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Wilcox NS, Amit U, Reibel JB, Berlin E, Howell K, Ky B. Cardiovascular disease and cancer: shared risk factors and mechanisms. Nat Rev Cardiol 2024:10.1038/s41569-024-01017-x. [PMID: 38600368 DOI: 10.1038/s41569-024-01017-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/12/2024]
Abstract
Cardiovascular disease (CVD) and cancer are among the leading causes of morbidity and mortality globally, and these conditions are increasingly recognized to be fundamentally interconnected. In this Review, we present the current epidemiological data for each of the modifiable risk factors shared by the two diseases, including hypertension, hyperlipidaemia, diabetes mellitus, obesity, smoking, diet, physical activity and the social determinants of health. We then review the epidemiological data demonstrating the increased risk of CVD in patients with cancer, as well as the increased risk of cancer in patients with CVD. We also discuss the shared mechanisms implicated in the development of these conditions, highlighting their inherent bidirectional relationship. We conclude with a perspective on future research directions for the field of cardio-oncology to advance the care of patients with CVD and cancer.
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Affiliation(s)
- Nicholas S Wilcox
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Uri Amit
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jacob B Reibel
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Hematology Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Eva Berlin
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kendyl Howell
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Bonnie Ky
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Ben-Mordechai T, Lawrence YR, Symon Z, Shimoni-Sebag A, Amit U. CX3CR1-Expressing Immune Cells Infiltrate the Tumor Microenvironment and Promote Radiation Resistance in a Mouse Model of Lung Cancer. Cancers (Basel) 2023; 15:5472. [PMID: 38001732 PMCID: PMC10669975 DOI: 10.3390/cancers15225472] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
INTRODUCTION Chemokine (C-X3-C Motif) Receptor 1 (CX3CR1) is present in a subset of the immune cells in the tumor microenvironment (TME) and plays an essential and diverse role in cancer progression. However, its potential function in the irradiated TME remains unknown. MATERIALS AND METHODS A mouse lung cancer model was performed by subcutaneously inoculating Lewis Lung Carcinoma (LLC) cells expressing luciferase (Luc-2) and mCherry cells in CX3CR1GFP/GFP, CX3CR1DTR/+, and wild-type (WT) mice. Bioluminescence imaging, clonogenic assay, and flow cytometry were used to assess tumor progression, proliferation, and cell composition after radiation. RESULTS Radiation provoked a significant influx of CX3CR1-expressing immune cells, notably monocytes and macrophages, into the TME. Co-culturing irradiated LLC cells with CX3CR1-deficient monocytes, and macrophages resulted in reduced clonogenic survival and increased apoptosis of the cancer cells. Interestingly, deficiency of CX3CR1 in macrophages led to a redistribution of the irradiated LLC cells in the S-phase, parallel to increased expression of cyclin E1, required for cell cycle G1/S transition. In addition, the deficiency of CX3CR1 expression in macrophages altered the cytokine secretion with a decrease in interleukin 6, a crucial mediator of cancer cell survival and proliferation. Next, LLC cells were injected subcutaneously into CX3CR1DTR/+ mice, sensitive to diphtheria toxin (DT), and WT mice. After injection, tumors were irradiated with 8 Gy, and mice were treated with DT, leading to conditional ablation of CX3CR1-expressing cells. After three weeks, CX3CR1-depleted mice displayed reduced tumor progression. Furthermore, combining the S-phase-specific chemotherapeutic gemcitabine with CX3CR1 cell ablation resulted in additional attenuation of tumor progression. CONCLUSIONS CX3CR1-expressing mononuclear cells invade the TME after radiation therapy in a mouse lung cancer model. CX3CR1 cell depletion attenuates tumor progression following radiation and sensitizes the tumor to S-phase-specific chemotherapy. Thus, we propose a novel strategy to improve radiation sensitivity by targeting the CX3CR1-expressing immune cells.
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Affiliation(s)
- Tamar Ben-Mordechai
- Radiation Oncology Department, Chaim Sheba Medical Center, Ramat Gan 52621, Israel; (T.B.-M.); (Y.R.L.); (Z.S.); (A.S.-S.)
| | - Yaacov R. Lawrence
- Radiation Oncology Department, Chaim Sheba Medical Center, Ramat Gan 52621, Israel; (T.B.-M.); (Y.R.L.); (Z.S.); (A.S.-S.)
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Zvi Symon
- Radiation Oncology Department, Chaim Sheba Medical Center, Ramat Gan 52621, Israel; (T.B.-M.); (Y.R.L.); (Z.S.); (A.S.-S.)
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Ariel Shimoni-Sebag
- Radiation Oncology Department, Chaim Sheba Medical Center, Ramat Gan 52621, Israel; (T.B.-M.); (Y.R.L.); (Z.S.); (A.S.-S.)
| | - Uri Amit
- Radiation Oncology Department, Tel Aviv Medical Center, Tel Aviv 64239, Israel
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, TRC 2 West Philadelphia, Philadelphia, PA 19104, USA
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Tiosano S, Banai A, Mulla W, Goldenberg I, Bayshtok G, Amit U, Shlomo N, Nof E, Rosso R, Glikson M, Guetta V, Barbash I, Beinart R. Left Atrial Appendage Occlusion versus Novel Oral Anticoagulation for Stroke Prevention in Atrial Fibrillation-One-Year Survival. J Clin Med 2023; 12:6693. [PMID: 37892833 PMCID: PMC10607551 DOI: 10.3390/jcm12206693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 08/06/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 10/29/2023] Open
Abstract
Aim To compare the 1-year survival rate of patients with atrial fibrillation (AF) following left atrial appendage occluder (LAAO) implantation vs. treatment with novel oral anticoagulants (NOACs). METHODS We have conducted an indirect, retrospective comparison between LAAO and NOAC registries. The LAAO registry is a national prospective cohort of 419 AF patients who underwent percutaneous LAAO between January 2008 and October 2015. The NOACs registry is a multicenter prospective cohort of 3138 AF patients treated with NOACs between November 2015 and August 2018. Baseline patient characteristics were retrospectively collected from coded diagnoses of hospitalization and outpatient clinic notes. Follow-up data was sorted from coded diagnoses and the national civil registry. Subjects were matched according to propensity score. Baseline characteristics were compared using Chi-Square and student's t-test. Survival analysis was performed using Kaplan-Meier survival curves, log-rank test, and multivariable Cox regression, adjusting for possible confounding variables. RESULTS This study included 114 subjects who underwent LAAO implantation and 342 subjects treated with NOACs. The mean age of participants was 77.9 ± 7.44 and 77.1 ± 11.2 years in the LAAO and NOAC groups, respectively (p = 0.4). The LAAO group had 70 (61%) men compared to 202 (59%) men in the NOAC group (p = 0.74). No significant differences were found in baseline comorbidities, renal function, or CHA2DS2-VASc score. One-year mortality was observed in 5 (4%) patients and 32 (9%) patients of the LAAO and NOAC groups, respectively. After adjusting for confounders, LAAO was significantly associated with a lower risk for 1-year mortality (HR 0.38, 95%CI 0.14-0.99). In patients with impaired renal function, this difference was even more prominent (HR 0.21 for creatinine clearance (CrCl) < 60 mL/min). CONCLUSIONS In a pooled analysis of two registries, we found a significantly lower risk for 1-year mortality in patients with AF who were implanted with LAAO than those treated with NOACs. This finding was more prominent in patients with impaired renal function. Future prospective direct studies should further investigate the efficacy and adverse effects of both treatment strategies.
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Affiliation(s)
- Shmuel Tiosano
- Leviev Heart Center, Sheba Medical Center, Ramat Gan 52621, Israel (W.M.)
- Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (A.B.)
| | - Ariel Banai
- Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (A.B.)
- Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel
| | - Wesam Mulla
- Leviev Heart Center, Sheba Medical Center, Ramat Gan 52621, Israel (W.M.)
- Surgeon General Headquarters, Israel Defense Forces, Ramat Gan 5262000, Israel
| | - Ido Goldenberg
- Leviev Heart Center, Sheba Medical Center, Ramat Gan 52621, Israel (W.M.)
- Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (A.B.)
| | - Gabriella Bayshtok
- Leviev Heart Center, Sheba Medical Center, Ramat Gan 52621, Israel (W.M.)
- Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (A.B.)
- Arrow Program, Sheba Medical Center, Ramat Gan 5266202, Israel
| | - Uri Amit
- Leviev Heart Center, Sheba Medical Center, Ramat Gan 52621, Israel (W.M.)
- Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (A.B.)
| | - Nir Shlomo
- Leviev Heart Center, Sheba Medical Center, Ramat Gan 52621, Israel (W.M.)
- Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (A.B.)
| | - Eyal Nof
- Leviev Heart Center, Sheba Medical Center, Ramat Gan 52621, Israel (W.M.)
- Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (A.B.)
| | - Raphael Rosso
- Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (A.B.)
- Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel
| | - Michael Glikson
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem 9103102, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9574425, Israel
| | - Victor Guetta
- Leviev Heart Center, Sheba Medical Center, Ramat Gan 52621, Israel (W.M.)
- Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (A.B.)
| | - Israel Barbash
- Leviev Heart Center, Sheba Medical Center, Ramat Gan 52621, Israel (W.M.)
- Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (A.B.)
| | - Roy Beinart
- Leviev Heart Center, Sheba Medical Center, Ramat Gan 52621, Israel (W.M.)
- Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (A.B.)
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Amit U, Mohiuddin JJ, Wojcieszynski AP, Harton J, Williams G, Manjunath S, Grandhi N, Doucette A, Plastaras JP, Metz JM, Ben-Josef E. Radiation dose is associated with improved local control for large, but not small, hepatocellular carcinomas. Radiat Oncol 2023; 18:133. [PMID: 37568200 PMCID: PMC10422771 DOI: 10.1186/s13014-023-02318-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/06/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND With advances in understanding liver tolerance, conformal techniques, image guidance, and motion management, dose-escalated radiotherapy has become a potential treatment for inoperable hepatocellular carcinoma (HCC). We aimed to evaluate the possible impact of biologically effective dose (BED) on local control and toxicity among patients with HCC. METHODS AND MATERIALS Patients treated at our institution from 2009 to 2018 were included in this retrospective analysis if they received definitive-intent radiotherapy with a nominal BED of at least 60 Gy. Patients were stratified into small and large tumors using a cutoff of 5 cm, based on our clinical practice. Toxicity was assessed using ALBI scores and rates of clinical liver function deterioration. RESULTS One hundred and twenty-eight patients were included, with a mean follow-up of 16 months. The majority of patients (90.5%) had a good performance status (ECOG 0-1), with Child-Pugh A (66.4%) and ALBI Grade 2 liver function at baseline (55.4%). Twenty (15.6%) patients had a local recurrence in the irradiated field during the follow-up period. Univariate and multivariate Cox proportional hazard analyses showed that only BED significantly predicted local tumor recurrence. Higher BED was associated with improved local control in tumors with equivalent diameters over 5 cm but not in smaller tumors. There was no difference in liver toxicity between the low and high-dose groups. CONCLUSIONS Higher radiotherapy dose is associated with improved local control in large tumors but not in tumors smaller than 5 cm in diameter. High-dose radiotherapy was not associated with increased liver toxicity.
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Affiliation(s)
- Uri Amit
- Department of Radiation Oncology, Perelman School of Medicine, Philadelphia, PA, USA.
- Department of Radiation Oncology, Tel Aviv Medical Center, Tel Aviv, Israel.
| | - Jahan J Mohiuddin
- Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
- Southeast Radiation Oncology Group, Charlotte, NC, USA
| | | | | | - Graeme Williams
- Department of Radiation Oncology, Perelman School of Medicine, Philadelphia, PA, USA
| | - Shwetha Manjunath
- Department of Radiation Oncology, Perelman School of Medicine, Philadelphia, PA, USA
| | - Nikhil Grandhi
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Abigail Doucette
- Abramson Cancer Center, Perelman School of Medicine, Philadelphia, PA, USA
| | - John P Plastaras
- Department of Radiation Oncology, Perelman School of Medicine, Philadelphia, PA, USA
| | - James M Metz
- Department of Radiation Oncology, Perelman School of Medicine, Philadelphia, PA, USA
| | - Edgar Ben-Josef
- Department of Radiation Oncology, Perelman School of Medicine, Philadelphia, PA, USA
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Abstract
ABSTRACT It is increasingly recognized that heterogeneities in tumor response and severity of adverse effects in irradiated patients can be attributed to the tumor microenvironment and host-related factors. Among the latter, a growing body of literature in recent years has demonstrated the role of the patient's microbiome in modulating both tumor and normal tissue response to radiotherapy (RT). Upon contact with the environment after birth, the infant's gastrointestinal tract is rapidly colonized by microbiota, which is low in diversity and predominantly characterized by 2 dominant species, Actinobacteria and Proteobacteria. With time, intestinal microbiota diversity increases, and colonization of Firmicutes and Bacteroidetes becomes dominant. By the time a child reaches 3 years, the gut microbiota composition has been reshaped and is relatively similar to that of an adult. The microbiome colonizing the different body organs comprises various species and abundances, which may impact human health. Although the adult microbiome composition is thought to remain stable in health, microbiome diversity and composition respond to different environmental and pathological conditions, including pharmaceutical interventions and RT. Our review focuses on how the gut microbiota modulates normal tissue toxicity and tumor control. Readers who want to learn more about how RT shapes gut microbiome diversity and composition are referred to several excellent recently published reviews.
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Affiliation(s)
| | | | - Edgar Ben-Josef
- From the Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Ungar OJ, Amit U, Wengier A, Cavel O, Oron Y, Handzel O. Balance Performance of Post-Call Medical Residents. Ear Nose Throat J 2023; 102:85-89. [PMID: 33393818 DOI: 10.1177/0145561320980242] [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: 02/02/2023] Open
Abstract
BACKGROUND Fatigue is thought of as a leading cause of iatrogenic accidents. A significant deterioration in qualitative balance function has been shown in sleep deprived individuals. AIM/OBJECTIVES To quantify the degree to which balance is impaired by sleep deprivation (SD) in post-call medical residents. METHODS Medical residents voluntarily underwent computed dynamic posturography (CDP) before and after an on-call night, at an identical time of the day. Order of test performance was random to avoid behavioral learning. Each participant served as his or her own control. RESULTS Seventeen residents were enrolled (median age 32years). Average sleeping duration the night before and during the night shift was 6.5 and 1 hour, respectively. The average response times difference between alert and fatigued was 10.15 milliseconds (95% CI: 6.81-13.49 milliseconds), yielding a significantly prolonged response times from 120 milliseconds before to 130 milliseconds after the night shift (P < .001). Comparison of additional measurements of CDP performance did not differ between test conditions. CONCLUSION Medical residents are fatigued due to the effect of on-call nights. Sleep deprivation prolongs response times to vestibular stimuli. This finding probably has an effect on execution of manual skills and may reflect a more generalized slowing of responses and overall performance impairment. SIGNIFICANCE The vestibular system is susceptible to SD.
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Affiliation(s)
- Omer J Ungar
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Uri Amit
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Anat Wengier
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Oren Cavel
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yahav Oron
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ophir Handzel
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Caller T, Shaihov Teper O, Schary Y, Lendengolts D, Rotem I, Peled R, Amit U, Shai R, Glick Saar E, Dominissini D, Boomgarden A, D'Souza-Schorey C, Naftali-Shani N, Leor J. Extracellular vesicles from the infarcted and failing heart drive tumor growth. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Aims
Heart disease might be an independent risk factor for cancer (reverse cardio-oncology). The co-occurrence of these diseases worsens patients' prognoses and limits therapeutic options. However, the cellular and molecular mechanisms that link heart disease to cancer remain elusive. Therefore, we hypothesized that cardiac extracellular vesicles (cEVs) secreted by diseased hearts carry and disseminate factors that promote tumor growth.
