1
|
Gordan LN, Ray D, Ijioma SC, Dranitsaris G, Warner A, Heritage T, Fink M, Wenk D, Chadwick P, Khrystolubova N, Peles S. Impact of a Best Practices Program in Patients with Relapsed/Refractory Multiple Myeloma Receiving Selinexor. Curr Oncol 2024; 31:501-510. [PMID: 38248119 PMCID: PMC10814155 DOI: 10.3390/curroncol31010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/31/2023] [Accepted: 01/12/2024] [Indexed: 01/23/2024] Open
Abstract
Best practice (BP) in cancer care consists of a multifaceted approach comprising individualized treatment plans, evidence-based medicine, the optimal use of supportive care and patient education. We investigated the impact of a BP program in patients with relapsed/refractory multiple myeloma (RRMM) receiving selinexor. Features of the BP program that were specific to selinexor were initiating selinexor at doses ≤80 mg once weekly and the upfront use of standardized antiemetics. Study endpoints included time to treatment failure (TTF), duration of therapy, dose limiting toxicities and overall survival. Comparative analysis on TTF and duration of therapy was conducted using a log-rank test and multivariate Cox proportional hazard regression. Over the ensuing 12-month post-BP period, 41 patients received selinexor-based therapy compared to 68 patients who received selinexor-based therapy pre-BP implementation. Patients treated in the post-BP period had reductions in TTF (hazard ratio [HR] = 0.50; 95% CI: 0.27 to 0.92). Patients in the pre-BP period were four times more likely to stop therapy than those in the post-period (odds ratio [OR] = 4.0, 95% CI: 1.75 to 9.3). The findings suggest a BP program tailored to selinexor could increase the time to treatment failure, increase treatment duration and lower the incidence of drug limiting toxicities.
Collapse
Affiliation(s)
- Lucio N. Gordan
- Florida Cancer Specialists and Research Institute, Tampa, FL 33609, USA
| | - David Ray
- Karyopharm Therapeutics Inc., Newton, MA 02459, USA
| | | | - George Dranitsaris
- Department of Public Health, Syracuse University, Syracuse, NY 13244, USA
| | - Amanda Warner
- Florida Cancer Specialists and Research Institute, Tampa, FL 33609, USA
| | - Trevor Heritage
- Florida Cancer Specialists and Research Institute, Tampa, FL 33609, USA
| | - Matthew Fink
- Florida Cancer Specialists and Research Institute, Tampa, FL 33609, USA
| | - David Wenk
- Florida Cancer Specialists and Research Institute, Tampa, FL 33609, USA
| | - Paul Chadwick
- Florida Cancer Specialists and Research Institute, Tampa, FL 33609, USA
| | | | - Shachar Peles
- Florida Cancer Specialists and Research Institute, Tampa, FL 33609, USA
| |
Collapse
|
2
|
Nguyen V, Alcius P, Peles S, Hodgin K. A Fresh Breath of Oxygen: Red Blood Cell Exchange Transfusion in Sickle Cell and COVID-19. Clin Case Rep 2021; 9:e04655. [PMID: 34466242 PMCID: PMC8385183 DOI: 10.1002/ccr3.4655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/15/2021] [Revised: 06/20/2021] [Accepted: 07/05/2021] [Indexed: 12/19/2022] Open
Abstract
Red blood cell exchange transfusion may be beneficial and should be considered in the early management of patients with sickle cell disease and COVID-19 to prevent the need for intubation and intensive care unit admission due to respiratory distress.
