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Müller-Stich BP, Probst P, Nienhüser H, Fazeli S, Senft J, Kalkum E, Heger P, Warschkow R, Nickel F, Billeter AT, Grimminger PP, Gutschow C, Dabakuyo-Yonli TS, Piessen G, Paireder M, Schoppmann SF, van der Peet DL, Cuesta MA, van der Sluis P, van Hillegersberg R, Hölscher AH, Diener MK, Schmidt T. Meta-analysis of randomized controlled trials and individual patient data comparing minimally invasive with open oesophagectomy for cancer. Br J Surg 2021; 108:1026-1033. [PMID: 34491293 DOI: 10.1093/bjs/znab278] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/23/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Minimally invasive oesophagectomy (MIO) for oesophageal cancer may reduce surgical complications compared with open oesophagectomy. MIO is, however, technically challenging and may impair optimal oncological resection. The aim of the present study was to assess if MIO for cancer is beneficial. METHODS A systematic literature search in MEDLINE, Web of Science and CENTRAL was performed and randomized controlled trials (RCTs) comparing MIO with open oesophagectomy were included in a meta-analysis. Survival was analysed using individual patient data. Random-effects model was used for pooled estimates of perioperative effects. RESULTS Among 3219 articles, six RCTs were identified including 822 patients. Three-year overall survival (56 (95 per cent c.i. 49 to 62) per cent for MIO versus 52 (95 per cent c.i. 44 to 60) per cent for open; P = 0.54) and disease-free survival (54 (95 per cent c.i. 47 to 61) per cent versus 50 (95 per cent c.i. 42 to 58) per cent; P = 0.38) were comparable. Overall complication rate was lower for MIO (odds ratio 0.33 (95 per cent c.i. 0.20 to 0.53); P < 0.010) mainly due to fewer pulmonary complications (OR 0.44 (95 per cent c.i. 0.27 to 0.72); P < 0.010), including pneumonia (OR 0.41 (95 per cent c.i. 0.22 to 0.77); P < 0.010). CONCLUSION MIO for cancer is associated with a lower risk of postoperative complications compared with open resection. Overall and disease-free survival are comparable for the two techniques. LAY SUMMARY Oesophagectomy for cancer is associated with a high risk of complications. A minimally invasive approach might be less traumatic, leading to fewer complications and may also improve oncological outcome. A meta-analysis of randomized controlled trials comparing minimally invasive to open oesophagectomy was performed. The analysis showed that the minimally invasive approach led to fewer postoperative complications, in particular, fewer pulmonary complications. Survival after surgery was comparable for the two techniques.
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Affiliation(s)
- B P Müller-Stich
- Department of General, Visceral and Transplant Surgery, Ruprecht Karl University of Heidelberg, Heidelberg, Germany
| | - P Probst
- Department of General, Visceral and Transplant Surgery, Ruprecht Karl University of Heidelberg, Heidelberg, Germany.,The Study Center of the German Surgical Society (SDGC), Ruprecht Karl University of Heidelberg, Heidelberg, Germany
| | - H Nienhüser
- Department of General, Visceral and Transplant Surgery, Ruprecht Karl University of Heidelberg, Heidelberg, Germany
| | - S Fazeli
- Department of General, Visceral and Transplant Surgery, Ruprecht Karl University of Heidelberg, Heidelberg, Germany
| | - J Senft
- Department of General, Visceral and Transplant Surgery, Ruprecht Karl University of Heidelberg, Heidelberg, Germany
| | - E Kalkum
- The Study Center of the German Surgical Society (SDGC), Ruprecht Karl University of Heidelberg, Heidelberg, Germany
| | - P Heger
- Department of General, Visceral and Transplant Surgery, Ruprecht Karl University of Heidelberg, Heidelberg, Germany.,The Study Center of the German Surgical Society (SDGC), Ruprecht Karl University of Heidelberg, Heidelberg, Germany
