific subprotocol involving 25 patients.Study design. In the neoadjuvant, randomized, open-label, intra-patient cross-over trial NEO-LET-EXE tumor biopsies are obtained at baseline, after two months on the first AI prior to swap to the other aromatase inhibitor, and, finally, at surgery following at least four months on AIs.Methods. Tumor DNA and RNA were extracted from FFPE samples, and normal DNA was extracted from blood samples. Tumor exome was sequenced to an average of 250x depth, normal exomes was sequenced to an average depth of 125x, and tumor RNA was sequenced with at least 200 million reads. Somatic variants and copy number changes were called, and gene expression was quantified from RNA-seq.Results. In order to explain the phenomenon of a lack of cross-resistance between steroidal and non-steroidal aromatase inhibitors we profiled biopsies at three time points per patient by whole exome and whole transcriptome sequencing from FFPE from 25 patients. A total of 56 DNA whole exomes and 41 RNA-seq transcriptomes were generated from FFPE samples available. Neoadjuvant treatment with sequential use of the two AIs caused a significant downregulation of all four members belonging to the sulfotransferase A1 subfamily (SULT1A1, SULT1A2, SULT1A3 and SULT1A4) following 4 months on AI therapy, irrespectively of the clinically chosen treatment sequence. A significant downregulation of ARSG, ESR1 and PGR was also observed during AI therapy. In addition, a low rate of CYP19A1 copy number changes could be detected in our material. A CYP19A1 deletion occurred in one patient during AI therapy. No DNA or RNA support for hot-spot ESR1 resistance mutations was found at any time point during early neoadjuvant AI therapy.Conclusions. Our findings suggest a significant downregulation of the entire sulfotransferase A1 subfamily during neoadjuvant therapy with AIs in patients with ER-positive LABC. These findings may reflect an early adaptation process caused by the AI-induced estrogen depression. A low rate of CYP19A1 copy number changes could be revealed during the first 4 months of neoadjuvant AI therapy in vivo.
Citation Format: Charles Vaske, Rahul Parulkar, Nazli Bahrami, Torill Sauer, Torben Lüders, Annika Lorentzen, Berit Gravdehaug, Vessela Kristensen, Jürgen Geisler. Time-course DNA and RNA profiling reveals down regulation of all members of the sulfotransferase A1 subfamily during neoadjuvant therapy with aromatase inhibitors [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-04-07.
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Affiliation(s)
| | | | - Nazli Bahrami
- 2Akershus University Hospital, Department of Breast and Endocrine Surgery, Lørenskog, Norway
| | - Torill Sauer
- 3University of Oslo, Akershus University Hospital Campus, Department of Pathology, Lørenskog, Norway
| | - Torben Lüders
- 4Akershus University Hospital, Epigen Research Laboratory, Lørenskog, Norway
| | - Annika Lorentzen
- 4Akershus University Hospital, Epigen Research Laboratory, Lørenskog, Norway
| | - Berit Gravdehaug
- 2Akershus University Hospital, Department of Breast and Endocrine Surgery, Lørenskog, Norway
| | - Vessela Kristensen
- 5University of Oslo, Akershus University Hospital Campus, Epigen Research Laboratory, Lørenskog, Norway
| | - Jürgen Geisler
- 6University of Oslo, Akershus University Hospital Campus, Department of Oncology, Lørenskog, Norway
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7
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Bahrami N, Sauer T, Engebretsen S, Aljabri B, Bemanian V, Lindstrøm J, Lüders T, Kristensen V, Lorentzen A, Loeng M, Ødegård HP, Kvaløy JØ, Vestøl IB, Geisler SB, Gravdehaug B, Gundersen JM, Geisler J. The NEOLETEXE trial: a neoadjuvant cross-over study exploring the lack of cross resistance between aromatase inhibitors. Future Oncol 2019; 15:3675-3682. [DOI: 10.2217/fon-2019-0258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The aromatase inhibitor letrozole (Femar®/Femara®) and the aromatase inactivator exemestane (Aromasin®) differ in their biochemical effect on the aromatase enzyme. Letrozole is a competitive aromatase inhibitor while exemestane binds irreversibly to the aromatase enzyme. This pharmacological difference is of clinical interest since a lack of cross-resistance has been documented. It has been demonstrated in several clinical trials that exemestane may cause a disease regression following resistance to nonsteroidal aromatase inhibitors. The exact mechanism(s) behind this phenomenon is yet unknown. Here, we present the NEOLETEXE trial with the aim of exploring the individual mechanisms involved behind the observed lack of cross resistance. Clinical trial registration: The trial has been approved by the Regional Ethics Committee of South-East Norway (project number 2015/84).
