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Malik P, Hashim T, Varma S, Diaz L, Chowdhary A, Bapat P, Alkhatib L, Centeno L, Poursina O, Pan H, Patil A. BTEX (benzene, toluene, ethylbenzene, and xylene) and risk of cancer - a study from Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.216] [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: 11/10/2022] Open
Abstract
Abstract
Introduction/Objective
BTEX (benzene, toluene, ethylbenzene, and xylene) is well know for its toxicity via through environmental, occupational and recreational exposures. However, there is limited literature about the carcinogenic effect of BTEX. Hence, we aim to study the prevalence and association of cancer amongst individuals with exposure of BTEX.
Methods/Case Report
A retrospective cross-sectional study was performed between 2013 and 2018 utilizing the NHANES database. Adult individuals having data on socio-demographic questionnaires and lab findings on exposure to BTEX were included. Prevalence of cancer was identified amongst exposure to BTEX (vs no-BTEX). Univariate (chi-squre test and Mann–Whitney U test) and Multivariate (survey logistic regression) analysis was performed to evaluate the epidemiologic characteristics of individuals exposred to BTEX and association of cancer with BTEX exposure in comparison to no BTEX exposure.The p value of <0.05 considered statistically significant.
Results (if a Case Study enter NA)
124,162 participants were identified with BTEX exposure. Individuals with BTEX exposure were young (40 vs 51 year old), male (91% vs female: 87%), and Mexican American (92% vs Non-Hispanic Black: 89% vs Non-Hispanic White: 89% vs other Hispanic: 87%). Univariate analysis showed higher total prevalence of cancer in BTEX (9.3% vs. 1.3%; p<0.0001) compared to no BTEX. Individuals with BTEX exposure had higher prevalnece of blood cancer (0.47% vs 0.00; p<0.0001), leukemia (0.56% vs 0.00; p<0.001), and lymphoma (1.72% vs 0.39%; p<0.0001) in comparison with no exposure. Multivaritate analysis showed participants with BTEX exposure had 10% higher risk of cancer (aOR: 1.10; 95%CI: 1.10-1.10; p<0.0001) compared to no BTEX exposure. Additionally, exposure to individual components of benzene (aOR: 1.24; 95%CI: 1.24; p<0.0001), ethylbenzene (aOR: 1.08; 95%CI: 1.08-1.08; p<0.0001), and o-xylene (aOR: 1.19; 95%CI: 1.19-1.19; p<0.0001) had higher risk of cancer compared to no exposure participants.
Conclusion
Our study conclude higher risk of cancer among participants with exposure to benzene, ethylbenzene and o-xylene. Future studies are warranted to evaluate the association of various types of cancers in BTEX exposure.
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Affiliation(s)
- P Malik
- Montefiore Medical Center , Bronx, New York , United States
| | - T Hashim
- Batterjee Medical College , Jeddah , Saudi arabia
| | - S Varma
- Madurai Medical College and Government Rajaji Hospital , Madurai , India
| | - L Diaz
- Universidad de Guayaquil , Guayaquil , Ecuador
| | - A Chowdhary
- Smt Kashibai Navale Medical College and General Hospital , Pune , India
| | - P Bapat
- Smt Kashibai Navale Medical College and General Hospital , Pune , India
| | | | - L Centeno
- University of Santo Tomas Faculty of Medicine and Surgery , Manila , Philippines
| | - O Poursina
- Houston Methodist Hospital , Houston, Texas , United States
| | - H Pan
- Tianjin University of Chinese Medicine , Tianjin, Tianjin , CHINA
| | - A Patil
- University of Miami, Miller School of Medicine , Miami, Florida , United States
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2
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Bapat P, Nobile C. Discovering the chlamydospore regulatory network in Candida albicans. Access Microbiol 2021. [DOI: 10.1099/acmi.cc2021.po0013] [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: 11/18/2022] Open
Abstract
A normal resident of healthy humans and warm-blooded animals, C. albicans is a commensal fungus that is also among the most common opportunistic pathogens of humans. C. albicans forms unique morphological structures called chlamydospores, which are large, spherical, thick-walled structures formed at the ends of hyphae that have unknown biological function. My goal is to discover the regulatory network controlling chlamydospore formation in C. albicans. By determining this network, we can gain insight into the biological roles of chlamydospores in the C. albicans lifestyle, better understand C. albicans morphological transitions, and determine the selective advantage (if any) provided by chlamydospores to this pathogenic fungus. To determine this regulatory network, I have screened a library of 211 C. albicans transcription factor (TF) homozygous deletion mutants to assay for their abilities to form chlamydospores under standard chlamydospore-inducing growth conditions. I have identified seven TF mutants that fail to produce any chlamydospores andthree TF mutants that produce high levels of chlamydospores relative to WT. To characterize the transcriptional changes occurring during chlamydospore formation, I have performed RNA sequencing (RNA-seq) on these identified regulator mutants to uncover the differentially regulated target genes of each chlamydospore regulator. I will use genome-wide chromatin immunoprecipitation followed by sequencing (ChIP-seq) on epitope-tagged versions of these regulators to determine which genes are directly under the control of each TF. RNA-seq coupled with ChIP-seq will allow me to determine the regulatory network controlling chlamydospore formation in C. albicans.
