1
|
Gabriel V, Lincoln A, Zdyrski C, Ralston A, Wickham H, Honold S, Ahmed BH, Paukner K, Feauto R, Merodio MM, Piñeyro P, Meyerholz D, Allenspach K, Mochel JP. Evaluation of different media compositions promoting hepatocyte differentiation in the canine liver organoid model. Heliyon 2024; 10:e28420. [PMID: 38590903 PMCID: PMC10999936 DOI: 10.1016/j.heliyon.2024.e28420] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/11/2024] [Accepted: 03/19/2024] [Indexed: 04/10/2024] Open
Abstract
Organoids are 3-dimensional (3D) self-assembled structures capable of replicating the microanatomy and physiology of the epithelial components of their organ of origin. Adult stem cell (ASC) derived organoids from the liver have previously been shown to differentiate into primarily mature cholangiocytes, and their partial differentiation into functional hepatocytes can be promoted using specific media compositions. While full morphological differentiation of mature hepatocytes from ASCs has not yet been reported for any species, the functional differentiation can be approximated using various media compositions. Six differentiation media formulations from published studies on hepatic organoids were used for the differentiation protocol. Target species for these protocols were humans, mice, cats, and dogs, and encompassed various combinations and concentrations of four major hepatocyte media components: Bone morphogenetic protein 7 (BMP7), Fibroblast Growth Factor 19 (FGF19), Dexamethasone (Dex), and Gamma-Secretase Inhibitor IX (DAPT). Additionally, removing R-spondin from basic organoid media has previously been shown to drive the differentiation of ASC into mature hepatocytes. Differentiation media (N = 20) were designed to encompass combinations of the four major hepatocyte media components. The preferred differentiation of ASC-derived organoids from liver tissue into mature hepatocytes over cholangiocytes was confirmed by albumin production in the culture supernatant. Out of the twenty media compositions tested, six media resulted in the production of the highest amounts of albumin in the supernatant of the organoids. The cell lines cultured using these six media were further characterized via histological staining, transmission electron microscopy, RNA in situ hybridization, analysis of gene expression patterns, immunofluorescence, and label-free proteomics. The results indicate that preferential hepatocyte maturation from canine ADC-derived organoids from liver tissue is mainly driven by Dexamethasone and DAPT components. FGF19 did not enhance organoid differentiation but improved cell culture survival. Furthermore, we confirm that removing R-spondin from the media is crucial for establishing mature hepatic organoid cultures.
Collapse
Affiliation(s)
- Vojtech Gabriel
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
| | - Addison Lincoln
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
| | - Christopher Zdyrski
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
- 3D Health Solutions Inc., Ames, IA, USA
- Precision One Health Initiative, Department of Pathology, University of Georgia College of Veterinary Medicine, 30602, Athens, GA, USA
| | | | - Hannah Wickham
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
| | - Sydney Honold
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
| | - Basant H. Ahmed
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
| | - Karel Paukner
- Laboratory for Atherosclerosis Research, Institute for Clinical and Experimental Medicine, Prague, CZ, Czech Republic
| | - Ryan Feauto
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
| | - Maria M. Merodio
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
| | - Pablo Piñeyro
- Veterinary Diagnostic Laboratory, Iowa State University, Ames, IA, USA
| | - David Meyerholz
- Department of Pathology, University of Iowa, Iowa City, IA, USA
| | - Karin Allenspach
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
- 3D Health Solutions Inc., Ames, IA, USA
- Precision One Health Initiative, Department of Pathology, University of Georgia College of Veterinary Medicine, 30602, Athens, GA, USA
| | - Jonathan P. Mochel
- 3D Health Solutions Inc., Ames, IA, USA
- Precision One Health Initiative, Department of Pathology, University of Georgia College of Veterinary Medicine, 30602, Athens, GA, USA
| |
Collapse
|
2
|
Paukner K, Filipejova Z, Mareš J, Vávra M, Rehakova K, Proks P, Gabriel V, Crha M. A comprehensive analysis of albuminuria in canine chronic kidney disease. Vet Med Sci 2024; 10:e1403. [PMID: 38419297 PMCID: PMC10902581 DOI: 10.1002/vms3.1403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/29/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Albuminuria, an important marker of decreased kidney function in chronic kidney disease (CKD), is not routinely used for CKD detection or proteinuria appearance. Its relationships with biochemical parameters and blood pressure in dogs are poorly understood. OBJECTIVES This study aimed to evaluate the relationship of albuminuria with various CKD markers, its correlation with the urinary protein to creatinine ratio (UPC), and hypertension in dogs with early stages of CKD. It also sought to determine the usability of the urinary albumin to creatinine ratio (UAC) for CKD screening. METHODS The study reviewed records of 102 dogs, categorising them into four groups based on disease status. UAC and UPC ratio, biochemistry and haematology variables, age, and systolic blood pressure were determined. RESULTS The Pearson's correlation coefficient between log-transformed values of UPC and UAC was r = 0.902 (95% CI: 0.87 to 0.93). Median UAC ratio values were 2.1 mg/g for the Healthy control group (n = 17), 54.2 mg/g for early stages CKD (n = 42), 5.8 mg/g for Acute sick control (n = 30), and 104 mg/g for Chronic sick control (n = 13). Thresholding UAC ratio as an indicator for impaired kidney function with the threshold of 10 mg/g (established based on the receiver operating characteristic curve) had a sensitivity 81.8%, specificity of 89.4%, positive predictive value (PPV) 90%, and negative predictive value (NPV) 80.1%. The correlation of UAC with biochemistry and haematology variables was statistically significant; for SDMA (μg/L), it was r = 0.566 and for other variables, it was weak to moderate. UAC was markedly elevated in cases of severe hypertension. CONCLUSIONS UAC ratio was significantly different among dogs with impaired and not impaired kidney function. The correlation strength for the UAC and UPC ratios was high. UAC ratio may be a promising marker for proteinuria analysis in dogs with CKD or other kidney function alterations.
Collapse
Affiliation(s)
- Karel Paukner
- Small Animal ClinicUniversity of Veterinary Sciences BrnoBrnoCzech Republic
- Center for Experimental MedicineInstitute for Clinical and Experimental MedicinePragueCzech Republic
| | - Zita Filipejova
- Small Animal ClinicUniversity of Veterinary Sciences BrnoBrnoCzech Republic
| | - Jan Mareš
- Department of Data ScienceInstitute for Clinical and Experimental MedicinePragueCzech Republic
| | - Miloš Vávra
- Small Animal ClinicUniversity of Veterinary Sciences BrnoBrnoCzech Republic
| | - Kristina Rehakova
- Small Animal Clinical LaboratoryUniversity of Veterinary Sciences BrnoBrnoCzech Republic
| | - Pavel Proks
- Small Animal ClinicUniversity of Veterinary Sciences BrnoBrnoCzech Republic
| | - Vojtech Gabriel
- Department of Biomedical SciencesCollege of Veterinary Medicine, Iowa State UniversityAmesIowaUSA
| | - Michal Crha
- Small Animal ClinicUniversity of Veterinary Sciences BrnoBrnoCzech Republic
| |
Collapse
|
3
|
Zdyrski C, Gabriel V, Gessler TB, Ralston A, Sifuentes-Romero I, Kundu D, Honold S, Wickham H, Topping NE, Sahoo DK, Bista B, Tamplin J, Ospina O, Piñeyro P, Arriaga M, Galan JA, Meyerholz DK, Allenspach K, Mochel JP, Valenzuela N. Establishment and characterization of turtle liver organoids provides a potential model to decode their unique adaptations. Commun Biol 2024; 7:218. [PMID: 38388772 PMCID: PMC10883927 DOI: 10.1038/s42003-024-05818-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/15/2024] [Indexed: 02/24/2024] Open
Abstract
Painted turtles are remarkable for their freeze tolerance and supercooling ability along with their associated resilience to hypoxia/anoxia and oxidative stress, rendering them an ideal biomedical model for hypoxia-induced injuries (including strokes), tissue cooling during surgeries, and organ cryopreservation. Yet, such research is hindered by their seasonal reproduction and slow maturation. Here we developed and characterized adult stem cell-derived turtle liver organoids (3D self-assembled in vitro structures) from painted, snapping, and spiny softshell turtles spanning ~175My of evolution, with a subset cryopreserved. This development is, to the best of our knowledge, a first for this vertebrate Order, and complements the only other non-avian reptile organoids from snake venom glands. Preliminary characterization, including morphological, transcriptomic, and proteomic analyses, revealed organoids enriched in cholangiocytes. Deriving organoids from distant turtles and life stages demonstrates that our techniques are broadly applicable to chelonians, permitting the development of functional genomic tools currently lacking in herpetological research. Such platform could potentially support studies including genome-to-phenome mapping, gene function, genome architecture, and adaptive responses to climate change, with implications for ecological, evolutionary, and biomedical research.