Methods and results
We subjected female mice to myocardial infarction (MI) or sham-MI and 28 days of follow-up. Left ventricular remodeling and dysfunction were assessed by echocardiography. To determine the role of cEVs in tumor growth, we focused on cardiac mesenchymal stromal cells (cMSCs), which play a central role in cardiac repair, remodeling, and fibrosis. We isolated cMSCs from mice hearts 10 or 28 days after MI or sham MI and purified cMSC-EVs from the conditioned medium using size exclusion chromatography. cEVs were characterized by nanoparticle tracking analysis (NTA), the classical EV markers: CD81 and Tumor susceptibility gene 101, and electron microscopy. cMSCs after MI secreted more small EVs than cMSCs from sham-MI (Fig. 1A, p<0.0001). Proteomic and biological process analysis revealed a distinctive profile of cEVs after MI with more EV-encapsulated proteins related to inflammation, angiogenesis, and cell cycle (Fig. 1B). Purified cMSC-EVs were labeled with PKH26 dye and found to target both breast and lung cancer cells in vitro. Colorimetric proliferation assay showed that MI-cEVs facilitated cancer cells proliferation compared with sham-MI cEVs (n=7 in each group, p<0.0001). Furthermore, by scratch assay, MI-cEVs facilitated cancer cell migration two times faster than sham-MI cEVs (Fig. 1C, p=0.0002). Finally, we established 2 models of heart disease with cancer. Lung or breast cancer cells (750x103 or 250x103) were inoculated into the hind limb or mammary pad 10 days before or after MI. Serial ultrasound examinations monitored tumor growth. While MI significantly stimulated lung cancer growth, EV inhibition by GW4869 markedly attenuated the tumorigenic effect of MI and left ventricular (LV) dysfunction (Fig. 1D, p for GW4869 <0.0001). Moreover, we found an inverse correlation between LV ejection fraction (LVEF) and the volume of breast cancer tumors. cEV inhibition by GW4869 attenuated this inverse correlation (for vehicle group: n=14, r=−0.54 and p=0.04. for GW4869 group: n=13, r=−0.43, and p=0.14).
Conclusions
Our results suggest, for the first time, that cMSCs from the infarcted and failing heart secret EVs that target tumor cells and accelerate tumor growth. We propose cEVs as potential mediators and therapeutic targets in patients with concomitant heart disease and cancer.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Seymour Fefer Grant
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Affiliation(s)
- T Caller
- Sheba Medical Center, Sackler School of Medicine , Tel Aviv , Israel
| | - O Shaihov Teper
- Sheba Medical Center, Sackler School of Medicine , Tel Aviv , Israel
| | - Y Schary
- Sheba Medical Center, Sackler School of Medicine , Tel Aviv , Israel
| | - D Lendengolts
- Sheba Medical Center, Sackler School of Medicine , Tel Aviv , Israel
| | - I Rotem
- Sheba Medical Center, Sackler School of Medicine , Tel Aviv , Israel
| | - R Peled
- Sheba Medical Center, Sackler School of Medicine , Tel Aviv , Israel
| | - U Amit
- Sourasky Medical Center, Sackler School of Medicine , Tel Aviv , Israel
| | - R Shai
- Sheba Medical Center, Pediatric Hemato-Oncology, Edmond and Lilly Safra Children's Hospital, Cancer Research Center , Tel Hashomer , Israel
| | - E Glick Saar
- The Chaim Sheba Medical Center, Cancer Research Center and Wohl Centre for Translational Medicine , Tel Hashomer , Israel
| | - D Dominissini
- The Chaim Sheba Medical Center, Cancer Research Center and Wohl Centre for Translational Medicine , Tel Hashomer , Israel
| | - A Boomgarden
- University of Notre Dame, Department of Biological Sciences , Notre Dame , United States of America
| | - C D'Souza-Schorey
- University of Notre Dame, Department of Biological Sciences , Notre Dame , United States of America
| | - N Naftali-Shani
- Sheba Medical Center, Sackler School of Medicine , Tel Aviv , Israel
| | - J Leor
- Sheba Medical Center, Sackler School of Medicine , Tel Aviv , Israel
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Caller T, Shaihov–Teper O, Schary Y, Lendengolts D, Rotem I, Peled R, Shai R, Amit U, Glick-Saar E, Dominissini D, Boomgarden A, D'Souza-Schorey C, Naftali-Shani N, Leor J. Abstract P3104: Extracellular Vesicles From The Infarcted Heart Facilitate Tumor Growth. Circ Res 2022. [DOI: 10.1161/res.131.suppl_1.p3104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Aim:
Heart disease might be an independent risk factor for cancer (reverse cardio-oncology). The cellular and molecular mechanisms that link heart disease to cancer remain elusive, and specific therapies are limited. We hypothesized that cardiac extracellular vesicles (cEVs) secreted by diseased hearts carry and disseminate factors that promote tumor growth.
Methods & Results:
We subjected female mice to myocardial infarction (MI) or sham-MI and 28 days of follow-up. Left ventricular remodeling was confirmed by echocardiography. To determine the role of cEVs in tumor growth, we focused on cardiac mesenchymal stromal cells (cMSCs), which play a central role in cardiac repair, remodeling, and fibrosis. Thus, we isolated cMSCs from mice hearts 10 or 28 days after MI or sham MI. cMSCs after MI secreted more small EVs than cMSCs from sham-MI. Proteomic analysis revealed a distinctive profile of cEVs after MI (
Fig A
). Purified cMSC-EVs targeted both breast and lung cancer cells in vitro. A scratch assay showed that MI-cEVs facilitated cancer cell proliferation and migration two times faster than sham-MI cEVs (
Fig B
, p=0.0002). Finally, lung or breast cancer cells were inoculated into the hind limb or mammary pad 10 days before or after MI. Tumor growth was monitored by serial ultrasound examinations. While MI stimulated tumor growth, EV inhibition by GW4869 markedly attenuated this effect (
Fig C
).
Conclusions:
We show, for the first time, that cMSCs from the infarcted and remodeling heart secret EVs that target tumor cells and facilitate tumor growth. We propose cEVs as potential mediators and therapeutic targets in patients with concomitant heart disease and cancer.
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Affiliation(s)
- Tal Caller
- Neufeld and Tamman Cardiovascular Rsch Institutes, Sheba Med Cntr, Sackler Sch of Medicine, Tel Aviv Univ, Tel Aviv, Israel
| | - Olga Shaihov–Teper
- Neufeld and Tamman Cardiovascular Rsch Institutes, Sheba Med Cntr, Sackler Sch of Medicine, Tel Aviv Univ, Tel Aviv, Israel
| | - Yeshai Schary
- Neufeld and Tamman Cardiovascular Rsch Institutes, Sheba Med Cntr, Sackler Sch of Medicine, Tel Aviv Univ, Tel Aviv, Israel
| | - Daria Lendengolts
- Neufeld and Tamman Cardiovascular Rsch Institutes, Sheba Med Cntr, Sackler Sch of Medicine, Tel Aviv Univ, Tel Aviv, Israel
| | - Itai Rotem
- Neufeld and Tamman Cardiovascular Rsch Institutes, Sheba Med Cntr, Sackler Sch of Medicine, Tel Aviv Univ, Tel Aviv, Israel
| | - Racheli Peled
- Neufeld and Tamman Cardiovascular Rsch Institutes, Sheba Med Cntr, Sackler Sch of Medicine, Tel Aviv Univ, Tel Aviv, Israel
| | - Ruty Shai
- Pediatric Hemato-Oncology, Edmond and Lilly Safra Children's Hosp, and Cancer Rsch Cntr, Sheba Med Cntr, Tel Hashomer, Ramat Gan, Israel
| | - Uri Amit
- Tel-Aviv Sourasky Med Cntr, Sackler Sch of Medicine, Tel-Aviv Univ, Tel Aviv, Israel
| | - Efrat Glick-Saar
- Cancer Rsch Cntr and Wohl Cntr for Translational Medicine, Chaim Sheba Med Cntr, Tel-Hashomer, Ramat Gan, Israel
| | - Dan Dominissini
- Cancer Rsch Cntr and Wohl Cntr for Translational Medicine, Chaim Sheba Med Cntr, Tel-Hashomer, Ramat Gan, Israel
| | - Alex Boomgarden
- Dept of Biological Sciences, Univ of Notre Dame, Notre Dame, IN
| | | | - Nili Naftali-Shani
- Neufeld and Tamman Cardiovascular Rsch Institutes, Sheba Med Cntr, Sackler Sch of Medicine, Tel Aviv Univ, Tel Aviv, Israel
| | - Jonathan Leor
- Neufeld and Tamman Cardiovascular Rsch Institutes, Sheba Med Cntr, Sackler Sch of Medicine, Tel Aviv Univ, Tel Aviv, Israel
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Weizman N, Baidun K, Goldstein A, Amit U, Saad A, Lawrence YR, Appel S, Orion I, Alezra D, Abrams R, Symon Z, Goldstein J. Initial estimates of continuous positive airway pressure (CPAP) on heart volume, position and motion in patients receiving chest radiation. Med Dosim 2022; 47:191-196. [DOI: 10.1016/j.meddos.2022.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 01/10/2022] [Accepted: 02/04/2022] [Indexed: 12/25/2022]
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Nissan E, Amit U, Baron L, Zabatani A, Urban D, Barshack I, Davidson T. The usefulness of [18F]FDG-PET/CT in detecting and managing cancers with unknown primary site depends on histological subtype. Sci Rep 2021; 11:17732. [PMID: 34489490 PMCID: PMC8421436 DOI: 10.1038/s41598-021-96451-z] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 08/05/2021] [Indexed: 11/09/2022] Open
Abstract
We assessed the role of [18F]FDG-PET/CT in identifying and managing cancer of unknown primary site (CUP syndrome). We reviewed [18F]FDG-PET/CT scans of individuals with CUP syndrome recorded in clinical referral letters from 2012 to 2019. We evaluated the identification of primary tumor (PT) by [18F]FDG-PET/CT, according to histological subtype, and the impact on clinical management. The median age was 65 years, 36/64 males (56%). PTs were detected in 28/64 (44%) patients. Detection was significantly lower in patients with squamous cell carcinoma (SCC) than with other histologies combined, p = 0.034. Mean age, mean SUVmax (10.6 ± 6.0) and organ involvement were similar between patients with and without discovered PTs; and between patients with SCC and with other histologies combined. However, those with SCC were less likely than the others to present with multi-lesion involvement, p < 0.001. [18F]FDG-PET/CT interpretations apparently affected treatment of 8/28 (29%) patients with PT detected, and in none of the 35 whose PT was not discovered, p < 0.001. [18F]FDG-PET/CT appeared helpful in detecting PT in almost half the patients with CUP syndrome; the lowest rate was for patients with SCC pathology. PET/CT showed limited overall value in guiding clinical management, however benefited those with discovered PT.
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Affiliation(s)
- Ella Nissan
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Uri Amit
- Radiation Oncology Department, Chaim Sheba Medical Center, Tel Hashomer, Israel.,The Dr. Pinchas Borenstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Leo Baron
- Department of Orthopedic Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Amit Zabatani
- Department of Orthopedic Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Damien Urban
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Oncology, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Iris Barshack
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Pathology, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Tima Davidson
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. .,Department of Nuclear Medicine, Chaim Sheba Medical Center, Tel Hashomer, Israel.
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11
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Sadetski I, Eshet Y, Kaidar-Person O, Amit U, Domachevsky L, Davidson T, Weiss I, Ben Ayun M, Symon Z. PSMA PET/CT to evaluate response to SBRT for prostate cancer bone metastases. Rep Pract Oncol Radiother 2021; 26:528-534. [PMID: 34434568 DOI: 10.5603/rpor.a2021.0071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/24/2021] [Indexed: 11/25/2022] Open
Abstract
Background In the current study we evaluated 68Ga PSMA PET/ CT to measure local control of bone metastasis in oligometastatic prostate cancer patients treated with SBRT. Materials and methods After the institutional review board approval, a retrospective review of medical records of consecutive prostate cancer patients treated between 2014 and 2018 was conducted. Only medical records of patients that were treated with SBRT for bone metastasis and had pre-and post-SBRT 68Ga PSMA PET/CT scans were included in our study. Data extracted from the medical files included patient-related (age), disease-related (Gleason score, site of metastasis), and treatment-related factors and outcomes. Results During the study period, a total of 12 patients (15 lesions) were included, with a median age of 73 years. The median follow-up was 26.5 months (range 13-45 months). Median time of 68Ga PSMA PET/ CT follow up was 17.0 months (range 3-39 months). The median pre-treatment PSA was 2 ng/mL (range 0.56-44 ng/mL) vs. post treatment PSA nadir of 0.01 ng/mL (0.01-4.32) with a median time to nadir of 7 months (range, 2-12). Local control was 93% during the follow up period and there was correlation with PS MA avidity on PE T. None patients developed recurrences in the treated bone. None of the patients had grade 3 or more toxicities during follow-up. Conclusions SBRT is a highly effective and safe method for treatment of prostate cancer bone metastases. More studies are required to determine if SBRT provides greater clinical benefit than standard fractionation for oligometastatic prostate cancer patients. 68Ga PSMA PET/CT should be further investigated for delineation and follow-up.
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Affiliation(s)
- Igor Sadetski
- Radiation Oncology, Chaim Sheba Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Israel
| | - Yael Eshet
- Nuclear Medicine, Chaim Sheba Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Israel
| | - Orit Kaidar-Person
- Radiation Oncology, Chaim Sheba Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Israel
| | - Uri Amit
- Radiation Oncology, Chaim Sheba Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Israel
| | - Liran Domachevsky
- Nuclear Medicine, Chaim Sheba Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Israel
| | - Tima Davidson
- Nuclear Medicine, Chaim Sheba Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Israel
| | - Ilana Weiss
- Radiation Oncology, Chaim Sheba Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Israel
| | - Maoz Ben Ayun
- Radiation Oncology, Chaim Sheba Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Israel
| | - Zvi Symon
- Radiation Oncology, Chaim Sheba Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Israel
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12
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Lewin R, Amit U, Laufer M, Berger R, Dotan Z, Domachevsky L, Davidson T, Portnoy O, Tsvang L, Ben-Ayun M, Weiss I, Symon Z. Salvage re-irradiation using stereotactic body radiation therapy for locally recurrent prostate cancer: the impact of castration sensitivity on treatment outcomes. Radiat Oncol 2021; 16:114. [PMID: 34162398 PMCID: PMC8220691 DOI: 10.1186/s13014-021-01839-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 05/02/2021] [Accepted: 06/10/2021] [Indexed: 12/03/2022] Open
Abstract
Background Advances in imaging, biomaterials and precision radiotherapy provide new opportunities to salvage locally recurrent prostate cancer (PC). This study evaluates the efficacy and safety of re-irradiation using stereotactic body radiation therapy (SBRT). We hypothesized that patients with castrate-resistant PC (CRPC) would benefit less from local salvage. Methods A prospective clinical database was reviewed to extract 30 consecutive patients treated with prostate re-irradiation. Gallium prostate specific membrane antigen (PSMA) ligand positron emission tomography was performed following prostate-specific antigen failure in all patients and biopsy was obtained in 18 patients (60%). Re-irradiation was either focal (n = 13) or whole-gland (n = 17). Endo-rectal balloons were used in twenty-two patients and hydrogel spacers in eight patients. The median prescription dose was 5 fractions of 6.5 (range: 6–8) Gray (Gy). Results Median follow-up was 28 months. Failure occurred in 10 (out of 11) CRPC patients versus 6 (out of 19) castrate-sensitive patients (91% vs. 32%, p = 0.008) after a median of 13 and 23 months, respectively. Metastases occurred in 64% (n = 7) of CRPC patients versus 16% (n = 3) of castrate-sensitive patients (p = 0.007). Two patients experienced local in-field recurrence, thus local control was 93%. The 2 and 3-year recurrence-free survival were 84% and 79% for castrate-sensitive patients versus 18% and 9% for CRPC patients (p < 0.001), and 3-year metastasis-free survival was 90% versus 27% (p < 0.01) for castrate-sensitive and CRPC patients, respectively. Acute grade II and III genitourinary (GU) toxicity occurred in 27% and 3%, and late GU toxicity in 30% and 3%, respectively. No ≥ grade II acute gastrointestinal (GI) toxicity occurred, and only one patient (3%) developed late grade II toxicity. Conclusions Early delivery of salvage SBRT for local recurrence is associated with excellent 3-year disease control and acceptable toxicity in the castrate-sensitive phenotype. PSMA imaging for detection of local recurrence and the use of precision radiotherapy with rectal protective devices should be further investigated as a novel salvage strategy for radio-recurrent PC.