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Seher TD, Nguyen N, Ramos D, Bapat P, Nobile CJ, Sindi SS, Hernday AD. AddTag, a two-step approach with supporting software package that facilitates CRISPR/Cas-mediated precision genome editing. G3 (Bethesda) 2021; 11:jkab216. [PMID: 34544122 PMCID: PMC8496238 DOI: 10.1093/g3journal/jkab216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/13/2021] [Indexed: 12/22/2022]
Abstract
CRISPR/Cas-induced genome editing is a powerful tool for genetic engineering, however, targeting constraints limit which loci are editable with this method. Since the length of a DNA sequence impacts the likelihood it overlaps a unique target site, precision editing of small genomic features with CRISPR/Cas remains an obstacle. We introduce a two-step genome editing strategy that virtually eliminates CRISPR/Cas targeting constraints and facilitates precision genome editing of elements as short as a single base-pair at virtually any locus in any organism that supports CRISPR/Cas-induced genome editing. Our two-step approach first replaces the locus of interest with an "AddTag" sequence, which is subsequently replaced with any engineered sequence, and thus circumvents the need for direct overlap with a unique CRISPR/Cas target site. In this study, we demonstrate the feasibility of our approach by editing transcription factor binding sites within Candida albicans that could not be targeted directly using the traditional gene-editing approach. We also demonstrate the utility of the AddTag approach for combinatorial genome editing and gene complementation analysis, and we present a software package that automates the design of AddTag editing.
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Affiliation(s)
- Thaddeus D Seher
- Quantitative and Systems Biology Graduate Program, University of California, Merced, Merced, CA 95343, USA
| | - Namkha Nguyen
- Quantitative and Systems Biology Graduate Program, University of California, Merced, Merced, CA 95343, USA
| | - Diana Ramos
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, Merced, CA 95343, USA
| | - Priyanka Bapat
- Quantitative and Systems Biology Graduate Program, University of California, Merced, Merced, CA 95343, USA
| | - Clarissa J Nobile
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, Merced, CA 95343, USA
- Health Sciences Research Institute, University of California, Merced, Merced, CA 95343, USA
| | - Suzanne S Sindi
- Health Sciences Research Institute, University of California, Merced, Merced, CA 95343, USA
- Department of Applied Mathematics, School of Natural Sciences, University of California, Merced, Merced, CA 95343, USA
| | - Aaron D Hernday
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, Merced, CA 95343, USA
- Health Sciences Research Institute, University of California, Merced, Merced, CA 95343, USA
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Bapat P, Sewell DG, Boylan M, Sharma AK, Spallholz JE. In Vitro Cytotoxicity of Trastuzumab (Tz) and Se-Trastuzumab (Se-Tz) against the Her/2 Breast Cancer Cell Lines JIMT-1 and BT-474. Int J Mol Sci 2021; 22:ijms22094655. [PMID: 33925081 PMCID: PMC8124313 DOI: 10.3390/ijms22094655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 11/24/2022] Open
Abstract
Her/2+ breast cancer accounts for ~25% mortality in women and overexpression of Her/2 leads to cell growth and tumor progression. Trastuzumab (Tz) with Taxane is the preferred treatment for Her/2+ patients. However, Tz responsive patients often develop resistance to Tz treatment. Herein, redox selenides (RSe-) were covalently linked to Tz using a selenium (Se)-modified Bolton–Hunter Reagent forming Seleno-Trastuzumab (Se-Tz; ~25 µgSe/mg). Se-Tz was compared to Tz and sodium selenite to assess the viability of JIMT-1 and BT-474 cells. Comparative cell viability was examined by microscopy and assessed by fluorometric/enzymatic assays. Se-Tz and selenite redox cycle producing superoxide (O2•−) are more cytotoxic to Tz resistant JIMT-1 and Tz sensitive BT-474 cells than Tz. The results of conjugating redox selenides to Tz suggest a wider application of this technology to other antibodies and targeting molecules.
