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Bollack A, Collij LE, García DV, Shekari M, Altomare D, Payoux P, Dubois B, Grau‐Rivera O, Boada M, Marquié M, Nordberg A, Walker Z, Scheltens P, Schöll M, Wolz R, Schott JM, Gismondi R, Stephens A, Buckley C, Frisoni GB, Hanseeuw B, Visser PJ, Vandenberghe R, Drzezga A, Yaqub M, Boellaard R, Gispert JD, Markiewicz P, Cash DM, Farrar G, Barkhof F. Investigating reliable amyloid accumulation in Centiloids: Results from the AMYPAD Prognostic and Natural History Study. Alzheimers Dement 2024; 20:3429-3441. [PMID: 38574374 PMCID: PMC11095430 DOI: 10.1002/alz.13761] [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: 10/09/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION To support clinical trial designs focused on early interventions, our study determined reliable early amyloid-β (Aβ) accumulation based on Centiloids (CL) in pre-dementia populations. METHODS A total of 1032 participants from the Amyloid Imaging to Prevent Alzheimer's Disease-Prognostic and Natural History Study (AMYPAD-PNHS) and Insight46 who underwent [18F]flutemetamol, [18F]florbetaben or [18F]florbetapir amyloid-PET were included. A normative strategy was used to define reliable accumulation by estimating the 95th percentile of longitudinal measurements in sub-populations (NPNHS = 101/750, NInsight46 = 35/382) expected to remain stable over time. The baseline CL threshold that optimally predicts future accumulation was investigated using precision-recall analyses. Accumulation rates were examined using linear mixed-effect models. RESULTS Reliable accumulation in the PNHS was estimated to occur at >3.0 CL/year. Baseline CL of 16 [12,19] best predicted future Aβ-accumulators. Rates of amyloid accumulation were tracer-independent, lower for APOE ε4 non-carriers, and for subjects with higher levels of education. DISCUSSION Our results support a 12-20 CL window for inclusion into early secondary prevention studies. Reliable accumulation definition warrants further investigations.
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Affiliation(s)
- Ariane Bollack
- Centre for Medical Image Computing (CMIC)Department of Medical Physics and BioengineeringUniversity College LondonLondonLondonUK
| | - Lyduine E. Collij
- Department of Radiology and Nuclear MedicineAmsterdam UMCAmsterdamThe Netherlands
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityMalmöSweden
- Amsterdam Neuroscience, Brain ImagingVU University AmsterdamAmsterdamThe Netherlands
| | - David Vállez García
- Department of Radiology and Nuclear MedicineAmsterdam UMCAmsterdamThe Netherlands
| | - Mahnaz Shekari
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall FoundationBarcelonaSpain
- Universitat Pompeu FabraBarcelonaSpain
- Instituto de investigaciones médicas Hospital del Mar (IMIM)BarcelonaSpain
| | - Daniele Altomare
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Pierre Payoux
- Department of Nuclear MedicineImaging PoleToulouse University HospitalToulouseFrance
- Toulouse NeuroImaging CenterUniversité de ToulouseInsermUPSCHU PurpanPavillon BaudotPlace du Docteur Joseph BaylacToulouseFrance
| | - Bruno Dubois
- Department of NeurologySalpêtrière HospitalAP‐HPSorbonne UniversityParisFrance
| | - Oriol Grau‐Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall FoundationBarcelonaSpain
| | - Mercè Boada
- Ace Alzheimer Center Barcelona – Universitat Internacional de CatalunyaBarcelonaSpain
- CIBERNEDNetwork Center for Biomedical Research in Neurodegenerative DiseasesNational Institute of Health Carlos IIIMadridSpain
| | - Marta Marquié
- Ace Alzheimer Center Barcelona – Universitat Internacional de CatalunyaBarcelonaSpain
- CIBERNEDNetwork Center for Biomedical Research in Neurodegenerative DiseasesNational Institute of Health Carlos IIIMadridSpain
| | - Agneta Nordberg
- Department of NeurobiologyCare Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska InstitutetStockholmSweden
- Theme Inflammation and Aging, Karolinska University Hospital, Karolinska InstitutetStockholmSweden
| | - Zuzana Walker
- Division of PsychiatryUniversity College LondonLondonUK
- Essex Partnership University NHS Foundation Trust, The LodgeWickfordUK
| | - Philip Scheltens
- Alzheimer Center and Department of NeurologyAmsterdam Neuroscience, VU University Medical Center, Alzheimercentrum AmsterdamAmsterdamThe Netherlands
| | - Michael Schöll
- Wallenberg Centre for Molecular and Translational Medicine, The University of GothenburgGothenburgSweden
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University HospitalGothenburgSweden
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyLondonUK
| | | | - Jonathan M. Schott
- Dementia Research Centre, UCL Queen Square Institute of NeurologyLondonUK
| | | | | | | | - Giovanni B. Frisoni
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Bernard Hanseeuw
- Department of NeurologyInstitute of Neuroscience, Université Catholique de Louvain, Cliniques Universitaires Saint‐LucBrusselsBelgium
- Gordon Center for Medical ImagingDepartment of RadiologyMassachusetts General HospitalBostonMassachusettsUSA
- WELBIO DepartmentWEL Research InstituteWavreBelgium
| | - Pieter Jelle Visser
- Department of Radiology and Nuclear MedicineAmsterdam UMCAmsterdamThe Netherlands
- Department of NeurobiologyCare Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska InstitutetStockholmSweden
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht UniversityMaastrichtThe Netherlands
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, LBI – KU Leuven Brain InstituteLeuvenBelgium
| | - Alexander Drzezga
- Department of Nuclear MedicineUniversity Hospital Cologne, Universitätsklinikums KölnKölnGermany
- Molecular Organization of the Brain, Institute for Neuroscience and Medicine, INM‐2), Forschungszentrum Jülich GmbHJülichGermany
- German Center for Neurodegenerative Diseases (DZNE)BonnGermany
| | - Maqsood Yaqub
- Department of Radiology and Nuclear MedicineAmsterdam UMCAmsterdamThe Netherlands
| | - Ronald Boellaard
- Department of Radiology and Nuclear MedicineAmsterdam UMCAmsterdamThe Netherlands
- Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of GroningenGroningenThe Netherlands
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall FoundationBarcelonaSpain
- Universitat Pompeu FabraBarcelonaSpain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos IIIMadridSpain
| | - Pawel Markiewicz
- Centre for Medical Image Computing (CMIC)Department of Medical Physics and BioengineeringUniversity College LondonLondonLondonUK
- Computer Science and Informatics, School of Engineering, London South Bank UniversityLondonUK
| | - David M. Cash
- Queen Square Institute of Neurology, University College LondonLondonUK
- UK Dementia Research Institute at University College LondonLondonUK
| | | | - Frederik Barkhof
- Centre for Medical Image Computing (CMIC)Department of Medical Physics and BioengineeringUniversity College LondonLondonLondonUK
- Department of Radiology and Nuclear MedicineAmsterdam UMCAmsterdamThe Netherlands
- Queen Square Institute of Neurology, University College LondonLondonUK
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2
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Bischof GN, Brendel M, Barthel H, Theis H, Barbe M, Bartenstein P, Claasen J, Danek A, Höglinger G, Levin J, Marek K, Neumaier B, Palleis C, Patt M, Rullmann M, Saur D, Schroeter ML, Seibyl J, Song M, Stephens A, Sabri O, Drzezga A, van Eimeren T. Improved Tau PET SUVR Quantification in 4-Repeat Tau Phenotypes with [ 18F]PI-2620. J Nucl Med 2024:jnumed.123.265930. [PMID: 38575191 DOI: 10.2967/jnumed.123.265930] [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: 10/17/2023] [Revised: 02/20/2024] [Indexed: 04/06/2024] Open
Abstract
We used a new data-driven methodology to identify a set of reference regions that enhanced the quantification of the SUV ratio of the second-generation tau tracer 2-(2-([18F]fluoro)pyridin-4-yl)-9H-pyrrolo[2,3-b:4,5-c']dipyridine ([18F]PI-2620) in a group of patients clinically diagnosed with 4-repeat tauopathy, specifically progressive supranuclear palsy or cortical basal syndrome. The study found that SUV ratios calculated using the identified reference regions (i.e., fusiform gyrus and crus-cerebellum) were significantly associated with symptom severity and disease duration. This establishes, for the first time to our knowledge, the suitability of [18F]PI-2620 for tracking disease progression in this 4-repeat disease population. This is an important step toward increased clinical utility, such as patient stratification and monitoring in disease-modifying treatment trials. Additionally, the applied methodology successfully optimized reference regions for automated detection of brain imaging tracers. This approach may also hold value for other brain imaging tracers.
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Affiliation(s)
- Gérard N Bischof
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany;
- Molecular Organization of the Brain, Institute for Neuroscience and Medicine, Jülich, Germany
| | - Matthias Brendel
- German Center for Neurodegenerative Diseases, Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Hendrik Theis
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael Barbe
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Peter Bartenstein
- Munich Cluster for Systems Neurology, Munich, Germany
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Joseph Claasen
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Adrian Danek
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Günter Höglinger
- German Center for Neurodegenerative Diseases, Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Johannes Levin
- German Center for Neurodegenerative Diseases, Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Ken Marek
- InviCRO, LLC, Boston, Massachusetts
- Molecular Neuroimaging, a division of inviCRO, New Haven, Connecticut
| | - Bernd Neumaier
- Institute of Radiochemistry and Experimental Molecular Imaging, University of Cologne, Cologne, Germany
- Institute of Neuroscience and Medicine, Nuclear Chemistry, Research Center Jülich, Jülich, Germany
| | - Carla Palleis
- German Center for Neurodegenerative Diseases, Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Michael Rullmann
- Clinic for Cognitive Neurology, University Hospital of Leipzig, and Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Dorothee Saur
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Matthias L Schroeter
- Clinic for Cognitive Neurology, University Hospital of Leipzig, and Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - John Seibyl
- InviCRO, LLC, Boston, Massachusetts
- Molecular Neuroimaging, a division of inviCRO, New Haven, Connecticut
| | - Mengmeng Song
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | | | - Osama Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
- Molecular Organization of the Brain, Institute for Neuroscience and Medicine, Jülich, Germany
- German Center for Neurodegenerative Diseases, Bonn/Cologne, Germany
| | - Thilo van Eimeren
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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3
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Le Tran N, Wang Y, Bilandzic M, Stephens A, Nie G. Podocalyxin promotes the formation of compact and chemoresistant cancer spheroids in high grade serous carcinoma. Sci Rep 2024; 14:7539. [PMID: 38553472 PMCID: PMC10980795 DOI: 10.1038/s41598-024-57053-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/13/2024] [Indexed: 04/01/2024] Open
Abstract
High grade serous carcinoma (HGSC) metastasises primarily intraperitoneally via cancer spheroids. Podocalyxin (PODXL), an anti-adhesive transmembrane protein, has been reported to promote cancer survival against chemotherapy, however its role in HGSC chemoresistance is unclear. This study investigated whether PODXL plays a role in promoting chemoresistance of HGSC spheroids. We first showed that PODXL was expressed variably in HGSC patient tissues (n = 17) as well as in ovarian cancer cell lines (n = 28) that are more likely categorised as HGSC. We next demonstrated that PODXL-knockout (KO) cells proliferated more slowly, formed less compact spheroids and were more fragile than control cells. Furthermore, when treated with carboplatin and examined for post-treatment recovery, PODXL-KO spheroids showed significantly poorer cell viability, lower number of live cells, and less Ki-67 staining than controls. A similar trend was also observed in ascites-derived primary HGSC cells (n = 6)-spheroids expressing lower PODXL formed looser spheroids, were more vulnerable to fragmentation and more sensitive to carboplatin than spheroids with higher PODXL. Our studies thus suggests that PODXL plays an important role in promoting the formation of compact/hardy HGSC spheroids which are more resilient to chemotherapy drugs; these characteristics may contribute to the chemoresistant nature of HGSC.
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Affiliation(s)
- Ngoc Le Tran
- Implantation and Pregnancy Research Laboratory, School of Health and Biomedical Sciences, RMIT University, Bundoora West Campus, Bundoora, VIC, 3083, Australia
| | - Yao Wang
- Implantation and Pregnancy Research Laboratory, School of Health and Biomedical Sciences, RMIT University, Bundoora West Campus, Bundoora, VIC, 3083, Australia
| | - Maree Bilandzic
- Hudson Institute of Medical Research, Clayton, VIC, 3168, Australia
- Department of Molecular and Translational Sciences, Monash University, Clayton, VIC, 3168, Australia
| | - Andrew Stephens
- Hudson Institute of Medical Research, Clayton, VIC, 3168, Australia
- Department of Molecular and Translational Sciences, Monash University, Clayton, VIC, 3168, Australia
| | - Guiying Nie
- Implantation and Pregnancy Research Laboratory, School of Health and Biomedical Sciences, RMIT University, Bundoora West Campus, Bundoora, VIC, 3083, Australia.
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4
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Ferschmann C, Messerschmidt K, Gnörich J, Barthel H, Marek K, Palleis C, Katzdobler S, Stockbauer A, Fietzek U, Finze A, Biechele G, Rumpf JJ, Saur D, Schroeter ML, Rullmann M, Beyer L, Eckenweber F, Wall S, Schildan A, Patt M, Stephens A, Classen J, Bartenstein P, Seibyl J, Franzmeier N, Levin J, Höglinger GU, Sabri O, Brendel M, Scheifele M. Tau accumulation is associated with dopamine deficiency in vivo in four-repeat tauopathies. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06637-6. [PMID: 38366196 DOI: 10.1007/s00259-024-06637-6] [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: 07/11/2023] [Accepted: 02/04/2024] [Indexed: 02/18/2024]
Abstract
PURPOSE We hypothesized that severe tau burden in brain regions involved in direct or indirect pathways of the basal ganglia correlate with more severe striatal dopamine deficiency in four-repeat (4R) tauopathies. Therefore, we correlated [18F]PI-2620 tau-positron-emission-tomography (PET) imaging with [123I]-Ioflupane single-photon-emission-computed tomography (SPECT) for dopamine transporter (DaT) availability. METHODS Thirty-eight patients with clinically diagnosed 4R-tauopathies (21 male; 69.0 ± 8.5 years) and 15 patients with clinically diagnosed α-synucleinopathies (8 male; 66.1 ± 10.3 years) who underwent [18F]PI-2620 tau-PET and DaT-SPECT imaging with a time gap of 3 ± 5 months were evaluated. Regional Tau-PET signals and DaT availability as well as their principal components were correlated in patients with 4R-tauopathies and α-synucleinopathies. Both biomarkers and the residuals of their association were correlated with clinical severity scores in 4R-tauopathies. RESULTS In patients with 4R-tauopathies, [18F]PI-2620 binding in basal ganglia and midbrain regions was negatively associated with striatal DaT availability (i.e. globus pallidus internus and putamen (β = - 0.464, p = 0.006, Durbin-Watson statistics = 1.824) in a multiple regression model. Contrarily, [18F]PI-2620 binding in the dentate nucleus showed no significant regression factor with DaT availability in the striatum (β = 0.078, p = 0.662, Durbin-Watson statistics = 1.686). Patients with α-synucleinopathies did not indicate any regional associations between [18F]PI-2620-binding and DaT availability. Higher DaT-SPECT binding relative to tau burden was associated with better clinical performance (β = - 0.522, p = 0.011, Durbin-Watson statistics = 2.663) in patients with 4R-tauopathies. CONCLUSION Tau burden in brain regions involved in dopaminergic pathways is associated with aggravated dopaminergic dysfunction in patients with clinically diagnosed primary tauopathies. The ability to sustain dopamine transmission despite tau accumulation may preserve motor function.