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Affiliation(s)
- Ron Lewin
- Radiation Oncology Department, Sheba Medical Center, 52621, Ramat-Gan, Israel.
| | - Uri Amit
- Radiation Oncology Department, Sheba Medical Center, 52621, Ramat-Gan, Israel
| | - Menachem Laufer
- Institute of Urology, Sheba Medical Center, Ramat-Gan, Israel
| | - Raanan Berger
- Institute of Oncology, Sheba Medical Center, Ramat-Gan, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Zohar Dotan
- Institute of Urology, Sheba Medical Center, Ramat-Gan, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Liran Domachevsky
- Department of Nuclear Medicine, Sheba Medical Center, Ramat-Gan, Israel
| | - Tima Davidson
- Department of Nuclear Medicine, Sheba Medical Center, Ramat-Gan, Israel
| | - Orith Portnoy
- Department of Radiology, Sheba Medical Center, Ramat-Gan, Israel
| | - Lev Tsvang
- Radiation Oncology Department, Sheba Medical Center, 52621, Ramat-Gan, Israel
| | - Maoz Ben-Ayun
- Radiation Oncology Department, Sheba Medical Center, 52621, Ramat-Gan, Israel
| | - Ilana Weiss
- Radiation Oncology Department, Sheba Medical Center, 52621, Ramat-Gan, Israel
| | - Zvi Symon
- Radiation Oncology Department, Sheba Medical Center, 52621, Ramat-Gan, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
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Abboud WA, Hassin-Baer S, Alon EE, Gluck I, Dobriyan A, Amit U, Yahalom R, Yarom N. Restricted Mouth Opening in Head and Neck Cancer: Etiology, Prevention, and Treatment. JCO Oncol Pract 2021; 16:643-653. [PMID: 33049177 DOI: 10.1200/op.20.00266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Restricted mouth opening or trismus is often encountered in patients with head and neck cancer. The restriction may be the presenting sign of malignancy, a sequela of tumor site or growth, an adverse effect of oncologic treatment, or a first sign of tumoral recurrence. In general, any insult to the temporomandibular joint, masticatory muscles, or their neural innervation may cause limitation in mouth opening. The etiologies leading to trismus are as follows: myospasm secondary to tumor infiltration; reflectory myospasm; radiation-induced myositis and myofibrosis; temporomandibular joint involvement with tumor; unfavorable postsurgical scarring; muscle and joint atrophy secondary to immobilization; pain; jaw fracture and hardware failure; and infection. Preventive measures should be implemented before, during, and after treatment. These measures include identification of high-risk patients, utilization of dose-sculpting radiation techniques whenever possible, performing reconstruction at the same time of resective surgery whenever feasible, and initiating mobilization exercises as early as possible. When trismus develops, treatments are often challenging and disappointing. These include physical therapy, mouth opening appliances, drug therapy, and release surgery. All medical specialties dealing with head and neck cancer should be familiar with the diagnosis and prevention of trismus and make an effort to ensure patients are referred to the appropriate care when needed. Trismus should not be considered a trivial sequela of head and neck cancer.
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Affiliation(s)
| | | | - Eran E Alon
- Sheba Medical Center at Tel HaShomer, Tel Aviv, Israel
| | - Iris Gluck
- Sheba Medical Center at Tel HaShomer, Tel Aviv, Israel
| | - Alex Dobriyan
- Sheba Medical Center at Tel HaShomer, Tel Aviv, Israel
| | - Uri Amit
- Sheba Medical Center at Tel HaShomer, Tel Aviv, Israel
| | - Ran Yahalom
- Sheba Medical Center at Tel HaShomer, Tel Aviv, Israel
| | - Noam Yarom
- Sheba Medical Center at Tel HaShomer, Tel Aviv, Israel
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Lawrence Y, Porper K, Shpatz Y, Amit U, Symon Z, Zach L. Abstract PO-004: A phase I clinical trial of dose-escalated metabolic therapy combined with concomitant radiation therapy in high-grade glioma. Clin Cancer Res 2021. [DOI: 10.1158/1557-3265.radsci21-po-004] [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 Animal brain-tumor models have demonstrated a synergistic interaction between radiation therapy and a ketogenic diet (KD). Metformin has in-vitro anti-cancer activity, through AMPK activation and mTOR inhibition. We hypothesized that metabolic stress (moderate hypoglycemia) would enhance the anti-tumor efficacy of concurrent DNA damage. We further hypothesized that concurrent metformin would decrease insulin resistance and consequently elevate ketone blood level. We performed a formal prospective phase I dose-escalation trial to assess the tolerability and feasibility of this approach. Methods A prospective single-institution phase I clinical trial of combined metabolic therapy and radiotherapy. Radiotherapy was either 60Gy over six weeks or 35Gy over two weeks for newly diagnosed and recurrent gliomas, respectively. The dietary intervention consisted of a KD supplemented with medium chain triglycerides (MCT). There were three cohorts 1) dietary intervention alone, 2) low-dose metformin (850mg twice-daily) combined with dietary intervention and 3) high-dose metformin (850mg three-times daily) combined with dietary intervention. Statistics: The prediction of blood ketones levels was performed using a mixed-model univariate analysis methodology. Clinicaltrials.gov NCT02149459. Results A total of 13 patients were accrued, median age 61 years, of whom 6 had newly diagnosed and 7 with recurrent disease. All completed radiation therapy; 5 patients stopped the metabolic intervention early. Metformin 850mg three-times daily was poorly tolerated. There were no grade 4/5 adverse events. Median levels of β-hydroxybutyrate increased from 0.09 mmol/l at baseline to 0.59 mmol/l during the trial (p=0.006). Ketone levels were associated with dietary factors (ketogenic ratio, p < 0.001), use of metformin (p = 0.02) and low insulin levels (p = 0.002). Median progression free survival was 10 months for newly diagnosed disease and 4 months for recurrent disease. Conclusions The intervention was fairly well tolerated. Metformin use and dietary intake were associated with higher serum ketone levels. The recommended phase II dose is the 8 weeks of a KD combined with 850mg metformin twice daily. The trial was supported by the EU FP7 Marie Curie program FP7-MC-CIG 303795, and the Rosetrees Trust. The MCT oil was provided by Nutricia, Netherlands.
Citation Format: Yaacov Lawrence, Keren Porper, Yael Shpatz, Uri Amit, Zvi Symon, Leor Zach. A phase I clinical trial of dose-escalated metabolic therapy combined with concomitant radiation therapy in high-grade glioma [abstract]. In: Proceedings of the AACR Virtual Special Conference on Radiation Science and Medicine; 2021 Mar 2-3. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(8_Suppl):Abstract nr PO-004.
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Affiliation(s)
| | | | | | - Uri Amit
- Sheba Medical Center, Ramat Gan, Israel
| | - Zvi Symon
- Sheba Medical Center, Ramat Gan, Israel
| | - Leor Zach
- Sheba Medical Center, Ramat Gan, Israel
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15
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Urban D, Urban GE, Margalit O, Amit U, Jacobson G, Symon Z, Golan T, Boursi B, Lawrence YR. Mortality Among Neutropenic Cancer Patients Within the United States: The Association With Hospital Volume. JCO Oncol Pract 2021; 17:e582-e592. [PMID: 33439696 DOI: 10.1200/op.20.00115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
PURPOSE Neutropenia is a serious complication of chemotherapy in patients with solid tumors. The influence of hospital volume on outcomes in patients with neutropenia has been little investigated. We hypothesized that large-volume hospitals would have reduced mortality rates for neutropenic patients compared with small-volume institutions. METHODS We used the Nationwide Inpatient Sample database of the Healthcare Cost and Utilization Project, for the years 2007-2011. All adult inpatient episodes with a diagnosis of both neutropenia and solid-tumor malignancy were included. Hospital volume was defined as the number of neutropenic cancer episodes per institution per year. Mortality was defined as death during admission. A multilevel mixed-effects logistic regression model was applied. RESULTS Twenty thousand three hundred and ten hospitalizations were included in the study, from 1,869 different institutions. Median age was 62 years. The overall inpatient mortality was 2.3%, and was dependent on age (age 50-59 years-1.6% and age 80-89 years-5.3%). The median number of neutropenic inpatient episodes in each institution per year was 14 (range, 1-168). Mortality was 3.3%, 2.7%, 2.2%, 2.2%, and 1.2% for each quintile of hospital volume (from lowest to highest volume, P < .001). Likewise, the proportion discharged home was 85.7%, 90.3%, 91.5%, 92.7%, and 95.4% (P < .001). The association between hospital volume and mortality remained significant after adjustment for patient-level and hospital-level variables. DISCUSSION Patients with neutropenia hospitalized in large-volume institutions have a substantially lower mortality compared with those hospitalized at low-volume institutions. Further study is required to validate our findings or overcome potential biases, understand mechanism, and investigate how smaller institutions can improve outcomes.
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Affiliation(s)
- Damien Urban
- Institute of Oncology, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | | | - Ofer Margalit
- Institute of Oncology, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Uri Amit
- Institute of Oncology, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Galia Jacobson
- Institute of Oncology, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Zvi Symon
- Institute of Oncology, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Talia Golan
- Institute of Oncology, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Ben Boursi
- Institute of Oncology, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
| | - Yaacov Richard Lawrence
- Institute of Oncology, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel.,Department of Radiation Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
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16
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Jacobson G, Ben-Mordechai T, Lawrence Y, Symon Z, Shimoni-Sebag A, Kordahji G, Leor J, Amit U. Detection of Radiation Induced Heart Disease Applying Speckle Tracking Echocardiography in a Mouse Model. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Lawrence YR, Margalit O, Jacobson G, Hamer L, Amit U, Halpern N, Shmueli ES, Boursi B, Goldes Y, Azoulay D, Golan T, Symon Z. The impact of pancreatic cancer resection in the era of effective systemic treatment. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.4_suppl.722] [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: 11/20/2022] Open
Abstract
722 Background: Surgical resection is the only curative modality in pancreatic cancer, yet the vast majority of patients undergoing surgery succumb of their disease. No randomized studies have been performed to assess the survival impact of the procedure. We hypothesized that in the era of effective systemic treatments, the survival advantage of surgical resection would be lessened. Methods: A meta-analysis of published phase III clinical trials in pancreatic cancer in both the post resection adjuvant setting and the locally advanced metastatic setting, based upon indirect aggregate data. Data was stratified based upon the systemic agents used. Patients from trials arms for which there were not complementary data sets with/without surgical resection were excluded. Primary endpoint was 3 year overall survival (OS). Results: Trials were published between 1997 and 2018. A total of 2722 patients were included in the data analysis, of whom 1645 underwent tumor resection and 814 were metastatic. Median follow-up was 40 months. Analyses were performed of five systemic options with / without tumor resection. Across the trials averaged 3 yr OS was 0%, 0.8%, 0%, and 3.8% for 5FU, gemcitabine, gemcitabine + capecitabine, & FOLFIRINOX respectively; and 18.1%, 30.0%, 37.9%, 42.5%, and 62.5% for the same systemic treatments delivered following surgical resection. Hence the additive impact of surgical resection on absolute 3 yr OS was only 18.1% in the absence of systemic treatment, but 30.0%, 37.1%, 42.5% and 58.8% in the presence of 5FU, gemcitabine, gemcitabine + capecitabine, FOLFIRINOX respectively. Conclusions: Within the limitations of this analysis, it appears that our hypothesis was incorrect, and that the opposite is true. The introduction of effective systemic therapies has greatly increased the impact of pancreatic surgery on long-term survival in pancreatic cancer. Consequently, every effort should be made to bring patients to curative resection.
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Affiliation(s)
| | | | | | | | - Uri Amit
- Sheba Medical Center, Ramat Gan, Israel
| | | | | | - Ben Boursi
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Yuri Goldes
- Chaim Sheba Medical Center, Ramat Gan, Israel
| | | | - Talia Golan
- The Oncology Institute, Sheba Medical Center at Tel-Hashomer, Tel Aviv University, Tel Aviv, Israel
| | - Zvi Symon
- Sheba Medical Center, Ramat Gan, Israel
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Ben-Mordechai T, Lawrence Y, Symon Z, Shimoni-Sebag A, Appel S, Amit U. CX3CR1 Expressing Macrophages Infiltrate the Tumor Microenvironment and Promote Radiation Resistance in a Mouse Model of Lung Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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19
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Sadetskii I, Eshet Y, Tsvang L, Amit U, Weiss I, Benayun M, Lawrence Y, Symon Z. Response assessment using 68 Gallium (68Ga) Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography - Computed Tomography (PT/CT) inpatients with oligometastatic prostate cancer undergoing Stereotactic Body Radiotherapy (SBRT). Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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20
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Lawrence YR, Hammer L, Morag O, Ben-Ailan M, Alezra D, Margalit O, Halpern N, Boursi B, Shmueli ES, Jacobson G, Amit U, Katzman T, Shefer K, Weiss I, Yanovsky I, Dicker AP, Golan T, Symon Z, Hausner D. Abstract CT147: Celiac plexus radiosurgery a new palliative modality for upper gastrointestinal malignancies - final quality of life results from a proof-of-concept clinical trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-ct147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: Many patients with upper-abdominal malignancies suffer from severe low back / epigastric pain caused by infiltration of the celiac plexus. The celiac plexus is a network of nociceptive nerves, located along the aorta. Contemporary approaches (opioids, celiac plexus chemical neurolysis, systemic chemotherapy) are often inadequate. The celiac plexus has not previously been targeted using radiation. We hypothesized that ablative radiation targeted to the celiac plexus would alleviate pain and improve quality of life (QOL).
Methods: We conducted a single arm prospective clinical trial. Eligible patients had celiac-pain > 4/10 on Numerical Rating Scale (NRS) and completed treatment per protocol with at least one post-treatment visit. The celiac plexus was irradiated from D12 to L2. Radiation was given as either five fractions of 9 Gy or a single-fraction 25 Gy. The primary endpoint was NRS pain 3 weeks post-treatment. Secondary endpoints were toxicity, pain at 6w, analgesic use, and pain interference with daily activities as evaluated by ‘Brief pain assessment short-form’. Analgesic use was not restricted. Here we report results from those who received single fraction treatment.
Results: 19 patients were evaluable. The median age of the study population was 67 yr with a median ECOG of 2, 89% had pancreatic cancer. Patients were a median 8 months from diagnosis, and had received a median of one systemic treatment. Toxicity was limited to grade 1-2. Average pain decreased from 5.9/10 at baseline, to 3.1/10 at 3w, and to 1.8/10 (both p < 0.0001) at 6w post-treatment. Number of rescue analgesic doses decreased from 3.6 (baseline) to 1.9 at 3w and 1.7 at 6w (both p<0.001). Improvement was seen in all domains of pain-interference (table).
Conclusions: Single fraction celiac plexus radiosurgery alleviates pain, and improves quality of life among patients with advanced upper-GI cancer. An international phase II trial is accruing.
Pain interference measuresdomainweek 0 (baseline)week 3p (w0 vs v3)week 6p (w0 vs v6)General Activity7.93.4<0.00012.0<0.0001Mood6.93.6<0.0051.80.0001Walking ability4.21.80.051.00.01Normal Work7.43.4<0.0051.30.0001Relations with other people62.40.0031.70.003Sleep6.93.2<0.0051.80.0001Enjoyment of life8.32.4<0.00011.8<0.0001
Citation Format: Yaacov R. Lawrence, Liat Hammer, Ofir Morag, Maoz Ben-Ailan, Dror Alezra, Ofer Margalit, Naama Halpern, Ben Boursi, Einat Shacham Shmueli, Galia Jacobson, Uri Amit, Tamar Katzman, Kinneret Shefer, Ilana Weiss, Inessa Yanovsky, Adam P. Dicker, Talia Golan, Zvi Symon, David Hausner. Celiac plexus radiosurgery a new palliative modality for upper gastrointestinal malignancies - final quality of life results from a proof-of-concept clinical trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr CT147.
