1
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Fey RM, Nichols RA, Tran TT, Vandenbark AA, Kulkarni RP. MIF and CD74 as Emerging Biomarkers for Immune Checkpoint Blockade Therapy. Cancers (Basel) 2024; 16:1773. [PMID: 38730725 PMCID: PMC11082995 DOI: 10.3390/cancers16091773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/18/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Immune checkpoint blockade (ICB) therapy is used to treat a wide range of cancers; however, some patients are at risk of developing treatment resistance and/or immune-related adverse events (irAEs). Thus, there is a great need for the identification of reliable predictive biomarkers for response and toxicity. The cytokine MIF (macrophage migration inhibitory factor) and its cognate receptor CD74 are intimately connected with cancer progression and have previously been proposed as prognostic biomarkers for patient outcome in various cancers, including solid tumors such as malignant melanoma. Here, we assess their potential as predictive biomarkers for response to ICB therapy and irAE development. We provide a brief overview of their function and roles in the context of cancer and autoimmune disease. We also review the evidence showing that MIF and CD74 may be of use as predictive biomarkers of patient response to ICB therapy and irAE development. We also highlight that careful consideration is required when assessing the potential of serum MIF levels as a biomarker due to its reported circadian expression in human plasma. Finally, we suggest future directions for the establishment of MIF and CD74 as predictive biomarkers for ICB therapy and irAE development to guide further research in this field.
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Affiliation(s)
- Rosalyn M. Fey
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA (R.A.N.)
| | - Rebecca A. Nichols
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA (R.A.N.)
| | - Thuy T. Tran
- Yale Cancer Center, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Arthur A. Vandenbark
- Neuroimmunology Research, R&D-31, VA Portland Health Care System, Portland, OR 97239, USA
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Molecular Microbiology and Immunology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Rajan P. Kulkarni
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA (R.A.N.)
- Cancer Early Detection Advanced Research Center (CEDAR), Portland, OR 97239, USA
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA
- Operative Care Division, U.S. Department of Veterans Affairs Portland Health Care System, Portland, OR 97239, USA
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2
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Garrison Z, Clister T, Bleem E, Berry EG, Kulkarni RP. Comparison of Immunotherapy versus Targeted Therapy Effectiveness in BRAF-Mutant Melanoma Patients and Use of cGAS Expression and Aneuploidy as Potential Prognostic Biomarkers. Cancers (Basel) 2024; 16:1027. [PMID: 38473384 DOI: 10.3390/cancers16051027] [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: 02/01/2024] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
BRAF-mutant melanoma patients can be treated with targeted therapy or immunotherapies, and it is not clear which should be provided first. Targeted treatments do not work in up to one-third of cases, while immunotherapies may only be effective in up to 60% and come with a high risk of immune-related side effects. Determining which treatment to provide first is thus of critical importance. Recent studies suggest that chromosomal instability and aneuploidy and cyclic GMP-AMP synthase (cGAS) can act as biomarkers for cancer severity and patient outcome. Neither potential biomarker has been extensively studied in melanoma. We examined 20 BRAF-mutant melanomas treated with immunotherapy or targeted therapy and measured chromosomal aneuploidy and cGAS expression levels. Treatment type, aneuploidy, and cGAS expression were correlated with progression-free survival (PFS) in these patients. Those treated with immunotherapy first had significantly better outcomes than those treated with targeted therapy, suggesting immunotherapy should be strongly considered as the first-line therapy for patients bearing BRAF-mutant melanoma. We found that there was no correlation of aneuploidy with outcome while there was some positive correlation of cGAS levels with PFS. Further studies are needed to confirm these findings and to test other potential biomarkers.
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Affiliation(s)
- Zachary Garrison
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Terri Clister
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Eric Bleem
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Elizabeth G Berry
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Operative Care Division, U.S. Department of Veterans Affairs Portland Health Care System, Portland, OR 97239, USA
| | - Rajan P Kulkarni
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Operative Care Division, U.S. Department of Veterans Affairs Portland Health Care System, Portland, OR 97239, USA
- Cancer Early Detection Advanced Research Center (CEDAR), Portland, OR 97239, USA
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3
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Clister T, Fey RM, Garrison ZR, Valenzuela CD, Bar A, Leitenberger JJ, Kulkarni RP. Optimization of Tissue Digestion Methods for Characterization of Photoaged Skin by Single Cell RNA Sequencing Reveals Preferential Enrichment of T Cell Subsets. Cells 2024; 13:266. [PMID: 38334658 PMCID: PMC10854603 DOI: 10.3390/cells13030266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/19/2024] [Accepted: 01/27/2024] [Indexed: 02/10/2024] Open
Abstract
Healthy human skin tissue is often used as a control for comparison to diseased skin in patients with skin pathologies, including skin cancers or other inflammatory conditions such as atopic dermatitis or psoriasis. Although non-affected skin from these patients is a more appropriate choice for comparison, there is a paucity of studies examining such tissue. This lack is exacerbated by the difficulty of processing skin tissue for experimental analysis. In addition, choosing a processing protocol for skin tissue which preserves cell viability and identity while sufficiently dissociating cells for single-cell analysis is not a trivial task. Here, we compare three digestion methods for human skin tissue, evaluating the cell yield and viability for each protocol. We find that the use of a sequential dissociation method with multiple enzymatic digestion steps produces the highest cell viability. Using single-cell sequencing, we show this method results in a relative increase in the proportion of non-antigen-presenting mast cells and CD8 T cells as well as a relative decrease in the proportion of antigen-presenting mast cells and KYNU+ CD4 T cells. Overall, our findings support the use of this sequential digestion method on freshly processed human skin samples for optimal cell yield and viability.
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Affiliation(s)
- Terri Clister
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA; (T.C.); (R.M.F.); (Z.R.G.); (A.B.); (J.J.L.)
| | - Rosalyn M. Fey
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA; (T.C.); (R.M.F.); (Z.R.G.); (A.B.); (J.J.L.)
| | - Zachary R. Garrison
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA; (T.C.); (R.M.F.); (Z.R.G.); (A.B.); (J.J.L.)
| | | | - Anna Bar
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA; (T.C.); (R.M.F.); (Z.R.G.); (A.B.); (J.J.L.)
| | - Justin J. Leitenberger
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA; (T.C.); (R.M.F.); (Z.R.G.); (A.B.); (J.J.L.)
| | - Rajan P. Kulkarni
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA; (T.C.); (R.M.F.); (Z.R.G.); (A.B.); (J.J.L.)
- Cancer Early Detection Advanced Research Center (CEDAR), Portland, OR 97239, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Operative Care Division, U.S. Department of Veterans Affairs Portland Health Care System, Portland, OR 97239, USA
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4
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Van Buren I, Madison C, Kohn A, Berry E, Kulkarni RP, Thompson RF. Survival Among Veterans Receiving Steroids for Immune-Related Adverse Events After Immune Checkpoint Inhibitor Therapy. JAMA Netw Open 2023; 6:e2340695. [PMID: 37906189 PMCID: PMC10618850 DOI: 10.1001/jamanetworkopen.2023.40695] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/19/2023] [Indexed: 11/02/2023] Open
Abstract
Importance Systemic steroids are commonly used to manage immune-related adverse events (irAEs), but it remains unclear whether they may undermine immune checkpoint inhibitor (ICI) therapy outcomes. Few studies have assessed the impact of steroid timing and its association with continuation or cessation of ICI therapy. Objective To characterize how systemic steroids and steroid timing for irAEs are associated with survival in patients receiving ICI therapy. Design, Setting, and Participants This multicenter retrospective cohort study encompassed veterans receiving ICI for cancer between January 1, 2010, and December 31, 2021. Data analysis was conducted September 8, 2023. Exposures Identifiable primary diagnosis of cancer. Patients were categorized into 3 cohorts: those receiving no steroids, systemic steroids for irAEs, and steroids for non-irAE-associated reasons. All eligible patients received 1 or more doses of an ICI (atezolizumab, avelumab, cemiplimab, durvalumab, ipilimumab, nivolumab, or pembrolizumab). Eligible patients in the steroid group received at least 1 dose (intravenous, intramuscular, or oral) of dexamethasone, hydrocortisone, methylprednisolone, prednisone, or prednisolone. Steroid use at baseline for palliation or infusion prophylaxis or delivered as a single dose was deemed to be non-irAE associated. All other patterns of steroid use were assumed to be for irAEs. Main Outcomes and Measures The primary outcome was overall survival, with a 5-year follow-up after ICI initiation. Kaplan-Meier survival analyses were performed with pairwise log-rank tests to determine significance. Risk was modeled with Cox proportional hazard regression. Results The cohort consisted of 20 163 veterans receiving ICI therapy including 12 221 patients (mean [SD] age, 69.5 [8.0] years; 11 830 male patients [96.8%]; 9394 White patients [76.9%]) who received systemic steroids during ICI treatment and 7942 patients (mean [SD] age, 70.3 [8.5] years; 7747 male patients [97.5%]; 6085 White patients [76.6%]) who did not. Patients with an irAE diagnosis had significantly improved overall survival (OS) compared with those without (median [IQR] OS, 17.4 [6.6 to 48.5] months vs 10.5 [3.5 to 36.8] months; adjusted hazard ratio, 0.84; 95% CI, 0.81-0.84; P < .001). For patients with irAEs, systemic steroids for irAEs were associated with significantly improved survival compared with those who received steroids for non-irAE-related reasons or no steroid treatment (median [IQR] OS, 21.3 [9.3 to 58.2] months vs 13.6 [5.5 to 33.7] months vs 15.8 [4.9 to not reached] months; P <.001). However, among those who received steroids for irAEs, early steroid use (<2 months after ICI initiation) was associated with reduced relative survival benefit vs later steroid use, regardless of ICI continuation or cessation following steroid initiation (median [IQR] OS after ICI cessation 4.4 [1.9 to 19.5] months vs 16.0 [8.0 to 42.2] months; median [IQR] OS after ICI continuation, 16.0 [7.1 to not reached] months vs 29.2 [16.5 to 53.5] months; P <.001). Conclusions and Relevance This study suggests that steroids for irAE management may not abrogate irAE-associated survival benefits. However, early steroid administration within 2 months of ICI initiation is associated with shorter survival despite continuation of ICI therapy.