Collapse
Affiliation(s)
| | | | - Shachar Peles
- Florida Cancer Specialists & Research InstituteLake WorthFLUSA
| | | |
Collapse
|
3
|
Abstract
A 36-year-old female with no significant past medical history presented with sudden onset of crushing substernal chest pain. When the emergency medical services (EMS) arrived, she had a cardiac arrest requiring defibrillation two times in the field prior to arriving at the hospital. In the emergency department (ED), the electrocardiogram (ECG) was significant for ST-elevation that suggested acute anterolateral infarct. Her laboratory evaluation also showed a platelet count of 1095 x 103/ul. Also, her troponin levels were at 0.16 ng/ml at the time of arrival and peaked at 42.8 ng/ml. She immediately underwent a cardiac catheterization which showed 100% occlusion of her left anterior descending (LAD) artery by a thrombus, which was then treated with a thrombectomy and a single drug-eluting stent was placed. Upon further work-up of her thrombocytosis, the patient had a bone marrow biopsy showing megakaryocytic hyperplasia which no evidence of fibrosis. She was tested for Janus kinase 2 (JAK2) mutation which was positive. The patient was diagnosed with essential thrombocytosis (ET) and was started on cytoreduction therapy with hydroxyurea. Her platelet counts responded appropriately and dropped to less than 500 x 103 at the time of discharge.
Collapse
Affiliation(s)
- Purva Sharma
- Internal Medicine, University of Miami Miller School of Medicine, Atlantis, USA
| | - Sameer Gupta
- Internal Medicine, University of Miami Miller School of Medicine, Atlantis, USA
| | - Pankit Patel
- Internal Medicine, University of Miami Miller School of Medicine, Atlantis, USA
| | | | | |
Collapse
|
4
|
Sharma P, Donath E, Byron B, Peles S. Study of clinical characteristics of breast cancer among women older than 70 years in a single institute. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e12578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Elie Donath
- University of Miami, Miller School of Medicine, Palm Beach Regional Campus, Atlantis, FL
| | - Beth Byron
- Florida Cancer Specialists, Atlantis, FL
| | | |
Collapse
|
5
|
Sharma P, Hakimian S, Jobanputra Y, Peles S, Byron B. Prevention of chemo-induced cardiotoxicity with ACE inhibitors and angiotensin receptor blockers. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e14513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Beth Byron
- Florida Cancer Specialists, Atlantis, FL
| |
Collapse
|
6
|
Collins G, Noy A, de Vos S, Thieblemont C, Martin P, Flowers C, Morschhauser F, Ma S, Coleman M, Peles S, Smith S, Barrientos J, Smith A, Munneke B, Dimery I, Beaupre D, Chen R. Safety and efficacy of single-agent ibrutinib in patients with relapsed/refractory (R/R) marginal zone lymphoma (MZL): A multicenter, open-label, phase 2 study. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_76] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- G.P. Collins
- Department of Haematology; Oxford University Hospitals NHS Foundation Trust; Oxford UK
| | - A. Noy
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center; New York USA
| | - S. de Vos
- Division of Hematology/Oncology; David Geffen School of Medicine at UCLA; Los Angeles USA
| | - C. Thieblemont
- APHP; Hopital Saint-Louis-Paris Diderot University, Hemato-oncology Department; Paris France
| | - P. Martin
- Division of Hematology/Oncology; Weill Cornell Medical College; New York USA
| | - C. Flowers
- Department of Hematology and Medical Oncology; Winship Cancer Institute of Emory University; Atlanta USA
| | - F. Morschhauser
- Hematologie; Centre Hospitalier Universitaire, Université de Lille, EA GRIIOT; Lille Cedex France
| | - S. Ma
- Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine; Northwestern University; Chicago USA
| | - M. Coleman
- Division of Hematology and Medical Oncology, Center for Lymphoma and Myeloma; New York-Presbyterian Hospital and Weill Medical College; New York USA