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Affiliation(s)
- Christian Ferschmann
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | | | - Johannes Gnörich
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Ken Marek
- InviCRO, LLC, Boston, MA, USA
- Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA
| | - Carla Palleis
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Sabrina Katzdobler
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Anna Stockbauer
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Urban Fietzek
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Anika Finze
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Gloria Biechele
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Jost-Julian Rumpf
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Dorothee Saur
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Matthias L Schroeter
- Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Michael Rullmann
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Florian Eckenweber
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Stephan Wall
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Andreas Schildan
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | | | - Joseph Classen
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - John Seibyl
- InviCRO, LLC, Boston, MA, USA
- Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA
| | - Nicolai Franzmeier
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Institute for Stroke and Dementia Research, LMU University Hospital, LMU Munich, Munich, Germany
| | - Johannes Levin
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Günter U Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Maximilian Scheifele
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
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5
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Fernández R, Soza-Ried C, Iagaru A, Stephens A, Müller A, Schieferstein H, Sandoval C, Amaral H, Kramer V. Imaging GRPr Expression in Metastatic Castration-Resistant Prostate Cancer with [ 68Ga]Ga-RM2-A Head-to-Head Pilot Comparison with [ 68Ga]Ga-PSMA-11. Cancers (Basel) 2023; 16:173. [PMID: 38201600 PMCID: PMC10778208 DOI: 10.3390/cancers16010173] [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: 11/08/2023] [Revised: 12/18/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND The gastrin-releasing peptide receptor (GRPr) is highly overexpressed in several solid tumors, including treatment-naïve and recurrent prostate cancer. [68Ga]Ga-RM2 is a well-established radiotracer for PET imaging of GRPr, and [177Lu]Lu-RM2 has been proposed as a therapeutic alternative for patients with heterogeneous and/or low expression of PSMA. In this study, we aimed to evaluate the expression of GRPr and PSMA in a group of patients diagnosed with castration-resistant prostate cancer (mCRPC) by means of PET imaging. METHODS Seventeen mCRPC patients referred for radio-ligand therapy (RLT) were enrolled and underwent [68Ga]Ga-PSMA-11 and [68Ga]Ga-RM2 PET/CT imaging, 8.8 ± 8.6 days apart, to compare the biodistribution of each tracer. Uptake in healthy organs and tumor lesions was assessed by SUV values, and tumor-to-background ratios were analyzed. RESULTS [68Ga]Ga-PSMA-11 showed significantly higher uptake in tumor lesions in bone, lymph nodes, prostate, and soft tissues and detected 23% more lesions compared to [68Ga]Ga-RM2. In 4/17 patients (23.5%), the biodistribution of both tracers was comparable. CONCLUSIONS Our results show that in our cohort of mCRPC patients, PSMA expression was higher compared to GRPr. Nevertheless, RLT with [177Lu]Lu-RM2 may be an alternative treatment option for selected patients or patients in earlier disease stages, such as biochemical recurrence.
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Affiliation(s)
- René Fernández
- Nuclear Medicine and PET/CT Center PositronMed, Providencia, Santiago 7501068, Chile; (C.S.-R.); (H.A.); (V.K.)
| | - Cristian Soza-Ried
- Nuclear Medicine and PET/CT Center PositronMed, Providencia, Santiago 7501068, Chile; (C.S.-R.); (H.A.); (V.K.)
- Positronpharma SA, Providencia, Santiago 7501068, Chile
| | - Andrei Iagaru
- Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Stanford University, Stanford, CA 94305, USA;
| | - Andrew Stephens
- Life Molecular Imaging GmbH, 13353 Berlin, Germany; (A.S.); (A.M.)
| | - Andre Müller
- Life Molecular Imaging GmbH, 13353 Berlin, Germany; (A.S.); (A.M.)
| | - Hanno Schieferstein
- Formerly Piramal Imaging GmbH, 13353 Berlin, Germany;
- Merck Healthcare KGaA, 64293 Darmstadt, Germany
| | - Camilo Sandoval
- Fundación Arturo López Pérez, Providencia, Santiago 750069, Chile;
| | - Horacio Amaral
- Nuclear Medicine and PET/CT Center PositronMed, Providencia, Santiago 7501068, Chile; (C.S.-R.); (H.A.); (V.K.)
- Positronpharma SA, Providencia, Santiago 7501068, Chile
| | - Vasko Kramer
- Nuclear Medicine and PET/CT Center PositronMed, Providencia, Santiago 7501068, Chile; (C.S.-R.); (H.A.); (V.K.)
- Positronpharma SA, Providencia, Santiago 7501068, Chile
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6
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Bader I, Bader I, Lopes Alves I, Vállez García D, Vellas B, Dubois B, Boada M, Marquié M, Altomare D, Scheltens P, Vandenberghe R, Hanseeuw B, Schöll M, Frisoni GB, Jessen F, Nordberg A, Kivipelto M, Ritchie CW, Grau-Rivera O, Molinuevo JL, Ford L, Stephens A, Gismondi R, Gispert JD, Farrar G, Barkhof F, Visser PJ, Collij LE. Recruitment of pre-dementia participants: main enrollment barriers in a longitudinal amyloid-PET study. Alzheimers Res Ther 2023; 15:189. [PMID: 37919783 PMCID: PMC10621165 DOI: 10.1186/s13195-023-01332-4] [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: 05/30/2023] [Accepted: 10/13/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND The mismatch between the limited availability versus the high demand of participants who are in the pre-dementia phase of Alzheimer's disease (AD) is a bottleneck for clinical studies in AD. Nevertheless, potential enrollment barriers in the pre-dementia population are relatively under-reported. In a large European longitudinal biomarker study (the AMYPAD-PNHS), we investigated main enrollment barriers in individuals with no or mild symptoms recruited from research and clinical parent cohorts (PCs) of ongoing observational studies. METHODS Logistic regression was used to predict study refusal based on sex, age, education, global cognition (MMSE), family history of dementia, and number of prior study visits. Study refusal rates and categorized enrollment barriers were compared between PCs using chi-squared tests. RESULTS 535/1856 (28.8%) of the participants recruited from ongoing studies declined participation in the AMYPAD-PNHS. Only for participants recruited from clinical PCs (n = 243), a higher MMSE-score (β = - 0.22, OR = 0.80, p < .05), more prior study visits (β = - 0.93, OR = 0.40, p < .001), and positive family history of dementia (β = 2.08, OR = 8.02, p < .01) resulted in lower odds on study refusal. General study burden was the main enrollment barrier (36.1%), followed by amyloid-PET related burden (PCresearch = 27.4%, PCclinical = 9.0%, X2 = 10.56, p = .001), and loss of research interest (PCclinical = 46.3%, PCresearch = 16.5%, X2 = 32.34, p < .001). CONCLUSIONS The enrollment rate for the AMYPAD-PNHS was relatively high, suggesting an advantage of recruitment via ongoing studies. In this observational cohort, study burden reduction and tailored strategies may potentially improve participant enrollment into trial readiness cohorts such as for phase-3 early anti-amyloid intervention trials. The AMYPAD-PNHS (EudraCT: 2018-002277-22) was approved by the ethical review board of the VU Medical Center (VUmc) as the Sponsor site and in every affiliated site.
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Affiliation(s)
- Ilse Bader
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, 1081 HV, Amsterdam, The Netherlands.
| | - Ilona Bader
- Radiology & Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, 1081 HV, The Netherlands
| | - Isadora Lopes Alves
- Radiology & Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, 1081 HV, The Netherlands
- Brain Research Center, 1081 GN, Amsterdam, The Netherlands
| | - David Vállez García
- Radiology & Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, 1081 HV, The Netherlands
| | - Bruno Vellas
- Gérontopole of Toulouse, University Hospital of Toulouse (CHU-Toulouse), 31300, Toulouse, France
- UMR INSERM 1027, University of Toulouse III, 31062, Toulouse, France
| | - Bruno Dubois
- Institute of Memory and Alzheimer's Disease (IM2A) and Brain Institute, Salpetriere Hospital, Sorbonne University, 75013, Paris, France
| | - Mercè Boada
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Marta Marquié
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Daniele Altomare
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, 25123, Brescia, Italy
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, 1081 HV, Amsterdam, The Netherlands
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Leuven Brain Institute, KU Leuven, 3001, Louvain, Belgium
| | - Bernard Hanseeuw
- Institute of Neuroscience, Université Catholique de Louvain, 1200, Brussels, Belgium
- Department of Neurology, Clinique Universitaires Saint-Luc, 1200, Brussels, Belgium
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02155, USA
- WELBIO Department, WEL Research Institute, Avenue Pasteur, 6, 1300, Wavre, Belgium
| | - Michael Schöll
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, 405 30, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30, Gothenburg, Sweden
- Dementia Research Centre, Queen Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, 1205, Geneva, Switzerland
- Geneva Memory Center, Geneva University Hospitals, 1205, Geneva, Switzerland
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), 53127, Bonn, Germany
| | - Agneta Nordberg
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, 171 77, Stockholm, Sweden
- Theme Inflammation, Karolinska University Hospital, Stockholm, 171 77, Sweden
- Theme Aging, Karolinska University Hospital, Stockholm, 171 77, Sweden
| | - Miia Kivipelto
- Kuopio University Hospital, 70210, Kuopio, Finland
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, 171 77, Stockholm, Sweden
- Imperial College London, London, SW7 2AZ, UK
| | | | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, 08005, Barcelona, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, 08005, Barcelona, Spain
- H. Lundbeck A/S, 2500, Copenhagen, Denmark
| | - Lisa Ford
- Janssen Research and Development, Titusville, NJ, 08560, USA
| | | | | | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, 08005, Barcelona, Spain
| | - Gill Farrar
- GE Healthcare, Pharmaceutical Diagnostics, Amersham, HP7 9LL, UK
| | - Frederik Barkhof
- Radiology & Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, 1081 HV, The Netherlands
- Institutes of Neurology and Healthcare Engineering, UCL, London, WC1N 3BG, UK
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, 1081 HV, Amsterdam, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, 6229 ER, The Netherlands
| | - Lyduine E Collij
- Radiology & Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, 1081 HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, 1081 HV, The Netherlands
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, 221 00, Malmö, Sweden
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Stephens A, Pham D, No HJ, Raja N, Lozko Y, Binkley MS, Vitzthum L. Comparison of Plan Quality Metrics after Left Anterior Descending Coronary Artery Sparing in VMAT Esophageal Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e706. [PMID: 37786067 DOI: 10.1016/j.ijrobp.2023.06.2197] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Cardiotoxicity is a significant late effect of esophageal radiotherapy (RT). Mean heart dose has been implicated with major adverse cardiac events (MACE) and emerging evidence increases MACE association with left anterior descending (LAD) coronary artery specific dose. This retrospective planning study investigates the dosimetric impact of including the LAD as an OAR-sparing objective for VMAT-based plan optimization in patients previously treated for esophageal cancers. MATERIALS/METHODS A retrospective cohort was identified of patients who underwent neoadjuvant RT for esophageal cancers between 2017-2020 without intentional LAD sparing. Treatment planning was performed using Eclipse™ treatment planning system. Doses were calculated using Acuros® XB algorithm or anisotropic analytical algorithm with a 2-2.5mm calculation grid. For each patient, the LAD was delineated and the treated VMAT plan was re-optimized to reduce the dose to the LAD receiving 15 Gy to less than 10%, when possible. Re-plans were performed such that 95% of the PTV received the prescription dose. Institutional constraints were used to minimize the dose to the heart, lung, and spinal cord (Table 1). A paired t-test was used to compare the dose between the original VMAT plan used for treatment (Esophagus Original) against those re-optimized (Esophagus + LAD), with significance of p<0.05. RESULTS A total of 19 patients were identified. Of those treated, 12 of 19 original plans (63%) exceeded the LAD constraint (V15<10%) with a mean V15 Gy of 47.1%. Plan re-optimization accounting for the LAD allowed for 66.7% (9/12) of cases to meet LAD V15 constraints. Aside from increased sparing of the mean heart dose, there were no statistically significant impacts on target coverage and OAR doses otherwise, including to that of the lung and spinal cord (Table 1). CONCLUSION Accounting for LAD dose in treatment planning may help reduce future MACE risks. LAD dose can be significantly reduced without compromising PTV coverage or having significant effects on other OAR dose sparing.
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Affiliation(s)
- A Stephens
- Stanford Health Care, Palo Alto, CA; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - D Pham
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - H J No
- University of Vermont, Burlington, VT
| | - N Raja
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - Y Lozko
- Stanford Cancer Institute Palo Alto, Palo Alto, CA
| | - M S Binkley
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Vitzthum
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Villemagne VL, Leuzy A, Bohorquez SS, Bullich S, Shimada H, Rowe CC, Bourgeat P, Lopresti B, Huang K, Krishnadas N, Fripp J, Takado Y, Gogola A, Minhas D, Weimer R, Higuchi M, Stephens A, Hansson O, Doré V. CenTauR: Toward a universal scale and masks for standardizing tau imaging studies. Alzheimers Dement (Amst) 2023; 15:e12454. [PMID: 37424964 PMCID: PMC10326476 DOI: 10.1002/dad2.12454] [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] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/26/2023] [Accepted: 05/26/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION Recently, an increasing number of tau tracers have become available. There is a need to standardize quantitative tau measures across tracers, supporting a universal scale. We developed several cortical tau masks and applied them to generate a tau imaging universal scale. METHOD One thousand forty-five participants underwent tau scans with either 18F-flortaucipir, 18F-MK6240, 18F-PI2620, 18F-PM-PBB3, 18F-GTP1, or 18F-RO948. The universal mask was generated from cognitively unimpaired amyloid beta (Aβ)- subjects and Alzheimer's disease (AD) patients with Aβ+. Four additional regional cortical masks were defined within the constraints of the universal mask. A universal scale, the CenTauRz, was constructed. RESULTS None of the regions known to display off-target signal were included in the masks. The CenTauRz allows robust discrimination between low and high levels of tau deposits. DISCUSSION We constructed several tau-specific cortical masks for the AD continuum and a universal standard scale designed to capture the location and degree of abnormality that can be applied across tracers and across centers. The masks are freely available at https://www.gaain.org/centaur-project.