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Affiliation(s)
- Inga Van Buren
- Graduate Medical Education, St Joseph’s Medical Center, Stockton, California
| | - Cecelia Madison
- Research and Development, VA Portland Healthcare System, Portland, Oregon
| | - Aimee Kohn
- Division of Hematology and Medical Oncology, Oregon Health & Science University, Portland
| | - Elizabeth Berry
- Department of Dermatology, Oregon Health & Science University, Portland
| | - Rajan P. Kulkarni
- Department of Dermatology, Oregon Health & Science University, Portland
- Operative Care Division, VA Portland Healthcare System, Portland, Oregon
| | - Reid F. Thompson
- Department of Radiation Medicine, Oregon Health & Science University, Portland
- Division of Hospital and Specialty Medicine, VA Portland Healthcare System, Portland, Oregon
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5
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Pavlick AC, Ariyan CE, Buchbinder EI, Davar D, Gibney GT, Hamid O, Hieken TJ, Izar B, Johnson DB, Kulkarni RP, Luke JJ, Mitchell TC, Mooradian MJ, Rubin KM, Salama AK, Shirai K, Taube JM, Tawbi HA, Tolley JK, Valdueza C, Weiss SA, Wong MK, Sullivan RJ. Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of melanoma, version 3.0. J Immunother Cancer 2023; 11:e006947. [PMID: 37852736 PMCID: PMC10603365 DOI: 10.1136/jitc-2023-006947] [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] [Accepted: 07/16/2023] [Indexed: 10/20/2023] Open
Abstract
Since the first approval for immune checkpoint inhibitors (ICIs) for the treatment of cutaneous melanoma more than a decade ago, immunotherapy has completely transformed the treatment landscape of this chemotherapy-resistant disease. Combination regimens including ICIs directed against programmed cell death protein 1 (PD-1) with anti-cytotoxic T lymphocyte antigen-4 (CTLA-4) agents or, more recently, anti-lymphocyte-activation gene 3 (LAG-3) agents, have gained regulatory approvals for the treatment of metastatic cutaneous melanoma, with long-term follow-up data suggesting the possibility of cure for some patients with advanced disease. In the resectable setting, adjuvant ICIs prolong recurrence-free survival, and neoadjuvant strategies are an active area of investigation. Other immunotherapy strategies, such as oncolytic virotherapy for injectable cutaneous melanoma and bispecific T-cell engager therapy for HLA-A*02:01 genotype-positive uveal melanoma, are also available to patients. Despite the remarkable efficacy of these regimens for many patients with cutaneous melanoma, traditional immunotherapy biomarkers (ie, programmed death-ligand 1 expression, tumor mutational burden, T-cell infiltrate and/or microsatellite stability) have failed to reliably predict response. Furthermore, ICIs are associated with unique toxicity profiles, particularly for the highly active combination of anti-PD-1 plus anti-CTLA-4 agents. The Society for Immunotherapy of Cancer (SITC) convened a panel of experts to develop this clinical practice guideline on immunotherapy for the treatment of melanoma, including rare subtypes of the disease (eg, uveal, mucosal), with the goal of improving patient care by providing guidance to the oncology community. Drawing from published data and clinical experience, the Expert Panel developed evidence- and consensus-based recommendations for healthcare professionals using immunotherapy to treat melanoma, with topics including therapy selection in the advanced and perioperative settings, intratumoral immunotherapy, when to use immunotherapy for patients with BRAFV600-mutated disease, management of patients with brain metastases, evaluation of treatment response, special patient populations, patient education, quality of life, and survivorship, among others.
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Affiliation(s)
| | - Charlotte E Ariyan
- Department of Surgery Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Diwakar Davar
- Hillman Cancer Center, University of Pittsburg Medical Center, Pittsburgh, Pennsylvania, USA
| | - Geoffrey T Gibney
- Lombardi Comprehensive Cancer Center, MedStar Georgetown University Hospital, Washington, District of Columbia, USA
| | - Omid Hamid
- The Angeles Clinic and Research Institute, A Cedars-Sinai Affiliate, Los Angeles, California, USA
| | - Tina J Hieken
- Department of Surgery and Comprehensive Cancer Center, Mayo Clinic, Rochester, Minnesota, USA
| | - Benjamin Izar
- Department of Medicine, Division of Hematology/Oncology, Columbia University Medical Center, New York, New York, USA
| | - Douglas B Johnson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Rajan P Kulkarni
- Departments of Dermatology, Oncological Sciences, Biomedical Engineering, and Center for Cancer Early Detection Advanced Research, Knight Cancer Institute, OHSU, Portland, Oregon, USA
- Operative Care Division, VA Portland Health Care System (VAPORHCS), Portland, Oregon, USA
| | - Jason J Luke
- Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Tara C Mitchell
- Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Meghan J Mooradian
- Cancer Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Krista M Rubin
- Cancer Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - April Ks Salama
- Department of Medicine, Division of Medical Oncology, Duke University, Durham, Carolina, USA
| | - Keisuke Shirai
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Janis M Taube
- Department of Dermatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hussein A Tawbi
- Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - J Keith Tolley
- Patient Advocate, Melanoma Research Alliance, Washington, DC, USA
| | - Caressa Valdueza
- Cutaneous Oncology Program, Weill Cornell Medicine, New York, New York, USA
| | - Sarah A Weiss
- Department of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Michael K Wong
- Patient Advocate, Melanoma Research Alliance, Washington, DC, USA
| | - Ryan J Sullivan
- Cancer Center, Massachusetts General Hospital, Boston, Massachusetts, USA
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6
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Adler FR, Anderson ARA, Bhushan A, Bogdan P, Bravo-Cordero JJ, Brock A, Chen Y, Cukierman E, DelGiorno KE, Denis GV, Ferrall-Fairbanks MC, Gartner ZJ, Germain RN, Gordon DM, Hunter G, Jolly MK, Karacosta LG, Mythreye K, Katira P, Kulkarni RP, Kutys ML, Lander AD, Laughney AM, Levine H, Lou E, Lowenstein PR, Masters KS, Pe'er D, Peyton SR, Platt MO, Purvis JE, Quon G, Richer JK, Riddle NC, Rodriguez A, Snyder JC, Lee Szeto G, Tomlin CJ, Yanai I, Zervantonakis IK, Dueck H. Modeling collective cell behavior in cancer: Perspectives from an interdisciplinary conversation. Cell Syst 2023; 14:252-257. [PMID: 37080161 PMCID: PMC10760508 DOI: 10.1016/j.cels.2023.03.002] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/20/2022] [Accepted: 03/08/2023] [Indexed: 04/22/2023]
Abstract
Collective cell behavior contributes to all stages of cancer progression. Understanding how collective behavior emerges through cell-cell interactions and decision-making will advance our understanding of cancer biology and provide new therapeutic approaches. Here, we summarize an interdisciplinary discussion on multicellular behavior in cancer, draw lessons from other scientific disciplines, and identify future directions.
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Affiliation(s)
- Frederick R Adler
- Department of Mathematics, University of Utah, Salt Lake City, UT 84112, USA; School of Biological Sciences, University of Utah, Salt Lake City, UT 84112, USA
| | - Alexander R A Anderson
- Integrated Mathematical Oncology Department, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Abhinav Bhushan
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL 60616, USA
| | - Paul Bogdan
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
| | - Jose Javier Bravo-Cordero
- Division of Hematology and Oncology, Department of Medicine, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Amy Brock
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX 78712, USA
| | - Yun Chen
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Edna Cukierman
- Cancer Signaling and Microenvironment Program, Marvin and Concetta Greenberg Pancreatic Cancer Institute, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Kathleen E DelGiorno
- Department of Cell and Developmental Biology, Vanderbilt University, Nashville, TN 37232, USA
| | - Gerald V Denis
- Boston University-Boston Medical Center Cancer Center, Boston University School of Medicine, Boston, MA 02118, USA
| | - Meghan C Ferrall-Fairbanks
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA; University of Florida Health Cancer Center, University of Florida, Gainesville, FL 32611, USA
| | - Zev Jordan Gartner
- Department of Pharmaceutical Chemistry, University of California, San Francisco, San Francisco, CA 94158, USA; NSF Center for Cellular Construction, San Francisco, CA 94158, USA; Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
| | - Ronald N Germain
- Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Deborah M Gordon
- Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Ginger Hunter
- Department of Biology, Clarkson University, Potsdam, NY 13699, USA
| | - Mohit Kumar Jolly
- Centre for BioSystems Science and Engineering, Indian Institute of Science, Bangalore, 560012, India
| | - Loukia Georgiou Karacosta
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Karthikeyan Mythreye
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; O'Neal Comprehensive Cancer Center, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Parag Katira
- Mechanical Engineering Department, San Diego State University, San Diego, CA 92182, USA; Computational Sciences Research Center, San Diego State University, San Diego, CA 92182, USA
| | - Rajan P Kulkarni
- Department of Dermatology, Oregon Health and Science University, Portland, OR 97239, USA; Department Biomedical Engineering, Oregon Health and Science University, Portland, OR 97239, USA; Department Oncological Sciences, Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA; Cancer Early Detection Advanced Research Center (CEDAR), Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA; Operative Care Division, VA Portland Health Care System, Portland, OR 97239, USA
| | - Matthew L Kutys
- Department of Cell and Tissue Biology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Arthur D Lander
- Department of Developmental and Cell Biology, University of California, Irvine, Irvine, CA 92697, USA; Center for Complex Biological Systems, University of California, Irvine, Irvine, CA 92697, USA
| | - Ashley M Laughney
- Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY 10021, USA; Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10021, USA; Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, New York, NY 10021, USA
| | - Herbert Levine
- Center for Theoretical Biological Physics, Northeastern University, Boston, MA 02115, USA
| | - Emil Lou
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Pedro R Lowenstein
- Department of Neurosurgery, Rogel Cancer Center, The University of Michigan, Ann Arbor, MI 48109, USA; Department of Cell and Developmental Biology, Rogel Cancer Center, The University of Michigan, Ann Arbor, MI 48109, USA; Department of Biomedical Engineering, The University of Michigan, Ann Arbor, MI 48109, USA
| | - Kristyn S Masters
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Dana Pe'er
- Computational and Systems Biology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Howard Hughes Medical Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Shelly R Peyton
- Department of Chemical Engineering, University of Massachusetts, Amherst, MA 01003, USA
| | - Manu O Platt
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30322, USA; Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Emory University, Atlanta, GA 30322, USA
| | - Jeremy E Purvis
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Gerald Quon
- Department of Molecular and Cellular Biology, University of California, Davis, Davis, CA 95616, USA
| | - Jennifer K Richer
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; University of Colorado Cancer Center, Aurora, CO 80045, USA
| | - Nicole C Riddle
- Department of Biology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Analiz Rodriguez
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Joshua C Snyder
- Department of Surgery, Duke University, Durham, NC 27710, USA; Department of Cell Biology, Duke University, Durham, NC 27710, USA
| | - Gregory Lee Szeto
- Allen Institute for Immunology, Seattle, WA 98109, USA; Seagen, Bothell, WA 98021, USA
| | - Claire J Tomlin
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Itai Yanai
- Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA; Institute for Computational Medicine, NYU Langone Health, New York, NY 10016, USA
| | - Ioannis K Zervantonakis
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15232, USA; Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA 15232, USA
| | - Hannah Dueck
- Division of Cancer Biology, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA.
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7
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Garrison ZR, Hall CM, Fey RM, Clister T, Khan N, Nichols R, Kulkarni RP. Advances in Early Detection of Melanoma and the Future of At-Home Testing. Life (Basel) 2023; 13:life13040974. [PMID: 37109503 PMCID: PMC10145469 DOI: 10.3390/life13040974] [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: 01/27/2023] [Revised: 02/17/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
The past decade has seen numerous advancements in approaches to melanoma detection, each with the common goal to stem the growing incidence of melanoma and its mortality rate. These advancements, while well documented to increase early melanoma detection, have also garnered considerable criticism of their efficacy for improving survival rates. In this review, we discuss the current state of such early detection approaches that do not require direct dermatologist intervention. Our findings suggest that a number of at-home and non-specialist methods exist with high accuracy for detecting melanoma, albeit with a few notable concerns worth further investigation. Additionally, research continues to find new approaches using artificial intelligence which have promise for the future.