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Affiliation(s)
- Nazli Bahrami
- Department of Oncology, Akershus University Hospital (AHUS), Lørenskog, Norway
- Department of Breast & Endocrine Surgery (AHUS), Akershus University Hospital, Lørenskog, Norway
- Translational Cancer Research Group, Akershus University Hospital, Lørenskog, Norway
| | - Torill Sauer
- Department of Pathology (AHUS), Akershus University Hospital, Lørenskog, Norway
- Translational Cancer Research Group, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, Campus AHUS, University of Oslo, Norway
| | - Siri Engebretsen
- Department of Breast & Endocrine Surgery (AHUS), Akershus University Hospital, Lørenskog, Norway
- Translational Cancer Research Group, Akershus University Hospital, Lørenskog, Norway
| | - Belal Aljabri
- Department of Oncology, Akershus University Hospital (AHUS), Lørenskog, Norway
- Translational Cancer Research Group, Akershus University Hospital, Lørenskog, Norway
| | - Vahid Bemanian
- Department of Gene Technology (AHUS), Akershus University Hospital, Lørenskog, Norway
- Translational Cancer Research Group, Akershus University Hospital, Lørenskog, Norway
| | - Jonas Lindstrøm
- Health Services Research Center (AHUS), Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, Campus AHUS, University of Oslo, Norway
| | - Torben Lüders
- Department of Clinical Molecular Biology (AHUS/EpiGen), Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, Campus AHUS, University of Oslo, Norway
| | - Vessela Kristensen
- Department of Clinical Molecular Biology (AHUS/EpiGen), Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, Campus AHUS, University of Oslo, Norway
| | - Annika Lorentzen
- Translational Cancer Research Group, Akershus University Hospital, Lørenskog, Norway
| | - Marie Loeng
- Translational Cancer Research Group, Akershus University Hospital, Lørenskog, Norway
| | - Hilde Presterud Ødegård
- Department of Oncology, Akershus University Hospital (AHUS), Lørenskog, Norway
- Translational Cancer Research Group, Akershus University Hospital, Lørenskog, Norway
| | - Jan Øyvind Kvaløy
- Department of Oncology, Akershus University Hospital (AHUS), Lørenskog, Norway
- Translational Cancer Research Group, Akershus University Hospital, Lørenskog, Norway
| | - Ingeborg Berge Vestøl
- Department of Oncology, Akershus University Hospital (AHUS), Lørenskog, Norway
- Translational Cancer Research Group, Akershus University Hospital, Lørenskog, Norway
| | - Stephanie Beate Geisler
- Department of Oncology, Akershus University Hospital (AHUS), Lørenskog, Norway
- Translational Cancer Research Group, Akershus University Hospital, Lørenskog, Norway
| | - Berit Gravdehaug
- Department of Breast & Endocrine Surgery (AHUS), Akershus University Hospital, Lørenskog, Norway
- Translational Cancer Research Group, Akershus University Hospital, Lørenskog, Norway
| | - Joanna Majak Gundersen
- Department of Breast & Endocrine Surgery (AHUS), Akershus University Hospital, Lørenskog, Norway
- Translational Cancer Research Group, Akershus University Hospital, Lørenskog, Norway
| | - Jürgen Geisler
- Department of Oncology, Akershus University Hospital (AHUS), Lørenskog, Norway
- Translational Cancer Research Group, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, Campus AHUS, University of Oslo, Norway
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Bahrami N, Jabeen S, Sauer T, Kristensen V, Gundersen J, Geisler J. The aromatase inactivator exemestane suppresses serum leptin levels significantly in vivo - in contrast to the aromatase inhibitor letrozole. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz097.005] [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: 11/13/2022] Open
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Bahrami N, Chang G, Kanaya N, Sauer T, Gravdehaug B, Chen S, Geisler J. Abstract P5-04-16: Total estrogenic activity during neoadjuvant therapy with letrozole and exemestane – An intra-patient cross-over comparison using the AroER tri-screen. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-04-16] [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
Background. Aromatase inhibitors (AIs), letrozole (Femarâ / Femaraâ) and exemestane (Aromasinâ), are widely used anti-hormonal drugs for breast cancer. Both compounds strongly reduce circulating estradiol levels in postmenopausal women. In the setting of metastatic breast cancer, these drugs may be used after another, causing new responses in selected patients by switching to the alternative drug after progressing on the first choice. This well-known ”lack of cross resistance” has been recognized for some time and is documented by several clinical trials. However, the precise explanation for this clinical observation is still unknown. The availability of mechanistic information may lead to an improved strategy against hormone-sensitive breast cancer.
