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Matsiukevich D, Kovacs A, Li T, Kokkonen-Simon K, Matkovich SJ, Oladipupo S, Ornitz DM. Characterization of a robust mouse model of heart failure with preserved ejection fraction. Am J Physiol Heart Circ Physiol 2023. [PMID: 37204871 DOI: 10.1152/ajpheart.00038.2023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/12/2023] [Indexed: 05/21/2023]
Abstract
Heart failure (HF) is a leading cause of morbidity and mortality particularly in older adults and patients with multiple metabolic comorbidities. Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome with multisystem organ dysfunction in which patients develop symptoms of HF as a result of high left ventricular (LV) diastolic pressure in the context of normal or near normal LV ejection fraction (LVEF; ≥50 percent). Challenges to create and reproduce a robust rodent phenotype that recapitulates the multiple comorbidities that exist in this disease explain the presence of various animal models that fail to satisfy all the criteria of HFpEF. Using a continuous infusion of angiotensin II and phenylephrine (AngII/PE), we demonstrate a strong HFpEF phenotype satisfying major clinically relevant manifestations and criteria of this disease, including exercise intolerance, pulmonary edema, concentric myocardial hypertrophy, diastolic dysfunction, histological signs of microvascular impairment, and fibrosis. Conventional echocardiographic analysis of diastolic dysfunction identified early stages of HFpEF development and speckle tracking echocardiography analysis including the left atrium (LA) identified strain abnormalities indicative of contraction-relaxation cycle impairment. Diastolic dysfunction was validated by cardiac catheterization and analysis of LV end diastolic pressure (LVEDP). Among mice that developed HFpEF, two major subgroups were identified with predominantly perivascular fibrosis and interstitial myocardial fibrosis. In addition to major phenotypic criteria of HFpEF that were evident at early stages of this model, accompanying RNAseq data demonstrate activation of pathways associated with myocardial metabolic changes, activation of ECM deposition, microvascular rarefaction, and pressure and volume related myocardial stress.
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Affiliation(s)
- Dzmitry Matsiukevich
- Pediatrics, Dept. of Developmental Biology & Pediatrics, Washington University in St. Louis School of Medicine, St. louis, MO, United States
| | - Attila Kovacs
- Dept. of Medicine, Washington University in St. Louis School of Medicine, St. Louis, United States
| | - Tiandao Li
- Dept. of Developmental Biology, Washington University in St. Louis School of Medicine, United States
| | | | | | | | - David M Ornitz
- Dept. of Developmental Biology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States
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Ademuyiwa FO, Gao F, Street CR, Chen I, Northfelt DW, Wesolowski R, Arora M, Brufsky A, Dees EC, Santa-Maria CA, Connolly RM, Force J, Moreno-Aspitia A, Herndon JM, Carmody M, Davies SR, Larson S, Pfaff KL, Jones SM, Weirather JL, Giobbie-Hurder A, Rodig SJ, Liu Z, Hagemann IS, Sharon E, Gillanders WE. A randomized phase 2 study of neoadjuvant carboplatin and paclitaxel with or without atezolizumab in triple negative breast cancer (TNBC) - NCI 10013. NPJ Breast Cancer 2022; 8:134. [PMID: 36585404 PMCID: PMC9803651 DOI: 10.1038/s41523-022-00500-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 12/13/2022] [Indexed: 12/31/2022] Open
Abstract
Atezolizumab with chemotherapy has shown improved progression-free and overall survival in patients with metastatic PD-L1 positive triple negative breast cancer (TNBC). Atezolizumab with anthracycline- and taxane-based neoadjuvant chemotherapy has also shown increased pathological complete response (pCR) rates in early TNBC. This trial evaluated neoadjuvant carboplatin and paclitaxel with or without atezolizumab in patients with clinical stages II-III TNBC. The co-primary objectives were to evaluate if chemotherapy and atezolizumab increase pCR rate and tumor infiltrating lymphocyte (TIL) percentage compared to chemotherapy alone in the mITT population. Sixty-seven patients (ages 25-78 years; median, 52 years) were randomly assigned - 22 patients to Arm A, and 45 to Arm B. Median follow up was 6.6 months. In the modified intent to treat population (all patients evaluable for the primary endpoints who received at least one dose of combination therapy), the pCR rate was 18.8% (95% CI 4.0-45.6%) in Arm A, and 55.6% (95% CI 40.0-70.4%) in Arm B (estimated treatment difference: 36.8%, 95% CI 8.5-56.6%; p = 0.018). Grade 3 or higher treatment-related adverse events occurred in 62.5% of patients in Arm A, and 57.8% of patients in Arm B. One patient in Arm B died from recurrent disease during the follow-up period. TIL percentage increased slightly from baseline to cycle 1 in both Arm A (mean ± SD: 0.6% ± 21.0%) and Arm B (5.7% ± 15.8%) (p = 0.36). Patients with pCR had higher median TIL percentages (24.8%) than those with non-pCR (14.2%) (p = 0.02). Although subgroup analyses were limited by the small sample size, PD-L1-positive patients treated with chemotherapy and atezolizumab had a pCR rate of 75% (12/16). The addition of atezolizumab to neoadjuvant carboplatin and paclitaxel resulted in a statistically significant and clinically relevant increased pCR rate in patients with clinical stages II and III TNBC. (Funded by National Cancer Institute).