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Affiliation(s)
- Zachary R Garrison
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Connor M Hall
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Rosalyn M Fey
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Terri Clister
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Nabeela Khan
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Rebecca Nichols
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Rajan P Kulkarni
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
- Cancer Early Detection Advanced Research Center (CEDAR), Portland, OR 97239, USA
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA
- Operative Care Division, U.S. Department of Veterans Affairs Portland Health Care System, Portland, OR 97239, USA
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8
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Kashani-Sabet M, Leachman SA, Stein JA, Arbiser JL, Berry EG, Celebi JT, Curiel-Lewandrowski C, Ferris LK, Grant-Kels JM, Grossman D, Kulkarni RP, Marchetti MA, Nelson KC, Polsky D, Seiverling EV, Swetter SM, Tsao H, Verdieck-Devlaeminck A, Wei ML, Bar A, Bartlett EK, Bolognia JL, Bowles TL, Cha KB, Chu EY, Hartman RI, Hawryluk EB, Jampel RM, Karapetyan L, Kheterpal M, Lawson DH, Leming PD, Liebman TN, Ming ME, Sahni D, Savory SA, Shaikh SS, Sober AJ, Sondak VK, Spaccarelli N, Usatine RP, Venna S, Kirkwood JM. Early Detection and Prognostic Assessment of Cutaneous Melanoma: Consensus on Optimal Practice and the Role of Gene Expression Profile Testing. JAMA Dermatol 2023; 159:545-553. [PMID: 36920356 DOI: 10.1001/jamadermatol.2023.0127] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Importance Therapy for advanced melanoma has transformed during the past decade, but early detection and prognostic assessment of cutaneous melanoma (CM) remain paramount goals. Best practices for screening and use of pigmented lesion evaluation tools and gene expression profile (GEP) testing in CM remain to be defined. Objective To provide consensus recommendations on optimal screening practices and prebiopsy diagnostic, postbiopsy diagnostic, and prognostic assessment of CM. Evidence Review Case scenarios were interrogated using a modified Delphi consensus method. Melanoma panelists (n = 60) were invited to vote on hypothetical scenarios via an emailed survey (n = 42), which was followed by a consensus conference (n = 51) that reviewed the literature and the rationale for survey answers. Panelists participated in a follow-up survey for final recommendations on the scenarios (n = 45). Findings The panelists reached consensus (≥70% agreement) in supporting a risk-stratified approach to melanoma screening in clinical settings and public screening events, screening personnel recommendations (self/partner, primary care provider, general dermatologist, and pigmented lesion expert), screening intervals, and acceptable appointment wait times. Participants also reached consensus that visual and dermoscopic examination are sufficient for evaluation and follow-up of melanocytic skin lesions deemed innocuous. The panelists reached consensus on interpreting reflectance confocal microscopy and some but not all results from epidermal tape stripping, but they did not reach consensus on use of certain pigmented lesion evaluation tools, such as electrical impedance spectroscopy. Regarding GEP scores, the panelists reached consensus that a low-risk prognostic GEP score should not outweigh concerning histologic features when selecting patients to undergo sentinel lymph node biopsy but did not reach consensus on imaging recommendations in the setting of a high-risk prognostic GEP score and low-risk histology and/or negative nodal status. Conclusions and Relevance For this consensus statement, panelists reached consensus on aspects of a risk-stratified approach to melanoma screening and follow-up as well as use of visual examination and dermoscopy. These findings support a practical approach to diagnosing and evaluating CM. Panelists did not reach consensus on a clearly defined role for GEP testing in clinical decision-making, citing the need for additional studies to establish the clinical use of existing GEP assays.
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Affiliation(s)
- Mohammed Kashani-Sabet
- Center for Melanoma Research and Treatment, California Pacific Medical Center Research Institute, San Francisco
| | - Sancy A Leachman
- Departments of Dermatology and Family Medicine, Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Jennifer A Stein
- Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York, New York
| | - Jack L Arbiser
- Department of Dermatology, Emory University School of Medicine, Winship Cancer Institute, Atlanta Veterans Administration Health Center, Atlanta, Georgia
| | - Elizabeth G Berry
- Departments of Dermatology and Family Medicine, Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Julide T Celebi
- Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York, New York
| | - Clara Curiel-Lewandrowski
- UA Cancer Center Skin Cancer Institute, Division of Dermatology, College of Medicine, University of Arizona, Tucson
| | - Laura K Ferris
- Departments of Dermatology and Medicine, University of Pittsburgh, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut School of Medicine, Farmington.,Department of Dermatology, University of Florida College of Medicine, Gainesville
| | | | - Rajan P Kulkarni
- Departments of Dermatology and Family Medicine, Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Michael A Marchetti
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kelly C Nelson
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston
| | - David Polsky
- Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York, New York
| | | | - Susan M Swetter
- Department of Dermatology/Pigmented Lesion and Melanoma Program, Stanford University Medical Center and Cancer Institute, Palo Alto, California.,Dermatology Service, VA Palo Alto Health Care System, Palo Alto, California
| | - Hensin Tsao
- Department of Dermatology, Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, Massachusetts
| | | | - Maria L Wei
- Dermatology Department, University of California, San Francisco.,Dermatology Service, San Francisco VA Health Care System, San Francisco, California
| | - Anna Bar
- Departments of Dermatology and Family Medicine, Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Edmund K Bartlett
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jean L Bolognia
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | | | - Kelly B Cha
- Department of Dermatology, Michigan Medicine, Ann Arbor
| | - Emily Y Chu
- Department of Dermatology, University of Pennsylvania, Philadelphia
| | - Rebecca I Hartman
- Department of Dermatology, Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, Massachusetts
| | - Elena B Hawryluk
- Department of Dermatology, Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, Massachusetts
| | - Risa M Jampel
- Department of Dermatology, University of Maryland, Baltimore, Maryland
| | - Lilit Karapetyan
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Meenal Kheterpal
- Department of Dermatology, Duke University, Durham, North Carolina
| | - David H Lawson
- Department of Dermatology, Emory University School of Medicine, Winship Cancer Institute, Atlanta Veterans Administration Health Center, Atlanta, Georgia
| | | | - Tracey N Liebman
- Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York, New York
| | - Michael E Ming
- Department of Dermatology, University of Pennsylvania, Philadelphia
| | | | - Stephanie A Savory
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas
| | - Saba S Shaikh
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Arthur J Sober
- Department of Dermatology, Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, Massachusetts
| | - Vernon K Sondak
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | | | | | - Suraj Venna
- Inova Schar Cancer Institute, Inova Fairfax Hospital, University of Virginia School of Medicine, Charlottesville
| | - John M Kirkwood
- Departments of Dermatology and Medicine, University of Pittsburgh, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania
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9
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Garrison Z, Hornick N, Cheng J, Kulkarni RP. Circulating biomarkers of response to immunotherapy and immune-related adverse events. Expert Rev Mol Diagn 2022; 22:855-865. [PMID: 36193802 DOI: 10.1080/14737159.2022.2130688] [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: 01/08/2023]
Abstract
INTRODUCTION Immune checkpoint blockade has revolutionized cancer treatment. However, response rates vary, and these treatments have a high rate of immune-related side effects, which can be limiting. Thus, tests to predict who will respond and who may experience side effects are of critical importance toward realizing the ultimate goal of precision oncology. AREAS COVERED We review several of the most recent advances in circulating biomarkers that have been reported to be useful in predicting response and immune-related adverse events (irAE) to checkpoint blockade immunotherapies (CBI). We focus on high-quality studies published within the last few years. We highlight significant findings, identify areas for improvement, and provide recommendations on how these biomarkers may be translated into clinical utility. EXPERT OPINION As newer immunotherapies are developed, there is a pressing need to identify circulating biomarkers that can help predict responses and side effects. Current studies are mostly small-scale and retrospective; there is a need for larger-scale and prospective studies to help validate several of the biomarkers detailed here. As oncology focuses more on precision-based approaches, it is likely that a combination of biomarkers, including circulating ones as detailed here, will have critical utility in guiding clinical decisions.
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Affiliation(s)
- Zachary Garrison
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA
| | - Noah Hornick
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA
| | - Jeffrey Cheng
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Rajan P Kulkarni
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA.,Cancer Early Detection Advanced Research Center (CEDAR), Portland, OR, USA.,Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA.,Operative Care Division, U.S. Department of Veterans Affairs Portland Health Care System, Portland, OR, USA
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10
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Seervai RNH, Sinha A, Kulkarni RP. Mechanisms of dermatologic toxicities to immune checkpoint inhibitor cancer therapies. Clin Exp Dermatol 2022; 47:1928-1942. [PMID: 35844072 DOI: 10.1111/ced.15332] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 11/30/2022]
Abstract
The discovery of immune checkpoint inhibition (ICI) sparked a revolution in the era of targeted anticancer therapy. While monoclonal antibodies targeting the CTLA-4 and PD-1 axes have improved survival in patients with advanced cancers, these immunotherapies are associated with a wide spectrum of dermatologic immune-related adverse events (irAEs). Several publications have addressed the clinical and histopathologic classification of these skin-directed irAEs, their impact on antitumor immunity and survival, and the critical role of supportive oncologic dermatology in their management. Here, we review the current understanding of the mechanistic drivers of immune-related skin toxicities with a focus on inflammatory, immunobullous, melanocyte/pigment-related reactions. We detail the specific immune-based mechanisms that may underlie different cutaneous reactions. We also discuss potential mechanisms as they relate to non-cutaneous irAEs and potential overlap with cutaneous irAEs, techniques to study differences in immune-related versus de novo skin reactions, and how treatment of these adverse events impacts cancer treatment, patient quality of life, and overall survival. An improved understanding of the mechanistic basis of cutaneous irAEs will allow us to develop and utilize blood-based biomarkers that could help ultimately predict onset and/or severity of these irAEs and to implement rational mechanistic-based treatment strategies that are targeted to the irAEs while potentially avoiding abrogating anti-tumor effect of ICIs.