Patients and methods. NEO-LET-EXE was a neoadjuvant, randomized, open-label, intra-patient cross-over trial. Postmenopausal patients with estrogen receptor (ER) positive (>50%), HER-2 negative, locally advanced breast cancer were enrolled. Sequential blood samples (obtained at baseline, after 2 months and 4 months of treatment) were available from 29 patients. All patients were randomized to sequential treatment starting with either letrozole (2.5 mg o.d.) or exemestane (25 mg o.d) for 2 months followed by another 2 months on the alternative compound. The total estrogenic activities in the collected blood samples were determined using AroER tri-screen assay developed by the Chen laboratory. The assay utilizes MCF-7aro ERE cells which contain both aromatase and ER. The samples were assayed in the presence as well as the absence of letrozole, to estimate relative contributions of estrogen and estrogen+androgen to the activities, respectively.
Results. Using the highly sensitive AroER tri-screen assay, estrogenic activity were detected at three time points in all blood samples. Importantly, a significantly higher total estrogenic activity was found during therapy with exemestane compared to letrozole in 23 out of 26 patients. Only in three patients, the activity was higher during therapy with letrozole compared to exemestane. When letrozole was included in the assay, the estrogenic activities in most samples collected during exemestane treatment were further reduced, suggesting that low levels of androgen were present in samples from exemestane treatment. Four samples collected after exemestane treatment and three after letrozole treatment had higher activities than baseline samples when assay was carried out with letrozole.
Discussion. Our results suggest the AroER tri-screen to be a very sensitive method to estimate the overall estrogen-mediated activity in human samples. Significant higher levels of estrogenic activity in human serum were observed during exemestane than those during letrozole treatment. Our observations, that additional letrozole could reduce further the estrogen activity in the exemestane-treated samples, demonstrate probably residual aromatase activity during therapy with exemestane alone.In addition to distinguish the effects of exemestane and letrozole, our results also demonstrate that the assay can also potentially detect the effects of estrogenic mimics.
Citation Format: Bahrami N, Chang G, Kanaya N, Sauer T, Gravdehaug B, Chen S, Geisler J. Total estrogenic activity during neoadjuvant therapy with letrozole and exemestane – An intra-patient cross-over comparison using the AroER tri-screen [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-04-16.
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Affiliation(s)
- N Bahrami
- Akershus University Hospital, Lørenskog, Norway; Beckman Research Institute of the City of Hope, Duarte, CA; Institute of Clinical Medicine, University of Oslo, Campus AHUS, Lørenskog, Norway
| | - G Chang
- Akershus University Hospital, Lørenskog, Norway; Beckman Research Institute of the City of Hope, Duarte, CA; Institute of Clinical Medicine, University of Oslo, Campus AHUS, Lørenskog, Norway
| | - N Kanaya
- Akershus University Hospital, Lørenskog, Norway; Beckman Research Institute of the City of Hope, Duarte, CA; Institute of Clinical Medicine, University of Oslo, Campus AHUS, Lørenskog, Norway
| | - T Sauer
- Akershus University Hospital, Lørenskog, Norway; Beckman Research Institute of the City of Hope, Duarte, CA; Institute of Clinical Medicine, University of Oslo, Campus AHUS, Lørenskog, Norway
| | - B Gravdehaug
- Akershus University Hospital, Lørenskog, Norway; Beckman Research Institute of the City of Hope, Duarte, CA; Institute of Clinical Medicine, University of Oslo, Campus AHUS, Lørenskog, Norway
| | - S Chen
- Akershus University Hospital, Lørenskog, Norway; Beckman Research Institute of the City of Hope, Duarte, CA; Institute of Clinical Medicine, University of Oslo, Campus AHUS, Lørenskog, Norway
| | - J Geisler
- Akershus University Hospital, Lørenskog, Norway; Beckman Research Institute of the City of Hope, Duarte, CA; Institute of Clinical Medicine, University of Oslo, Campus AHUS, Lørenskog, Norway
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Bahrami N, Sauer T, Loeng M, Gravdehaug B, Engebretsen SS, Aljabri B, Bemanian V, Lindstrøm JC, Lüders T, Kristensen VN, Geisler J. Abstract OT1-01-01: The NEO-LET-EXE-trial: An intra-patient cross-over trial to explore the "lack of cross-resistance" between steroidal and non-steroidal aromatase inhibitors. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot1-01-01] [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
Background. The aromatase inhibitor letrozole and the aromatase inactivator exemestane currently belong to the most widely used antihormonal drugs for breast cancer worldwide. Both compounds are strongly suppressing estradiol levels in postmenopausal patients with breast cancer. However, in the metastatic setting, these drugs may be used after another, causing new responses in selected patients following switching to the alternative drug after progressing on the first choice. This well-known “lack of cross resistance” has been recognized for some time and is documented by several trials. However, the precise explanation for this clinical observation is still unknown. The solution may potentially lead us to a novel strategy to treat hormone-sensitive breast cancer.
Trial design. NEO-LET-EXE is a neoadjuvant, randomized, open-label, intra-patient cross-over trial .