Collapse
Affiliation(s)
- Christopher Zdyrski
- SMART Pharmacology, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA.
- 3D Health Solutions Inc., Ames, IA, USA.
- SMART Pharmacology, Precision One Health Initiative, University of Georgia, Athens, GA, USA.
| | - Vojtech Gabriel
- SMART Pharmacology, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
| | - Thea B Gessler
- Department of Ecology, Evolution, and Organismal Biology, Iowa State University, Ames, IA, USA
| | | | - Itzel Sifuentes-Romero
- Department of Ecology, Evolution, and Organismal Biology, Iowa State University, Ames, IA, USA
| | - Debosmita Kundu
- Department of Statistics, Iowa State University, Ames, IA, USA
| | - Sydney Honold
- SMART Pharmacology, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
| | - Hannah Wickham
- SMART Pharmacology, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
| | - Nicholas E Topping
- Department of Ecology, Evolution, and Organismal Biology, Iowa State University, Ames, IA, USA
| | - Dipak Kumar Sahoo
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, USA
| | - Basanta Bista
- Department of Ecology, Evolution, and Organismal Biology, Iowa State University, Ames, IA, USA
| | - Jeffrey Tamplin
- Department of Biology, University of Northern Iowa, Cedar Falls, IA, USA
| | - Oscar Ospina
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Pablo Piñeyro
- Veterinary Diagnostic Laboratory, Iowa State University, Ames, IA, USA
| | - Marco Arriaga
- Department of Human Genetics, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Jacob A Galan
- Department of Human Genetics, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | | | - Karin Allenspach
- SMART Pharmacology, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
- 3D Health Solutions Inc., Ames, IA, USA
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, USA
- SMART Pharmacology, Precision One Health Initiative, University of Georgia, Athens, GA, USA
| | - Jonathan P Mochel
- SMART Pharmacology, Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
- 3D Health Solutions Inc., Ames, IA, USA
- SMART Pharmacology, Precision One Health Initiative, University of Georgia, Athens, GA, USA
| | - Nicole Valenzuela
- Department of Ecology, Evolution, and Organismal Biology, Iowa State University, Ames, IA, USA.
| |
Collapse
|
4
|
Gabriel V, Zdyrski C, Sahoo DK, Ralston A, Wickham H, Bourgois-Mochel A, Ahmed B, Merodio MM, Paukner K, Piñeyro P, Kopper J, Rowe EW, Smith JD, Meyerholz D, Kol A, Viall A, Elbadawy M, Mochel JP, Allenspach K. Adult Animal Stem Cell-Derived Organoids in Biomedical Research and the One Health Paradigm. Int J Mol Sci 2024; 25:701. [PMID: 38255775 PMCID: PMC10815683 DOI: 10.3390/ijms25020701] [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: 12/05/2023] [Revised: 12/14/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
Preclinical biomedical research is limited by the predictiveness of in vivo and in vitro models. While in vivo models offer the most complex system for experimentation, they are also limited by ethical, financial, and experimental constraints. In vitro models are simplified models that do not offer the same complexity as living animals but do offer financial affordability and more experimental freedom; therefore, they are commonly used. Traditional 2D cell lines cannot fully simulate the complexity of the epithelium of healthy organs and limit scientific progress. The One Health Initiative was established to consolidate human, animal, and environmental health while also tackling complex and multifactorial medical problems. Reverse translational research allows for the sharing of knowledge between clinical research in veterinary and human medicine. Recently, organoid technology has been developed to mimic the original organ's epithelial microstructure and function more reliably. While human and murine organoids are available, numerous other organoids have been derived from traditional veterinary animals and exotic species in the last decade. With these additional organoid models, species previously excluded from in vitro research are becoming accessible, therefore unlocking potential translational and reverse translational applications of animals with unique adaptations that overcome common problems in veterinary and human medicine.
Collapse
Affiliation(s)
- Vojtech Gabriel
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA; (H.W.); (B.A.); (J.P.M.)
| | | | - Dipak K. Sahoo
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA 50011, USA; (D.K.S.); (A.B.-M.); (J.K.)
| | - Abigail Ralston
- 3D Health Solutions Inc., Ames, IA 50010, USA; (C.Z.); (A.R.); (M.M.M.)
| | - Hannah Wickham
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA; (H.W.); (B.A.); (J.P.M.)
| | - Agnes Bourgois-Mochel
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA 50011, USA; (D.K.S.); (A.B.-M.); (J.K.)
| | - Basant Ahmed
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA; (H.W.); (B.A.); (J.P.M.)
| | - Maria M. Merodio
- 3D Health Solutions Inc., Ames, IA 50010, USA; (C.Z.); (A.R.); (M.M.M.)
| | - Karel Paukner
- Atherosclerosis Research Laboratory, Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine, 14021 Prague, Czech Republic;
| | - Pablo Piñeyro
- Department of Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA; (P.P.); (J.D.S.)
| | - Jamie Kopper
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA 50011, USA; (D.K.S.); (A.B.-M.); (J.K.)
| | - Eric W. Rowe
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA; (H.W.); (B.A.); (J.P.M.)
| | - Jodi D. Smith
- Department of Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA; (P.P.); (J.D.S.)
| | - David Meyerholz
- Department of Pathology, University of Iowa, Iowa City, IA 52242, USA;
| | - Amir Kol
- Department of Pathology, University of California, Davis, CA 94143, USA; (A.K.); (A.V.)
| | - Austin Viall
- Department of Pathology, University of California, Davis, CA 94143, USA; (A.K.); (A.V.)
| | - Mohamed Elbadawy
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA 30530, USA;
- Department of Pharmacology, Faculty of Veterinary Medicine, Benha University, Toukh 13736, Egypt
| | - Jonathan P. Mochel
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA; (H.W.); (B.A.); (J.P.M.)
- 3D Health Solutions Inc., Ames, IA 50010, USA; (C.Z.); (A.R.); (M.M.M.)
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA 30530, USA;
| | - Karin Allenspach
- 3D Health Solutions Inc., Ames, IA 50010, USA; (C.Z.); (A.R.); (M.M.M.)
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA 50011, USA; (D.K.S.); (A.B.-M.); (J.K.)
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA 30530, USA;
| |
Collapse
|
5
|
Díaz-Regañón D, Gabriel V, Livania V, Liu D, Ahmed BH, Lincoln A, Wickham H, Ralston A, Merodio MM, Sahoo DK, Zdyrski C, Meyerholz DK, Mochel JP, Allenspach K. Changes of Enterocyte Morphology and Enterocyte: Goblet Cell Ratios in Dogs with Protein-Losing and Non-Protein-Losing Chronic Enteropathies. Vet Sci 2023; 10:417. [PMID: 37505823 PMCID: PMC10383676 DOI: 10.3390/vetsci10070417] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 04/14/2023] [Revised: 06/18/2023] [Accepted: 06/26/2023] [Indexed: 07/29/2023] Open
Abstract
This study aimed to assess the morphometry of enterocytes as well as the goblet cell-to-enterocyte ratio in different intestinal segments of dogs with chronic enteropathies (CE). Histopathological intestinal samples from 97 dogs were included in the study (19 healthy juveniles, 21 healthy adults, 24 dogs with protein-losing enteropathy (PLE), and 33 CE dogs without PLE). Healthy adult small intestinal enterocytes showed progressively reduced epithelial cell height in the aboral direction, while juvenile dogs showed progressively increased epithelial cell height in the aboral direction. CE dogs had increased epithelial cell height in the duodenum, while PLE dogs had decreased epithelial cell heights compared to healthy adult dogs. Both the CE and PLE dogs showed decreased enterocyte width in the duodenal segment, and the ileal and colonic enterocytes of CE dogs were narrower than those of healthy adult dogs. CE dogs had a lower goblet cell-to-enterocyte ratio in the colon segment compared to healthy dogs. This study provides valuable morphometric information on enterocytes during canine chronic enteropathies, highlighting significant morphological enterocyte alterations, particularly in the small intestine, as well as a reduced goblet cell-to-enterocyte ratio in the colon of CE cases compared to healthy adult dogs.