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Affiliation(s)
| | | | - Ofir Morag
- 1Sheba Medical Center, Tel HaShomer, Israel
| | | | | | | | | | - Ben Boursi
- 1Sheba Medical Center, Tel HaShomer, Israel
| | | | | | - Uri Amit
- 1Sheba Medical Center, Tel HaShomer, Israel
| | | | | | | | | | | | | | - Zvi Symon
- 1Sheba Medical Center, Tel HaShomer, Israel
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Amit U, Lawrence YR, Weiss I, Symon Z. Radiotherapy with or without androgen deprivation therapy in intermediate risk prostate cancer? Radiat Oncol 2019; 14:99. [PMID: 31182119 PMCID: PMC6558831 DOI: 10.1186/s13014-019-1298-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 02/18/2019] [Accepted: 05/15/2019] [Indexed: 11/22/2022] Open
Abstract
Objective Androgen deprivation therapy (ADT) is beneficial for unfavorable intermediate-risk (IR) prostate cancer patients receiving curative radiotherapy (RT). However, for favorable IR patients the latest NCCN guidelines recommends RT alone. We retrospectively studied treatment patterns and outcomes of patients with IR prostate cancer in our institution over the past two decades. Materials and methods Three hundred seventy-three IR prostate cancer patients treated with definitive RT between 5/2002–5/2016 were identified in an institutional review board approved database. All patients received conformal RT to the prostate while the vast majority did not receive nodal radiation. ADT was commenced 2 months prior to RT and was continued for 4 months after RT. Results Compared to RT alone, patients receiving combined RT+ ADT had more positive biopsy cores, higher pre-radiation PSA, more IR factors, and were more likely to receive pelvic lymph node radiation. However, there were no differences in failure either biochemical, local or distal, nor on survival between the favorable RT alone and the unfavorable RT+ ADT cohorts, suggesting a beneficial role for ADT. On multivariate analysis, patients 70 years or younger receiving RT alone were at increased risk for biochemical failure during a 6-year follow-up (HR 3.06, P = 0.025). Biochemical relapse free survival in patients ≤70 years who received RT alone was 82.1% vs 94.0% for RT + ADT (P = 0.030). There was no difference for combined treatment modality in patients > 70 years (P = 0.87). Conclusions Men 70 years or younger with favorable IR prostate cancer treated with RT alone to 78 Gy are at increased risk of biochemical failure. Short term ADT should be considered in this cohort of men. Electronic supplementary material The online version of this article (10.1186/s13014-019-1298-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Uri Amit
- Radiation Oncology Department, Chaim Sheba Medical Center, Tel-Hashomer, Israel. .,The Dr. Pinchas Borenstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
| | - Yaacov R Lawrence
- Radiation Oncology Department, Chaim Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilana Weiss
- Radiation Oncology Department, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Zvi Symon
- Radiation Oncology Department, Chaim Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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22
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Naftali-Shani N, Arad M, Kuperstein R, Amit U, Leor J. Response by Naftali-Shani et al to Letter Regarding Article, "Modeling Peripartum Cardiomyopathy With Human Induced Pluripotent Stem Cells Reveals Distinctive Abnormal Function of Cardiomyocytes". Circulation 2019; 139:e992-e993. [PMID: 31107621 DOI: 10.1161/circulationaha.119.040323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Nili Naftali-Shani
- Neufeld Cardiac Research Institute (N.N.-S., U.A., J.L.), Tel-Aviv University, Israel.,Sackler Faculty of Medicine (N.N.-S., M.A., R.K., U.A., J.L.), Tel-Aviv University, Israel.,Tamman Cardiovascular Research Institute (N.N.-S., U.A., J.L.), Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Michael Arad
- Sackler Faculty of Medicine (N.N.-S., M.A., R.K., U.A., J.L.), Tel-Aviv University, Israel.,Department of Cardiology (M.A., R.K., J.L.), Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Rafael Kuperstein
- Sackler Faculty of Medicine (N.N.-S., M.A., R.K., U.A., J.L.), Tel-Aviv University, Israel.,Department of Cardiology (M.A., R.K., J.L.), Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Uri Amit
- Neufeld Cardiac Research Institute (N.N.-S., U.A., J.L.), Tel-Aviv University, Israel.,Sackler Faculty of Medicine (N.N.-S., M.A., R.K., U.A., J.L.), Tel-Aviv University, Israel.,Tamman Cardiovascular Research Institute (N.N.-S., U.A., J.L.), Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Jonathan Leor
- Neufeld Cardiac Research Institute (N.N.-S., U.A., J.L.), Tel-Aviv University, Israel.,Sackler Faculty of Medicine (N.N.-S., M.A., R.K., U.A., J.L.), Tel-Aviv University, Israel.,Tamman Cardiovascular Research Institute (N.N.-S., U.A., J.L.), Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel.,Department of Cardiology (M.A., R.K., J.L.), Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel
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Naftali-Shani N, Molotski N, Nevo-Caspi Y, Arad M, Kuperstein R, Amit U, Huber I, Zeltzer LA, Levich A, Abbas H, Monserrat L, Paret G, Leor J. Modeling Peripartum Cardiomyopathy With Human Induced Pluripotent Stem Cells Reveals Distinctive Abnormal Function of Cardiomyocytes. Circulation 2018; 138:2721-2723. [DOI: 10.1161/circulationaha.118.035950] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Nili Naftali-Shani
- Neufeld Cardiac Research Institute (N.N.-S., N.M., U.A., L.-a.Z, A.L., J.L.), Tel-Aviv University, Israel
- Tamman Cardiovascular Research Institute (N.N.-S., N.M., U.A., L.-a.Z, A.L., J.L.), Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Natali Molotski
- Neufeld Cardiac Research Institute (N.N.-S., N.M., U.A., L.-a.Z, A.L., J.L.), Tel-Aviv University, Israel
- Tamman Cardiovascular Research Institute (N.N.-S., N.M., U.A., L.-a.Z, A.L., J.L.), Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Yael Nevo-Caspi
- Department of Pediatric Critical Care Medicine, Safra Children’s Hospital, Tel-Hashomer, Israel (Y.N.-C., H.A., G.P.)
| | - Michael Arad
- SacklerSchool of Medicine (M.A., R.K., J.L.), Tel-Aviv University, Israel
- Department of Cardiology (M.A., R.K., J.L.), Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Rafael Kuperstein
- SacklerSchool of Medicine (M.A., R.K., J.L.), Tel-Aviv University, Israel
- Department of Cardiology (M.A., R.K., J.L.), Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Uri Amit
- Neufeld Cardiac Research Institute (N.N.-S., N.M., U.A., L.-a.Z, A.L., J.L.), Tel-Aviv University, Israel
- Tamman Cardiovascular Research Institute (N.N.-S., N.M., U.A., L.-a.Z, A.L., J.L.), Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Irit Huber
- The Sohnis Family Laboratory for Cardiac Electrophysiology and Regenerative Medicine, Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel (I.H.)
| | - Li-at Zeltzer
- Neufeld Cardiac Research Institute (N.N.-S., N.M., U.A., L.-a.Z, A.L., J.L.), Tel-Aviv University, Israel
- Tamman Cardiovascular Research Institute (N.N.-S., N.M., U.A., L.-a.Z, A.L., J.L.), Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Alina Levich
- Neufeld Cardiac Research Institute (N.N.-S., N.M., U.A., L.-a.Z, A.L., J.L.), Tel-Aviv University, Israel
- Tamman Cardiovascular Research Institute (N.N.-S., N.M., U.A., L.-a.Z, A.L., J.L.), Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Haya Abbas
- Department of Pediatric Critical Care Medicine, Safra Children’s Hospital, Tel-Hashomer, Israel (Y.N.-C., H.A., G.P.)
| | | | - Gideon Paret
- Department of Pediatric Critical Care Medicine, Safra Children’s Hospital, Tel-Hashomer, Israel (Y.N.-C., H.A., G.P.)
| | - Jonathan Leor
- Neufeld Cardiac Research Institute (N.N.-S., N.M., U.A., L.-a.Z, A.L., J.L.), Tel-Aviv University, Israel
- SacklerSchool of Medicine (M.A., R.K., J.L.), Tel-Aviv University, Israel
- Tamman Cardiovascular Research Institute (N.N.-S., N.M., U.A., L.-a.Z, A.L., J.L.), Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel
- Department of Cardiology (M.A., R.K., J.L.), Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel
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Hammer L, Hausner D, Morag O, ben-Ayun M, Alezra D, Dubinski S, Tsvang L, Jacobson G, Amit U, Katzman T, Gnessin H, Shefer K, Weiss I, Yanovsky I, Golan T, Symon Z, Lawrence Y. Celiac Plexus Radiosurgery, a New Modality for Cancer Pain Management – Final Results of a Phase II Clinical Trial. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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25
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Ungar OJ, Amit U, Cavel O, Oron Y, Handzel O. Age-dependent variations of scalp thickness in the area designated for a cochlear implant receiver stimulator. Laryngoscope Investig Otolaryngol 2018; 3:496-499. [PMID: 30599036 PMCID: PMC6302726 DOI: 10.1002/lio2.218] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/21/2018] [Accepted: 09/14/2018] [Indexed: 11/09/2022] Open
Abstract
Objective The integrity of the scalp overlying a cochlear implant receiver stimulator (RS) is critical for the long‐term survival of the implant. Exposure or extrusion of the device will likely result in the need for its removal. There is a global trend of acceleration of population aging, thus raising the prevalence of cochlear implantation (CI) in the elderly. The aim of this study was to define age‐dependent changes in scalp thickness and discuss the implication of that anatomical characteristic for CI in the geriatric population. Methods Scalp thickness over the location of the RS in the temporo‐parietal area was measured directly with a needle in patients of various ages. Results Two‐hundred thirty‐six temporo‐parietal scalps were measured in patients aged 18 to 85 years. A strong inverse correlation was found between age and scalp thickness (rs = ‐0.723, P < .001). Scalp thickness decreased with age from a mean of 8 mm in the third decade of life to 5 mm in the ninth decade of life. Conclusion The human scalp thins with age and most likely undergoes a reduction in its strength. As a consequence, implantable hearing devices that are shielded by the scalp can be at increased risk of exposure and extrusion in the aging recipient. This needs to be taken into account when considering an implantation procedure, the surgical approach and patient instructions on need for and venues for continuing care over time. Level of Evidence 2B
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Affiliation(s)
- Omer J Ungar
- Department of Otolaryngology Head, Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine Tel-Aviv University Tel-Aviv Israel
| | - Uri Amit
- Department of Otolaryngology Head, Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine Tel-Aviv University Tel-Aviv Israel
| | - Oren Cavel
- Department of Otolaryngology Head, Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine Tel-Aviv University Tel-Aviv Israel
| | - Yahav Oron
- Department of Otolaryngology Head, Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine Tel-Aviv University Tel-Aviv Israel
| | - Ophir Handzel
- Department of Otolaryngology Head, Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine Tel-Aviv University Tel-Aviv Israel
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26
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Tsoref O, Tyomkin D, Amit U, Landa N, Cohen-Rosenboim O, Kain D, Golan M, Naftali-Shani N, David A, Leor J. E-selectin-targeted copolymer reduces atherosclerotic lesions, adverse cardiac remodeling, and dysfunction. J Control Release 2018; 288:136-147. [DOI: 10.1016/j.jconrel.2018.08.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/15/2018] [Accepted: 08/20/2018] [Indexed: 01/08/2023]
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27
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Lawrence YR, Hammer L, Morag O, Ben-Ailan M, Alezra D, Margalit O, Halpern N, Boursi B, Shmueli ES, Jacobson G, Amit U, Katzman T, Shefer K, Weiss I, Yanovsky I, Dicker A, Golan T, Hausner D, Symon Z. Celiac plexus radiosurgery: A new palliative modality for upper gastrointestinal malignancies—Final results of a proof-of-concept clinical trial. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.10098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - Ben Boursi
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | | | | | - Uri Amit
- Sheba Medical Center, Ramat Gan, Israel
| | | | | | | | | | - Adam Dicker
- The Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA
| | | | - David Hausner
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Zvi Symon
- Sheba Medical Center, Ramat Gan, Israel
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28
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Nair NU, Das A, Amit U, Robinson W, Park SG, Basu M, Lugo A, Leor J, Ruppin E, Hannenhalli S. Putative functional genes in idiopathic dilated cardiomyopathy. Sci Rep 2018; 8:66. [PMID: 29311597 PMCID: PMC5758757 DOI: 10.1038/s41598-017-18524-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 12/12/2017] [Indexed: 12/16/2022] Open
Abstract
Idiopathic dilated cardiomyopathy (DCM) is a complex disorder with a genetic and an environmental component involving multiple genes, many of which are yet to be discovered. We integrate genetic, epigenetic, transcriptomic, phenotypic, and evolutionary features into a method - Hridaya, to infer putative functional genes underlying DCM in a genome-wide fashion, using 213 human heart genomes and transcriptomes. Many genes identified by Hridaya are experimentally shown to cause cardiac complications. We validate the top predicted genes, via five different genome-wide analyses: First, the predicted genes are associated with cardiovascular functions. Second, their knockdowns in mice induce cardiac abnormalities. Third, their inhibition by drugs cause cardiac side effects in human. Fourth, they tend to have differential exon usage between DCM and normal samples. Fifth, analyzing 213 individual genotypes, we show that regulatory polymorphisms of the predicted genes are associated with elevated risk of cardiomyopathy. The stratification of DCM patients based on cardiac expression of the functional genes reveals two subgroups differing in key cardiac phenotypes. Integrating predicted functional genes with cardiomyocyte drug treatment experiments reveals novel potential drug targets. We provide a list of investigational drugs that target the newly identified functional genes that may lead to cardiac side effects.
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Affiliation(s)
- Nishanth Ulhas Nair
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, 20742, USA.
| | - Avinash Das
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, 20742, USA
| | - Uri Amit
- The Neufeld Cardiac Research Institute, Tel Aviv University, Tel Aviv-Yafo, Israel
- Tamman Cardiovascular Research Institute, Sheba Medical Center, Ramat Gan, Israel
- The Dr. Pinchas Borenstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel-Hashomer, Israel
- Department of Radiation Oncology, Sheba Medical Center, Tel-Hashomer, Israel
| | - Welles Robinson
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, 20742, USA
| | - Seung Gu Park
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, 20742, USA
| | - Mahashweta Basu
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, 20742, USA
| | - Alex Lugo
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, 20742, USA
| | - Jonathan Leor
- The Neufeld Cardiac Research Institute, Tel Aviv University, Tel Aviv-Yafo, Israel
- Tamman Cardiovascular Research Institute, Sheba Medical Center, Ramat Gan, Israel
| | - Eytan Ruppin
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, 20742, USA
- The Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, 69978, Israel
| | - Sridhar Hannenhalli
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, 20742, USA.
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Davidson T, Ben-David M, Galper S, Haskin T, Howes M, Scaife R, Kanana N, Amit U, Weizman N, Chikman B, Goshen E, Ben-Haim S, Symon Z, Goldstein J. Use of 18 F-FDG PET-CT imaging to determine internal mammary lymph node location for radiation therapy treatment planning in breast cancer patients. Pract Radiat Oncol 2017; 7:373-381. [DOI: 10.1016/j.prro.2016.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/31/2016] [Accepted: 11/02/2016] [Indexed: 10/20/2022]
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30
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Alpert EA, Amit U, Guranda L, Mahagna R, Grossman SA, Bentancur A. Emergency department point-of-care ultrasonography improves time to pericardiocentesis for clinically significant effusions. Clin Exp Emerg Med 2017; 4:128-132. [PMID: 29026885 PMCID: PMC5635453 DOI: 10.15441/ceem.16.169] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 03/08/2017] [Accepted: 03/15/2017] [Indexed: 12/03/2022] Open
Abstract
Objective Our objective was to determine the utility of point-of-care ultrasound (POCUS) to identify and guide treatment of tamponade or clinically significant pericardial effusions in the emergency department (ED). Methods This was a retrospective cohort study of non-trauma patients who were diagnosed with large pericardial effusions or tamponade by the ED physician using POCUS. The control group was composed of those patients later diagnosed on the medical wards or incidentally in the ED by other means such as a computed tomography. The following data were abstracted from the patient’s file: demographics, medical background, electrocardiogram results, chest radiograph readings, echocardiogram results, and patient outcomes. Results There were 18 patients in the POCUS arm and 55 in the control group. The POCUS arm had a decreased time to pericardiocentesis (11.3 vs. 70.2 hours, P=0.055) as well as a shorter length of stay (5.1 vs. 7.0 days, P=0.222). A decreased volume of pericardial fluid was drained (661 vs. 826 mL, P=0.139) in the group diagnosed by POCUS. Conclusion This study suggests that POCUS may effectively identify pericardial effusions and guide appropriate treatment, leading to a decreased time to pericardiocentesis and decreased length of hospital stay. Pericardial tamponade or a large pericardial effusion should be considered in all patients presenting to the ED with clinical, radiographic, or electrocardiographic signs of cardiovascular compromise.