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Affiliation(s)
- Riyad N H Seervai
- Department of Internal Medicine, Providence Portland Medical Center, Portland, Oregon, 97213.,Medical Scientist Training Program, Baylor College of Medicine, 77030, Houston, Texas, USA.,Department of Dermatology, Baylor College of Medicine, 77030, Houston, Texas, USA
| | - Avilasha Sinha
- Department of Dermatology, Baylor College of Medicine, 77030, Houston, Texas, USA.,Department of Medicine, Baylor College of Medicine, 77030, Houston, Texas, USA
| | - Rajan P Kulkarni
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon 97239, USA.,Department of Biomedical Engineering, Oregon Health and Science University, 97239, Portland, OR.,Cancer Early Detection Advanced Research Center, Knight Cancer Institute, Oregon Health and Science University, 97239, Portland, OR.,Operative Care Division, VA Portland Health Care System, 92739, Portland, OR
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11
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Kulkarni RP, Yu WY, Leachman SA. To Improve Melanoma Outcomes, Focus on Risk Stratification, Not Overdiagnosis. JAMA Dermatol 2022; 158:485-487. [PMID: 35385059 DOI: 10.1001/jamadermatol.2022.0097] [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: 11/14/2022]
Affiliation(s)
- Rajan P Kulkarni
- Department of Dermatology, Oregon Health and Science University, Portland.,Department of Biomedical Engineering, Oregon Health and Science University, Portland.,Cancer Early Detection Advanced Research Center, Knight Cancer Institute, Oregon Health and Science University, Portland.,Operative Care Division, VA Portland Health Care System, Portland, Oregon
| | - Wesley Y Yu
- Department of Dermatology, Oregon Health and Science University, Portland.,Operative Care Division, VA Portland Health Care System, Portland, Oregon
| | - Sancy A Leachman
- Department of Dermatology, Oregon Health and Science University, Portland
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12
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Humphries BA, Hwang PY, Kendrick AA, Kulkarni RP, Pozzar RA, San Martin R. Overstretched and overlooked: solving challenges faced by early-career investigators after the pandemic. Trends Cancer 2021; 7:879-882. [PMID: 34462237 PMCID: PMC8391088 DOI: 10.1016/j.trecan.2021.07.005] [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] [Received: 06/25/2021] [Revised: 07/27/2021] [Accepted: 07/30/2021] [Indexed: 12/05/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has had a detrimental effect on research. However, little has been done to identify and solve the unique challenges faced by early career investigators (ECIs). As a group of American Cancer Society-funded ECIs, we provide recommendations for solving these challenges in the aftermath of the pandemic.
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Affiliation(s)
- Brock A Humphries
- Center for Molecular Imaging, Department of Radiology, University of Michigan, Ann Arbor, MI, 48109, USA.
| | - Priscilla Y Hwang
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA.
| | - Agnieszka A Kendrick
- Department of Cellular and Molecular Medicine, University of California, San Diego, La Jolla, CA, USA.
| | - Rajan P Kulkarni
- Department of Dermatology, Oregon Health and Science University (OHSU), Portland, OR, USA; Department of Biomedical Engineering, Oregon Health and Science University (OHSU), Portland, OR, USA; Cancer Early Detection Advanced Research Center (CEDAR), Knight Cancer Institute, Oregon Health and Science University (OHSU), Portland, OR, USA; Operative Care Division, VA Portland Health Care System (VAPORHCS), Portland, OR, USA.
| | - Rachel A Pozzar
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA, USA.
| | - Rebeca San Martin
- Biochemistry & Cellular and Molecular Biology, University of Tennessee, Knoxville, TN, USA.
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13
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Fuiten AM, Fankhauser RG, Smit DJ, Stark MS, Enright TF, Wood MA, DePatie NA, Pivik K, Sturm RA, Berry EG, Kulkarni RP. Genetic analysis of multiple primary melanomas arising within the boundaries of congenital nevi depigmentosa. Pigment Cell Melanoma Res 2021; 34:1123-1130. [PMID: 33884765 DOI: 10.1111/pcmr.12979] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/24/2021] [Accepted: 04/07/2021] [Indexed: 11/28/2022]
Abstract
Here, we present a rare case of a patient who developed multiple primary melanomas within the boundaries of two nevi depigmentosa. The melanomas were excised, and as a preventive measure, the remainder of the nevi depigmentosa were removed. We performed whole-exome sequencing on excised tissue from the nevus depigmentosus, adjacent normal skin, and saliva to explain this intriguing phenomenon. We also performed a GeneTrails Comprehensive Solid Tumor Panel analysis on one of the melanoma tissues. Genetic analysis revealed germline MC1R V92M and TYR R402Q polymorphisms and a MET E168D germline mutation that may have increased the risk of melanoma development. This genetic predisposition, combined with a patient-reported history of substantial sun exposure and sunburns, which were more severe within the boundaries of the nevi depigmentosa due to the lack of photoprotective melanin, produced numerous somatic mutations in the melanocytes of the nevi depigmentosa. Fitting with this paradigm for melanoma development in chronically sun-damaged skin, the patient's melanomas harbored somatic mutations in CDKN2A (splice site), NF1, and ATRX and had a tumor mutation burden in the 90-95th percentile for melanoma.
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Affiliation(s)
- Allison M Fuiten
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA
| | - Reilly G Fankhauser
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA
| | - Darren J Smit
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Mitchell S Stark
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Trevor F Enright
- Department of Molecular and Medical Genetics, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Mary A Wood
- Computational Biology Program, School of Medicine, Oregon Health and Science University, Portland, OR, USA.,Phase Genomics, Seattle, WA, USA
| | - Nicholas A DePatie
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA
| | | | - Richard A Sturm
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Elizabeth G Berry
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA
| | - Rajan P Kulkarni
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA.,Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, USA.,Cancer Early Detection Advanced Research Center, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA.,Operative Care Division, VA Portland Health Care System, Portland, OR, USA
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14
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Kulkarni RP. Undressing drug reactions, one cell at a time. Sci Transl Med 2020. [DOI: 10.1126/scitranslmed.aba9015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Single-cell transcriptomic analysis allowed successful treatment of a patient with refractory severe drug-induced hypersensitivity syndrome.
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Affiliation(s)
- Rajan P. Kulkarni
- Department of Dermatology and Center for Early Cancer Detection and Research (CEDAR), Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA; Operative Care Division, VA Portland Health Care System, Portland, OR 97239, USA
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15
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Affiliation(s)
- Rajan P. Kulkarni
- Department of Dermatology and Center for Early Cancer Detection and Research (CEDAR), Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA; Operative Care Division, VA Portland Health Care System, Portland, OR 97239, USA
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16
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Abstract
Systemic corticosteroid therapy selectively affects low-affinity memory CD8+ T cells and may alter the efficacy of immune checkpoint blockade.
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Affiliation(s)
- Rajan P. Kulkarni
- Department of Dermatology and Center for Early Cancer Detection and Research (CEDAR), Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA; Operative Care Division, VA Portland Health Care System, Portland, OR 97239, USA.
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17
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Abstract
Introduction: The advent of checkpoint blockade immunotherapy has revolutionized cancer treatment, but clinical response to immunotherapies is highly heterogeneous among individual patients and between cancer types. This represents a challenge to oncologists when choosing specific immunotherapies for personalized medicine. Thus, biomarkers that can predict tumor responsiveness to immunotherapies before and during treatment are invaluable. Areas covered: We review the latest advances in 'liquid biopsy' biomarkers for noninvasive prediction and in-treatment monitoring of tumor response to immunotherapy, focusing primarily on melanoma and non-small cell lung cancer. We concentrate on high-quality studies published within the last five years on checkpoint blockade immunotherapies, and highlight significant breakthroughs, identify key areas for improvement, and provide recommendations for how these diagnostic tools can be translated into clinical practice. Expert opinion: The first biomarkers proposed to predict tumor response to immunotherapy were based on PD1/PDL1 expression, but their predictive value is limited to specific cancers or patient populations. Recent advances in single-cell molecular profiling of circulating tumor cells and host cells using next-generation sequencing has dramatically expanded the pool of potentially useful predictive biomarkers. As immunotherapy moves toward personalized medicine, a composite panel of both genomic and proteomic biomarkers will have enormous utility in therapeutic decision-making.
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Affiliation(s)
- Ernest Y Lee
- Department of Bioengineering, UCLA , Los Angeles , CA , USA.,Department of Dermatology, UCLA , Los Angeles , CA , USA.,UCLA-Caltech Medical Scientist Training Program, David Geffen School of Medicine at UCLA , Los Angeles , CA , USA
| | - Rajan P Kulkarni
- Department of Dermatology, OHSU , Portland , OR , USA.,Cancer Early Detection and Advanced Research Center (CEDAR), Knight Cancer Institute (KCI), OHSU , Portland , OR , USA.,Division of Operative Care, Portland VA Medical Center (PVAMC) , Portland , OR , USA
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18
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Kulkarni RP. Better living through your gut microbes. Sci Transl Med 2019. [DOI: 10.1126/scitranslmed.aay7700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Correcting gut microbial dysbiosis improves health and life span in a mouse model of accelerated aging by restoring intestinal bile acid and small-molecule metabolite balance.
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Affiliation(s)
- Rajan P. Kulkarni
- Department of Dermatology and Center for Early Cancer Detection and Research (CEDAR), Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA; Operative Care Division, VA Portland Health Care System, Portland, OR 97239, USA
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19
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Abstract
Mouse models of pancreatic ductal adenocarcinoma respond to immunotherapy when given in combination with the cyclooxygenase-2 inhibitor celecoxib.
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Affiliation(s)
- Rajan P. Kulkarni
- Department of Dermatology and Center for Early Cancer Detection and Research (CEDAR), Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA; Operative Care Division, VA Portland Health Care System, Portland, OR 97239, USA
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20
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Kulkarni RP. Continuously capturing circulating cancer cells. Sci Transl Med 2019. [DOI: 10.1126/scitranslmed.aax1730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A wearable apheresis device allows for continuous and specific capture of circulating tumor cells.
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Affiliation(s)
- Rajan P. Kulkarni
- Department of Dermatology and Center for Early Cancer Detection and Research (CEDAR), Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA; Operative Care Division, VA Portland Health Care System, Portland, OR 97239, USA
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21
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Shigeta A, Huang V, Zuo J, Besada R, Nakashima Y, Lu Y, Ding Y, Pellegrini M, Kulkarni RP, Hsiai T, Deb A, Zhou B, Nakano H, Nakano A. Endocardially Derived Macrophages Are Essential for Valvular Remodeling. Dev Cell 2019; 48:617-630.e3. [PMID: 30799229 PMCID: PMC6440481 DOI: 10.1016/j.devcel.2019.01.021] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 12/06/2018] [Accepted: 01/22/2019] [Indexed: 12/24/2022]
Abstract
During mammalian embryogenesis, de novo hematopoiesis occurs transiently in multiple anatomical sites including the yolk sac, dorsal aorta, and heart tube. A long-unanswered question is whether these local transient hematopoietic mechanisms are essential for embryonic growth. Here, we show that endocardial hematopoiesis is critical for cardiac valve remodeling as a source of tissue macrophages. Colony formation assay from explanted heart tubes and genetic lineage tracing with the endocardial specific Nfatc1-Cre mouse revealed that hemogenic endocardium is a de novo source of tissue macrophages in the endocardial cushion, the primordium of the cardiac valves. Surface marker characterization, gene expression profiling, and ex vivo phagocytosis assay revealed that the endocardially derived cardiac tissue macrophages play a phagocytic and antigen presenting role. Indeed, genetic ablation of endocardially derived macrophages caused severe valve malformation. Together, these data suggest that transient hemogenic activity in the endocardium is indispensable for the valvular tissue remodeling in the heart.