Eligibility criteria. Postmenopausal patients suffering from estrogen receptor (ER) positive (>50%), HER-2 negative, locally advanced breast cancer, suitable for neoadjuvant/presurgical antihormonal therapy, may be enrolled. Age: 18+ (no upper limit).
Specific aims. To explain the phenomenon of a lack of cross-resistance between steroidal and non-steroidal aromatase inhibitors in vivo. Sequential tumor biopsies and blood samples, obtained at baseline and following 2 months of therapy with each drug given in sequence, will be used to perform a comprehensive exploration of the consequences of each drug therapy. The influence on plasma and tissue steroids (estrogens, androgens, etc.) will be compared. In addition, whole genome sequencing, whole exome sequencing, epigenetics, proteomics and plasma analysis (cytokines, tumor DNA fragments, etc.) will be performed.
Statistical methods. Data will be analyzed using mixed effects models.
Present accrural and target accrural. 49 out of planned 100 patients have been enrolled so far. The last patient is expected to enter the trial in Q4 2019.
Citation Format: Bahrami N, Sauer T, Loeng M, Gravdehaug B, Engebretsen SS, Aljabri B, Bemanian V, Lindstrøm JC, Lüders T, Kristensen VN, Geisler J. The NEO-LET-EXE-trial: An intra-patient cross-over trial to explore the "lack of cross-resistance" between steroidal and non-steroidal aromatase inhibitors [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT1-01-01.
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Affiliation(s)
- N Bahrami
- Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - T Sauer
- Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - M Loeng
- Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - B Gravdehaug
- Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - SS Engebretsen
- Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - B Aljabri
- Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - V Bemanian
- Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - JC Lindstrøm
- Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - T Lüders
- Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - VN Kristensen
- Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - J Geisler
- Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
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Vaske CJ, Parulkar R, Bahrami N, Sauer T, Loeng M, Gravdehaug B, Aljabri B, Bemanian V, Lindstrøm J, Lüders T, Kristensen V, Geisler J. Abstract P3-06-11: Time-course DNA and RNA profiling of tumors from intra-patient cross-over trial of sequential use of aromatase inhibitors. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-06-11] [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
Background. The NEO-LET-EXE trial examines the neoadjuvant use of sequential administration of the aromatase inhibitor letrozole (Femar / Femara) and the aromatase inactivator exemestane (Aromasin). Although both drugs nearly completely inhibit aromatase, resistance to both is developed with time. However, when used sequentially, in some patients after switching to the alternative drug and progressing on the first choice, new responses may appear. The mechanism behind this clinical observation is currently not known. The solution may lead to a novel strategy to re-sensitize tumors to hormonal treatment. Prior studies have examined genomics at the four month time point, but not at both two months and four months.
Material. Postmenopausal patients with estrogen receptor (ER) positive (>50%), HER-2 negative locally advanced breast cancer may be enrolled. Age: 18+ (no upper limit). Present accrural and target accrural: 49 out of planned 100 patients have been enrolled so far. The last patient is expected to enter the trial in Q4 2019.
Study design. In the neoadjuvant, randomized, open-label, intra-patient cross-over trial NEO-LET-EXE biopsies are taken before treatment, after two months on one aromatase inhibitor and swap to the other aromatase inhibitor, and at surgery at four months.
Results. In order to explain the phenomenon of a lack of cross-resistance between steroidal and non-steroidal aromatase inhibitors we profiled biopsies at three time points per patient by whole exome and whole transcriptome sequencing from FFPE from 25 patients. A total of 56 DNA whole exomes and 41 RNA seq transcriptomes were generated from FFPE samples available. When grouping both arms together, mutational burden decreased at two months, while clonality of mutations increased, providing evidence of selection. At four months, mutational burden increased from the two month timepoint. In particular, PIK3CA somatic variants present at the first time point were not detected at two months. However, these were detected again at significant variant allele fractions at four months after switch of treatment. The majority of gene expression changes happen in the initial two months, with fewer changes between two and four months. Instead, significant changes in alternative splicing at two months and four months were observed, for example for FGFR1, which does not experience a large fold change in expression between these two points. Our preliminary results show significant DNA and RNA changes in the first two months of aromatase inhibition leading to fewer, more clonal variants. Comparison of the four month to two month time point shows fewer RNA changes than the prior two months and an increase in the number of somatic variants compared to the two month timepoint.
Citation Format: Vaske CJ, Parulkar R, Bahrami N, Sauer T, Loeng M, Gravdehaug B, Aljabri B, Bemanian V, Lindstrøm J, Lüders T, Kristensen V, Geisler J. Time-course DNA and RNA profiling of tumors from intra-patient cross-over trial of sequential use of aromatase inhibitors [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-06-11.
