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Lee HI, Ahn MJ, Yoo JK, Ahn SH, Park SY, Seo H, Kim MJ, Lee YJ, Jang HH, Shim SC, Won EJ, Park C, Choi C, Kim TJ. Exosome-mediated delivery of super-repressor IκBα alleviates inflammation and joint damages in rheumatoid arthritis. Arthritis Res Ther 2024; 26:2. [PMID: 38167497 PMCID: PMC10759503 DOI: 10.1186/s13075-023-03225-1] [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: 09/17/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND This study aims to investigate the potential anti-inflammatory effects of exosomes engineered to carry super-repressor IκB (Exo-srIκB), an exosome-based NF-κB inhibitor, in the context of RA. METHODS Peripheral blood mononuclear cells (PBMCs) and synovial fluid mononuclear cells (SFMCs) were collected from patients diagnosed with RA and treated with Exo-srIκB to test the therapeutic potential. Flow cytometry analysis was performed to assess the production of inflammatory cytokines (IL-17A and GM-CSF) by the cells. ELISA was utilized to measure the levels of TNF-α, IL-17A, IL-6, and GM-CSF. Arthritis was induced in SKG mice by intraperitoneal injection of curdlan. DBA/1 J mice were used in collagen-induced arthritis (CIA) experiments. After the development of arthritis, mice were injected with either Exo-Naïve (control exosome) or Exo-srIκB. Arthritis scores were recorded biweekly, and histological observations of the ankle joint were conducted using H&E and safranin-O staining. Additionally, bone erosion was evaluated using micro-CT imaging. RESULTS In the ex vivo study involving human PBMCs and SFMCs, treatment with Exo-srIκB demonstrated a notable reduction in inflammatory cytokines. Furthermore, in both the SKG and CIA models, Exo-srIκB treatment exhibited significant reductions in inflammation, cartilage destruction, and bone erosion within the joint tissues when compared to the Exo-Naive control group. Additionally, the radiographic score assessed through microCT showed a significant decrease compared to the Exo-Naive control group. CONCLUSION Overall, these findings suggest that Exo-srIκB possesses anti-inflammatory properties in human RA cells and animal models, making it a promising therapeutic candidate for the treatment of RA.
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Affiliation(s)
- Hae-In Lee
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, 501-757, Republic of Korea
- Department of Biomedical Sciences, Graduate School of Chonnam National University, Gwangju, Republic of Korea
| | - Min-Joo Ahn
- Division of Rheumatology, Daejeon Rheumatoid & Degenerative Arthritis Center, Chungnam National University Hospital, Daejeon, Republic of Korea
| | | | - So-Hee Ahn
- ILIAS Biologics Inc, Daejeon, Republic of Korea
| | | | - Hyangmi Seo
- ILIAS Biologics Inc, Daejeon, Republic of Korea
| | - Moon-Ju Kim
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, 501-757, Republic of Korea
| | - Yu Jeong Lee
- Department of Biomedical Sciences, Graduate School of Chonnam National University, Gwangju, Republic of Korea
| | - Hyun Hee Jang
- Department of Biomedical Sciences, Graduate School of Chonnam National University, Gwangju, Republic of Korea
| | - Seung Cheol Shim
- Division of Rheumatology, Daejeon Rheumatoid & Degenerative Arthritis Center, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Eun Jeong Won
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | - Chulhee Choi
- ILIAS Biologics Inc, Daejeon, Republic of Korea.
| | - Tae-Jong Kim
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, 501-757, Republic of Korea.
- Department of Biomedical Sciences, Graduate School of Chonnam National University, Gwangju, Republic of Korea.
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Kim HH, Shim YR, Choi SE, Falana TE, Yoo JK, Ahn SH, Park M, Seo H, Choi C, Jeong WI. Exosome-Based Delivery of Super-Repressor IκBα Alleviates Alcohol-Associated Liver Injury in Mice. Pharmaceutics 2023; 15:pharmaceutics15020636. [PMID: 36839957 PMCID: PMC9965399 DOI: 10.3390/pharmaceutics15020636] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
Activation of Kupffer cells (KCs) by gut-derived lipopolysaccharide (LPS) instigates nuclear factor-κB (NF-κB)-mediated inflammatory responses in alcohol-associated liver diseases (ALD). Here, we utilized a novel optogenetically engineered exosome technology called 'exosomes for protein loading via optically reversible protein-protein interactions (EXPLOR)' to efficiently deliver the super-repressor IκB-loaded exosomes (Exo-srIκB) to the liver and examined its therapeutic potential in acute-on-chronic alcohol-associated liver injury. We detected enhanced uptake of DiI-labeled Exo-srIκB by LPS-treated inflammatory KCs, which suppressed LPS-induced inflammatory gene expression levels. In animal experiments, a single intravenous injection of Exo-srIκB prior to alcohol binge drinking significantly attenuated alcohol-associated hepatic steatosis and infiltration of neutrophils and macrophages but not a liver injury. Notably, three consecutive days of Exo-srIκB injection remarkably reduced alcohol-associated liver injury, steatosis, apoptosis of hepatocytes, fibrosis-related gene expression levels in hepatic stellate cells, infiltration of neutrophils and macrophages, and inflammatory gene expression levels in hepatocytes and KCs. In particular, the above effects occurred with inhibition of nuclear translocation of NF-κB in liver tissues, and these beneficial effects of Exo-srIκB on ALD were shown regardless of doses. Our results suggest an exosome-based modulation of NF-κB activity in KCs by Exo-srIκB as a novel and efficient therapeutic approach in ALD.
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Affiliation(s)
- Hee-Hoon Kim
- Laboratory of Liver Research, Graduate School of Medical Science and Engineering, KAIST, Daejeon 34141, Republic of Korea
| | - Young-Ri Shim
- Laboratory of Liver Research, Graduate School of Medical Science and Engineering, KAIST, Daejeon 34141, Republic of Korea
| | - Sung Eun Choi
- Laboratory of Liver Research, Graduate School of Medical Science and Engineering, KAIST, Daejeon 34141, Republic of Korea
| | - Tolulope Esther Falana
- Laboratory of Liver Research, Graduate School of Medical Science and Engineering, KAIST, Daejeon 34141, Republic of Korea
| | - Jae-Kwang Yoo
- ILIAS Biologics Inc., Daejeon 34014, Republic of Korea
| | - So-Hee Ahn
- ILIAS Biologics Inc., Daejeon 34014, Republic of Korea
| | - Minhye Park
- ILIAS Biologics Inc., Daejeon 34014, Republic of Korea
| | - Hyangmi Seo
- ILIAS Biologics Inc., Daejeon 34014, Republic of Korea
| | - Chulhee Choi
- ILIAS Biologics Inc., Daejeon 34014, Republic of Korea
- Correspondence: (C.C.); (W.-I.J.); Tel.: +82-42-863-4450 (C.C.); +82-42-450-4239 (W.-I.J.)
| | - Won-Il Jeong
- Laboratory of Liver Research, Graduate School of Medical Science and Engineering, KAIST, Daejeon 34141, Republic of Korea
- Correspondence: (C.C.); (W.-I.J.); Tel.: +82-42-863-4450 (C.C.); +82-42-450-4239 (W.-I.J.)
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Ahn SH, Ryu SW, Choi H, You S, Park J, Choi C. Manufacturing Therapeutic Exosomes: from Bench to Industry. Mol Cells 2022; 45:284-290. [PMID: 35534190 PMCID: PMC9095511 DOI: 10.14348/molcells.2022.2033] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/08/2022] [Accepted: 02/14/2022] [Indexed: 12/12/2022] Open
Abstract
Process of manufacturing therapeutics exosome development for commercialization. The development of exosome treatment starts at the bench, and in order to be commercialized, it goes through the manufacturing, characterization, and formulation stages, production under Good Manufacturing Practice (GMP) conditions for clinical use, and close consultation with regulatory authorities. Exosome, a type of nanoparticles also known as small extracellular vesicles are gaining attention as novel therapeutics for various diseases because of their ability to deliver genetic or bioactive molecules to recipient cells. Although many pharmaceutical companies are gradually developing exosome therapeutics, numerous hurdles remain regarding manufacture of clinical-grade exosomes for therapeutic use. In this mini-review, we will discuss the manufacturing challenges of therapeutic exosomes, including cell line development, upstream cell culture, and downstream purification process. In addition, developing proper formulations for exosome storage and, establishing good manufacturing practice facility for producing therapeutic exosomes remains as challenges for developing clinicalgrade exosomes. However, owing to the lack of consensus regarding the guidelines for manufacturing therapeutic exosomes, close communication between regulators and companies is required for the successful development of exosome therapeutics. This review shares the challenges and perspectives regarding the manufacture and quality control of clinical grade exosomes.
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Affiliation(s)
- So-Hee Ahn
- ILIAS Biologics Inc., Daejeon 34014, Korea
| | | | - Hojun Choi
- ILIAS Biologics Inc., Daejeon 34014, Korea
| | | | - Jun Park
- ILIAS Biologics Inc., Daejeon 34014, Korea
| | - Chulhee Choi
- ILIAS Biologics Inc., Daejeon 34014, Korea
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Korea
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Choi H, Yim H, Park C, Ahn SH, Ahn Y, Lee A, Yang H, Choi C. Targeted Delivery of Exosomes Armed with Anti-Cancer Therapeutics. Membranes 2022; 12:membranes12010085. [PMID: 35054611 PMCID: PMC8782002 DOI: 10.3390/membranes12010085] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/25/2021] [Accepted: 01/03/2022] [Indexed: 02/04/2023]
Abstract
Among extracellular vesicles, exosomes have gained great attention for their role as therapeutic vehicles for delivering various active pharmaceutical ingredients (APIs). Exosomes “armed” with anti-cancer therapeutics possess great potential for an efficient intracellular delivery of anti-cancer APIs and enhanced targetability to tumor cells. Various technologies are being developed to efficiently incorporate anti-cancer APIs such as genetic materials (miRNA, siRNA, mRNA), chemotherapeutics, and proteins into exosomes and to induce targeted delivery to tumor burden by exosomal surface modification. Exosomes can incorporate the desired therapeutic molecules via direct exogenous methods (e.g., electroporation and sonication) or indirect methods by modifying cells to produce “armed” exosomes. The targeted delivery of “armed” exosomes to tumor burden could be accomplished either by “passive” targeting using the natural tropism of exosomes or by “active” targeting via the surface engineering of exosomal membranes. Although anti-cancer exosome therapeutics demonstrated promising results in preclinical studies, success in clinical trials requires thorough validation in terms of chemistry, manufacturing, and control techniques. While exosomes possess multiple advantages over synthetic nanoparticles, challenges remain in increasing the loading efficiency of anti-cancer agents into exosomes, as well as establishing quantitative and qualitative analytical methods for monitoring the delivery of in vivo administered exosomes and exosome-incorporated anti-cancer agents to the tumor parenchyma.
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Affiliation(s)
- Hojun Choi
- ILIAS Biologics Inc., Daejeon 34014, Korea; (H.C.); (H.Y.); (C.P.); (S.-H.A.); (Y.A.); (A.L.)
| | - Hwayoung Yim
- ILIAS Biologics Inc., Daejeon 34014, Korea; (H.C.); (H.Y.); (C.P.); (S.-H.A.); (Y.A.); (A.L.)
| | - Cheolhyoung Park
- ILIAS Biologics Inc., Daejeon 34014, Korea; (H.C.); (H.Y.); (C.P.); (S.-H.A.); (Y.A.); (A.L.)
| | - So-Hee Ahn
- ILIAS Biologics Inc., Daejeon 34014, Korea; (H.C.); (H.Y.); (C.P.); (S.-H.A.); (Y.A.); (A.L.)
| | - Yura Ahn
- ILIAS Biologics Inc., Daejeon 34014, Korea; (H.C.); (H.Y.); (C.P.); (S.-H.A.); (Y.A.); (A.L.)
| | - Areum Lee
- ILIAS Biologics Inc., Daejeon 34014, Korea; (H.C.); (H.Y.); (C.P.); (S.-H.A.); (Y.A.); (A.L.)
| | - Heekyoung Yang
- In Vivo Pharmacology, 1ST Biotherapeutics Inc., Seongnam-si 13493, Korea;
| | - Chulhee Choi
- ILIAS Biologics Inc., Daejeon 34014, Korea; (H.C.); (H.Y.); (C.P.); (S.-H.A.); (Y.A.); (A.L.)
- Department of Bio and Brain Engineering, KAIST, Daejeon 34141, Korea
- Correspondence: ; Tel.: +82-42-863-4450
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Park DJ, Kim YW, Yang HK, Ryu KW, Han SU, Kim HH, Hyung WJ, Park JH, Suh YS, Kwon OK, Yoon HM, Kim W, Park YK, Kong SH, Ahn SH, Lee HJ. Short-term outcomes of a multicentre randomized clinical trial comparing laparoscopic pylorus-preserving gastrectomy with laparoscopic distal gastrectomy for gastric cancer (the KLASS-04 trial). Br J Surg 2021; 108:1043-1049. [PMID: 34487147 DOI: 10.1093/bjs/znab295] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/20/2021] [Accepted: 07/14/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND There remain concerns about the safety and functional benefit of laparoscopic pylorus-preserving gastrectomy (LPPG) compared with laparoscopic distal gastrectomy (LDG). This study evaluated short-term outcomes of a randomized clinical trial (RCT) comparing LPPG with LDG for gastric cancer. METHODS The Korean Laparoendoscopic Gastrointestinal Surgery Study (KLASS)-04 trial was an investigator-initiated, open-label, parallel-assigned, superiority, multicentre RCT in Korea. Patients with cT1N0M0 cancer located in the middle third of the stomach at least 5 cm from the pylorus were randomized to undergo LPPG or LDG. Participants, care givers and those assessing the outcomes were not blinded to group assignment. Outcomes were 30-day postoperative morbidity rate and death at 90 days. RESULTS Some 256 patients from nine institutions were randomized (LPPG 129 patients, LDG 127 patients) between July 2015 and July 2017 and outcomes for 253 patients were analysed. Postoperative complications within 30 days were seen in 19.3 and 15.5 per cent in the LPPG and LDG groups respectively (P = 0·419). Postoperative pyloric stenosis was observed in nine (7.2 per cent) and two (1·5 per cent) patients in the LPPG and LDG groups (P = 0·026) respectively. In multivariable analysis higher BMI was a risk factor for postoperative complications (odds ratio 1·17, 95 per cent c.i. 1·04 to 1·32; P = 0·011). Death at 90 days was zero in both groups. CONCLUSION Postoperative complications and mortality was comparable in patients undergoing LPPG and LDG. Registration number: NCT02595086 (http://www.clinicaltrials.gov).
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Affiliation(s)
- D J Park
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Y-W Kim
- Department of Surgery, National Cancer Centre, Goyang, Korea
| | - H-K Yang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - K W Ryu
- Department of Surgery, National Cancer Centre, Goyang, Korea
| | - S-U Han
- Department of Surgery, Ajou University Hospital, Suwon, Korea
| | - H-H Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - W-J Hyung
- Department of Surgery, Yonsei University Severance Hospital, Seoul, Korea
| | - J H Park
- Department of Surgery, Gyeongsang National University Hospital, Daegu, Korea
| | - Y-S Suh
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - O K Kwon
- Department of Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - H M Yoon
- Department of Surgery, National Cancer Centre, Goyang, Korea
| | - W Kim
- Department of Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Y-K Park
- Department of Surgery, Chonnam National University Medical School, Hwasun, Korea
| | - S-H Kong
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - S H Ahn
- Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - H-J Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
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Kim S, Lee SA, Yoon H, Kim MY, Yoo JK, Ahn SH, Park CH, Park J, Nam BY, Park JT, Han SH, Kang SW, Kim NH, Kim HS, Han D, Yook JI, Choi C, Yoo TH. Exosome-based delivery of super-repressor IκBα ameliorates kidney ischemia-reperfusion injury. Kidney Int 2021; 100:570-584. [PMID: 34051264 DOI: 10.1016/j.kint.2021.04.039] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [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: 08/13/2020] [Revised: 04/22/2021] [Accepted: 04/30/2021] [Indexed: 12/15/2022]
Abstract
Ischemia-reperfusion injury is a major cause of acute kidney injury. Recent studies on the pathophysiology of ischemia-reperfusion-induced acute kidney injury showed that immunologic responses significantly affect kidney ischemia-reperfusion injury and repair. Nuclear factor (NF)-ĸB signaling, which controls cytokine production and cell survival, is significantly involved in ischemia-reperfusion-induced acute kidney injury, and its inhibition can ameliorate ischemic acute kidney injury. Using EXPLOR, a novel, optogenetically engineered exosome technology, we successfully delivered the exosomal super-repressor inhibitor of NF-ĸB (Exo-srIĸB) into B6 wild type mice before/after kidney ischemia-reperfusion surgery, and compared outcomes with those of a control exosome (Exo-Naïve)-injected group. Exo-srIĸB treatment resulted in lower levels of serum blood urea nitrogen, creatinine, and neutrophil gelatinase-associated lipocalin in post-ischemic mice than in the Exo-Naïve treatment group. Systemic delivery of Exo-srIĸB decreased NF-ĸB activity in post-ischemic kidneys and reduced apoptosis. Post-ischemic kidneys showed decreased gene expression of pro-inflammatory cytokines and adhesion molecules with Exo-srIĸB treatment as compared with the control. Intravital imaging confirmed the uptake of exosomes in neutrophils and macrophages. Exo-srIĸB treatment also significantly affected post-ischemic kidney immune cell populations, lowering neutrophil, monocyte/macrophage, and T cell frequencies than those in the control. Thus, modulation of NF-ĸB signaling through exosomal delivery can be used as a novel therapeutic method for ischemia-reperfusion-induced acute kidney injury.