Collapse
Affiliation(s)
- David Díaz-Regañón
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Vojtech Gabriel
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, USA; (V.G.); (V.L.); (D.L.); (B.H.A.); (A.L.); (H.W.); (M.M.M.); (C.Z.); (J.P.M.)
| | - Vanessa Livania
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, USA; (V.G.); (V.L.); (D.L.); (B.H.A.); (A.L.); (H.W.); (M.M.M.); (C.Z.); (J.P.M.)
| | - Dongjie Liu
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, USA; (V.G.); (V.L.); (D.L.); (B.H.A.); (A.L.); (H.W.); (M.M.M.); (C.Z.); (J.P.M.)
| | - Basant H. Ahmed
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, USA; (V.G.); (V.L.); (D.L.); (B.H.A.); (A.L.); (H.W.); (M.M.M.); (C.Z.); (J.P.M.)
| | - Addison Lincoln
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, USA; (V.G.); (V.L.); (D.L.); (B.H.A.); (A.L.); (H.W.); (M.M.M.); (C.Z.); (J.P.M.)
| | - Hannah Wickham
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, USA; (V.G.); (V.L.); (D.L.); (B.H.A.); (A.L.); (H.W.); (M.M.M.); (C.Z.); (J.P.M.)
| | | | - Maria M. Merodio
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, USA; (V.G.); (V.L.); (D.L.); (B.H.A.); (A.L.); (H.W.); (M.M.M.); (C.Z.); (J.P.M.)
| | - Dipak K. Sahoo
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA 50011, USA;
| | - Christopher Zdyrski
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, USA; (V.G.); (V.L.); (D.L.); (B.H.A.); (A.L.); (H.W.); (M.M.M.); (C.Z.); (J.P.M.)
- 3D Health Solutions Inc., Ames, IA 50010, USA;
| | - David K. Meyerholz
- Department of Pathology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA;
| | - Jonathan P. Mochel
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, USA; (V.G.); (V.L.); (D.L.); (B.H.A.); (A.L.); (H.W.); (M.M.M.); (C.Z.); (J.P.M.)
- 3D Health Solutions Inc., Ames, IA 50010, USA;
| | - Karin Allenspach
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, USA; (V.G.); (V.L.); (D.L.); (B.H.A.); (A.L.); (H.W.); (M.M.M.); (C.Z.); (J.P.M.)
- 3D Health Solutions Inc., Ames, IA 50010, USA;
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA 50011, USA;
| |
Collapse
|
6
|
Sahoo DK, Martinez MN, Dao K, Gabriel V, Zdyrski C, Jergens AE, Atherly T, Iennarella-Servantez CA, Burns LE, Schrunk D, Volpe DA, Allenspach K, Mochel JP. Canine Intestinal Organoids as a Novel In Vitro Model of Intestinal Drug Permeability: A Proof-of-Concept Study. Cells 2023; 12:cells12091269. [PMID: 37174669 PMCID: PMC10177590 DOI: 10.3390/cells12091269] [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: 03/31/2023] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
A key component of efforts to identify the biological and drug-specific aspects contributing to therapeutic failure or unexpected exposure-associated toxicity is the study of drug-intestinal barrier interactions. While methods supporting such assessments are widely described for human therapeutics, relatively little information is available for similar evaluations in support of veterinary pharmaceuticals. There is, therefore, a critical need to develop novel approaches for evaluating drug-gut interactions in veterinary medicine. Three-dimensional (3D) organoids can address these difficulties in a reasonably affordable system that circumvents the need for more invasive in vivo assays in live animals. However, a first step in developing such systems is understanding organoid interactions in a 2D monolayer. Given the importance of orally administered medications for meeting the therapeutic need of companion animals, we demonstrate growth conditions under which canine-colonoid-derived intestinal epithelial cells survive, mature, and differentiate into confluent cell systems with high monolayer integrity. We further examine the applicability of this canine-colonoid-derived 2D model to assess the permeability of three structurally diverse, passively absorbed β-blockers (e.g., propranolol, metoprolol, and atenolol). Both the absorptive and secretive apparent permeability (Papp) of these drugs at two different pH conditions were evaluated in canine-colonoid-derived monolayers and compared with that of Caco-2 cells. This proof-of-concept study provides promising preliminary results with regard to the utility of canine-derived organoid monolayers for species-specific assessments of therapeutic drug passive permeability.
Collapse
Affiliation(s)
- Dipak Kumar Sahoo
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA 50011, USA
| | - Marilyn N Martinez
- Office of New Animal Drug Evaluation, Center for Veterinary Medicine, Food and Drug Administration, Rockville, MD 20852, USA
| | - Kimberly Dao
- 3D Health Solutions, Iowa State University, Ames, IA 50011, USA
| | - Vojtech Gabriel
- Department of Biomedical Sciences, SMART Pharmacology, Iowa State University, Ames, IA 50011, USA
| | - Christopher Zdyrski
- 3D Health Solutions, Iowa State University, Ames, IA 50011, USA
- Department of Biomedical Sciences, SMART Pharmacology, Iowa State University, Ames, IA 50011, USA
| | - Albert E Jergens
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA 50011, USA
| | - Todd Atherly
- 3D Health Solutions, Iowa State University, Ames, IA 50011, USA
| | | | - Laura E Burns
- Veterinary Diagnostic Laboratory, Iowa State University, Ames, IA 50011, USA
| | - Dwayne Schrunk
- Veterinary Diagnostic Laboratory, Iowa State University, Ames, IA 50011, USA
| | - Donna A Volpe
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD 20852, USA
| | - Karin Allenspach
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA 50011, USA
- 3D Health Solutions, Iowa State University, Ames, IA 50011, USA
| | - Jonathan P Mochel
- 3D Health Solutions, Iowa State University, Ames, IA 50011, USA
- Department of Biomedical Sciences, SMART Pharmacology, Iowa State University, Ames, IA 50011, USA
| |
Collapse
|
7
|
Sotillo S, Ward JL, Guillot E, Domenig O, Yuan L, Smith JS, Gabriel V, Iennarella-Servantez CA, Mochel JP. Dose-response of benazepril on biomarkers of the classical and alternative pathways of the renin-angiotensin-aldosterone system in dogs. Sci Rep 2023; 13:2684. [PMID: 36792677 PMCID: PMC9932142 DOI: 10.1038/s41598-023-29771-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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
Angiotensin-converting enzyme inhibitors (ACEI) such as benazepril are commonly prescribed in both humans and dogs with heart disease to mitigate the renin-angiotensin-aldosterone system (RAAS); however, the dose-dependent effects of benazepril on comprehensive RAAS components remain unknown. In this study, nine purpose-bred healthy dogs received three different dosages of oral benazepril (0.125 mg/kg, 0.25 mg/kg, or 0.5 mg/kg) in a randomized crossover design following induction of RAAS activation by consuming a low-sodium diet. Blood samples were collected at serial time intervals after benazepril dosing to measure plasma benazeprilat (active metabolite of benazepril) and serum RAAS biomarkers. Blood pressure and echocardiogram were performed at baseline and after each benazepril administration. Time-weighted averages for RAAS biomarkers for 12 h post-dose and hemodynamic variables were compared between dosing groups using Wilcoxon rank-sum testing. Compared to the lowest dosage of benazepril (0.125 mg/kg), the highest dosage (0.5 mg/kg) resulted in lower time-weighted average values of angiotensin (Ang) II (- 38%, P = 0.004), Ang1-5 (- 53%, P = 0.001), ACE-S (surrogate for ACE activity; - 59%, P = 0.0002), and ALT-S (surrogate for alternative RAAS activity; - 22%, P = 0.004), and higher values of AngI (+ 78%, P = 0.014) and PRA-S (surrogate for plasma renin activity; + 58%, P = 0.040). There were no relevant differences between dosing groups for blood pressure or echocardiographic variables. Knowledge of dose-dependent alterations in biomarkers of the classical and alternative RAAS pathways could help inform clinical trials for dosage optimization in both dogs and humans.