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Affiliation(s)
- CJ Vaske
- NantOmics, Santa Cruz, CA; Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; EPIGEN Research Laboratory, Akershus University Hospital, Lørenskog, Norway
| | - R Parulkar
- NantOmics, Santa Cruz, CA; Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; EPIGEN Research Laboratory, Akershus University Hospital, Lørenskog, Norway
| | - N Bahrami
- NantOmics, Santa Cruz, CA; Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; EPIGEN Research Laboratory, Akershus University Hospital, Lørenskog, Norway
| | - T Sauer
- NantOmics, Santa Cruz, CA; Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; EPIGEN Research Laboratory, Akershus University Hospital, Lørenskog, Norway
| | - M Loeng
- NantOmics, Santa Cruz, CA; Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; EPIGEN Research Laboratory, Akershus University Hospital, Lørenskog, Norway
| | - B Gravdehaug
- NantOmics, Santa Cruz, CA; Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; EPIGEN Research Laboratory, Akershus University Hospital, Lørenskog, Norway
| | - B Aljabri
- NantOmics, Santa Cruz, CA; Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; EPIGEN Research Laboratory, Akershus University Hospital, Lørenskog, Norway
| | - V Bemanian
- NantOmics, Santa Cruz, CA; Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; EPIGEN Research Laboratory, Akershus University Hospital, Lørenskog, Norway
| | - J Lindstrøm
- NantOmics, Santa Cruz, CA; Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; EPIGEN Research Laboratory, Akershus University Hospital, Lørenskog, Norway
| | - T Lüders
- NantOmics, Santa Cruz, CA; Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; EPIGEN Research Laboratory, Akershus University Hospital, Lørenskog, Norway
| | - V Kristensen
- NantOmics, Santa Cruz, CA; Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; EPIGEN Research Laboratory, Akershus University Hospital, Lørenskog, Norway
| | - J Geisler
- NantOmics, Santa Cruz, CA; Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; EPIGEN Research Laboratory, Akershus University Hospital, Lørenskog, Norway
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Karunamuni R, Bahrami N, Tringale K, Burkeen J, McDonald C, Hattangadi-Gluth J. Neurocognitive Classification of Primary Brain Tumor Patients Prior to Radiation Therapy. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.862] [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: 11/24/2022]
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Tringale K, Nguyen T, Bahrami N, Marshall D, Leyden K, Karunamuni R, Seibert T, Gorman M, Connor M, Burkeen J, Piccioni D, Farid N, McDonald C, Hattangadi-Gluth J. Early Diffusion Imaging Biomarkers of Prefrontal Lobe White Matter Microstructural Damage are Associated with Executive Dysfunction Following Radiation Therapy in Patients with Primary Brain Tumors: A Prospective, Longitudinal Study. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.034] [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: 10/28/2022]
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Bahrami N, Piccioni D, Karunamuni R, Chang YH, White N, Delfanti R, Seibert TM, Hattangadi-Gluth JA, Dale A, Farid N, McDonald CR. Edge Contrast of the FLAIR Hyperintense Region Predicts Survival in Patients with High-Grade Gliomas following Treatment with Bevacizumab. AJNR Am J Neuroradiol 2018; 39:1017-1024. [PMID: 29622553 DOI: 10.3174/ajnr.a5620] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 02/07/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Treatment with bevacizumab is standard of care for recurrent high-grade gliomas; however, monitoring response to treatment following bevacizumab remains a challenge. The purpose of this study was to determine whether quantifying the sharpness of the fluid-attenuated inversion recovery hyperintense border using a measure derived from texture analysis-edge contrast-improves the evaluation of response to bevacizumab in patients with high-grade gliomas. MATERIALS AND METHODS MRIs were evaluated in 33 patients with high-grade gliomas before and after the initiation of bevacizumab. Volumes of interest within the FLAIR hyperintense region were segmented. Edge contrast magnitude for each VOI was extracted using gradients of the 3D FLAIR images. Cox proportional hazards models were generated to determine the relationship between edge contrast and progression-free survival/overall survival using age and the extent of surgical resection as covariates. RESULTS After bevacizumab, lower edge contrast of the FLAIR hyperintense region was associated with poorer progression-free survival (P = .009) and overall survival (P = .022) among patients with high-grade gliomas. Kaplan-Meier curves revealed that edge contrast cutoff significantly stratified patients for both progression-free survival (log-rank χ2 = 8.3, P = .003) and overall survival (log-rank χ2 = 5.5, P = .019). CONCLUSIONS Texture analysis using edge contrast of the FLAIR hyperintense region may be an important predictive indicator in patients with high-grade gliomas following treatment with bevacizumab. Specifically, low FLAIR edge contrast may partially reflect areas of early tumor infiltration. This study adds to a growing body of literature proposing that quantifying features may be important for determining outcomes in patients with high-grade gliomas.