| | - S. Peles
- Hematology; Florida Cancer Specialists; Atlantis USA
| | - S. Smith
- Department of Medicine and Clinical Research Division, Division of Medical Oncology; University of Washington and Fred Hutchinson Cancer Research Center; Seattle USA
| | - J. Barrientos
- Clinical Research Division, Fred Hutchinson Cancer Research Center; Hempstead USA
| | - A. Smith
- Clinical Operations, Pharmacylics LLC, an Abbvie Company; Sunnyvale USA
| | - B. Munneke
- Biostatistics; Pharmacylics LLC, an Abbvie Company; Sunnyvale USA
| | - I. Dimery
- Clinical Operations, Pharmacylics LLC, an Abbvie Company; Sunnyvale USA
| | - D. Beaupre
- Clinical Operations, Pharmacylics LLC, an Abbvie Company; Sunnyvale USA
| | - R. Chen
- Hematology/Oncology; City of Hope National Medical Center; Duarte USA
| |
Collapse
|
7
|
Safra T, Borgato L, Nicoletto M, Rolnitzky L, Curtin J, Geva R, Peles S, Grenader T, Gabizon A, Muggia F. Pegylated liposomal doxorubicin (PLD) treatment for recurrent epithelial ovarian cancer (rEOC): Implications of BRCA mutations. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.5043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
8
|
Asna N, Peles S, Slutzky L, Vexler A, Ben-Yosef R. Cetuximab and Carboplatin in Combination with Radiation Therapy in Locally Advanced Squamous Cell Carcinoma of the Head and Neck. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
9
|
Peles S, Medda BK, Zhang Z, Banerjee B, Lehmann A, Shaker R, Sengupta JN. Differential effects of transient receptor vanilloid one (TRPV1) antagonists in acid-induced excitation of esophageal vagal afferent fibers of rats. Neuroscience 2009; 161:515-25. [PMID: 19324074 DOI: 10.1016/j.neuroscience.2009.03.040] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2009] [Revised: 02/17/2009] [Accepted: 03/17/2009] [Indexed: 12/17/2022]
Abstract
Gastro-esophageal acid reflux can stimulate esophageal vagal sensory afferents by activating proton-sensitive ion channel transient receptor vanilloid one (TRPV1). The objective of this study was to investigate the response characteristics of vagal afferent fibers of rats to acid (0.1 N HCl) and capsaicin (CAP) following esophagitis and differential effects of two classes of TRPV1 antagonists on responses of vagal afferent fibers. The chronic reflux was induced by ligating the fundus of the stomach and partial constriction of pylorus. Extracellular single fiber recordings were made from the cervical vagal afferent fibers from naive control and fundus-ligated (FL) esophagitis rats. Innervations of fibers were identified to esophageal distension (ED) and subsequently tested to CAP and acid before and after injection of TRPV1 antagonist JYL1421 or AMG9810 (10 micromol/kg i.v.). Seventy-five vagal afferent fibers from 70 rats were identified to ED. Intra-esophageal CAP (0.1 ml of 1 mg/ml) excited 39.5% (17/43, 5/22 from naive and 12/21 from FL rats) fibers. In contrast, i.v. injection of CAP (0.03-0.3 micromol/kg) dose-dependently excited 72% (42/58) fibers. Responses to CAP were significantly greater for fibers from FL rats (n=32) than naive rats (n=25). TRPV1 antagonists JYL1421 and AMG9810 (10 micromol/kg) significantly blocked response to CAP. Intra-esophageal acid infusion stimulated 5/17 (29.4%) fibers from naive rats and 12/28 (42%) from FL rats. Effect of acid was significantly blocked by AMG9810, but not by JYL1421. Results indicate that following esophagitis the number of fibers responsive to CAP and acid is greater than noninflamed esophagus, which may contribute to esophageal hypersensitivity. Acid-induced excitation of vagal sensory afferents can be differentially attenuated by different classes of TRPV1 antagonists. Therefore, TRPV1 antagonists play a key role in attenuation of hypersensitivity following reflux-induced esophagitis. The use of TRPV1 antagonists could be an alternative to the traditional symptoms-based treatment of chronic acid reflux and esophageal hypersensitivity.