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Affiliation(s)
- Victor L. Villemagne
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Molecular Imaging & TherapyAustin HealthMelbourneVictoriaAustralia
| | - Antoine Leuzy
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityMalmöSweden
| | | | | | - Hitoshi Shimada
- Department of Functional Brain ImagingNational Institutes for Quantum and Radiological Science and TechnologyChibaJapan
- Brain Research InstituteNiigata UniversityNiigataJapan
| | - Christopher C. Rowe
- Department of Molecular Imaging & TherapyAustin HealthMelbourneVictoriaAustralia
- Florey Department of Neurosciences & Mental HealthThe University of MelbourneMelbourneParkvilleAustralia
- The Australian Dementia Network (ADNeT)MelbourneVictoriaAustralia
| | - Pierrick Bourgeat
- Health and Biosecurity FlagshipThe Australian eHealth Research CentreCSIROBrisbaneQueenslandAustralia
| | - Brian Lopresti
- Department of RadiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Kun Huang
- Department of Molecular Imaging & TherapyAustin HealthMelbourneVictoriaAustralia
| | - Natasha Krishnadas
- Department of Molecular Imaging & TherapyAustin HealthMelbourneVictoriaAustralia
- Florey Institute of Neurosciences & Mental HealthParkvilleVictoriaAustralia
| | - Jurgen Fripp
- Health and Biosecurity FlagshipThe Australian eHealth Research CentreCSIROBrisbaneQueenslandAustralia
| | - Yuhei Takado
- Department of Functional Brain ImagingNational Institutes for Quantum and Radiological Science and TechnologyChibaJapan
| | - Alexandra Gogola
- Department of RadiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Davneet Minhas
- Department of RadiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | | - Makoto Higuchi
- Department of Functional Brain ImagingNational Institutes for Quantum and Radiological Science and TechnologyChibaJapan
| | | | - Oskar Hansson
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityMalmöSweden
- Memory ClinicSkåne University HospitalMalmöSweden
| | - Vincent Doré
- Department of Molecular Imaging & TherapyAustin HealthMelbourneVictoriaAustralia
- Health and Biosecurity FlagshipThe Australian eHealth Research CentreCSIROHeidelbergVictoriaAustralia
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9
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Su SH, Song Y, Stephens A, Situ M, McCloskey MC, McGrath JL, Andjelkovic AV, Singer BH, Kurabayashi K. A tissue chip with integrated digital immunosensors: In situ brain endothelial barrier cytokine secretion monitoring. Biosens Bioelectron 2023; 224:115030. [PMID: 36603283 PMCID: PMC10401069 DOI: 10.1016/j.bios.2022.115030] [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: 10/29/2022] [Revised: 12/08/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
Organ-on-a-chip platforms have potential to offer more cost-effective, ethical, and human-resembling models than animal models for disease study and drug discovery. Particularly, the Blood-Brain-Barrier-on-a-chip (BBB-oC) has emerged as a promising tool to investigate several neurological disorders since it promises to provide a model of the multifunctional tissue working as an important node to control pathogen entry, drug delivery and neuroinflammation. A comprehensive understanding of the multiple physiological functions of the tissue model requires biosensors detecting several tissue-secreted substances in a BBB-oC system. However, current sensor-integrated BBB-oC platforms are only available for tissue membrane integrity characterization based on permeability measurement. Protein secretory pathways are closely associated with the tissue's various diseased conditions. At present, no biosensor-integrated BBB-oC platform exists that permits in situ tissue protein secretion analysis over time, which prohibits researchers from fully understanding the time-evolving pathology of a tissue barrier. Herein, the authors present a platform named "Digital Tissue-BArrier-CytoKine-counting-on-a-chip (DigiTACK)," which integrates digital immunosensors into a tissue chip system and demonstrates on-chip multiplexed, ultrasensitive, longitudinal cytokine secretion profiling of cultured brain endothelial barrier tissues. The integrated digital sensors utilize a novel beadless microwell format to perform an ultrafast "digital fingerprinting" of the analytes while achieving a low limit of detection (LoD) around 100-500 fg/mL for mouse MCP1 (CCL2), IL-6 and KC (CXCL1). The DigiTACK platform is extensively applicable to profile temporal cytokine secretion of other barrier-related organ-on-a-chip systems and can provide new insight into the secretory dynamics of the BBB by sequentially controlled experiments.
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Affiliation(s)
- Shiuan-Haur Su
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Yujing Song
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Andrew Stephens
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Muyu Situ
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Molly C McCloskey
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, 14627, USA
| | - James L McGrath
- Department of Biomedical Engineering, University of Rochester, Rochester, NY, 14627, USA
| | - Anuska V Andjelkovic
- Department of Pathology and Neurosurgery, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Benjamin H Singer
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, 48109, USA; Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, MI, 48109, USA.
| | - Katsuo Kurabayashi
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA; Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, 48109, USA; Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, MI, 48109, USA.
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10
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Haque F, Ryde J, Broughton L, Huang C, Sethi S, Stephens A, Pillai A, Mirza S, Brown V, Avery G, Bozas G, Maraveyas A. Validation of the HULL Score clinical prediction rule (CPR) for unsuspected pulmonary embolism in ambulatory cancer patients. ERJ Open Res 2023; 9:00651-2022. [PMID: 37143830 PMCID: PMC10152252 DOI: 10.1183/23120541.00651-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 01/25/2023] [Indexed: 02/05/2023] Open
Abstract
BackgroundClinical prediction rules (CPRs) developed to predict adverse outcomes of suspected pulmonary embolism (PE) and facilitate outpatient management have limitations in discriminating outcomes for ambulatory cancer patients with unsuspected PE (UPE). The HULL Score CPR uses a 5-point scoring system incorporating performance status (PS) and self-reported new or recently evolving symptoms at UPE diagnosis. It stratifies patients into low, intermediate and high risk for proximate mortality.AimThis study aimed validation of the HULL Score CPR in ambulatory cancer patients with UPE.Patients and methods282 consecutive patients managed under the UPE-acute oncology service in Hull University Teaching Hospitals NHS Trust were included from January 2015 to March 2020. The primary endpoint was all-cause mortality, and outcome measures were proximate mortality for the three risk categories of the Hull Score CPR.Results30-day, 90-day and 180-day mortality for the whole cohort was 3.4% (n=7), 21.1% (n=43) and 39.2% (n= 80), respectively. The HULL Score CPR stratified patients into low 35.5% (100), intermediate 33.7% (95) and high 28.7% (81) risk groups. Correlation of the risk categories with 30-day, 90-day, 180-day mortality and OS was consistent with the derivation cohort (area under the curve [AUC] 0.717 [95% CI 0.522, 0.912], AUC 0.772 [95% CI 0.707, 0.838], AUC 0.751 [95% CI 0.692, 0.809], AUC 0.749 [95% CI 0.686, 0.811], respectively).ConclusionThis study validates the capacity of the HULL Score CPR to stratify proximate mortality risk in ambulatory cancer patients with UPE. The score uses immediately available clinical parameters and is easy to integrate into an acute outpatient oncology setting.
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Davis M, Stephens A, Morrison C, Majdalany S, Affas R, Arora S, Corsi N, Rakic I, Sood A, Rogers C, Abdollah F. Racial disparities in future development of lethal prostate cancer based on PSA levels in midlife. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01236-8] [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: 02/12/2023]
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Davis M, Stephens A, Morrison C, Majdalany S, Affas R, Arora S, Corsi N, Rakic I, Sood A, Rogers C, Abdollah F. Baseline PSA levels in midlife & future development of lethal prostate cancer: A diverse North American cohort analysis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00307-x] [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: 02/12/2023]
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13
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Rakic I, Davis M, Corsi N, Stephens A, Arora S, Rakic N, Morrison C, Malchow T, Affas R, Sood A, Rogers C, Abdollah F. Evaluating the role of lymphvascular invasion as an indicator for adverse outcomes for patients with upper tract urothelial carcinoma and its histological subtypes. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00960-0] [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: 02/12/2023]
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14
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Corsi N, Stephens A, Malchow T, Piontkowski A, Corsi M, Davis M, Arora S, Rakic I, Morrison C, Autorino R, Sood A, Rogers C, Abdollah F. Testing the external validity of the pout III trial (adjuvant platnium-based chemotherapy in upper tract urothelial carcinoma) in a North American cohort. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00558-4] [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: 02/12/2023]
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Collij LE, Farrar G, Valléz García D, Bader I, Shekari M, Lorenzini L, Pemberton H, Altomare D, Pla S, Loor M, Markiewicz P, Yaqub M, Buckley C, Frisoni GB, Nordberg A, Payoux P, Stephens A, Gismondi R, Visser PJ, Ford L, Schmidt M, Birck C, Georges J, Mett A, Walker Z, Boada M, Drzezga A, Vandenberghe R, Hanseeuw B, Jessen F, Schöll M, Ritchie C, Lopes Alves I, Gispert JD, Barkhof F. The amyloid imaging for the prevention of Alzheimer's disease consortium: A European collaboration with global impact. Front Neurol 2023; 13:1063598. [PMID: 36761917 PMCID: PMC9907029 DOI: 10.3389/fneur.2022.1063598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/08/2022] [Indexed: 01/22/2023] Open
Abstract
Background Amyloid-β (Aβ) accumulation is considered the earliest pathological change in Alzheimer's disease (AD). The Amyloid Imaging to Prevent Alzheimer's Disease (AMYPAD) consortium is a collaborative European framework across European Federation of Pharmaceutical Industries Associations (EFPIA), academic, and 'Small and Medium-sized enterprises' (SME) partners aiming to provide evidence on the clinical utility and cost-effectiveness of Positron Emission Tomography (PET) imaging in diagnostic work-up of AD and to support clinical trial design by developing optimal quantitative methodology in an early AD population. The AMYPAD studies In the Diagnostic and Patient Management Study (DPMS), 844 participants from eight centres across three clinical subgroups (245 subjective cognitive decline, 342 mild cognitive impairment, and 258 dementia) were included. The Prognostic and Natural History Study (PNHS) recruited pre-dementia subjects across 11 European parent cohorts (PCs). Approximately 1600 unique subjects with historical and prospective data were collected within this study. PET acquisition with [18F]flutemetamol or [18F]florbetaben radiotracers was performed and quantified using the Centiloid (CL) method. Results AMYPAD has significantly contributed to the AD field by furthering our understanding of amyloid deposition in the brain and the optimal methodology to measure this process. Main contributions so far include the validation of the dual-time window acquisition protocol to derive the fully quantitative non-displaceable binding potential (BP ND ), assess the value of this metric in the context of clinical trials, improve PET-sensitivity to emerging Aβ burden and utilize its available regional information, establish the quantitative accuracy of the Centiloid method across tracers and support implementation of quantitative amyloid-PET measures in the clinical routine. Future steps The AMYPAD consortium has succeeded in recruiting and following a large number of prospective subjects and setting up a collaborative framework to integrate data across European PCs. Efforts are currently ongoing in collaboration with ARIDHIA and ADDI to harmonize, integrate, and curate all available clinical data from the PNHS PCs, which will become openly accessible to the wider scientific community.
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Affiliation(s)
- Lyduine E. Collij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, location VUmc, Amsterdam, Netherlands,Amsterdam Neuroscience, Brain Imaging, Amsterdam, Netherlands,*Correspondence: Lyduine E. Collij ✉
| | | | - David Valléz García
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, location VUmc, Amsterdam, Netherlands,Amsterdam Neuroscience, Brain Imaging, Amsterdam, Netherlands
| | - Ilona Bader
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, location VUmc, Amsterdam, Netherlands,Amsterdam Neuroscience, Brain Imaging, Amsterdam, Netherlands
| | | | - Luigi Lorenzini
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, location VUmc, Amsterdam, Netherlands,Amsterdam Neuroscience, Brain Imaging, Amsterdam, Netherlands
| | - Hugh Pemberton
- Centre for Medical Image Computing, and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Daniele Altomare
- Laboratory of Neuroimaging of Aging (LANVIE), Université de Genève, Geneva, Switzerland
| | - Sandra Pla
- Synapse Research Management Partners, Barcelona, Spain
| | - Mery Loor
- Synapse Research Management Partners, Barcelona, Spain
| | - Pawel Markiewicz
- Centre for Medical Image Computing, and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Maqsood Yaqub
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, location VUmc, Amsterdam, Netherlands
| | | | - Giovanni B. Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), Université de Genève, Geneva, Switzerland
| | - Agneta Nordberg
- Department of Neurobiology, Care Sciences and Society, Center of Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Pierre Payoux
- Department of Nuclear Medicine, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Andrew Stephens
- Life Molecular Imaging GmbH, Berlin, Baden-Württemberg, Germany
| | | | - Pieter Jelle Visser
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, location VUmc, Amsterdam, Netherlands
| | - Lisa Ford
- Janssen Pharmaceutica NV, Beerse, Belgium
| | | | | | | | - Anja Mett
- GE Healthcare, Amersham, United Kingdom
| | - Zuzana Walker
- Centre for Medical Image Computing, and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Mercé Boada
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Alexander Drzezga
- Department of Psychiatry, University Hospital of Cologne, Cologne, North Rhine-Westphalia, Germany
| | - Rik Vandenberghe
- Faculty of Medicine, University Hospitals Leuven, Leuven, Brussels, Belgium
| | - Bernard Hanseeuw
- Institute of Neuroscience (IONS), Université Catholique de Louvain, Brussels, Belgium
| | - Frank Jessen
- Department of Psychiatry, University Hospital of Cologne, Cologne, North Rhine-Westphalia, Germany
| | - Michael Schöll
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Craig Ritchie
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | | | - Juan Domingo Gispert
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, location VUmc, Amsterdam, Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, location VUmc, Amsterdam, Netherlands,Amsterdam Neuroscience, Brain Imaging, Amsterdam, Netherlands,Centre for Medical Image Computing, and Queen Square Institute of Neurology, UCL, London, United Kingdom
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Collij LE, Salvadó G, de Wilde A, Altomare D, Shekari M, Gispert JD, Bullich S, Stephens A, Barkhof F, Scheltens P, Bouwman F, van der Flier WM. Quantification of [
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F]florbetaben amyloid‐PET imaging in a mixed memory clinic population: The ABIDE project. Alzheimers Dement 2022. [DOI: 10.1002/alz.12886] [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] [Received: 07/06/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Lyduine E. Collij
- Department of Radiology and Nuclear Medicine Amsterdam University Medical Center Amsterdam Neuroscience Amsterdam The Netherlands
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
- Clinical Memory Research Unit Department of Clinical Sciences Lund University Malmö Sweden
| | - Arno de Wilde
- Department of Neurology Alzheimer Center Amsterdam Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam The Netherlands
| | - Daniele Altomare
- Laboratory of Neuroimaging of Aging (LANVIE) University of Geneva Geneva Switzerland
- Memory Center Geneva University Hospitals Geneva Switzerland
| | - Mahnaz Shekari
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
- IMIM (Hospital del Mar Medical Research Institute) Barcelona Spain
- Pompeu Fabra University Barcelona Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
- IMIM (Hospital del Mar Medical Research Institute) Barcelona Spain
- Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales y Nanomedicina (CIBER‐BBN) Madrid Spain
| | | | | | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine Amsterdam University Medical Center Amsterdam Neuroscience Amsterdam The Netherlands
- Centre for Medical Image Computing and Queen Square Institute of Neurology UCL London UK
| | - Philip Scheltens
- Department of Neurology Alzheimer Center Amsterdam Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam The Netherlands
| | - Femke Bouwman
- Department of Neurology Alzheimer Center Amsterdam Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam The Netherlands
| | - Wiesje M. van der Flier
- Department of Neurology Alzheimer Center Amsterdam Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam The Netherlands
- Department of Epidemiology & Data Science Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam The Netherlands
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McPolin-Hall E, Stephens A, Pardieu C, Allaker R, Philpott M, Pople J, Hannen R. 200 Optimised 3D skin models incorporating microbiome and host immune responses. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.211] [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: 11/19/2022]
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18
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Bullich S, Mueller A, De Santi S, Koglin N, Krause S, Kaplow J, Kanekiyo M, Roé-Vellvé N, Perrotin A, Jovalekic A, Scott D, Gee M, Stephens A, Irizarry M. Evaluation of tau deposition using 18F-PI-2620 PET in MCI and early AD subjects—a MissionAD tau sub-study. Alzheimers Res Ther 2022; 14:105. [PMID: 35897078 PMCID: PMC9327167 DOI: 10.1186/s13195-022-01048-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022]
Abstract
Background The ability of 18F-PI-2620 PET to measure the spatial distribution of tau pathology in Alzheimer’s disease (AD) has been demonstrated in previous studies. The objective of this work was to evaluate tau deposition using 18F-PI-2620 PET in beta-amyloid positive subjects with a diagnosis of mild cognitive impairment (MCI) or mild AD dementia and characterize it with respect to amyloid deposition, cerebrospinal fluid (CSF) assessment, hippocampal volume, and cognition. Methods Subjects with a diagnosis of MCI due to AD or mild AD dementia and a visually amyloid-positive 18F-florbetaben PET scan (n=74, 76 ± 7 years, 38 females) underwent a baseline 18F-PI-2620 PET, T1-weighted magnetic resonance imaging (MRI), CSF assessment (Aβ42/Aβ40 ratio, p-tau, t-tau) (n=22) and several cognitive tests. A 1-year follow-up 18F-PI-2620 PET scans and cognitive assessments were done in 15 subjects. Results Percentage of visually tau-positive scans increased with amyloid-beta deposition measured in 18F-florbetaben Centiloids (CL) (7.7% (<36 CL), 80% (>83 CL)). 18F-PI-2620 standardized uptake value ratio (SUVR) was correlated with increased 18F-florbetaben CL in several regions of interest. Elevated 18F-PI-2620 SUVR (fusiform gyrus) was associated to high CSF p-tau and t-tau (p=0.0006 and p=0.01, respectively). Low hippocampal volume was associated with increased tau load at baseline (p=0.006 (mesial temporal); p=0.01 (fusiform gyrus)). Significant increases in tau SUVR were observed after 12 months, particularly in the mesial temporal cortex, fusiform gyrus, and inferior temporal cortex (p=0.04, p=0.047, p=0.02, respectively). However, no statistically significant increase in amyloid-beta load was measured over the observation time. The MMSE (Recall score), ADAS-Cog14 (Word recognition score), and CBB (One-card learning score) showed the strongest association with tau deposition at baseline. Conclusions The findings support the hypothesis that 18F-PI-2620 PET imaging of neuropathologic tau deposits may reflect underlying neurodegeneration in AD with significant correlations with hippocampal volume, CSF biomarkers, and amyloid-beta load. Furthermore, quantifiable increases in 18F-PI-2620 SUVR over a 12-month period in regions with early tau deposition are consistent with the hypothesis that cortical tau is associated with cognitive impairment. This study supports the utility of 18F-PI-2620 PET to assess tau deposits in an early AD population. Quantifiable tau load and its corresponding increase in early AD cases could be a relevant target engagement marker in clinical trials of anti-amyloid and anti-tau agents. Trial registration Data used in this manuscript belong to a tau PET imaging sub-study of the elenbecestat MissionAD Phase 3 program registered in ClinicalTrials.gov (NCT02956486; NCT03036280). Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01048-x.