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Affiliation(s)
- Priyanka Bapat
- Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, TX 79409, USA; (P.B.); (D.G.S.); (M.B.)
| | - Debalina Goswami Sewell
- Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, TX 79409, USA; (P.B.); (D.G.S.); (M.B.)
| | - Mallory Boylan
- Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, TX 79409, USA; (P.B.); (D.G.S.); (M.B.)
| | - Arun K. Sharma
- Department of Pharmacology, Penn State Cancer Institute, CH72, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA;
| | - Julian E. Spallholz
- Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, TX 79409, USA; (P.B.); (D.G.S.); (M.B.)
- Correspondence: ; Tel.: +1-806-786-8349
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Bapat P, Singh G, Nobile CJ. Visible Lights Combined with Photosensitizing Compounds Are Effective against Candida albicans Biofilms. Microorganisms 2021; 9:microorganisms9030500. [PMID: 33652865 PMCID: PMC7996876 DOI: 10.3390/microorganisms9030500] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 12/11/2022] Open
Abstract
Fungal infections are increasing in prevalence worldwide, especially in immunocompromised individuals. Given the emergence of drug-resistant fungi and the fact that there are only three major classes of antifungal drugs available to treat invasive fungal infections, there is a need to develop alternative therapeutic strategies effective against fungal infections. Candida albicans is a commensal of the human microbiota that is also one of the most common fungal pathogens isolated from clinical settings. C. albicans possesses several virulence traits that contribute to its pathogenicity, including the ability to form drug-resistant biofilms, which can make C. albicans infections particularly challenging to treat. Here, we explored red, green, and blue visible lights alone and in combination with common photosensitizing compounds for their efficacies at inhibiting and disrupting C. albicans biofilms. We found that blue light inhibited biofilm formation and disrupted mature biofilms on its own and that the addition of photosensitizing compounds improved its antibiofilm potential. Red and green lights, however, inhibited biofilm formation only in combination with photosensitizing compounds but had no effects on disrupting mature biofilms. Taken together, these results suggest that photodynamic therapy may be an effective non-drug treatment for fungal biofilm infections that is worthy of further exploration.
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Affiliation(s)
- Priyanka Bapat
- Department of Molecular and Cell Biology, School of Natural Science, University of California, Merced, CA 95343, USA; (P.B.); (G.S.)
- Quantitative and Systems Biology Graduate Program, University of California, Merced, CA 95343, USA
| | - Gurbinder Singh
- Department of Molecular and Cell Biology, School of Natural Science, University of California, Merced, CA 95343, USA; (P.B.); (G.S.)
| | - Clarissa J. Nobile
- Department of Molecular and Cell Biology, School of Natural Science, University of California, Merced, CA 95343, USA; (P.B.); (G.S.)