| | - R Warschkow
- Department of Surgery, Kantonsspital, St. Gallen, Switzerland
| | - F Nickel
- Department of General, Visceral and Transplant Surgery, Ruprecht Karl University of Heidelberg, Heidelberg, Germany
| | - A T Billeter
- Department of General, Visceral and Transplant Surgery, Ruprecht Karl University of Heidelberg, Heidelberg, Germany
| | - P P Grimminger
- Department of General, Visceral and Transplant Surgery, Johannes Gutenberg University, Mainz, Germany
| | - C Gutschow
- Department of Visceral and Transplant Surgery, University Hospital Zurich, Zurich, Switzerland
| | - T S Dabakuyo-Yonli
- Epidemiology and Quality of Life Unit, INSERM 1231, Centre Georges François Leclerc, Dijon, France
| | - G Piessen
- Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France
| | - M Paireder
- Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - S F Schoppmann
- Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - D L van der Peet
- Gastrointestinal and Minimally Invasive Surgery, Vrije University Medical Centre, Amsterdam, the Netherlands
| | - M A Cuesta
- Gastrointestinal and Minimally Invasive Surgery, Vrije University Medical Centre, Amsterdam, the Netherlands
| | - P van der Sluis
- Department of Surgical Oncology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - R van Hillegersberg
- Department of Surgical Oncology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - A H Hölscher
- Contilia Centre for Oesophageal Diseases, Elisabeth Hospital, Essen, Germany
| | - M K Diener
- Department of General, Visceral and Transplant Surgery, Ruprecht Karl University of Heidelberg, Heidelberg, Germany
| | - T Schmidt
- Department of General, Visceral and Transplant Surgery, Ruprecht Karl University of Heidelberg, Heidelberg, Germany
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2
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Jang H, Ma YJ, Chang EY, Fazeli S, Lee RR, Lombardi AF, Bydder GM, Corey-Bloom J, Du J. Inversion Recovery Ultrashort TE MR Imaging of Myelin is Significantly Correlated with Disability in Patients with Multiple Sclerosis. AJNR Am J Neuroradiol 2021; 42:868-874. [PMID: 33602747 DOI: 10.3174/ajnr.a7006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 11/16/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND PURPOSE MR imaging has been widely used for the noninvasive evaluation of MS. Although clinical MR imaging sequences are highly effective in showing focal macroscopic tissue abnormalities in the brains of patients with MS, they are not specific to myelin and correlate poorly with disability. We investigated direct imaging of myelin using a 2D adiabatic inversion recovery ultrashort TE sequence to determine its value in assessing disability in MS. MATERIALS AND METHODS The 2D inversion recovery ultrashort TE sequence was evaluated in 14 healthy volunteers and 31 patients with MS. MPRAGE and T2-FLAIR images were acquired for comparison. Advanced Normalization Tools were used to correlate inversion recovery ultrashort TE, MPRAGE, and T2-FLAIR images with disability assessed by the Expanded Disability Status Scale. RESULTS Weak correlations were observed between normal-appearing white matter volume (R = -0.03, P = .88), lesion load (R = 0.22, P = .24), and age (R = 0.14, P = .44), and disability. The MPRAGE signal in normal-appearing white matter showed a weak correlation with age (R = -0.10, P = .49) and disability (R = -0.19, P = .31). The T2-FLAIR signal in normal-appearing white matter showed a weak correlation with age (R = 0.01, P = .93) and disability (R = 0.13, P = .49). The inversion recovery ultrashort TE signal was significantly negatively correlated with age (R = -0.38, P = .009) and disability (R = -0.44; P = .01). CONCLUSIONS Direct imaging of myelin correlates with disability in patients with MS better than indirect imaging of long-T2 water in WM using conventional clinical sequences.