Collapse
Affiliation(s)
- S Peles
- Division of Gastroenterology and Hepatology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | | | | | | | | | | | | |
Collapse
|
10
|
Uy GL, Trivedi R, Peles S, Fisher NM, Zhang QJ, Tomasson MH, DiPersio JF, Vij R. Bortezomib inhibits osteoclast activity in patients with multiple myeloma. ACTA ACUST UNITED AC 2008; 7:587-9. [PMID: 18186967 DOI: 10.3816/clm.2007.n.045] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The antimyeloma agent bortezomib functions as an inhibitor of nuclear factor (NF)-kappaB. Although NF-kappaB inhibition is predicted to affect osteoclast function, preclinical and clinical studies have primarily reported an effect on osteoblasts. PATIENTS AND METHODS We examined parameters of bone turnover prospectively in patients with multiple myeloma treated with bortezomib before and after autologous transplantation. Thirty-nine patients received 2 cycles of bortezomib on days 1, 4, 8, and 11 of a 21-day cycle. After high-dose melphalan with autologous stem cell transplantation, bortezomib 1.3 mg/m2 on days 1, 8, 15, and 22 of a 5-week cycle was administered as maintenance therapy. RESULTS During posttransplantation bortezomib, decreases in the urinary excretion of collagen N-telopeptide indicated that bortezomib suppresses osteoclast function. CONCLUSION The effects on osteoclasts occurred in the absence of bisphosphonate treatment and independently of changes in monoclonal protein levels. Further studies exploring the role of bortezomib as a bone protective agent could be warranted.
Collapse
Affiliation(s)
- Geoffrey L Uy
- Section of Bone Marrow Transplant and Leukemia, Division of Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Miranda A, Peles S, McLean PG, Sengupta JN. Effects of the 5-HT3 receptor antagonist, alosetron, in a rat model of somatic and visceral hyperalgesia. Pain 2006; 126:54-63. [PMID: 16844296 DOI: 10.1016/j.pain.2006.06.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [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: 01/13/2006] [Revised: 05/26/2006] [Accepted: 06/09/2006] [Indexed: 01/03/2023]
Abstract
Conflicting results exist regarding the role of 5-HT3 receptors in somatic and visceral nociceptive processing. We aimed to investigate the effects of the 5-HT3 receptor antagonist, alosetron, in a rat model of somatic and visceral hyperalgesia. Two injections (100 microl) of either pH 4.0 or 7.2 saline were given unilaterally in the gastrocnemius (GN) muscle. In all groups, the paw withdrawal thresholds (PWT) to von Frey filaments and the visceromotor responses (VMR) to colorectal distension (CRD) were recorded before the saline injections and 72 h, and 1 week after the second injection. Intrathecal (i.t.) (25 nmol) or intravenous (i.v.) (100 microg/kg/day) alosetron was given daily following the second injection and compared to either i.v. or i.t. saline (vehicle). There was a significant decrease in the mean PWT bilaterally in all groups following pH 4.0 injections (p<0.05). Intravenous alosetron resulted in a significant increase in the PWT bilaterally on days 2 and 3. Intrathecal alosetron resulted in significant increase in the PWT starting at day 3 and was significantly higher than baseline on days 4-7 (p<0.05). At CRD pressures 30 mmHg, the VMR of pH 4.0 injected rats was significantly increased at 72 h and 1 week (p<0.05). Both i.v. and i.t. alosetron treated rats failed to demonstrate any alteration in the VMR. Control rats (pH 7.2) failed to show any alteration in the VMR and were unaffected by alosetron. Both, systemically and centrally administered alosetron, reversed the mechanical somatic hypersensitivity and prevented the development of visceral hyperalgesia, suggesting a centrally mediated effect.