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Jafary R, Armstrong S, Byrne T, Stephens A, Pellegrino V, Gregory SD. Fabrication and Characterization of Tissue-Mimicking Phantoms for Ultrasound-Guided Cannulation Training. ASAIO J 2022; 68:940-948. [PMID: 34799525 DOI: 10.1097/mat.0000000000001593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/27/2022] Open
Abstract
Tissue-mimicking materials (TMMs) have been investigated and used for decades as imaging phantoms in various medical applications. They are designed and fabricated to replicate certain biological tissue characteristics, a process often dictated by the target application. Moreover, TMMs have been utilized in some medical procedural training requiring the use of imaging modalities. One potential application for TMMs is ultrasound-guided cannulation training. Cannulation is a procedure that requires a level of dexterity to gain vascular access using ultrasound guidance while avoiding complications like vessel laceration and bleeding. However, an ideal phantom for this application is yet to be developed. This work investigates the development and characterization of high-fidelity phantoms for cannulation training. The mechanical (shore hardness, elastic modulus, and needle-interaction forces) and acoustic (B-mode ultrasound scans) properties of candidate materials were quantitatively compared with biological tissue. The evaluated materials included ballistic gel, plasticized polyvinyl chloride (PVC), silicone, gelatin, agar, and polyvinyl alcohol (PVA)- cryogel. Mechanical testing demonstrated that each material could replicate the Shore hardness and elasticity characteristics of different biological tissues (skin, fat, and muscle), with PVA and PVC showing tunability by varying composition or fabrication processes. Shore hardness (OO-range) for PVA ranged between 6.3 ± 1.0 to 59.3 ± 2.6 and PVC from 4.8 ± 0.7 to 14.6 ± 0.8. Ultrasound scans of PVA were the closest to human scans, both qualitatively (based on experts' opinion) and quantitatively (based on pixel intensity measurements). Modified mixtures of PVA are found to best serve as high-fidelity cannulation phantoms. Alternatively, PVC can be used to avoid troublesome fabrication processes of PVA.
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Affiliation(s)
- Rezan Jafary
- From the Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, Victoria, Australia
- Cardiorespiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Sophie Armstrong
- From the Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, Victoria, Australia
- Cardiorespiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Timothy Byrne
- Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventative Care, School of Public Health, Monash University, Melbourne, Victoria, Australia
| | - Andrew Stephens
- From the Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, Victoria, Australia
- Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Vincent Pellegrino
- Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventative Care, School of Public Health, Monash University, Melbourne, Victoria, Australia
| | - Shaun D Gregory
- From the Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, Victoria, Australia
- Cardiorespiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
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Haque F, Jawad N, Brzuszek A, Birk R, Stephens A, Brown V, Bozas G, Avery G, Maraveyas A. PO-37: A study of the evolution of radiological features of untreated small volume pulmonary embolism (PE) in cancer patients. Thromb Res 2022. [DOI: 10.1016/s0049-3848(22)00227-4] [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: 10/18/2022]
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21
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Stephens A. Research methodologies of educational psychology: critical skills. Educational Psychology in Practice 2022. [DOI: 10.1080/02667363.2022.2049564] [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: 10/18/2022]
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22
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Abstract
Aim and objective Sagittal guided growth of the distal anterior femur has been shown to be effective for the correction of fixed knee flexion deformity that is encountered in clinical practice. The opposite deformity, namely genu recurvatum, is comparatively uncommon in children. The most common aetiology is post-traumatic. Acute correction by means of osteotomy has significant associated risks. Our objective was to determine whether a posterior 8-plate would suffice in correcting tibial recurvatum and obviate the need for an osteotomy. Materials and methods We included a total of five deformities, three boys (one bilateral) and one girl, managed by means of tethering of the posterior proximal tibial physis with a tension band plate. Standard radiographs obtained preoperatively and at follow-up included a standing anteroposterior (AP) of the legs noting limb lengths and the mechanical axis. We also obtained standing lateral views of each knee in maximal extension to measure and compare the posterior proximal tibial angle (PPTA). Results The same-day surgery was well tolerated and there were no surgical or post-operative complications. The preoperative PPTA ranged from 106° to 117° and averaged 84° at follow-up. Correction occurred in an average of 20 months (range of 18–24 months). The patient with bilateral recurvatum due to Hurler's syndrome developed unilateral recurrent recurvatum culminating in percutaneous reinsertion of the metaphyseal screw. For each patient, knee hyperextension and associated pseudo-laxity resolved and limb lengths remained equal at follow-up. Conclusion Children with progressive genu recurvatum typically present with an insidious onset of symptoms. Guided growth of the posterior proximal tibia is a safe and effective means of correcting the deformity; osteotomy was avoided in this series. Level of evidence III – retrospective case series – no controls. How to cite this article Stevens P, Stephens A, Rothberg D. Guided Growth for Tibial Recurvatum. Strategies Trauma Limb Reconstr 2021;16(3):172–175.
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Affiliation(s)
- Peter Stevens
- Department of Orthopedics, University of Utah, Salt Lake City, Utah, United States of America
- Peter Stevens, Department of Orthopedics, University of Utah, Salt Lake City, Utah, United States of America, Phone: +801 330-3656, e-mail:
| | - Andrew Stephens
- Department of Orthopedics, University of Utah, Salt Lake City, Utah, United States of America
| | - David Rothberg
- Department of Orthopedics, University of Utah, Salt Lake City, Utah, United States of America
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23
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Kroth H, Oden F, Serra AM, Molette J, Mueller A, Berndt M, Capotosti F, Gabellieri E, Schmitt-Willich H, Hickman D, Pfeifer A, Dinkelborg L, Stephens A. Structure-activity relationship around PI-2620 highlights the importance of the nitrogen atom position in the tricyclic core. Bioorg Med Chem 2021; 52:116528. [PMID: 34839158 DOI: 10.1016/j.bmc.2021.116528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
Tau aggregates represent a critical pathology in Alzheimer's disease (AD) and other forms of dementia. The extent of Tau neurofibrillary tangles across defined brain regions corresponds well to the observed level of cognitive decline in AD. Compound 1 (PI-2620) was recently identified as a promising Tau positron emission tomography tracer for AD and non-AD tauopathies. To evaluate the impact of the N-atom position with respect to Tau- and off-target binding, tricyclic core analogs of PI-2620 with nitrogen atoms at different positions were prepared. Affinity to aggregated Tau was evaluated using human AD brain homogenates, and their off-target binding was evaluated in a monoamine oxidase A (MAO-A) competition assay. The novel tricyclic core derivatives all displayed inferior Tau binding or MAO-A off-target selectivity, indicating PI-2620 to be the optimal design for high affinity binding to Tau and high MAO-A selectivity.
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Affiliation(s)
- Heiko Kroth
- AC Immune SA, EPFL Innovation Park, Building B, 1015 Lausanne, Switzerland.
| | - Felix Oden
- Life Molecular Imaging GmbH, Tegeler Strasse 6-7, 13353 Berlin, Germany
| | | | - Jerome Molette
- AC Immune SA, EPFL Innovation Park, Building B, 1015 Lausanne, Switzerland
| | - Andre Mueller
- Life Molecular Imaging GmbH, Tegeler Strasse 6-7, 13353 Berlin, Germany
| | - Mathias Berndt
- Life Molecular Imaging GmbH, Tegeler Strasse 6-7, 13353 Berlin, Germany
| | | | | | | | - David Hickman
- AC Immune SA, EPFL Innovation Park, Building B, 1015 Lausanne, Switzerland
| | - Andrea Pfeifer
- AC Immune SA, EPFL Innovation Park, Building B, 1015 Lausanne, Switzerland
| | - Ludger Dinkelborg
- Life Molecular Imaging GmbH, Tegeler Strasse 6-7, 13353 Berlin, Germany
| | - Andrew Stephens
- Life Molecular Imaging GmbH, Tegeler Strasse 6-7, 13353 Berlin, Germany
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24
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Tzolos E, Bing R, Andrews J, Macaskill M, Tavares A, MacNaught G, Clarke T, Williams MC, Van Beek EJR, Koglin N, Stephens A, Dweck MR, Newby DE. In vivo coronary artery thrombus imaging with 18F-GP1 PET-CT. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Coronary artery thrombus is typically present in type 1 myocardial infarction, but small volumes in the setting of an uncertain culprit lesion may be beyond the detection limit of current imaging modalities.
Purpose
Using a novel glycoprotein IIb/IIIa-receptor radiotracer, 18F-GP1, we investigated whether positron emission tomography-computed tomography (PET-CT) could detect thrombus formation in coronary arteries.
Methods
In a single centre cross-sectional study, patients over 40 years of age with myocardial infarction were recruited after myocardial infarction and underwent underwent CT angiography and 18F-GP1 PET-CT. Stable patients with and without coronary artery disease formed a control cohort. Coronary artery 18F-GP1 uptake was visually assessed and quantified using maximum target-to-background ratios (TBRmax).
Results
Ninety-four (44 post-myocardial infarction and 50 control patients) were included in the cross-sectional analysis. The mean age of the post-myocardial infarction group was 61±9 years, three-quarters were male and two thirds had presented with ST elevation on electrocardiography. 34 (80%) patients post-myocardial infarction, but none of the control patients, demonstrated focal 18F-GP1 uptake in the coronary arteries.
Of 42 vessels with an angiographic culprit lesion, 35 (83%) had 18F-GP1 uptake which was significantly higher than non-culprit vessels (p<0.0001) as well as control vessels (p<0.0001), while non-culprit vessel uptake was similar to control vessel uptake (p=0.567): culprit vessel median TBRmax 1.2 [interquartile range 0.96–1.44], non-culprit vessel TBRmax 0.96 [0.84–1.03] and control vessel TBRmax 0.9 [0.76 to 0.94]. Linear regression models demonstrated univariable associations between coronary 18F-GP1 TBRmax and time from myocardial infarction, male sex and presence of culprit vessel. On multivariable analysis, only culprit vessel status was associated with TBRmax (adjusted R2= 0.22, P<0.001). Based on the Youden's index of the ROC curves, the optimal cut-off of predicting the presence of a culprit vessel was 1.20 with a specificity of 97%, accuracy of 83%, sensitivity (60%) and c-statictic of 0.74.
A patient with ectatic vessel and visual thrombus demonstrated the most intense 18F-GP1 uptake (TBRmax 2.0, highest in the cohort) in the region of heaviest thrombus burden (Figure 2). Extra-coronary uptake was seen in regions of left ventricular thrombus, left atrial appendage thrombus, pulmonary thromboembolism and intramyocardial microvascular obstruction.
Conclusions
18F-GP1 PET-CT is able to detect coronary artery thrombus in culprit lesions following myocardial infarction, as well as extra-coronary thrombotic pathologies that may be important in guiding patient management. 18F-GP1 is highly specific in recognising a culprit lesion from a non-culprit lesion both visually as well as quantitatively.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation Figure 1Figure 2
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Affiliation(s)
- E Tzolos
- University of Edinburgh, Edinburgh, United Kingdom
| | - R Bing
- University of Edinburgh, Edinburgh, United Kingdom
| | - J Andrews
- University of Edinburgh, Edinburgh, United Kingdom
| | - M Macaskill
- University of Edinburgh, Edinburgh, United Kingdom
| | - A Tavares
- University of Edinburgh, Edinburgh, United Kingdom
| | - G MacNaught
- University of Edinburgh, Edinburgh, United Kingdom
| | - T Clarke
- University of Edinburgh, Edinburgh, United Kingdom
| | - M C Williams
- University of Edinburgh, Edinburgh, United Kingdom
| | | | - N Koglin
- Life Molecular Imaging, Berlin, Germany
| | | | - M R Dweck
- University of Edinburgh, Edinburgh, United Kingdom
| | - D E Newby
- University of Edinburgh, Edinburgh, United Kingdom
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25
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Deutsch MA, Zabel R, Preuss R, Lindner O, Friedrichs K, Rudolph TK, Rudolph V, Bleiziffer S, Milting H, Stephens A, Koglin N, Gummert JF, Burchert W, Hugenberg V. Glycoprotein IIb/IIIa receptor targeted PET/CT imaging: a novel diagnostic tool for detecting bioprosthetic valve thrombosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0131] [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
Background/Introduction
Bioprosthetic valve thrombosis (BPVT) is an important clinical entity eventually following both bioprosthetic surgical and transcatheter aortic valve replacement. Although dynamic contrast-enhanced 4D-MDCT has improved the diagnosis of BPVT, more sensitive and pathology-specific non-invasive imaging tools are lacking. Recently, the glycoprotein IIb/IIIa receptor targeted, elarofiban-derived PET/CT imaging radiotracer [18F]GP1 has been successfully used for visualization of acute venous and arterial thrombi.
Purpose
We hypothesized that [18F]GP1 PET/CT imaging is suitable to detect BPVT.
Methods
In this proof-of-concept study, patients after bioprosthetic aortic valve replacement with symptomatic, severe hemodynamic valve dysfunction and confirmed hypoattenuated leaflet thickening (HALT) in dynamic 4D-MDCT were offered to participate in compassionate use examinations to undergo PET/CT imaging with the investigational [18F]GP1 PET tracer at baseline and after a 12-week course of therapeutic oral anticoagulation.
Results
This case series reports on three patients after aortic valve replacement. Two patients with symptomatic, obstructive BPVT as confirmed by echocardiography and 4D-MDCT fulfilled specified criteria and underwent [18F]GP1 PET/CT imaging. [18F]GP1 PET/CT clearly distinguished between blood pool activity and thrombotic foci. Clot-to-blood ratios at baseline were 8.2 and 4.5, respectively. A 12-week trial of therapeutic oral anticoagulation was associated with a regression of mean transprosthetic pressure gradient and reversal of HALT. Follow-up 4D-MDCT corroborated thrombus resolution in both patients. Correspondingly, [18F]GP1 PET/CT imaging demonstrated decreased tracer uptake in both patients. Clot-to-blood ratio at follow-up visit decreased to 1.2 and 2.9, respectively. While absent tracer uptake was seen in patient #1, residual tracer uptake was observed in patient #2 suggestive of ongoing platelet aggregation. One asymptomatic SAVR patient was examined with [18F]GP1 PET/CT for a different compassionate use and no thrombotic foci were detected on the leaflets.