Collapse
Affiliation(s)
- Samantha Sotillo
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - Jessica L Ward
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA.
| | - Emilie Guillot
- Ceva Santé Animale, Companion Animal Franchise, Libourne, France
| | | | - Lingnan Yuan
- Department of Veterinary Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - Joseph S Smith
- Department of Veterinary Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - Vojtech Gabriel
- Department of Veterinary Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | | | - Jonathan P Mochel
- Department of Veterinary Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| |
Collapse
|
8
|
Sahoo DK, Allenspach K, Mochel JP, Parker V, Rudinsky AJ, Winston JA, Bourgois-Mochel A, Ackermann M, Heilmann RM, Köller G, Yuan L, Stewart T, Morgan S, Scheunemann KR, Iennarella-Servantez CA, Gabriel V, Zdyrski C, Pilla R, Suchodolski JS, Jergens AE. Synbiotic-IgY Therapy Modulates the Mucosal Microbiome and Inflammatory Indices in Dogs with Chronic Inflammatory Enteropathy: A Randomized, Double-Blind, Placebo-Controlled Study. Vet Sci 2022; 10:vetsci10010025. [PMID: 36669027 PMCID: PMC9867299 DOI: 10.3390/vetsci10010025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023] Open
Abstract
Chronic inflammatory enteropathy (CE) is a common cause of persistent gastrointestinal signs and intestinal inflammation in dogs. Since evidence links dysbiosis to mucosal inflammation, probiotics, prebiotics, or their combination (synbiotics) may reduce intestinal inflammation and ameliorate dysbiosis in affected dogs. This study's aim was to investigate the effects of the synbiotic-IgY supplement on clinical signs, inflammatory indices, and mucosal microbiota in dogs with CE. Dogs with CE were enrolled in a randomized prospective trial. Twenty-four client-owned dogs were fed a hydrolyzed diet and administered supplement or placebo (diet) for 6 weeks. Dogs were evaluated at diagnosis and 2- and 6-week post-treatment. Outcome measures included clinical activity, endoscopic and histologic scores, inflammatory markers (fecal calprotectin, C-reactive protein), and composition of the mucosal microbiota via FISH. Eleven supplement- and nine placebo-treated dogs completed the trial. After 6 weeks of therapy, clinical activity and endoscopic scores decreased in both groups. Compared to placebo-treated dogs, dogs administered supplement showed decreased calprotectin at 2-week post-treatment, decreased CRP at 2- and 6-week post-treatment increased mucosal Clostridia and Bacteroides and decreased Enterobacteriaceae in colonic biopsies at trial completion. Results suggest a beneficial effect of diet and supplements on host responses and mucosal microbiota in dogs with CE.
Collapse
Affiliation(s)
- Dipak Kumar Sahoo
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
- Correspondence: or (D.K.S.); (A.E.J.)
| | - Karin Allenspach
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | - Jonathan P. Mochel
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | - Valerie Parker
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Adam Joseph Rudinsky
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Jenessa A. Winston
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Agnes Bourgois-Mochel
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | - Mark Ackermann
- National Animal Disease Center USDA, ARS, Ames, IA 50010, USA
| | - Romy M. Heilmann
- Department for Small Animals, Veterinary Teaching Hospital, College of Veterinary Medicine, University of Leipzig, DE-04103 Leipzig, SN, Germany
| | - Gabor Köller
- Department for Large Animals, University of Leipzig, DE-04103 Leipzig, SN, Germany
| | - Lingnan Yuan
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | - Tracey Stewart
- Roy J. Carver High Resolution Microscopy Facility, Iowa State University, Ames, IA 50011, USA
| | - Shannon Morgan
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | - Kaitlyn R Scheunemann
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | | | - Vojtech Gabriel
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | - Christopher Zdyrski
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | - Rachel Pilla
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA
| | - Albert E. Jergens
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
- Correspondence: or (D.K.S.); (A.E.J.)
| |
Collapse
|
9
|
Bedos L, Wickham H, Gabriel V, Zdyrski C, Allbaugh RA, Sahoo DK, Sebbag L, Mochel JP, Allenspach K. Culture and characterization of canine and feline corneal epithelial organoids: A new tool for the study and treatment of corneal diseases. Front Vet Sci 2022; 9:1050467. [PMID: 36406087 PMCID: PMC9672346 DOI: 10.3389/fvets.2022.1050467] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 09/21/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
In this study, we isolated and cultured canine and feline 3D corneal organoids. Samples derived from corneal limbal epithelium from one canine and one feline patient were obtained by enucleation after euthanasia. Stem cell isolation and organoid culture were performed by culturing organoids in Matrigel. Organoids were subsequently embedded in paraffin for further characterization. The expression of key corneal epithelial and stromal cell markers in canine and feline organoids was evaluated at the mRNA level by RNA-ISH and at the protein level by immunofluorescence (IF) and immunohistochemistry (IHC), while histochemical analysis was performed on both tissues and organoids using periodic-acid Schiff (PAS), Sirius Red, Gomori's Trichrome, and Colloidal Iron stains. IF showed consistent expression of AQP1 within canine and feline organoids and tissues. P63 was present in canine tissues, canine organoids, and feline tissues, but not in feline organoids. Results from IHC staining further confirmed the primarily epithelial origin of the organoids. Canine and feline 3D corneal organoids can successfully be cultured and maintained and express epithelial and stem cell progenitor markers typical of the cornea. This novel in vitro model can be used in veterinary ophthalmology disease modeling, corneal drug testing, and regenerative medicine.
Collapse
Affiliation(s)
- Leila Bedos
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, United States
| | - Hannah Wickham
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA, United States
| | - Vojtech Gabriel
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA, United States
| | - Christopher Zdyrski
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA, United States
| | - Rachel A. Allbaugh
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, United States
| | - Dipak Kumar Sahoo
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, United States
| | - Lionel Sebbag
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, United States
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Jonathan P. Mochel
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA, United States
- 3D Health Solutions Inc., Ames, IA, United States
| | - Karin Allenspach
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, United States
- SMART Lab, Department of Biomedical Sciences, Iowa State University, Ames, IA, United States
- 3D Health Solutions Inc., Ames, IA, United States
- *Correspondence: Karin Allenspach
| |
Collapse
|
10
|
Allenspach K, Borcherding DC, Iennarella-Servantez CA, Mosichuk AP, Atherly T, Sahoo DK, Kathrani A, Suchodolski JS, Bourgois-Mochel A, Serao MR, Serao NV, Willette A, Perez BA, Gabriel V, Mao S, Kilburn L, Dang V, Borts D, Almada LL, Fernandez-Zapico ME, Phillips GJ, Jergens AE, Mochel JP. Ketogenic diets in healthy dogs induce gut and serum metabolome changes suggestive of anti-tumourigenic effects: A model for human ketotherapy trials. Clin Transl Med 2022; 12:e1047. [PMID: 36149786 PMCID: PMC9506423 DOI: 10.1002/ctm2.1047] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/15/2022] [Accepted: 08/23/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- Karin Allenspach