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Affiliation(s)
- Ayako Shigeta
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Vincent Huang
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Jonathan Zuo
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Rana Besada
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Yasuhiro Nakashima
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Yan Lu
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Yichen Ding
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Matteo Pellegrini
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, Los Angeles, CA 90095, USA; Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Rajan P Kulkarni
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA; Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Tzung Hsiai
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Arjun Deb
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, Los Angeles, CA 90095, USA; Division of Cardiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA; Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA 90095, USA; Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA 90095, USA; Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Bin Zhou
- Department of Genetics, Pediatrics, and Medicine (Cardiology), Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Haruko Nakano
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Atsushi Nakano
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, Los Angeles, CA 90095, USA; Division of Cardiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA; Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA 90095, USA; Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA 90095, USA; Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA.
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22
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Ding Y, Ma J, Langenbacher AD, Baek KI, Lee J, Chang CC, Hsu JJ, Kulkarni RP, Belperio J, Shi W, Ranjbarvaziri S, Ardehali R, Tintut Y, Demer LL, Chen JN, Fei P, Packard RRS, Hsiai TK. Multiscale light-sheet for rapid imaging of cardiopulmonary system. JCI Insight 2018; 3:121396. [PMID: 30135307 PMCID: PMC6141183 DOI: 10.1172/jci.insight.121396] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The ability to image tissue morphogenesis in real-time and in 3-dimensions (3-D) remains an optical challenge. The advent of light-sheet fluorescence microscopy (LSFM) has advanced developmental biology and tissue regeneration research. In this review, we introduce a LSFM system in which the illumination lens reshapes a thin light-sheet to rapidly scan across a sample of interest while the detection lens orthogonally collects the imaging data. This multiscale strategy provides deep-tissue penetration, high-spatiotemporal resolution, and minimal photobleaching and phototoxicity, allowing in vivo visualization of a variety of tissues and processes, ranging from developing hearts in live zebrafish embryos to ex vivo interrogation of the microarchitecture of optically cleared neonatal hearts. Here, we highlight multiple applications of LSFM and discuss several studies that have allowed better characterization of developmental and pathological processes in multiple models and tissues. These findings demonstrate the capacity of multiscale light-sheet imaging to uncover cardiovascular developmental and regenerative phenomena.
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Affiliation(s)
- Yichen Ding
- Department of Medicine, David Geffen School of Medicine at UCLA, and
- Department of Bioengineering, UCLA, Los Angeles, California, USA
| | - Jianguo Ma
- Department of Medicine, David Geffen School of Medicine at UCLA, and
- School of Instrumentation Science and Opto-electronics Engineering, Beihang University, Beijing, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beijing, China
| | - Adam D. Langenbacher
- Department of Molecular, Cell and Developmental Biology, UCLA, Los Angeles, California, USA
| | - Kyung In Baek
- Department of Bioengineering, UCLA, Los Angeles, California, USA
| | - Juhyun Lee
- Department of Bioengineering, UCLA, Los Angeles, California, USA
| | | | - Jeffrey J. Hsu
- Department of Medicine, David Geffen School of Medicine at UCLA, and
| | - Rajan P. Kulkarni
- Department of Medicine, David Geffen School of Medicine at UCLA, and
| | - John Belperio
- Department of Medicine, David Geffen School of Medicine at UCLA, and
| | - Wei Shi
- Developmental Biology and Regenerative Medicine Program, Department of Surgery, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | | | - Reza Ardehali
- Department of Medicine, David Geffen School of Medicine at UCLA, and
| | - Yin Tintut
- Department of Medicine, David Geffen School of Medicine at UCLA, and
| | - Linda L. Demer
- Department of Medicine, David Geffen School of Medicine at UCLA, and
| | - Jau-Nian Chen
- Department of Molecular, Cell and Developmental Biology, UCLA, Los Angeles, California, USA
| | - Peng Fei
- Department of Medicine, David Geffen School of Medicine at UCLA, and
- School of Optical and Electronic Information, Huazhong University of Science and Technology, Wuhan, China
| | | | - Tzung K. Hsiai
- Department of Medicine, David Geffen School of Medicine at UCLA, and
- Department of Bioengineering, UCLA, Los Angeles, California, USA
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23
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O'Leary RE, Holland V, Kulkarni RP. Ecthyma gangrenosum due to Pseudomonas fluorescens. Cutis 2018; 102:E13-E15. [PMID: 30138506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Ryan E O'Leary
- Division of Dermatology, David Geffen School of Medicine at University of California, Los Angeles, USA
| | - Vanessa Holland
- Division of Dermatology, David Geffen School of Medicine at University of California, Los Angeles, USA
| | - Rajan P Kulkarni
- Division of Dermatology, David Geffen School of Medicine at University of California, Los Angeles, USA
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24
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Yu J, Seldin MM, Fu K, Li S, Lam L, Wang P, Wang Y, Huang D, Nguyen TL, Wei B, Kulkarni RP, Di Carlo D, Teitell M, Pellegrini M, Lusis AJ, Deb A. Topological Arrangement of Cardiac Fibroblasts Regulates Cellular Plasticity. Circ Res 2018; 123:73-85. [PMID: 29691232 DOI: 10.1161/circresaha.118.312589] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 04/17/2018] [Accepted: 04/22/2018] [Indexed: 01/03/2023]
Abstract
RATIONALE Cardiac fibroblasts do not form a syncytium but reside in the interstitium between myocytes. This topological relationship between fibroblasts and myocytes is maintained throughout postnatal life until an acute myocardial injury occurs, when fibroblasts are recruited to, proliferate and aggregate in the region of myocyte necrosis. The accumulation or aggregation of fibroblasts in the area of injury thus represents a unique event in the life cycle of the fibroblast, but little is known about how changes in the topological arrangement of fibroblasts after cardiac injury affect fibroblast function. OBJECTIVE The objective of the study was to investigate how changes in topological states of cardiac fibroblasts (such as after cardiac injury) affect cellular phenotype. METHODS AND RESULTS Using 2 and 3-dimensional (2D versus 3D) culture conditions, we show that simple aggregation of cardiac fibroblasts is sufficient by itself to induce genome-wide changes in gene expression and chromatin remodeling. Remarkably, gene expression changes are reversible after the transition from a 3D back to 2D state demonstrating a topological regulation of cellular plasticity. Genes induced by fibroblast aggregation are strongly associated and predictive of adverse cardiac outcomes and remodeling in mouse models of cardiac hypertrophy and failure. Using solvent-based tissue clearing techniques to create optically transparent cardiac scar tissue, we show that fibroblasts in the region of dense scar tissue express markers that are induced by fibroblasts in the 3D conformation. Finally, using live cell interferometry, a quantitative phase microscopy technique to detect absolute changes in single cell biomass, we demonstrate that conditioned medium collected from fibroblasts in 3D conformation compared with that from a 2D state significantly increases cardiomyocyte cell hypertrophy. CONCLUSIONS Taken together, these findings demonstrate that simple topological changes in cardiac fibroblast organization are sufficient to induce chromatin remodeling and global changes in gene expression with potential functional consequences for the healing heart.
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Affiliation(s)
- Jingyi Yu
- From the Division of Cardiology, Department of Medicine (J.Y., M.M.S., S.L., P.W., Y.W., A.J.L., A.D.).,Cardiovascular Research Laboratory (J.Y., M.M.S., S.L., P.W., Y.W., A.J.L., A.D.).,Department of Molecular, Cell, and Developmental Biology (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Eli & Edythe Broad Center of Regenerative Medicine and Stem Cell Research (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Molecular Biology Institute (J.Y., K.F., S.L., L.L., P.W., Y.W., M.T., M.P., A.D.).,Jonsson Comprehensive Cancer Center (J.Y., K.F., S.L., L.L., P.W., Y.W., R.P.K., D.D.C., M.T., M.P., A.D.)
| | - Marcus M Seldin
- From the Division of Cardiology, Department of Medicine (J.Y., M.M.S., S.L., P.W., Y.W., A.J.L., A.D.).,Cardiovascular Research Laboratory (J.Y., M.M.S., S.L., P.W., Y.W., A.J.L., A.D.).,Departments of Human Genetics and Microbiology, Immunology and Molecular Genetics (M.M.S., A.J.L.)
| | - Kai Fu
- Department of Molecular, Cell, and Developmental Biology (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Eli & Edythe Broad Center of Regenerative Medicine and Stem Cell Research (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Molecular Biology Institute (J.Y., K.F., S.L., L.L., P.W., Y.W., M.T., M.P., A.D.).,Jonsson Comprehensive Cancer Center (J.Y., K.F., S.L., L.L., P.W., Y.W., R.P.K., D.D.C., M.T., M.P., A.D.)
| | - Shen Li
- From the Division of Cardiology, Department of Medicine (J.Y., M.M.S., S.L., P.W., Y.W., A.J.L., A.D.).,Cardiovascular Research Laboratory (J.Y., M.M.S., S.L., P.W., Y.W., A.J.L., A.D.).,Department of Molecular, Cell, and Developmental Biology (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Eli & Edythe Broad Center of Regenerative Medicine and Stem Cell Research (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Molecular Biology Institute (J.Y., K.F., S.L., L.L., P.W., Y.W., M.T., M.P., A.D.).,Jonsson Comprehensive Cancer Center (J.Y., K.F., S.L., L.L., P.W., Y.W., R.P.K., D.D.C., M.T., M.P., A.D.)
| | - Larry Lam
- Department of Molecular, Cell, and Developmental Biology (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Eli & Edythe Broad Center of Regenerative Medicine and Stem Cell Research (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Jonsson Comprehensive Cancer Center (J.Y., K.F., S.L., L.L., P.W., Y.W., R.P.K., D.D.C., M.T., M.P., A.D.)
| | - Ping Wang
- From the Division of Cardiology, Department of Medicine (J.Y., M.M.S., S.L., P.W., Y.W., A.J.L., A.D.).,Cardiovascular Research Laboratory (J.Y., M.M.S., S.L., P.W., Y.W., A.J.L., A.D.).,Department of Molecular, Cell, and Developmental Biology (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Eli & Edythe Broad Center of Regenerative Medicine and Stem Cell Research (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Molecular Biology Institute (J.Y., K.F., S.L., L.L., P.W., Y.W., M.T., M.P., A.D.).,Jonsson Comprehensive Cancer Center (J.Y., K.F., S.L., L.L., P.W., Y.W., R.P.K., D.D.C., M.T., M.P., A.D.)
| | - Yijie Wang
- From the Division of Cardiology, Department of Medicine (J.Y., M.M.S., S.L., P.W., Y.W., A.J.L., A.D.).,Cardiovascular Research Laboratory (J.Y., M.M.S., S.L., P.W., Y.W., A.J.L., A.D.).,Department of Molecular, Cell, and Developmental Biology (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Eli & Edythe Broad Center of Regenerative Medicine and Stem Cell Research (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Molecular Biology Institute (J.Y., K.F., S.L., L.L., P.W., Y.W., M.T., M.P., A.D.).,Jonsson Comprehensive Cancer Center (J.Y., K.F., S.L., L.L., P.W., Y.W., R.P.K., D.D.C., M.T., M.P., A.D.)