Collapse
Affiliation(s)
- Adrian Miranda
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
| | | | | | | |
Collapse
|
12
|
Miranda A, Peles S, Shaker R, Rudolph C, Sengupta JN. Neonatal nociceptive somatic stimulation differentially modifies the activity of spinal neurons in rats and results in altered somatic and visceral sensation. J Physiol 2006; 572:775-87. [PMID: 16513666 PMCID: PMC1779998 DOI: 10.1113/jphysiol.2006.108258] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [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] [Indexed: 01/16/2023] Open
Abstract
The role ofintramuscular, low pH saline injections during the neonatal period in the development and maintenance of visceral hyperalgesia has not been systematically studied. We aimed to investigate alterations in visceral sensation and neural circuitry that result from noxious stimuli in early life. Neonatal male Sprague-Dawley rats received sterile saline injections of pH 4.0 or 7.4 in the gastrocnemius muscle starting at postnatal day 8. Injections were given unilaterally every other day for 12 days ending on postnatal day 20. A third group received needle prick only on the same shedule as the second group, while a fourth group was left naïve. At 2 months of age, rats underwent assessment of cutaneous and deep somatic sensitivity using von Frey filaments and gastrocnemius muscle pinch, respectively. A visceromotor response (VMR) to graded colorectal distension (CRD; 10-80 mmHg for 30 s with 180 s interstimulus intervals) was recorded. Extracellular single-unit recordings from the thoracolumbar spinal neurons (T13-L1) were performed in adult pH 4.0 injected and naïve controls. There was no difference in the threshold for response to mechanical stimulation of the paw in rats injected with pH 4.0 saline compared to all other groups. Conversely, rats treated with pH 4.0 saline showed a significant bilateral reduction in withdrawal threshold to muscle pinch as adults (P < 0.05). At colorectal distensions > or = 20 mmHg, an increase in the VMR was observed in the pH 4.0 injected group compared to all other groups (P < 0.05). Spinal neurons were classified as short latency abrupt (SL-A) or short latency sustained (SL-S). Spontaneous firing of SL-S (20.6 +/- 2.2 impulses s(-1)), but not SL-A neurons (5.3 +/- 0.9 impulses s(-1)) in the pH 4.0 treated rats was significantly higher than in control rats (SL-S, 2.6 +/- 0.8 impulses s(-1); SL-A, 3.1 +/- 0.7 impulses s(-1)). The response of SL-S neurons to CRD in the pH 4.0 group was significantly higher at distension pressures > or = 20 mmHg. Nociceptive somatic stimulation in neonatal rats results in chronic deep somatic and visceral hyperalgesia in adulthood. Colorectal distension-sensitive SL-S neurons are primarily sensitized to neonatal somatic stimulation.
Collapse
Affiliation(s)
- Adrian Miranda
- Division of Gastroenterology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
| | | | | | | | | |
Collapse
|
13
|
Peles S, Fisher NM, Gao F, Tomasson MH, Dipersio JF, Vij R. A prospective study of the effects of once weekly bortezomib on markers of bone metabolism in patients with multiple myeloma (MM). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7548] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7548 Background: Increased osteoclast activity in MM leads to bone resorption, osteoporosis and osteolytic bone lesions. Urinary excretion of N-telopeptide (NTX), a marker of bone resorption, decreases by 20–70% following treatment with bisphosphonates. Preclinical studies have shown bortezomib to decrease osteoclast function through inhibition of NF-kB. However, no clinical data exists on the effect of bortezomib on markers of bone resorption. Methods: Six cycles of consolidation bortezomib 1.3mg/m2 were given once weekly for 4 of every 5 weeks, 90–120 days post transplant. Urinary NTX excretion and serum osteocalcin were measured on day 1 of cycles 1, 2 and 3 of therapy. Bisphosphonates were prohibited from 42 days prior to stem cell collection and until cycle 3 of consolidation therapy. Results: 33 of 40 enrolled patients received bortezomib consolidation. Patient population and disease characteristics (no. of patients): male (22), female (11), median age 56 years (range 39–70), Stage II (9), Stage III (24), IgG (22), IgA (9), free light chain (2). The median duration between discontinuation of bisphosphonates and initiation of consolidation bortezomib was 158 days (Range 110–196). Only one patient had a >50% reduction in myeloma paraprotein. Nevertheless, excretion of NTX declined by a mean of 32% over baseline values after 2 cycles of consolidation therapy. The only patient with an increase in NTX of >30% was also the only patient with evidence of disease progression during this period of therapy. Contrary to reports of proteasome inhibition resulting in increased osteoblastic bone formation, a decline was seen in osteocalcin. Conclusions: Bortezomib has an inhibitory effect on osteoclastic bone resorption in MM similar to that with bisphosphonates even in the absence of effects on malignant plasma cells. Bisphosphonates may result in nephrotoxicity and osteonecrosis of the jaw and bortezomib represents an alternative agent that may control both the myeloma and bone disease. [Table: see text] No significant financial relationships to disclose.