- Health Sciences Research Institute, University of California, Merced, CA 95343, USA
- Correspondence: ; Tel.: +1-209-228-2427
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Sircaik S, Román E, Bapat P, Lee KK, Andes DR, Gow NAR, Nobile CJ, Pla J, Panwar SL. The protein kinase Ire1 impacts pathogenicity of Candida albicans by regulating homeostatic adaptation to endoplasmic reticulum stress. Cell Microbiol 2021; 23:e13307. [PMID: 33403715 PMCID: PMC8044019 DOI: 10.1111/cmi.13307] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 12/20/2022]
Abstract
The unfolded protein response (UPR), crucial for the maintenance of endoplasmic reticulum (ER) homeostasis, is tied to the regulation of multiple cellular processes in pathogenic fungi. Here, we show that Candida albicans relies on an ER‐resident protein, inositol‐requiring enzyme 1 (Ire1) for sensing ER stress and activating the UPR. Compromised Ire1 function impacts cellular processes that are dependent on functional secretory homeostasis, as inferred from transcriptional profiling. Concordantly, an Ire1‐mutant strain exhibits pleiotropic roles in ER stress response, antifungal tolerance, cell wall regulation and virulence‐related traits. Hac1 is the downstream target of C. albicans Ire1 as it initiates the unconventional splicing of the 19 bp intron from HAC1 mRNA during tunicamycin‐induced ER stress. Ire1 also activates the UPR in response to perturbations in cell wall integrity and cell membrane homeostasis in a manner that does not necessitate the splicing of HAC1 mRNA. Furthermore, the Ire1‐mutant strain is severely defective in hyphal morphogenesis and biofilm formation as well as in establishing a successful infection in vivo. Together, these findings demonstrate that C. albicans Ire1 functions to regulate traits that are essential for virulence and suggest its importance in responding to multiple stresses, thus integrating various stress signals to maintain ER homeostasis.
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Affiliation(s)
- Shabnam Sircaik
- Yeast Molecular Genetics Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Elvira Román
- Departamento de Microbiología y Parasitología-IRYCIS, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain
| | - Priyanka Bapat
- Department of Molecular and Cell Biology, University of California, Merced, California, USA.,Quantitative and System Biology Graduate Program, University of California, Merced, California, USA
| | - Keunsook K Lee
- The Aberdeen Fungal Group, MRC Centre for Medical Mycology, School of Medicine, Medical Sciences & Nutrition, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - David R Andes
- Department of Medicine, Section of Infectious Diseases, University of Wisconsin, Madison, Wisconsin, USA
| | - Neil A R Gow
- The Aberdeen Fungal Group, MRC Centre for Medical Mycology, School of Medicine, Medical Sciences & Nutrition, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK.,Medical Research Council Centre for Medical Mycology, University of Exeter, Exeter, UK
| | - Clarissa J Nobile
- Department of Molecular and Cell Biology, University of California, Merced, California, USA.,Health Sciences Research Institute, University of California, Merced, California, USA
| | - Jesús Pla
- Departamento de Microbiología y Parasitología-IRYCIS, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain
| | - Sneh Lata Panwar
- Yeast Molecular Genetics Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
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7
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Gulati M, Lohse MB, Ennis CL, Gonzalez RE, Perry AM, Bapat P, Arevalo AV, Rodriguez DL, Nobile CJ. In Vitro Culturing and Screening of Candida albicans Biofilms. ACTA ACUST UNITED AC 2018; 50:e60. [PMID: 29995344 DOI: 10.1002/cpmc.60] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Candida albicans is a normal member of the human microbiota that asymptomatically colonizes healthy individuals, however it is also an opportunistic pathogen that can cause severe infections, especially in immunocompromised individuals. The medical impact of C. albicans depends, in part, on its ability to form biofilms, communities of adhered cells encased in an extracellular matrix. Biofilms can form on both biotic and abiotic surfaces, such as tissues and implanted medical devices. Once formed, biofilms are highly resistant to antifungal agents and the host immune system, and can act as a protected reservoir to seed disseminated infections. Here, we present several in vitro biofilm protocols, including protocols that are optimized for high-throughput screening of mutant libraries and antifungal compounds. We also present protocols to examine specific stages of biofilm development and protocols to evaluate interspecies biofilms that C. albicans forms with interacting microbial partners. © 2018 by John Wiley & Sons, Inc.