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Affiliation(s)
- N Bahrami
- From the Center for Multimodal Imaging and Genetics (N.B., N.W., C.R.M.) .,Department of Psychiatry (N.B., Y.-H.C., C.R.M.).,Department of Radiology (N.B., N.W., R.D., A.D., N.F., C.R.M.).,Multimodal Imaging Laboratory (N.B., N.W., A.D., C.R.M.)
| | - D Piccioni
- Department of Neurosciences (D.P., A.D., N.F.)
| | - R Karunamuni
- Department of Radiation Medicine (R.K., T.M.S., J.A.H.-G.), University of California, San Diego, La Jolla, California
| | - Y-H Chang
- Department of Psychiatry (N.B., Y.-H.C., C.R.M.)
| | - N White
- From the Center for Multimodal Imaging and Genetics (N.B., N.W., C.R.M.).,Department of Radiology (N.B., N.W., R.D., A.D., N.F., C.R.M.).,Multimodal Imaging Laboratory (N.B., N.W., A.D., C.R.M.)
| | - R Delfanti
- Department of Radiology (N.B., N.W., R.D., A.D., N.F., C.R.M.)
| | - T M Seibert
- Department of Radiation Medicine (R.K., T.M.S., J.A.H.-G.), University of California, San Diego, La Jolla, California
| | - J A Hattangadi-Gluth
- Department of Radiation Medicine (R.K., T.M.S., J.A.H.-G.), University of California, San Diego, La Jolla, California
| | - A Dale
- Multimodal Imaging Laboratory (N.B., N.W., A.D., C.R.M.).,Department of Neurosciences (D.P., A.D., N.F.)
| | - N Farid
- Department of Radiology (N.B., N.W., R.D., A.D., N.F., C.R.M.).,Department of Neurosciences (D.P., A.D., N.F.)
| | - C R McDonald
- From the Center for Multimodal Imaging and Genetics (N.B., N.W., C.R.M.).,Department of Psychiatry (N.B., Y.-H.C., C.R.M.).,Department of Radiology (N.B., N.W., R.D., A.D., N.F., C.R.M.).,Multimodal Imaging Laboratory (N.B., N.W., A.D., C.R.M.)
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Bayat M, Garajei A, Afshari Pour E, Hasheminasab M, Ghorbani Y, Kalantar Motamedi MH, Bahrami N. The Effect of Locally Administered Pamidronate on Autogenous Bone Graft in Maxillofacial Reconstruction: A Randomized Clinical Trial. Int J Organ Transplant Med 2017; 8:43-47. [PMID: 28299027 PMCID: PMC5347405] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Although bone grafts are commonly used in reconstructive surgeries, they are sensitive to local perfusion and are thus prone to severe resorption. Biphosphonates can inactivate osteoclasts and can be used to control the undesirable bone resorption. OBJECTIVE To assess the effect of administration of biphosphonates on bone resorption. METHODS 20 patients with bony defects who were candidates for free autogenous grafts were randomized into "pamidronate" and "control" groups. Bone segments were soaked in either pamidronate solution or normal saline and were inserted into the area of the surgery. Bone densities were measured post-surgery and in 6-month follow-up. Data were obtained via Digora software and analyzed. RESULTS The mean±SD bone density in pamidronate group changed from 93.4±14.6 to 93.6±17.5 (p<0.05); in the control group the density decreased from 89.7±13.2 to 78.9±11.4 (p<0.05). The mean difference of bone density in anterior areas of the jaws showed higher DXA in comparison to posterior regions (p=0.002). CONCLUSION Locally administered pamidronate affects reduction in bone resorption.
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Affiliation(s)
- M. Bayat
- Craniomaxillofacial Research center, Tehran University of Medical Sciences, Tehran, Iran,Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - A. Garajei
- Craniomaxillofacial Research center, Tehran University of Medical Sciences, Tehran, Iran,Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - E. Afshari Pour
- Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - M. Hasheminasab
- Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Y. Ghorbani
- Department of Physiology, Islamic Azad University, Tehran, Iran
| | - M. H. Kalantar Motamedi
- Oral and Maxillofacial Surgery, Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran,Attending Faculty, Department of Oral and Maxillofacial Surgery, Azad University of Medical Sciences, Dental College, Tehran, Iran
| | - N. Bahrami
- Craniomaxillofacial Research center, Tehran University of Medical Sciences, Tehran, Iran,Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran,Correspondence: Dr. Naghmeh Bahrami, Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran, E-mail:
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Alinia H, Moradi Tuchayi S, Smith J, Richardson I, Bahrami N, Jaros S, Sandoval L, Farhangian M, Anderson K, Huang K, Feldman S. Long-term adherence to topical psoriasis treatment can be abysmal: a 1-year randomized intervention study using objective electronic adherence monitoring. Br J Dermatol 2016; 176:759-764. [DOI: 10.1111/bjd.15085] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2016] [Indexed: 12/01/2022]
Affiliation(s)
- H. Alinia
- Department of Dermatology (Center for Dermatology Research); Wake Forest School of Medicine; Medical Center Boulevard; Winston-Salem NC 27157-1071 U.S.A
| | - S. Moradi Tuchayi
- Department of Dermatology (Center for Dermatology Research); Wake Forest School of Medicine; Medical Center Boulevard; Winston-Salem NC 27157-1071 U.S.A
| | - J.A. Smith
- Department of Dermatology (Center for Dermatology Research); Wake Forest School of Medicine; Medical Center Boulevard; Winston-Salem NC 27157-1071 U.S.A
| | - I.M. Richardson
- Department of Dermatology (Center for Dermatology Research); Wake Forest School of Medicine; Medical Center Boulevard; Winston-Salem NC 27157-1071 U.S.A
| | - N. Bahrami
- Department of Dermatology (Center for Dermatology Research); Wake Forest School of Medicine; Medical Center Boulevard; Winston-Salem NC 27157-1071 U.S.A
- Department of Biomedical Engineering; Virginia Tech-Wake Forest University; Winston-Salem NC U.S.A
- Department of Radiology; Wake Forest School of Medicine; Medical Center Boulevard; Winston-Salem NC 27157-1071 U.S.A
| | - S.C. Jaros
- Department of Dermatology (Center for Dermatology Research); Wake Forest School of Medicine; Medical Center Boulevard; Winston-Salem NC 27157-1071 U.S.A
| | - L.F. Sandoval
- Department of Dermatology (Center for Dermatology Research); Wake Forest School of Medicine; Medical Center Boulevard; Winston-Salem NC 27157-1071 U.S.A
| | - M.E. Farhangian
- Department of Dermatology (Center for Dermatology Research); Wake Forest School of Medicine; Medical Center Boulevard; Winston-Salem NC 27157-1071 U.S.A
| | - K.L. Anderson
- Department of Dermatology (Center for Dermatology Research); Wake Forest School of Medicine; Medical Center Boulevard; Winston-Salem NC 27157-1071 U.S.A
| | - K.E. Huang
- Department of Dermatology (Center for Dermatology Research); Wake Forest School of Medicine; Medical Center Boulevard; Winston-Salem NC 27157-1071 U.S.A
| | - S.R. Feldman
- Department of Dermatology (Center for Dermatology Research); Wake Forest School of Medicine; Medical Center Boulevard; Winston-Salem NC 27157-1071 U.S.A
- Department of Pathology; Wake Forest School of Medicine; Medical Center Boulevard; Winston-Salem NC 27157-1071 U.S.A
- Department of Public Health Sciences; Wake Forest School of Medicine; Medical Center Boulevard; Winston-Salem NC 27157-1071 U.S.A
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Kadkhoda Z, Safarpour A, Azmoodeh F, Adibi S, Khoshzaban A, Bahrami N. Histopathological Comparison between Bone Marrow- and Periodontium-derived Stem Cells for Bone Regeneration in Rabbit Calvaria. Int J Organ Transplant Med 2016; 7:9-18. [PMID: 26889369 PMCID: PMC4756260] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Periodontitis is an important oral disease. Stem cell therapy has found its way in treatment of many diseases. OBJECTIVE To evaluate the regenerative potential of periodontal ligament-derived stem cells (PDLSCs) and osteoblast differentiated from PDLSC in comparison with bone marrow-derived mesenchymal stem cells (BM-MSCs) and pre-osteoblasts in calvarial defects. METHODS After proving the existence of surface markers by flow cytometry, BM-MSCs were differentiated into osteoblasts. 5 defects were made on rabbit calvaria. 3 of them were first covered with collagen membrane and then with BM-MSCs, PDLSCs, and pre-osteoblasts. The 4(th) defect was filled with collagen membrane and the 5(th) one was served as control. After 4 weeks, histological (quantitative) and histomorphological (qualitative) surveys were performed. RESULTS Both cell lineages were positive for CD-90 cell marker, which was specifically related to stem cells. Alizarin red staining was done for showing mineral material. RT-PCR set up for the expression of Cbfa1 gene, BMP4 gene, and PGLAP gene, confirmed osteoblast differentiation. The findings indicated that although PDLSCs and pre-osteoblasts could be used for bone regeneration, the rate of regeneration in BM-MSCs-treated cavities was more significant (p<0.0001). CONCLUSION The obtained results are probably attributable to the effective micro-environmental signals caused by different bone types and the rate of cell maturation.
