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Oliveira DVNP, Prahm KP, Christensen IJ, Hansen A, Høgdall CK, Høgdall EV. Gene expression profile association with poor prognosis in epithelial ovarian cancer patients. Sci Rep 2021; 11:5438. [PMID: 33686173 PMCID: PMC7940404 DOI: 10.1038/s41598-021-84953-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 03/03/2020] [Accepted: 01/22/2021] [Indexed: 12/24/2022] Open
Abstract
Ovarian cancer (OC) is the eighth most common type of cancer for women worldwide. The current diagnostic and prognostic routine available for OC management either lack specificity or are very costly. Gene expression profiling has shown to be a very effective tool in exploring new molecular markers for patients with OC, although association of such markers with patient survival and clinical outcome is still elusive. Here, we performed gene expression profiling of different subtypes of OC to evaluate its association with patient overall survival (OS) and aggressive forms of the disease. By global mRNA microarray profiling in a total of 196 epithelial OC patients (161 serous, 15 endometrioid, 11 mucinous, and 9 clear cell carcinomas), we found four candidates-HSPA1A, CD99, RAB3A and POM121L9P, which associated with OS and poor clinicopathological features. The overexpression of all combined was correlated with shorter OS and progression-free survival (PFS). Furthermore, the combination of at least two markers were further associated with advanced grade, chemotherapy resistance, and progressive disease. These results indicate that a panel comprised of a few predictors that associates with a more aggressive form of OC may be clinically relevant, presenting a better performance than one marker alone.
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Affiliation(s)
| | - Kira P Prahm
- Department of Pathology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Ib J Christensen
- Department of Pathology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | | | - Claus K Høgdall
- Department of Gynaecology, Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Estrid V Høgdall
- Department of Pathology, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
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Jensen BR, Berthelsen MP, Husu E, Christensen SB, Prahm KP, Vissing J. Body weight-supported training in Becker and limb girdle 2I muscular dystrophy. Muscle Nerve 2016; 54:239-43. [PMID: 26773840 DOI: 10.1002/mus.25039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 05/28/2015] [Revised: 01/04/2016] [Accepted: 01/08/2016] [Indexed: 11/10/2022]
Abstract
INTRODUCTION We studied the functional effects of combined strength and aerobic anti-gravity training in severely affected patients with Becker and Limb-Girdle muscular dystrophies. METHODS Eight patients performed 10-week progressive combined strength (squats, calf raises, lunges) and aerobic (walk/run, jogging in place or high knee-lift) training 3 times/week in a lower-body positive pressure environment. Closed-kinetic-chain leg muscle strength, isometric knee strength, rate of force development (RFD), and reaction time were evaluated. RESULTS Baseline data indicated an intact neural activation pattern but showed compromised muscle contractile properties. Training (compliance 91%) improved functional leg muscle strength. Squat series performance increased 30%, calf raises 45%, and lunges 23%. CONCLUSIONS Anti-gravity training improved closed-kinetic-chain leg muscle strength despite no changes in isometric knee extension strength and absolute RFD. The improved closed-kinetic-chain performance may relate to neural adaptation involving motor learning and/or improved muscle strength of other muscles than the weak knee extensors. Muscle Nerve 54: 239-243, 2016.