| | - Dian Huang
- Department of Bioengineering (D.H., T.L.N., D.D.C.)
| | | | - Bowen Wei
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine (B.W., R.P.K.)
| | - Rajan P Kulkarni
- Jonsson Comprehensive Cancer Center (J.Y., K.F., S.L., L.L., P.W., Y.W., R.P.K., D.D.C., M.T., M.P., A.D.).,Division of Dermatology, Department of Medicine, David Geffen School of Medicine (B.W., R.P.K.)
| | - Dino Di Carlo
- Jonsson Comprehensive Cancer Center (J.Y., K.F., S.L., L.L., P.W., Y.W., R.P.K., D.D.C., M.T., M.P., A.D.).,Department of Bioengineering (D.H., T.L.N., D.D.C.)
| | - Michael Teitell
- Molecular Biology Institute (J.Y., K.F., S.L., L.L., P.W., Y.W., M.T., M.P., A.D.).,Jonsson Comprehensive Cancer Center (J.Y., K.F., S.L., L.L., P.W., Y.W., R.P.K., D.D.C., M.T., M.P., A.D.).,Department of Pathology and Laboratory Medicine, David Geffen School of Medicine (M.T.), University of California, Los Angeles
| | - Matteo Pellegrini
- Department of Molecular, Cell, and Developmental Biology (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Eli & Edythe Broad Center of Regenerative Medicine and Stem Cell Research (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Molecular Biology Institute (J.Y., K.F., S.L., L.L., P.W., Y.W., M.T., M.P., A.D.).,Jonsson Comprehensive Cancer Center (J.Y., K.F., S.L., L.L., P.W., Y.W., R.P.K., D.D.C., M.T., M.P., A.D.)
| | - Aldons J Lusis
- From the Division of Cardiology, Department of Medicine (J.Y., M.M.S., S.L., P.W., Y.W., A.J.L., A.D.).,Cardiovascular Research Laboratory (J.Y., M.M.S., S.L., P.W., Y.W., A.J.L., A.D.).,Departments of Human Genetics and Microbiology, Immunology and Molecular Genetics (M.M.S., A.J.L.)
| | - Arjun Deb
- From the Division of Cardiology, Department of Medicine (J.Y., M.M.S., S.L., P.W., Y.W., A.J.L., A.D.) .,Cardiovascular Research Laboratory (J.Y., M.M.S., S.L., P.W., Y.W., A.J.L., A.D.).,Department of Molecular, Cell, and Developmental Biology (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Eli & Edythe Broad Center of Regenerative Medicine and Stem Cell Research (J.Y., K.F., S.L., L.L., P.W., Y.W., M.P., A.D.).,Molecular Biology Institute (J.Y., K.F., S.L., L.L., P.W., Y.W., M.T., M.P., A.D.).,Jonsson Comprehensive Cancer Center (J.Y., K.F., S.L., L.L., P.W., Y.W., R.P.K., D.D.C., M.T., M.P., A.D.)
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25
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Sereti KI, Nguyen NB, Kamran P, Zhao P, Ranjbarvaziri S, Park S, Sabri S, Engel JL, Sung K, Kulkarni RP, Ding Y, Hsiai TK, Plath K, Ernst J, Sahoo D, Mikkola HKA, Iruela-Arispe ML, Ardehali R. Analysis of cardiomyocyte clonal expansion during mouse heart development and injury. Nat Commun 2018; 9:754. [PMID: 29467410 PMCID: PMC5821855 DOI: 10.1038/s41467-018-02891-z] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [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: 02/23/2017] [Accepted: 01/05/2018] [Indexed: 12/31/2022] Open
Abstract
The cellular mechanisms driving cardiac tissue formation remain poorly understood, largely due to the structural and functional complexity of the heart. It is unclear whether newly generated myocytes originate from cardiac stem/progenitor cells or from pre-existing cardiomyocytes that re-enter the cell cycle. Here, we identify the source of new cardiomyocytes during mouse development and after injury. Our findings suggest that cardiac progenitors maintain proliferative potential and are the main source of cardiomyocytes during development; however, the onset of αMHC expression leads to reduced cycling capacity. Single-cell RNA sequencing reveals a proliferative, "progenitor-like" population abundant in early embryonic stages that decreases to minimal levels postnatally. Furthermore, cardiac injury by ligation of the left anterior descending artery was found to activate cardiomyocyte proliferation in neonatal but not adult mice. Our data suggest that clonal dominance of differentiating progenitors mediates cardiac development, while a distinct subpopulation of cardiomyocytes may have the potential for limited proliferation during late embryonic development and shortly after birth.
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Affiliation(s)
- Konstantina-Ioanna Sereti
- Division of Cardiology, Department of Internal Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Ngoc B Nguyen
- Division of Cardiology, Department of Internal Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Molecular, Cellular and Integrative Physiology Graduate Program, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Paniz Kamran
- Division of Cardiology, Department of Internal Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Peng Zhao
- Division of Cardiology, Department of Internal Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Sara Ranjbarvaziri
- Division of Cardiology, Department of Internal Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Molecular, Cellular and Integrative Physiology Graduate Program, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Shuin Park
- Division of Cardiology, Department of Internal Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Molecular, Cellular and Integrative Physiology Graduate Program, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Shan Sabri
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Department of Biological Chemistry, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Jonsson Comprehensive Cancer Center, Los Angeles, CA, 90095, USA.,UCLA Bioinformatics Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - James L Engel
- Division of Cardiology, Department of Internal Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Molecular, Cellular and Integrative Physiology Graduate Program, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Kevin Sung
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Rajan P Kulkarni
- Jonsson Comprehensive Cancer Center, Los Angeles, CA, 90095, USA.,Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Yichen Ding
- Division of Cardiology, Department of Internal Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Tzung K Hsiai
- Division of Cardiology, Department of Internal Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Kathrin Plath
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Department of Biological Chemistry, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Jonsson Comprehensive Cancer Center, Los Angeles, CA, 90095, USA.,UCLA Bioinformatics Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Jason Ernst
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Department of Biological Chemistry, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Jonsson Comprehensive Cancer Center, Los Angeles, CA, 90095, USA.,UCLA Bioinformatics Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Debashis Sahoo
- Departments of Pediatrics and Computer Science and Engineering, University of California San Diego, La Jolla, CA, 92093, USA
| | - Hanna K A Mikkola
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Jonsson Comprehensive Cancer Center, Los Angeles, CA, 90095, USA.,Department of Molecular, Cell and Developmental Biology, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - M Luisa Iruela-Arispe
- Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Department of Molecular, Cell and Developmental Biology, University of California, Los Angeles, Los Angeles, CA, 90095, USA.,Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Reza Ardehali
- Division of Cardiology, Department of Internal Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA. .,Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, 90095, USA. .,Molecular, Cellular and Integrative Physiology Graduate Program, University of California, Los Angeles, Los Angeles, CA, 90095, USA. .,Jonsson Comprehensive Cancer Center, Los Angeles, CA, 90095, USA. .,Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
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26
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Hsu JJ, Lu J, Umar S, Lee JT, Kulkarni RP, Ding Y, Chang CC, Hsiai TK, Hokugo A, Gkouveris I, Tetradis S, Nishimura I, Demer LL, Tintut Y. Effects of teriparatide on morphology of aortic calcification in aged hyperlipidemic mice. Am J Physiol Heart Circ Physiol 2018; 314:H1203-H1213. [PMID: 29451816 DOI: 10.1152/ajpheart.00718.2017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Calcific aortic vasculopathy correlates with bone loss in osteoporosis in an age-independent manner. Prior work suggests that teriparatide, the bone anabolic treatment for postmenopausal osteoporosis, may inhibit the onset of aortic calcification. Whether teriparatide affects the progression of preexisting aortic calcification, widespread among this patient population, is unknown. Female apolipoprotein E-deficient mice were aged for over 1 yr to induce aortic calcification, treated for 4.5 wk with daily injections of control vehicle (PBS), 40 µg/kg teriparatide (PTH40), or 400 µg/kg teriparatide (PTH400), and assayed for aortic calcification by microcomputed tomography (microCT) before and after treatment. In a followup cohort, aged female apolipoprotein E-deficient mice were treated with PBS or PTH400 and assayed for aortic calcification by serial microCT and micropositron emission tomography. In both cohorts, aortic calcification detected by microCT progressed similarly in all groups. Mean aortic 18F-NaF incorporation, detected by serial micropositron emission tomography, increased in the PBS-treated group (+14 ± 5%). In contrast, 18F-NaF incorporation decreased in the PTH400-treated group (-33 ± 20%, P = 0.03). Quantitative histochemical analysis by Alizarin red staining revealed a lower mineral surface area index in the PTH400-treated group compared with the PBS-treated group ( P = 0.04). Furthermore, Masson trichrome staining showed a significant increase in collagen deposition in the left ventricular myocardium of mice that received PTH400 [2.1 ± 0.6% vs. control mice (0.5 ± 0.1%), P = 0.02]. In summary, although teriparatide may not affect the calcium mineral content of aortic calcification, it reduces 18F-NaF uptake in calcified lesions, suggesting the possibility that it may reduce mineral surface area with potential impact on plaque stability. NEW & NOTEWORTHY Parathyroid hormone regulates bone mineralization and may also affect vascular calcification, which is an important issue, given that its active fragment, teriparatide, is widely used for the treatment of osteoporosis. To determine whether teriparatide alters vascular calcification, we imaged aortic calcification in mice treated with teriparatide and control mice. Although teriparatide did not affect the calcium content of cardiovascular deposits, it reduced their fluoride tracer uptake.