- Departments, of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa, USA
| | - Dana C Borcherding
- Department of Biomedical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa, USA
| | - Chelsea A Iennarella-Servantez
- Department of Biomedical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa, USA.,Royal Veterinary College, University of London, London, UK
| | - Allison P Mosichuk
- Departments, of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa, USA
| | - Todd Atherly
- Departments, of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa, USA
| | - Dipak Kumar Sahoo
- Department of Biomedical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa, USA
| | - Aarti Kathrani
- Royal Veterinary College, University of London, London, UK
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Texas A&M University, College of Veterinary Medicine & Biomedical Sciences, College Station, Texas, USA
| | - Agnes Bourgois-Mochel
- Departments, of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa, USA
| | | | - Nick V Serao
- Department of Animal Science, Iowa State University, Ames, Iowa, USA
| | - Auriel Willette
- Food Science and Human Nutrition, Iowa State University, Ames, Iowa, USA
| | - Beatriz Agulla Perez
- Departments, of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa, USA
| | - Vojtech Gabriel
- Departments, of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa, USA
| | - Sichao Mao
- Departments, of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa, USA
| | - Logan Kilburn
- Department of Animal Science, Iowa State University, Ames, Iowa, USA
| | - Viet Dang
- Veterinary Diagnostics Laboratory, Iowa State University, Ames, Iowa, USA
| | - David Borts
- Veterinary Diagnostics Laboratory, Iowa State University, Ames, Iowa, USA
| | - Luciana L Almada
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Martin E Fernandez-Zapico
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Gregory J Phillips
- Department of Veterinary Microbiology and Preventive Medicine, Iowa State University, Ames, Iowa, USA
| | - Albert E Jergens
- Departments, of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa, USA
| | - Jonathan P Mochel
- Department of Biomedical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa, USA
| |
Collapse
|
11
|
Gabriel V, Zdyrski C, Sahoo DK, Dao K, Bourgois-Mochel A, Atherly T, Martinez MN, Volpe DA, Kopper J, Allenspach K, Mochel JP. Canine Intestinal Organoids in a Dual-Chamber Permeable Support System. J Vis Exp 2022. [DOI: 10.3791/63612] [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] [Indexed: 10/31/2022] Open
|
12
|
Gabriel V, Zdyrski C, Sahoo DK, Dao K, Bourgois-Mochel A, Kopper J, Zeng XL, Estes MK, Mochel JP, Allenspach K. Standardization and Maintenance of 3D Canine Hepatic and Intestinal Organoid Cultures for Use in Biomedical Research. J Vis Exp 2022. [DOI: 10.3791/63515] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
|
13
|
Iennarella-Servantez CA, Kathrani A, Sahoo D, Long E, Zdyrski C, Gabriel V, Mao S, Bourgois-Mochel A, Resop M, Rund L, Rossoni-Serao MC, Jergens A, Mochel J, Allenspach K. 109 Diet-induced Clinical Responsiveness of Translational Dog Model for Human Western Diet (WD)-related Disease Research. J Anim Sci 2021. [DOI: 10.1093/jas/skab235.104] [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: 11/14/2022] Open
Abstract
Abstract
Human consumption of Western diets (WD) has been strongly associated with increased central obesity, adipocyte hypertrophy, intestinal epithelial stemness/proliferation, dyslipidemia, and blood pressure. These changes reflect metabolic dysfunction and contribute to increased risk of type 2 diabetes mellitus and colorectal cancer. As comprehensive molecular/clinical comparisons have not been performed, the objective of this study was to evaluate diet-induced changes in dogs as a clinically-responsive model for human WD-related disease research. Methods: In a crossover design, 10 dogs were fed either a 1.) control diet (CON) formulated based on the Acceptable Macronutrient Distribution Ranges and fiber recommendations for humans; or 2.) Western diet (WD) formulated based on National Health and Nutrition Examination Survey dataset parameters. Diets were prepared cooked with the same ingredients and formulated to meet/exceed nutrient/energy requirements for both humans/dogs and fed isocalorically based on calculated metabolizable energy (ME). Following each period (~7–8 weeks), experimental parameters were measured. Results/Conclusions: Mean body weights were 8.83 and 9.28kg for CON and WD diets, respectively (P = 0.0018). Fasted (10-hour) blood samples differed significantly (P < 0.01) for mean fasting bile acids (CON=0.79, WD=8.94μmol/L), serum triglycerides (CON=45.70, WD=67.80mg/dL), and serum cholesterol (CON=140.10, WD=175.40mg/dL) demonstrating diet-dependent alterations in lipid profiles. Mean systolic blood pressures were 131.66 and 140.02mmHg for CON and WD, respectively (P < 0.0001). Histological analysis revealed diet-dependent changes in colonic epithelial villus height (CON=182, WD=207μm) and villus:crypt ratio (CON=2.61, WD=3.89). Preliminary RNA-ISH analysis (n = 3 dogs) showed increased LGR5+ expression (intestinal stem-cell marker) in WD compared to CON group (P = 0.0019) suggesting an increased “stemnness” of colonic epithelium. Further, mean adipocyte diameters were increased in omental fat biopsies (CON=58.6, WD=62.5μm; P < 0.0001) but not subcutaneous fat biopsies (P >0.05) following WD feeding, consistent with centralized obesity. Collectively, these results demonstrate effects of diet-induced changes in dogs as a clinically-responsive model for human WD-related disease research.
Collapse
|
14
|
Luz R, Leal R, Mendonça R, Gabriel V, Simões J, Matos I. W025 AMNIOCENTESIS AND ADVANCED MATERNAL AGE. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)61750-0] [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: 11/17/2022]
|
15
|
Fusaro M, Fusaro M, Noale M, Tripepi G, D'angelo A, Miozzo D, Gallieni M, Study Group PV, Tsamelesvili M, Dimitriadis C, Papagianni A, Raidis C, Efstratiadis G, Memmos D, Mutluay R, Konca Degertekin C, Derici U, Deger SM, Akkiyal F, Gultekin S, Gonen S, Tacoy G, Arinsoy T, Sindel S, Sanchez-Perales C, Vazquez E, Merino E, Perez Del Barrio P, Borrego FJ, Borrego MJ, Liebana A, Krzanowski M, Janda K, Dumnicka P, Krasniak A, Sulowicz W, Kim YO, Yoon SA, Yun YS, Song HC, Kim BS, Cheong MA, Pasch A, Farese S, Floege J, Jahnen-Dechent W, Ohtake T, Ohtake T, Furuya R, Iwagami M, Tsutsumi D, Mochida Y, Ishioka K, Oka M, Maesato K, Moriya H, Hidaka S, Kobayashi S, Guedes A, Malho Guedes A, Pinho A, Fragoso A, Cruz A, Mendes P, Morgado E, Bexiga I, Silva AP, Neves P, Oyake N, Suzuki K, Itoh S, Yano S, Turkmen K, Kayikcioglu H, Ozbek O, Saglam M, Toker A, Tonbul HZ, Gelev S, Trajceska L, Srbinovska E, Pavleska S, Amitov V, Selim G, Dzekova P, Sikole A, Bouarich H, Lopez S, Alvarez C, Arribas I, DE Sequera P, Rodriguez D, Fusaro M, Fusaro M, Noale M, Tripepi G, D'angelo A, Miozzo D, Gallieni M, Study Group PV, Tanaka S, Kanemitsu T, Sugahara M, Kobayashi M, Uchida L, Ishimoto Y, Kotera N, Tanimoto S, Tanabe K, Hara K, Sugimoto T, Mise N, Goldstein B, Turakhia M, Arce C, Winkelmayer W, Zayed BED, Said K, Nishimura M, Nishimura M, Okamoto Y, Tokoro T, Nishida M, Hashimoto T, Iwamoto N, Takahashi H, Ono T, Nishimura M, Okamoto Y, Tokoro T, Sato N, Nishida M, Hashimoto T, Iwamoto N, Takahashi H, Ono T, Guedes A, Malho Guedes A, Cruz A, Morgado E, Pinho A, Fragoso A, Mendes P, Bexiga I, Silva AP, Neves P, Raimann J, Usvyat LA, Sands J, Levin NW, Kotanko P, Iwasaki M, Joki N, Tanaka Y, Ikeda N, Hayashi T, Kubo S, Imamura TA, Takahashi Y, Hirahata K, Imamura Y, Hase H, Claes K, Meijers B, Bammens B, Kuypers D, Naesens M, Vanrenterghem Y, Evenepoel P, Boscutti G, Calabresi L, Bosco M, Simonelli S, Boer E, Vitali C, Martone M, Mattei