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Affiliation(s)
- Seonghun Kim
- Department of Oral Pathology, Oral Cancer Research Institute, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Sul A Lee
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, South Korea; Department of Internal Medicine, MetroWest Medical Center, Framingham, Massachusetts, USA
| | - Heakyung Yoon
- ILIAS Innovation Center, ILIAS Biologics Inc., Daejeon, South Korea
| | - Myung Yoon Kim
- ILIAS Innovation Center, ILIAS Biologics Inc., Daejeon, South Korea
| | - Jae-Kwang Yoo
- ILIAS Innovation Center, ILIAS Biologics Inc., Daejeon, South Korea
| | - So-Hee Ahn
- ILIAS Innovation Center, ILIAS Biologics Inc., Daejeon, South Korea
| | | | - Jimin Park
- Severance Biomedical Science Institute, College of Medicine, Yonsei University, Seoul, South Korea
| | - Bo Young Nam
- Severance Biomedical Science Institute, College of Medicine, Yonsei University, Seoul, South Korea
| | - Jung Tak Park
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, South Korea
| | - Seung Hyeok Han
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, South Korea
| | - Shin-Wook Kang
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, South Korea
| | - Nam Hee Kim
- Department of Oral Pathology, Oral Cancer Research Institute, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Hyun Sil Kim
- Department of Oral Pathology, Oral Cancer Research Institute, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Dawool Han
- Department of Oral Pathology, Oral Cancer Research Institute, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Jong In Yook
- Department of Oral Pathology, Oral Cancer Research Institute, College of Dentistry, Yonsei University, Seoul, South Korea.
| | - Chulhee Choi
- ILIAS Innovation Center, ILIAS Biologics Inc., Daejeon, South Korea; Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea.
| | - Tae-Hyun Yoo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, South Korea.
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Jang MJ, Bae SK, Jung YS, Kim JC, Kim JS, Park SK, Suh JS, Yi SJ, Ahn SH, Lim JO. Enhanced wound healing using a 3D printed VEGF-mimicking peptide incorporated hydrogel patch in a pig model. Biomed Mater 2021; 16. [PMID: 33761488 DOI: 10.1088/1748-605x/abf1a8] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/24/2021] [Indexed: 02/04/2023]
Abstract
There is a need for effective wound healing through rapid wound closure, reduction of scar formation, and acceleration of angiogenesis. Hydrogel is widely used in tissue engineering, but it is not an ideal solution because of its low vascularization capability and poor mechanical properties. In this study, gelatin methacrylate (GelMA) was tested as a viable option with tunable physical properties. GelMA hydrogel incorporating a vascular endothelial growth factor (VEGF) mimicking peptide was successfully printed using a three-dimensional (3D) bio-printer owing to the shear-thinning properties of hydrogel inks. The 3D structure of the hydrogel patch had high porosity and water absorption properties. Furthermore, the bioactive characterization was confirmed by cell culture with mouse fibroblasts cell lines (NIH 3T3) and human umbilical vein endothelial cells. VEGF peptide, which is slowly released from hydrogel patches, can promote cell viability, proliferation, and tubular structure formation. In addition, a pig skin wound model was used to evaluate the wound-healing efficacy of GelMA-VEGF hydrogel patches; the results suggest that the GelMA-VEGF hydrogel patch can be used for wound dressing.
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Affiliation(s)
- M J Jang
- Daegu Gyeongbuk Medical Innovation Foundation, Laboratory Animal Center, Daegu, Republic of Korea
| | - S K Bae
- Daegu Gyeongbuk Medical Innovation Foundation, Laboratory Animal Center, Daegu, Republic of Korea
| | - Y S Jung
- Daegu Gyeongbuk Medical Innovation Foundation, Laboratory Animal Center, Daegu, Republic of Korea
| | - J C Kim
- Daegu Gyeongbuk Medical Innovation Foundation, Laboratory Animal Center, Daegu, Republic of Korea
| | - J S Kim
- Daegu Gyeongbuk Medical Innovation Foundation, Laboratory Animal Center, Daegu, Republic of Korea
| | - S K Park
- Daegu Gyeongbuk Medical Innovation Foundation, Laboratory Animal Center, Daegu, Republic of Korea
| | - J S Suh
- Department of Laboratory Medicine, Kyungpook National University, School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - S J Yi
- School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - S H Ahn
- Daegu Gyeongbuk Medical Innovation Foundation, Laboratory Animal Center, Daegu, Republic of Korea
| | - J O Lim
- Biomedical Research Institute, Joint Institute for Regenerative Medicine, Kyungpook National University, School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
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Mirzaaghasi A, Han Y, Ahn SH, Choi C, Park JH. Biodistribution and Pharmacokinectics of Liposomes and Exosomes in a Mouse Model of Sepsis. Pharmaceutics 2021; 13:427. [PMID: 33809966 PMCID: PMC8004782 DOI: 10.3390/pharmaceutics13030427] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 03/04/2021] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 01/24/2023] Open
Abstract
Exosomes have attracted considerable attention as drug delivery vehicles because their biological properties can be utilized for selective delivery of therapeutic cargoes to disease sites. In this context, analysis of the in vivo behaviors of exosomes in a diseased state is required to maximize their therapeutic potential as drug delivery vehicles. In this study, we investigated biodistribution and pharmacokinetics of HEK293T cell-derived exosomes and PEGylated liposomes, their synthetic counterparts, into healthy and sepsis mice. We found that biodistribution and pharmacokinetics of exosomes were significantly affected by pathophysiological conditions of sepsis compared to those of liposomes. In the sepsis mice, a substantial number of exosomes were found in the lung after intravenous injection, and their prolonged blood residence was observed due to the liver dysfunction. However, liposomes did not show such sepsis-specific effects significantly. These results demonstrate that exosome-based therapeutics can be developed to manage sepsis and septic shock by virtue of their sepsis-specific in vivo behaviors.
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Affiliation(s)
- Amin Mirzaaghasi
- Department of Bio and Brain Engineering and KAIST Institute for Health Science and Technology, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Korea; (A.M.); (Y.H.)
| | - Yunho Han
- Department of Bio and Brain Engineering and KAIST Institute for Health Science and Technology, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Korea; (A.M.); (Y.H.)
| | - So-Hee Ahn
- Analytic Development Team, ILIAS Biologics Incorporated, Daejeon 34014, Korea;
| | - Chulhee Choi
- Department of Bio and Brain Engineering and KAIST Institute for Health Science and Technology, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Korea; (A.M.); (Y.H.)
- Analytic Development Team, ILIAS Biologics Incorporated, Daejeon 34014, Korea;
| | - Ji-Ho Park
- Department of Bio and Brain Engineering and KAIST Institute for Health Science and Technology, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Korea; (A.M.); (Y.H.)
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9
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Hwang UJ, Lee MS, Jung SH, Ahn SH, Kwon OY. Relationship Between Sexual Function and Pelvic Floor and Hip Muscle Strength in Women With Stress Urinary Incontinence. Sex Med 2021; 9:100325. [PMID: 33662705 PMCID: PMC8072144 DOI: 10.1016/j.esxm.2021.100325] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/06/2021] [Accepted: 01/12/2021] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION The pelvic floor muscle (PFM) could affect female sexual functions. The hip muscles are morphologically and functionally linked to PFM and are important elements of female sexual attraction. AIM To determine the relationship between female sexual function and hip muscle strength and PFM functions in women with stress urinary incontinence (SUI). METHODS A total of 42 women with SUI were recruited in this study. Female sexual function was measured using the pelvic organ prolapse urinary incontinence sexual function questionnaire (PISQ). PFM functions were measured using a perineometer. Hip muscle strength was measured using a Smart KEMA tension sensor. The relationship between female sexual function and PFM function and hip muscle strength was assessed using Pearson correlation coefficients and multiple regression analyses with forward selection. MAIN OUTCOME MEASURES PISQ score, PFM functions (strength and endurance), and strength of hip extensor, abductor, and adductor were the main outcome measures. RESULTS For the behavioral/emotive domain in the PISQ, hip extensor strength (r = 0.452), PFM strength (r = 0.441), PFM endurance (r = 0.362), and hip adductor strength (r = 0.324) were significantly correlated and hip extensor strength emerged in multiple regression. For the physical domain in the PISQ, hip abductor strength (r = 0.417), PFM endurance (r = 0.356), hip adductor strength (r = 0.332), and PFM strength (r = 0.322) were significantly correlated and hip abductor strength entered in multiple regression. For partner-related domain in the PISQ, hip adductor (r = 0.386) and abductor strength (r = 0.314) were significantly correlated and hip adductor strength appeared in multiple regression. For the PISQ total score, hip extensor strength (r = 0.484), PFM endurance (r = 0.470), hip adductor strength (r = 0.424), hip abductor strength (r = 0.393), and PFM strength (r = 0.387) were significantly correlated and hip extensor strength and PFM endurance emerged in multiple regression. CONCLUSION The female sexual function could be related to not only PFM functions but also hip muscle strength in women with SUI. Hwang UJ, Lee MS, Jung SH, Ahn SH, Kwon OY. Relationship Between Sexual Function and Pelvic Floor and Hip Muscle Strength in Women With Stress Urinary Incontinence. Sex Med 2021;9:100325.
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Affiliation(s)
- U J Hwang
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - M S Lee
- Sophie-Marceau Women's Clinic, Daegu, South Korea
| | - S H Jung
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - S H Ahn
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - O Y Kwon
- Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis, Yonsei University, Wonju, South Korea.
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Kang CH, Roh J, Yeom JA, Ahn SH, Park MG, Park KP, Baik SK. Asymptomatic Cerebral Vasoconstriction after Carotid Artery Stenting. AJNR Am J Neuroradiol 2020; 41:305-309. [PMID: 31974083 DOI: 10.3174/ajnr.a6385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/01/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Carotid artery stent placement is widely performed for treatment of carotid stenosis. The purpose of this study is to present our observations on cerebral vasoconstriction in ipsilateral anterior circulation during immediate poststenting angiography in patients with near-total occlusion of the proximal ICA. MATERIALS AND METHODS We retrospectively reviewed patient data from December 2008 to December 2018. There were 28 patients with carotid near-total occlusion. Two neuroradiologists reviewed the final cerebral angiographic finding of carotid artery stent placement to evaluate the presence of vasoconstriction or vasodilation. RESULTS A total of 28 patients with near-total occlusion (mean ± standard deviation age, 69.0 ± 6.5 years; 92.9% male) were analyzed. Ten patients showed vasoconstriction in the treated territory, and 18 patients did not show vasoconstriction after carotid artery stenting. There were no statistically significant differences in comorbidity, frequency of symptomatic lesions, antiplatelet medication, mean procedure time, and initial NIHSS and baseline modified Rankin scale scores between the 2 groups. However, vasoconstriction is more likely to happen in patients with isolated territory from the contralateral anterior and posterior circulation (66.7% in the isolated territory group and 12.5% in the not-isolated territory group; P < .05). No headache or neurologic deficit was noted in all 10 patients with cerebral vasoconstriction. CONCLUSIONS Cerebral vasoconstriction may occur after carotid artery stenting more frequently than expected. It occurs more frequently in patients with near-total occlusion and with isolation of the cerebral circulation. A large-scale study is necessary to assess the clinical implications of cerebral vasoconstriction after carotid artery stenting.
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Affiliation(s)
- C H Kang
- From the Departments of Radiology (C.H.K., J.R., J.A.Y., S.K.B.)
| | - J Roh
- From the Departments of Radiology (C.H.K., J.R., J.A.Y., S.K.B.)
| | - J A Yeom
- From the Departments of Radiology (C.H.K., J.R., J.A.Y., S.K.B.)
| | - S H Ahn
- Neurology (S.H.A., M.G.P., K.P.P.), Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - M G Park
- Neurology (S.H.A., M.G.P., K.P.P.), Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - K P Park
- Neurology (S.H.A., M.G.P., K.P.P.), Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - S K Baik
- From the Departments of Radiology (C.H.K., J.R., J.A.Y., S.K.B.)
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Almekhlafi MA, Kunz WG, McTaggart RA, Jayaraman MV, Najm M, Ahn SH, Fainardi E, Rubiera M, Khaw AV, Zini A, Hill MD, Demchuk AM, Goyal M, Menon BK. Imaging Triage of Patients with Late-Window (6-24 Hours) Acute Ischemic Stroke: A Comparative Study Using Multiphase CT Angiography versus CT Perfusion. AJNR Am J Neuroradiol 2019; 41:129-133. [PMID: 31806593 DOI: 10.3174/ajnr.a6327] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/01/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND PURPOSE The role of collateral imaging in selecting patients for endovascular thrombectomy beyond 6 hours from onset has not been established. To assess the comparative utility of collateral imaging using multiphase CTA in selecting late window patients for EVT. MATERIALS AND METHODS We used data from a prospective multicenter observational study in which all patients underwent imaging with multiphase CT angiography as well as CTP. Two blinded reviewers evaluated patients' eligibility for endovascular thrombectomy using published collateral imaging (multiphase CTA) criteria compared with CTP using the selection criteria of the Clinical Mismatch in the Triage of Wake Up and Late Presenting Strokes Undergoing Neurointervention with Trevo (DAWN) and Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3 (DEFUSE-3) trials. CTP images were processed using automated commercial software. The outcomes of patients eligible for endovascular thrombectomy according to multiphase CTA, DAWN, or DEFUSE-3 criteria were compared using multivariable logistic regression modeling. Model characteristics were compared using the C-statistic for the receiver operating characteristic curve, the Akaike information criterion, and the Bayesian information criterion. RESULTS Eighty-six patients presented beyond 6 hours from onset/last known well (median, 9.6 hours; interquartile range, 4.1 hours). Thirty-five patients (40.7%) received endovascular thrombectomy, of whom good functional outcome (90-day mRS, 0-2) was achieved in 16/35 (47%). Collateral-based imaging paradigms significantly modified the treatment effect of endovascular thrombectomy on 90-day mRS 0-2 (P interaction = .007). The multiphase CTA-based regression model best fit the data for the 90-day outcome (C-statistic, 0.86; 95% CI, 0.77-0.94) and was associated with the least information loss (Akaike information criterion, 95.7; Bayesian information criterion, 114.9) compared with CTP-based models. CONCLUSIONS The collateral-based imaging paradigm using multiphase CTA compares well with CTP in selecting patients for endovascular thrombectomy in the late time window.
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Affiliation(s)
- M A Almekhlafi
- From the Department of Clinical Neurosciences (M.A.A., M.N., M.D.H., A.M.D., M.G., B.K.M.).,Calgary Stroke Program, Department of Radiology (M.A.A., M.D.H., A.M.D., M.G., B.K.M.).,Department of Community Health Sciences (M.A.A., M.D.H., B.K.M.)
| | - W G Kunz
- Department of Radiology (W.G.K.), University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - R A McTaggart
- Departments of Neurology, Diagnostic Imaging, and Neurosurgery (R.A.M., M.V.J.), Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - M V Jayaraman
- Departments of Neurology, Diagnostic Imaging, and Neurosurgery (R.A.M., M.V.J.), Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - M Najm
- From the Department of Clinical Neurosciences (M.A.A., M.N., M.D.H., A.M.D., M.G., B.K.M.)
| | - S H Ahn
- Department of Neurology (S.H.A.), Chosun University School of Medicine, Gwang Ju, South Korea
| | - E Fainardi
- Department of Neurosciences and Rehabilitation (E.F.), University Hospital, Ferrara, Italy
| | - M Rubiera
- Department of Neurology (M.R.), Hospital Vall d'Hebron, Passeig de la Vall d'Hebron, Barcelona, Spain
| | - A V Khaw
- Department of Clinical Neurosciences (A.V.K.), University of Western Ontario, London, Ontario, Canada
| | - A Zini
- Department of Neurology and Stroke Center (A.Z.), Istituto Di Ricovero e Cura a Carattere Scientifico Istituto di Scienze Neurologiche di Bologna, Maggiore Hospital, Bologna, Italy
| | - M D Hill
- From the Department of Clinical Neurosciences (M.A.A., M.N., M.D.H., A.M.D., M.G., B.K.M.).,Calgary Stroke Program, Department of Radiology (M.A.A., M.D.H., A.M.D., M.G., B.K.M.).,Department of Community Health Sciences (M.A.A., M.D.H., B.K.M.).,Department of Medicine (M.D.H.), Hotchkiss Brain Institute, Cumming School of Medicine University of Calgary, Calgary, Alberta, Canada
| | - A M Demchuk
- From the Department of Clinical Neurosciences (M.A.A., M.N., M.D.H., A.M.D., M.G., B.K.M.).,Calgary Stroke Program, Department of Radiology (M.A.A., M.D.H., A.M.D., M.G., B.K.M.)
| | - M Goyal
- From the Department of Clinical Neurosciences (M.A.A., M.N., M.D.H., A.M.D., M.G., B.K.M.).,Calgary Stroke Program, Department of Radiology (M.A.A., M.D.H., A.M.D., M.G., B.K.M.)
| | - B K Menon
- From the Department of Clinical Neurosciences (M.A.A., M.N., M.D.H., A.M.D., M.G., B.K.M.) .,Calgary Stroke Program, Department of Radiology (M.A.A., M.D.H., A.M.D., M.G., B.K.M.).,Department of Community Health Sciences (M.A.A., M.D.H., B.K.M.)