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Affiliation(s)
| | - Feng Gao
- Washington University School of Medicine, St Louis, MO, 63110, USA
| | | | - Ina Chen
- Washington University School of Medicine, St Louis, MO, 63110, USA
| | | | - Robert Wesolowski
- Ohio State University Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Mili Arora
- UC Davis Comprehensive Cancer Center, Sacramento, CA, 95817, USA
| | - Adam Brufsky
- University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - E Claire Dees
- University of North Carolina School of Medicine, Chapel Hill, NC, 27514, USA
| | - Cesar A Santa-Maria
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, 21287, USA
| | | | - Jeremy Force
- Duke University School of Medicine, Durham, NC, 27710, USA
| | | | - John M Herndon
- Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Madelyn Carmody
- Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Sherri R Davies
- Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Sarah Larson
- Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Kathleen L Pfaff
- Cancer Immune Monitoring and Analysis Center, Dana-Farber Cancer Institute, Boston, MA, 02215, USA
| | - Stephanie M Jones
- Cancer Immune Monitoring and Analysis Center, Dana-Farber Cancer Institute, Boston, MA, 02215, USA
| | - Jason L Weirather
- Cancer Immune Monitoring and Analysis Center, Dana-Farber Cancer Institute, Boston, MA, 02215, USA
| | - Anita Giobbie-Hurder
- Cancer Immune Monitoring and Analysis Center, Dana-Farber Cancer Institute, Boston, MA, 02215, USA
| | - Scott J Rodig
- Cancer Immune Monitoring and Analysis Center, Dana-Farber Cancer Institute, Boston, MA, 02215, USA
| | - Zheng Liu
- Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Ian S Hagemann
- Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Elad Sharon
- National Cancer Institute, Bethesda, MD, 20892, USA
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Lalli MA, Langmade JS, Chen X, Fronick CC, Sawyer CS, Burcea LC, Wilkinson MN, Fulton RS, Heinz M, Buchser WJ, Head RD, Mitra RD, Milbrandt J. Rapid and Extraction-Free Detection of SARS-CoV-2 from Saliva by Colorimetric Reverse-Transcription Loop-Mediated Isothermal Amplification. Clin Chem 2021; 67:415-424. [PMID: 33098427 PMCID: PMC7665435 DOI: 10.1093/clinchem/hvaa267] [Citation(s) in RCA: 164] [Impact Index Per Article: 54.7] [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: 08/07/2020] [Accepted: 10/08/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Rapid, reliable, and widespread testing is required to curtail the ongoing COVID-19 pandemic. Current gold-standard nucleic acid tests are hampered by supply shortages in critical reagents including nasal swabs, RNA extraction kits, personal protective equipment, instrumentation, and labor. METHODS To overcome these challenges, we developed a rapid colorimetric assay using reverse-transcription loop-mediated isothermal amplification (RT-LAMP) optimized on human saliva samples without an RNA purification step. We describe the optimization of saliva pretreatment protocols to enable analytically sensitive viral detection by RT-LAMP. We optimized the RT-LAMP reaction conditions and implemented high-throughput unbiased methods for assay interpretation. We tested whether saliva pretreatment could also enable viral detection by conventional reverse-transcription quantitative polymerase chain reaction (RT-qPCR). Finally, we validated these assays on clinical samples. RESULTS The optimized saliva pretreatment protocol enabled analytically sensitive extraction-free detection of SARS-CoV-2 from saliva by colorimetric RT-LAMP or RT-qPCR. In simulated samples, the optimized RT-LAMP assay had a limit of detection of 59 (95% confidence interval: 44-104) particle copies per reaction. We highlighted the flexibility of LAMP assay implementation using 3 readouts: naked-eye colorimetry, spectrophotometry, and real-time fluorescence. In a set of 30 clinical saliva samples, colorimetric RT-LAMP and RT-qPCR assays performed directly on pretreated saliva samples without RNA extraction had accuracies greater than 90%. CONCLUSIONS Rapid and extraction-free detection of SARS-CoV-2 from saliva by colorimetric RT-LAMP is a simple, sensitive, and cost-effective approach with broad potential to expand diagnostic testing for the virus causing COVID-19.
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Affiliation(s)
- Matthew A Lalli
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Joshua S Langmade
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Xuhua Chen
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Catrina C Fronick
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - Christopher S Sawyer
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - Lauren C Burcea
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - Michael N Wilkinson
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Robert S Fulton
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - Michael Heinz
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - William J Buchser
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - Richard D Head
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - Robi D Mitra
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - Jeffrey Milbrandt
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
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