PL, Franceschini G, Baligh E, Zayed BED, Said K, El-Shafey E, Ezaat A, Zawada A, Rogacev K, Hummel B, Grun O, Friedrich A, Rotter B, Winter P, Geisel J, Fliser D, Heine GH, Makino JI, Makino KS, Ito T, Genovesi S, Santoro A, Fabbrini P, Rossi E, Pogliani D, Stella A, Bonforte G, Remuzzi G, Bertoli S, Pozzi C, Gallieni M, Pasquali S, Cagnoli L, Conte F, Santoro A, Buzadzic I, Tosic J, Dimkovic N, Djuric Z, Popovic J, Pejin Grubisa I, Barjaktarevic N, DI Napoli A, DI Lallo D, Salvatori MF, Franco F, Chicca S, Guasticchi G, Onofriescu M, Hogas S, Luminita V, Mugurel A, Gabriel V, Laura F, Irina M, Adrian C, Bosch E, Baamonde E, Culebras C, Perez G, El Hayek B, Ramirez JI, Ramirez A, Garcia C, Lago M, Toledo A, Checa MD, Taira T, Hirano T, Nohtomi K, Hyodo T, Chiba T, Saito A, Kim YK, Song HC, Choi EJ, Yang CW, Kim YS, Lim PS, Ming Ying W, Ya-Chung J, Zaripova I, Kayukov I, Essaian A, Nimgirova A, Young H, Dungey M, Watson EL, Baines R, Burton JO, Smith AC, Joki N, Iwasaki M, Tanaka Y, Kubo S, Hayashi T, Ikeda N, Yamazaki K, Hase H, Bossola M, Colacicco L, Scribano D, Vulpio C, Tazza L, Okada T, Okada N, Michibata I, Yura T, Montero N, Soler M, Pascual M, Barrios C, Marquez E, Rodriguez E, Orfila MA, Cao H, Arcos E, Comas J, Pascual J, Ferrario M, Garzotto F, Sironi T, Monacizzo S, Basso F, Garzotto F, Cruz DN, Moissl U, Tetta C, Signorini MG, Cerutti S, Ronco C, Mostovaya I, Grooteman M, Van den Dorpel M, Penne L, Van der Weerd N, Mazairac A, Den Hoedt C, Levesque R, Nube M, Ter Wee P, Bots M, Blankestijn P, Liu J, MA KL, Zhang X, Liu BC, Vladu ID, Mustafa R, Cana-Ruiu D, Vaduva C, Grauntanu C, Mota E, Singh R, Abbasian N, Stover C, Brunskill N, Burton J, Abbasian N, Herbert K, Bevington A, Brunskill N, Burton J, Wu M, Tang RN, Gao M, Liu H, Chen L, LV LL, Liu BC, Nikodimopoulou M, Liakos S, Kapoulas S, Karvounis C, Fedak D, Kuzniewski M, Paulina D, Kusnierz-Cabala B, Kapusta M, Solnica B, Sulowicz W, Junque A, Vicent ES, Moreno L, Fulquet M, Duarte V, Saurina A, Pou M, Macias J, Lavado M, Ramirez de Arellano M, Ryuzaki M, Nakamoto H, Kinoshita S, Kobayashi E, Takimoto C, Shishido T, Enia G, Torino C, Tripepi R, Panuccio V, Postorino M, Clementi A, Garozzo M, Bonanno G, Boito R, Natale G, Cicchetti T, Chippari A, Logozzo D, Alati G, Cassani S, Sellaro A, Zoccali C, Quiroga B, Verde E, Abad S, Vega A, Goicoechea M, Reque J, Lopez-Gomez JM, Luno J, Cabre Menendez C, Moles V, Vives JP, Villa D, Vinas J, Compte T, Arruche M, Diaz C, Soler J, Aguilera J, Martinez Vea A, De Mauri A, David P, Conte MM, Chiarinotti D, Ruva CE, De Leo M, Bargnoux AS, Morena M, Jaussent I, Chalabi L, Bories P, Dion JJ, Henri P, Delage M, Dupuy AM, Badiou S, Canaud B, Cristol JP, Fabbrini P, Sironi E, Pieruzzi F, Galbiati E, Vigano MR, Stella A, Genovesi S, Anpalakhan S, Anpalakhan S, Rocha S, Chitalia N, Sharma R, Kaski JC, Chambers J, Goldsmith D, Banerjee D, Cernaro V, Lacquaniti A, Lupica R, Lucisano S, Fazio MR, Donato V, Buemi M, Segalen I, Segalen I, Vinsonneau U, Tanquerel T, Quiniou G, Le Meur Y, Seibert E, Girndt M, Zohles K, Ulrich C, Kluttig A, Nuding S, Swenne C, Kors J, Werdan K, Fiedler R, Van der Weerd NC, Grooteman MP, Bots M, Van den Dorpel MA, Den Hoedt C, Nube MJ, Wetzels J, Swinkels DW, Blankestijn P, Ter Wee PM, Khandekar A, Khandge J, Lee JE, Moon SJ, Choi KH, Lee HY, Kim BS, Morena M, Tuaillon E, Jaussent I, Rodriguez A, Chenine L, Vendrell JP, Cristol JP, Canaud B, Sue YM, Tang CH, Chen YC, Sanchez-Perales C, Vazquez E, Segura P, Garcia Cortes MJ, Gil JM, Biechy MM, Liebana A, Poulikakos D, Shah A, Persson M, Banerjee D, Dattolo P, Amidone M, Amidone M, Michelassi S, Moriconi L, Betti G, Conti P, Rosati A, Mannarino A, Panichi V, Pizzarelli F, Klejna K, Naumnik B, Koc-Zorawska E, Mysliwiec M, Dimitrie S, Simona H, Mihaela O, Mugurel A, Gabriela O, Radu S, Octavian P, Adrian C, Akdam H, Akar H, Yenicerioglu Y, Kucuk O, Kurt Omurlu I, Goldsmith D, Thambiah S, Roplekar R, Manghat P, Manghat P, Fogelman I, Fraser W, Hampson G, Likaj E, Likaj E, Caco G, Seferi S, Rroji M, Barbullushi M, Thereska N, Onofriescu M, Hogas S, Luminita V, Mugurel A, Serban A, Carmen V, Cristian S, Silvia L, Covic A. Cardiovascular complications in CKD 5D. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs225] [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: 11/14/2022] Open
|
16
|
Abstract
BACKGROUND Itching is a subjective and multidimensional experience which is difficult to quantify. Most methodologies to assess itching suffer from being unidimensional, for example only measuring intensity without impact on quality of life, or only measuring scratching activity. None has actually been demonstrated to be able to detect change over time, which is essential to using them as an outcome measure of response to an intervention. The 5-D itch scale was developed as a brief but multidimensional questionnaire designed to be useful as an outcome measure in clinical trials. The five dimensions are degree, duration, direction, disability and distribution. OBJECTIVES To study the 5-D with respect to validity, reliability and response to change. METHODS The 5-D was administered to 234 individuals with chronic pruritus due to liver disease (n = 63), kidney disease (n = 36), dermatological disorders (n = 56), HIV/AIDS (n = 28) and burn injuries (n = 51). The 5-D was administered at baseline and after a 6-week follow-up period. A subset of 50 untreated patients was retested after 3 days to assess test-retest reliability. RESULTS The 5-D score correlated strongly with a visual analogue score: r = 0.727 at baseline (P < 0.0001), r = 0.868 at the 3-day repeat (P < 0.0001), and r = 0.892 at the 6-week follow-up (P < 0.0001). There was no change in mean 5-D score between day 1 and day 3 in untreated individuals (intraclass correlation coefficient = 0.96, P < 0.0001). The 5-D did, however, detect significant changes in pruritus over the 6-week follow-up period (P < 0.0001). Subanalysis of the different patient groups revealed similar response patterns and scores, with the exception of lower total scores for the burn victims due to lower scores on the distribution domain because they itched only at the site of their burn. CONCLUSIONS The 5-D, therefore, is a reliable, multidimensional measure of itching that has been validated in patients with chronic pruritus to able to detect changes over time. The 5-D should be useful as an outcome measure in clinical trials.
Collapse
Affiliation(s)
- S Elman
- University of Wisconsin School of Medicine, Madison, WI, USA
| | | | | | | |
Collapse
|
17
|
Armon K, Stephenson T, Gabriel V, MacFaul R, Eccleston P, Werneke U, Smith S. Determining the common medical presenting problems to an accident and emergency department. Arch Dis Child 2001; 84:390-2. [PMID: 11316679 PMCID: PMC1718762 DOI: 10.1136/adc.84.5.390] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
All accident and emergency (A&E) attendances over a one year period were prospectively studied in order to determine common medical presenting problems. Data were collected on children (0-15 years) attending a paediatric A&E department in Nottingham between February 1997 and February 1998. A total of 38 982 children were seen. The diagnoses of 26 756 (69%) were classified as trauma or surgical, and 10 369 (27%) as medical; 1857 (4%) could not be classified. The commonest presenting problems reported for "medical" children were breathing difficulty (31%), febrile illness (20%), diarrhoea with or without vomiting (16%), abdominal pain (6%), seizure (5%), and rash (5%). The most senior doctor seeing these patients in A&E was a senior house officer (intern or junior resident) in 78% of cases, paediatric registrar (senior resident) in 19%, consultant (attending physician) in 1.4%, and "other" in 2.6%. Guidelines developed for A&E should target the commonest presenting problem categories, six of which account for 83% of all medical attendances, and be directed towards senior house officers.