Collapse
Affiliation(s)
- S. Peles
- Washington University, St. Louis, MO
| | | | - F. Gao
- Washington University, St. Louis, MO
| | | | | | - R. Vij
- Washington University, St. Louis, MO
| |
Collapse
|
14
|
Uy G, Peles S, Fisher N, Tomasson M, DiPersio J, Vij R. Bortezomib prior to autologous transplant in multiple myeloma: Effects on mobilization, engraftment, and markers of immune function. Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.355] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
15
|
Peles S, Uy G, Fisher N, Tomasson M, DiPersio J, Vij R. High rates of reactivation of varicella zoster virus (VZV) associated with bortezomib (VELCADE) when given pre and post high dose chemotherapy (HDCT). Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.357] [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: 11/30/2022]
|
16
|
Peles S, Miranda A, Shaker R, Sengupta JN. Acute nociceptive somatic stimulus sensitizes neurones in the spinal cord to colonic distension in the rat. J Physiol 2004; 560:291-302. [PMID: 15284340 PMCID: PMC1665216 DOI: 10.1113/jphysiol.2004.069070] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2004] [Accepted: 07/26/2004] [Indexed: 12/20/2022] Open
Abstract
The common co-existence of fibromyalgia and chronic abdominal pain could be due to sensitization of spinal neurones (SNs), as a result of viscero-somatic convergence. The objective of this study is to explore the influence of acute nociceptive somatic stimulation in the form of acid injections, into the ipsilateral somatic receptive field of neurones responsive to colorectal distension (CRD), and the potential role of ionotropic glutamate receptors on sensitization. Action potentials of CRD-sensitive SNs were recorded extracellularly from the lumbar (L(2)-L(5)) spinal cord. Stimulus-response functions (SRFs) to graded CRD (10-80 mmHg, 30 s) were constructed before and 30 min after ipsilateral injection of low pH (4.0, 100 microl) saline into the somatic receptive fields. In some experiments, cervical (C(1)-C(2)) spinalization was performed to eliminate supraspinal influence. The selective NMDA receptor antagonist CGS 19755 and AMPA receptor antagonist NBQX were injected (25 micromol kg(-1), i.v.) to examine their influence on sensitization. Three types of neurones were characterized as short-latency abrupt (SLA, n = 24), short latency sustained (SLS, n = 12), and long-latency (LL, n = 6) to CRD. Ipsilateral injection of low pH (4.0) in the somatic receptive field, but not the contralateral gastrocnemius (GN) or front leg muscles, sensitized responses of these neurones to CRD. Spinalization had no influence on the development of low pH-induced sensitization. Both CGS 19755 and NBQX significantly attenuated the sensitized response to CRD in intact and spinalized animals. Acute nociceptive somatic stimulus sensitizes CRD-sensitive SNs receiving viscero-somatic convergence. The sensitization occurs at the spinal level and is independent of supraspinal influence. Ionotropic glutamate receptors in the spinal cord are involved in sensitization.
