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Robinson NL, Marcellino C, Johnston M, Abcejo AS. A human cadaveric model for venous air embolism tool development. Res Sq 2023:rs.3.rs-3320755. [PMID: 37720030 PMCID: PMC10503849 DOI: 10.21203/rs.3.rs-3320755/v1] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Purpose A human cadaveric model combining standard lung protective mechanical ventilation and modified cardiac bypass techniques was developed to allow investigation into automated modes of detection of venous air emboli (VAE) prior to in vivo human or animal investigations. Methods In this study, in order to create an artificial cardiopulmonary circuit in a cadaver that could mimic VAE physiology, the direction of flow was reversed from conventional cardiac bypass. Saline was circulated in isolation through the heart and lungs as opposed to the peripheral organs by placing the venous cannula into the aorta and the arterial cannula into the inferior vena cava with selective ligation of other vessels. Results Mechanical ventilation and this reversed cardiac bypass scheme allowed preliminary detection of VAE independently but not in concert in our current simulation scheme due to pulmonary edema in the cadaver. A limited dissection approach was used initially followed by a radical exposure of the great vessels, and both proved feasible in terms of air signal detection. We used electrical impendence as a preliminary tool to validate detection in this cadaveric model however we theorize that it would work for echocardiographic, intravenous ultrasound or other novel modalities as well. Conclusion A cadaveric model allows monitoring technology development with reduced use of animal and conventional human testing.
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Abstract
We describe a 60-year-old female patient who suffered an apparently intentional overdose of lacosamide and who developed status epilepticus secondary to its toxicity, complicated by refractory ventricular arrhythmia necessitating advanced cardiac life support and percutaneous stellate ganglion blockade. Extracorporeal membrane oxygenation was considered, and arterial and venous small-bore sheaths were placed in order to allow for extracorporeal cardiopulmonary resuscitation if cardiac arrest recurred, but they were not ultimately used. She suffered an embolic left middle cerebral artery stroke but otherwise recovered from the episode. This eventful clinical course highlights the dangers of lacosamide in high doses.
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Marcellino C, Zalewski NL, Rabinstein AA. Treatment of Vascular Myelopathies. Curr Treat Options Neurol 2021. [DOI: 10.1007/s11940-021-00689-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: 10/20/2022]
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Affiliation(s)
- Chris Marcellino
- Division of Neurocritical Care and Hospital Neurology, Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
- Department of Neurologic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902, USA
| | - Sherri A Braksick
- Division of Neurocritical Care and Hospital Neurology, Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Eelco F M Wijdicks
- Division of Neurocritical Care and Hospital Neurology, Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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5
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Marcellino C, O'Brien EK, Choby G, Stokken JK. Distributed monitoring of sinonasal symptoms using a mobile device application-a pilot study. Int Forum Allergy Rhinol 2021; 11:1283-1286. [PMID: 33749094 DOI: 10.1002/alr.22795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Chris Marcellino
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Erin K O'Brien
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.,Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Garret Choby
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.,Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Janalee K Stokken
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.,Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Tyagi R, Bulman CA, Cho-Ngwa F, Fischer C, Marcellino C, Arkin MR, McKerrow JH, McNamara CW, Mahoney M, Tricoche N, Jawahar S, Janetka JW, Lustigman S, Sakanari J, Mitreva M. An Integrated Approach to Identify New Anti-Filarial Leads to Treat River Blindness, a Neglected Tropical Disease. Pathogens 2021; 10:71. [PMID: 33466870 PMCID: PMC7830784 DOI: 10.3390/pathogens10010071] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/05/2021] [Accepted: 01/11/2021] [Indexed: 11/17/2022] Open
Abstract
Filarial worms cause multiple debilitating diseases in millions of people worldwide, including river blindness. Currently available drugs reduce transmission by killing larvae (microfilariae), but there are no effective cures targeting the adult parasites (macrofilaricides) which survive and reproduce in the host for very long periods. To identify effective macrofilaricides, we carried out phenotypic screening of a library of 2121 approved drugs for clinical use against adult Brugia pahangi and prioritized the hits for further studies by integrating those results with a computational prioritization of drugs and associated targets. This resulted in the identification of 18 hits with anti-macrofilaricidal activity, of which two classes, azoles and aspartic protease inhibitors, were further expanded upon. Follow up screening against Onchocerca spp. (adult Onchocerca ochengi and pre-adult O. volvulus) confirmed activity for 13 drugs (the majority having IC50 < 10 μM), and a counter screen of a subset against L. loa microfilariae showed the potential to identify selective drugs that prevent adverse events when co-infected individuals are treated. Stage specific activity was also observed. Many of these drugs are amenable to structural optimization, and also have known canonical targets, making them promising candidates for further optimization that can lead to identifying and characterizing novel anti-macrofilarial drugs.