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Affiliation(s)
- Megha Gulati
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, Merced, California
| | - Matthew B Lohse
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, California.,Department of Biology, BioSynesis, Inc., San Francisco, California
| | - Craig L Ennis
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, Merced, California.,Quantitative and Systems Biology Graduate Program, University of California, Merced, Merced, California
| | - Ruth E Gonzalez
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, Merced, California
| | - Austin M Perry
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, Merced, California.,Quantitative and Systems Biology Graduate Program, University of California, Merced, Merced, California
| | - Priyanka Bapat
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, Merced, California.,Quantitative and Systems Biology Graduate Program, University of California, Merced, Merced, California
| | - Ashley Valle Arevalo
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, Merced, California.,Quantitative and Systems Biology Graduate Program, University of California, Merced, Merced, California
| | - Diana L Rodriguez
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, Merced, California.,Quantitative and Systems Biology Graduate Program, University of California, Merced, Merced, California
| | - Clarissa J Nobile
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, Merced, California
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Srivastava A, Sircaik S, Husain F, Thomas E, Ror S, Rastogi S, Alim D, Bapat P, Andes DR, Nobile CJ, Panwar SL. Distinct roles of the 7-transmembrane receptor protein Rta3 in regulating the asymmetric distribution of phosphatidylcholine across the plasma membrane and biofilm formation in Candida albicans. Cell Microbiol 2017; 19. [PMID: 28745020 DOI: 10.1111/cmi.12767] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 03/10/2017] [Revised: 07/10/2017] [Accepted: 07/14/2017] [Indexed: 12/17/2022]
Abstract
Fungal pathogens such as Candida albicans exhibit several survival mechanisms to evade attack by antifungals and colonise host tissues. Rta3, a member of the Rta1-like family of lipid-translocating exporters has a 7-transmembrane domain topology, similar to the G-protein-coupled receptors and is unique to the fungal kingdom. Our findings point towards a role for the plasma membrane localised Rta3 in providing tolerance to miltefosine, an analogue of alkylphosphocholine, by maintaining mitochondrial energetics. Concurrent with miltefosine susceptibility, the rta3Δ/Δ strain displays increased inward translocation (flip) of fluorophore-labelled phosphatidylcholine (PC) across the plasma membrane attributed to enhanced PC-specific flippase activity. We also assign a novel role to Rta3 in the Bcr1-regulated pathway for in vivo biofilm development. Transcriptome analysis reveals that Rta3 regulates expression of Bcr1 target genes involved in cell surface properties, adhesion, and hyphal growth. We show that rta3Δ/Δ mutant is biofilm-defective in a rat venous catheter model of infection and that BCR1 overexpression rescues this defect, indicating that Bcr1 functions downstream of Rta3 to mediate biofilm formation in C. albicans. The identification of this novel Rta3-dependent regulatory network that governs biofilm formation and PC asymmetry across the plasma membrane will provide important insights into C. albicans pathogenesis.