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Affiliation(s)
- H Jang
- From the Department of Radiology (H.J., Y.-J.M., E.Y.C., S.F., R.R.L., A.F.L., G.M.B., J.D.), University of California San Diego, San Diego, California
| | - Y-J Ma
- From the Department of Radiology (H.J., Y.-J.M., E.Y.C., S.F., R.R.L., A.F.L., G.M.B., J.D.), University of California San Diego, San Diego, California
| | - E Y Chang
- From the Department of Radiology (H.J., Y.-J.M., E.Y.C., S.F., R.R.L., A.F.L., G.M.B., J.D.), University of California San Diego, San Diego, California
- Radiology Service (E.Y.C., R.R.L.), VA San Diego Healthcare System, San Diego, California
| | - S Fazeli
- From the Department of Radiology (H.J., Y.-J.M., E.Y.C., S.F., R.R.L., A.F.L., G.M.B., J.D.), University of California San Diego, San Diego, California
| | - R R Lee
- From the Department of Radiology (H.J., Y.-J.M., E.Y.C., S.F., R.R.L., A.F.L., G.M.B., J.D.), University of California San Diego, San Diego, California
- Radiology Service (E.Y.C., R.R.L.), VA San Diego Healthcare System, San Diego, California
| | - A F Lombardi
- From the Department of Radiology (H.J., Y.-J.M., E.Y.C., S.F., R.R.L., A.F.L., G.M.B., J.D.), University of California San Diego, San Diego, California
| | - G M Bydder
- From the Department of Radiology (H.J., Y.-J.M., E.Y.C., S.F., R.R.L., A.F.L., G.M.B., J.D.), University of California San Diego, San Diego, California
| | - J Corey-Bloom
- Department of Neurosciences (J.C.-B.), University of California San Diego, San Diego, California
| | - J Du
- From the Department of Radiology (H.J., Y.-J.M., E.Y.C., S.F., R.R.L., A.F.L., G.M.B., J.D.), University of California San Diego, San Diego, California
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3
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Settergren C, Savarese G, Thorvaldsen T, Meyers A, Fazeli S, Bueckmann M, Brodovics K, Dalstrom U, H Lund L. P3544Role of cardiovascular comorbidities in heart failure across the ejection fraction spectrum. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0407] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Comorbidities are associated with heart failure (HF) development, severity and outcomes, but may play different roles in HF with preserved (HFpEF) vs. mid-range (HFmrEF) vs. reduced ejection fraction (HFrEF). A detailed characterization of HF patients according to EF and comorbidities may improve prognostication and facilitate trial design.
Purpose
To investigate characteristics and outcomes in a large and unselected cohort of HF patients according to EF strata and presence/absence of concomitant type 2 diabetes (T2DM), atrial fibrillation (AF) and chronic kidney disease (CKD).
Methods
Patients enrolled in the Swedish HF registry between 2000–2012 were considered. Kaplan Meier curves and multivariable Cox regression models were fitted to assess risk and predictors of outcomes (HF and all-cause hospitalization; composite of cardiovascular (CV) death and HF hospitalization).
Results
Of 42,583 patients (23% HFpEF, 21% HFmrEF, 56% HFrEF), 24% had T2DM, 49% CKD defined as eGFR<60 ml/min/1.73m2, and 56% AF. T2DM, AF and CKD coexisted in 8% of the population with similar distribution across all EF strata. AF and CKD were the most likely to coexist. Prevalence of AF and/or CKD was highest in HFpEF and lowest in HFrEF, whereas prevalence of T2DM was similar across the EF spectrum (Figure). Compared to patients without T2DM and/or AF and/or CKD, those with any of them were more likely to suffer from other comorbidities (i.e. hypertension, anemia, COPD), to be inpatients, have more severe HF (higher NYHA class, NT-proBNP levels and use of diuretics, longer HF duration) but less likely to be followed-up in specialty vs. primary care. Concomitant history of ischemic heart disease was more likely in patients with vs. without CKD and/or T2DM but less likely in those with vs without AF.
Patients with vs. without T2DM and/or CKD and/or AF had worse prognosis. In particular, risk of HF hospitalization and composite of HF hospitalization/CV death was highest in patients with HFrEF and concomitant comorbidities, whereas the risk of all-cause hospitalization was highest in those with HFpEF or HFmrEF and concomitant comorbidities. Prognostic predictors of CV death/HF hospitalization were consistent in patients with T2DM, CKD or AF, regardless of EF (e.g. male sex, older age, lower EF category, more severe HF, ischemic heart disease, anemia, COPD).