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Affiliation(s)
- Rahul Tyagi
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, 4523 Clayton Ave., St. Louis, MO 63110, USA;
| | - Christina A. Bulman
- Department of Pharmaceutical Chemistry, University of California San Francisco, 1700 4th Street, San Francisco, CA 94158, USA; (C.A.B.); (C.F.); (M.R.A.)
| | - Fidelis Cho-Ngwa
- ANDI Centre of Excellence for Onchocerciasis Drug Research, Biotechnology Unit, Faculty of Science, University of Buea, Buea CM-00237, Cameroon;
| | - Chelsea Fischer
- Department of Pharmaceutical Chemistry, University of California San Francisco, 1700 4th Street, San Francisco, CA 94158, USA; (C.A.B.); (C.F.); (M.R.A.)
| | - Chris Marcellino
- Division of Neurocritical Care and Hospital Neurology, Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA;
| | - Michelle R. Arkin
- Department of Pharmaceutical Chemistry, University of California San Francisco, 1700 4th Street, San Francisco, CA 94158, USA; (C.A.B.); (C.F.); (M.R.A.)
| | - James H. McKerrow
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, CA 92093, USA;
| | - Case W. McNamara
- Calibr, a Division of The Scripps Research Institute, 11119 Torrey Pines Road, La Jolla, CA 92037, USA;
| | - Matthew Mahoney
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO 63110, USA; (M.M.); (J.W.J.)
| | - Nancy Tricoche
- Lindsley F. Kimball Research Institute, New York City, NY 10065, USA; (N.T.); (S.J.); (S.L.)
| | - Shabnam Jawahar
- Lindsley F. Kimball Research Institute, New York City, NY 10065, USA; (N.T.); (S.J.); (S.L.)
| | - James W. Janetka
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO 63110, USA; (M.M.); (J.W.J.)
| | - Sara Lustigman
- Lindsley F. Kimball Research Institute, New York City, NY 10065, USA; (N.T.); (S.J.); (S.L.)
| | - Judy Sakanari
- Department of Pharmaceutical Chemistry, University of California San Francisco, 1700 4th Street, San Francisco, CA 94158, USA; (C.A.B.); (C.F.); (M.R.A.)
| | - Makedonka Mitreva
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, 4523 Clayton Ave., St. Louis, MO 63110, USA;
- McDonnell Genome Institute, Washington University School of Medicine, 4444 Forest Park Ave., St. Louis, MO 63108, USA
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Marcellino C, Van Gompel JJ, Hocker S. Letter: Nonepileptic, Stereotypical, and Intermittent Symptoms (NESIS) in Patients With Subdural Hematoma: Proposal for a New Clinical Entity With Therapeutic and Prognostic Implications. Neurosurgery 2020; 86:E484. [PMID: 31980823 DOI: 10.1093/neuros/nyaa010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Chris Marcellino
- Department of Neurologic Surgery Mayo Clinic Rochester, Minnesota.,Department of Neurology Mayo Clinic Rochester, Minnesota
| | | | - Sara Hocker
- Department of Neurology Mayo Clinic Rochester, Minnesota
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Sorenson TJ, Marcellino C, Acciarri N, Rangel Castilla L, Lanzino G. "Interlocking" Clipping of an Irregular Middle Cerebral Artery Bifurcation Aneurysm: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2019; 16:273. [PMID: 29850879 DOI: 10.1093/ons/opy147] [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] [Received: 01/18/2018] [Accepted: 05/09/2018] [Indexed: 11/13/2022] Open
Abstract
Middle cerebral artery (MCA) aneurysms often have an irregular morphology that might require creative clipping techniques even in the case of small aneurysms. In this video, we illustrate the case of a patient with an incidental but very irregular MCA aneurysm. The presence of 2 separate, asymmetric lobes was dealt with by utilizing the "interlocking" clip technique in which a regular clip is used to obliterate 1 portion of the aneurysm and a fenestrated clip, with the ring of the fenestration circling the body of the first clip, is used to obtain obliteration of the other lobe. This patient also had a contralateral internal carotid artery occlusion, and we discuss the pitfalls of temporary clipping in such a situation.