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Affiliation(s)
- Bente R Jensen
- Biomechanics and Motor Control Laboratory, Integrative Physiology, Department of Nutrition, Exercise and Sport, University of Copenhagen, Nørre Allé 51, DK-2100, Copenhagen, Denmark
| | - Martin P Berthelsen
- Biomechanics and Motor Control Laboratory, Integrative Physiology, Department of Nutrition, Exercise and Sport, University of Copenhagen, Nørre Allé 51, DK-2100, Copenhagen, Denmark
| | - Edith Husu
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Sofie B Christensen
- Biomechanics and Motor Control Laboratory, Integrative Physiology, Department of Nutrition, Exercise and Sport, University of Copenhagen, Nørre Allé 51, DK-2100, Copenhagen, Denmark
| | - Kira P Prahm
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - John Vissing
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
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Andersen G, Prahm KP, Dahlqvist JR, Citirak G, Vissing J. Aerobic training and postexercise protein in facioscapulohumeral muscular dystrophy: RCT study. Neurology 2015; 85:396-403. [PMID: 26156512 DOI: 10.1212/wnl.0000000000001808] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 02/23/2015] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To investigate the effect of regular aerobic training and postexercise protein-carbohydrate supplementation in patients with facioscapulohumeral muscular dystrophy (FSHD). METHODS In this randomized, double-blind, placebo-controlled parallel study, we randomized untrained men (n = 21) and women (n = 20) with FSHD (age 19-65 years) to 2 training groups-training with protein supplement (n = 18) and training with placebo supplement (n = 13)-and a nonintervention control group (n = 10). We assessed fitness, walking speed, muscle strength, questionnaires, and daily activity levels before and after 12 weeks of interventions. Training involved 36 sessions of 30-minute cycle-ergometer training. After each session, patients drank either a protein-carbohydrate or placebo beverage. RESULTS In the trained participants, fitness, workload, and walking speed improved (10% [confidence interval (CI) 4%-15%], 18% [CI 10%-26%], 7% [CI 4%-11%], respectively, p < 0.001, number needed to treat = 2.1). Self-assessed physical capacity and health (Short Form-36) also improved. Muscle strength and daily activity levels did not change with training. Protein-carbohydrate supplementation did not result in further improvements in any tests compared to training alone. CONCLUSIONS This randomized, controlled study showed that regular endurance training improves fitness, walking speed, and self-assessed health in patients with FSHD without causing muscle damage. Postexercise protein-carbohydrate supplementation does not add any further improvement to training effects alone. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that regular aerobic training with or without postexercise protein-carbohydrate supplementation improves fitness and workload in patients with FSHD.
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Affiliation(s)
- Grete Andersen
- From the Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark.
| | - Kira P Prahm
- From the Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Julia R Dahlqvist
- From the Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Gülsenay Citirak
- From the Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - John Vissing
- From the Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
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Prahm KP, Witting N, Vissing J. Decreased variability of the 6-minute walk test by heart rate correction in patients with neuromuscular disease. PLoS One 2014; 9:e114273. [PMID: 25479403 PMCID: PMC4257612 DOI: 10.1371/journal.pone.0114273] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Accepted: 11/09/2014] [Indexed: 11/18/2022] Open
Abstract
Objective The 6-minute walk test is widely used to assess functional status in neurological disorders. However, the test is subject to great inter-test variability due to fluctuating motivation, fatigue and learning effects. We investigated whether inter-test variability of the 6MWT can be reduced by heart rate correction. Methods Sixteen patients with neuromuscular diseases, including Facioscapulohumeral muscular dystrophy, Limb-girdle muscular dystrophy, Charcot-Marie-Tooths, Dystrophia Myotonica and Congenital Myopathy and 12 healthy subjects were studied. Patients were excluded if they had cardiac arrhythmias, if they received drug treatment for hypertension or any other medical conditions that could interfere with the interpretation of the heart rate and walking capability. All completed three 6-minute walk tests on three different test-days. Heart rate was measured continuously. Results Successive standard 6-minute walk tests showed considerable learning effects between Tests 1 and 2 (4.9%; P = 0.026), and Tests 2 and 3 (4.5%; P = 0.020) in patients. The same was seen in controls between Tests 1 and 2 (8.1%; P = 0.039)). Heart rate correction abolished this learning effect. Conclusion A modified 6-minute walk test, by correcting walking distance with average heart rate during walking, decreases the variability among repeated 6-minute walk tests, and should be considered as an alternative outcome measure to the standard 6-minute walk test in future clinical follow-up and treatment trials.