Comorbidities burden
Conclusion
HF patients show a high burden of concomitant diseases, specifically T2DM, CKD and AF. CKD and AF are more prevalent in HFpEF vs. HFmrEF vs. HFrEF, whereas T2DM prevalence is consistent across the EF spectrum. Presence of comorbidities identifies patients with more severe HF regardless of EF category. Presence of comorbidities may identify patients at higher risk of CV outcomes in HFrEF and those at higher risk of non-CV events in HFpEF.
Acknowledgement/Funding
This study has been supported by funding from Boehringer Ingelheim
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Affiliation(s)
- C Settergren
- Karolinska Institute, Medicine department, Stockholm, Sweden
| | - G Savarese
- Karolinska Institute, Medicine department, Stockholm, Sweden
| | - T Thorvaldsen
- Karolinska Institute, Medicine department, Stockholm, Sweden
| | - A Meyers
- Boehringer Ingelheim Pharmaceuticals, Ridgefield, United States of America
| | - S Fazeli
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | - M Bueckmann
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | - K Brodovics
- Boehringer Ingelheim Pharmaceuticals, Ridgefield, United States of America
| | - U Dalstrom
- Linkopings University, Linköping, Sweden
| | - L H Lund
- Karolinska Institute, Medicine department, Stockholm, Sweden
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Bordon JM, Fernandez-Botran R, Wiemken TL, Peyrani P, Uriarte SM, Arnold FW, Rodriquez-Hernandez L, Rane MJ, Kelley RR, Binford LE, Uppatla S, Cavallazzi R, Blasi F, Aliberti S, Restrepo MI, Fazeli S, Mathur A, Rahmani M, Ayesu K, Ramirez J. Bacteremic pneumococcal pneumonia: clinical outcomes and preliminary results of inflammatory response. Infection 2015; 43:729-38. [PMID: 26424683 DOI: 10.1007/s15010-015-0837-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [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: 12/23/2014] [Accepted: 08/24/2015] [Indexed: 12/24/2022]
Abstract
PURPOSE Further examination of clinical outcomes and inflammatory response of bacteremic pneumococcal community-acquired pneumonia (CAP) is of great interest to enhance the care of patients with pneumococcal CAP. METHODS This is a secondary analysis of the Community Acquired Pneumonia Organization (CAPO) to compare the time to clinical stability (TCS), length of hospital stay (LOS), and in-hospital mortality of hospitalized pneumococcal CAP patients with and without bacteremia. To measure the effect of bacteremia in pneumococcal CAP patients on outcomes, we modeled all-cause in-hospital mortality using a Poisson regression model, and TCS and LOS using Cox proportional hazards models. Adjusted multivariate regression models were also used to predict the probability of occurrence of each of the study outcomes. To investigate the inflammatory response, we measured the plasma levels of pro- and anti-inflammatory cytokines [tumor necrosis factor (TNF)-α, interleukin (IL)-1rα, IL-6, IL-8, IL-10], inflammatory biomarkers [C-reactive protein (CRP), pro-calcitonin (PCT), and B-type natriuretic peptide (BNP)], and peripheral blood neutrophil responses in 10 patients, 4 bacteremic and 6 non-bacteremic pneumococcal CAP, upon admission and every other day during the first 6 days of hospitalization. Functional data were presented as median and standard error of the median (SEM); due to small number of samples no statistical comparisons were performed between groups. RESULTS From 833 pneumococcal CAP patients, 394 patients (47 %) were bacteremic. Bacteremic pneumococcal CAP were less likely to reach TCS with an adjusted hazard ratio (AHR) of 0.82 (95 % CI 0.69-0.97; p = 0.02) and had higher in-hospital mortality with an AHR of 1.63 (95 % CI 1.06-2.50, p = 0.026). Bacteremic pneumococcal CAP patients had a longer LOS than non-bacteremic pneumococcal CAP (p < 0.003). Higher plasma levels of CRP, PCT, and BNP were found in bacteremic than in non-bacteremic patients. The bacteremic group had consistently higher plasma levels of both pro- and anti-inflammatory cytokines. The blood neutrophil functional responses were similar in both groups of patients. CONCLUSIONS Bacteremic pneumococcal CAP patients were significantly associated with higher in-hospital mortality, lower TCS, and longer LOS. HIV-infected patients showed a greater mortality which was not statistically significant. Bacteremic pneumococcal CAP patients had higher levels of biomarkers and systemic cytokines.