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12
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Kim BJ, Yoo HJ, Park SJ, Kwak MK, Lee SH, Kim SJ, Hamrick MW, Isales CM, Ahn SH, Koh JM. Association of blood n-3 fatty acid with bone mass and bone marrow TRAP-5b in the elderly with and without hip fracture. Osteoporos Int 2019; 30:1071-1078. [PMID: 30719549 DOI: 10.1007/s00198-019-04881-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 01/27/2019] [Indexed: 10/27/2022]
Abstract
UNLABELLED The plasma n-3 fatty acid level was 26.2% lower in patients with osteoporotic hip fracture than in those with osteoarthritis. In all patients, n-3 fatty acid was positively associated with bone mineral density and inversely associated with tartrate-resistant acid phosphatase-5b level in bone marrow aspirates, reflecting the bone microenvironment. INTRODUCTION Despite the potential beneficial role of n-3 fatty acid (FA) on bone metabolism, the specific mechanisms underlying these effects in humans remain unclear. Here, we assessed whether the plasma n-3 level, as an objective indicator of its status, is associated with osteoporosis-related phenotypes and bone-related markers in human bone marrow (BM) samples. METHODS This was a case-control and cross-sectional study conducted in a clinical unit. n-3 FA in the blood and bone biochemical markers in the BM aspirates were measured by gas chromatography/mass spectrometry and immunoassay, respectively. BM fluids were collected from 72 patients who underwent hip surgery because of either osteoporotic hip fracture (HF; n = 28) or osteoarthritis (n = 44). RESULTS After adjusting for confounders, patients with HF had 26.2% lower plasma n-3 levels than those with osteoarthritis (P = 0.006), and each standard deviation increment in plasma n-3 was associated with a multivariate-adjusted odds ratio of 0.40 for osteoporotic HF (P = 0.010). In multivariate analyses including all patients, a higher plasma n-3 level was associated with higher bone mass at the lumbar spine (β = 0.615, P = 0.002) and total femur (β = 0.244, P = 0.045). Interestingly, the plasma n-3 level was inversely associated with the tartrate-resistant acid phosphatase-5b level (β = - 0.633, P = 0.023), but not with the bone-specific alkaline phosphatase level, in BM aspirates. CONCLUSIONS These findings provide clinical evidence that n-3 FA is a potential inhibitor of osteoclastogenesis that favors human bone health.
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Affiliation(s)
- B-J Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
| | - H J Yoo
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - S J Park
- Asan Institute for Life Sciences, Seoul, South Korea
| | - M K Kwak
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - S H Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - S J Kim
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - M W Hamrick
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - C M Isales
- Department of Orthopedic Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - S H Ahn
- Department of Endocrinology, Inha University School of Medicine, Incheon, South Korea
| | - J-M Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
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Ahn SH, Kim JH, Cho YY, Suh S, Kim BJ, Hong S, Lee SH, Koh JM, Song KH. The effects of cortisol and adrenal androgen on bone mass in Asians with and without subclinical hypercortisolism. Osteoporos Int 2019; 30:1059-1069. [PMID: 30719548 DOI: 10.1007/s00198-019-04871-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 01/21/2019] [Indexed: 11/26/2022]
Abstract
UNLABELLED Analyses using the largest Korean cohort of adrenal incidentaloma (AI) revealed that subtle cortisol excess in premenopausal women and reduced dehydroepiandrosterone-sulfate (DHEA-S) in postmenopausal women and men are associated with bone mineral density (BMD) reduction in Asian patients with subclinical hypercortisolism (SH). INTRODUCTION Few studies evaluated bone metabolism in Asians with SH. We investigated associations of cortisol and DHEA-S, an adrenal androgen, with BMD in Asians with AI, with or without SH. METHODS We used cross-sectional data of a prospective multicenter study from Korea. We measured BMD, bone turnover markers, cortisol levels after 1-mg dexamethasone suppression test (1-mg DST), DHEA-S, and baseline cortisol to DHEA-S ratio (cort/DHEA-S) in 109 AI patients with SH (18 premenopausal, 38 postmenopausal women, and 53 men) and 686 with non-functional AI (NFAI; 59 premenopausal, 199 postmenopausal women, and 428 men). RESULTS Pre- and postmenopausal women, but not men, with SH had lower BMDs at lumbar spine (LS) than those with NFAI (P = 0.008~0.016). Premenopausal women with SH also had lower BMDs at the hip than those with NFAI (P = 0.009~0.012). After adjusting for confounders, cortisol levels after 1-mg DST demonstrated inverse associations with BMDs at all skeletal sites only in premenopausal women (β = - 0.042~- 0.033, P = 0.019~0.040). DHEA-S had positive associations with LS BMD in postmenopausal women (β = 0.096, P = 0.001) and men (β = 0.029, P = 0.038). The cort/DHEA-S had inverse associations with LS BMD in postmenopausal women (β = - 0.081, P = 0.004) and men (β = - 0.029, P = 0.011). These inverse associations of cort/DHEA-S remained significant after adjusting for cortisol levels after 1-mg DST (β = - 0.079~- 0.026, P = 0.006~0.029). In postmenopausal women, the odds ratios of lower BMD by DHEA-S and cort/DHEA-S was 0.26 (95% CI, 0.08-0.82) and 3.40 (95% CI, 1.12-10.33), respectively. CONCLUSION Subtle cortisol excess in premenopausal women and reduced DHEA-S in postmenopausal women and men may contribute to BMD reduction in Asians with SH.
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Affiliation(s)
- S H Ahn
- Division of Endocrinology and Metabolism, Department of Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - J H Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Y Y Cho
- Division of Endocrinology and Metabolism, Department of Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, South Korea
| | - S Suh
- Division of Endocrinology and Metabolism, Department of Medicine, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, South Korea
| | - B-J Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43 gil, Songpa-gu, Seoul, 05505, South Korea
| | - S Hong
- Division of Endocrinology and Metabolism, Department of Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - S H Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43 gil, Songpa-gu, Seoul, 05505, South Korea
| | - J-M Koh
- Division of Endocrinology and Metabolism, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43 gil, Songpa-gu, Seoul, 05505, South Korea.
| | - K-H Song
- Division of Endocrinology and Metabolism, Department of Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, South Korea.
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Yogendrakumar V, Al-Ajlan F, Najm M, Puig J, Calleja A, Sohn SI, Ahn SH, Mikulik R, Asdaghi N, Field TS, Jin A, Asil T, Boulanger JM, Hill MD, Demchuk AM, Menon BK, Dowlatshahi D. Clot Burden Score and Early Ischemia Predict Intracranial Hemorrhage following Endovascular Therapy. AJNR Am J Neuroradiol 2019; 40:655-660. [PMID: 30872416 DOI: 10.3174/ajnr.a6009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Received: 11/23/2018] [Accepted: 02/11/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Intracranial hemorrhage is a known complication following endovascular thrombectomy. The radiologic characteristics of a CT scan may assist with hemorrhage risk stratification. We assessed the radiologic predictors of intracranial hemorrhage following endovascular therapy using data from the INTERRSeCT (Identifying New Approaches to Optimize Thrombus Characterization for Predicting Early Recanalization and Reperfusion With IV Alteplase and Other Treatments Using Serial CT Angiography) study. MATERIALS AND METHODS Patients undergoing endovascular therapy underwent baseline imaging, postprocedural angiography, and 24-hour follow-up imaging. The primary outcome was any intracranial hemorrhage observed on follow-up imaging. The secondary outcome was symptomatic hemorrhage. We assessed the relationship between hemorrhage occurrence and baseline patient characteristics, clinical course, and imaging factors: baseline ASPECTS, thrombus location, residual flow grade, collateralization, and clot burden score. Multivariable logistic regression with backward selection was used to adjust for relevant covariates. RESULTS Of the 199 enrolled patients who met the inclusion criteria, 46 (23%) had an intracranial hemorrhage at 24 hours. On multivariable analysis, postprocedural hemorrhage was associated with pretreatment ASPECTS (OR, 1.56 per point lost; 95% CI, 1.12-2.15), clot burden score (OR, 1.19 per point lost; 95% CI, 1.03-1.38), and ICA thrombus location (OR, 3.10; 95% CI, 1.07-8.91). In post hoc analysis, clot burden scores of ≤3 (sensitivity, 41%; specificity, 82%; OR, 3.12; 95% CI, 1.36-7.15) and pretreatment ASPECTS ≤ 7 (sensitivity, 48%; specificity, 82%; OR, 3.17; 95% CI, 1.35-7.45) robustly predicted hemorrhage. Residual flow grade and collateralization were not associated with hemorrhage occurrence. Symptomatic hemorrhage was observed in 4 patients. CONCLUSIONS Radiologic factors, early ischemia on CT, and increased CTA clot burden are associated with an increased risk of intracranial hemorrhage in patients undergoing endovascular therapy.
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Affiliation(s)
- V Yogendrakumar
- From the Department of Medicine (Neurology) (V.Y., D.D.), University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Canada
| | - F Al-Ajlan
- Department of Neurosciences (F.A.-A.), King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - M Najm
- Calgary Stroke Program (M.N., M.D.H., A.M.D., B.K.M.), Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
| | - J Puig
- Institut de Diagnostic per la Imatge (J.P.), Girona Biomedical Research Institute, University Hospital Dr Josep Trueta, Girona, Spain
| | - A Calleja
- Department of Neurology (A.C.), Stroke Unit, Hospital Clínico Universitario de Valladolid, Universidad de Valladolid, Valladolid, Spain
| | - S-I Sohn
- Department of Neurology (S-.I.S.), Keimyung University, Daegu, Republic of Korea
| | - S H Ahn
- Department of Neurology (S.H.A.), Chosun University School of Medicine and Hospital, Gwangju, Republic of Korea
| | - R Mikulik
- International Clinical Research Center (R.M.), St. Anne's University Hospital, Brno, Czech Republic
| | - N Asdaghi
- Department of Neurology (N.A.), Miller School of Medicine, University of Miami, Miami, Florida
| | - T S Field
- Division of Neurology (T.S.F.), Vancouver Stroke Program, University of British Columbia, Vancouver, Canada
| | - A Jin
- Division of Neurology (A.J.), Queen's University, Kingston, Canada
| | - T Asil
- Bezmialem Vakif Üniversitesi Nöroloji (T.A., J.-M.B.), Istanbul, Turkey
| | - J-M Boulanger
- Bezmialem Vakif Üniversitesi Nöroloji (T.A., J.-M.B.), Istanbul, Turkey
- Department of Medicine (J.-M.B.), Charles LeMoyne Hospital, Greenfield Park, Canada
| | - M D Hill
- Calgary Stroke Program (M.N., M.D.H., A.M.D., B.K.M.), Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
| | - A M Demchuk
- Calgary Stroke Program (M.N., M.D.H., A.M.D., B.K.M.), Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
| | - B K Menon
- Calgary Stroke Program (M.N., M.D.H., A.M.D., B.K.M.), Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
| | - D Dowlatshahi
- From the Department of Medicine (Neurology) (V.Y., D.D.), University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Canada
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Ko B, Kim N, Seo J, Kim H, Gong G, Kim S, Son B, Ahn SH. Abstract P3-13-01: Application of supine MRI-based 3D printing breast surgical guide for precision breast-conserving surgery. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-13-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
If the size of the tumor is large, neoadjuvant systemic therapy (NST) is performed to reduce the size of the tumor and to conserve the breast. It is known that magnetic resonance imaging is more accurate than mammography (MMG) or ultrasonography (USG) in determining the area of residual cancer in breast-conserving surgery (BSG) after NST. However, there are some problems when performing BCS using MRI. Because the posture of MRI test is different from the posture at surgery, it is difficult to accurately mark the area of the tumor observed in MRI. Neoadjuvant systemic therapy reduces tumor size and often makes it difficult to detect the original tumor area on preoperative MRI. Even if the tumor is not visible in the image, the cancer cells may remain, so it is important to accurately indicate the extent of the initial tumor and remove it. Until now, however, there has been no way to accurately mark past breast tumors in the breast. We have developed a breast surgical guide (BSG) that can mark a range of tumor directly on the breast using three-dimensional printing technology based on supine MRI. This study analyzed the results of patients who underwent BCS using a 3D printing breast surgical guide (3D-BSG) based on supine MRI.
Methods
This trial was designed as a prospective single-institution cohort study. Our study protocol was approved by the Institutional Review Board of Asan Medical Center, Seoul, Korea (IRB No. 2016-1237). Patients who were expected to undergo BCS after NST were enrolled in this study and supine MRI was performed before and after NST. From MRI images, morphological shapes of breasts and tumors were modeled. The prepared digital model was saved in stereolithography file format and then exported to a 3D printer. 3D-BSG is designed to be able to mark the skin and attach the dye injecting column to mark the around the tumor. The breast tissue was removed with blue dye on the basis of the border. To obtain tumor free margin, intraoperative frozen sections were identified in several cavities and re-excision was performed if tumor positive.
Results
Between January 2016 and May 2017, 50 patients were enrolled in the study. BCS was applied to 40 patients, except for those who were rejected or mastectomy. Complete remission was observed in 15 patients after NST. Four patients had tumor positive on resection margins on frozen biopsy during operation, two with IDC and two with DCIS. Re-excision was performed in these patients and tumor negative margin was confirmed in all patients in the final pathology results. The median size of the long axis of the tumor was 1.7 cm (range, 0.5 to 4.5 cm) and the median size of the long axis of the removed breast tissue was 5.1 cm (range, 2.3 to 8.1 cm). The distance between tumor and resection margin was 1.2 cm (range, 0.1 to 4.8 cm)..
Conclusions
In BCS, the application of the supine MRI based 3D-BSG showed low rates of positive margins. Unlike conventional localization techniques, application of 3D-BSG does not cause pain to the patient, has no radiation exposure, and has no time required for the localization procedure, so it will be helpful for patients in BCS in the future.
Citation Format: Ko B, Kim N, Seo J, Kim H, Gong G, Kim S, Son B, Ahn SH. Application of supine MRI-based 3D printing breast surgical guide for precision breast-conserving surgery [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-13-01.
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Affiliation(s)
- B Ko
- Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - N Kim
- Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - J Seo
- Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - H Kim
- Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - G Gong
- Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - S Kim
- Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - B Son
- Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - SH Ahn
- Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
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Lee S, Ahn SH, Lee JW, Chung IY, Ko BS, Kim HJ, Kim J, Shon G, Son BH. Abstract P2-14-21: Not presented. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-14-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was not presented at the conference.
Citation Format: Lee S, Ahn SH, Lee JW, Chung IY, Ko BS, Kim HJ, Kim J, Shon G, Son BH. Not presented [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-14-21.
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Affiliation(s)
- S Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - SH Ahn
- Asan Medical Center, Seoul, Republic of Korea
| | - JW Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - IY Chung
- Asan Medical Center, Seoul, Republic of Korea
| | - BS Ko
- Asan Medical Center, Seoul, Republic of Korea
| | - HJ Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - J Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - G Shon
- Asan Medical Center, Seoul, Republic of Korea
| | - BH Son
- Asan Medical Center, Seoul, Republic of Korea
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Gwark SC, Kim J, Kim YH, Kim MS, Park JY, Lee SB, Sohn G, Chung IY, Ko BS, Kim HJ, Lee JW, Son BH, Ahn SH. Abstract P6-09-09: Analysis of serial circulating tumor cell count during neoadjuvant systemic therapy in breast cancer patients. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-09-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: We aimed to evaluate the clinical implication of circulating tumor cell (CTC) counts in correlation with prognosis and radiologic/pathologic response to therapy in locally advanced breast cancer patients undergoing preoperative systemic therapy.
Methods: From Feb 2014 to May 2017, 207 patients without distant metastasis were prospectively enrolled from AMC. CTC counts were analyzed before-during-after the therapy. CTC isolation was performed using a SMART BIOPSY™ SYSTEM Isolation kit (Cytogen, Inc., Seoul, Korea). Recurrence-free and overall survival was analyzed according to CTC counts.
Result: The mean follow-up period was 22.46 months and mean age was 46.48 years. One or more CTC was identified in 132 of 203 patients(65.0%) before NST, in 135 of 186 patients(72.0%) during NST and 103 of 171 patients(60.2%) after NST. Initial tumor burden at diagnosis -tumor size, lymph node metastasis- was not correlated with CTC positivity. Overall, CTC count ((≥1 CTC, ≥2 CTCs, and ≥5 CTCs) was not correlated with response to therapy. Using RECIST criteria, 86.5% (179/204) were responders (complete, partial response, CR/PR) and 12.1% (25/204) were non-responders (stable, progressive disease, SD/PD). 14.5% (30/207) showed a pathologic complete response (pCR), yet no association was found between CTC count/changes and radiologic/pathologic response to therapy. Also, CTC count was not correlated with prognosis among the whole population. However, HR+ tumors, CTC detection before NST was significantly associated with treatment response by RECIST criteria (responder vs. non-responder) (p=0.003, p=0.017 and p=0.023, respectively).
Conclusions: Our findings support limited value of CTC count for locally advanced breast cancers undergoing neoadjuvant systemic therapy.
Citation Format: Gwark S-C, Kim J, Kim YH, Kim MS, Park JY, Lee SB, Sohn G, Chung IY, Ko BS, Kim HJ, Lee JW, Son BH, Ahn SH. Analysis of serial circulating tumor cell count during neoadjuvant systemic therapy in breast cancer patients [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-09-09.
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Affiliation(s)
- S-C Gwark
- Asan Medical Center, Seoul, Republic of Korea; Cytogen Inc., Seoul, Republic of Korea
| | - J Kim
- Asan Medical Center, Seoul, Republic of Korea; Cytogen Inc., Seoul, Republic of Korea
| | - YH Kim
- Asan Medical Center, Seoul, Republic of Korea; Cytogen Inc., Seoul, Republic of Korea
| | - MS Kim
- Asan Medical Center, Seoul, Republic of Korea; Cytogen Inc., Seoul, Republic of Korea
| | - JY Park
- Asan Medical Center, Seoul, Republic of Korea; Cytogen Inc., Seoul, Republic of Korea
| | - SB Lee
- Asan Medical Center, Seoul, Republic of Korea; Cytogen Inc., Seoul, Republic of Korea
| | - G Sohn
- Asan Medical Center, Seoul, Republic of Korea; Cytogen Inc., Seoul, Republic of Korea
| | - IY Chung
- Asan Medical Center, Seoul, Republic of Korea; Cytogen Inc., Seoul, Republic of Korea
| | - BS Ko
- Asan Medical Center, Seoul, Republic of Korea; Cytogen Inc., Seoul, Republic of Korea
| | - HJ Kim
- Asan Medical Center, Seoul, Republic of Korea; Cytogen Inc., Seoul, Republic of Korea
| | - JW Lee
- Asan Medical Center, Seoul, Republic of Korea; Cytogen Inc., Seoul, Republic of Korea
| | - BH Son
- Asan Medical Center, Seoul, Republic of Korea; Cytogen Inc., Seoul, Republic of Korea
| | - SH Ahn
- Asan Medical Center, Seoul, Republic of Korea; Cytogen Inc., Seoul, Republic of Korea
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Lee Y, Lee HS, Ahn SH, Son BH, Kim J, Lee SB. Abstract P1-02-04: Is asymptomatic surveillance after standard treatment beneficial? : A 10yr-survival analysis of recurrent breast cancer patients by detection method of recurrence. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-02-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Surveillance of recurrence after standard treatment of breast cancer (BC) for early detection and it's impact on overall survival are known to differ depending on recurrent site. Current guideline recommends asymptomatic surveillance to only detect loco-regional recurrences. As the evidences depend on historical randomized clinical trials we aimed to address questions whether earlier detection might have impact on survival now that plenty of new treatment strategies can be offered. Also to give answers to heterogeneous surveillance strategy in real-world practice we performed a retrospective 10yr-survival analysis of a large cohort of recurrent BC patients according to their detection method.