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Affiliation(s)
- Evan Avraham Alpert
- Department of Emergency Medicine, Sheba Medical Center, Tel Hashomer, Israel
| | - Uri Amit
- Neufeld Cardiac Research Institute, Sheba Medical Center, Tel-Aviv University, Tel Hashomer, Israel
| | - Larisa Guranda
- Department of Radiology, Sheba Medical Center, Tel Hashomer, Israel
| | - Rafea Mahagna
- Department of Emergency Medicine, Sheba Medical Center, Tel Hashomer, Israel
| | - Shamai A Grossman
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ariel Bentancur
- Department of Emergency Medicine, Sheba Medical Center, Tel Hashomer, Israel
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Golan T, Sella T, Margalit O, Amit U, Halpern N, Aderka D, Shacham-Shmueli E, Urban D, Lawrence YR. Short- and Long-Term Survival in Metastatic Pancreatic Adenocarcinoma, 1993-2013. J Natl Compr Canc Netw 2017; 15:1022-1027. [PMID: 28784864 DOI: 10.6004/jnccn.2017.0138] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 04/17/2017] [Indexed: 11/17/2022]
Abstract
Background: During the past 2 decades, numerous clinical trials have focused on improving outcomes in patients with metastatic pancreatic cancer (mPDAC). The efficacy of new treatments has been demonstrated among highly selected patients in randomized phase III trials; hence, it is not clear to what extent these advances are reflected within the broader mPDAC population. Materials and Methods: Survival statistics were extracted from the SEER database for patients diagnosed with mPDAC between 1993 and 2013. Survival was analyzed using the Kaplan-Meier method and proportional hazard models. Results: The study population consisted of 57,263 patients diagnosed with mPDAC between 1993 and 2013; 52% were male, with a median age of 69 years (range, 15-104). Superior prognosis correlated with younger age, being married, tumor located within the head of the pancreas, lower grade disease, and more recent year of diagnosis. Median overall survival (OS) remained stable at 2 months between 1993 and 2013. Improvements in OS were seen for younger patients (age <50 years) and those with a more recent year of diagnosis (2009-2013). The percentage of patients who died within 2 months of initial diagnosis decreased between 1993 and 2013 (from 63.5% to 50.6%; P<.0001). The percentage of patients surviving ≥12 months improved from 4.9% in 1993 to 12.7% in 2013 (P<.0001). Conclusions: In recent years a modest improvement in OS has been seen among younger patients with mPDAC. The percentage of patients living beyond 1 year has significantly increased over time; however, the percentage of those dying within 2 months remains substantial.
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Amit U, Kain D, Wagner A, Sahu A, Nevo-Caspi Y, Gonen N, Molotski N, Konfino T, Landa N, Naftali-Shani N, Blum G, Merquiol E, Karo-Atar D, Kanfi Y, Paret G, Munitz A, Cohen HY, Ruppin E, Hannenhalli S, Leor J. New Role for Interleukin-13 Receptor α1 in Myocardial Homeostasis and Heart Failure. J Am Heart Assoc 2017; 6:JAHA.116.005108. [PMID: 28528324 PMCID: PMC5524075 DOI: 10.1161/jaha.116.005108] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The immune system plays a pivotal role in myocardial homeostasis and response to injury. Interleukins-4 and -13 are anti-inflammatory type-2 cytokines, signaling via the common interleukin-13 receptor α1 chain and the type-2 interleukin-4 receptor. The role of interleukin-13 receptor α1 in the heart is unknown. METHODS AND RESULTS We analyzed myocardial samples from human donors (n=136) and patients with end-stage heart failure (n=177). We found that the interleukin-13 receptor α1 is present in the myocardium and, together with the complementary type-2 interleukin-4 receptor chain Il4ra, is significantly downregulated in the hearts of patients with heart failure. Next, we showed that Il13ra1-deficient mice develop severe myocardial dysfunction and dyssynchrony compared to wild-type mice (left ventricular ejection fraction 29.7±9.9 versus 45.0±8.0; P=0.004, left ventricular end-diastolic diameter 4.2±0.2 versus 3.92±0.3; P=0.03). A bioinformatic analysis of mouse hearts indicated that interleukin-13 receptor α1 regulates critical pathways in the heart other than the immune system, such as extracellular matrix (normalized enrichment score=1.90; false discovery rate q=0.005) and glucose metabolism (normalized enrichment score=-2.36; false discovery rate q=0). Deficiency of Il13ra1 was associated with reduced collagen deposition under normal and pressure-overload conditions. CONCLUSIONS The results of our studies in humans and mice indicate, for the first time, a role of interleukin-13 receptor α1 in myocardial homeostasis and heart failure and suggests a new therapeutic target to treat heart disease.
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Affiliation(s)
- Uri Amit
- Neufeld Cardiac Research Institute, Tel Aviv University, Tel-Hashomer, Israel
- Sheba Center for Regenerative Medicine, Stem Cell, and Tissue Engineering, Sheba Medical Center, Tel-Hashomer, Israel
- Tamman Cardiovascular Research Institute, Sheba Medical Center, Tel-Hashomer, Israel
- The Dr. Pinchas Borenstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel-Hashomer, Israel
| | - David Kain
- Neufeld Cardiac Research Institute, Tel Aviv University, Tel-Hashomer, Israel
- Sheba Center for Regenerative Medicine, Stem Cell, and Tissue Engineering, Sheba Medical Center, Tel-Hashomer, Israel
- Tamman Cardiovascular Research Institute, Sheba Medical Center, Tel-Hashomer, Israel
| | - Allon Wagner
- The Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
- Department of Electrical Engineering and Computer Science, University of California, Berkeley, CA
| | - Avinash Sahu
- Department of Cell Biology and Molecular Genetics, Center for Bioinformatics and Computational Biology, University of Maryland, College Park, MD
| | - Yael Nevo-Caspi
- Department of Pediatric Critical Care Medicine, Safra Children's Hospital, Tel-Hashomer, Israel
| | - Nir Gonen
- The Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
| | - Natali Molotski
- Neufeld Cardiac Research Institute, Tel Aviv University, Tel-Hashomer, Israel
- Sheba Center for Regenerative Medicine, Stem Cell, and Tissue Engineering, Sheba Medical Center, Tel-Hashomer, Israel
- Tamman Cardiovascular Research Institute, Sheba Medical Center, Tel-Hashomer, Israel
| | - Tal Konfino
- Neufeld Cardiac Research Institute, Tel Aviv University, Tel-Hashomer, Israel
- Sheba Center for Regenerative Medicine, Stem Cell, and Tissue Engineering, Sheba Medical Center, Tel-Hashomer, Israel
- Tamman Cardiovascular Research Institute, Sheba Medical Center, Tel-Hashomer, Israel
| | - Natalie Landa
- Neufeld Cardiac Research Institute, Tel Aviv University, Tel-Hashomer, Israel
- Sheba Center for Regenerative Medicine, Stem Cell, and Tissue Engineering, Sheba Medical Center, Tel-Hashomer, Israel
- Tamman Cardiovascular Research Institute, Sheba Medical Center, Tel-Hashomer, Israel
| | - Nili Naftali-Shani
- Neufeld Cardiac Research Institute, Tel Aviv University, Tel-Hashomer, Israel
- Sheba Center for Regenerative Medicine, Stem Cell, and Tissue Engineering, Sheba Medical Center, Tel-Hashomer, Israel
- Tamman Cardiovascular Research Institute, Sheba Medical Center, Tel-Hashomer, Israel
| | - Galia Blum
- The Institute of Drug Research, The School of Pharmacy, The Faculty of Medicine, Campus Ein Karem, Hebrew University, Jerusalem, Israel
| | - Emmanuelle Merquiol
- The Institute of Drug Research, The School of Pharmacy, The Faculty of Medicine, Campus Ein Karem, Hebrew University, Jerusalem, Israel
| | - Danielle Karo-Atar
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yariv Kanfi
- Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Gidi Paret
- Department of Pediatric Critical Care Medicine, Safra Children's Hospital, Tel-Hashomer, Israel
| | - Ariel Munitz
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Haim Y Cohen
- Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Eytan Ruppin
- The Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
- The Blavatnik School of Computer Science and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sridhar Hannenhalli
- Department of Cell Biology and Molecular Genetics, Center for Bioinformatics and Computational Biology, University of Maryland, College Park, MD
| | - Jonathan Leor
- Neufeld Cardiac Research Institute, Tel Aviv University, Tel-Hashomer, Israel
- Sheba Center for Regenerative Medicine, Stem Cell, and Tissue Engineering, Sheba Medical Center, Tel-Hashomer, Israel
- Tamman Cardiovascular Research Institute, Sheba Medical Center, Tel-Hashomer, Israel
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Roichman A, Kanfi Y, Glazz R, Naiman S, Amit U, Landa N, Tinman S, Stein I, Pikarsky E, Leor J, Cohen HY. SIRT6 Overexpression Improves Various Aspects of Mouse Healthspan. J Gerontol A Biol Sci Med Sci 2017; 72:603-615. [PMID: 27519885 DOI: 10.1093/gerona/glw152] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 03/22/2016] [Accepted: 07/18/2016] [Indexed: 01/08/2023] Open
Abstract
The extension in human lifespan in the last century results in a significant increase in incidence of age related diseases. It is therefore crucial to identify key factors that control elderly healthspan. Similar to dietary restriction, mice overexpressing the NAD+ dependent protein deacylase SIRT6 (MOSES) live longer and have reduced IGF-1 levels. However, it is as yet unknown whether SIRT6 also affects various healthspan parameters. Here, a range of age related phenotypes was evaluated in MOSES mice. In comparison to their wild-type (WT) littermates, old MOSES mice showed amelioration of a variety of age-related disorders, including: improved glucose tolerance, younger hormonal profile, reduced age-related adipose inflammation and increased physical activity. The increased activity was accompanied with increased muscle AMP-activated protein kinase (AMPK) activity. Altogether, these results indicate that overexpression of SIRT6 in mice retards important aspects of the aging process and suggest SIRT6 to be a potential therapeutic target for the treatment of a set of age-related disorders.
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Affiliation(s)
- Asael Roichman
- The Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Yariv Kanfi
- The Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Renana Glazz
- The Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Shoshana Naiman
- The Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Uri Amit
- Tamman and Neufeld Cardiovascular Research Institute, Sheba Center of Regenerative Medicine, Sheba Medical Center, Tel Aviv University, Israel
| | - Natalie Landa
- Tamman and Neufeld Cardiovascular Research Institute, Sheba Center of Regenerative Medicine, Sheba Medical Center, Tel Aviv University, Israel
| | - Simon Tinman
- The Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Ilan Stein
- The Lautenberg Center for Immunology and Cancer Research, IMRIC, Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Eli Pikarsky
- The Lautenberg Center for Immunology and Cancer Research, IMRIC, Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Jonathan Leor
- Tamman and Neufeld Cardiovascular Research Institute, Sheba Center of Regenerative Medicine, Sheba Medical Center, Tel Aviv University, Israel
| | - Haim Y Cohen
- The Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
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Naftali-Shani N, Levin-Kotler LP, Palevski D, Amit U, Kain D, Landa N, Hochhauser E, Leor J. Left Ventricular Dysfunction Switches Mesenchymal Stromal Cells Toward an Inflammatory Phenotype and Impairs Their Reparative Properties Via Toll-Like Receptor-4. Circulation 2017; 135:2271-2287. [PMID: 28356441 DOI: 10.1161/circulationaha.116.023527] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [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: 05/05/2016] [Accepted: 03/17/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Little is known about the potentially unfavorable effects of mesenchymal stromal cell (MSC) activation on the heart. MSCs can respond to tissue injury by anti- or proinflammatory activation. We aimed to study the potential negative interaction between left ventricular dysfunction (LVD) and MSC activation. METHODS We isolated MSCs from cardiac and subcutaneous fat tissues of mice with LVD 28 days after myocardial infarction or sham operation. To evaluate the effect of LVD on MSCs, we characterized cardiac MSCs and subcutaneous MSCs in vitro. Subsequently, we injected MSCs or saline into the infarcted myocardium of mice and evaluated LV remodeling and function 28 days after myocardial infarction. To test the hypothesis that toll-like receptor 4 (TLR4) mediates proinflammatory polarization of MSCs, we characterized cardiac MSCs from TLR4-/- and wild-type (WT) mice after inflammatory stimulation in vitro. Next, we transplanted cardiac MSCs from TLR4-/- and WT male mice into the infarcted myocardium of female WT mice and evaluated infarct size, MSC retention, inflammation, remodeling, and function after 7 days. RESULTS LVD switched cardiac MSCs toward an inflammatory phenotype, with increased secretion of inflammatory cytokines as well as chemokines. The effect of LVD on subcutaneous MSCs was less remarkable. Although transplantation of cardiac MSCs and subcutaneous MSCs from LVD and sham hearts did not improve LV remodeling and function, cardiac MSCs from LVD exacerbated anterior wall thinning 28 days after myocardial infarction. The inflammatory polarization of cardiac MSCs by LVD was mediated by TLR4, as we found less secretion of inflammatory cytokines and higher secretion of anti-inflammatory cytokines from activated cardiac MSCs of TLR4-deficient mice, compared with WT cardiac MSCs. Significantly, TLR4 deficiency preserved the expression of CD47 (don't eat me signal) on cardiac MSCs after both TLR4 stimulation in vitro and transplantation into the infarcted heart. Compared with WT cardiac MSCs and saline, TLR4-/- cardiac MSCs survived in the cardiac tissue and maintained their reparative properties, reduced infarct size, increased scar thickness, and attenuated LV dilatation 7 days after myocardial infarction. CONCLUSIONS The environment of the failing and infarcted myocardium drives resident and transplanted MSCs toward a proinflammatory phenotype and restricts their survival and reparative effects in a mechanism mediated by TLR4.
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Affiliation(s)
- Nili Naftali-Shani
- From Neufeld Cardiac Research Institute, Sackler Faculty of Medicine, Tel-Aviv University, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Tamman Cardiovascular Research Institute, Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Sheba Center for Regenerative Medicine, Stem Cell and Tissue Engineering, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); and Cardiac Research Laboratory, Department of Cardiothoracic Surgery, Felsenstein Medical Research Center, Rabin Medical Center, Tel-Aviv University, Petah Tikva, Israel (E.H.)
| | - La-Paz Levin-Kotler
- From Neufeld Cardiac Research Institute, Sackler Faculty of Medicine, Tel-Aviv University, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Tamman Cardiovascular Research Institute, Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Sheba Center for Regenerative Medicine, Stem Cell and Tissue Engineering, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); and Cardiac Research Laboratory, Department of Cardiothoracic Surgery, Felsenstein Medical Research Center, Rabin Medical Center, Tel-Aviv University, Petah Tikva, Israel (E.H.)
| | - Dahlia Palevski
- From Neufeld Cardiac Research Institute, Sackler Faculty of Medicine, Tel-Aviv University, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Tamman Cardiovascular Research Institute, Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Sheba Center for Regenerative Medicine, Stem Cell and Tissue Engineering, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); and Cardiac Research Laboratory, Department of Cardiothoracic Surgery, Felsenstein Medical Research Center, Rabin Medical Center, Tel-Aviv University, Petah Tikva, Israel (E.H.)
| | - Uri Amit
- From Neufeld Cardiac Research Institute, Sackler Faculty of Medicine, Tel-Aviv University, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Tamman Cardiovascular Research Institute, Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Sheba Center for Regenerative Medicine, Stem Cell and Tissue Engineering, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); and Cardiac Research Laboratory, Department of Cardiothoracic Surgery, Felsenstein Medical Research Center, Rabin Medical Center, Tel-Aviv University, Petah Tikva, Israel (E.H.)
| | - David Kain
- From Neufeld Cardiac Research Institute, Sackler Faculty of Medicine, Tel-Aviv University, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Tamman Cardiovascular Research Institute, Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Sheba Center for Regenerative Medicine, Stem Cell and Tissue Engineering, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); and Cardiac Research Laboratory, Department of Cardiothoracic Surgery, Felsenstein Medical Research Center, Rabin Medical Center, Tel-Aviv University, Petah Tikva, Israel (E.H.)
| | - Natalie Landa
- From Neufeld Cardiac Research Institute, Sackler Faculty of Medicine, Tel-Aviv University, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Tamman Cardiovascular Research Institute, Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Sheba Center for Regenerative Medicine, Stem Cell and Tissue Engineering, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); and Cardiac Research Laboratory, Department of Cardiothoracic Surgery, Felsenstein Medical Research Center, Rabin Medical Center, Tel-Aviv University, Petah Tikva, Israel (E.H.)
| | - Edith Hochhauser
- From Neufeld Cardiac Research Institute, Sackler Faculty of Medicine, Tel-Aviv University, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Tamman Cardiovascular Research Institute, Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Sheba Center for Regenerative Medicine, Stem Cell and Tissue Engineering, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); and Cardiac Research Laboratory, Department of Cardiothoracic Surgery, Felsenstein Medical Research Center, Rabin Medical Center, Tel-Aviv University, Petah Tikva, Israel (E.H.)
| | - Jonathan Leor
- From Neufeld Cardiac Research Institute, Sackler Faculty of Medicine, Tel-Aviv University, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Tamman Cardiovascular Research Institute, Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); Sheba Center for Regenerative Medicine, Stem Cell and Tissue Engineering, Tel-Hashomer, Israel (N.N.-S., L.-P.L.-K., D.P., U.A., D.K., N.L., J.L.); and Cardiac Research Laboratory, Department of Cardiothoracic Surgery, Felsenstein Medical Research Center, Rabin Medical Center, Tel-Aviv University, Petah Tikva, Israel (E.H.).