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Affiliation(s)
- Archita Srivastava
- Yeast Molecular Genetics Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Shabnam Sircaik
- Yeast Molecular Genetics Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Farha Husain
- Yeast Molecular Genetics Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Edwina Thomas
- Yeast Molecular Genetics Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Shivani Ror
- Yeast Molecular Genetics Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Sumit Rastogi
- Yeast Molecular Genetics Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Darakshan Alim
- Yeast Molecular Genetics Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Priyanka Bapat
- Department of Molecular and Cell Biology, University of California, Merced, California, USA.,Quantitative and System Biology Graduate Program, University of California, Merced, California, USA
| | - David R Andes
- Department of Medicine, Section of Infectious Diseases, University of Wisconsin, Madison, Wisconsin, USA
| | - Clarissa J Nobile
- Department of Molecular and Cell Biology, University of California, Merced, California, USA
| | - Sneh L Panwar
- Yeast Molecular Genetics Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
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Bapat P, Pinto LSR, Lubetsky A, Aleksa K, Berger H, Koren G, Ito S. Examining the transplacental passage of apixaban using the dually perfused human placenta. J Thromb Haemost 2016; 14:1436-41. [PMID: 27149680 DOI: 10.1111/jth.13353] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 04/18/2016] [Indexed: 12/16/2022]
Abstract
UNLABELLED Essentials Apixaban is a novel oral anticoagulant that has not been studied in pregnant patients. Our objective was to determine the rate and extent of the placental transfer of apixaban. Apixaban rapidly crosses the ex vivo term human placenta from maternal to fetal circulation. Fetal apixaban levels in vivo are estimated to be 35-90% of the corresponding maternal levels. SUMMARY Background Apixaban is a novel oral anticoagulant that is increasingly being prescribed to women of reproductive age. However, information regarding its placental transfer is non-existent. Objective To determine the rate and extent of placental transfer of apixaban, using the human placenta ex vivo. Methods Placentae collected after Caesarean or vaginal delivery of healthy term infants were perfused in the respective maternal and fetal circulation. At the start of the experiment, apixaban was added to the maternal circulation at a concentration of 150 ng mL(-1) , and samples from maternal and fetal reservoirs were collected over 3 h. Results There was a rapid decline of apixaban in the maternal compartment, followed by emergence in the fetal compartment with a median fetal-to-maternal drug concentration ratio of 0.77 (interquartile range [IQR], 0.76-0.81) and fetal concentration of 39.0 ng mL(-1) (IQR, 36.8-40.6) after 3 h (n = 5). The perfusion results were subsequently adjusted to account for differences in the concentration of plasma proteins in maternal and fetal blood, as apixaban remains highly bound to albumin and alpha-1 acid glycoprotein. After the adjustment, the predicted fetal-to-maternal ratio of total (bound plus unbound) apixaban concentrations in vivo ranged from 0.35 to 0.90. Conclusions We conclude that unbound apixaban rapidly crosses from the maternal to fetal circulation. We further predict that total apixaban concentrations in cord blood in vivo are 35-90% of the corresponding maternal levels, suggesting that apixaban could have a possible adverse effect on fetal and neonatal coagulation.
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Affiliation(s)
- P Bapat
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, ON, Canada
| | - L S R Pinto
- Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, ON, Canada
| | - A Lubetsky
- Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, ON, Canada
| | - K Aleksa
- Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, ON, Canada
| | - H Berger
- Department of Obstetrics and Gynecology, St Michael's Hospital, Toronto, ON, Canada
| | - G Koren
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - S Ito
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, ON, Canada
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Wang S, Matthan NR, Wu D, Reed DB, Bapat P, Yin X, Grammas P, Shen CL, Lichtenstein AH. Lipid content in hepatic and gonadal adipose tissue parallel aortic cholesterol accumulation in mice fed diets with different omega-6 PUFA to EPA plus DHA ratios. Clin Nutr 2013; 33:260-6. [PMID: 23672804 DOI: 10.1016/j.clnu.2013.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [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: 02/26/2013] [Revised: 04/08/2013] [Accepted: 04/08/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Diets with low omega (ω)-6 polyunsaturated fatty acids (PUFA) to eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) ratios have been shown to decrease aortic cholesterol accumulation and have been suggested to promote weight loss. The involvement of the liver and gonadal adipose tissue (GAT) in mediating these effects is not well understood. LDL receptor null mice were used to assess the effect of an atherogenic diet with different ω-6:EPA+DHA ratios on weight gain, hepatic and GAT lipid accumulation, and their relationship to atherosclerosis. METHODS Four groups of mice were fed a high saturated fat and cholesterol diet (HSF ω-6) alone, or with ω-6 PUFA to EPA+DHA ratios up to 1:1 for 32 weeks. Liver and GAT were collected for lipid and gene expression analysis. RESULTS The fatty acid profile of liver and GAT reflected the diets. All diets resulted in similar weight gains. Compared to HSF ω-6 diet, the 1:1 ratio diet resulted in lower hepatic total cholesterol (TC) content. Aortic TC was positively correlated with hepatic and GAT TC and triglyceride. These differences were accompanied by significantly lower expression of CD36, ATP-transporter cassette A1, scavenger receptor B class 1, 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR), acetyl-CoA carboxylase alpha, acyl-CoA synthetase long-chain family member 5, and stearoyl-coenzyme A desaturase 1 (SCD1) in GAT, and HMGCR, SCD1 and cytochrome P450 7A1 in liver. CONCLUSIONS Dietary ω-6:EPA+DHA ratios did not affect body weight, but lower ω-6:EPA+DHA ratio diets decreased liver lipid accumulation, which possibly contributed to the lower aortic cholesterol accumulation.