From 4188 operable breast cancer patients who completed standard treatment Asan Medical Center from 2006 to 2008 469 patients with recurrent BC were analyzed. Median disease free interval was 35.3 months (range 2.8-97.6) and overall survival (OS) was analyzed as time from initial diagnosis/surgery to death. Among 469 patients who developed recurrence 23.7% were local (ipsilateral breast skin chest wall) 22.6% were regional (ipsilateral axillary internal mammary lymph nodes) and 53.7% developed distant metastasis. 10yr-overall survival was analyzed according to recurrent site and it's detection method.
Detection of recurrence were categorized as 'asymptomatic surveillance (N=162, 34.5%)' and 'symptom-guided (N=307, 65.5%)'. Asymptomatic screening method included mammography breast-ultrasound serum tumor marker (CA15-3) and systemic images (eg. chest X-ray bone scan PET scans). Symptom-guided detection rate for local regional and distant metastasis was 14.9%, 5.5% and 15.1% respectively. Overall asymptomatic vs symptomatic 10yr-OS did not differ (81.3 vs 78.8 months, p=0.778). Among patients with distant metastasis 10ys-OS was not significantly different (70.3 vs 66.7 months p=0.846) and was similar according to stage/subtype. Among patients with local recurrence only 10yr-OS was 95.1 months ('symptomatic' vs 'aymptomatic 94.4 vs 94.5, p=0.809) which may be insufficient number of events to show significant difference. Among regional recurrent BCs, longer OS was observed in asymptomatically detected patients than symptom-guided group (86.1 vs 63.4, p=0.004). In Cox regression analyses asymptomatic detection showed significant better survival (HR=3.9, 95%CI:1.6-9.5) and this observation was more evident in patients with hormone receptor(HR) negative primary BCs (69.9 vs 47.9, p=0.029). Intriguingly, only 8.6% (7/80) of regional recurrence were diagnosed by mammography.
We observed survival benefit with asymptomatic screening in detecting regional recurrence especially in HR-negative primary BC patients. And role of systemic radiology even in advanced high risk breast cancer patients were limited. Although with limitation that surveillance method varied widely we emphasize the role of aymptomatic surveillance of regional nodal evaluation including breast-ultrasound. These findings are to be validated from a prospective clinical study along with using cutting edge modalities other than radiology which enable detection of micro-metastasis.
Citation Format: Lee Y, Lee HS, Ahn SH, Son BH, Kim J, Lee SB. Is asymptomatic surveillance after standard treatment beneficial? : A 10yr-survival analysis of recurrent breast cancer patients by detection method of recurrence [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-02-04.
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Affiliation(s)
- Y Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - HS Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - SH Ahn
- Asan Medical Center, Seoul, Republic of Korea
| | - BH Son
- Asan Medical Center, Seoul, Republic of Korea
| | - J Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - SB Lee
- Asan Medical Center, Seoul, Republic of Korea
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Gwark SC, Lee JW, Lee SB, Sohn G, Kim J, Chung IY, Ko BS, Kim HJ, Son BH, Ahn SH. Abstract P2-08-22: Clinical implication of HER2/neu status in hormone receptor positive pure mucinous breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Mucinous carcinoma of the breast is a rare type of breast cancer with favorable outcome compared with other types of breast cancer. The current guideline does not recommend chemotherapy/anti-HER2 therapy for mucinous breast cancer with hormone receptor-positive subtype regardless of HER2/neu status. In this study, we evaluated the survival of pure mucinous breast cancer according to tumor stage and subtype.
Methods: Between 1989 and 2014, in Asan Medical Center, Korea, total 473 pure mucinous carcinomas (stage I-III) undergone curative surgery were reviewed retrospectively. 5yr disease-free and overall survival were analyzed according to size, lymph node metastasis, hormone receptor/HER2 status and given therapy.
Result: Total of 473 patients with pure mucinous breast cancer were analyzed and median follow-up duration was 78.00 months. 439 patients were hormone receptor-positive, 374 were node negative, 55 were HER2/neu positive. Among 374 patients with hormone receptor-positive and node-negative, tumor size was <1cm in 46 patients, 1-2.9cm in 259 patients, ≥3cm in 69 patients. In HR-positive/Node-positive BCs, 90.8%(59/65)were given chemotherapy and 35.3%(6/17) were also given trastuzumab. Sixteen patients given trastuzumab were only included in the analysis to assess the benefit of trastuzumab among HER2 positive BCs.
Overall, 5-year disease-free survival (DFS) rate was 94.1% and the 5-year overall survival (OS) rate was 95.9%. Using Cox regression analysis, lymph node metastasis was the only significant prognostic factor for both DFS (HR4.0, 95%CI:1.8-9.0, p=0.001) and OS (HR3.5, 95%CI:1.3-8.9, p=0.008). Among HR-positive/node-negative with tumor size ≥3cm, HER2/neu positivity was only significantly associated with 5yr-DFS (71.4% in HER2/neu+ vs. 96.4% in HER2/neu-, HR9.5, 95%CI:1.3-67.5, p=0.024). This observation was consistently combining both 'HR-positive/node-negative/>3cm' and 'HR-positive/node positive' BCs (N=127) that HER2 positive tumors showed worse survival (HR 3.7, 95%CI:1.2-10.8, p=0.015). Intriguingly, within this subgroup of HR-positive/node-negative/>3cm' and 'HR-positive/node positive' BCs, among HER2 positive tumors, while 5yr-DFS was 63.7% in patients who didn't receive trastuzumab, 100% were disease free in patients who were given trastuzumab.
Conclusions: Overall, nodal status was the most significant prognostic factor for pure mucinous breast cancer. In hormone receptor-positive, lymph node negative mucinous breast cancer with tumor of ≥3cm, HER2 positive BCs showed worse survival, suggesting a potential role of anti-HER2 strategy in this subgroup.
Citation Format: Gwark S-C, Lee JW, Lee SB, Sohn G, Kim J, Chung IY, Ko BS, Kim HJ, Son BH, Ahn SH. Clinical implication of HER2/neu status in hormone receptor positive pure mucinous breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-22.
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Affiliation(s)
- S-C Gwark
- Asan Medical Center, Seoul, Republic of Korea
| | - JW Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - SB Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - G Sohn
- Asan Medical Center, Seoul, Republic of Korea
| | - J Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - IY Chung
- Asan Medical Center, Seoul, Republic of Korea
| | - BS Ko
- Asan Medical Center, Seoul, Republic of Korea
| | - HJ Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - BH Son
- Asan Medical Center, Seoul, Republic of Korea
| | - SH Ahn
- Asan Medical Center, Seoul, Republic of Korea
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Kim J, Jo WK, Kim KY, Kim BJ, Lee SB, Lee HJ, Yu JH, Kim HJ, Chung IY, Ko BS, Kim SB, Jung KH, Ahn JH, Chang S, Lee JW, Son BH, Ahn SH. Abstract P4-01-11: Genomic alterations of cell-free DNA in early breast cancer patients with recurrence. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-01-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Cell-free DNA (cfDNA), as a non-invasive strategy, provides substantial benefit to overcome tumor heterogeneity. Surveillance of recurrence after standard treatment in early breast cancer (BC) using cfDNA, enables to detect minimal residual disease (MRD), also to identify genomic alterations driving recurrences. We aimed to assess the role of cfDNA in detecting MRD by investigating genomic alterations of 1)primary, recurred tumor and 2)cfDNA at time of recurrence using deep targeted sequencing. Fifty-four early BC patients were enrolled prospectively between 2014 and 2017 at time of recurrence. Median disease free interval was 28.5 months (rage 6.2-49.8). 62.7% (32/51) were hormone receptor (HR) positive (28 HRpos/HER2neg, 4 HRpos/HER2pos), 11.8% (6/51) were HRneg/HER2pos and 25.5% (13/51) were triple negative BCs. 59.3% (32/54) patients developed loco-regional recurrence (15 local recurrence only, 13 regional only, 4 with both) and distant metastasis was observed among 40.7% (22/54) patients. Cell-free DNA was extracted from 5cc blood at time of recurrence. Deep targeted sequencing was performed using customized NGS panel –encompassing 426 cancer-related target coding region, 242 fusion and amplification-related region- of cfDNA and FFPE(formalin fixed paraffin embedded) tumor samples archived from surgical resection or biopsy. Deep targeted sequencing data was successfully performed in 72.1% (31/43) plasma samples and sequencing yield was significantly lower when stored for more than 2yrs (46.2% vs 83.3%).
Mutations of cfDNA and tumor (primary, recurred) were analyzed. Mean sequencing depth of cfDNA and FFPE were x425.7 and x777.6 respectively. Median number of pathogenic mutations found in primary tumor, cfDNA and recurred tumor were 27(range 12-99), 25(range 8-85) and 9(range 0-23). Among mutations found in primary tumor, 27.4% were shared mutations (range 8.1%-72.7%) with recurred tumor and 26.1% were shared mutations (range 4.7%-69.2%) observed in cfDNA sample. Among mutations found in recurred tumor, 40.9% were observed in cfDNA (range 17.7-87.5%). In primary tumor, median number of mutations with allelic fraction (MAF)>10% were 12 (range 4-21) and at least one mutation was found in cfDNA at time of recurrence. Among mutations with MAF>10%, 59.4% and 69.1% were found in cfDNA and recurred tumor. Known oncogenic mutations of PIK3CA, TP53, GATA3, AKT1, ESR1, RELN, ERBB2, ERBB3, BRCA1 mutation were found. PIK3CA gene (p.H1047R) was found in two cases both in primary tumor and cfDNA at recurrence (MAF 11.4% vs 5.3% and 12.3% vs 15.4%) suggesting de novo driver mutation. One patient developed regional recurrence during adjuvant aromatase inhibitor with ESR1 V392I mutation in both cfDNA and recurred tumor (MAF 48.1 and 54.5%), while another patient's recurred tumor during aromatase inhibitor harbored ESR1 D538G mutation exclusively in recurred tumor with MAF <1%. Both patients had no ESR1 hotpot mutation in primary tumor.
Our data showed sequencing yield of 83.3% in plasma samples within 2yr. Pathogenic mutations in primary tumor, especially when MAF>10%, half of them was observed in cfDNA at time of recurrence. ESR1 mutation should be included in cfDNA surveillance for patients undergoing endocrine therapy even absent in primary tumor.
Citation Format: Kim J, Jo WK, Kim KY, Kim BJ, Lee SB, Lee HJ, Yu JH, Kim HJ, Chung IY, Ko BS, Kim S-B, Jung KH, Ahn JH, Chang S, Lee JW, Son BH, Ahn SH. Genomic alterations of cell-free DNA in early breast cancer patients with recurrence [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-01-11.
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Affiliation(s)
- J Kim
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - WK Jo
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - KY Kim
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - BJ Kim
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - SB Lee
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - HJ Lee
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - JH Yu
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - HJ Kim
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - IY Chung
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - BS Ko
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S-B Kim
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - KH Jung
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - JH Ahn
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S Chang
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - JW Lee
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - BH Son
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - SH Ahn
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Kim HJ, Noh WC, Nam SJ, Park BW, Lee ES, Im SA, Jung YS, Yoon JH, Kang SS, Park KH, Lee SJ, Jung J, Lee MH, Cho SH, Kim SY, Kim HA, Han SH, Han W, Hur MH, Ahn SH. Abstract P4-14-04: Time course changes in serum FSH, estradiol, and menstruation restoration in premenopausal patients with breast cancer taking adjuvant tamoxifen after completing chemotherapy: A report from the ASTRRA study. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-14-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND
Assessment of restoration of ovarian function after chemotherapy is critical with respect to the initiation of different types of endocrine treatment in young high risk breast cancer patients
METHODS
In total, 1289 women who remained premenopausal or resumed premenopausal status after chemotherapy were randomized to receive 5 years of tamoxifen or 5 years of tamoxifen plus 2 years of ovarian suppression. The patients who did not resume menstruation were followed up for 2 years with tamoxifen treatment after finishing chemotherapy. Prospectively collected consecutive post-chemotherapy hormone and menstruation data were available for 705 breast cancer patients who enrolled tamoxifen-only treatment group or did not resume menstruation during follow up. This analysis evaluated the proportion of patients with pre-menopausal FSH levels (<30 mIU/ml), E2 levels (340 pg/ml), and menstruation at any time point during treatment with tamoxifen.
RESULTS
During 5 years of tamoxifen treatment after chemotherapy for premenopausal breast cancer patients, 62% of patients resumed menstruation. Menstruation returned in 92% of patients under 35 years old but only in 31% of patients over 45 years old. Ovarian function, defined by serum FSH and E2 levels, resumed in 94% and 65% of patients, respectively, over 5 years. Most patients achieved ovarian function restoration during the first 2 years after chemotherapy, with 47.1% resuming menstruation and 86.2% and 50.3% achieving pre-menopausal FSH and E2 levels, respectively, in the first 2 years. Clinical factors related to menstruation restoration were younger age (HR = 6.38, 95% CI 1.33-3.47), 6 month hormone profile after chemotherapy (FSH<30: HR=1.67, 95% CI 1.28-2.17; E2 >40: HR=2.96, 95% CI 2.25-3.89), and anthracycline without taxane chemotherapy (HR=1.63, 95% CI 1.25-2.13).
CONCLUSIONS
During 5 years of tamoxifen treatment after chemotherapy, half of patients experienced menstruation restoration, including most very young patients under 35 years. The majority of patients experienced menstruation restoration in the first 2 years of tamoxifen treatment.
Citation Format: Kim HJ, Noh WC, Nam SJ, Park B-w, Lee ES, Im SA, Jung YS, Yoon JH, Kang SS, Park KH, Lee S-J, Jung J, Lee MH, Cho SH, Kim SY, Kim H-A, Han S-H, Han W, Hur MH, Ahn SH. Time course changes in serum FSH, estradiol, and menstruation restoration in premenopausal patients with breast cancer taking adjuvant tamoxifen after completing chemotherapy: A report from the ASTRRA study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-14-04.
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Affiliation(s)
- HJ Kim
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - WC Noh
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SJ Nam
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - B-w Park
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - ES Lee
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SA Im
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - YS Jung
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - JH Yoon
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SS Kang
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - KH Park
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - S-J Lee
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - J Jung
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - MH Lee
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SH Cho
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SY Kim
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - H-A Kim
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - S-H Han
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - W Han
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - MH Hur
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SH Ahn
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
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22
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Lee S, Ahn SH, Son BH, Lee JW, Chung IY, Ko BS, Kim HJ, Kim J, Shon G. Abstract P2-08-60: Withdrawn. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
Citation Format: Lee S, Ahn SH, Son BH, Lee JW, Chung IY, Ko BS, Kim HJ, Kim J, Shon G. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-60.
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Affiliation(s)
- S Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - SH Ahn
- Asan Medical Center, Seoul, Republic of Korea
| | - BH Son
- Asan Medical Center, Seoul, Republic of Korea
| | - JW Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - IY Chung
- Asan Medical Center, Seoul, Republic of Korea
| | - BS Ko
- Asan Medical Center, Seoul, Republic of Korea
| | - HJ Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - J Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - G Shon
- Asan Medical Center, Seoul, Republic of Korea
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Agarwal K, Ahn SH, Elkhashab M, Lau AH, Gaggar A, Bulusu A, Tian X, Cathcart AL, Woo J, Subramanian GM, Andreone P, Kim HJ, Chuang WL, Nguyen MH. Safety and efficacy of vesatolimod (GS-9620) in patients with chronic hepatitis B who are not currently on antiviral treatment. J Viral Hepat 2018; 25:1331-1340. [PMID: 29851204 DOI: 10.1111/jvh.12942] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/08/2018] [Indexed: 12/23/2022]
Abstract
Vesatolimod is an oral agonist of toll-like receptor 7 designed to minimize systemic exposure and side effects. We assessed the safety and efficacy of vesatolimod in viremic chronic hepatitis B (CHB) patients not currently on oral antiviral treatment (OAV) in a phase 2, multicentre, double-blind, randomized, placebo-controlled study. A total of 192 patients stratified by HBeAg status and alanine aminotransferase level were randomized 2:2:2:1 to receive oral vesatolimod (1-, 2- or 4-mg) or placebo once weekly for 12 weeks; tenofovir disoproxil fumarate (300-mg daily) was administered daily for 48 weeks. Efficacy was assessed by quantitative serum HBsAg decline at Week 24 from baseline. In addition to safety assessments, changes in whole-blood interferon-stimulated gene (ISG) transcripts and serum cytokines were explored. Most patients were male (64.1%) and HBeAg-negative (60.9%) at baseline. Among vesatolimod-treated patients, most (60.4%-69.1%) experienced ≥1 treatment-emergent adverse event; the majority were mild or moderate in severity. No clinically meaningful differences in HBsAg changes from baseline were observed between treatment groups. No patients experienced HBsAg loss, while 3 patients experienced HBeAg loss and hepatitis B e-antibody seroconversion at week 48. HBV DNA suppression rates were similar across all treatment arms at Week 24. ISG15 induction was dose-dependent and did not correlate with HBsAg changes. A small proportion of patients exhibited dose-dependent interferon-α induction that correlated with grade of influenza-like adverse events. Overall, vesatolimod is safe and well tolerated in CHB patients. Although consistent dose-dependent pharmacodynamic induction of ISGs was demonstrated, it did not result in clinically significant HBsAg decline.