Conclusions
[18F]GP1 PET/CT is a novel imaging technique in patients with obstructive BPVT. In a head-to-head comparison we show that [18F]GP1 PET/CT may have incremental diagnostic value over dynamic contrast-enhanced 4D-MDCT alone by detection of sites of ongoing platelet aggregation at the molecular level. [18F]GP1 PET/CT may serve as a novel, highly sensitive tool to overcome some limitations of current diagnostic imaging modalities for detecting BPVT and may prove useful for the monitoring and guidance of therapeutic interventions.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Life Molecular Imaging provided material for [18F]GP1 radiolabeling free of charge as part of an ongoing research collaboration.
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Affiliation(s)
- M A Deutsch
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - R Zabel
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - R Preuss
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - O Lindner
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - K Friedrichs
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - T K Rudolph
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - V Rudolph
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - S Bleiziffer
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - H Milting
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - A Stephens
- Life Molecular Imaging GmbH, Berlin, Germany
| | - N Koglin
- Life Molecular Imaging GmbH, Berlin, Germany
| | - J F Gummert
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - W Burchert
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - V Hugenberg
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
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26
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Cort J, Eaton L, Smets M, Stephens A, Malone G, Porto R. A comparison of the physical demands associated with various right-angle direct-current power tools. Appl Ergon 2021; 96:103488. [PMID: 34120001 DOI: 10.1016/j.apergo.2021.103488] [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] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 06/12/2023]
Abstract
This work examined the physical demands associated with 4 commercially available direct current right-angle power tools along with their computer controlled fastening strategies. Physical demands were measured via an external instrumented handle that could also control the trigger of each tool. Data revealed that forces recorded by the external handle for each of the 4 tools differed. Independent of Joint-Hardness and Target Torque the Atlas Copco TurboTight® and Cleco Low Torque Reaction fastening strategies, both using a rapid spindle-head rotation strategy, produced the lowest peak and impulse force, respectfully, when compared to the 2 tools that were designed to fasten with a longer duration. This work has shown that short duration fastening strategies provide an ergonomics benefit to the users as it requires less force to operate, such force reduction in previous research has been linked to reduced handle displacement and lower muscle effort.
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Affiliation(s)
- J Cort
- Department of Kinesiology, University of Windsor, Windsor, Ontario, Canada.
| | - L Eaton
- Fiat Chrysler Automobiles, Auburn Hills, MI, USA
| | - M Smets
- Ford Motor Company, Dearborn, MI, USA
| | | | | | - R Porto
- General Motors, Warren, MI, USA
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27
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Kroth H, Oden F, Molette J, Schieferstein H, Gabellieri E, Mueller A, Berndt M, Sreenivasachary N, Serra AM, Capotosti F, Schmitt-Willich H, Hickman D, Pfeifer A, Dinkelborg L, Stephens A. PI-2620 Lead Optimization Highlights the Importance of Off-Target Assays to Develop a PET Tracer for the Detection of Pathological Aggregated Tau in Alzheimer's Disease and Other Tauopathies. J Med Chem 2021; 64:12808-12830. [PMID: 34455780 DOI: 10.1021/acs.jmedchem.1c00861] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The first candidate PI-2014 was tested in healthy controls and subjects with Alzheimer's disease (AD). As PI-2014 displayed off-target binding to monoamine oxidase A (MAO-A), a new lead with improved binding to Tau and decreased MAO-A binding was required. For compound optimization, Tau binding assays based on both human AD brain homogenate and Tau-paired helical filaments were employed. Furthermore, two MAO-A screening assays based on (1) human-recombinant MAO-A and (2) displacement of 2-fluoro-ethyl-harmine from mouse brain homogenate were employed. Removing the N-methyl group from the tricyclic core resulted in compounds displaying improved Tau binding. For the final round of optimization, the cyclic amine substituents were replaced by pyridine derivatives. PI-2620 (2-(2-fluoropyridin-4-yl)-9H-pyrrolo[2,3-b:4,5-c']dipyridine) emerged as a best candidate displaying high Tau binding, low MAO-A binding, high brain uptake, and fast and complete brain washout. Furthermore, PI-2620 showed Tau binding on brain sections from corticobasal degeneration, progressive supranuclear palsy, and Pick's disease.
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Affiliation(s)
- Heiko Kroth
- AC Immune SA, EPFL Innovation Park, Building B, 1015 Lausanne, Switzerland
| | - Felix Oden
- Life Molecular Imaging GmbH, Tegeler Strasse 6-7, 13353 Berlin, Germany
| | - Jerome Molette
- AC Immune SA, EPFL Innovation Park, Building B, 1015 Lausanne, Switzerland
| | | | | | - Andre Mueller
- Life Molecular Imaging GmbH, Tegeler Strasse 6-7, 13353 Berlin, Germany
| | - Mathias Berndt
- Life Molecular Imaging GmbH, Tegeler Strasse 6-7, 13353 Berlin, Germany
| | | | | | | | | | - David Hickman
- AC Immune SA, EPFL Innovation Park, Building B, 1015 Lausanne, Switzerland
| | - Andrea Pfeifer
- AC Immune SA, EPFL Innovation Park, Building B, 1015 Lausanne, Switzerland
| | - Ludger Dinkelborg
- Life Molecular Imaging GmbH, Tegeler Strasse 6-7, 13353 Berlin, Germany
| | - Andrew Stephens
- Life Molecular Imaging GmbH, Tegeler Strasse 6-7, 13353 Berlin, Germany
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28
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Su SH, Song Y, Newstead MW, Cai T, Wu M, Stephens A, Singer BH, Kurabayashi K. Ultrasensitive Multiparameter Phenotyping of Rare Cells Using an Integrated Digital-Molecular-Counting Microfluidic Well Plate. Small 2021; 17:e2101743. [PMID: 34170616 PMCID: PMC8349899 DOI: 10.1002/smll.202101743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/08/2021] [Indexed: 06/13/2023]
Abstract
Integrated microfluidic cellular phenotyping platforms provide a promising means of studying a variety of inflammatory diseases mediated by cell-secreted cytokines. However, immunosensors integrated in previous microfluidic platforms lack the sensitivity to detect small signals in the cellular secretion of proinflammatory cytokines with high precision. This limitation prohibits researchers from studying cells secreting cytokines at low abundance or existing at a small population. Herein, the authors present an integrated platform named the "digital Phenoplate (dPP)," which integrates digital immunosensors into a microfluidic chip with on-chip cell assay chambers, and demonstrates ultrasensitive cellular cytokine secretory profile measurement. The integrated sensors yield a limit of detection as small as 0.25 pg mL-1 for mouse tumor necrosis factor alpha (TNF-α). Each on-chip cell assay chamber confines cells whose population ranges from ≈20 to 600 in arrayed single-cell trapping microwells. Together, these microfluidic features of the dPP simultaneously permit precise counting and image-based cytometry of individual cells while performing parallel measurements of TNF-α released from rare cells under multiple stimulant conditions for multiple samples. The dPP platform is broadly applicable to the characterization of cellular phenotypes demanding high precision and high throughput.
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Affiliation(s)
- Shiuan-Haur Su
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Yujing Song
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Michael W Newstead
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Tao Cai
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - MengXi Wu
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Andrew Stephens
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Benjamin H Singer
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, 48109, USA
- Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Katsuo Kurabayashi
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
- Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, 48109, USA
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Willroider M, Roeber S, Horn AKE, Arzberger T, Scheifele M, Respondek G, Sabri O, Barthel H, Patt M, Mishchenko O, Schildan A, Mueller A, Koglin N, Stephens A, Levin J, Höglinger GU, Bartenstein P, Herms J, Brendel M, Beyer L. Superiority of Formalin-Fixed Paraffin-Embedded Brain Tissue for in vitro Assessment of Progressive Supranuclear Palsy Tau Pathology With [ 18 F]PI-2620. Front Neurol 2021; 12:684523. [PMID: 34276540 PMCID: PMC8282895 DOI: 10.3389/fneur.2021.684523] [Citation(s) in RCA: 5] [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: 03/24/2021] [Accepted: 05/25/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Autoradiography on brain tissue is used to validate binding targets of newly discovered radiotracers. The purpose of this study was to correlate quantification of autoradiography signal using the novel next-generation tau positron emission tomography (PET) radiotracer [18F]PI-2620 with immunohistochemically determined tau-protein load in both formalin-fixed paraffin-embedded (FFPE) and frozen tissue samples of patients with Alzheimer's disease (AD) and Progressive Supranuclear Palsy (PSP). Methods: We applied [18F]PI-2620 autoradiography to postmortem cortical brain samples of six patients with AD, five patients with PSP and five healthy controls, respectively. Binding intensity was compared between both tissue types and different disease entities. Autoradiography signal quantification (CWMR = cortex to white matter ratio) was correlated with the immunohistochemically assessed tau load (AT8-staining, %-area) for FFPE and frozen tissue samples in the different disease entities. Results: In AD tissue, relative cortical tracer binding was higher in frozen samples when compared to FFPE samples (CWMRfrozen vs. CWMRFFPE: 2.5-fold, p < 0.001), whereas the opposite was observed in PSP tissue (CWMRfrozen vs. CWMRFFPE: 0.8-fold, p = 0.004). In FFPE samples, [18F]PI-2620 autoradiography tracer binding and immunohistochemical tau load correlated significantly for both PSP (R = 0.641, p < 0.001) and AD tissue (R = 0.435, p = 0.016), indicating a high agreement of relative tracer binding with underlying pathology. In frozen tissue, the correlation between autoradiography and immunohistochemistry was only present in AD (R = 0.417, p = 0.014) but not in PSP tissue (R = -0.115, p = n.s.). Conclusion: Our head-to-head comparison indicates that FFPE samples show superiority over frozen samples for autoradiography assessment of PSP tau pathology by [18F]PI-2620. The [18F]PI-2620 autoradiography signal in FFPE samples reflects AT8 positive tau in samples of both PSP and AD patients.
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Affiliation(s)
- Marie Willroider
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Sigrun Roeber
- Center for Neuropathology and Prion Research, LMU Munich, Munich, Germany
| | - Anja K E Horn
- Institute of Anatomy and Cell Biology, LMU Munich, Munich, Germany
| | - Thomas Arzberger
- Center for Neuropathology and Prion Research, LMU Munich, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Maximilian Scheifele
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Gesine Respondek
- Department of Neurology, Hannover Medical School, Hanover, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Olena Mishchenko
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Andreas Schildan
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | | | | | | | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Department of Neurology, University Hospital Munich, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Günter U Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Department of Neurology, Hannover Medical School, Hanover, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,Department of Neurology, Technical University Munich, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Jochen Herms
- Center for Neuropathology and Prion Research, LMU Munich, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany.,Center for Neuropathology and Prion Research, LMU Munich, Munich, Germany
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30
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Steingraber C, Devries D, Eaton L, Smets M, Stephens A, Malone G, Porto R, Cort J. Physical demands associated with right-angle direct-current power-tools: An evaluation of current technology. Appl Ergon 2021; 93:103374. [PMID: 33545561 DOI: 10.1016/j.apergo.2021.103374] [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] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 06/12/2023]
Abstract
The purpose of this work was to evaluate the physical demands associated with three direct current powered right-angle power tool tightening strategies at various fastener-location-orientations, target torques and joint-hardness. Physical demands were measured using surface electromyography, handle force and upper body kinematics. Results identified TurboTight®, a rapid and short duration fastening strategy, to produce lower handle force impulse, less joint angle displacement, and lower EMG magnitudes when compared to the longer duration fastening strategies tested. The reduced magnitudes associated with TurboTight®, independent of fastener-location-orientations, target torques and joint-hardness, indicate a lower physical demand on power tool operators, providing a significant ergonomic benefit when compared to the slower fastening strategies.
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Affiliation(s)
- C Steingraber
- Department of Kinesiology, University of Windsor, Windsor, ON, Canada
| | - D Devries
- Department of Kinesiology, University of Windsor, Windsor, ON, Canada
| | - L Eaton
- Fiat Chrysler Automobiles, Auburn Hills, MI, USA
| | - M Smets
- Ford Motor Company, Dearborn, MI, USA
| | | | | | - R Porto
- General Motors, Warren, MI, USA
| | - J Cort
- Department of Kinesiology, University of Windsor, Windsor, ON, Canada.
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31
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Stephens A, Rudd H, Stephens E, Ward J. 91 Mrs Bad Bones: Impact of COVID-19 on Secondary Prevention of Fragility Fractures. Age Ageing 2021. [PMCID: PMC7989631 DOI: 10.1093/ageing/afab030.52] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction Management of osteoporosis is an important consideration for neck of femur fracture patients due to the morbidity and mortality it poses, and the significant financial burden to the NHS. Orthogeriatric teams input is invaluable in coordinating secondary fragility fracture prevention. The COVID-19 pandemic resulted in the rapid restructuring of healthcare teams and led to the redeployment of the orthogeriatricians to assist with the influx of medically unwell patients. This study explored the impact COVID-19 had on secondary fragility fracture prevention. Method A retrospective audit looking at the prescription of vitamin D/calcium supplements, bone-sparing medications, and DEXA scan requests in consecutive neck of femur fracture patients admitted to a trauma and orthopaedic unit pre- and post- UK lockdown in response to the pandemic. A re-audit was conducted following the implementation of our new mnemonic, “MRS BAD BONES”: Medication Review Rheumatology/Renal Advice Smoking Cessation Blood tests Alcohol limits DEXA scan Bone-sparing medications Orthogeriatric review Nutrition Exercise Supplements. Results Data for 50 patients was available in each phase. The orthogeriatric team reviewed 88% of patients pre-lockdown falling to 0% due to redeployment, before recovering to 38% in the post-intervention period. Upon lockdown there was a significant drop in the prescription of vitamin D/calcium supplements from 81.6% to 58.0% (p = 0.0156); of bone-sparing medications from 60.7% to 18.2% (p = 0.0037), and DEXA scan requests from 40.1% to 3.6% (p = 0.0027). Following the implementation of our mnemonic, there was a significant increase in the prescription of vitamin D/calcium supplements to 85.7% (p = 0.0034), bone-sparing medications to 72.4% (p = 0.0002) and DEXA scan requests to 60% (p < 0.0001). Conclusion COVID-19 had a major impact on the secondary prevention of fragility fractures in this population. The “MRS BAD BONES” mnemonic significantly improved the management and could be considered for use in a wider setting.
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Affiliation(s)
- A Stephens
- University Hospitals Coventry and Warwickshire; University Hospitals Coventry and Warwickshire; University Hospitals Coventry and Warwickshire; University Hospitals Coventry and Warwickshire
| | - H Rudd
- University Hospitals Coventry and Warwickshire; University Hospitals Coventry and Warwickshire; University Hospitals Coventry and Warwickshire; University Hospitals Coventry and Warwickshire
| | - E Stephens
- University Hospitals Coventry and Warwickshire; University Hospitals Coventry and Warwickshire; University Hospitals Coventry and Warwickshire; University Hospitals Coventry and Warwickshire
| | - J Ward
- University Hospitals Coventry and Warwickshire; University Hospitals Coventry and Warwickshire; University Hospitals Coventry and Warwickshire; University Hospitals Coventry and Warwickshire
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32
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Song Y, Zhao J, Cai T, Stephens A, Su SH, Sandford E, Flora C, Singer BH, Ghosh M, Choi SW, Tewari M, Kurabayashi K. Machine learning-based cytokine microarray digital immunoassay analysis. Biosens Bioelectron 2021; 180:113088. [PMID: 33647790 PMCID: PMC7896497 DOI: 10.1016/j.bios.2021.113088] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 12/15/2020] [Accepted: 02/10/2021] [Indexed: 12/19/2022]
Abstract
Serial measurement of a large panel of protein biomarkers near the bedside could provide a promising pathway to transform the critical care of acutely ill patients. However, attaining the combination of high sensitivity and multiplexity with a short assay turnaround poses a formidable technological challenge. Here, the authors develop a rapid, accurate, and highly multiplexed microfluidic digital immunoassay by incorporating machine learning-based autonomous image analysis. The assay has achieved 12-plexed biomarker detection in sample volume <15 μL at concentrations < 5 pg/mL while only requiring a 5-min assay incubation, allowing for all processes from sampling to result to be completed within 40 min. The assay procedure applies both a spatial-spectral microfluidic encoding scheme and an image data analysis algorithm based on machine learning with a convolutional neural network (CNN) for pre-equilibrated single-molecule protein digital counting. This unique approach remarkably reduces errors facing the high-capacity multiplexing of digital immunoassay at low protein concentrations. Longitudinal data obtained for a panel of 12 serum cytokines in human patients receiving chimeric antigen receptor-T (CAR-T) cell therapy reveals the powerful biomarker profiling capability. The assay could also be deployed for near-real-time immune status monitoring of critically ill COVID-19 patients developing cytokine storm syndrome.