Collapse
Affiliation(s)
- Shachar Peles
- Division of Gastroenterology and Hepatology, MaccFund Research Center, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | | | | | | |
Collapse
|
17
|
Sengupta JN, Petersen J, Peles S, Shaker R. Response properties of antral mechanosensitive afferent fibers and effects of ionotropic glutamate receptor antagonists. Neuroscience 2004; 125:711-23. [PMID: 15099685 DOI: 10.1016/j.neuroscience.2004.02.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [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] [Accepted: 02/05/2004] [Indexed: 11/19/2022]
Abstract
The ionotropic glutamate receptors N-methyl-d-aspartate (NMDA) and alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors are present peripherally in the primary sensory afferent neurons innervating the viscera. Multiple studies have reported roles of glutamate receptors in gastric functions. However, no study has previously shown the direct influence of ionotropic glutamate receptor antagonist on vagal sensory neurons. The objective of this study was to investigate the effects of NMDA and AMPA receptor antagonists on mechanotransduction properties of vagal afferent fibers innervating the rat stomach. Action potentials were recorded from the hyponodal vagus nerve innervating the antrum of the Long-Evans rats. For antral distension (AD), a small latex balloon was inserted into the stomach and positioned in the antrum. The antral contractions were recorded with solid-state probe inserted into the water-filled balloon. Antral units were identified to isovolumic (0.2-1 ml) or isobaric AD (5-60 mm Hg). NMDA and AMPA receptor antagonists were injected in a cumulative fashion (1-100 micromol/kg, i.v.). After the conclusion of experiment, the abdomen was opened and receptive field was mapped by probing the serosa of the stomach. Thirty-two fibers were identified to AD. The receptive fields of 26 fibers were located in the posterior part of the antrum. All fibers exhibited spontaneous firing (mean: 7.00+/-0.97 impulses/s). Twenty fibers exhibited a rhythmic firing that was in phase with antral contractions, whereas 12 fibers exhibited non-rhythmic spontaneous firing unrelated to spontaneous antral contraction. Both groups of fibers exhibited a linear increase in responses to graded isovolumic or isobaric distensions. NMDA (memantine HCl and dizocilpine (MK-801)) and AMPA/kainate (6-cyano-7-nitroquinoxaline 2,3-dione; CNQX) receptor antagonists dose-dependently attenuated the mechanotransduction properties of these fibers to AD. However, competitive NMDA antagonist dl-2-amino-5 phosphopentanoic acid (AP-5) had no effect. The study documents that glutamate receptor antagonists can attenuate responses of gastric vagal sensory afferent fibers innervating the distal stomach, offering insight to potential pharmacological agents in the treatment of gastric disorders.
Collapse
MESH Headings
- Action Potentials/drug effects
- Action Potentials/physiology
- Animals
- Dilatation/instrumentation
- Dilatation/methods
- Dose-Response Relationship, Drug
- Excitatory Amino Acid Antagonists/pharmacology
- Glutamic Acid/metabolism
- Male
- Mechanoreceptors/drug effects
- Mechanoreceptors/metabolism
- Mechanotransduction, Cellular/drug effects
- Mechanotransduction, Cellular/physiology
- Muscle Contraction/drug effects
- Muscle Contraction/physiology
- Muscle, Smooth/drug effects
- Muscle, Smooth/physiology
- Neurons, Afferent/drug effects
- Neurons, Afferent/metabolism
- Physical Stimulation/instrumentation
- Physical Stimulation/methods
- Pyloric Antrum/drug effects
- Pyloric Antrum/innervation
- Pyloric Antrum/physiology
- Rats
- Rats, Long-Evans
- Receptors, AMPA/antagonists & inhibitors
- Receptors, AMPA/metabolism
- Receptors, Glutamate/drug effects
- Receptors, Glutamate/metabolism
- Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors
- Receptors, N-Methyl-D-Aspartate/metabolism
- Vagus Nerve/drug effects
- Vagus Nerve/physiology
- Visceral Afferents/drug effects
- Visceral Afferents/metabolism
Collapse
Affiliation(s)
- J N Sengupta
- Division of Gastroenterology and Hepatology, MaccFund Research Center, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
| | | | | | | |
Collapse
|
18
|
Abstract
BACKGROUND & AIMS Patients with fibromyalgia commonly have symptoms of abdominal pain, suggesting that altered somatic afferent activity may influence visceral sensations. It is hypothesized that a noxious somatic stimulus increases input to the projection neurons in the dorsal horn, resulting in visceral hyperalgesia. METHODS Two injections (100 microL, pH 4.0) were given unilaterally in the gastrocnemius muscle 2 days apart in male Sprague-Dawley rats. Paw withdrawal reflex (PWR) was measured to assess somatic pain. The control group received pH 7.2 saline injections. Similar injections (pH 4.0) were given in the front leg in a different group. Electromyography (EMG) from the external oblique muscle was recorded to graded colorectal distention at different time intervals. NMDA receptor antagonist (CGS-19755, 20 nmol) or AMPA/kainate receptor antagonist (NBQX, 20 nmol) was injected intrathecally before low-pH injections. RESULTS A bilateral decrease in PWR threshold occurred 72 hours after the second low-pH injection. There was no decrease in the threshold in rats injected with pH 7.2 saline. A significant increase in EMG to colorectal distention (> or =30 mm Hg) occurred at 72 hours and 2 weeks in the pH 4.0 group. No change in EMG was observed following 2 unilateral low-pH injections in the front leg. Both the visceral hyperalgesia and the decrease in somatic pain thresholds were prevented by prior intrathecal CGS-19755 or NBQX injections. CONCLUSIONS Noxious somatic afferent input from the hind limb facilitates visceral hyperalgesia, which is due to viscerosomatic convergence in the lower spinal cord. This can be blocked by ionotropic glutamate receptor antagonists.