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Affiliation(s)
| | - Chris Marcellino
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Nicola Acciarri
- Department of Neurologic Surgery, Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Leonardo Rangel Castilla
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.,Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Giuseppe Lanzino
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.,Department of Radiology, Mayo Clinic, Rochester, Minnesota
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Zimmermann T, Marcellino C, Van Abel K, Van Gompel J, Link M, O'Brien E, Stokken J. Timing of Postoperative CSF Leak after Skull Base Surgery in Patients with Obstructive Sleep Apnea. Skull Base Surg 2017. [DOI: 10.1055/s-0037-1600727] [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: 10/20/2022]
Affiliation(s)
| | | | | | | | - Michael Link
- Mayo Clinic, Rochester, Minnesota, United States
| | - Erin O'Brien
- Mayo Clinic, Rochester, Minnesota, United States
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10
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Bulman CA, Bidlow CM, Lustigman S, Cho-Ngwa F, Williams D, Rascón, Jr AA, Tricoche N, Samje M, Bell A, Suzuki B, Lim KC, Supakorndej N, Supakorndej P, Wolfe AR, Knudsen GM, Chen S, Wilson C, Ang KH, Arkin M, Gut J, Franklin C, Marcellino C, McKerrow JH, Debnath A, Sakanari JA. Repurposing auranofin as a lead candidate for treatment of lymphatic filariasis and onchocerciasis. PLoS Negl Trop Dis 2015; 9:e0003534. [PMID: 25700363 PMCID: PMC4336141 DOI: 10.1371/journal.pntd.0003534] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 01/12/2015] [Indexed: 02/03/2023] Open
Abstract
Two major human diseases caused by filariid nematodes are onchocerciasis, or river blindness, and lymphatic filariasis, which can lead to elephantiasis. The drugs ivermectin, diethylcarbamazine (DEC), and albendazole are used in control programs for these diseases, but are mainly effective against the microfilarial stage and have minimal or no effect on adult worms. Adult Onchocerca volvulus and Brugia malayi worms (macrofilariae) can live for up to 15 years, reproducing and allowing the infection to persist in a population. Therefore, to support control or elimination of these two diseases, effective macrofilaricidal drugs are necessary, in addition to current drugs. In an effort to identify macrofilaricidal drugs, we screened an FDA-approved library with adult worms of Brugia spp. and Onchocerca ochengi, third-stage larvae (L3s) of Onchocerca volvulus, and the microfilariae of both O. ochengi and Loa loa. We found that auranofin, a gold-containing drug used for rheumatoid arthritis, was effective in vitro in killing both Brugia spp. and O. ochengi adult worms and in inhibiting the molting of L3s of O. volvulus with IC50 values in the low micromolar to nanomolar range. Auranofin had an approximately 43-fold higher IC50 against the microfilariae of L. loa compared with the IC50 for adult female O. ochengi, which may be beneficial if used in areas where Onchocerca and Brugia are co-endemic with L. loa, to prevent severe adverse reactions to the drug-induced death of L. loa microfilariae. Further testing indicated that auranofin is also effective in reducing Brugia adult worm burden in infected gerbils and that auranofin may be targeting the thioredoxin reductase in this nematode. Onchocerciasis or river blindness, and lymphatic filariasis, which can lead to disfiguring elephantiasis, are two neglected tropical diseases that affect millions of people, primarily in developing countries. Both diseases are caused by filariid nematodes; onchocerciasis is caused by Onchocerca volvulus and lymphatic filariasis is caused by Brugia malayi, B. timori, and Wuchereria bancrofti. Currently, there are no drugs available that are highly efficacious against adult worms; existing drugs mainly kill the first-stage larvae (microfilariae). While these drugs can reduce the transmission of infections in a population, the adult filariids (macrofilariae) can continue to produce microfilariae and perpetuate the cycle of infection. Finding a drug that could kill the adult worms would be an important tool in eliminating onchocerciasis and lymphatic filariasis. To identify potential macrofilaricidal drugs, we developed a high throughput screening method to test FDA-approved drugs on adult Brugia spp., which serves as a model for O. volvulus. Using this screening method, we identified a drug called auranofin that kills adult Onchocerca and adult Brugia spp. in vitro, inhibits the molting of O. volvulus L3s, and reduces the worm burden in an in vivo gerbil-B. pahangi model system. Auranofin is known to inhibit a critical enzyme called thioredoxin reductase in some parasite species, and subsequent testing of the effects of auranofin on the thioredoxin reductase of Brugia indicates that this may be auranofin’s mode of action in this nematode as well.