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Affiliation(s)
- Yujing Song
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Jingyang Zhao
- Department of Energy Engineering, Zhejiang University, Hangzhou, Zhejiang, 310027, China
| | - Tao Cai
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Andrew Stephens
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Shiuan-Haur Su
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Erin Sandford
- Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Christopher Flora
- Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Benjamin H Singer
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, 48109, USA; Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Monalisa Ghosh
- Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Sung Won Choi
- Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, 48109, USA; Department of Pediatrics, University of Michigan, Ann Arbor, MI, 48109, USA; Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Muneesh Tewari
- Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI, 48109, USA; Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, 48109, USA; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA; Center for Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Katsuo Kurabayashi
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA; Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, 48109, USA; Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, 48109, USA.
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Chishom T, Stephens A, Raley S, Ange B, Looney S, Street L, Browne P. Amniotic fluid index curves in the obese gravida. J Neonatal Perinatal Med 2021; 14:131-137. [PMID: 32333553 DOI: 10.3233/npm-190290] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine whether amniotic fluid volume as measured by amniotic fluid index (AFI) is influenced by maternal pre-gestational obesity as measured by body mass index (BMI). METHODS This was a retrospective cohort study of pregnant women between 20 and 43 weeks gestation receiving ultrasounds with AFI measurements at Augusta University Medical Center between 2003 and 2017. A subset of 500 charts that met inclusion and exclusion criteria were reviewed to obtain maternal clinical data. The study cohort was subdivided by maternal BMI at initial obstetric visit into three groups: normal weight (18.5 kg/m2-24.9 kg/m2), overweight (25.0 kg/m2-29.9 kg/m2), and obese (≥ 30 kg/m2). Chi-square analysis was used to compare BMI groups in terms of categorical clinical characteristics and outcome variables, and analysis of variance (ANOVA) was used for continuous variables. Mixed effects regression models (MRMs) were used to evaluate AFI throughout gestation separately in each group, and MRM-based analysis of covariance was used to compare AFI throughout gestation among groups. AFI curves were constructed for the 5th, 50th, and 95th percentiles for all study subjects combined and separately for normal weight, overweight, and obese subjects. RESULTS Fitted curves relating AFI percentiles to estimated gestational age (EGA) showed statistically significant differences among BMI groups. There was also a significant difference in AFI over gestation across the obesity groups. CONCLUSION Fitted curves for AFI throughout pregnancy showed statistically significant differences among BMI groups.
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Affiliation(s)
- T Chishom
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Augusta University Medical Center at Medical College of Georgia, Augusta, GA, USA
| | - A Stephens
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Augusta University Medical Center at Medical College of Georgia, Augusta, GA, USA
| | - S Raley
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Augusta University Medical Center at Medical College of Georgia, Augusta, GA, USA
| | - B Ange
- Department of Biostatistics and Epidemiology at Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - S Looney
- Department of Biostatistics and Epidemiology at Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - L Street
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Augusta University Medical Center at Medical College of Georgia, Augusta, GA, USA
| | - P Browne
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Augusta University Medical Center at Medical College of Georgia, Augusta, GA, USA
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34
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Song Y, Ye Y, Su SH, Stephens A, Cai T, Chung MT, Han M, Newstead MW, Yessayan L, Frame D, Humes D, Singer BH, Kurabayashi K. A digital protein microarray for COVID-19 cytokine storm monitoring. Lab Chip 2021; 21:331-343. [PMID: 33211045 PMCID: PMC7855944 DOI: 10.1039/d0lc00678e] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Despite widespread concern regarding cytokine storms leading to severe morbidity in COVID-19, rapid cytokine assays are not routinely available for monitoring critically ill patients. We report the clinical application of a digital protein microarray platform for rapid multiplex quantification of cytokines from critically ill COVID-19 patients admitted to the intensive care unit (ICU) at the University of Michigan Hospital. The platform comprises two low-cost modules: (i) a semi-automated fluidic dispensing/mixing module that can be operated inside a biosafety cabinet to minimize the exposure of the technician to the virus infection and (ii) a 12-12-15 inch compact fluorescence optical scanner for the potential near-bedside readout. The platform enabled daily cytokine analysis in clinical practice with high sensitivity (<0.4 pg mL-1), inter-assay repeatability (∼10% CV), and rapid operation providing feedback on the progress of therapy within 4 hours. This test allowed us to perform serial monitoring of two critically ill patients with respiratory failure and to support immunomodulatory therapy using the selective cytopheretic device (SCD). We also observed clear interleukin-6 (IL-6) elevations after receiving tocilizumab (IL-6 inhibitor) while significant cytokine profile variability exists across all critically ill COVID-19 patients and to discover a weak correlation between IL-6 to clinical biomarkers, such as ferritin and C-reactive protein (CRP). Our data revealed large subject-to-subject variability in patients' response to COVID-19, reaffirming the need for a personalized strategy guided by rapid cytokine assays.
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Affiliation(s)
- Yujing Song
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, United States
| | - Yuxuan Ye
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, United States
| | - Shiuan-Haur Su
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, United States
| | - Andrew Stephens
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, United States
| | - Tao Cai
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, United States
| | - Meng-Ting Chung
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, United States
| | - Meilan Han
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, 48109, United States
| | - Michael W. Newstead
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, 48109, United States
| | - Lenar Yessayan
- Department of Internal Medicine, Division of Nephrology, University of Michigan, Ann Arbor, MI, 48109, United States
| | - David Frame
- Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, MI, 48109, United States
| | - David Humes
- Department of Internal Medicine, Division of Nephrology, University of Michigan, Ann Arbor, MI, 48109, United States
| | - Benjamin H. Singer
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, 48109, United States
- Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, 48109, United States
| | - Katsuo Kurabayashi
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, United States
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, 48109, United States
- Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, 48109, United States
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35
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Brendel M, Barthel H, van Eimeren T, Marek K, Beyer L, Song M, Palleis C, Gehmeyr M, Fietzek U, Respondek G, Sauerbeck J, Nitschmann A, Zach C, Hammes J, Barbe MT, Onur O, Jessen F, Saur D, Schroeter ML, Rumpf JJ, Rullmann M, Schildan A, Patt M, Neumaier B, Barret O, Madonia J, Russell DS, Stephens A, Roeber S, Herms J, Bötzel K, Classen J, Bartenstein P, Villemagne V, Levin J, Höglinger GU, Drzezga A, Seibyl J, Sabri O. Assessment of 18F-PI-2620 as a Biomarker in Progressive Supranuclear Palsy. JAMA Neurol 2020; 77:1408-1419. [PMID: 33165511 PMCID: PMC7341407 DOI: 10.1001/jamaneurol.2020.2526] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Importance Progressive supranuclear palsy (PSP) is a 4-repeat tauopathy. Region-specific tau aggregates establish the neuropathologic diagnosis of definite PSP post mortem. Future interventional trials against tau in PSP would strongly benefit from biomarkers that support diagnosis. Objective To investigate the potential of the novel tau radiotracer 18F-PI-2620 as a biomarker in patients with clinically diagnosed PSP. Design, Setting, and Participants In this cross-sectional study, participants underwent dynamic 18F-PI-2620 positron emission tomography (PET) from 0 to 60 minutes after injection at 5 different centers (3 in Germany, 1 in the US, and 1 in Australia). Patients with PSP (including those with Richardson syndrome [RS]) according to Movement Disorder Society PSP criteria were examined together with healthy controls and controls with disease. Four additionally referred individuals with PSP-RS and 2 with PSP-non-RS were excluded from final data analysis owing to incomplete dynamic PET scans. Data were collected from December 2016 to October 2019 and were analyzed from December 2018 to December 2019. Main Outcomes and Measures Postmortem autoradiography was performed in independent PSP-RS and healthy control samples. By in vivo PET imaging, 18F-PI-2620 distribution volume ratios were obtained in globus pallidus internus and externus, putamen, subthalamic nucleus, substantia nigra, dorsal midbrain, dentate nucleus, dorsolateral, and medial prefrontal cortex. PET data were compared between patients with PSP and control groups and were corrected for center, age, and sex. Results Of 60 patients with PSP, 40 (66.7%) had RS (22 men [55.0%]; mean [SD] age, 71 [6] years; mean [SD] PSP rating scale score, 38 [15]; score range, 13-71) and 20 (33.3%) had PSP-non-RS (11 men [55.0%]; mean [SD] age, 71 [9] years; mean [SD] PSP rating scale score, 24 [11]; score range, 11-41). Ten healthy controls (2 men; mean [SD] age, 67 [7] years) and 20 controls with disease (of 10 [50.0%] with Parkinson disease and multiple system atrophy, 7 were men; mean [SD] age, 61 [8] years; of 10 [50.0%] with Alzheimer disease, 5 were men; mean [SD] age, 69 [10] years). Postmortem autoradiography showed blockable 18F-PI-2620 binding in patients with PSP and no binding in healthy controls. The in vivo findings from the first large-scale observational study in PSP with 18F-PI-2620 indicated significant elevation of tracer binding in PSP target regions with strongest differences in PSP vs control groups in the globus pallidus internus (mean [SD] distribution volume ratios: PSP-RS, 1.21 [0.10]; PSP-non-RS, 1.12 [0.11]; healthy controls, 1.00 [0.08]; Parkinson disease/multiple system atrophy, 1.03 [0.05]; Alzheimer disease, 1.08 [0.06]). Sensitivity and specificity for detection of PSP-RS vs any control group were 85% and 77%, respectively, when using classification by at least 1 positive target region. Conclusions and Relevance This multicenter evaluation indicates a value of 18F-PI-2620 to differentiate suspected patients with PSP, potentially facilitating more reliable diagnosis of PSP.
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Affiliation(s)
- Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Thilo van Eimeren
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany,Department of Neurology, University Hospital Cologne, Cologne, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany
| | - Ken Marek
- InviCRO LLC, Boston, Massachusetts,Molecular Neuroimaging, A Division of InviCRO, New Haven, Connecticut
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Mengmeng Song
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Carla Palleis
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Mona Gehmeyr
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Urban Fietzek
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Gesine Respondek
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Julia Sauerbeck
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Alexander Nitschmann
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Christian Zach
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Jochen Hammes
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Michael T. Barbe
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Oezguer Onur
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany,Department of Psychiatry, University Hospital Cologne, Cologne, Germany,Center for Memory Disorders, University Hospital Cologne, Cologne, Germany
| | - Dorothee Saur
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Matthias L. Schroeter
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany,LIFE–Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany,Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | | | - Michael Rullmann
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Andreas Schildan
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Bernd Neumaier
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany,Forschungszentrum Jülich GmbH, Institute of Neuroscience and Medicine, Nuclear Chemistry (INM-5), Jülich, Germany
| | - Olivier Barret
- InviCRO LLC, Boston, Massachusetts,Molecular Neuroimaging, A Division of InviCRO, New Haven, Connecticut
| | - Jennifer Madonia
- InviCRO LLC, Boston, Massachusetts,Molecular Neuroimaging, A Division of InviCRO, New Haven, Connecticut
| | - David S. Russell
- InviCRO LLC, Boston, Massachusetts,Molecular Neuroimaging, A Division of InviCRO, New Haven, Connecticut
| | | | - Sigrun Roeber
- Center for Neuropathology and Prion Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Jochen Herms
- Center for Neuropathology and Prion Research, University Hospital of Munich, LMU Munich, Munich, Germany,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Kai Bötzel
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Joseph Classen
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Victor Villemagne
- Department of Molecular Imaging & Therapy, Austin Health, Heidelberg, Victoria, Australia,Department of Medicine, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Johannes Levin
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Günter U. Höglinger
- Department of Neurology, Hannover Medical School, Hannover, Germany,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany,Department of Neurology, Technical University Munich, Munich, Germany
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany,Forschungszentrum Jülich GmbH, Institute of Neuroscience and Medicine, Nuclear Chemistry (INM-5), Jülich, Germany
| | - John Seibyl
- InviCRO LLC, Boston, Massachusetts,Molecular Neuroimaging, A Division of InviCRO, New Haven, Connecticut
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
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Bing R, Andrews J, Williams M, Clark T, Semple S, Van Beek E, Lucatelli C, Sellers S, Leipsic J, Tavares A, Stephens A, Koglin N, Dweck M, Newby D. Thrombus formation on bioprosthetic aortic valves. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0290] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
18F-GP1 is a novel radiotracer with a high affinity for the platelet glycoprotein IIb/IIIa receptor. Subclinical bioprosthetic valve thrombus has been postulated as a trigger for accelerated valve degeneration.
Purpose
To determine the feasibility of 18F-GP1 positron-emission tomography-computed tomography (PET-CT) for the detection of subclinical bioprosthetic aortic valve thrombus.
Methods
(i) Explanted degenerated aortic valve prostheses underwent histology and imaging. (ii) In a prospective observational study, patients with bioprosthetic aortic valve replacement (AVR) underwent echocardiography and 18F-GP1 PET-CT. Valves were assessed for hypoattenuating leaflet thickening (HALT), hypo-attenuation affection leaflet motion (HAM) and GP1 uptake.
Results
(i) GP1 correlated with thrombus on explanted valves (Figure). (ii) The first 6 patients (Table) were asymptomatic and had normally functioning surgical bioprostheses on echocardiography. At a median of 166 (range 122–189) days post-AVR, no patients had HALT or HAM on CT. There was avid focal GP1 uptake on the leaflets of all 6 patients which appeared most prominent along the leaflet edges (Figure). Only one patient had focal uptake in the valve frame, remote from the leaflets. In a separate cohort undergoing 18F-GP1 PET-CT for other conditions, there was no uptake on normal, native aortic valves (n=8).
Conclusion
For the first time, we demonstrate that 18F-GP1 PET-CT is a highly sensitive method of assessing platelet activation on bioprosthetic aortic valves. Despite the absence of CT evidence, early thrombus appeared to be a universal finding on recently implanted valve prostheses. The biological and clinical implications of subclinical bioprosthetic aortic valve thrombus have yet to be established.