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Affiliation(s)
- K Agarwal
- Institute of Liver Studies, Kings College Hospital, London, UK
| | - S H Ahn
- Brain Korea 21 Project of Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | | | - A H Lau
- Gilead Sciences, Inc., Foster City, CA, USA
| | - A Gaggar
- Gilead Sciences, Inc., Foster City, CA, USA
| | - A Bulusu
- Gilead Sciences, Inc., Foster City, CA, USA
| | - X Tian
- Gilead Sciences, Inc., Foster City, CA, USA
| | | | - J Woo
- Gilead Sciences, Inc., Foster City, CA, USA
| | | | - P Andreone
- Center for the Study and Research on Hepatitis, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - H J Kim
- Chung-Ang University Hospital, Seoul, South Korea
| | - W L Chuang
- Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - M H Nguyen
- Stanford University Medical Center, Palo Alto, CA, USA
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Jeong Y, Jin B, Lee HW, Park HJ, Park JY, Kim DY, Han KH, Ahn SH, Kim S. Evolution and persistence of resistance-associated substitutions of hepatitis C virus after direct-acting antiviral treatment failures. J Viral Hepat 2018; 25:1251-1259. [PMID: 29768695 DOI: 10.1111/jvh.12932] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 04/03/2018] [Indexed: 01/19/2023]
Abstract
Daclatasvir plus asunaprevir (DCV+ASV) treatment is an all-oral direct-acting antiviral (DAA) therapy for the genotype 1b HCV-infected patients. In this study, we investigated how resistance-associated substitutions (RASs) evolved after treatment failures and assessed the effect of those substitutions on viral fitness. Sequencing of NS5A and NS3 revealed typical RASs after treatment failures. Interestingly, the RASs of NS3 reverted to the wild-type amino acid within 1 year after treatment failures. However, the RASs of NS5A were stable and did not change. The effect of NS5A and NS3 RASs on viral RNA replication was assessed after mutagenic substitution in the genotype 1b HCV RNA. Among single substitutions, the effect of D168V was more substantial than the others and the effect of the triple mutant combination (D168V+L31V+Y93H) was the most severe. The RAS at NS5A Y93 affected both viral RNA replication and virus production. Finally, the effect of trans-complementation of NS5A was demonstrated in our co-transfection experiments and these results suggest that such a trans-complementation effect of NS5A may help maintain the NS5A RASs for a long time even after cessation of the DAA treatment. In conclusion, the results from this investigation would help understand the emergence and persistence of RASs.
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Affiliation(s)
- Y Jeong
- Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - B Jin
- Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - H W Lee
- Yonsei Liver Center, Severance Hospital, Seoul, Korea.,Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - H J Park
- Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - J Y Park
- Yonsei Liver Center, Severance Hospital, Seoul, Korea.,Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - D Y Kim
- Yonsei Liver Center, Severance Hospital, Seoul, Korea.,Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - K-H Han
- Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea.,Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - S H Ahn
- Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea.,Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - S Kim
- Yonsei Liver Center, Severance Hospital, Seoul, Korea.,Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea.,Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Korea
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Kim BJ, Kwak MK, Ahn SH, Kim JS, Lee SH, Koh JM. The association of cortisol and adrenal androgen with trabecular bone score in patients with adrenal incidentaloma with and without autonomous cortisol secretion. Osteoporos Int 2018; 29:2299-2307. [PMID: 29971455 DOI: 10.1007/s00198-018-4608-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/15/2018] [Indexed: 12/22/2022]
Abstract
UNLABELLED Despite ethnic differences in cortisol sensitivity, only one study in Caucasians has assessed trabecular bone score (TBS) in patients with subclinical hypercortisolism (SH). We showed that both subtle cortisol excess and reduced adrenal androgen may contribute to impaired bone quality in Asian women with SH. INTRODUCTION One study in Caucasians has assessed trabecular bone score (TBS), an index of bone microstructure, in adrenal incidentaloma (AI) patients with subclinical hypercortisolism (SH). There are ethnic differences in cortisol sensitivities between Caucasian and Asian populations. We investigated the associations of cortisol and the adrenal androgen dehydroepiandrosterone-sulfate (DHEA-S) with TBS in AI patients with SH, adrenal Cushing's syndrome (CS), and nonfunctional AI (NFAI). METHODS We measured TBS, cortisol levels after the overnight 1 mg dexamethasone suppression test (1 mg DST), and cortisol/DHEA-S in 61 patients with SH (30 men; 31 women), 19 with adrenal CS (4 men; 15 women), and 355 with NFAI (213 men; 142 women). RESULTS After adjusting for confounders, the serum cortisol level after 1 mg DST was inversely correlated with TBS in men (β = -0.133, P = 0.045) and women (β = - 0.140, P = 0.048). Higher cortisol/DHEA-S ratio was associated with lower TBS in women (β = - 0.252, P < 0.001), but not men. This inverse association of cortisol/DHEA-S ratio in women remained statistically significant after adjusting for the serum cortisol level after 1 mg DST (β = - 0.221, P = 0.008). Compared with women with NFAI, women with SH had 2.2% lower TBS (P = 0.040). Deteriorated bone microstructure (TBS < 1.230) was associated with the serum cortisol level after 1 mg DST (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.04-4.53) and cortisol/DHEA-S ratio (OR, 2.05; 95% CI, 1.03-4.08). CONCLUSIONS Subtle cortisol excess in both genders and reduced DHEA-S, especially in women, may contribute to impaired bone quality in Asian patients with SH.
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Affiliation(s)
- B-J Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - M K Kwak
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - S H Ahn
- Department of Endocrinology, Inha University School of Medicine, Incheon, 22332, South Korea
| | - J S Kim
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - S H Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea.
| | - J-M Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea.
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Han E, Lee YH, Kim BK, Park JY, Kim DY, Ahn SH, Lee BW, Kang ES, Cha BS, Han KH, Kim SU. Sarcopenia is associated with the risk of significant liver fibrosis in metabolically unhealthy subjects with chronic hepatitis B. Aliment Pharmacol Ther 2018; 48:300-312. [PMID: 29920701 DOI: 10.1111/apt.14843] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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] [Received: 10/13/2017] [Revised: 11/02/2017] [Accepted: 05/20/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Sarcopenia is significantly associated with the degree of liver fibrosis. This study investigated the influence of sarcopenia on liver fibrosis in individuals with chronic hepatitis B. METHODS Data from the Korean National Health and Nutrition Examination Surveys 2008-2011 were analysed. The sarcopenia index (total appendicular skeletal muscle mass [kg]/body mass index [kg/m2 ]) was calculated using dual-energy X-ray absorptiometry. Sarcopenia was defined as the lowest quintile sarcopenia index value (cut-offs: 0.89 for men and 0.58 for women). The fibrotic burden was assessed using the nonalcoholic fatty liver disease fibrosis score and fibrosis-4 index. Significant fibrosis was defined as the highest nonalcoholic fatty liver disease fibrosis score quartile and a fibrosis-4 index ≥2.67. RESULTS Among the 506 respondents with chronic hepatitis B (258 men and 248 women), the nonalcoholic fatty liver disease fibrosis score and fibrosis-4 index identified sarcopenia and significant fibrosis in 126 (24.9%) and 217 (42.9%), respectively. Sarcopenia was significantly associated with significant fibrosis, regardless of the fibrosis prediction model used (all P < 0.05). When the study population was stratified according to metabolic factors, sarcopenia was specifically associated with an increased risk of significant fibrosis among subgroups with obesity, insulin resistance, metabolic syndrome and liver steatosis (odds ratio 2.37-3.57; all P < 0.05). An independent association between sarcopenia and significant fibrosis was identified after adjusting for other confounders (odds ratio 2.67-3.62 by the nonalcoholic fatty liver disease fibrosis score and 2.04-2.62 by the fibrosis-4 index; all P < 0.05). CONCLUSIONS Sarcopenia is associated with significant fibrosis in subjects with chronic hepatitis B, specifically those with obesity, insulin resistance, metabolic syndrome and liver steatosis.
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Affiliation(s)
- E Han
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Y-H Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - B K Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - J Y Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - D Y Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - S H Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - B-W Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - E S Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - B-S Cha
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - K-H Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - S U Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
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Jung Y, Ahn SH, Park H, Park SH, Choi K, Choi C, Kang JL, Choi YH. MCP-1 and MIP-3α Secreted from Necrotic Cell-Treated Glioblastoma Cells Promote Migration/Infiltration of Microglia. Cell Physiol Biochem 2018; 48:1332-1346. [PMID: 30048972 DOI: 10.1159/000492092] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 05/25/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Glioblastoma multiforme (GBM) is the most common primary brain tumor in adults. The defining characteristics of GBM are diffuse infiltration of tumor cells into normal brain parenchyma, rapid growth, a high degree of infiltration of microglia and macrophages, and the presence of necrosis. Microglia/macrophages are frequently found in gliomas and they extensively infiltrate GBM tissue, up to 30% of total tumor mass. However, little is known about the effect of necrotic cells (NCs) on microglia infiltration in GBM and the tumor-infiltrating microglia-induced factors in GBMs. METHODS In this study, to address whether necrosis or necrosis-exposed GBM cells affect the degree of microglia/macrophage infiltration, migration and invasion/infiltration assays were performed. Culture supernatants and nuclear extracts of CRT-MG cells treated or untreated with necrotic cells were analyzed using a chemokine array and electrophoretic mobility shift assay, respectively. RESULTS The presence of NCs promoted the migration/infiltration of microglia, and GBM cell line CRT-MG cells exposed to NCs further enhanced the migration and infiltration of HMO6 microglial cells. Treatment with NCs induced mRNA and protein expression of chemokines such as <unterline>M</unterline>onocyte <unterline>C</unterline>hemoattractant <unterline>P</unterline>rotein-1 (CCL2/MCP-1) and <unterline>M</unterline>acrophage <unterline>I</unterline>nflammatory <unterline>P</unterline>rotein-3α (CCL20/MIP-3α) in CRT-MG cells. In particular, CCL2/MCP-1 and CCL20/MIP-3α were significantly increased in NC-treated CRT-MG cells. NCs induced DNA binding of the transcription factors <unterline>N</unterline>uclear <unterline>F</unterline>actor (NF)-κB and <unterline>A</unterline>ctivator <unterline>P</unterline>rotein 1 (AP-1) to the CCL2/MCP-1 and CCL20/MIP-3α promoters, leading to increased CCL2/MCP-1 and CCL20/MIP-3α mRNA and protein expression in CRT-MG cells. CONCLUSION These results provide evidence that NCs induce the expression of CCL2/MCP-1 and CCL20/MIP-3α in glioblastoma cells through activation of NF-κB and AP-1 and facilitate the infiltration of microglia into tumor tissues.
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Affiliation(s)
- Yieun Jung
- Department of physiology, Ewha Womans University School of medicine, Seoul, Republic of Korea.,Tissue Injury Defense Research Center, Ewha Womans University School of medicine, Seoul, Republic of Korea
| | - So-Hee Ahn
- Department of physiology, Ewha Womans University School of medicine, Seoul, Republic of Korea.,Tissue Injury Defense Research Center, Ewha Womans University School of medicine, Seoul, Republic of Korea
| | - Hyunju Park
- Department of physiology, Ewha Womans University School of medicine, Seoul, Republic of Korea.,Tissue Injury Defense Research Center, Ewha Womans University School of medicine, Seoul, Republic of Korea
| | - Sang Hui Park
- Department of Pathology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Kyungsun Choi
- Cellex Life Sciences Inc., Daejeon, Republic of Korea
| | - Chulhee Choi
- Cellex Life Sciences Inc., Daejeon, Republic of Korea.,Department of Bio and Brain Engineering, KAIST, Daejeon, Republic of Korea
| | - Jihee Lee Kang
- Department of physiology, Ewha Womans University School of medicine, Seoul, Republic of Korea.,Tissue Injury Defense Research Center, Ewha Womans University School of medicine, Seoul, Republic of Korea
| | - Youn-Hee Choi
- Department of physiology, Ewha Womans University School of medicine, Seoul, Republic of Korea.,Tissue Injury Defense Research Center, Ewha Womans University School of medicine, Seoul, Republic of Korea
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Chon YE, Jung KS, Kim MJ, Choi JY, An C, Park JY, Ahn SH, Kim BK, Kim SU, Park H, Hwang SK, Rim KS, Han KH, Kim DY. Predictors of failure to detect early hepatocellular carcinoma in patients with chronic hepatitis B who received regular surveillance. Aliment Pharmacol Ther 2018; 47:1201-1212. [PMID: 29492988 DOI: 10.1111/apt.14578] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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] [Received: 09/04/2017] [Revised: 09/28/2017] [Accepted: 01/30/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND A proportion of chronic hepatitis B (CHB) patients are diagnosed with advanced hepatocellular carcinoma (HCC) despite regular surveillance. AIMS To determine predictors for HCC detection failure in CHB patients who underwent regular surveillance. METHODS CHB patients with well-preserved liver function, who underwent ultrasonography and alpha-foetoprotein (AFP) analysis every 6 months, were enrolled. Cox regression analysis was used to identify predictors for detection failure, defined as HCC initially diagnosed at Barcelona Clinic Liver Cancer (BCLC) stage B or C. RESULTS Of the 4590 CHB patients (mean age, 52.1 years; men, 61.6%), 169 patients were diagnosed with HCC (3.68%) and 35 (20.7%) HCC patients were initially diagnosed with HCC BCLC stage B or C. The cumulative incidence of HCC detection failure was 0.2% at year 1 and 1.3% at year 5. Multivariate analyses indicated that cirrhosis (hazard ratio [HR], 3.078; 95% CI, 1.389-6.821; P = 0.006), AFP levels ≥9 ng/mL (HR, 5.235; 95% CI, 2.307-11.957; P = 0.010), and diabetes mellitus (HR, 3.336; 95% CI, 1.341-8.296; P = 0.010) were independent predictors of HCC detection failure. Another model that incorporated liver stiffness (LS) values identified LS values ≥11.7 kPa (HR, 11.045; 95% CI, 2.066-59.037; P = 0.005) and AFP levels ≥9 ng/mL (HR, 4.802; 95% CI, 1.613-14.297; P = 0.005) as predictors of detection failure. CONCLUSIONS In CHB patients undergoing regular surveillance with ultrasonography and alpha-foetoprotein (AFP) analysis every 6 months, the HCC detection failure rate was not high (0.8% per person; 0.1% per test). However, careful attention should be paid in patients with advanced liver fibrosis (clinical cirrhosis or LS value >11.7 kPa), high AFP levels, or diabetes mellitus, who are prone to surveillance failure.
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Affiliation(s)
- Y E Chon
- Department of Internal Medicine, CHA Bundang Medical Center, Institute of Gastroenterology, CHA University, Seongnam, Korea.,CHA Bundang Liver Center, CHA Bundang Medical Center, Seongnam, Korea
| | - K S Jung
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - M-J Kim
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - J-Y Choi
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - C An
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - J Y Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - S H Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - B K Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - S U Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - H Park
- Department of Internal Medicine, CHA Bundang Medical Center, Institute of Gastroenterology, CHA University, Seongnam, Korea.,CHA Bundang Liver Center, CHA Bundang Medical Center, Seongnam, Korea
| | - S K Hwang
- Department of Internal Medicine, CHA Bundang Medical Center, Institute of Gastroenterology, CHA University, Seongnam, Korea.,CHA Bundang Liver Center, CHA Bundang Medical Center, Seongnam, Korea
| | - K S Rim
- Department of Internal Medicine, CHA Bundang Medical Center, Institute of Gastroenterology, CHA University, Seongnam, Korea.,CHA Bundang Liver Center, CHA Bundang Medical Center, Seongnam, Korea
| | - K-H Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - D Y Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Seoul, Korea
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Gwark SC, Lee JW, Lee SB, Sohn G, Kim J, Chung IY, Kim HJ, Ko BS, Son BH, Ahn SH. Abstract P1-07-29: Clinicopathologic characteristics and prognostic factors of pure mucinous breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-07-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Mucinous carcinoma of the breast is a uncommon particular type of breast cancer and comprises approximately 4% of all invasive breast cancers. It is charactarized by abundant extracellular mucin production and present a more favorable prognosis than IDC-NOS. Pathologically, mucinous carcinoma is divided into two subtypes : pure and mixed. In this study, we reviewed the clinicopathologic characteristics and prognostic factors of pure mucinous carcinoma.
Methods: We reviewed the 23 years cumulative data of pure mucinous breast cancer patients from database of the Breast Cancer Center at ASAN medical center, Korea, between 1989-2011, retrospectively. Total 386 pure mucinous carcinoma cases were reviewed to analyze clinicopathologic characteristics and prognosis.
Result: Total of 386 patients with pure mucinous breast cancer were identified. Mean age was 46.7. 149 patients underwent modified radical mastectomy and 236 underwent breast-conserving therapy. The T-stage was T1 in 187 patients, T2 in 178 patients, T3 in 17 patient and T4 in 4 patients. Node negative was 325 and node positive was 61. Estrogen receptor was positive in 342 and negative in 29. Progesterone receptor was positive in 276 and negative in 95. HER-2 was positive in 47 and negative in 273. 152 patients received adjuvant chemotherapy and 240 patients received adjuvant radiotherapy. 351 patients received hormone therapy and among these patients, 231 patients were treated with Tamoxifen alone, 81 were Tamoxifen with ovarian function suppression, 37 were AI only and one patient was ovarian function suppression only. The 5 year disease free survival rate was 93.3%, 5 year cancer specific survival rate was 98.2% and 5 year overall survival rate was 96.6%. Univariate analysis showed that ER status, nodal status and Her2 status were appear to be prognostic factor of Disease free survival rate. Using Cox regression, result of multivariate analysis revealed that only nodal status is the most significant prognostic factor for survival rate.