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Affiliation(s)
- Christina A. Bulman
- Center for Discovery and Innovation in Parasitic Diseases, University of California San Francisco, San Francisco, California, United States of America
| | - Chelsea M. Bidlow
- Center for Discovery and Innovation in Parasitic Diseases, University of California San Francisco, San Francisco, California, United States of America
| | - Sara Lustigman
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
| | - Fidelis Cho-Ngwa
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, SW Region, Cameroon
| | - David Williams
- Department of Immunology and Microbiology, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Alberto A. Rascón, Jr
- Center for Discovery and Innovation in Parasitic Diseases, University of California San Francisco, San Francisco, California, United States of America
- Department of Chemistry, San Jose State University, San Jose, California, United States of America
| | - Nancy Tricoche
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
| | - Moses Samje
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, SW Region, Cameroon
| | - Aaron Bell
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
| | - Brian Suzuki
- Center for Discovery and Innovation in Parasitic Diseases, University of California San Francisco, San Francisco, California, United States of America
| | - K. C. Lim
- Center for Discovery and Innovation in Parasitic Diseases, University of California San Francisco, San Francisco, California, United States of America
| | | | - Prasit Supakorndej
- Department of Infectious Diseases, University of Georgia, Athens, Georgia, United States of America
| | - Alan R. Wolfe
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California, United States of America
| | - Giselle M. Knudsen
- UCSF Mass Spectrometry Facility, Department of Pharmaceutical Chemistry, University of California San Francisco, San Francisco, California, United States of America
| | - Steven Chen
- Small Molecule Discovery Center, University of California San Francisco, San Francisco, California, United States of America
| | - Chris Wilson
- Small Molecule Discovery Center, University of California San Francisco, San Francisco, California, United States of America
| | - Kean-Hooi Ang
- Small Molecule Discovery Center, University of California San Francisco, San Francisco, California, United States of America
| | - Michelle Arkin
- Small Molecule Discovery Center, University of California San Francisco, San Francisco, California, United States of America
| | - Jiri Gut
- Center for Discovery and Innovation in Parasitic Diseases, University of California San Francisco, San Francisco, California, United States of America
| | - Chris Franklin
- Center for Discovery and Innovation in Parasitic Diseases, University of California San Francisco, San Francisco, California, United States of America
| | - Chris Marcellino
- Case Western Reserve University School of Medicine, Cleveland, Ohio, United States of America
| | - James H. McKerrow
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego, California, United States of America
| | - Anjan Debnath
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego, California, United States of America
| | - Judy A. Sakanari
- Center for Discovery and Innovation in Parasitic Diseases, University of California San Francisco, San Francisco, California, United States of America
- * E-mail:
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Storey B, Marcellino C, Miller M, Maclean M, Mostafa E, Howell S, Sakanari J, Wolstenholme A, Kaplan R. Utilization of computer processed high definition video imaging for measuring motility of microscopic nematode stages on a quantitative scale: "The Worminator". Int J Parasitol Drugs Drug Resist 2014; 4:233-43. [PMID: 25516834 PMCID: PMC4266792 DOI: 10.1016/j.ijpddr.2014.08.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [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] [Indexed: 10/27/2022]
Abstract
A major hindrance to evaluating nematode populations for anthelmintic resistance, as well as for screening existing drugs, new compounds, or bioactive plant extracts for anthelmintic properties, is the lack of an efficient, objective, and reproducible in vitro assay that is adaptable to multiple life stages and parasite genera. To address this need we have developed the "Worminator" system, which objectively and quantitatively measures the motility of microscopic stages of parasitic nematodes. The system is built around the computer application "WormAssay", developed at the Center for Discovery and Innovation in Parasitic Diseases at the University of California, San Francisco. WormAssay was designed to assess motility of macroscopic parasites for the purpose of high throughput screening of potential anthelmintic compounds, utilizing high definition video as an input to assess motion of adult stage (macroscopic) parasites (e.g. Brugia malayi). We adapted this assay for use with microscopic parasites by modifying the software to support a full frame analysis mode that applies the motion algorithm to the entire video frame. Thus, the motility of all parasites in a given well are recorded and measured simultaneously. Assays performed on third-stage larvae (L3) of the bovine intestinal nematode Cooperia spp., as well as microfilariae (mf) of the filarioid nematodes B. malayi and Dirofilaria immitis, yielded reproducible dose responses using the macrocyclic lactones ivermectin, doramectin, and moxidectin, as well as the nicotinic agonists, pyrantel, oxantel, morantel, and tribendimidine. This new computer based-assay is simple to use, requires minimal new investment in equipment, is robust across nematode genera and developmental stage, and does not require subjective scoring of motility by an observer. Thus, the "Worminator" provides a relatively low-cost platform for developing genera- and stage-specific assays with high efficiency and reproducibility, low labor input, and yields objective motility data that is not subject to scorer bias.