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Affiliation(s)
- Jeffrey J Hsu
- Department of Medicine, School of Medicine, University of California , Los Angeles, California
| | - Jinxiu Lu
- Department of Physiology, School of Medicine, University of California , Los Angeles, California
| | - Soban Umar
- Department of Anesthesiology, School of Medicine, University of California , Los Angeles, California
| | - Jason T Lee
- Department of Molecular and Medical Pharmacology and Crump Institute for Molecular Imaging, School of Medicine, University of California , Los Angeles, California
| | - Rajan P Kulkarni
- Department of Medicine, School of Medicine, University of California , Los Angeles, California.,Department of Bioengineering, School of Engineering and Applied Sciences, University of California , Los Angeles, California
| | - Yichen Ding
- Department of Medicine, School of Medicine, University of California , Los Angeles, California.,Department of Bioengineering, School of Engineering and Applied Sciences, University of California , Los Angeles, California
| | - Chih-Chiang Chang
- Department of Bioengineering, School of Engineering and Applied Sciences, University of California , Los Angeles, California
| | - Tzung K Hsiai
- Department of Medicine, School of Medicine, University of California , Los Angeles, California.,Department of Bioengineering, School of Engineering and Applied Sciences, University of California , Los Angeles, California
| | - Akishige Hokugo
- Department of Plastic Surgery, School of Medicine, University of California , Los Angeles, California
| | - Ioannis Gkouveris
- Division of Diagnostic and Surgical Sciences, School of Engineering and Applied Sciences, University of California , Los Angeles, California
| | - Sotirios Tetradis
- Division of Diagnostic and Surgical Sciences, School of Engineering and Applied Sciences, University of California , Los Angeles, California
| | - Ichiro Nishimura
- Advanced Prosthodontics, School of Dentistry, University of California , Los Angeles, California
| | - Linda L Demer
- Department of Medicine, School of Medicine, University of California , Los Angeles, California.,Department of Physiology, School of Medicine, University of California , Los Angeles, California.,Department of Bioengineering, School of Engineering and Applied Sciences, University of California , Los Angeles, California
| | - Yin Tintut
- Department of Medicine, School of Medicine, University of California , Los Angeles, California.,Department of Physiology, School of Medicine, University of California , Los Angeles, California.,Department of Orthopaedic Surgery, School of Medicine, University of California , Los Angeles, California
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27
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Shen J, Chang J, Mendenhall M, Cherry G, Goldman JW, Kulkarni RP. Diverse cutaneous adverse eruptions caused by anti-programmed cell death-1 (PD-1) and anti-programmed cell death ligand-1 (PD-L1) immunotherapies: clinical features and management. Ther Adv Med Oncol 2018; 10:1758834017751634. [PMID: 29383039 PMCID: PMC5784551 DOI: 10.1177/1758834017751634] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [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: 08/23/2017] [Accepted: 11/03/2017] [Indexed: 12/22/2022] Open
Abstract
Background The anti-programmed cell death-1 (PD-1) and anti-programmed cell death ligand-1 (PD-L1) immunotherapies have shown exceptional activity in many cancers. However, these immunotherapies can also result in diverse adverse cutaneous eruptions that need to be better characterized for ongoing management. The objective was to provide clinical and histopathologic descriptions of the variety of cutaneous adverse events seen in patients who received anti-PD-1/PD-L1 treatment and discuss their management. Methods Patients with advanced cancers in clinical trials at University of California Los Angeles (UCLA), receiving anti-PD-1/PD-L1 treatment between 2012 and 2016 who developed cutaneous eruptions and were evaluated in the dermatology clinic were included in this retrospective case series study. A total of 16 patients were included in this study; of these, five were treated with pembrolizumab alone, two with avelumab alone, eight with nivolumab plus ipilimumab and one with nivolumab plus T-Vec. Of these 16 patients, eight had received systemic chemotherapy, six had received radiotherapy, and one had received trememlimumab prior to the immunotherapies described in this study. Results Cutaneous eruptions occurred at variable times, from week 1 to 88, with a median of 11.5 weeks; the morphologies included lichenoid, bullous, psoriasiform, macular, morbiliform appearances, and alopecia which were confirmed histopathologically in several of the cases. All cutaneous immune-related adverse events were either grade 1 or 2. Ten patients were treated with topical corticosteroids, and one also received NBUVB. Four patients eventually required systemic steroids. Three required discontinuation of their anti-PD-1/PD-L1 therapy secondary to the cutaneous eruptions. Conclusions There are several different types of adverse cutaneous morphologies that may be seen with administration of PD-1 and PD-L1 inhibitors. Identifying the patterns of eruption may assist in prompt treatment. Most eruptions could be managed with topical corticosteroids and without discontinuation of the systemic treatment.
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Affiliation(s)
- John Shen
- Division of Hematology/Oncology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Jason Chang
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Melody Mendenhall
- Division of Hematology/Oncology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Grace Cherry
- Division of Hematology/Oncology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Jonathan W Goldman
- Division of Hematology/Oncology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Rajan P Kulkarni
- Division of Dermatology 52-121 CHS, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
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28
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Che J, Yu V, Dhar M, Renier C, Matsumoto M, Heirich K, Garon EB, Goldman J, Rao J, Sledge GW, Pegram MD, Sheth S, Jeffrey SS, Kulkarni RP, Sollier E, Di Carlo D. Classification of large circulating tumor cells isolated with ultra-high throughput microfluidic Vortex technology. Oncotarget 2017; 7:12748-60. [PMID: 26863573 PMCID: PMC4914319 DOI: 10.18632/oncotarget.7220] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [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: 01/18/2016] [Accepted: 01/21/2016] [Indexed: 02/07/2023] Open
Abstract
Circulating tumor cells (CTCs) are emerging as rare but clinically significant non-invasive cellular biomarkers for cancer patient prognosis, treatment selection, and treatment monitoring. Current CTC isolation approaches, such as immunoaffinity, filtration, or size-based techniques, are often limited by throughput, purity, large output volumes, or inability to obtain viable cells for downstream analysis. For all technologies, traditional immunofluorescent staining alone has been employed to distinguish and confirm the presence of isolated CTCs among contaminating blood cells, although cells isolated by size may express vastly different phenotypes. Consequently, CTC definitions have been non-trivial, researcher-dependent, and evolving. Here we describe a complete set of objective criteria, leveraging well-established cytomorphological features of malignancy, by which we identify large CTCs. We apply the criteria to CTCs enriched from stage IV lung and breast cancer patient blood samples using the High Throughput Vortex Chip (Vortex HT), an improved microfluidic technology for the label-free, size-based enrichment and concentration of rare cells. We achieve improved capture efficiency (up to 83%), high speed of processing (8 mL/min of 10x diluted blood, or 800 μL/min of whole blood), and high purity (avg. background of 28.8±23.6 white blood cells per mL of whole blood). We show markedly improved performance of CTC capture (84% positive test rate) in comparison to previous Vortex designs and the current FDA-approved gold standard CellSearch assay. The results demonstrate the ability to quickly collect viable and pure populations of abnormal large circulating cells unbiased by molecular characteristics, which helps uncover further heterogeneity in these cells.
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Affiliation(s)
- James Che
- Department of Bioengineering, University of California, Los Angeles, California, USA.,Vortex Biosciences, Menlo Park, California, USA
| | - Victor Yu
- Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Manjima Dhar
- Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Corinne Renier
- Vortex Biosciences, Menlo Park, California, USA.,Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Melissa Matsumoto
- Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Kyra Heirich
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Edward B Garon
- Department of Hematology & Oncology, UCLA Medical Center, Los Angeles, California, USA
| | - Jonathan Goldman
- Department of Hematology & Oncology, UCLA Medical Center, Los Angeles, California, USA
| | - Jianyu Rao
- Department of Pathology & Laboratory Medicine, UCLA Medical Center, Los Angeles, California, USA
| | | | - Mark D Pegram
- Stanford Women's Cancer Center, Stanford, California, USA
| | - Shruti Sheth
- Stanford Women's Cancer Center, Stanford, California, USA
| | - Stefanie S Jeffrey
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA.,Stanford Women's Cancer Center, Stanford, California, USA
| | - Rajan P Kulkarni
- Department of Bioengineering, University of California, Los Angeles, California, USA.,Division of Dermatology, UCLA Medical Center, Los Angeles, California, USA
| | - Elodie Sollier
- Department of Bioengineering, University of California, Los Angeles, California, USA.,Vortex Biosciences, Menlo Park, California, USA.,Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Dino Di Carlo
- Department of Bioengineering, University of California, Los Angeles, California, USA.,California NanoSystems Institue, Los Angeles, California, USA.,Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
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29
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Zhang Y, Shin Y, Sung K, Yang S, Chen H, Wang H, Teng D, Rivenson Y, Kulkarni RP, Ozcan A. 3D imaging of optically cleared tissue using a simplified CLARITY method and on-chip microscopy. Sci Adv 2017; 3:e1700553. [PMID: 28819645 PMCID: PMC5553818 DOI: 10.1126/sciadv.1700553] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 07/12/2017] [Indexed: 05/07/2023]
Abstract
High-throughput sectioning and optical imaging of tissue samples using traditional immunohistochemical techniques can be costly and inaccessible in resource-limited areas. We demonstrate three-dimensional (3D) imaging and phenotyping in optically transparent tissue using lens-free holographic on-chip microscopy as a low-cost, simple, and high-throughput alternative to conventional approaches. The tissue sample is passively cleared using a simplified CLARITY method and stained using 3,3'-diaminobenzidine to target cells of interest, enabling bright-field optical imaging and 3D sectioning of thick samples. The lens-free computational microscope uses pixel super-resolution and multi-height phase recovery algorithms to digitally refocus throughout the cleared tissue and obtain a 3D stack of complex-valued images of the sample, containing both phase and amplitude information. We optimized the tissue-clearing and imaging system by finding the optimal illumination wavelength, tissue thickness, sample preparation parameters, and the number of heights of the lens-free image acquisition and implemented a sparsity-based denoising algorithm to maximize the imaging volume and minimize the amount of the acquired data while also preserving the contrast-to-noise ratio of the reconstructed images. As a proof of concept, we achieved 3D imaging of neurons in a 200-μm-thick cleared mouse brain tissue over a wide field of view of 20.5 mm2. The lens-free microscope also achieved more than an order-of-magnitude reduction in raw data compared to a conventional scanning optical microscope imaging the same sample volume. Being low cost, simple, high-throughput, and data-efficient, we believe that this CLARITY-enabled computational tissue imaging technique could find numerous applications in biomedical diagnosis and research in low-resource settings.
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Affiliation(s)
- Yibo Zhang
- Electrical Engineering Department, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Bioengineering Department, University of California, Los Angeles, Los Angeles, CA 90095, USA
- California NanoSystems Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Yoonjung Shin
- Bioengineering Department, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Kevin Sung
- Bioengineering Department, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Sam Yang
- Electrical Engineering Department, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Harrison Chen
- Bioengineering Department, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Hongda Wang
- Electrical Engineering Department, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Bioengineering Department, University of California, Los Angeles, Los Angeles, CA 90095, USA
- California NanoSystems Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Da Teng
- Computer Science Department, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Yair Rivenson
- Electrical Engineering Department, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Bioengineering Department, University of California, Los Angeles, Los Angeles, CA 90095, USA
- California NanoSystems Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Rajan P. Kulkarni
- Bioengineering Department, University of California, Los Angeles, Los Angeles, CA 90095, USA
- California NanoSystems Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Aydogan Ozcan
- Electrical Engineering Department, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Bioengineering Department, University of California, Los Angeles, Los Angeles, CA 90095, USA
- California NanoSystems Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
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30
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Kim JT, Liu Y, Kulkarni RP, Lee KK, Dai B, Lovely G, Ouyang Y, Wang P, Yang L, Baltimore D. Dendritic cell-targeted lentiviral vector immunization uses pseudotransduction and DNA-mediated STING and cGAS activation. Sci Immunol 2017; 2:2/13/eaal1329. [PMID: 28733470 DOI: 10.1126/sciimmunol.aal1329] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 03/14/2017] [Accepted: 06/12/2017] [Indexed: 12/12/2022]
Abstract
Dendritic cell (DC) activation and antigen presentation are critical for efficient priming of T cell responses. Here, we study how lentiviral vectors (LVs) deliver antigen and activate DCs to generate T cell immunization in vivo. We report that antigenic proteins delivered in vector particles via pseudotransduction were sufficient to stimulate an antigen-specific immune response. The delivery of the viral genome encoding the antigen increased the magnitude of this response in vivo but was irrelevant in vitro. Activation of DCs by LVs was independent of MyD88, TRIF, and MAVS, ruling out an involvement of Toll-like receptor or RIG-I-like receptor signaling. Cellular DNA packaged in LV preparations induced DC activation by the host STING (stimulator of interferon genes) and cGAS (cyclic guanosine monophosphate-adenosine monophosphate synthase) pathway. Envelope-mediated viral fusion also activated DCs in a phosphoinositide 3-kinase-dependent but STING-independent process. Pseudotransduction, transduction, viral fusion, and delivery of cellular DNA collaborate to make the DC-targeted LV preparation an effective immunogen.