Conclusions: Pure mucinous carcinoma of the breast is a rare subtype with a favorable prognosis. Nodal status rather than ER status, Her2 status are considered to be the most significant prognostic factor of pure mucinos breast cancer.
Citation Format: Gwark SC, Lee JW, Lee SB, Sohn G, Kim J, Chung IY, Kim HJ, Ko BS, Son BH, Ahn SH. Clinicopathologic characteristics and prognostic factors of pure mucinous breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-07-29.
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Affiliation(s)
- SC Gwark
- Asan Medical Center, Seoul, Republic of Korea
| | - JW Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - SB Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - G Sohn
- Asan Medical Center, Seoul, Republic of Korea
| | - J Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - IY Chung
- Asan Medical Center, Seoul, Republic of Korea
| | - HJ Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - BS Ko
- Asan Medical Center, Seoul, Republic of Korea
| | - BH Son
- Asan Medical Center, Seoul, Republic of Korea
| | - SH Ahn
- Asan Medical Center, Seoul, Republic of Korea
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Ahn SH, Seo DH, Kim SH, Nam MS, Hong S. The relationship between fatty liver index and bone mineral density in Koreans: KNHANES 2010-2011. Osteoporos Int 2018; 29:181-190. [PMID: 29051986 DOI: 10.1007/s00198-017-4257-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 10/05/2017] [Indexed: 12/28/2022]
Abstract
UNLABELLED Analyses using a nationally representative cohort have revealed that high fatty liver index (FLI) is associated with low bone mineral density (BMD) regardless of insulin resistance in men, thereby supporting the deteriorated bone metabolism in nonalcoholic fatty liver disease (NAFLD). INTRODUCTION NAFLD is linked to deteriorated bone health. We investigated the association of FLI, a scoring model for NAFLD, with BMD. METHODS This was a population-based, cross-sectional study from the Korea National Health and Nutrition Examination Surveys including 4264 Koreans (1908 men and 2356 women). FLI was calculated using body mass index, waist circumference, serum triglyceride, and gamma-glutamyltranspeptidase level. Insulin resistance was evaluated using the homeostasis model assessment-estimated insulin resistance (HOMA-IR) index. BMD was measured using dual-energy X-ray absorptiometry at the lumbar spine, total hip, femoral neck, and whole body. RESULTS Men had a higher FLI than women, while the HOMA-IR index was similar between men and women. The significant association between FLI and BMD was observed only in men, but not in women. FLI was negatively correlated with total hip, femoral neck, and whole body BMD in men after adjusting for all potential confounders, including HOMA-IR (P < 0.001 to 0.010). Lumbar spine, total hip, femoral neck, and whole body BMD in men showed a decreasing trend as the FLI tertile increased after adjusting for all potential confounders, including HOMA-IR (P for trends < 0.001 to 0.034). In men aged 50 years or older, odds ratios for combined osteopenia and osteoporosis increased across increasing FLI tertiles after adjusting for confounders (P for trends < 0.011 to 0.029). CONCLUSION NAFLD is associated with low bone density regardless of insulin resistance in men. These findings suggest an undiscovered direct link between liver and bone that increases the risk of osteoporosis in men with NAFLD.
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Affiliation(s)
- S H Ahn
- Division of Endocrinology and Metabolism, Inha University Hospital, Inha University School of Medicine, Incheon, 22332, Republic of Korea
| | - D H Seo
- Division of Endocrinology and Metabolism, Inha University Hospital, Inha University School of Medicine, Incheon, 22332, Republic of Korea
| | - S H Kim
- Division of Endocrinology and Metabolism, Inha University Hospital, Inha University School of Medicine, Incheon, 22332, Republic of Korea
| | - M-S Nam
- Division of Endocrinology and Metabolism, Inha University Hospital, Inha University School of Medicine, Incheon, 22332, Republic of Korea
| | - S Hong
- Division of Endocrinology and Metabolism, Inha University Hospital, Inha University School of Medicine, Incheon, 22332, Republic of Korea.
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Park H, Ahn SH, Jung Y, Yoon J, Choi YH. Leptin Suppresses Glutamate-Induced Apoptosis Through Regulation of ERK1/2 Signaling Pathways in Rat Primary Astrocytes. Cell Physiol Biochem 2017; 44:2117-2128. [DOI: 10.1159/000485950] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/17/2017] [Indexed: 11/19/2022] Open
Abstract
Background/Aims: Leptin is a hormone expressed by adipose tissue that regulates body energy homeostasis and weight loss by activating leptin receptors in the hypothalamus. Leptin receptors are also expressed in astrocytes. An anti-apoptosis effect of leptin in brain has recently been reported. However, the anti-apoptosis mechanism of leptin in the brain is unknown. Methods: To investigate whether leptin exerts protective effects against glutamate-induced apoptosis in astrocytes, we performed cell viability assays and apoptosis assays using rat primary astrocytes. Intracellular signaling pathways involved in anti-apoptosis effects of leptin were analyzed by immunoblotting together with a leptin mutant (S120A/T121A) with antagonist function and pharmacological inhibitors. Results: We found that glutamate-induced apoptosis in rat primary astrocytes was significantly decreased by treatment with leptin. Leptin inhibited glutamate-induced phosphorylation of ERK1/2 in astrocytes. The leptin S120A/T121A mutant did not inhibit glutamate-induced ERK1/2 phosphorylation and ERK1/2-mediated apoptosis. Conclusions: Collectively, our results provide initial evidence that leptin exerts an anti-apoptotic effect against glutamate toxicity through activation of intracellular signaling pathways which reverse glutamate-induced ERK1/2 phosphorylation in primary astrocytes. Therefore, our findings suggest that leptin might be considered a candidate for potential therapeutic applications in glutamate-induced brain excitotoxicity.
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Kim HA, Hwang UJ, Jung SH, Ahn SH, Kim JH, Kwon OY. Comparison of shoulder strength in males with and without myofascial trigger points in the upper trapezius. Clin Biomech (Bristol, Avon) 2017; 49:134-138. [PMID: 28934634 DOI: 10.1016/j.clinbiomech.2017.09.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 08/31/2017] [Accepted: 09/01/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study was conducted in order to compare the strength of scapular elevator and shoulder abductor with and without restricted scapular elevation between male subjects with and without myofascial trigger points in the upper trapezius. METHODS In total, 15 male subjects with myofascial trigger points, and 15age- and weight-matched male subjects without myofascial trigger points in the upper trapezius. Each subject was measured in the strength of maximum isometric scapular elevation and shoulder abduction with and without restricted scapular elevation. Maximum isometric contractions were measured using the Smart KEMA strength measurement system. Independent t-tests were used to compare shoulder strength values between the myofascial trigger points and non- myofascial trigger points groups. FINDING The results showed that shoulder abductor strength in the group with myofascial trigger points (5.64kgf) was significantly lower than in the group without myofascial trigger points (11.96kgf) when scapular elevation was restricted (p<0.05). However, there was no significant difference in the strength of the scapular elevator or shoulder abductor between groups (p>0.05). INTERPRETATION These findings suggest that decreased strength in the shoulder abductor with restricted scapular elevation should be considered in evaluating and treating individuals with myofascial trigger points of the upper trapezius.
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Affiliation(s)
- H A Kim
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - U J Hwang
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea..
| | - S H Jung
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea..
| | - S H Ahn
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea..
| | - J H Kim
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea..
| | - O Y Kwon
- Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis, Yonsei University, Wonju, South Korea.
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Jung Y, Ahn SH, Park SH, Choi YH. Effect of glucose level on chemical hypoxia- and hydrogen peroxide-induced chemokine expression in human glioblastoma cell lines. Korean J Physiol Pharmacol 2017; 21:509-518. [PMID: 28883755 PMCID: PMC5587601 DOI: 10.4196/kjpp.2017.21.5.509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 04/30/2017] [Accepted: 06/01/2017] [Indexed: 01/21/2023]
Abstract
Glioblastoma multiforme (GBM) is the most common primary intracranial tumor in adults and has poor prognosis. The GBM-specific tumor microenvironment (TME) plays a crucial role in tumor progression, immune escape, local invasion, and metastasis of GBM. Here, we demonstrate that hypoxia, reactive oxygen species (ROS), and differential concentration of glucose influence the expression of cytokines and chemokines, such as IL-6, IL-8, and IP-10, in human glial cell lines. Treatment with cobalt chloride (CoCl2) and hydrogen peroxide (H2O2) significantly increased the expression levels of IL-6, IL-8, and IP-10 in a dose-dependent manner in CRT-MG and U251-MG astroglioma cells, but not in microglia cells. However, we found strikingly different patterns of expression of cytokines and chemokines between H2O2-treated CRT-MG cells cultured in low- and high-glucose medium. These results suggest that astroglioma and microglia cells exhibit distinct patterns of cytokine and chemokine expression in response to CoCl2 and H2O2 treatment, and different concentrations of glucose influence this expression under either hypoxic or oxidant-enriched conditions.
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Affiliation(s)
- Yieun Jung
- Department of Physiology, Ewha Womans University School of Medicine, Seoul 07985, Korea.,Tissue Injury Defense Research Center, Ewha Womans University School of Medicine, Seoul 07985, Korea
| | - So-Hee Ahn
- Department of Physiology, Ewha Womans University School of Medicine, Seoul 07985, Korea.,Tissue Injury Defense Research Center, Ewha Womans University School of Medicine, Seoul 07985, Korea
| | - Sang Hui Park
- Department of Pathology, Ewha Womans University School of Medicine, Seoul 07985, Korea
| | - Youn-Hee Choi
- Department of Physiology, Ewha Womans University School of Medicine, Seoul 07985, Korea.,Tissue Injury Defense Research Center, Ewha Womans University School of Medicine, Seoul 07985, Korea
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Siddique MP, Jang WJ, Lee JM, Ahn SH, Suraiya S, Kim CH, Kong IS. groEL is a suitable genetic marker for detecting Vibrio parahaemolyticus by loop-mediated isothermal amplification assay. Lett Appl Microbiol 2017; 65:106-113. [PMID: 28585379 DOI: 10.1111/lam.12760] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 03/09/2017] [Revised: 04/18/2017] [Accepted: 05/18/2017] [Indexed: 01/13/2023]
Abstract
A groEL gene-based loop-mediated isothermal amplification (LAMP) assay was developed to detect Vibrio parahaemolyticus in contaminated seafood and water. The assay was optimized and conducted at 63°C for 40 min using Bacillus stearothermophilus (Bst) DNA polymerase, large fragment. Amplification was analysed via multiple detection methods, including opacity, formation of white precipitate, DNA intercalating dyes (ethidium bromide and SYBR Green I), metal ion-binding indicator dye, calcein, and 2% agarose gel electrophoresis. A characteristic ladder-like band pattern on agarose gel and the desired colour changes when using different dyes were observed in positive cases, and these were species-specific for V. parahaemolyticus when compared with other closely related Vibrio spp. The limit of detection (LoD) of this assay was 100 fg per reaction, 100-fold higher than that for conventional polymerase chain reaction (PCR). When tested on artificially contaminated seafood and seawater, the LoDs of the LAMP assay were 120 and 150 fg per reaction respectively, and those of conventional PCR were 120 and 150 pg per reaction respectively. Based on our results, the groEL gene-based LAMP assay is rapid, specific, sensitive, and reliable for detecting V. parahaemolyticus, and it could be used in field diagnosis. SIGNIFICANCE AND IMPACT OF THE STUDY The loop-mediated isothermal amplification (LAMP) assay using groEL gene (an abundant, highly conserved gene and member of the groESL chaperone gene family) provided rapid, species-specific and highly sensitive method for detecting Vibrio parahaemolyticus, the leading causal agent of seafood-borne diseases worldwide. Moreover, groEL LAMP revealed high efficiency than conventional PCR assay for V. parahaemolyticus using template both from pure culture and artificially contaminated seafood and water, which indicated the applicability in the field and environmental screening purpose for the organism.
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Affiliation(s)
- M P Siddique
- Department of Biotechnology, Pukyong National University, Busan, Korea
| | - W J Jang
- Department of Biotechnology, Pukyong National University, Busan, Korea
| | - J M Lee
- Department of Biotechnology, Pukyong National University, Busan, Korea
| | - S H Ahn
- Department of Oral Biochemistry, Dental Science Research Institute, Medical Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - S Suraiya
- Department of Biotechnology, Pukyong National University, Busan, Korea
| | - C H Kim
- Department of Marine Bio-materials & Aquaculture, Pukyong National University, Busan, Korea
| | - I S Kong
- Department of Biotechnology, Pukyong National University, Busan, Korea
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Jung Y, Ahn SH, Park H, Lim J, Kang JL, Choi YH, Kim EJ. Abstract 5924: Necrotic cells promote microglia infiltration in glioblastoma through regulating MCP-1 and MIP-3α expression. Tumour Biol 2017. [DOI: 10.1158/1538-7445.am2017-5924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ahn SH, Park H, Kim JS, Ahn YH, Kim S, Cho MS, Kang JL, Choi YH. Abstract 5931: Effect of necrosis on the migration, invasion and miRNA-mRNA association in glioblastoma cells. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-5931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Grade IV astrocytoma, also called glioblastoma multiforme (GBM), is considered the most malignant glial tumor. The purpose of our study is to understand the molecular mechanisms underlying the signaling network between necrotic tissues and GBM cells by exploring the effect of necrosis on GBM migration, invasion and miRNA-mRNA association. The migration and invasion of the CRT-MG human astroglioma cells were significantly enhanced by treatment with necrotic cells, as shown by assays for scratch wound healing and spheroid invasion. Incubation with necrotic cells induced IL-8 secretion in CRT-MG in dose-dependent manner. Immunohistochemical and immunoflurorescence analysis for IL-8 in human GBM tissues showed that positively stained cells were mainly distributed in perinecrotic region. Necrotic cells induced NF-κB and AP-1 activation and their DNA binding to IL-8 promoter, leading to enhanced IL-8 production and secretion in GBM cells. To determine the effect of necrosis on the miRNA profiles and regulatory relationship, the expression profiles of miRNA and mRNA and association between mRNA and their corresponding miRNAs were analyzed by next-generation sequencing (NGS). Our results demonstrate that necrotic cells enhance the migration and invasion of GBM cells through NF-κB/AP-1/IL-8 signaling pathway and induce dysregulation of miRNA and mRNA expression profiles in GBM cells.
Citation Format: So-Hee Ahn, Hyunju Park, Jeong Seon Kim, Young-Ho Ahn, Sewha Kim, Min-Sun Cho, Jihee Lee Kang, Youn-Hee Choi. Effect of necrosis on the migration, invasion and miRNA-mRNA association in glioblastoma cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 5931. doi:10.1158/1538-7445.AM2017-5931
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Affiliation(s)
- So-Hee Ahn
- 1Department Physiology, Tissue Injury Defense Research Center, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Hyunju Park
- 1Department Physiology, Tissue Injury Defense Research Center, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Jeong Seon Kim
- 2Department Molecular Medicine, Tissue Injury Defense Research Center, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Young-Ho Ahn
- 2Department Molecular Medicine, Tissue Injury Defense Research Center, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Sewha Kim
- 3Deparment of Pathology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Min-Sun Cho
- 3Deparment of Pathology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Jihee Lee Kang
- 1Department Physiology, Tissue Injury Defense Research Center, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Youn-Hee Choi
- 1Department Physiology, Tissue Injury Defense Research Center, Ewha Womans University School of Medicine, Seoul, Republic of Korea
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Ahn SH, Ahn JH, Ryu DR, Lee J, Cho MS, Choi YH. Effect of Necrosis on the miRNA-mRNA Regulatory Network in CRT-MG Human Astroglioma Cells. Cancer Res Treat 2017; 50:382-397. [PMID: 28546527 PMCID: PMC5912152 DOI: 10.4143/crt.2016.551] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 11/22/2016] [Accepted: 04/25/2017] [Indexed: 12/14/2022] Open
Abstract
Purpose Glioblastoma multiforme (GBM) is the most common adult primary intracranial tumor. The remarkable features of GBM include central necrosis. MicroRNAs (miRNAs) have been considered as diagnostic/prognostic biomarkers for many cancers, including glioblastoma. However, the effect of necrosis on the miRNA expression profile and predicted miRNA-mRNA regulatory information remain unclear. The purpose of this study is to examine the effect of necrotic cells on the modulation of miRNA and mRNA expression profiles and miRNA-mRNA network in CRT-MG cells. Materials and Methods We used human astroglioma cells, CRT-MG, treated with necrotic CRT-MG cells to examine the effect of necrosis on the modulation of miRNA and mRNA by next-generation sequencing. For preparation of necrotic cells, CRT-MGcellswere frozen and thawed through cycle of liquid nitrogen–water bath. The putative miRNA-mRNA regulatory relationshipwas inferred through target information, using miRDB. Results The necrotic cells induced dysregulation of 106 miRNAs and 887 mRNAs. Among them, 11 miRNAs that had a negative correlation value of p < 0.05 by the hypergeometric test were screened, and their target mRNAs were analyzed by Gene Ontology enrichment analysis. Using the Kyoto Encyclopedia of Genes and Genomes database, we also found several necrotic cell treatment-activated pathways that were modulated by relevant gene targets of differentially expressed miRNAs. Conclusion Our result demonstrated that dysregulation of miRNA and mRNA expression profiles occurs when GBM cells are exposed to necrotic cells, suggesting that several miRNAs may have the potential to be used as biomarkers for predicting GBM progression and pathogenesis.