GP1 uptake in AVR
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): British Heart Foundation
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Affiliation(s)
- R Bing
- University of Edinburgh, Edinburgh, United Kingdom
| | - J Andrews
- University of Edinburgh, Edinburgh, United Kingdom
| | - M Williams
- University of Edinburgh, Edinburgh, United Kingdom
| | - T Clark
- University of Edinburgh, Edinburgh, United Kingdom
| | - S Semple
- University of Edinburgh, Edinburgh, United Kingdom
| | - E Van Beek
- University of Edinburgh, Edinburgh, United Kingdom
| | - C Lucatelli
- University of Edinburgh, Edinburgh, United Kingdom
| | - S Sellers
- University of British Columbia, Vancouver, Canada
| | - J Leipsic
- University of British Columbia, Vancouver, Canada
| | - A Tavares
- University of Edinburgh, Edinburgh, United Kingdom
| | | | - N Koglin
- Life Molecular Imaging, Berlin, Germany
| | - M Dweck
- University of Edinburgh, Edinburgh, United Kingdom
| | - D Newby
- University of Edinburgh, Edinburgh, United Kingdom
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Gabellieri E, Capotosti F, Molette J, Sreenivasachary N, Mueller A, Berndt M, Schieferstein H, Juergens T, Varisco Y, Oden F, Schmitt-Willich H, Hickman D, Dinkelborg L, Stephens A, Pfeifer A, Kroth H. Discovery of 2-(4-(2-fluoroethoxy)piperidin-1-yl)-9-methyl-9H-pyrrolo[2,3-b:4,5-c']dipyridine ([18F]PI-2014) as PET tracer for the detection of pathological aggregated tau in Alzheimer's disease and other tauopathies. Eur J Med Chem 2020; 204:112615. [PMID: 32771872 DOI: 10.1016/j.ejmech.2020.112615] [Citation(s) in RCA: 4] [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: 04/17/2020] [Revised: 06/04/2020] [Accepted: 06/21/2020] [Indexed: 12/29/2022]
Abstract
The compound screening was initiated with a direct staining assay to identify compounds binding to Tau aggregates and not Abeta plaques using human brain sections derived from late stage Alzheimer's disease donors. The binding of Tau aggregate selective compounds was then quantitatively assessed with human brain derived paired helical filaments utilizing the label-free Back Scattering Interferometry assay. In vivo biodistribution experiments of selected fluorine-18 labeled compounds were performed in mice to assess brain uptake, brain washout, and defluorination. Compound 11 emerged as the most promising candidate, displaying high in vitro binding affinity and selectivity to neurofibrillary tangles. Fluorine-18 labeled compound 11 showed high brain uptake and rapid washout from the mouse brain with no observed bone uptake. Furthermore, compound 11 was able to detect Tau aggregates in tauopathy brain sections from corticobasal degeneration, progressive supranuclear palsy, and Pick's disease donors. Thus, 2-(4-(2-fluoroethoxy)piperidin-1-yl)-9-methyl-9H-pyrrolo[2,3-b:4,5-c']dipyridine (PI-2014, compound 11) was selected for characterization in a first-in-human study.
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Affiliation(s)
| | | | - Jerome Molette
- AC Immune SA, EPFL Innovation Park, Building B, 1015, Lausanne, Switzerland
| | | | - Andre Mueller
- Life Molecular Imaging GmbH, Tegeler Strasse 6-7, 13353, Berlin, Germany
| | - Mathias Berndt
- Life Molecular Imaging GmbH, Tegeler Strasse 6-7, 13353, Berlin, Germany
| | - Hanno Schieferstein
- Formerly Piramal Imaging GmbH, Tegeler Strasse 6-7, 13353, Berlin, Germany; Merck KGaA, Frankfurter Strasse 250, 64293, Darmstadt, Germany
| | - Tanja Juergens
- AC Immune SA, EPFL Innovation Park, Building B, 1015, Lausanne, Switzerland
| | - Yvan Varisco
- AC Immune SA, EPFL Innovation Park, Building B, 1015, Lausanne, Switzerland
| | - Felix Oden
- Life Molecular Imaging GmbH, Tegeler Strasse 6-7, 13353, Berlin, Germany
| | | | - David Hickman
- AC Immune SA, EPFL Innovation Park, Building B, 1015, Lausanne, Switzerland
| | - Ludger Dinkelborg
- Life Molecular Imaging GmbH, Tegeler Strasse 6-7, 13353, Berlin, Germany
| | - Andrew Stephens
- Life Molecular Imaging GmbH, Tegeler Strasse 6-7, 13353, Berlin, Germany
| | - Andrea Pfeifer
- AC Immune SA, EPFL Innovation Park, Building B, 1015, Lausanne, Switzerland
| | - Heiko Kroth
- AC Immune SA, EPFL Innovation Park, Building B, 1015, Lausanne, Switzerland.
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38
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Song Y, Ye Y, Su SH, Stephens A, Cai T, Chung MT, Han M, Newstead MW, Frame D, Singer BH, Kurabayashi K. A Digital Protein Microarray for COVID-19 Cytokine Storm Monitoring. medRxiv 2020:2020.06.15.20131870. [PMID: 32587979 PMCID: PMC7310633 DOI: 10.1101/2020.06.15.20131870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
Despite widespread concern for cytokine storms leading to severe morbidity in COVID-19, rapid cytokine assays are not routinely available for monitoring critically ill patients. We report the clinical application of a machine learning-based digital protein microarray platform for rapid multiplex quantification of cytokines from critically ill COVID-19 patients admitted to the intensive care unit (ICU) at the University of Michigan Hospital. The platform comprises two low-cost modules: (i) a semi-automated fluidic dispensing/mixing module that can be operated inside a biosafety cabinet to minimize the exposure of technician to the virus infection and (ii) a 12-12-15 inch compact fluorescence optical scanner for the potential near-bedside readout. The platform enabled daily cytokine analysis in clinical practice with high sensitivity (<0.4pg/mL), inter-assay repeatability (~10% CV), and near-real-time operation with a 10 min assay incubation. A cytokine profiling test with the platform allowed us to observe clear interleukin-6 (IL-6) elevations after receiving tocilizumab (IL-6 inhibitor) while significant cytokine profile variability exists across all critically ill COVID-19 patients and to discover a weak correlation between IL-6 to clinical biomarkers, such as Ferritin and CRP. Our data revealed large subject-to-subject variability in a patient's response to anti-inflammatory treatment for COVID-19, reaffirming the need for a personalized strategy guided by rapid cytokine assays.
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Lopes Alves I, Collij LE, Altomare D, Frisoni GB, Saint‐Aubert L, Payoux P, Kivipelto M, Jessen F, Drzezga A, Leeuwis A, Wink AM, Visser PJ, van Berckel BN, Scheltens P, Gray KR, Wolz R, Stephens A, Gismondi R, Buckely C, Gispert JD, Schmidt M, Ford L, Ritchie C, Farrar G, Barkhof F, Molinuevo JL. Quantitative amyloid PET in Alzheimer's disease: the AMYPAD prognostic and natural history study. Alzheimers Dement 2020; 16:750-758. [PMID: 32281303 PMCID: PMC7984341 DOI: 10.1002/alz.12069] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/12/2019] [Accepted: 12/23/2019] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The Amyloid Imaging to Prevent Alzheimer's Disease (AMYPAD) Prognostic and Natural History Study (PNHS) aims at understanding the role of amyloid imaging in the earliest stages of Alzheimer's disease (AD). AMYPAD PNHS adds (semi-)quantitative amyloid PET imaging to several European parent cohorts (PCs) to predict AD-related progression as well as address methodological challenges in amyloid PET. METHODS AMYPAD PNHS is an open-label, prospective, multi-center, cohort study recruiting from multiple PCs. Around 2000 participants will undergo baseline amyloid positron emission tomography (PET), half of whom will be invited for a follow-up PET 12 at least 12 months later. RESULTS Primary include several amyloid PET measurements (Centiloid, SUVr, BPND , R1 ), and secondary are their changes from baseline, relationship to other amyloid markers (cerebrospinal fluid and visual assessment), and predictive value of AD-related decline. EXPECTED IMPACT Determining the role of amyloid PET for the understanding of this complex disease and potentially improving secondary prevention trials.
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Affiliation(s)
- Isadora Lopes Alves
- Department of Radiology and Nuclear MedicineAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Lyduine E. Collij
- Department of Radiology and Nuclear MedicineAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Daniele Altomare
- Laboratory of Neuroimaging of Aging (LANVIE)University of GenevaGenevaSwitzerland
- Memory ClinicUniversity Hospital of GenevaGenevaSwitzerland
| | - Giovanni B. Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE)University of GenevaGenevaSwitzerland
- Memory ClinicUniversity Hospital of GenevaGenevaSwitzerland
| | - Laure Saint‐Aubert
- Department of Nuclear MedicineImaging PoleToulouse, University HospitalToulouseFrance
- Toulouse NeuroImaging CenterUniversité de Toulouse, Inserm, UPSToulouseFrance
| | - Pierre Payoux
- Department of Nuclear MedicineImaging PoleToulouse, University HospitalToulouseFrance
- Toulouse NeuroImaging CenterUniversité de Toulouse, Inserm, UPSToulouseFrance
| | - Miia Kivipelto
- Department of Geriatric MedicineKarolinska University Hospital HuddingeStockholmSweden
| | - Frank Jessen
- Department of Nuclear MedicineUniversity of CologneCologneGermany
| | | | - Annebet Leeuwis
- Department of Neurology, Amsterdam UMCVrije Universiteit AmsterdamAlzheimercenterAmsterdamthe Netherlands
| | - Alle Meije Wink
- Department of Radiology and Nuclear MedicineAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Pieter Jelle Visser
- Department of Neurology, Amsterdam UMCVrije Universiteit AmsterdamAlzheimercenterAmsterdamthe Netherlands
| | - Bart N.M. van Berckel
- Department of Radiology and Nuclear MedicineAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Philip Scheltens
- Department of Neurology, Amsterdam UMCVrije Universiteit AmsterdamAlzheimercenterAmsterdamthe Netherlands
| | | | | | | | | | | | - Juan Domingo Gispert
- Barcelona β Brain Research CenterBarcelonaSpain
- Centro de Investigación Biomédica en Red de BioingenieríaBiomateriales y Nanomedicina (CIBER‐BBN)MadridSpain
- Universitat Pompeu FabraBarcelonaSpain
| | | | - Lisa Ford
- Janssen Pharmaceutica RNDTitusvilleNew JerseyUSA
| | - Craig Ritchie
- Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUnited Kingdom
| | - Gill Farrar
- GE HealthcareLife SciencesAmershamUnited Kingdom
| | - Frederik Barkhof
- Department of Radiology and Nuclear MedicineAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
- Centre for Medical Image ComputingMedical Physics and Biomedical Engineering, UCLLondonUnited Kingdom
| | - José Luis Molinuevo
- Barcelona β Brain Research CenterBarcelonaSpain
- Universitat Pompeu FabraBarcelonaSpain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES)MadridSpain
| | - the AMYPAD Consortium
- Department of Radiology and Nuclear MedicineAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
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40
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Gregory SD, Pauls JP, Wu EL, Stephens A, Steinseifer U, Tansley G, Fraser JF. An advanced mock circulation loop for in vitro cardiovascular device evaluation. Artif Organs 2020; 44:E238-E250. [PMID: 31951020 DOI: 10.1111/aor.13636] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 09/30/2019] [Revised: 12/11/2019] [Accepted: 01/07/2020] [Indexed: 11/28/2022]
Abstract
Controlled and repeatable in vitro evaluation of cardiovascular devices using a mock circulation loop (MCL) is essential prior to in vivo or clinical trials. MCLs often consist of only a systemic circulation with no autoregulatory responses and limited validation. This study aimed to develop, and validate against human data, an advanced MCL with systemic, pulmonary, cerebral, and coronary circulations with autoregulatory responses. The biventricular MCL was constructed with pneumatically controlled hydraulic circulations with Starling responsive ventricles and autoregulatory cerebral and coronary circulations. Hemodynamic repeatability was assessed and complemented by validation using impedance cardiography data from 50 healthy humans. The MCL successfully simulated patient scenarios including rest, exercise, and left heart failure with and without cardiovascular device support. End-systolic pressure-volume relationships for respective healthy and heart failure conditions had slopes of 1.27 and 0.54 mm Hg mL-1 (left ventricle), and 0.18 and 0.10 mm Hg mL-1 (right ventricle), aligning with the literature. Coronary and cerebral autoregulation showed a strong correlation (R2 : .99) between theoretical and experimentally derived circuit flow. MCL repeatability was demonstrated with correlation coefficients being statistically significant (P < .05) for all simulated conditions while MCL hemodynamics aligned well with human data. This advanced MCL is a valuable tool for inexpensive and controlled evaluation of cardiovascular devices.
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Affiliation(s)
- Shaun D Gregory
- Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, VIC, Australia.,Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.,School of Engineering and Built Environment, Griffith University, Southport, QLD, Australia.,School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Jo P Pauls
- Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.,School of Engineering and Built Environment, Griffith University, Southport, QLD, Australia.,School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Eric L Wu
- Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.,School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Andrew Stephens
- Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, VIC, Australia.,Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Ulrich Steinseifer
- Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, VIC, Australia.,Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Geoff Tansley
- Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.,School of Engineering and Built Environment, Griffith University, Southport, QLD, Australia
| | - John F Fraser
- Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.,School of Medicine, University of Queensland, Brisbane, QLD, Australia
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41
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Hobson C, Nelsen EF, Hsiao J, Kern ME, Stephens A, O'Brien ET, Falvo MR, Superfine R. A Side-view on Nuclear Mechanics: Combined Atomic Force Microscopy and Light Sheet Microscopy Inform Chromatin's Role in Regulating Nuclear Morphology. Biophys J 2020. [DOI: 10.1016/j.bpj.2019.11.1624] [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] Open
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42
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Pauls JP, Roberts LA, Stephens A, Fraser JF, Tansley G, Gregory SD. Improving In vitro Evaluation Capabilities of Cardiac Assist Devices through a Validated Exercise Simulation. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:4901-4904. [PMID: 31946959 DOI: 10.1109/embc.2019.8856936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Cardiac assist devices require thorough in vitro evaluation prior to in vivo animal trials, which is often undertaken in mock circulatory loops. To allow for best possible device development, mock circulatory loops need to be able to simulate a variety of patient scenarios. Transition from rest to exercise is one of the most commonly simulated patient scenarios, however, to validate in vitro exercise test beds, baseline data on how the healthy heart and circulatory system responds to exercise is required. Steady state and time response data for heart rate (HR), stroke volume (SV) and cardiac output (CO) was continuously recorded using impedance cardiography in 50 healthy subjects (27 male / 23 female) during exercise on a recumbent exercise ergometer. This data was then used to implement an exercise simulation in a mock circulatory loop and both the steady state and transient results were compared with the mean response of subjects transitioning from rest to 60 W exercise. When transitioning from rest to exercise the time constant (τ) and rise time (tr) for HR, SV and CO were between 10.6-19.3s and 24.7-44.3s respectively for both sexes. No significant differences between the genders were found for τ and tr (p>0.05). Mock circulatory loop results of HR, SV and CO were in good accordance with human data. The present data was used to successfully validate in vitro exercise simulations and may be used to validate in silico numerical simulations of exercise, thus further improving the evaluation capabilities for existing and under development cardiac assist devices.