Collapse
Affiliation(s)
- Adrian Miranda
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, 53226, USA
| | | | | | | | | |
Collapse
|
19
|
Peles S, Petersen J, Aviv R, Policker S, Abu-Hatoum O, Ben-Haim SA, Gutterman DD, Sengupta JN. Enhancement of antral contractions and vagal afferent signaling with synchronized electrical stimulation. Am J Physiol Gastrointest Liver Physiol 2003; 285:G577-85. [PMID: 12801883 DOI: 10.1152/ajpgi.00109.2003] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Gastric filling activates vagal afferents involved in peripheral signaling to the central nervous system (CNS) for food intake. It is not known whether these afferents linearly encode increasing contractions of the antrum during antral distension (AD). The aim of this study was to investigate effects of AD and electrically enhanced antral contractions on responses of vagal afferents innervating the antrum. Single-fiber recordings were made from the vagal afferents in anesthetized male Long-Evans rats. Antral contractions were measured with a solid-state probe placed in the antrum. A nonexcitatory electrical stimulation (NES) inducing no smooth muscle contractions was applied during the ascending phase of antral contractions to enhance subsequent antral contractions. Fifty-six fibers identified during AD (1 ml for 30 s) were studied through different types of mechanical stimuli. Under normal conditions, one group of fibers exhibited rhythmic firing in phase with antral contractions. Another group of fibers had nonrhythmic spontaneous firing. Responses of 15 fibers were tested with NES during multiple-step distension (MSD). NES produced a mean increase in antral contraction amplitude (177.1 +/- 35.3%) and vagal afferent firing (21.6 +/- 2.6%). Results show that both passive distension and enhanced antral contractions activate distension-sensitive vagal afferents. Responses of these fibers increase linearly to enhanced antral contraction induced by NES or MSD up to a distending volume of 0.6 ml. However, responses reached a plateau at a distending volume >0.8 ml. We concluded that enhanced contraction of the antrum can activate vagal afferents signaling to the CNS.
Collapse
Affiliation(s)
- Shachar Peles
- Cardiovascular Research Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Kobes R, Liu J, Peles S. Analysis of a parametrically driven pendulum. Phys Rev E Stat Nonlin Soft Matter Phys 2001; 63:036219. [PMID: 11308753 DOI: 10.1103/physreve.63.036219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2000] [Revised: 11/13/2000] [Indexed: 05/23/2023]
Abstract
We study in this paper the behavior of a periodically driven nonlinear mechanical system. Bifurcation diagrams are found which locate regions of quasiperiodic, periodic, and chaotic behavior within the parameter space of the system. We also conduct a symbolic analysis of the model which demonstrates that the symbolic dynamics of two-dimensional maps can be applied effectively to the study of ordinary differential equations in order to gain global knowledge about them.
Collapse
Affiliation(s)
- R Kobes
- Department of Physics, University of Winnipeg, Winnipeg, Manitoba, Canada R3B 2E9.
| | | | | |
Collapse
|