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Affiliation(s)
- Kira P. Prahm
- Neuromuscular Research Unit, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Nanna Witting
- Neuromuscular Research Unit, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - John Vissing
- Neuromuscular Research Unit, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
- * E-mail:
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Witting N, Kruuse C, Nyhuus B, Prahm KP, Citirak G, Lundgaard SJ, von Huth S, Vejlstrup N, Lindberg U, Krag TO, Vissing J. Effect of sildenafil on skeletal and cardiac muscle in Becker muscular dystrophy. Ann Neurol 2014; 76:550-7. [PMID: 25042931 DOI: 10.1002/ana.24216] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 06/19/2014] [Accepted: 06/19/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Patients with Becker muscular dystrophy (BMD) and Duchenne muscular dystrophy lack neuronal nitric oxide synthase (nNOS). nNOS mediates physiological sympatholysis, thus ensuring adequate blood supply to working muscle. In mice lacking dystrophin, restoration of nNOS effects by a phosphodiesterase 5 (PDE5) inhibitor (sildenafil) improves skeletal and cardiac muscle performance. Sildenafil also improves blood flow in patients with BMD. We therefore hypothesized that sildenafil would improve blood flow, maximal work capacity, and heart function in patients with BMD. METHODS A randomized, double-blind, placebo-controlled crossover design with two 4-week periods of treatment, separated by 2-week washout was used. We assessed brachial artery blood flow during maximal handgrip exercise, 6-minute walk test, maximal oxidative capacity, and life quality; cardiac function was evaluated by magnetic resonance imaging (MRI) at rest and during maximal handgrip exercise. Muscle nNOS and PDE5 were tested with Western blotting in 5 patients. RESULTS Sixteen patients completed all skeletal muscle evaluations, and 13 completed the cardiac MRI investigations. Sildenafil had no effect on any of the outcome parameters. No serious adverse effects were recorded. PDE5 and nNOS were deficient in 5 of 5 biopsies. INTERPRETATION Despite positive evidence from animal models of dystrophinopathy and physiological findings in patients with BMD, this double-blind, placebo-controlled clinical study showed no effect of sildenafil on blood flow, maximal work capacity, and heart function in adults with BMD. This discrepancy may be explained by a significant downregulation of PDE5 in muscle.
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Affiliation(s)
- Nanna Witting
- Neuromuscular Research Unit and Department of Neurology, Rigshospitalet, University Hospital Glostrup, University of Copenhagen, Copenhagen, Denmark
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Vissing CR, Preisler N, Husu E, Prahm KP, Vissing J. Aerobic training in patients with anoctamin 5 myopathy and hyperckemia. Muscle Nerve 2014; 50:119-23. [DOI: 10.1002/mus.24112] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/18/2013] [Accepted: 10/29/2013] [Indexed: 02/01/2023]
Affiliation(s)
- Christoffer R. Vissing
- Neuromuscular Research Unit, Department of Neurology, Section 3342, Rigshospitalet; University of Copenhagen; Blegdamsvej 9, DK-2100 Copenhagen Denmark
| | - Nicolai Preisler
- Neuromuscular Research Unit, Department of Neurology, Section 3342, Rigshospitalet; University of Copenhagen; Blegdamsvej 9, DK-2100 Copenhagen Denmark
| | - Edith Husu
- Neuromuscular Research Unit, Department of Neurology, Section 3342, Rigshospitalet; University of Copenhagen; Blegdamsvej 9, DK-2100 Copenhagen Denmark
| | - Kira P. Prahm
- Neuromuscular Research Unit, Department of Neurology, Section 3342, Rigshospitalet; University of Copenhagen; Blegdamsvej 9, DK-2100 Copenhagen Denmark
| | - John Vissing
- Neuromuscular Research Unit, Department of Neurology, Section 3342, Rigshospitalet; University of Copenhagen; Blegdamsvej 9, DK-2100 Copenhagen Denmark
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