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Affiliation(s)
- J M Bordon
- Section of Infectious Diseases, Providence Hospital, Washington, DC, 20017, USA.
| | - R Fernandez-Botran
- Department of Pathology and Laboratory Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - T L Wiemken
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - P Peyrani
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - S M Uriarte
- Division of Nephrology, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - F W Arnold
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - L Rodriquez-Hernandez
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - M J Rane
- Division of Nephrology, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - R R Kelley
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - L E Binford
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - S Uppatla
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - R Cavallazzi
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - F Blasi
- Department of Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Ca` Granda Ospedale Maggiore, Milan, Italy
| | - S Aliberti
- Respiratory Unit, Department of Health Science, University of Milan Bicocca, AO San Gerardo, Monza, Italy
| | - M I Restrepo
- Department of Pulmonary Diseases, South Texas Veterans Health Care System and University of Texas at San Antonio, San Antonio, TX, USA
| | - S Fazeli
- Section of Infectious Diseases, Providence Hospital, Washington, DC, 20017, USA
| | - A Mathur
- Section of Infectious Diseases, Providence Hospital, Washington, DC, 20017, USA
| | - M Rahmani
- Section of Infectious Diseases, Providence Hospital, Washington, DC, 20017, USA
| | - K Ayesu
- Department of Internal Medicine, Orlando Health, Florida, USA
| | - J Ramirez
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA.,Veterans Administration Medical Center, Louisville, KY, USA
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Fazeli S, Bamberg C, Brauer M, Mayer B, Salama A, Hüsemann D, Hinkson L, Henrich W. Perinatales Management bei fetaler Anämie durch irreguläre Antikörper: 2 Fälle schwerer fetaler Anämie bei Alloimmunisierung durch Anti-cellano- Antikörper und Anti-Rh 17- Antikörper. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361472] [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: 10/26/2022]
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Werdehausen R, Fazeli S, Braun S, Hermanns H, Essmann F, Hollmann MW, Bauer I, Stevens MF. Apoptosis induction by different local anaesthetics in a neuroblastoma cell line. Br J Anaesth 2009; 103:711-8. [PMID: 19700777 DOI: 10.1093/bja/aep236] [Citation(s) in RCA: 148] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Werdehausen
- Department of Anaesthesiology, University of Düsseldorf, Düsseldorf, Germany
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Walsh FS, Hobbs C, Wells DJ, Slater CR, Fazeli S. Ectopic expression of NCAM in skeletal muscle of transgenic mice results in terminal sprouting at the neuromuscular junction and altered structure but not function. Mol Cell Neurosci 2000; 15:244-61. [PMID: 10736202 DOI: 10.1006/mcne.1999.0815] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The neuromuscular system provides an excellent model for the analysis of molecular interactions involved in the development and plasticity of synaptic contacts. The neural cell adhesion molecule (NCAM) is believed to be involved in the development and plasticity of the neuromuscular junction, in particular the axonal sprouting response observed in paralyzed and denervated muscle. In order to explore the role of myofiber NCAM in modulating the differentiation of motor neurons, we generated transgenic mice expressing a GPI-anchored NCAM isoform that is normally found in developing and denervated muscle, under the control of a skeletal muscle-specific promoter. This results in the constitutive expression of NCAM at postnatal ages, a time when the endogenous mouse NCAM is absent from the myofiber. We found that a significant number of neuromuscular junctions in adult transgenic animals displayed terminal sprouting (>20%) reminiscent of that elicited in response to cessation of neuromuscular activity. Additionally, a significant increase in the size and complexity of neuromuscular synapses as a result of extensive intraterminal sprouting was detected. Electrophysiological studies, however, revealed no significant alterations of neuromuscular transmission at this highly efficient synapse. Sprouting in response to paralysis or following nerve crush was also significantly enhanced in transgenic animals. These results suggest that in this ectopic expression model NCAM can directly modulate synaptic structure and motor neuron-muscle interactions. The results contrast with knockout experiments of the NCAM gene, where very limited changes in the neuromuscular system were observed.