Collapse
Affiliation(s)
- K Armon
- Academic Division of Child Health, School of Human Development, Medical Faculty, University of Nottingham, Nottingham NG7 2UH, UK.
| | | | | | | | | | | | | |
Collapse
|
18
|
Clements H, Stephenson T, Gabriel V, Harrison T, Millar M, Smyth A, Tong W, Linton CJ. Rationalised prescribing for community acquired pneumonia: a closed loop audit. Arch Dis Child 2000; 83:320-4. [PMID: 10999868 PMCID: PMC1718512 DOI: 10.1136/adc.83.4.320] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.1] [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] [Indexed: 11/03/2022]
Abstract
AIMS To audit the management of community acquired pneumonia before and after the introduction of a protocol. To determine the aetiology of pneumonia using routine investigations and polymerase chain reaction (PCR). METHODS Retrospective and prospective audit following the introduction of a management protocol. Prospective cases were investigated routinely and with PCR on blood and nasopharyngeal aspirate. RESULTS There was a significant increase in rational prescribing following introduction of the protocol with 75% of children receiving intravenous penicillin or erythromycin compared with 26% beforehand. Of 89 children in the prospective group, 51 microbiological diagnoses were achieved in 48 children. Seven children had Streptococcus pneumoniae infection, 14 had Mycoplasma infection, six had pertussis, and one had Chlamydia pneumoniae infection. Twenty three children had a viral cause of which respiratory syncytial virus was commonest. CONCLUSIONS Introduction of the protocol led to improved prescribing. PCR increased the diagnostic yield and the results support the management protocol.
Collapse
Affiliation(s)
- H Clements
- Academic Division of Child Health, University Hospital, Nottingham NG7 2UH, UK
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Harbarth S, Pittet D, Gabriel V, Garbino J, Lew D. Cefepime--assessment of its need at a tertiary care center. J Clin Pharm Ther 1998; 23:11-7. [PMID: 9756106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To assess the need and possible indications for a fourth-generation cephalosporin (cefepime). METHOD A cohort study was carried out over a 17-month period in a 1500-bed Swiss university hospital. RESULTS In 256 (22.6%) of the 1135 patients followed consecutively by our Infectious Diseases Division, cefepime could have been chosen as an alternative to other broad-spectrum antibiotics, including imipenem/cilastatin (n=94), ciprofloxacine (n=52) and ceftazidime (n=49). Considering the low price-strategy of the pharmaceutical company promoting this drug in Switzerland, there would have been considerable cost savings for the hospital pharmacy if cefepime had been used as first-line treatment in these occasions. Nevertheless, we could not observe any potential advantage of cefepime compared to already introduced broad-spectrum antibiotics, except that cefepime was effective against infections caused by Enterobacter spp. resistant to ceftazidime. CONCLUSION We conclude that fourth-generation cephalosporins such as cefepime may be introduced into large hospitals only after careful assessment of their potential benefits and that consultation by an Infectious Diseases Division is useful when evaluating the need for new broad-spectrum antibiotics in the hospital setting.
Collapse
Affiliation(s)
- S Harbarth
- Division of Infectious Diseases, University Hospitals of Geneva, Switzerland
| | | | | | | | | |
Collapse
|
20
|
Vanhems P, Morabia A, Pechère M, Gabriel V, Hirschel B. Duration of hospitalization during the first two years after AIDS diagnosis: a descriptive study. Soz Praventivmed 1997; 42:314-9. [PMID: 9403952 DOI: 10.1007/bf01592328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Has there been a change in the duration of periods of hospitalization during the first two years after diagnosis of AIDS between patients diagnosed before 1988, compared with patients diagnosed since 1988? A cohort of 212 AIDS patients was studied. They were diagnosed before December 31, 1990 and were hospitalized between January 1, 1981 and March 31, 1993 in the University Hospital of Geneva, Switzerland. Overall, the duration of hospitalization did not seem to differ according to the year of AIDS diagnosis, though the more recently diagnosed patients were hospitalized with a more advanced level of immunosuppression. However, the pattern of hospitalization was slightly different. The periods of hospitalization for subjects diagnosed before 1988 were relatively longer soon after the AIDS diagnosis and at a late stage in the course of the disease, whereas for the more recent patients the lengths of hospital stays were more uniform during the whole course of the disease.
Collapse
|
21
|
Stalder N, Sudre P, Olmari M, Opravil M, Gabriel V, Sansonetti A, von Overbeck J, Herbort CP, Hirschel B. Cytomegalovirus retinitis: decreased risk of bilaterality with increased use of systemic treatment. Swiss HIV Cohort Study Group. Clin Infect Dis 1997; 24:620-4. [PMID: 9145735 DOI: 10.1093/clind/24.4.620] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Cytomegalovirus (CMV) retinitis may be treated systemically or intravitreally. We reviewed retrospectively patients with CMV retinitis, in order to determine whether systemic treatment was associated with less spread of CMV retinitis from one eye to the other. Of 222 cases, 92 patients had bilateral disease at onset of CMV retinitis, leaving 130 for analysis. Bilaterality occurred in 10 patients during 12,687 days of systemic treatment and in 34 during 14,791 days without systemic treatment (odds ratio [OR] = 2.92; confidence interval [CI], 1.44-5.90). Patients who had received systemic treatment for <50% of the follow-up period had a greater risk of bilaterality (OR = 3.7; CI, 2.79-4.54) than did the more intensively treated patients. CD4 cell levels also contributed to increased risk, but multivariate analysis showed that CD4 cell counts and treatment intensity were independent risk factors. CMV retinitis was more likely to become bilateral in patients who received less intravenous therapy. Local treatment can complete but does not replace systemically administered therapy.
Collapse
Affiliation(s)
- N Stalder
- Department of Ophthalmology, University Hospital, Geneva, Switzerland
| | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
OBJECTIVE To study whether absence of prophylaxis is a risk factor for cerebral toxoplasmosis, and to determine the reasons for absence of prophylaxis among AIDS patients diagnosed with Toxoplasma encephalitis (TE). DESIGN Retrospective chart review and matched case-control study. PATIENTS Patients (104 first episodes and 26 relapses of TE) were registered in the Swiss HIV Cohort Study from three centres from July 1992 to December 1994; 91 matched controls were included for 52 patients with a first episode, and 17 matched controls for 17 patients with relapse of TE. RESULTS Prophylaxis was prescribed to 17 patients (16%) with a first episode and 19 patients (73%) with a relapse of TE. Reasons for the absence of prophylaxis included patient refusal (25%), non-proposal by physicians (17%), and drug intolerance (17%). Reduced absorption due to non-compliance, diarrhoea or vomiting was identified among 12 patients with a first episode and 14 patients with a relapse of TE. Absence of prescription of prophylaxis was associated with a 10-fold increased risk of a first episode of TE (odds ratio, 9.8; 95% confidence interval, 2.7-35.4) in the matched case-control study. CONCLUSIONS TE continues to occur among patients not receiving prophylaxis. At least one-half of the cases may be prevented with better motivation of physicians and increased compliance of patients.
Collapse
Affiliation(s)
- C Van Delden
- Division of Infectious Diseases, University Hospitals of Geneva, Switzerland
| | | | | | | | | | | |
Collapse
|
23
|
Gabriel V, Packham DR. Heterosexual transmission: a growing risk factor for HIV spread. Aust N Z J Obstet Gynaecol 1993; 33:174-6. [PMID: 8216119 DOI: 10.1111/j.1479-828x.1993.tb02386.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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The risk of human immunodeficiency virus (HIV) spread by heterosexual contact is emerging as a risk factor for women in Sydney in the 1990's. As shown by this study, heterosexual exposure to the virus accounted for 40% of women in Western Sydney acquiring the disease between 1989-1991 inclusive, compared with 0% in 1982-1985 inclusive. Further public awareness of this mode of transmission and information on safe sex practices is necessary to limit the spread of the AIDS virus.