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Golan T, Sela T, Margalit O, Amit U, Halpern N, Aderka D, Shmueli ES, Urban D, Lawrence YR. Short and long-term survival in metastatic pancreatic adenocarcinoma, 1993-2013. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
232 Background: Over the previous two decades several new agents have been approved for the treatment of metastatic pancreatic cancer (mPDAC). Their efficacy was demonstrated amongst highly selected patients that participate in randomized phase III trials, hence it is not clear to what extent these advances are reflected within the broader mPDAC population. We performed a population-based survival analysis of newly diagnosed patients who presented with mPDAC. Methods: Survival statistics were extracted from the Survival, Epidemiology and End Results (SEER) Database for patients diagnosed with mPDAC between 1993-2013. Demographic variables collected included age, gender, race, and marital status. Tumor characteristics collected included location and grade. Survival was analyzed using the Kaplan-Meier method and proportional hazard models as appropriate. Exclusion criteria included diagnosis at autopsy, unknown histology and pancreatic neuroendocrine tumors. Results: The study population consisted of 57,263 patients diagnosed with mPDAC from 1993-2013, 52% male, median age 69 years (range 15-104). Prognosis correlated with age, gender, race, marital status, tumor location, grade and year of diagnosis. Median overall survival (OS) stayed stable at 2 months between 1993 and 2013. Improvements in OS were seen for all patients, but especially for younger patients ( < 50 years of age) and more recent year of diagnosis group (2009-2013). The percentage of patients who died within two months of initial diagnosis decreased between 1993 and 2013 (from 63.5% to 50.6%, p < 0.0001). The subgroup of patients achieving longer-term survival has increased, with 12-month survival improving from 4.9 % to 12.7% (p < 0.0001) between 1993 and 2013. Conclusions: There has been a continuous but modest improvement in OS of patients diagnosed with mPDAC between 1993 and 2013. The percentage of patients living beyond one year has significantly increased over time; however the percentage of patients dying within 2 months has only slightly decreased.
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Affiliation(s)
- Talia Golan
- The Oncology Institute Sheba Medical Center, Tel-Hashomer, Israel
| | - Tal Sela
- The Oncology Institute Sheba Medical Center, Ramat Gan, Israel
| | | | - Uri Amit
- Sheba Medical Center, Ramat Gan, Israel
| | - Naama Halpern
- The Oncology Institute Sheba Medical Center, Ramat Gan, Israel
| | | | | | - Damian Urban
- The Oncology Institute Sheba Medical Center,, Ramat Gan, Israel
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Shimony N, Amit U, Minz B, Grossman R, Dany MA, Gonen L, Kandov K, Ram Z, Weinbroum AA. Perioperative pregabalin for reducing pain, analgesic consumption, and anxiety and enhancing sleep quality in elective neurosurgical patients: a prospective, randomized, double-blind, and controlled clinical study. J Neurosurg 2016; 125:1513-1522. [DOI: 10.3171/2015.10.jns151516] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
The aim of this study was to assess in-hospital (immediate) postoperative pain scores and analgesic consumption (primary goals) and preoperative anxiety and sleep quality (secondary goals) in patients who underwent craniotomy and were treated with pregabalin (PGL). Whenever possible, out-of-hospital pain scores and analgesics usage data were obtained as well.
METHODS
This prospective, randomized, double-blind and controlled study was conducted in consenting patients who underwent elective craniotomy for brain tumor resection at Tel Aviv Medical Center between 2012 and 2014. Patients received either 150 mg PGL (n = 50) or 500 mg starch (placebo; n = 50) on the evening before surgery, 1.5 hours before surgery, and twice daily for 72 hours following surgery. All patients spent the night before surgery in the hospital, and no other premedication was administered. Opioids and nonsteroidal antiinflammatory drugs were used for pain, which was self-rated by means of a numerical rating scale (score range 0–10).
RESULTS
Eighty-eight patients completed the study. Data on the American Society of Anesthesiologists class, age, body weight, duration of surgery, and intraoperative drugs were similar for both groups. The pain scores during postoperative Days 0 to 2 were significantly lower in the PGL group than in the placebo group (p < 0.01). Analgesic consumption was also lower in the PGL group, both immediately and 1 month after surgery. There were fewer requests for antiemetics in the PGL group, and the rate of postoperative nausea and vomiting was lower. The preoperative anxiety level and the quality of sleep were significantly better in the PGL group (p < 0.01). There were no PGL-associated major adverse events.
CONCLUSIONS
Perioperative use of twice-daily 150 mg pregabalin attenuates preoperative anxiety, improves sleep quality, and reduces postoperative pain scores and analgesic usage without increasing the rate of adverse effects.
Clinical trial registration no.: NCT01612832 (clinicaltrials.gov)
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Affiliation(s)
- Nir Shimony
- 2Neurosurgery, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine at the Tel Aviv University, Tel Aviv, Israel
| | - Uri Amit
- Departments of 1Anesthesia and Post-Anesthesia Care Unit and
| | - Bella Minz
- 2Neurosurgery, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine at the Tel Aviv University, Tel Aviv, Israel
| | - Rachel Grossman
- 2Neurosurgery, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine at the Tel Aviv University, Tel Aviv, Israel
| | - Marc A. Dany
- Departments of 1Anesthesia and Post-Anesthesia Care Unit and
| | - Lior Gonen
- 2Neurosurgery, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine at the Tel Aviv University, Tel Aviv, Israel
| | - Karina Kandov
- 2Neurosurgery, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine at the Tel Aviv University, Tel Aviv, Israel
| | - Zvi Ram
- 2Neurosurgery, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine at the Tel Aviv University, Tel Aviv, Israel
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Starr KF, Porsch EA, Seed PC, Heiss C, Naran R, Forsberg LS, Amit U, Yagupsky P, Azadi P, St. Geme JW. Kingella kingae Expresses Four Structurally Distinct Polysaccharide Capsules That Differ in Their Correlation with Invasive Disease. PLoS Pathog 2016; 12:e1005944. [PMID: 27760194 PMCID: PMC5070880 DOI: 10.1371/journal.ppat.1005944] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 09/21/2016] [Indexed: 02/03/2023] Open
Abstract
Kingella kingae is an encapsulated gram-negative organism that is a common cause of osteoarticular infections in young children. In earlier work, we identified a glycosyltransferase gene called csaA that is necessary for synthesis of the [3)-β-GalpNAc-(1→5)-β-Kdop-(2→] polysaccharide capsule (type a) in K. kingae strain 269-492. In the current study, we analyzed a large collection of invasive and carrier isolates from Israel and found that csaA was present in only 47% of the isolates. Further examination of this collection using primers based on the sequence that flanks csaA revealed three additional gene clusters (designated the csb, csc, and csd loci), all encoding predicted glycosyltransferases. The csb locus contains the csbA, csbB, and csbC genes and is associated with a capsule that is a polymer of [6)-α-GlcpNAc-(1→5)-β-(8-OAc)Kdop-(2→] (type b). The csc locus contains the cscA, cscB, and cscC genes and is associated with a capsule that is a polymer of [3)-β-Ribf-(1→2)-β-Ribf-(1→2)-β-Ribf-(1→4)-β-Kdop-(2→] (type c). The csd locus contains the csdA, csdB, and csdC genes and is associated with a capsule that is a polymer of [P-(O→3)[β-Galp-(1→4)]-β-GlcpNAc-(1→3)-α-GlcpNAc-1-] (type d). Introduction of the csa, csb, csc, and csd loci into strain KK01Δcsa, a strain 269-492 derivative that lacks the native csaA gene, was sufficient to produce the type a capsule, type b capsule, type c capsule, and type d capsule, respectively, indicating that these loci are solely responsible for determining capsule type in K. kingae. Further analysis demonstrated that 96% of the invasive isolates express either the type a or type b capsule and that a disproportionate percentage of carrier isolates express the type c or type d capsule. These results establish that there are at least four structurally distinct K. kingae capsule types and suggest that capsule type plays an important role in promoting K. kingae invasive disease.
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Affiliation(s)
- Kimberly F. Starr
- Department of Pediatrics and Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC
| | - Eric A. Porsch
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Patrick C. Seed
- Department of Pediatrics and Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC
| | - Christian Heiss
- Complex Carbohydrate Research Center, University of Georgia, Athens, GA
| | - Radnaa Naran
- Complex Carbohydrate Research Center, University of Georgia, Athens, GA
| | - L. Scott Forsberg
- Complex Carbohydrate Research Center, University of Georgia, Athens, GA
| | - Uri Amit
- Radiation Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Pablo Yagupsky
- Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Parastoo Azadi
- Complex Carbohydrate Research Center, University of Georgia, Athens, GA
| | - Joseph W. St. Geme
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- * E-mail:
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Weizman N, Baidun K, Goldstein A, Amit U, Lawrence Y, Appel S, Benayun M, Dubinski S, Orion I, Alezra D, Gnessin H, Symon Z, Goldstein J. Effects of Continuous Positive Airway Pressure (CPAP) Used for Respiratory Motion Management in Patients Receiving Chest Radiation to the Heart: An Analysis of Size, Position, and Motion. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Davidson T, Ben-David M, Galper S, Haskin T, Howes M, Scaife R, Kanana N, Amit U, Weizman N, Chikman B, Goshen E, Ben-Haim S, Symon Z, Goldstein J. The Use of Positron Emission Tomography/Computed Tomography Imaging to Determine Internal Mammary Lymph Node Involvement and Location for Radiation Therapy Treatment Planning in Breast Cancer Patients. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Amit U, Goldstein J, Davidson T, Hahiashvili M, Goshen E, Oksman Y, Berger R, Saad A, Sadetsky I, Chikman B, Lawrence Y, Ben-Haim S, Symon Z. The Role of Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography/Computed Tomography in the Management of Patients With Prostate Cancer: Implications for Selection of Patients for Radiation Therapy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gowran A, Kulikova T, Lewis FC, Foldes G, Fuentes L, Viiri LE, Spinelli V, Costa A, Perbellini F, Sid-Otmane C, Bax NAM, Pekkanen-Mattila M, Schiano C, Chaloupka A, Forini F, Sarkozy M, De Jager SCA, Vajen T, Glezeva N, Lee HW, Golovkin A, Kucera T, Musikhina NA, Korzhenkov NP, Santuchi MDEC, Munteanu D, Garcia RG, Ang R, Usui S, Kamilova U, Jumeau C, Aberg M, Kostina DA, Brandt MM, Muntean D, Lindner D, Sadaba R, Bacova B, Nikolov A, Sedmera D, Ryabov V, Neto FP, Lynch M, Portero V, Kui P, Howarth FC, Gualdoni A, Prorok J, Diolaiuti L, Vostarek F, Wagner M, Abela MA, Nebert C, Xiang W, Kloza M, Maslenko A, Grechanyk M, Bhattachariya A, Morawietz H, Babaeva AR, Martinez Sanchez SM, Krychtiuk KA, Starodubova J, Fiorelli S, Rinne P, Ozkaramanli Gur D, Hofbauer T, Starodubova J, Stellos K, Pinon P, Tsoref O, Thaler B, Fraga-Silva RA, Fuijkschot WW, Shaaban MNS, Matthaeus C, Deluyker D, Scardigli M, Zahradnikova A, Dominguez A, Kondrat'eva D, Sosorburam T, Murarikova M, Duerr GD, Griecsova L, Portnichenko VI, Smolina N, Duicu OANAM, Elder JM, Zaglia T, Lorenzon A, Ruperez C, Woudstra L, Suffee N, De Lucia C, Tsoref O, Russell-Hallinan A, Menendez-Montes I, Kapelko VI, Emmens RW, Hetman O, Van Der Laarse WJ, Goncharov S, Adao R, Huisamen B, Sirenko O, Kamilova U, Nassiri I, Tserendavaa SUMIYA, Yushko K, Baldan Martin M, Falcone C, Vigorelli V, Nigro P, Pompilio G, Stepanova O, Valikhov M, Samko A, Masenko V, Tereschenko S, Teoh T, Domenjo-Vila E, Theologou T, Field M, Awad W, Yasin M, Nadal-Ginard B, Ellison-Hughes GM, Hellen N, Vittay O, Harding SE, Gomez-Cid L, Fernandez-Santos ME, Suarez-Sancho S, Plasencia V, Climent A, Sanz-Ruiz R, Hedhammar M, Atienza F, Fernandez-Aviles F, Kiamehr M, Oittinen M, Viiri KM, Kaikkonen M, Aalto-Setala K, Diolaiuti L, Laurino A, Sartiani L, Vona A, Zanardelli M, Cerbai E, Failli P, Hortigon-Vinagre MP, Van Der Heyden M, Burton FL, Smith GL, Watson S, Scigliano M, Tkach S, Alayoubi S, Harding SE, Terracciano CM, Ly HQ, Mauretti A, Van Marion MH, Van Turnhout MC, Van Der Schaft DWJ, Sahlgren CM, Goumans MJ, Bouten CVC, Vuorenpaa H, Penttinen K, Sarkanen R, Ylikomi T, Heinonen T, Aalto-Setala K, Grimaldi V, Aprile M, Esposito R, Maiello C, Soricelli A, Colantuoni V, Costa V, Ciccodicola A, Napoli C, Rowe GC, Johnson K, Arany ZP, Del Monte F, D'aurizio R, Kusmic C, Nicolini G, Baumgart M, Groth M, Ucciferri N, Iervasi G, Pitto L, Pipicz M, Gaspar R, Siska A, Foldesi I, Kiss K, Bencsik P, Thum T, Batkai S, Csont T, Haan JJ, Bosch L, Brans MAD, Van De Weg SM, Deddens JC, Lee SJ, Sluijter JPG, Pasterkamp G, Werner I, Projahn D, Staudt M, Curaj A, Soenmez TT, Simsekyilmaz S, Hackeng TM, Von Hundelshausen P, Koenen RR, Weber C, Liehn EA, Santos-Martinez M, Medina C, Watson C, Mcdonald K, Gilmer J, Ledwidge M, Song SH, Lee MY, Park MH, Choi JC, Ahn JH, Park JS, Oh JH, Choi JH, Lee HC, Cha KS, Hong TJ, Kudryavtsev I, Serebryakova M, Malashicheva A, Shishkova A, Zhiduleva E, Moiseeva O, Durisova M, Blaha M, Melenovsky V, Pirk J, Kautzner J, Petelina TI, Gapon LI, Gorbatenko EA, Potolinskaya YV, Arkhipova EV, Solodenkova KS, Osadchuk MA, Dutra MF, Oliveira FCB, Silva MM, Passos-Silva DG, Goncalves R, Santos RAS, Da Silva RF, Gavrilescu CM, Paraschiv CM, Manea P, Strat LC, Gomez JMG, Merino D, Hurle MA, Nistal JF, Aires A, Cortajarena AL, Villar AV, Abramowitz J, Birnbaumer L, Gourine AV, Tinker A, Takamura M, Takashima S, Inoue O, Misu H, Takamura T, Kaneko S, Alieva TOHIRA, Mougenot N, Dufilho M, Hatem S, Siegbahn A, Kostina AS, Uspensky VE, Moiseeva OM, Kostareva AA, Malashicheva AB, Van Dijk CGM, Chrifi I, Verhaar MC, Duncker DJ, Cheng C, Sturza A, Petrus A, Duicu O, Kiss L, Danila M, Baczko I, Jost N, Gotzhein F, Schon J, Schwarzl M, Hinrichs S, Blankenberg S, Volker U, Hammer E, Westermann D, Martinez-Martinez E, Arrieta V, Fernandez-Celis A, Jimenez-Alfaro L, Melero A, Alvarez-Asiain V, Cachofeiro V, Lopez-Andres N, Tribulova N, Wallukat G, Knezl V, Radosinska J, Barancik M, Tsinlikov I, Tsinlikova I, Nicoloff G, Blazhev A, Pesevski Z, Kvasilova A, Stopkova T, Eckhardt A, Buffinton CM, Nanka O, Kercheva M, Suslova T, Gusakova A, Ryabova T, Markov V, Karpov R, Seemann H, Alcantara TC, Santuchi MDEC, Fonseca SG, Da Silva RF, Barallobre-Barreiro J, Oklu R, Fava M, Baig F, Yin X, Albadawi H, Jahangiri M, Stoughton J, Mayr M, Podliesna SP, Veerman CCV, Verkerk AOV, Klerk MK, Lodder EML, Mengarelli IM, Bezzina CRB, Remme CAR, Takacs H, Polyak A, Morvay N, Lepran I, Tiszlavicz L, Nagy N, Ordog B, Farkas A, Forster T, Varro A, Farkas AS, Jayaprakash P, Parekh K, Ferdous Z, Oz M, Dobrzynski H, Adrian TE, Landi S, Bonzanni M, D'souza A, Boyett M, Bucchi A, Baruscotti M, Difrancesco D, Barbuti A, Kui P, Takacs H, Oravecz K, Hezso T, Polyak A, Levijoki J, Pollesello P, Koskelainen T, Otsomaa L, Farkas AS, Papp JGY, Varro A, Toth A, Acsai K, Dini L, Mazzoni L, Sartiani L, Cerbai E, Mugelli A, Svatunkova J, Sedmera D, Deffge C, Baer C, Weinert S, Braun-Dullaeus RC, Herold J, Cassar AC, Zahra GZ, Pllaha EP, Dingli PD, Montefort SM, Xuereb RGX, Aschacher T, Messner B, Eichmair E, Mohl W, Reglin B, Rong W, Nitzsche B, Maibier M, Guimaraes P, Ruggeri A, Secomb TW, Pries AR, Baranowska-Kuczko M, Karpinska O, Kusaczuk M, Malinowska B, Kozlowska H, Demikhova N, Vynnychenko L, Prykhodko O, Grechanyk N, Kuryata A, Cottrill KA, Du L, Bjorck HM, Maleki S, Franco-Cereceda A, Chan SY, Eriksson P, Giebe S, Cockcroft N, Hewitt K, Brux M, Brunssen C, Tarasov AA, Davidov SI, Reznikova EA, Tapia Abellan A, Angosto Bazarra D, Pelegrin Vivancos P, Montoro Garcia S, Kastl SP, Pongratz T, Goliasch G, Gaspar L, Maurer G, Huber K, Dostal E, Pfaffenberger S, Oravec S, Wojta J, Speidl WS, Osipova I, Sopotova I, Eligini S, Cosentino N, Marenzi G, Tremoli E, Rami M, Ring L, Steffens S, Gur O, Gurkan S, Mangold A, Scherz T, Panzenboeck A, Staier N, Heidari H, Mueller J, Lang IM, Osipova I, Sopotova I, Gatsiou A, Stamatelopoulos K, Perisic L, John D, Lunella FF, Eriksson P, Hedin U, Zeiher A, Dimmeler S, Nunez L, Moure R, Marron-Linares G, Flores X, Aldama G, Salgado J, Calvino R, Tomas M, Bou G, Vazquez N, Hermida-Prieto M, Vazquez-Rodriguez JM, Amit U, Landa N, Kain D, Tyomkin D, David A, Leor J, Hohensinner PJ, Baumgartner J, Krychtiuk KA, Maurer G, Huber K, Baik N, Miles LA, Wojta J, Seeman H, Montecucco F, Da Silva AR, Costa-Fraga FP, Anguenot L, Mach FP, Santos RAS, Stergiopulos N, Da Silva RF, Kupreishvili K, Vonk ABA, Smulders YM, Van Hinsbergh VWM, Stooker W, Niessen HWM, Krijnen PAJ, Ashmawy MM, Salama MA, Elamrosy MZ, Juettner R, Rathjen FG, Bito V, Crocini C, Ferrantini C, Gabbrielli T, Silvestri L, Coppini R, Tesi C, Cerbai E, Poggesi C, Pavone FS, Sacconi L, Mackova K, Zahradnik I, Zahradnikova A, Diaz I, Sanchez De Rojas De Pedro E, Hmadcha K, Calderon Sanchez E, Benitah JP, Gomez AM, Smani