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Affiliation(s)
- Bob Storey
- Department of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - Chris Marcellino
- Center for Discovery and Innovation in Parasitic Diseases, University of California San Francisco, San Francisco, CA, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Melissa Miller
- Department of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - Mary Maclean
- Department of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - Eman Mostafa
- Department of Infectious Diseases, University of Georgia, Athens, GA, USA
- Parasitology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sue Howell
- Department of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - Judy Sakanari
- Center for Discovery and Innovation in Parasitic Diseases, University of California San Francisco, San Francisco, CA, USA
| | - Adrian Wolstenholme
- Department of Infectious Diseases, University of Georgia, Athens, GA, USA
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | - Ray Kaplan
- Department of Infectious Diseases, University of Georgia, Athens, GA, USA
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Marcellino C, Gut J, Lim KC, Singh R, McKerrow J, Sakanari J. WormAssay: a novel computer application for whole-plate motion-based screening of macroscopic parasites. PLoS Negl Trop Dis 2012; 6:e1494. [PMID: 22303493 PMCID: PMC3269415 DOI: 10.1371/journal.pntd.0001494] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 12/07/2011] [Indexed: 11/28/2022] Open
Abstract
Lymphatic filariasis is caused by filarial nematode parasites, including Brugia malayi. Adult worms live in the lymphatic system and cause a strong immune reaction that leads to the obstruction of lymph vessels and swelling of the extremities. Chronic disease leads to the painful and disfiguring condition known as elephantiasis. Current drug therapy is effective against the microfilariae (larval stage) of the parasite, but no drugs are effective against the adult worms. One of the major stumbling blocks toward developing effective macrofilaricides to kill the adult worms is the lack of a high throughput screening method for candidate drugs. Current methods utilize systems that measure one well at a time and are time consuming and often expensive. We have developed a low-cost and simple visual imaging system to automate and quantify screening entire plates based on parasite movement. This system can be applied to the study of many macroparasites as well as other macroscopic organisms. The World Health Organization estimates that there are approximately 37 million people who are afflicted by Onchocerca volvulus (the parasitic worm that causes river blindness) and over 120 million people afflicted by the filarial worms Wuchereria and Brugia spp. (causative agents of lymphatic filariasis or elephantiasis). Current mass drug administration includes albendazole and either diethylcarbamazine or ivermectin. These drugs, however, are effective at killing the early larval stage (microfilariae) released from adult female worms but they do not kill the adult worms. Adult worms can live up to 10 or more years, releasing thousands of microfilariae per day. It is essential therefore to treat infected individuals with macrofilaricides in order to prevent the adult parasites from producing microfiliariae for the duration of the infection and to treat the disease. In order to screen candidate drugs for use as macrofilaricides, we have developed an inexpensive system and simple method for quantifying the effectiveness of drugs on parasite movement. The apparatus uses a commodity video camera, a computer and a newly developed free and open source software application to provide automated and quantitative measurements of parasite motility on each plate of worms. This system is not only useful for high throughput screening of macroparasites but can also be applied to the study of other macroscopic organisms as well.
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Affiliation(s)
- Chris Marcellino
- Sandler Center for Drug Discovery, University of California San Francisco, San Francisco, California, USA.
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Portaleone D, Marcellino C, Casale F, Cellerino P, Vismara E, Barca M, Sganzerla E, Pastorino G, Volterrani F, Carnelli V. [Clinical improvement induced by chemotherapy and social rehabilitation in a preterminal case of brain stem neoplasm: the objective and instrumental aspects]. Pediatr Med Chir 1993; 15:221-3. [PMID: 8321730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
A sixteen-years-old boy with a brain-stem neoplasia inducing coma was treated with chemotherapeutic agents. It resulted in dramatic clinical and instrumental improvement; radiologic findings were evaluated, showing decreasing dimension of intracranial mass. Brain-stem auditory evoked potentials were highly sensitive. We think that chemotherapy can be considered among the options a physician can offer to such a patient explaining informed consensus.
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Affiliation(s)
- D Portaleone
- Ia Clinica Pediatrica dell'Università degli Studi di Milano, Italia
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