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Affiliation(s)
- So-Hee Ahn
- Department of Physiology, Ewha Womans University School of Medicine,Seoul, Korea.,Tissue Injury Defense Research Center, Ewha Womans University School of Medicine,Seoul, Korea
| | - Jung-Hyuck Ahn
- Tissue Injury Defense Research Center, Ewha Womans University School of Medicine,Seoul, Korea.,Department of Biochemistry, Ewha Womans University School of Medicine,Seoul, Korea
| | - Dong-Ryeol Ryu
- Tissue Injury Defense Research Center, Ewha Womans University School of Medicine,Seoul, Korea.,Department of Internal medicine, Ewha Womans University School of Medicine,Seoul, Korea
| | - Jisoo Lee
- Department of Internal medicine, Ewha Womans University School of Medicine,Seoul, Korea
| | - Min-Sun Cho
- Department of Pathology, Ewha Womans University School of Medicine,Seoul, Korea
| | - Youn-Hee Choi
- Department of Physiology, Ewha Womans University School of Medicine,Seoul, Korea.,Tissue Injury Defense Research Center, Ewha Womans University School of Medicine,Seoul, Korea
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Kim H, Baek KH, Lee SY, Ahn SH, Lee SH, Koh JM, Rhee Y, Kim CH, Kim DY, Kang MI, Kim BJ, Min YK. Association of circulating dipeptidyl-peptidase 4 levels with osteoporotic fracture in postmenopausal women. Osteoporos Int 2017; 28:1099-1108. [PMID: 27866216 DOI: 10.1007/s00198-016-3839-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 11/10/2016] [Indexed: 01/15/2023]
Abstract
UNLABELLED Postmenopausal women with osteoporotic fracture (OF) had higher plasma dipeptidyl-peptidase 4 (DPP4) levels than those without. Furthermore, higher plasma DPP4 levels were significantly associated with higher bone turnover and a higher prevalence of OF. These results indicated that DPP4 may be associated with OF by mediating bone turnover rate. INTRODUCTION Evidence indicates that dipeptidyl-peptidase 4 (DPP4) plays a distinct role in bone metabolism. However, there has been no report on the association, if any, between circulating DPP4 levels and osteoporosis-related phenotypes, including osteoporotic fracture (OF). Therefore, we performed a case-control study to investigate these associations in postmenopausal women. METHODS This study was conducted in multiple centers in Korea. We enrolled 178 cases with OF and 178 age- and body mass index-matched controls. OF was assessed by an interviewer-assisted questionnaire and lateral thoracolumbar radiographs. Bone turnover markers (BTMs), bone mineral density (BMD), and plasma DPP4 levels were obtained in all subjects. RESULTS After adjustment for potential confounders, subjects with OF had significantly higher DPP4 levels than those without (P = 0.021). Higher DPP4 levels were significantly positively associated with higher levels of all BTMs, but not with BMD at all measured sites. The differences in DPP4 levels according to OF status disappeared after an additional adjustment for each BTM, but not after adjustment for any BMD values. BTMs explained approximately half of the relationship between DPP4 and OF. The risk of OF was 3.80-fold (95% confidence interval = 1.53-9.42) higher in subjects in the highest DPP4 quartile than in those in the lowest quartile after adjustment for potential confounders, including femoral neck BMD. CONCLUSIONS DPP4 may be associated with OF by at least partly mediating the bone turnover rate. Circulating DPP4 levels may be a potential biomarker that could increase the predictive power of current fracture risk assessment models.
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Affiliation(s)
- H Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea
| | - K H Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, 137-701, South Korea
| | - S-Y Lee
- Asan Institute for Life Science, Seoul, 138-736, South Korea
| | - S H Ahn
- Department of Endocrinology, Inha University School of Medicine, Incheon, 402-751, South Korea
| | - S H Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea
| | - J-M Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea
| | - Y Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, 120-752, South Korea
| | - C H Kim
- Department of Internal Medicine, Sejong General Hospital, Bucheon, 422-711, South Korea
| | - D-Y Kim
- Department of Nuclear Medicine, Kyunghee University School of Medicine, Seoul, 130-872, South Korea
| | - M-I Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, 137-701, South Korea
| | - B-J Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
| | - Y-K Min
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Republic of Korea.
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Chung IY, Lee JW, Lee JS, Park YR, Lee Y, Lee SB, Kim HJ, Ko BS, Son BH, Ahn SH. Abstract P6-09-38: Interaction between body mass index and hormone receptor status as a prognostic factor in node-positive breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-09-38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: The aim of this study was to investigate the interaction between BMI at breast cancer diagnosis and the various factors including hormone-receptor, menopausal and nodal status, and to find a specific subgroup where BMI has an effect on breast cancer prognosis.
Methods: We retrospectively analyzed the data of 8,763 non-metastatic invasive breast cancer patients from the Asan Medical Center's research database. Overall survival (OS) and breast cancer-specific survival (BCSS) among BMI groups were compared using the Kaplan-Meier method and Cox proportional hazard model with interaction term.
Results: Only in node-positive breast cancer, there was a significant interaction between obesity (BMI ≥ 30.0 kg/m2) at diagnosis and positive hormone receptor which showed worse overall survival (OS) and breast cancer specific survival (BCSS) than normal weight patients (adjusted hazard ratio [HR] = 1.65, 95% confidence interval [CI] = 1.01 to 2.69 and HR = 1.90, 95% CI = 1.15 to 3.15, respectively). Underweight (BMI<18.50 kg/m2) which interacted with negative hormone receptor status in node-positive breast cancer was associated with decreased OS (HR = 2.01, 95% CI = 1.02 to 3.98) and BCSS (HR = 2.15, 95% CI = 1.08 to 4.26). There was no significant interaction between BMI and hormone receptor status in node-negative setting and BMI did not interact with menopausal status in any population.
Conclusions: BMI interacts with hormone receptor status in node positive setting, thereby playing a role in the breast cancer prognosis.
Citation Format: Chung IY, Lee JW, Lee JS, Park YR, Lee Y, Lee SB, Kim HJ, Ko BS, Son BH, Ahn SH. Interaction between body mass index and hormone receptor status as a prognostic factor in node-positive breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-09-38.
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Affiliation(s)
- IY Chung
- Asan Medical Center, Seoul, Republic of Korea
| | - JW Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - JS Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - YR Park
- Asan Medical Center, Seoul, Republic of Korea
| | - Y Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - SB Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - HJ Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - BS Ko
- Asan Medical Center, Seoul, Republic of Korea
| | - BH Son
- Asan Medical Center, Seoul, Republic of Korea
| | - SH Ahn
- Asan Medical Center, Seoul, Republic of Korea
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Lee S, Ahn SH, Jung KS, Kim DY, Kim BK, Kim SU, Baatarkhuu O, Ku HJ, Han K, Park JY. Tenofovir versus tenofovir plus entecavir for chronic hepatitis B with lamivudine resistance and entecavir resistance. J Viral Hepat 2017; 24:141-147. [PMID: 27766731 DOI: 10.1111/jvh.12623] [Citation(s) in RCA: 18] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 08/23/2016] [Indexed: 12/29/2022]
Abstract
We compared the viral suppressive efficacy of tenofovir disoproxil fumarate (TDF) mono-rescue therapy (TDF group) and TDF plus entecavir (ETV) combination-rescue therapy (TDF + ETV group) in chronic hepatitis B (CHB) patients with lamivudine resistance and entecavir resistance. One hundred and thirty-three CHB patients with lamivudine and entecavir resistance were investigated. Ninety-six patients were treated with TDF and 37 with TDF + ETV for at least 6 months. We compared the virologic response rate (HBV DNA level <20 IU/mL) between the two groups and identified the predictive factors of treatment outcome. There were no significant differences between the two groups in demographic characteristics. Up to 24 months [median: 18 (range 6-24) months], 85.4% and 89.2% of the TDF group and TDF + ETV group, respectively, achieved a virologic response (P=.068). Only the HBV DNA level at baseline was significantly associated with a virologic response in the multivariate analysis. In a subanalysis of patients with HBV DNA levels ≥4 log (IU/mL) at baseline, a higher proportion of patients in the TDF + ETV group than the TDF group achieved a virologic response (92.9% vs 68.3%; P<.001), while 90% of patients with HBV DNA (IU/mL) levels <4 log in all both TDF and TDF + ETV groups achieved a virologic response. TDF mono-rescue therapy is a reasonable option in patients with lamivudine resistance and entecavir resistance. However, the combination strategy should be considered in patients with high baseline HBV DNA levels.
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Affiliation(s)
- S Lee
- Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon Metropolitan City, Korea.,Institute for Integrative Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon Metropolitan City, Korea
| | - S H Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - K S Jung
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - D Y Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - B K Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - S U Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - O Baatarkhuu
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Infectious Diseases, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - H J Ku
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - K Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - J Y Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
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Marcellin P, Ahn SH, Chuang WL, Hui AJ, Tabak F, Mehta R, Petersen J, Lee CM, Ma X, Caruntu FA, Tak WY, Elkhashab M, Lin L, Wu G, Martins EB, Charuworn P, Yee LJ, Lim SG, Foster GR, Fung S, Morano L, Samuel D, Agarwal K, Idilman R, Strasser SI, Buti M, Gaeta GB, Papatheodoridis G, Flisiak R, Chan HLY. Predictors of response to tenofovir disoproxil fumarate plus peginterferon alfa-2a combination therapy for chronic hepatitis B. Aliment Pharmacol Ther 2016; 44:957-966. [PMID: 27629859 DOI: 10.1111/apt.13779] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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] [Received: 05/27/2016] [Revised: 06/17/2016] [Accepted: 08/04/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND In patients with chronic hepatitis B, tenofovir disoproxil fumarate (TDF) plus pegylated interferon (PEG-IFN) for 48-weeks results in higher rates of hepatitis B surface antigen (HBsAg) loss than either monotherapy. AIM To identify baseline and on-treatment factors associated with HBsAg loss at Week 72 and provide a model for predicting HBsAg loss in patients receiving combination therapy for 48 weeks. METHODS A secondary analysis of data from an open-label study where patients were randomised to TDF (300 mg/day, oral) plus PEG-IFN (PI, 180 μg/week, subcutaneous) for 48 weeks (TDF/PI-48w); TDF plus PEG-IFN for 16 weeks, TDF for 32 weeks (TDF/PI-16w+TDF-32w); TDF for 120 weeks (TDF-120w) or PEG-IFN for 48 weeks (PI-48w). Logistic regression methods were used to identify models that best predicted HBsAg loss at Week 72. RESULTS Rates of HBsAg loss at Week 72 were significantly higher in the TDF/PI-48w group (6.5%) than in the TDF/PI-16w+TDF-32w (0.5%), TDF-120w (0%) and PI-48w (2.2%) groups (P = 0.09). The only baseline factor associated with response was genotype A. HBsAg decline at Week 12 or 24 of treatment was associated with HBsAg loss at Week 72 (P < 0.001). HBsAg decline >3.5 log10 IU/mL at Week 24 in the TDF/PI-48w group resulted in a positive predictive value of 85% and a negative predictive value of 99% for HBsAg loss at Week 72. CONCLUSIONS HBsAg decline at Week 24 of TDF plus PEG-IFN combination therapy may identify patients who, after completing 48 weeks of treatment, have a better chance of achieving HBsAg loss at Week 72.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - L Lin
- Gilead Sciences, Inc., Foster City, CA, USA
| | - G Wu
- Gilead Sciences, Inc., Foster City, CA, USA
| | | | | | - L J Yee
- Gilead Sciences, Inc., Foster City, CA, USA
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Ahn SH, Roh HJ, Cho HJ, You SG, Lee SH, Kwon YS. Pure non-gestational choriocarcinoma arising in the ovary. EUR J GYNAECOL ONCOL 2016; 37:549-553. [PMID: 29894083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Non-gestational choriocarcinoma (NGCO) is a rare primary ovarian cancer with poor prognosis. It is important to distinguish it from gestational ovarian choriocarcinoma (GCO), because there are different treatment options. However, it is difficult to distinguish the two types by routine histologic, ultrastructural, or immunohistochemical examination. The authors present NGCO in a 41-year-old woman, which was confirmed by DNA polymorphism analysis. All tested microsatellite markers had identical DNA profiles with the same allelic sizes between tumor and normal myometrium of the patient, indicating that both tissues originated from the same person. The results confirmed that the tumor was non-gestational in origin. Although the tumor was large, the authors performed hand- assisted laparoscopic surgical (HALS) staging. After three cycles of combination chemotherapy and surgery, the patient has not had any evidence of disease 48 months after treatment. This case demonstrates the usefulness of HALS staging and DNA polymorphism analysis in NGCO.
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Bae SJ, Lee SH, Ahn SH, Kim HM, Kim BJ, Koh JM. The circulating sphingosine-1-phosphate level predicts incident fracture in postmenopausal women: a 3.5-year follow-up observation study. Osteoporos Int 2016; 27:2533-41. [PMID: 26984570 DOI: 10.1007/s00198-016-3565-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 03/08/2016] [Indexed: 12/31/2022]
Abstract
UNLABELLED A high level of circulating sphingosine-1-phosphate (S1P) is associated with a high incidence of osteoporotic fracture and a high rate of an insufficient response to bisphosphonate therapy. INTRODUCTION Sphingosine-1-phosphate (S1P) is a significant regulator of bone metabolism. Recently, we found that a high plasma S1P level is associated with low bone mineral density (BMD), high levels of bone resorption markers (BRMs), and a high risk of prevalent vertebral fracture in postmenopausal women. We investigated the possibility that S1P is a predictor of incident fracture. METHODS A total of 248 postmenopausal women participated in this longitudinal study and were followed up for a mean duration of 3.5 years (untreated [n = 76] or treated with bisphosphonate or hormone replacement therapy [n = 172]). The baseline plasma S1P level and prevalent and incident fracture occurrence were assessed. RESULTS A high S1P level was significantly associated with a higher rate of prevalent fracture after adjusting for femoral neck (FN) BMD, BRM, and potential confounders (odds ratio = 2.05; 95 % confidence interval [CI] = 1.03-4.00). Incident fractures occurred more frequently in the highest S1P tertile (T3) than in the lower two tertiles (T1-2) after adjusting for confounders, including baseline FN BMD, prevalent fracture, antiosteoporotic medication, annualized changes in FN BMD, BRM, and potential confounders (hazard ratio = 5.52; 95 % CI = 1.04-56.54). Insufficient response to bisphosphonate therapy occurred more frequently in T3 than T1-2 (odds ratio = 4.43; 95 % CI = 1.02-21.25). CONCLUSIONS The plasma S1P level may be a potential predictor of fracture occurrence and an insufficient response to bisphosphonate therapy in postmenopausal women.
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Affiliation(s)
- S J Bae
- Health Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43 gil, Ulsan, Seoul, 05505, South Korea
| | - S H Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-gu, Seoul, 05505, South Korea
| | - S H Ahn
- Department of Endocrinology, Inha University School of Medicine, 27 Inhang-ro, Jung-Gu, Songpa-gu, Incheon, 22332, South Korea
| | - H-M Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-gu, Seoul, 05505, South Korea
| | - B-J Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-gu, Seoul, 05505, South Korea
| | - J-M Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-gu, Seoul, 05505, South Korea.
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Ahn SH, Cho SH, Song JE, Kim S, Oh SS, Jung S, Cho KA, Lee TH. Caveolin-1 serves as a negative effector in senescent human gingival fibroblasts during Fusobacterium nucleatum infection. Mol Oral Microbiol 2016; 32:236-249. [PMID: 27315395 DOI: 10.1111/omi.12167] [Citation(s) in RCA: 15] [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] [Accepted: 06/15/2016] [Indexed: 12/11/2022]
Abstract
It is well established that aging is associated with increased susceptibility to infectious diseases. Fusobacterium nucleatum is a well-known bacterial species that plays a central bridging role between early and late colonizers in the human oral cavity. Further, the ability of F. nucleatum to invade gingival fibroblasts (GFs) is critical to the development of periodontal diseases. However, the mechanisms underlying the age-related infection of GFs by F. nucleatum remain unknown. We used young (fourth passage) and senescent (22nd passage) GFs to investigate the mechanisms of F. nucleatum infection in aged GFs and first observed increased invasion of F. nucleatum in senescent GFs. We also found that the co-localization of caveolin-1 (Cav-1), a protein marker of aging, with F. nucleatum and the knockdown of Cav-1 in GFs reduced F. nucleatum invasion. Additionally, F. nucleatum infection triggered the production of reactive oxygen species (ROS) through activation of NADPH oxidase in GFs, but senescent GFs exhibited significantly lower levels of NADPH oxidase activity and ROS production compared with young GFs in both the uninfected and infected conditions. Also, senescent GFs exhibited a decline in proinflammatory cytokine production and extracellular signal regulated kinase (ERK) phosphorylation following F. nucleatum infection. Interestingly, the knockdown of Cav-1 in senescent GFs increased NADPH oxidase activity and caused the upregulation of interleukin-6 and interleukin-8 and the phosphorylation of ERK. Collectively, the increased expression of Cav-1 might play a critical role in F. nucleatum invasion and could hinder the host response in senescent GFs.