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Affiliation(s)
- F S Walsh
- Department of Neuroscience Research, SmithKline Beecham Pharmaceuticals, New Frontiers Science Park North, Third Avenue, Harlow, Essex, CM19 5AW, United Kingdom
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8
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Fazeli S, Wells DJ, Hobbs C, Walsh FS. Altered secondary myogenesis in transgenic animals expressing the neural cell adhesion molecule under the control of a skeletal muscle alpha-actin promoter. J Cell Biol 1996; 135:241-51. [PMID: 8858177 PMCID: PMC2121031 DOI: 10.1083/jcb.135.1.241] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The majority of skeletal muscle fibers are generated through the process of secondary myogenesis. Cell adhesion molecules such as NCAM are thought to be intricately involved in the cell-cell interactions between developing secondary and primary myotubes. During secondary myogenesis, the expression of NCAM in skeletal muscle is under strict spatial and temporal control. To investigate the role of NCAM in the regulation of primary-secondary myotube interactions and muscle fusion in vivo, we have examined muscle development in transgenic mice expressing the 125-kD muscle-specific, glycosylphosphatidylinositol-anchored isoform of human NCAM, under the control of a human skeletal muscle alpha-actin promoter that is active from about embryonic day 15 onward. Analysis of developing muscle from transgenic animals revealed a significantly lower number of myofibers encased by basal lamina at postnatal day 1 compared with nontransgenic littermates, although the total number of developing myofibers was similar. An increase in muscle fiber size and decreased numbers of VCAM-1-positive secondary myoblasts at postnatal day 1 was also found, indicating enhanced secondary myoblast fusion in the transgenic animals. There was also a significant decrease in myofiber number but no increase in overall muscle size in adult transgenic animals; other measurements such as the number of nuclei per fiber and the size of individual muscle fibers were significantly increased, again suggesting increased secondary myoblast fusion. Thus the level of NCAM in the sarcolemma is a key regulator of cell-cell interactions occurring during secondary myogenesis in vivo and fulfills the prediction derived from transfection studies in vitro that the 125-kD NCAM isoform can enhance myoblast fusion.
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MESH Headings
- Actins/genetics
- Animals
- Cell Communication
- Cell Fusion
- Cell Size
- DNA/analysis
- Gene Dosage
- Gene Expression Regulation, Developmental
- Glycosylphosphatidylinositols
- Humans
- Integrin alpha4beta1
- Integrins/analysis
- Mice
- Mice, Transgenic
- Morphogenesis
- Muscle Development
- Muscle Fibers, Skeletal/chemistry
- Muscle Fibers, Skeletal/cytology
- Muscle, Skeletal/chemistry
- Muscle, Skeletal/cytology
- Muscle, Skeletal/growth & development
- Neural Cell Adhesion Molecules/analysis
- Neural Cell Adhesion Molecules/genetics
- Neural Cell Adhesion Molecules/physiology
- Promoter Regions, Genetic/genetics
- RNA, Messenger/analysis
- Receptors, Lymphocyte Homing/analysis
- Vascular Cell Adhesion Molecule-1/analysis
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Affiliation(s)
- S Fazeli
- Department of Experimental Pathology, UMDS, Guy's Hospital, London, United Kingdom
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