T, Ordonez A, Afanasiev SA, Egorova MV, Popov SV, Wu Qing P, Cheng X, Carnicka S, Pancza D, Jasova M, Kancirova I, Ferko M, Ravingerova T, Wu S, Schneider M, Marggraf V, Verfuerth L, Frede S, Boehm O, Dewald O, Baumgarten G, Kim SC, Farkasova V, Gablovsky I, Bernatova I, Ravingerova T, Nosar V, Portnychenko A, Drevytska T, Mankovska I, Gogvadze V, Sejersen T, Kostareva A, Sturza A, Wolf A, Privistirescu A, Danila M, Muntean D, O ' Gara P, Sanchez-Alonso JL, Harding SE, Lyon AR, Prando V, Pianca N, Lo Verso F, Milan G, Pesce P, Sandri M, Mongillo M, Beffagna G, Poloni G, Dazzo E, Sabatelli P, Doliana R, Polishchuk R, Carnevale D, Lembo G, Bonaldo P, Braghetta P, Rampazzo A, Cairo M, Giralt M, Villarroya F, Planavila A, Biesbroek PS, Emmens RWE, Juffermans LJM, Van Der Wall AC, Van Rossum AC, Niessen JWM, Krijnen PAJ, Moor Morris T, Dilanian G, Farahmand P, Puceat M, Hatem S, Gambino G, Petraglia L, Elia A, Komici K, Femminella GD, D'amico ML, Pagano G, Cannavo A, Liccardo D, Koch WJ, Nolano M, Leosco D, Ferrara N, Rengo G, Amit U, Landa N, Kain D, Leor J, Neary R, Shiels L, Watson C, Baugh J, Palacios B, Escobar B, Alonso AV, Guzman G, Ruiz-Cabello J, Jimenez-Borreguero LJ, Martin-Puig S, Lakomkin VL, Lukoshkova EV, Abramov AA, Gramovich VV, Vyborov ON, Ermishkin VV, Undrovinas NA, Shirinsky VP, Smilde BJ, Woudstra L, Fong Hing G, Wouters D, Zeerleder S, Murk JL, Van Ham SM, Heymans S, Juffermans LJM, Van Rossum AC, Niessen JWM, Krijnen PAJ, Krakhmalova O, Van Groen D, Bogaards SJP, Schalij I, Portnichenko GV, Tumanovska LV, Goshovska YV, Lapikova-Bryhinska TU, Nagibin VS, Dosenko VE, Mendes-Ferreira P, Maia-Rocha C, Santos-Ribeiro D, Potus F, Breuils-Bonnet S, Provencher S, Bonnet S, Rademaker M, Leite-Moreira AF, Bras-Silva C, Lopes J, Kuryata O, Lusynets T, Alikulov I, Nourddine M, Azzouzi L, Habbal R, Tserendavaa SUMIYA, Enkhtaivan ODKHUU, Enkhtaivan ODKHUU, Shagdar ZORIGO, Shagdar ZORIGO, Malchinkhuu MUNKHZ, Malchinkhuu MUNLHZ, Koval S, Starchenko T, Mourino-Alvarez L, Gonzalez-Calero L, Sastre-Oliva T, Lopez JA, Vazquez J, Alvarez-Llamas G, Ruilope LUISM, De La Cuesta F, Barderas MG, Bozzini S, D'angelo A, Pelissero G. Poster session 3Cell growth, differentiation and stem cells - Heart511The role of the endocannabinoid system in modelling muscular dystrophy cardiac disease with induced pluripotent stem cells.512An emerging role of T lymphocytes in cardiac regenerative processes in heart failure due to dilated cardiomyopathy513Canonical wnt signaling reverses the ‘aged/senescent’ human endogenous cardiac stem cell phenotype514Hippo signalling modulates survival of human induced pluripotent stem cell-derived cardiomyocytes515Biocompatibility of mesenchymal stem cells with a spider silk matrix and its potential use as scaffold for cardiac tissue regeneration516A snapshot of genome-wide transcription in human induced pluripotent stem cell-derived hepatocyte-like cells (iPSC-HLCs)517Can NOS/sGC/cGK1 pathway trigger the differentiation and maturation of mouse embryonic stem cells (ESCs)?518Introduction of external Ik1 to human-induced pluripotent stem cell-derived cardiomyocytes via Ik1-expressing HEK293519Cell therapy of the heart studied using adult myocardial slices in vitro520Enhancement of the paracrine potential of human adipose derived stem cells when cultured as spheroid bodies521Mechanosensitivity of cardiomyocyte progenitor cells: the strain response in 2D and 3D environments522The effect of the vascular-like network on the maturation of the human induced pluripotent stem cell derived cardiomyocytes.Transcriptional control and RNA species - Heart525Gene expression regulation in heart failure: from pathobiology to bioinformatics526Human transcriptome in idiopathic dilated cardiomyopathy - a novel high throughput screening527A high-throghput approach unveils putative miRNA-mediated mitochondria-targeted cardioprotective circuits activated by T3 in the post ischemia reperfusion setting528The effect of uraemia on the expression of miR-212/132 and the calcineurin pathway in the rat heartCytokines and cellular inflammation - Heart531Lack of growth differentiation factor 15 aggravates adverse cardiac remodeling upon pressure-overload in mice532Blocking heteromerization of platelet chemokines ccl5 and cxcl4 reduces inflammation and preserves heart function after myocardial infarction533Is there an association between low-dose aspirin use and clinical outcome in HFPEF? Implications of modulating monocyte function and inflammatory mediator release534N-terminal truncated intracellular matrix metalloproteinase-2 expression in diabetic heart.535Expression of CD39 and CD73 on peripheral T-cell subsets in calcific aortic stenosis536Mast cells in the atrial myocardium of patients with atrial fibrillation: a comparison with patients in sinus rhythm539Characteristics of the inflammatory response in patients with coronary artery disease and arterial hypertension540Pro-inflammatory cytokines as cardiovascular events predictors in rheumatoid arthritis and asymptomatic atherosclerosis541Characterization of FVB/N murinic bone marrow-derived macrophage polarization into M1 and M2 phenotypes542The biological expression and thoracic anterior pain syndromeSignal transduction - Heart545The association of heat shock protein 90 and TGFbeta receptor I is involved in collagen production during cardiac remodelling in aortic-banded mice546Loss of the inhibitory GalphaO protein in the rostral ventrolateral medulla of the brainstem leads to abnormalities in cardiovascular reflexes and altered ventricular excitablitiy547Selenoprotein P regulates pressure overload-induced cardiac remodeling548Study of adenylyl cyclase activity in erythrocyte membranes in patients with chronic heart failure549Direct thrombin inhibitors inhibit atrial myocardium hypertrophy in a rat model of heart failure and atrial remodeling550Tissue factor / FVIIa transactivates the IGF-1R by a Src-dependent phosphorylation of caveolin-1551Notch signaling is differently altered in endothelial and smooth muscle cells of ascending aortic aneurysm patients552Frizzled 5 expression is essential for endothelial proliferation and migration553Modulation of vascular function and ROS production by novel synthetic benzopyran analogues in diabetes mellitusExtracellular matrix and fibrosis - Heart556Cardiac fibroblasts as inflammatory supporter cells trigger cardiac inflammation in heart failure557A role for galectin-3 in calcific aortic valve stenosis558Omega-3 polyunsaturated fatty acids- can they decrease risk for ventricular fibrillation?559Serum levels of elastin derived peptides and circulating elastin-antielastin immune complexes in sera of patients with coronary artery disease560Endocardial fibroelastosis is secondary to hemodynamic alterations in the chick model of hypoplastic left heart syndrome561Dynamics of serum levels of matrix metalloproteinases in primary anterior STEMI patients564Deletion of the alpha-7 nicotinic acetylcholine receptor changes the vascular remodeling induced by transverse aortic constriction in mice.565Extracellular matrix remodelling in response to venous hypertension: proteomics of human varicose veinsIon channels, ion exchangers and cellular electrophysiology - Heart568Microtubule-associated protein RP/EB family member 1 modulates sodium channel trafficking and cardiac conduction569Investigation of electrophysiological abnormalities in a rabbit athlete's heart model570Upregulation of expression of multiple genes in the atrioventricular node of streptozotocin-induced diabetic rat571miR-1 as a regulator of sinoatrial rhythm in endurance training adaptation572Selective sodium-calcium exchanger inhibition reduces myocardial dysfunction associated with hypokalaemia and ventricular fibrillation573Effect of racemic and levo-methadone on action potential of human ventricular cardiomyocytes574Acute temperature effects on the chick embryonic heart functionVasculogenesis, angiogenesis and arteriogenesis577Clinical improvement and enhanced collateral vessel growth after monocyte transplantation in mice578The role of HIF-1 alpha, VEGF and obstructive sleep apnoea in the development of coronary collateral circulation579Initiating cardiac repair with a trans-coronary sinus catheter intervention in an ischemia/reperfusion porcine animal model580Early adaptation of pre-existing collaterals after acute arteriolar and venular microocclusion: an in vivo study in chick chorioallantoic membraneEndothelium583EDH-type responses to the activator of potassium KCa2.3 and KCa3.1 channels SKA-31 in the small mesenteric artery from spontaneously hypertensive rats584The peculiarities of endothelial dysfunction in patients with chronic renocardial syndrome585Endothelial dysfunction, atherosclerosis of the carotid arteries and level of leptin in patient with coronary heart disease in combination with hepatic steatosis depend from body mass index.586Role of non-coding RNAs in thoracic aortic aneurysm associated with bicuspid aortic valve587Cigarette smoke extract abrogates atheroprotective effects of high laminar flow on endothelial function588The prognostic value of anti-connective tissue antibodies in coronary heart disease and asymptomatic atherosclerosis589Novel potential properties of bioactive peptides from spanish dry-cured ham on the endothelium.Lipids592Intermediate density lipoprotein is associated with monocyte subset distribution in patients with stable atherosclerosis593The characteristics of dyslipidemia in rheumatoid arthritisAtherosclerosis596Macrophages differentiated in vitro are heterogeneous: morphological and functional profile in patients with coronary artery disease597Palmitoylethanolamide promotes anti-inflammatory phenotype of macrophages and attenuates plaque formation in ApoE-/- mice598Amiodarone versus esmolol in the perioperative period: an in vitro study of coronary artery bypass grafts599BMPRII signaling of fibrocytes, a mesenchymal progenitor cell population, is increased in STEMI and dyslipidemia600The characteristics of atherogenesis and systemic inflammation in rheumatoid arthritis601Role of adenosine-to-inosine RNA editing in human atherosclerosis602Presence of bacterial DNA in thrombus aspirates of patients with myocardial infarction603Novel E-selectin binding polymers reduce atherosclerotic lesions in ApoE(-/-) mice604Differential expression of the plasminogen receptor Plg-RKT in monocyte and macrophage subsets - possible functional consequences in atherogenesis605Apelin-13 treatment enhances the stability of atherosclerotic plaques606Mast cells are increased in the media of coronary lesions in patients with myocardial infarction and favor atherosclerotic plaque instability607Association of neutrophil to lymphocyte ratio with presence of isolated coronary artery ectasiaCalcium fluxes and excitation-contraction coupling610The coxsackie- and adenovirus receptor (CAR) regulates calcium homeostasis in the developing heart611HMW-AGEs application acutely reduces ICaL in adult cardiomyocytes612Measuring electrical conductibility of cardiac T-tubular systems613Postnatal development of cardiac excitation-contraction coupling in rats614Role of altered Ca2+ homeostasis during adverse cardiac remodeling after ischemia/reperfusion615Experimental study of sarcoplasmic reticulum dysfunction and energetic metabolism in failing myocardium associated with diabetes mellitusHibernation, stunning and preconditioning618Volatile anesthetic preconditioning attenuates ischemic-reperfusion injury in type II diabetic patients undergoing on-pump heart surgery619The effect of early and delayed phase of remote ischemic preconditioning on ischemia-reperfusion injury in the isolated hearts of healthy and diabetic rats620Post-conditioning with 1668-thioate leads to attenuation of the inflammatory response and remodeling with less fibrosis and better left ventricular function in a murine model of myocardial infarction621Maturation-related changes in response to ischemia-reperfusion injury and in effects of classical ischemic preconditioning and remote preconditioningMitochondria and energetics624Phase changes in myocardial mitochondrial respiration caused by hypoxic preconditioning or periodic hypoxic training625Desmin mutations depress mitochondrial metabolism626Methylene blue modulates mitochondrial function and monoamine oxidases-related ROS production in diabetic rat hearts627Doxorubicin modulates the real-time oxygen consumption rate of freshly isolated adult rat and human ventricular cardiomyocytesCardiomyopathies and fibrosis630Effects of genetic or pharmacologic inhibition of the ubiquitin/proteasome system on myocardial proteostasis and cardiac function631Suppression of Wnt signalling in a desmoglein-2 transgenic mouse model for arrhythmogenic cardiomyopathy632Cold-induced cardiac hypertrophy is reversed after thermo-neutral deacclimatization633CD45 is a sensitive marker to diagnose lymphocytic myocarditis in endomyocardial biopsies of living patients and in autopsies634Atrial epicardial adipose tissue derives from epicardial progenitors635Caloric restriction ameliorates cardiac function, sympathetic cardiac innervation and beta-adrenergic receptor signaling in an experimental model of post-ischemic heart failure636High fat diet improves cardiac remodelling and function after extensive myocardial infarction in mice637Epigenetic therapy reduces cardiac hypertrophy in murine models of heart failure638Imbalance of the VHL/HIF signaling in WT1+ Epicardial Progenitors results in coronary vascular defects, fibrosis and cardiac hypertrophy639Diastolic dysfunction is the first stage of the developing heart failure640Colchicine aggravates coxsackievirus B3 infection in miceArterial and pulmonary hypertension642Osteopontin as a marker of pulmonary hypertension in patients with coronary heart disease combined with chronic obstructive pulmonary disease643Myocardial dynamic stiffness is increased in experimental pulmonary hypertension partly due to incomplete relaxation644Hypotensive effect of quercetin is possibly mediated by down-regulation of immunotroteasome subunits in aorta of spontaneously hypertensive rats645Urocortin-2 improves right ventricular function and attenuates experimental pulmonary arterial hypertension646A preclinical evaluation of the anti-hypertensive properties of an aqueous extract of Agathosma (Buchu)Biomarkers648The adiponectin level in hypertensive females with rheumatoid arthritis and its relationship with subclinical atherosclerosis649Markers for identification of renal dysfunction in the patients with chronic heart failure650cardio-hepatic syndromes in chronic heart failure: North Africa profile651To study other biomarkers that assess during myocardial infarction652Interconnections of apelin levels with parameters of lipid metabolism in hypertension patients653Plasma proteomics in hypertension: prediction and follow-up of albuminuria during chronic renin-angiotensin system suppression654Soluble RAGE levels in plasma of patients with cerebrovascular events. Cardiovasc Res 2016. [DOI: 10.1093/cvr/cvw150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lawrence YR, Golan T, Urban D, Hammer L, Amit U, Catane R, Bar J, Goldstein J, Symon Z, Urban G. Effect of hospital volume on mortality rates amongst neutropenic cancer patients within the United States. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.6600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Uri Amit
- Sheba Medical Center, Ramat Gan, Israel
| | | | - Jair Bar
- Sheba Medical Center, Tel Hashomer, Israel
| | | | - Zvi Symon
- Sheba Medical Center, Tel Hashomer, Israel
| | - Gavin Urban
- St George's, University of London, London, United Kingdom
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Wagner A, Cohen N, Kelder T, Amit U, Liebman E, Steinberg DM, Radonjic M, Ruppin E. Drugs that reverse disease transcriptomic signatures are more effective in a mouse model of dyslipidemia. Mol Syst Biol 2016; 11:791. [PMID: 26148350 PMCID: PMC4380926 DOI: 10.15252/msb.20145486] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
High-throughput omics have proven invaluable in studying human disease, and yet day-to-day clinical practice still relies on physiological, non-omic markers. The metabolic syndrome, for example, is diagnosed and monitored by blood and urine indices such as blood cholesterol levels. Nevertheless, the association between the molecular and the physiological manifestations of the disease, especially in response to treatment, has not been investigated in a systematic manner. To this end, we studied a mouse model of diet-induced dyslipidemia and atherosclerosis that was subject to various drug treatments relevant to the disease in question. Both physiological data and gene expression data (from the liver and white adipose) were analyzed and compared. We find that treatments that restore gene expression patterns to their norm are associated with the successful restoration of physiological markers to their baselines. This holds in a tissue-specific manner—treatments that reverse the transcriptomic signatures of the disease in a particular tissue are associated with positive physiological effects in that tissue. Further, treatments that introduce large non-restorative gene expression alterations are associated with unfavorable physiological outcomes. These results provide a sound basis to in silico methods that rely on omic metrics for drug repurposing and drug discovery by searching for compounds that reverse a disease's omic signatures. Moreover, they highlight the need to develop drugs that restore the global cellular state to its healthy norm rather than rectify particular disease phenotypes.