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43
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de Wilde A, van der Flier WM, Pelkmans W, Bouwman F, Verwer J, Groot C, van Buchem MM, Zwan M, Ossenkoppele R, Yaqub M, Kunneman M, Smets EMA, Barkhof F, Lammertsma AA, Stephens A, van Lier E, Biessels GJ, van Berckel BN, Scheltens P. Association of Amyloid Positron Emission Tomography With Changes in Diagnosis and Patient Treatment in an Unselected Memory Clinic Cohort: The ABIDE Project. JAMA Neurol 2019; 75:1062-1070. [PMID: 29889941 DOI: 10.1001/jamaneurol.2018.1346] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Importance Previous studies have evaluated the diagnostic effect of amyloid positron emission tomography (PET) in selected research cohorts. However, these research populations do not reflect daily practice, thus hampering clinical implementation of amyloid imaging. Objective To evaluate the association of amyloid PET with changes in diagnosis, diagnostic confidence, treatment, and patients' experiences in an unselected memory clinic cohort. Design, Setting, and Participants Amyloid PET using fluoride-18 florbetaben was offered to 866 patients who visited the tertiary memory clinic at the VU University Medical Center between January 2015 and December 2016 as part of their routine diagnostic dementia workup. Of these patients, 476 (55%) were included, 32 (4%) were excluded, and 358 (41%) did not participate. To enrich this sample, 31 patients with mild cognitive impairment from the University Medical Center Utrecht memory clinic were included. For each patient, neurologists determined a preamyloid and postamyloid PET diagnosis that existed of both a clinical syndrome (dementia, mild cognitive impairment, or subjective cognitive decline) and a suspected etiology (Alzheimer disease [AD] or non-AD), with a confidence level ranging from 0% to 100%. In addition, the neurologist determined patient treatment in terms of ancillary investigations, medication, and care. Each patient received a clinical follow-up 1 year after being scanned. Main Outcomes and Measures Primary outcome measures were post-PET changes in diagnosis, diagnostic confidence, and patient treatment. Results Of the 507 patients (mean [SD] age, 65 (8) years; 201 women [39%]; mean [SD] Mini-Mental State Examination score, 25 [4]), 164 (32%) had AD dementia, 70 (14%) non-AD dementia, 114 (23%) mild cognitive impairment, and 159 (31%) subjective cognitive decline. Amyloid PET results were positive for 242 patients (48%). The suspected etiology changed for 125 patients (25%) after undergoing amyloid PET, more often due to a negative (82 of 265 [31%]) than a positive (43 of 242 [18%]) PET result (P < .01). Post-PET changes in suspected etiology occurred more frequently in patients older (>65 years) than younger (<65 years) than the typical age at onset of 65 years (74 of 257 [29%] vs 51 of 250 [20%]; P < .05). Mean diagnostic confidence (SD) increased from 80 (13) to 89 (13%) (P < .001). In 123 patients (24%), there was a change in patient treatment post-PET, mostly related to additional investigations and therapy. Conclusions and Relevance This prospective diagnostic study provides a bridge between validating amyloid PET in a research setting and implementing this diagnostic tool in daily clinical practice. Both amyloid-positive and amyloid-negative results had substantial associations with changes in diagnosis and treatment, both in patients with and without dementia.
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Affiliation(s)
- Arno de Wilde
- Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Wiesje M van der Flier
- Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands.,Department of Epidemiology & Biostatistics, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Wiesje Pelkmans
- Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Femke Bouwman
- Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Jurre Verwer
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Colin Groot
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Marieke M van Buchem
- Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Marissa Zwan
- Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Rik Ossenkoppele
- Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands.,Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Maqsood Yaqub
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Marleen Kunneman
- Department of Medical Psychology, Amsterdam Neuroscience, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Ellen M A Smets
- Department of Medical Psychology, Amsterdam Neuroscience, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Frederik Barkhof
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands.,Institutes of Neurology and Healthcare Engineering, University College London, London, England
| | - Adriaan A Lammertsma
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | | | | | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Bart N van Berckel
- Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands.,Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Philip Scheltens
- Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
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Stephens A, Nidetz R, Mesyngier N, Chung MT, Song Y, Fu J, Kurabayashi K. Mass-producible microporous silicon membranes for specific leukocyte subset isolation, immunophenotyping, and personalized immunomodulatory drug screening in vitro. Lab Chip 2019; 19:3065-3076. [PMID: 31389447 PMCID: PMC6736731 DOI: 10.1039/c9lc00315k] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Widespread commercial and clinical adaptation of biomedical microfluidic technology has been limited in large part due to the lack of mass producibility of polydimethylsiloxane (PDMS) and glass-based devices commonly as reported in the literature. Here, we present a batch-fabricated, robust, and mass-producible immunophenotyping microfluidic device using silicon micromachining processes. Our Si and glass-based microfluidic device, named the silicon microfluidic immunophenotyping assay (SiMIPA), consists of a highly porous (∼40%) silicon membrane that can selectively separate microparticles below a certain size threshold. The device is capable of isolating and stimulating specific leukocyte populations, and allows for measuring their secretion of cell signaling proteins by means of a no-wash homogeneous chemiluminescence-based immunoassay. The high manufacturing throughput (∼170 devices per wafer) makes a large quantity of SiMIPA chips readily available for clinically relevant applications, which normally require large dataset acquisitions for statistical accuracy. With 30 SiMIPA chips, we performed in vitro immunomodulatory drug screening on isolated leukocyte subsets, yielding 5 data points at 6 drug concentrations. Furthermore, the excellent structural integrity of the device allowed for samples and reagents to be loaded using a micropipette, greatly simplifying the experimental protocol.
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Affiliation(s)
- Andrew Stephens
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan 48109, USA
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Kroth H, Oden F, Molette J, Schieferstein H, Capotosti F, Mueller A, Berndt M, Schmitt-Willich H, Darmency V, Gabellieri E, Boudou C, Juergens T, Varisco Y, Vokali E, Hickman DT, Tamagnan G, Pfeifer A, Dinkelborg L, Muhs A, Stephens A. Discovery and preclinical characterization of [ 18F]PI-2620, a next-generation tau PET tracer for the assessment of tau pathology in Alzheimer's disease and other tauopathies. Eur J Nucl Med Mol Imaging 2019; 46:2178-2189. [PMID: 31264169 PMCID: PMC6667408 DOI: 10.1007/s00259-019-04397-2] [Citation(s) in RCA: 125] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 06/10/2019] [Indexed: 01/11/2023]
Abstract
PURPOSE Tau deposition is a key pathological feature of Alzheimer's disease (AD) and other neurodegenerative disorders. The spreading of tau neurofibrillary tangles across defined brain regions corresponds to the observed level of cognitive decline in AD. Positron-emission tomography (PET) has proved to be an important tool for the detection of amyloid-beta (Aβ) aggregates in the brain, and is currently being explored for detection of pathological misfolded tau in AD and other non-AD tauopathies. Several PET tracers targeting tau deposits have been discovered and tested in humans. Limitations have been reported, especially regarding their selectivity. METHODS In our screening campaign we identified pyrrolo[2,3-b:4,5-c']dipyridine core structures with high affinity for aggregated tau. Further characterization showed that compounds containing this moiety had significantly reduced monoamine oxidase A (MAO-A) binding compared to pyrido[4,3-b]indole derivatives such as AV-1451. RESULTS Here we present preclinical data of all ten fluoropyridine regioisomers attached to the pyrrolo[2,3-b:4,5-c']dipyridine scaffold, revealing compounds 4 and 7 with superior properties. The lead candidate [18F]PI-2620 (compound 7) displayed high affinity for tau deposits in AD brain homogenate competition assays. Specific binding to pathological misfolded tau was further demonstrated by autoradiography on AD brain sections (Braak I-VI), Pick's disease and progressive supranuclear palsy (PSP) pathology, whereas no specific tracer binding was detected on brain slices from non-demented donors. In addition to its high affinity binding to tau aggregates, the compound showed excellent selectivity with no off-target binding to Aβ or MAO-A/B. Good brain uptake and fast washout were observed in healthy mice and non-human primates. CONCLUSIONS Therefore, [18F]PI-2620 was selected for clinical validation.
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Affiliation(s)
| | - Felix Oden
- Life Molecular Imaging, GmbH, Berlin, Germany
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Stephens A, Gregory S, Tansley G, Busch A, Salamonsen R. In vitro evaluation of an adaptive Starling-like controller for dual rotary ventricular assist devices. Artif Organs 2019; 43:E294-E307. [PMID: 31188476 DOI: 10.1111/aor.13510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 01/28/2019] [Revised: 05/19/2019] [Accepted: 05/31/2019] [Indexed: 01/02/2023]
Abstract
Rotary ventricular assist devices (VADs) operated clinically under constant speed control (CSC) cannot respond adequately to changes in patient cardiac demand, resulting in sub-optimal VAD flow regulation. Starling-like control (SLC) of VADs mimics the healthy ventricular flow regulation and automatically adjusts VAD speed to meet varying patient cardiac demand. The use of a fixed control line (CL - the relationship between ventricular preload and VAD flow) limits the flow regulating capability of the controller, especially in the case of exercise. Adaptive SLC (ASLC) overcomes this limitation by allowing the controller to adapt the CL to meet a diverse range of circulatory conditions. This study evaluated ASLC, SLC and CSC in a biventricular supported mock circulation loop under the simulated conditions of exercise, sleep, fluid loading and systemic hypertension. Each controller was evaluated on its ability to remain within predefined limits of VAD flow, preload, and afterload. The ASLC produced superior cardiac output (CO) during exercise (10.1 L/min) compared to SLC (7.3 L/min) and CSC (6.3 L/min). The ASLC produced favourable haemodynamics during sleep, fluid loading and systemic hypertension and could remain within a predefined haemodynamic range in three out of four simulations, suggesting improved haemodynamic performance over SLC and CSC.
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Affiliation(s)
- Andrew Stephens
- Department of Mechanical and Aerospace Engineering, Monash University, Victoria, Australia.,Cardiorespiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Victoria, Australia.,Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia.,School of Engineering and Built Environment, Griffith Sciences, Griffith University, Queensland, Australia
| | - Shaun Gregory
- Department of Mechanical and Aerospace Engineering, Monash University, Victoria, Australia.,Cardiorespiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Victoria, Australia.,Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia.,School of Engineering and Built Environment, Griffith Sciences, Griffith University, Queensland, Australia
| | - Geoff Tansley
- Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia.,School of Engineering and Built Environment, Griffith Sciences, Griffith University, Queensland, Australia
| | - Andrew Busch
- School of Engineering and Built Environment, Griffith Sciences, Griffith University, Queensland, Australia
| | - Robert Salamonsen
- Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia
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Pauls JP, Miotto A, Stephens A, Gregory SD, Tansley G. OpenHeart Project-An Open-Source Research Community in the Field of Mechanical Circulatory Support. Artif Organs 2019; 42:939-942. [PMID: 30375678 DOI: 10.1111/aor.13361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Jo P Pauls
- Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,School of Medicine, University of Queensland, Brisbane, Australia
| | - Amanda Miotto
- eResearch Services, Griffith University, Southport, Australia
| | - Andrew Stephens
- Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,School of Engineering and Built Environment, Griffith University, Southport, Australia
| | - Shaun D Gregory
- Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,School of Medicine, University of Queensland, Brisbane, Australia.,School of Engineering and Built Environment, Griffith University, Southport, Australia.,Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, Australia
| | - Geoff Tansley
- Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,School of Engineering and Built Environment, Griffith University, Southport, Australia
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Boone AC, Gregory SD, Wu EL, Stephens A, Liao S, Pauls JP, Salamonsen R, Fraser J, Tansley GD. Evaluation of an intraventricular balloon pump for short-term support of patients with heart failure. Artif Organs 2019; 43:860-869. [PMID: 30868602 DOI: 10.1111/aor.13454] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 03/01/2019] [Accepted: 03/04/2019] [Indexed: 12/22/2022]
Abstract
The high cost of ventricular assist devices results in poor cost-effectiveness when used as a short-term bridging solution, thus a low-cost alternative is desirable. The present study aimed to develop an intraventricular balloon pump (IVBP) for short-term circulatory support, and to evaluate the effect of balloon actuation timing on the degree of cardiac support provided to a simulated in vitro severe heart failure (SHF) patient. A silicone IVBP was designed to avoid contact with internal left ventricular (LV) features (ie, papillary muscles, chordae, aortic, and mitral valves) based on LV computed tomography data of 10 SHF patients with dilated cardiomyopathy. The hemodynamic effects of varying balloon inflation and deflation timing parameters (inflation duty [D] and end-inflation point [σ]) were evaluated in a purpose-built systemic mock circulatory loop. Three IVBP actuation timing categories were defined: co-, transitional, and counterpulsation. Compared to the SHF baseline, co-pulsation increased aortic flow from 3.5 to 5.2 L/min, mean arterial pressure from 72.1 to 94.8 mmHg and ejection fraction from 14.4% to 21.5%, while mean left atrial pressure decreased from 14.6 to 10 mmHg. Transitional and counterpulsation resulted in a double ventricular pulse and extended the duration of increased ventricular pressure, potentially impeding diastolic filling and coronary perfusion. This in vitro study showed the IVBP could restore the hemodynamic balance of a simulated SHF patient with dilated cardiomyopathy to healthy levels.
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Affiliation(s)
- Alice C Boone
- School of Engineering and Built Environment, Griffith University, Queensland, Australia.,Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia
| | - Shaun D Gregory
- School of Engineering and Built Environment, Griffith University, Queensland, Australia.,Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,School of Medicine, The University of Queensland, Brisbane, Australia.,Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, Australia
| | - Eric L Wu
- Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,School of Medicine, The University of Queensland, Brisbane, Australia
| | - Andrew Stephens
- School of Engineering and Built Environment, Griffith University, Queensland, Australia.,Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, Australia
| | - Sam Liao
- Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Jo P Pauls
- School of Engineering and Built Environment, Griffith University, Queensland, Australia.,Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia
| | - Robert Salamonsen
- Department of Epidemiology and Preventative Medicine, Monash University.,Intensive Care Unit, Alfred Hospital, Melbourne, Australia
| | - John Fraser
- Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,School of Medicine, The University of Queensland, Brisbane, Australia
| | - Geoff D Tansley
- School of Engineering and Built Environment, Griffith University, Queensland, Australia.,Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia
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Moffitt L, Karimnia N, Stephens A, Bilandzic M. Therapeutic Targeting of Collective Invasion in Ovarian Cancer. Int J Mol Sci 2019; 20:E1466. [PMID: 30909510 PMCID: PMC6471817 DOI: 10.3390/ijms20061466] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 03/14/2019] [Accepted: 03/15/2019] [Indexed: 12/31/2022] Open
Abstract
Ovarian cancer is the seventh most commonly diagnosed cancer amongst women and has the highest mortality rate of all gynaecological malignancies. It is a heterogeneous disease attributed to one of three cell types found within the reproductive milieu: epithelial, stromal, and germ cell. Each histotype differs in etiology, pathogenesis, molecular biology, risk factors, and prognosis. Furthermore, the origin of ovarian cancer remains unclear, with ovarian involvement secondary to the contribution of other gynaecological tissues. Despite these complexities, the disease is often treated as a single entity, resulting in minimal improvement to survival rates since the introduction of platinum-based chemotherapy over 30 years ago. Despite concerted research efforts, ovarian cancer remains one of the most difficult cancers to detect and treat, which is in part due to the unique mode of its dissemination. Ovarian cancers tend to invade locally to neighbouring tissues by direct extension from the primary tumour, and passively to pelvic and distal organs within the peritoneal fluid or ascites as multicellular spheroids. Once at their target tissue, ovarian cancers, like most epithelial cancers including colorectal, melanoma, and breast, tend to invade as a cohesive unit in a process termed collective invasion, driven by specialized cells termed "leader cells". Emerging evidence implicates leader cells as essential drivers of collective invasion and metastasis, identifying collective invasion and leader cells as a viable target for the management of metastatic disease. However, the development of targeted therapies specifically against this process and this subset of cells is lacking. Here, we review our understanding of metastasis, collective invasion, and the role of leader cells in ovarian cancer. We will discuss emerging research into the development of novel therapies targeting collective invasion and the leader cell population.
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Affiliation(s)
- Laura Moffitt
- Hudson Institute of Medical Research, Clayton VIC 3168, Australia.
- Department of Molecular and Translational Sciences, Monash University, Clayton VIC 3800, Australia.
| | - Nazanin Karimnia
- Hudson Institute of Medical Research, Clayton VIC 3168, Australia.
- Department of Molecular and Translational Sciences, Monash University, Clayton VIC 3800, Australia.
| | - Andrew Stephens
- Hudson Institute of Medical Research, Clayton VIC 3168, Australia.
- Department of Molecular and Translational Sciences, Monash University, Clayton VIC 3800, Australia.
| | - Maree Bilandzic
- Hudson Institute of Medical Research, Clayton VIC 3168, Australia.
- Department of Molecular and Translational Sciences, Monash University, Clayton VIC 3800, Australia.
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Hobson C, Nelsen EF, Hsiao J, Stephens A, Timothy O'Brien E, Falvo MR, Superfine R. Nuclear Deformation with Combined AFM and 3D Multi-Color Live-Cell Line Bessel Sheet Imaging. Biophys J 2019. [DOI: 10.1016/j.bpj.2018.11.173] [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: 11/28/2022] Open
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