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Affiliation(s)
- Shu Wang
- Department of Nutrition, Texas Tech University, Lubbock, TX 79409, USA.
| | - Nirupa R Matthan
- JM USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA
| | - Dayong Wu
- JM USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA
| | - Debra B Reed
- Department of Nutrition, Texas Tech University, Lubbock, TX 79409, USA
| | - Priyanka Bapat
- Department of Nutrition, Texas Tech University, Lubbock, TX 79409, USA
| | - Xiangling Yin
- Garrison Institute on Aging, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Paula Grammas
- Garrison Institute on Aging, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Chwan-Li Shen
- Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Alice H Lichtenstein
- JM USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA
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Bapat P, Wang S. Effect of nano-encapsulated (-) epigallocatechin gallate on triglyceride accumulation in 3T3-L1 adipocytes. BMC Proc 2012. [PMCID: PMC3374255 DOI: 10.1186/1753-6561-6-s3-p55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bapat P, Jago RH, Joshi RN. Reply. Can J Anaesth 1997. [DOI: 10.1007/bf03011949] [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] Open
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Bapat P, Verghese C. Local anaesthesia to the airway reduces sedation requirements in patients undergoing artificial ventilation. Br J Anaesth 1997; 78:479-80. [PMID: 9135337 DOI: 10.1093/bja/78.4.479-a] [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: 02/04/2023] Open
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Bapat P, Verghese C. Unexpected difficult placement of laryngeal mask airways. Anaesthesia 1997; 52:383; author reply 383-4. [PMID: 9135196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Bapat P, Joshi RN, Young E, Jago RH. Comparison of propofol versus thiopentone with midazolam or lidocaine to facilitate laryngeal mask insertion. Can J Anaesth 1996; 43:564-8. [PMID: 8773861 DOI: 10.1007/bf03011767] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [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: 02/02/2023] Open
Abstract
PURPOSE To assess the ease of insertion of laryngeal mask airway (LMA) comparing propofol with lidocaine or midazolam followed by thiopentone and compare the costs with each technique. METHODS One hundred and fifty ASA 1 or 2 patients equally divided into three groups scheduled for elective surgery were recruited into this prospective, single blind, randomized, parallel groups study. Anaesthetic induction was achieved with 1 microgram.kg-1 fentanyl i.v. followed by either 2.5 mg.kg-1 propofol (group P), or a sequence of 1.5 mg.kg-1 lidocaine and 5 mg.kg-1 thiopentone (group LT), or midazolam 0.1 mg.kg-1 and, three minutes later, 5 mg.kg-1 thiopentone (group MT). The LMA was inserted by the blinded anaesthetist who assessed and graded the conditions for LMA insertion and noted any adverse responses (i.e., inadequate jaw relaxation, gagging, coughing, limb or head movement, hiccough and laryngospasm). Conditions were considered "excellent" if there were no adverse responses, and "satisfactory" if such a response was mild and transient. RESULTS Excellent or satisfactory conditions were observed in 48 (96%) patients in the midazolam-thiopentone group, 46 (92%) in the propofol group, and 34 (68%) in the lidocaine-thiopentone group (P = 0.0001). The incidence of gagging (P = 0.042), limb movement (P = 0.031), and laryngospasm (P = 0.0001) was higher in the lidocaine-thiopentone group. CONCLUSIONS With the above doses, a fentanyl-midazolam-thiopentone combination which is about 35% less expensive than fentanyl-propofol, provides equally good conditions for the insertion of LMA.
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Affiliation(s)
- P Bapat
- Department of Anaesthetics, Royal Berkshire Hospital, Reading, United Kingdom
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