Collapse
|
24
|
Renold C, Sugar A, Chave JP, Perrin L, Delavelle J, Pizzolato G, Burkhard P, Gabriel V, Hirschel B. Toxoplasma encephalitis in patients with the acquired immunodeficiency syndrome. Medicine (Baltimore) 1992; 71:224-39. [PMID: 1355579 DOI: 10.1097/00005792-199207000-00005] [Citation(s) in RCA: 102] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Among 504 cases of AIDS diagnosed between 1983 and 1990, there were 86 patients (17%) with toxoplasma encephalitis (TE). All were symptomatic at the time of diagnosis. General signs such as fever, neck stiffness, or headache were present in 87.2%, and 75.6% had focal signs. The primary means of diagnosis was computerized tomographic scanning, revealing 169 lesions of which 80% were immediately contrast-enhancing. All patients had IgG antibodies against Toxoplasma gondii either before (74 of 75 evaluable patients) or at the time of diagnosis of TE (73 of 75). Elevated antibody titers were present in 44% of evaluable patients, compared to 11% of patients with AIDS and other opportunistic infections. Initial treatment was pyrimethamine plus sulfonamides in 65 patients, and pyrimethamine plus clindamycin in 12 patients, with other combinations or no treatment accounting for the remainder. Life-table analysis of the time to discontinuation of treatment because of suspected side effects suggested that sulfadiazine was significantly more toxic, with 48% of patients experiencing an interruption in treatment after 30 days, than pyrimethamine (12%) or clindamycin (24%). The 30-day mortality rate was 12%, and median survival was 310 days after diagnosis, 530 in patients treated with zidovudine and 190 days in those not so treated. Of 82 evaluable patients, 16 relapsed once and 4 of these more than once. The risk of relapse was 27% 1 year after diagnosis of a first episode of TE.
Collapse
Affiliation(s)
- C Renold
- Division des Maladies Infectieuses, Hôpital Cantonal Universitaire, Geneva, Switzerland
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Heald A, Flepp M, Chave JP, Malinverni R, Rüttimann S, Gabriel V, Renold C, Sugar A, Hirschel B. Treatment for cerebral toxoplasmosis protects against Pneumocystis carinii pneumonia in patients with AIDS. The Swiss HIV Cohort Study. Ann Intern Med 1991; 115:760-3. [PMID: 1929023 DOI: 10.7326/0003-4819-115-10-760] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To determine whether long-term maintenance treatment for toxoplasmosis protects against Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome (AIDS). DESIGN Cohort study. SETTING Switzerland. PATIENTS A total of 453 patients with human immunodeficiency virus (HIV) entered the Swiss HIV Cohort Study. Ninety-nine patients with cerebral toxoplasmosis but no previous or simultaneous P. carinii pneumonia were compared with 240 patients with AIDS and other severe opportunistic infections (Centers for Disease Control [CDC] stage IVC1 infection other than toxoplasmosis and P. carinii pneumonia) as well as with 114 patients receiving inhaled pentamidine in a study of primary pneumocystis prophylaxis in patients infected with HIV. MEASUREMENTS Life-table analysis for P. carinii-free survival. MAIN RESULTS Six of 99 (6%) patients with toxoplasmosis, 50 of 240 (21%) patients with other severe opportunistic infections, and 8 of 114 (6%) patients receiving inhaled pentamidine developed P. carinii pneumonia. Life-table analysis showed that the incidence of pneumonia was substantially lower in patients with toxoplasmosis compared with that in patients with other severe opportunistic infections and was similar to the incidence in patients receiving pentamidine as prophylaxis. Analysis of the medication records from patients with toxoplasmosis showed that pyrimethamine and sulfonamides were administered 50% of the time; pyrimethamine and clindamycin, 25% of the time; and pyrimethamine alone, 9.9% of the time but that only one of the six patients with toxoplasmosis who developed P. carinii pneumonia received pyrimethamine and sulfonamides in the month before diagnosis. CONCLUSION Patients with cerebral toxoplasmosis have a low risk for subsequently developing P. carinii pneumonia. This decreased risk is probably the result of chronic suppressive treatment with pyrimethamine and sulfonamides.
Collapse
Affiliation(s)
- A Heald
- Hôpital Cantonal Universitaire de Genève, Switzerland
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Hirschel B, Lazzarin A, Chopard P, Opravil M, Furrer HJ, Rüttimann S, Vernazza P, Chave JP, Ancarani F, Gabriel V. A controlled study of inhaled pentamidine for primary prevention of Pneumocystis carinii pneumonia. N Engl J Med 1991; 324:1079-83. [PMID: 2008181 DOI: 10.1056/nejm199104183241602] [Citation(s) in RCA: 120] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Current recommendations for prophylaxis of Pneumocystis carinii pneumonia (PCP) are based on data from patients who have had at least one episode of PCP (secondary prevention). We designed a study to determine the efficacy and side effects of inhaled pentamidine in the primary prevention of PCP. METHODS Two hundred twenty-three patients sero-positive for human immunodeficiency virus (HIV) who had the acquired immunodeficiency syndrome (AIDS) but not PCP, who had advanced AIDS-related complex, or who had less than 0.2 x 10(9) CD4-positive lymphocytes per liter received either 300 mg of pentamidine isethionate or 300 mg of sodium isethionate every 28 days by inhaler. The proportion of patients surviving without PCP was analyzed with the log-rank test as a function of time spent in the trial, according to the intention to treat with either placebo or pentamidine. RESULTS The third of five planned interim analyses showed a significant difference in the occurrence of PCP, with 8 cases in pentamidine group and 23 in the placebo group (nominal P value = 0.0021). There were no deaths within 60 days of the diagnosis of PCP and no significant differences in survival between groups. Approximately 53 inhalations were needed to prevent one episode of pneumonia. Thirty-eight of 114 patients given pentamidine (33 percent) and 7 of 109 given placebo (6 percent) had moderate-to-severe coughing during inhalations (two-tailed P less than 0.00001), which caused 4 patients given pentamidine (3.5 percent) to discontinue taking it. CONCLUSIONS A dose of 300 mg of aerosolized pentamidine given every four weeks was well tolerated and 60 to 70 percent effective in preventing a first episode of PCP in patients with HIV infection.
Collapse
Affiliation(s)
- B Hirschel
- Division of Infectious Diseases, Hôpital Cantonal Universitaire, Geneva, Switzerland
| | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Chamot E, Hirschel B, Wintsch J, Robert CF, Gabriel V, Déglon JJ, Yerly S, Perrin L. Loss of antibodies against hepatitis C virus in HIV-seropositive intravenous drug users. AIDS 1990; 4:1275-7. [PMID: 1965126 DOI: 10.1097/00002030-199012000-00016] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A time-point survey of 262 ex-intravenous drug users (IVDUs) on methadone treatment showed serological evidence of hepatitis C virus (HCV) in 64%, hepatitis B virus in 74% and HIV in 36%. Analysis of previously collected frozen stored sera of the same patients showed that 31 further IVDUs had had anti-HCV antibodies in the past and had lost them in a time-dependent fashion. Most HCV seroreversion was detected in HIV-positive people: 20 out of 85 in the HIV-positive group versus 11 out of 18 in the HIV-negative group.
Collapse
Affiliation(s)
- E Chamot
- Department of Medicine, Geneva University Hospital, Switzerland
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Robert CF, Déglon JJ, Wintsch J, Martin JL, Perrin L, Bourquin M, Gabriel V, Hirschel B. Behavioural changes in intravenous drug users in Geneva: rise and fall of HIV infection, 1980-1989. AIDS 1990; 4:657-60. [PMID: 2397058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In the early 1980s, more than 90% of intravenous drug users (IVDUs) shared needles and syringes in Geneva. The prevalence of antibodies to HIV in the sera of outpatient IVDUs increased from 6% in 1981 to 38% in 1983; it was, however, still only 37% in 1988. IVDUs starting methadone maintenance in 1987-1989 had a seroprevalence rate of 22%. In 1989 the percentage of IVDUs exchanging syringes and needles fell to only 5% of seropositive addicts. Only one seroconversion was observed in 1094 patient-months of observation in 1988-1989, which was probably due to sexual contact. The evidence suggests that, in the IDVUs studied, transmission of HIV has diminished since the early 1980s.
Collapse
Affiliation(s)
- C F Robert
- Division of Infectious Diseases, Hôpital Cantonal Universitaire, Geneva, Switzerland
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Gabriel V. [Clinical comments on a vegetable enzyme, a bromelain, in dental surgery]. Rev Assoc Paul Cir Dent 1968; 22:56-60. [PMID: 5245071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|