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Affiliation(s)
- Allon Wagner
- The Blavatnik School of Computer Science, Tel Aviv UniversityTel Aviv, Israel
- Department of Electrical Engineering and Computer Science, University of CaliforniaBerkeley, CA, USA
- * Corresponding author. Tel. +972 3 640 5378; E-mail:
| | - Noa Cohen
- The Blavatnik School of Computer Science, Tel Aviv UniversityTel Aviv, Israel
| | - Thomas Kelder
- Microbiology and Systems Biology, TNOZeist, the Netherlands
| | - Uri Amit
- Neufeld Cardiac Research Institute, Tel Aviv UniversityTel Aviv, Israel
- Regenerative Medicine Stem Cells and Tissue Engineering Center, Sheba Medical CenterTel Hashomer, Israel
| | - Elad Liebman
- Department of Computer Science, University of Texas at AustinAustin, TX, USA
| | - David M Steinberg
- Department of Statistics and Operations Research, Tel Aviv UniversityTel Aviv, Israel
| | | | - Eytan Ruppin
- The Blavatnik School of Computer Science, Tel Aviv UniversityTel Aviv, Israel
- The Sackler School of Medicine, Tel Aviv UniversityTel Aviv, Israel
- Department of Computer Science, Institute of Advanced Computer Sciences (UMIACS) & the Center for Bioinformatics and Computational Biology, University of MarylandCollege Park, MD, USA
- ** Corresponding author. Tel. +972 3 640 6528; E-mail:
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Amit U, Flaishmakher S, Dagan R, Porat N, Yagupsky P. Age-Dependent Carriage of Kingella kingae in Young Children and Turnover of Colonizing Strains. J Pediatric Infect Dis Soc 2014; 3:160-2. [PMID: 26625369 DOI: 10.1093/jpids/pit003] [Citation(s) in RCA: 26] [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: 09/21/2012] [Accepted: 11/13/2012] [Indexed: 11/13/2022]
Abstract
In a longitudinal study, Kingella kingae carriage rate was nil below 6 months of age, 1.5% at 6 months, 9.6% at 12 months, remained stable between 10.4% and 12.0% during the second year of life, and decreased significantly to 5.3% at 30 months. Replacement of carried strains occurred over time.
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Affiliation(s)
- Uri Amit
- Clinical Microbiology Laboratory
| | | | - Ron Dagan
- Pediatric Infectious Diseases Unit, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nurith Porat
- Pediatric Infectious Diseases Unit, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Klempfner R, Goldenberg I, Fisman EZ, Matetzky S, Amit U, Shemesh J, Tenenbaum A. Comparison of statin alone versus bezafibrate and statin combination in patients with diabetes mellitus and acute coronary syndrome. Am J Cardiol 2014; 113:12-6. [PMID: 24157192 DOI: 10.1016/j.amjcard.2013.08.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 08/14/2013] [Accepted: 08/14/2013] [Indexed: 11/30/2022]
Abstract
Acute coronary syndromes (ACS) in patients with diabetes mellitus (DM) are associated with a high risk for major adverse cardiovascular events (MACEs) despite statin treatment. The impact of combined bezafibrate and statin therapy in patients with DM and ACS has not been specifically investigated. The aim of this study was to evaluate the association of combined therapy with 30-day MACEs in patients with DM participating in the nationwide Acute Coronary Syndrome Israeli Surveys (ACSIS). The study population comprised 3,063 patients with DM from the ACSIS 2000, 2002, 2004, 2006, 2008, and 2010 enrollment waves who were alive at discharge and received statins. Of these, 225 (7.3%) received on discharge combined bezafibrate and statin therapy, and 2,838 (92.7%) were treated with statins alone. MACEs were defined as a composite measure of death, recurrent myocardial infarction, recurrent ischemia, stent thrombosis, ischemic stroke, and urgent revascularization. The development of 30-day MACEs was recorded in 8% patients receiving combination therapy and 14.2% of those receiving statins alone (p = 0.01). Crude 1-year mortality and 30-day rehospitalization rates were also significantly lower in patients receiving combination therapy: 4.0% versus 8.1% (p = 0.03) and 13.3% versus 21.6% (p = 0.003), respectively. Multivariate analysis identified combined therapy as an independent predictor of reduced risk for 30-day MACEs, with an odds ratio of 0.56 (95% confidence interval 0.34 to 0.92), corresponding to a 44% relative risk reduction. In conclusion, a significantly lower risk for 30-day MACEs was observed in statin-treated patients with DM who also received bezafibrate after ACS. Signals regarding improvement of 30-day rehospitalization and 1-year mortality rates emerged as well.
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Affiliation(s)
- Robert Klempfner
- Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Leviev Heart Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Israeli Society for the Prevention of Heart Attacks, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ilan Goldenberg
- Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Leviev Heart Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Israeli Society for the Prevention of Heart Attacks, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Shlomi Matetzky
- Leviev Heart Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Israeli Society for the Prevention of Heart Attacks, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Uri Amit
- Israeli Society for the Prevention of Heart Attacks, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Joseph Shemesh
- Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Alexander Tenenbaum
- Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Leviev Heart Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Israeli Society for the Prevention of Heart Attacks, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Cardiovascular Diabetology Research Foundation, Holon, Israel.
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Klempfner R, Goldenberg I, Fisman EZ, Amit U, Haitovich A, Matetzky S, Medvedofsky D, Shemesh J, Tenenbaum A. Bezafibrate treatment is associated with a reduced rate of re-hospitalization in smokers after acute coronary syndrome. Cardiol J 2013; 21:364-9. [PMID: 24142677 DOI: 10.5603/cj.a2013.0127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 08/12/2013] [Accepted: 08/13/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Significantly increased rate of hospitalizations in current smokers is a major smoking-related problem which is associated with a heavy economic burden, whereas cardiovascular disease accounted for nearly half of hospitalizations. The effect of bezafibrate on the rate of re-hospitalization in smokers already treated with statin immediately post-acute coronary syndrome (ACS) is unknown. The aim of this study was to investigate 30-day rate of re-hospitalization in current smokers participating in the ACS Israeli Surveys (ACSIS) and who were treated on discharge with a bezafibrate/statin combination vs. statin alone. METHODS The study population comprised 3392 patients with confirmed current smoking status from the ACSIS 2000, 2002, 2004, 2006, 2008 and 2010 enrollment waves who were alive on discharge and received statin. Of these, 3189 (94%) were discharged with statin alone, 203 (6%) with a combination of a statin and bezafibrate. RESULTS Thirty-day re-hospitalization rate was significantly lower in patients from the combination group than in their counterparts from the statin monotherapy group: 12.8% vs. 19%, p = 0.028. Multivariable analysis identified the combined bezafibrate/statin treatment as an independent predictor of reduced risk of 30-day re-hospitalization rate with odds ratio (OR) 0.53 (95% confidence interval [CI] 0.31-0.91), and it corresponded to 47% risk reduction. Other significant variables in our model associated with independent risk of 30-day re-hospitalization rate during the follow-up were female gender (OR 1.43, CI 1.05-1.95, p = 0.03) and age > 65 years (OR 1.49, CI 1.13-1.95, p = 0.004). CONCLUSIONS Adding bezafibrate to statin in smokers was associated with a significantly reduced 30-day rate of re-hospitalization after ACS.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Alexander Tenenbaum
- Cardiac Rehabilitation Institute, Sackler Faculty of Medicine, Tel-Aviv, Israel Leviev Heart Institute, Sackler Faculty of Medicine, Tel-Aviv, Israel Israeli Society for the Prevention of Heart Attacks, Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel Cardiovascular Diabetology Research Foundation, Holon, Israel.
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Klempfner R, Goldenberg I, Fisman EZ, Matetzky S, Amit U, Shemesh J, Tenenbaum A. Comparison of statin alone versus bezafibrate and statin combination in patients with diabetes mellitus and acute coronary syndrome. Am J Cardiol 2013. [PMID: 24157192 DOI: 10.1016/j.amjcard.2013.08.033s0002-9149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Acute coronary syndromes (ACS) in patients with diabetes mellitus (DM) are associated with a high risk for major adverse cardiovascular events (MACEs) despite statin treatment. The impact of combined bezafibrate and statin therapy in patients with DM and ACS has not been specifically investigated. The aim of this study was to evaluate the association of combined therapy with 30-day MACEs in patients with DM participating in the nationwide Acute Coronary Syndrome Israeli Surveys (ACSIS). The study population comprised 3,063 patients with DM from the ACSIS 2000, 2002, 2004, 2006, 2008, and 2010 enrollment waves who were alive at discharge and received statins. Of these, 225 (7.3%) received on discharge combined bezafibrate and statin therapy, and 2,838 (92.7%) were treated with statins alone. MACEs were defined as a composite measure of death, recurrent myocardial infarction, recurrent ischemia, stent thrombosis, ischemic stroke, and urgent revascularization. The development of 30-day MACEs was recorded in 8% patients receiving combination therapy and 14.2% of those receiving statins alone (p = 0.01). Crude 1-year mortality and 30-day rehospitalization rates were also significantly lower in patients receiving combination therapy: 4.0% versus 8.1% (p = 0.03) and 13.3% versus 21.6% (p = 0.003), respectively. Multivariate analysis identified combined therapy as an independent predictor of reduced risk for 30-day MACEs, with an odds ratio of 0.56 (95% confidence interval 0.34 to 0.92), corresponding to a 44% relative risk reduction. In conclusion, a significantly lower risk for 30-day MACEs was observed in statin-treated patients with DM who also received bezafibrate after ACS. Signals regarding improvement of 30-day rehospitalization and 1-year mortality rates emerged as well.
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Affiliation(s)
- Robert Klempfner
- Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Leviev Heart Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Israeli Society for the Prevention of Heart Attacks, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ilan Goldenberg
- Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Leviev Heart Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Israeli Society for the Prevention of Heart Attacks, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Shlomi Matetzky
- Leviev Heart Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Israeli Society for the Prevention of Heart Attacks, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Uri Amit
- Israeli Society for the Prevention of Heart Attacks, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Joseph Shemesh
- Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Alexander Tenenbaum
- Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Leviev Heart Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Israeli Society for the Prevention of Heart Attacks, Chaim Sheba Medical Center, Tel-Hashomer, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Cardiovascular Diabetology Research Foundation, Holon, Israel.
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Sabbag A, Amit U, Fefer P, Goldenberg I, Guetta V. Major bleeding in acute coronary syndrome patients a decade long perspective. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Amit U, Porat N, Basmaci R, Bidet P, Bonacorsi S, Dagan R, Yagupsky P. Genotyping of Invasive Kingella kingae Isolates Reveals Predominant Clones and Association With Specific Clinical Syndromes. Clin Infect Dis 2012; 55:1074-9. [DOI: 10.1093/cid/cis622] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Porat N, Amit U, Givon-Lavi N, Leibovitz E, Dagan R. Increasing importance of multidrug-resistant serotype 6A Streptococcus pneumoniae clones in acute otitis media in southern Israel. Pediatr Infect Dis J 2010; 29:126-30. [PMID: 19927039 DOI: 10.1097/inf.0b013e3181b78e6e] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The major aim of this study was to establish the molecular epidemiology dynamics of Streptococcus pneumoniae serotype 6A in acute otitis media, before the introduction of the 7-valent pneumococcal conjugate vaccine. METHODS Acute otitis media in Jewish and Bedouin children <5 years old undergoing tympanocentesis during 1999 to 2006, were studied. Serotype 6A was identified by the Quellung reaction and by polymerase chain reaction (PCR) of the wciN gene, to differentiate between 6A and 6C. Antibiogram and molecular typing by pulsed field gel electrophoresis were performed on all 6A isolates. Multilocus sequence typing was performed on representative isolates of each clone. The 7-valent conjugate vaccine had not yet been licensed in Israel during the study period. RESULTS Serotype 6A constituted 5.8% (254/4408) of all pneumococcal acute otitis media episodes. The yearly proportion of serotype 6A among the Jewish children showed no distinct trend, whereas among the Bedouin children serotype 6A exhibited a significant increase, from 3.0% in 1999 to 7.6% in 2006. Among the Jewish children a single penicillin-nonsusceptible and erythromycin-resistant clone, ST-473, constituted 73.6% of the strains and dominated throughout the study period. Among the Bedouin children, the proportions of the most common, penicillin-nonsusceptible clone, ST-1988, gradually decreased, from 44.1% in 1999 to 2000 to 21.4% in 2005 to 2006, concurrently with the expansion of a multidrug-resistant clone, ST-457, from 5.9% in 1999 to 2000 to 28.6% in 2005 to 2006. CONCLUSIONS The expansion of multidrug-resistant serotype 6A clone occurred before the introduction of the vaccine. Continued surveillance following vaccine introduction is warranted to further investigate its efficacy on vaccine-related serotypes.
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Affiliation(s)
- Nurith Porat
- Pediatric Infectious Disease Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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