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Affiliation(s)
- Z. Kadkhoda
- Periodontology Department, Dental Faculty of Tehran University of Medical Sciences, Tehran, Iran
| | - A. Safarpour
- Periodontology Department, Dental Faculty of Tehran University of Medical Sciences, Tehran, Iran
| | - F. Azmoodeh
- Pathology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - S. Adibi
- Dental Research of Torabinejad Research Centre, Isfahan, Iran
| | - A. Khoshzaban
- Stem Cells Preparation Unit, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - N. Bahrami
- Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran,Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran,CORRESPONDENCE: NAGHMEH BAHRAMI, ORAL AND MAXILLOFACIAL SURGERY DEPARTMENT, SCHOOL OF DENTISTRY, TEHRAN UNIVERSITY OF MEDICAL SCIENCES, NORTH AMIRABAD ST, TEHRAN, IRAN,E-mail:
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Lotfipour F, Valizadeh H, Milani M, Bahrami N, Ghotaslou R. Study of Antimicrobial Effects of Clarithromycin Loaded PLGA Nanoparticles against Clinical Strains of Helicobacter pylori. Drug Res (Stuttg) 2015; 66:41-5. [PMID: 25919643 DOI: 10.1055/s-0035-1548910] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Clarithromycin (CLR) formulation was prepared as PLGA nanoparticles in order to enhance the therapeutic effects using the distinctive features of a nanoparticulate delivery system. CLR loaded PLGA nanoparticles were prepared by Quasi Emulsion Solvent Diffusion (QESD) method using Poly lactic-co-Glycolic Acid (PLGA) as a biodegradable polymer. Antibacterial activity of the prepared formulations was evaluated against clinical strains of Helicobacter pylori, isolated from gastric biopsies of patients with gastritis, duodenal ulcer, peptic ulcer, and gastroesophageal reflux disease undergoing endoscopy, by using agar dilution method.Spherical nanoparticles with relatively narrow size distribution (between 200 and 800 nm) in the size range of 305 ± 138, 344 ± 148 and 362 ± 110 nm were achieved for F22, F23 and F23 respectively. CLR encapsulation percentages were measured to be 57.4 ± 4.3 to 80.2 ± 4.0%. CLR loaded PLGA nanoparticles showed equal or enhanced eradication effect against H. pylori strains according to the declined MIC values in comparison with the untreated CLR.In conclusion, the prepared CLR nanoformulation showed appropriate physicochemical properties and improved activity against H. pylori that could be a suitable candidate for oral preparations.
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Affiliation(s)
- F Lotfipour
- Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - H Valizadeh
- Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - M Milani
- School of Advanced Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - N Bahrami
- Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - R Ghotaslou
- Department of Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Bayat M, Momen Heravi F, Mahmoudi M, Bahrami N. Bone Reconstruction following Application of Bone Matrix Gelatin to Alveolar Defects: A Randomized Clinical Trial. Int J Organ Transplant Med 2015; 6:176-81. [PMID: 26576263 PMCID: PMC4644570] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Conventional dentoalveolar osseous reconstruction often involves the use of graft materials with or without barrier membranes. OBJECTIVE To evaluate the efficacy of bone induction by bone matrix gelatin (BMG), delivered on an absorbable collagen sponge (ACS), compared to a placebo (ACS alone) in human alveolar socket defects. METHODS 20 alveolar sockets from 10 healthy adults were studied. In all cases, both the mandibular premolar area and the contralateral premolar area (as the control site) were involved. In each of the 10 patients, the extraction sites were filled randomly with BMG and ACS. The repair response was examined on day 90. Qualitative histological and quantitative histometric analysis, including the percentage of new-formed bone fill and density were done. RESULTS Assessment of the alveolar bone indicated that patients treated with BMG had significantly (p<0.05) better bone quality and quantity compared to the controls. In addition, bone density and histology revealed no differences between the newly induced and native bone. CONCLUSION The data from this single-blind clinical trial demonstrated that the novel combination of BMG had a striking effect on de novo osseous formation for the bone regeneration.
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Affiliation(s)
- M. Bayat
- Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - F. Momen Heravi
- Harvard Catalyst Laboratory for Innovative Translational Technologies, Harvard Medical School, Boston, MA, USA
| | - M. Mahmoudi
- Harvard Catalyst Laboratory for Innovative Translational Technologies, Harvard Medical School, Boston, MA, USA
| | - N. Bahrami
- Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran,,Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran,Correspondence: Naghmeh Bahrami, DMD, Assistant Professor, Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, North Kargar St, Tehran, Iran ,Tel: +98-919-804-4011, E-mail:
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Robati BK, Bahrami N, Mehrabian F, Naeni HN. 216 ICODEXTRIN REDUCES ADHESION FORMATION IN RABBITS FOLLOWING GYNECOLOGICAL SURGERY. Maturitas 2012. [DOI: 10.1016/s0378-5122(12)70327-4] [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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Strauß G, Bahrami N, Pößneck A, Strauß M, Dietz A, Korb W, Lüth T, Haase R, Moeckel H, Grunert R. Evaluation eines Trainingssystems für die Felsenbeinchirurgie mit optoelektrischer Detektion. HNO 2009; 57:999-1009. [DOI: 10.1007/s00106-008-1763-5] [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: 11/30/2022]
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