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Affiliation(s)
- S H Ahn
- Department of Oral Biochemistry, Dental Science Research Institute, Medical Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - S-H Cho
- Department of Molecular Medicine (BK21plus), Chonnam National University Graduate School, Gwangju, Korea
| | - J-E Song
- Department of Molecular Medicine (BK21plus), Chonnam National University Graduate School, Gwangju, Korea
| | - S Kim
- Department of Oral Biochemistry, Dental Science Research Institute, Medical Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, Korea.,Department of Molecular Medicine (BK21plus), Chonnam National University Graduate School, Gwangju, Korea
| | - S S Oh
- Department of Oral Biochemistry, Dental Science Research Institute, Medical Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - S Jung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - K A Cho
- Department of Biochemistry, Chonnam National University Medical School, Gwangju, Korea
| | - T-H Lee
- Department of Oral Biochemistry, Dental Science Research Institute, Medical Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, Korea.,Department of Molecular Medicine (BK21plus), Chonnam National University Graduate School, Gwangju, Korea
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45
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Ahn SH, Lim YS, Lee KS, Paik SW, Lee YJ, Jeong SH, Kim JH, Yoon SK, Yim HJ, Tak WY, Han SY, Yang JC, Mo H, Mathias A, Han L, Knox SJ, Brainard DM, Kim YJ, Byun KS, Kim YS, Heo J, Han KH. A phase 3b study of sofosbuvir plus ribavirin in treatment-naive and treatment-experienced Korean patients chronically infected with genotype 2 hepatitis C virus. J Viral Hepat 2016; 23:358-65. [PMID: 26864153 DOI: 10.1111/jvh.12499] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/05/2015] [Indexed: 01/04/2023]
Abstract
In Korea, patients with chronic hepatitis C virus (HCV) infection are typically treated with pegylated interferon-alpha plus ribavirin, but interferons are contraindicated in many patients and are often poorly tolerated, particularly by the elderly and those with advanced liver disease. No interferon-free treatment regimens are approved in Korea. Sofosbuvir is an oral nucleotide analog inhibitor of the HCV nonstructural 5B RNA polymerase. It is approved in the USA, European Union and Japan for treating a number of HCV genotypes, including genotype 2. Genotype 2 has a seroprevalence of 38-46% in Korea. This single-arm, phase 3b study (NCT02021643) examined the efficacy and safety of sofosbuvir plus ribavirin (12-week duration) in chronic genotype 2 HCV-infected treatment-naive and treatment-experienced Korean patients with and without cirrhosis. The proportion of patients with sustained virologic response 12 weeks after treatment discontinuation (SVR12) was 97% (125/129), with 96% (101/105) of treatment-naive and 100% (24/24) of treatment-experienced patients achieving SVR12. Two patients experienced virologic failure (n = 1, on-treatment failure; n = 1, relapse). No patient discontinued study treatment due to an adverse event (AE). The most common treatment-emergent AEs were headache (18%, 23/129) and pruritus (15%, 19/129). Few patients had grade 3 AEs (5%, 6/129) or grade 3 laboratory abnormalities (12%, 15/129). No grade 4 AE was reported. These data suggest that 12 weeks of treatment with the all-oral, interferon-free regimen of sofosbuvir plus ribavirin is effective and well tolerated in Korean patients with chronic genotype 2 HCV infection.
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Affiliation(s)
- S H Ahn
- Yonsei University College of Medicine, Seoul-Korea, South Korea
| | - Y S Lim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul-Korea, South Korea
| | - K S Lee
- Gangnam Severance Hospital, Yonsei University Health System, Seoul-Korea, South Korea
| | - S W Paik
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul-Korea, South Korea
| | - Y J Lee
- Pusan Paik Hospital, Inje University, Busan-Korea, South Korea
| | - S H Jeong
- Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-Korea, South Korea
| | - J H Kim
- Gachon University Gil Hospital, Incheon-Korea, South Korea
| | - S K Yoon
- Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul-Korea, South Korea
| | - H J Yim
- Korea University Ansan Hospital, Ansan-si, Gyeonggi-do-Korea, South Korea
| | - W Y Tak
- Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, South Korea
| | - S Y Han
- Dong-A University Medical Center, Busan-Korea, South Korea
| | - J C Yang
- Gilead Sciences Inc., Foster City, CA, USA
| | - H Mo
- Gilead Sciences Inc., Foster City, CA, USA
| | - A Mathias
- Gilead Sciences Inc., Foster City, CA, USA
| | - L Han
- Gilead Sciences Inc., Foster City, CA, USA
| | - S J Knox
- Gilead Sciences Inc., Foster City, CA, USA
| | | | - Y J Kim
- Seoul National University Hospital, Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea
| | - K S Byun
- Korea University Guro Hospital, Seoul-Korea, South Korea
| | - Y S Kim
- Soonchunhyang University Bucheon Hospital, Bucheon-Korea, South Korea
| | - J Heo
- Pusan National University and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - K H Han
- Yonsei University College of Medicine, Seoul-Korea, South Korea
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46
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Ahn SH, Park H, Ahn YH, Kim S, Cho MS, Kang JL, Choi YH. Necrotic cells influence migration and invasion of glioblastoma via NF-κB/AP-1-mediated IL-8 regulation. Sci Rep 2016; 6:24552. [PMID: 27076368 PMCID: PMC4830983 DOI: 10.1038/srep24552] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [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: 02/02/2016] [Accepted: 03/31/2016] [Indexed: 01/01/2023] Open
Abstract
Glioblastoma multiforme (GBM) is the most common primary intracranial tumor in adults and has poor prognosis. Diffuse infiltration into normal brain parenchyma, rapid growth, and the presence of necrosis are remarkable hallmarks of GBM. However, the effect of necrotic cells on GBM growth and metastasis is poorly understood at present. In this study, we examined the biological significance of necrotic tissues by exploring the molecular mechanisms underlying the signaling network between necrotic tissues and GBM cells. The migration and invasion of the GBM cell line CRT-MG was significantly enhanced by treatment with necrotic cells, as shown by assays for scratch wound healing and spheroid invasion. Incubation with necrotic cells induced IL-8 secretion in CRT-MG cells in a dose-dependent manner. In human GBM tissues, IL-8 positive cells were mainly distributed in the perinecrotic region, as seen in immunohistochemistry and immunofluorescence analysis. Necrotic cells induced NF-κB and AP-1 activation and their binding to the IL-8 promoter, leading to enhanced IL-8 production and secretion in GBM cells. Our data demonstrate that when GBM cells are exposed to and stimulated by necrotic cells, the migration and invasion of GBM cells are enhanced and facilitated via NF-κB/AP-1 mediated IL-8 upregulation.
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Affiliation(s)
- So-Hee Ahn
- Department of Physiology, Ewha Womans University School of Medicine, Seoul 911-1, Korea.,Tissue Injury Defense Research Center , School of Medicine, Ewha Womans University, Seoul, Korea
| | - Hyunju Park
- Department of Physiology, Ewha Womans University School of Medicine, Seoul 911-1, Korea.,Tissue Injury Defense Research Center , School of Medicine, Ewha Womans University, Seoul, Korea
| | - Young-Ho Ahn
- Tissue Injury Defense Research Center , School of Medicine, Ewha Womans University, Seoul, Korea.,Department of Molecular Medicine , School of Medicine, Ewha Womans University, Seoul, Korea
| | - Sewha Kim
- Department of Pathology, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Min-Sun Cho
- Department of Pathology, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Jihee Lee Kang
- Department of Physiology, Ewha Womans University School of Medicine, Seoul 911-1, Korea.,Tissue Injury Defense Research Center , School of Medicine, Ewha Womans University, Seoul, Korea
| | - Youn-Hee Choi
- Department of Physiology, Ewha Womans University School of Medicine, Seoul 911-1, Korea.,Tissue Injury Defense Research Center , School of Medicine, Ewha Womans University, Seoul, Korea
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47
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Visvanathan K, Lang T, Ryan K, Wilson R, Skinner NA, Thompson AJV, Ahn SH, Weilert F, Abbott W, Gane E, Colledge D, Li K, Locarnini S, Mansell A, Revill PA. Toll-IL1 receptor-mediated innate immune responses vary across HBV genotype and predict treatment response to pegylated-IFN in HBeAg-positive CHB patients. J Viral Hepat 2016; 23:170-9. [PMID: 26436722 DOI: 10.1111/jvh.12477] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 07/30/2015] [Indexed: 12/18/2022]
Abstract
Patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) have suppressed TLR2 expression, function and cytokine production. The aim of this study was to explore the importance of hepatitis B virus (HBV) genotype in innate immune responses and investigate whether Toll-like receptor (TLR) expression/function has potential roles as predictive biomarkers of successful therapy with pegylated interferon (Peg-IFN) therapy of HBeAg seroconversion in HBeAg-positive patients. We showed that as early as 4 weeks after initiation of Peg-IFN, future HBeAg seroconverters had significantly elevated levels of TLR2 expression on monocytes. TLR2-associated IL-6 production at baseline and week 4 of therapy and TLR4 IL-6 production at week 4 were also markedly elevated in HBeAg seroconverters. HBV genotype also influenced treatment response, with genotypes A and B more likely to seroconvert than D. We were able to demonstrate that these differences were due in part to the interaction of the specific HBeAg proteins with TLR pathway adaptor molecules, and these interactions were genotype dependent. HBeAg-mediated modulation of TLR signalling was also observed in Huh7 cells, following stimulation with Pam3Cys. Importantly, the addition of IFN-α to TLR2-stimulated cells cotransfected with an HBeAg expression plasmid reversed HBeAg-mediated suppression of hepatocytes. These findings demonstrate that patients with an activated inflammatory response are much more likely to respond to IFN therapy, with TLR responses showing promise as potential biomarkers of HBeAg seroconversion in this setting. Furthermore, our findings suggest there is differential genotype-specific HBeAg suppression of innate signalling pathways which may account for some of the clinical differences observed across the CHB spectrum.
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Affiliation(s)
- K Visvanathan
- Department of Medicine, Monash University (MMC), Melbourne, Vic., Australia
| | - T Lang
- Monash Institute of Medical Research, Clayton, Vic., Australia
| | - K Ryan
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Vic., Australia
| | - R Wilson
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Vic., Australia
| | - N A Skinner
- Department of Medicine, Monash University (MMC), Melbourne, Vic., Australia
| | - A J V Thompson
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Vic., Australia.,Department of Gastroenterology, St Vincent's Hospital, Melbourne, Vic., Australia
| | - S H Ahn
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Vic., Australia.,Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - F Weilert
- New Zealand Liver Transplant Unit, Auckland, New Zealand
| | - W Abbott
- New Zealand Liver Transplant Unit, Auckland, New Zealand
| | - E Gane
- New Zealand Liver Transplant Unit, Auckland, New Zealand
| | - D Colledge
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Vic., Australia
| | - K Li
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Centre, Memphis, TN, USA
| | - S Locarnini
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Vic., Australia
| | - A Mansell
- Monash Institute of Medical Research, Clayton, Vic., Australia
| | - P A Revill
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Vic., Australia
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48
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Kim BJ, Shin KO, Kim H, Ahn SH, Lee SH, Seo CH, Byun SE, Chang JS, Koh JM, Lee YM. The effect of sphingosine-1-phosphate on bone metabolism in humans depends on its plasma/bone marrow gradient. J Endocrinol Invest 2016. [PMID: 26219613 DOI: 10.1007/s40618-015-0364-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Although recent studies provide clinical evidence that sphingosine-1-phosphate (S1P) may primarily affect bone resorption in humans, rather than bone formation or the osteoclast-osteoblast coupling phenomenon, those studies could not determine which bone resorption mechanism is more important, i.e., chemorepulsion of osteoclast precursors via the blood to bone marrow S1P gradient or receptor activator of NF-κB ligand (RANKL) elevation in osteoblasts via local S1P. AIM To investigate how S1P mainly contributes to increased bone resorption in humans, we performed this case-control study at a clinical unit in Korea. METHODS Blood and bone marrow samples were contemporaneously collected from 70 patients who underwent hip surgery due to either osteoporotic hip fracture (HF) (n = 10) or other causes such as osteoarthritis (n = 60). RESULTS After adjusting for sex, age, BMI, smoking, alcohol, previous fracture, diabetes, and stroke, subjects with osteoporotic HF demonstrated a 3.2-fold higher plasma/bone marrow S1P ratio than those without HF, whereas plasma and bone marrow S1P levels were not significantly different between these groups. Consistently, the risk of osteoporotic HF increased 1.38-fold per increment in the plasma/bone marrow S1P ratio in a multivariate adjustment model. However, the odds ratios for prevalent HF according to the increment in the plasma and bone marrow S1P level were not statistically significant. CONCLUSION Our current results using simultaneously collected blood and bone marrow samples suggest that the detrimental effects of S1P on bone metabolism in humans may depend on the S1P gradient between the peripheral blood and bone marrow cavity.
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Affiliation(s)
- B-J Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea
| | - K-O Shin
- College of Pharmacy and MRC, Chungbuk National University, Cheongju, 361-763, Korea
| | - H Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea
| | - S H Ahn
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea
| | - S H Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea
| | - C-H Seo
- College of Pharmacy and MRC, Chungbuk National University, Cheongju, 361-763, Korea
| | - S-E Byun
- Department of Orthopedic Surgery, CHA Bundang Medical Center, CHA University, Seongnam, 463-712, Korea
| | - J S Chang
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea
| | - J-M Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea.
| | - Y-M Lee
- College of Pharmacy and MRC, Chungbuk National University, Cheongju, 361-763, Korea.
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49
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Kim HJ, Lee MH, Lee JE, Park SH, Lee ES, Kang YJ, Lee JH, Shin HN, Kim SI, Im SA, Ahn SH, Lee KS, Sohn J, Han W, Nam SJ. Abstract P1-12-09: The oncologic effect of a gonadotropin releasing hormone (GnRH) agonist for ovarian protection during breast cancer chemotherapy. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-12-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Recently, chemotherapy with a GnRH agonist was reported to protect against ovarian failure. This study was aimed at determining the oncologic effect of a GnRH agonist concurrent with chemotherapy for breast cancer patients.
Patients and Methods: A total of 1189 patients aged 20 to 40 years with stage I to III breast cancer who received (neo or adjuvant) chemotherapy from five hospitals in Korea from 2002 to 2012 were reviewed. A gonadotropin releasing hormone (GnRH) agonist was given to 410 patients for ovarian protection during chemotherapy (GnRH agonist group), and 779 patients received chemotherapy without ovarian protection (Chemotherapy alone group). A matching strategy was used to create matched sets of two groups by age, stage, hormone receptor status, Her2/neu status, neo or adjuvant chemotherapy, and institute.
Results: Survival analysis using Cox regression showed that the GnRH agonist group had better distant metastatic-free survival (HR=0.65, 95%CI 0.44-0.97) outcomes but similar disease free survival (HR=0.78, 95% CI 0.57-1.08) compared with the chemotherapy alone group. The survival benefit was significant for hormone receptor positive, Her2/neu negative breast cancer on distant metastasis (HR=0.44, 95% CI 0.20-0.99) and disease free survival (HR0.47 95% CI 0.23-0.93).
Conclusion: Ovarian protection using a GnRH agonist can be safely considered for premenopausal breast cancer patients for whom chemotherapy is planned.
Citation Format: Kim HJ, Lee MH, Lee JE, Park SH, Lee ES, Kang Y-J, Lee JH, Shin HN, Kim SI, Im SA, Ahn SH, Lee KS, Sohn J, Han W, Nam SJ. The oncologic effect of a gonadotropin releasing hormone (GnRH) agonist for ovarian protection during breast cancer chemotherapy. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-12-09.
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Affiliation(s)
- HJ Kim
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - MH Lee
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - JE Lee
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - SH Park
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - ES Lee
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - Y-J Kang
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - JH Lee
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - HN Shin
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - SI Kim
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - SA Im
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - SH Ahn
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - KS Lee
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - J Sohn
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - W Han
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - SJ Nam
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
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50
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Yoon TI, Kim HJ, Yu JH, Sohn G, Ko BS, Lee JW, Son BH, Ahn SH. Abstract P5-13-06: Concurrent gonadotropin-releasing hormone (GnRH) agonist administration with chemotherapy improves neoadjuvant chemotherapy responses in young premenopausal breast cancer patients. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-13-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Gonadotropin-releasing hormone (GnRH) agonist therapy for ovarian function preservation shows promising results. This study aimed to determine the oncologic efficacy of GnRH agonist treatment concurrent with chemotherapy in a neoadjuvant setting.
Patients and Methods
A retrospective analysis was performed on 332 cases of invasive breast cancer in patients who were <40 years old at diagnosis and received GnRH agonists concurrent with neoadjuvant chemotherapy (GnRH agonist group) or neoadjuvant chemotherapy alone (neochemotherapy-alone group) at Asan Medical Center from December 2010 to September 2014. Pathologic complete response rates (pCR) and Ki-67 changes were evaluated between the two groups. For hormone receptor (HR)-positive tumors, the clinical response and preoperative endocrine prognostic index (PEPI) score also were evaluated.
Results
The median age was 32 ± 3.9 and 36 ± 3.0 years old in the GnRH agonist group and neochemotherapy-alone group, respectively (P < .001). Adjusted for tumor size, grade, lymph node metastasis, HR status, and chemotherapy regimen, the GnRH agonist group exhibited a higher pCR rate with an odds ratio (OR) of 2.98 (95% CI, 1.37–6.34) and more decreased Ki-67 expression during treatment (P = 0.05) than the neochemotherapy-alone group. In HR-negative tumors, the GnRH agonist group showed a higher pCR rate (multivariate OR = 3.50; 95% CI, 1.37–8.95) and more decreased Ki-67 expression (P = 0.047). In HR-positive breast cancer, the pCR rate, change in Ki-67 index, and clinical response were higher and preoperative prognostic index (PEPI) scores were lower in the GnRH agonist group, but not significant between the two treatment groups.
Conclusion
Concurrent administration of GnRH agonists during neoadjuvant chemotherapy improved pCR rates and suppressed Ki-67 expression especially in HR-negative tumors.
Citation Format: Yoon TI, Kim HJ, Yu JH, Sohn G, Ko BS, Lee JW, Son BH, Ahn SH. Concurrent gonadotropin-releasing hormone (GnRH) agonist administration with chemotherapy improves neoadjuvant chemotherapy responses in young premenopausal breast cancer patients. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-13-06.
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Affiliation(s)
- TI Yoon
- Asan Medical Center, Seoul, Republic of Korea
| | - HJ Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - JH Yu
- Asan Medical Center, Seoul, Republic of Korea
| | - G Sohn
- Asan Medical Center, Seoul, Republic of Korea
| | - BS Ko
- Asan Medical Center, Seoul, Republic of Korea
| | - JW Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - BH Son
- Asan Medical Center, Seoul, Republic of Korea
| | - SH Ahn
- Asan Medical Center, Seoul, Republic of Korea
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