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Affiliation(s)
- Jocelyn T Kim
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA.,Division of Infectious Diseases, Department of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Yarong Liu
- Mork Family Department of Chemical Engineering and Materials Science, University of Southern California, Los Angeles, CA 90089, USA
| | - Rajan P Kulkarni
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA.,Division of Dermatology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Kevin K Lee
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Bingbing Dai
- Mork Family Department of Chemical Engineering and Materials Science, University of Southern California, Los Angeles, CA 90089, USA
| | - Geoffrey Lovely
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Yong Ouyang
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Pin Wang
- Mork Family Department of Chemical Engineering and Materials Science, University of Southern California, Los Angeles, CA 90089, USA
| | - Lili Yang
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA.,Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - David Baltimore
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA.
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31
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Renier C, Pao E, Che J, Liu HE, Lemaire CA, Matsumoto M, Triboulet M, Srivinas S, Jeffrey SS, Rettig M, Kulkarni RP, Di Carlo D, Sollier-Christen E. Label-free isolation of prostate circulating tumor cells using Vortex microfluidic technology. NPJ Precis Oncol 2017; 1:15. [PMID: 29872702 PMCID: PMC5859469 DOI: 10.1038/s41698-017-0015-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [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: 10/24/2016] [Revised: 02/28/2017] [Accepted: 03/05/2017] [Indexed: 01/21/2023] Open
Abstract
There has been increased interest in utilizing non-invasive "liquid biopsies" to identify biomarkers for cancer prognosis and monitoring, and to isolate genetic material that can predict response to targeted therapies. Circulating tumor cells (CTCs) have emerged as such a biomarker providing both genetic and phenotypic information about tumor evolution, potentially from both primary and metastatic sites. Currently, available CTC isolation approaches, including immunoaffinity and size-based filtration, have focused on high capture efficiency but with lower purity and often long and manual sample preparation, which limits the use of captured CTCs for downstream analyses. Here, we describe the use of the microfluidic Vortex Chip for size-based isolation of CTCs from 22 patients with advanced prostate cancer and, from an enumeration study on 18 of these patients, find that we can capture CTCs with high purity (from 1.74 to 37.59%) and efficiency (from 1.88 to 93.75 CTCs/7.5 mL) in less than 1 h. Interestingly, more atypical large circulating cells were identified in five age-matched healthy donors (46-77 years old; 1.25-2.50 CTCs/7.5 mL) than in five healthy donors <30 years old (21-27 years old; 0.00 CTC/7.5 mL). Using a threshold calculated from the five age-matched healthy donors (3.37 CTCs/mL), we identified CTCs in 80% of the prostate cancer patients. We also found that a fraction of the cells collected (11.5%) did not express epithelial prostate markers (cytokeratin and/or prostate-specific antigen) and that some instead expressed markers of epithelial-mesenchymal transition, i.e., vimentin and N-cadherin. We also show that the purity and DNA yield of isolated cells is amenable to targeted amplification and next-generation sequencing, without whole genome amplification, identifying unique mutations in 10 of 15 samples and 0 of 4 healthy samples.
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Affiliation(s)
- Corinne Renier
- Vortex Biosciences Inc., 1490 O’Brien Drive, Suite E, Menlo Park, CA 94025 USA
| | - Edward Pao
- Department of Bioengineering, University of California, 420 Westwood Plaza, 5121 Engineering V, PO Box 951600, Los Angeles, CA 90095 USA
| | - James Che
- Vortex Biosciences Inc., 1490 O’Brien Drive, Suite E, Menlo Park, CA 94025 USA
| | - Haiyan E. Liu
- Vortex Biosciences Inc., 1490 O’Brien Drive, Suite E, Menlo Park, CA 94025 USA
| | | | - Melissa Matsumoto
- Department of Bioengineering, University of California, 420 Westwood Plaza, 5121 Engineering V, PO Box 951600, Los Angeles, CA 90095 USA
| | - Melanie Triboulet
- Department of Surgery, Stanford University School of Medicine, MSLS Bldg, 1201 Welch Road, Stanford, CA 94305 USA
| | - Sandy Srivinas
- Department of Medicine, Stanford University School of Medicine, 875 Blake Wilbur Drive, Stanford, CA 94305 USA
| | - Stefanie S. Jeffrey
- Department of Surgery, Stanford University School of Medicine, MSLS Bldg, 1201 Welch Road, Stanford, CA 94305 USA
| | - Matthew Rettig
- Departments of Medicine Urology, UCLA Medical Center, Los Angeles, CA 90095 USA
- Department of Medicine, VA Greater Los Angeles Healthcare System-West Los Angeles, Los Angeles, CA 90073 USA
- Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095 USA
| | - Rajan P. Kulkarni
- Department of Bioengineering, University of California, 420 Westwood Plaza, 5121 Engineering V, PO Box 951600, Los Angeles, CA 90095 USA
- Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095 USA
- California NanoSystems Institute, 570 Westwood Plaza, Building 114, Los Angeles, CA 90095 USA
- Division of Dermatology, UCLA Medical Center, 52-121 CHS, Los Angeles, CA 90095 USA
| | - Dino Di Carlo
- Department of Bioengineering, University of California, 420 Westwood Plaza, 5121 Engineering V, PO Box 951600, Los Angeles, CA 90095 USA
- Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095 USA
- California NanoSystems Institute, 570 Westwood Plaza, Building 114, Los Angeles, CA 90095 USA
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32
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Ding Y, Lee J, Ma J, Sung K, Yokota T, Singh N, Dooraghi M, Abiri P, Wang Y, Kulkarni RP, Nakano A, Nguyen TP, Fei P, Hsiai TK. Light-sheet fluorescence imaging to localize cardiac lineage and protein distribution. Sci Rep 2017; 7:42209. [PMID: 28165052 PMCID: PMC5292685 DOI: 10.1038/srep42209] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [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: 10/04/2016] [Accepted: 01/03/2017] [Indexed: 12/24/2022] Open
Abstract
Light-sheet fluorescence microscopy (LSFM) serves to advance developmental research and regenerative medicine. Coupled with the paralleled advances in fluorescence-friendly tissue clearing technique, our cardiac LSFM enables dual-sided illumination to rapidly uncover the architecture of murine hearts over 10 by 10 by 10 mm3 in volume; thereby allowing for localizing progenitor differentiation to the cardiomyocyte lineage and AAV9-mediated expression of exogenous transmembrane potassium channels with high contrast and resolution. Without the steps of stitching image columns, pivoting the light-sheet and sectioning the heart mechanically, we establish a holistic strategy for 3-dimentional reconstruction of the "digital murine heart" to assess aberrant cardiac structures as well as the spatial distribution of the cardiac lineages in neonates and ion-channels in adults.
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Affiliation(s)
- Yichen Ding
- Division of Cardiology, Department of Medicine, UCLA, Los Angeles, CA 90095, USA.,Department of Bioengineering, School of Engineering &Applied Sciences, UCLA, Los Angeles, CA 90095, USA
| | - Juhyun Lee
- Department of Bioengineering, School of Engineering &Applied Sciences, UCLA, Los Angeles, CA 90095, USA
| | - Jianguo Ma
- Division of Cardiology, Department of Medicine, UCLA, Los Angeles, CA 90095, USA
| | - Kevin Sung
- Department of Bioengineering, School of Engineering &Applied Sciences, UCLA, Los Angeles, CA 90095, USA
| | - Tomohiro Yokota
- Departments of Anesthesiology, Physiology and Medicine, Cardiovascular Research Laboratories, UCLA, Los Angeles, CA 90095, USA
| | - Neha Singh
- Division of Cardiology, Department of Medicine, UCLA, Los Angeles, CA 90095, USA
| | - Mojdeh Dooraghi
- Division of Cardiology, Department of Medicine, UCLA, Los Angeles, CA 90095, USA
| | - Parinaz Abiri
- Division of Cardiology, Department of Medicine, UCLA, Los Angeles, CA 90095, USA.,Department of Bioengineering, School of Engineering &Applied Sciences, UCLA, Los Angeles, CA 90095, USA
| | - Yibin Wang
- Departments of Anesthesiology, Physiology and Medicine, Cardiovascular Research Laboratories, UCLA, Los Angeles, CA 90095, USA
| | - Rajan P Kulkarni
- Department of Bioengineering, School of Engineering &Applied Sciences, UCLA, Los Angeles, CA 90095, USA.,Division of Dermatology, Department of Medicine, UCLA, Los Angeles, CA 90095, USA.,California NanoSystems Institute, UCLA, Los Angeles, CA 90095, USA
| | - Atsushi Nakano
- Department of Molecular, Cellular and Developmental Biology, UCLA, Los Angeles, CA 90095, USA.,Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, UCLA, Los Angeles, CA 90095, USA
| | - Thao P Nguyen
- Division of Cardiology, Department of Medicine, UCLA, Los Angeles, CA 90095, USA
| | - Peng Fei
- School of Optical and Electronic Information, Huazhong University of Science and Technology, Wuhan, China
| | - Tzung K Hsiai
- Division of Cardiology, Department of Medicine, UCLA, Los Angeles, CA 90095, USA.,Department of Bioengineering, School of Engineering &Applied Sciences, UCLA, Los Angeles, CA 90095, USA.,California NanoSystems Institute, UCLA, Los Angeles, CA 90095, USA
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33
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Pan M, Reid MA, Lowman XH, Kulkarni RP, Tran TQ, Liu X, Yang Y, Hernandez-Davies JE, Rosales KK, Li H, Hugo W, Song C, Xu X, Schones DE, Ann DK, Gradinaru V, Lo RS, Locasale JW, Kong M. Regional glutamine deficiency in tumours promotes dedifferentiation through inhibition of histone demethylation. Nat Cell Biol 2016; 18:1090-101. [PMID: 27617932 DOI: 10.1038/ncb3410] [Citation(s) in RCA: 254] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 08/12/2016] [Indexed: 12/14/2022]
Abstract
Poorly organized tumour vasculature often results in areas of limited nutrient supply and hypoxia. Despite our understanding of solid tumour responses to hypoxia, how nutrient deprivation regionally affects tumour growth and therapeutic response is poorly understood. Here, we show that the core region of solid tumours displayed glutamine deficiency compared with other amino acids. Low glutamine in tumour core regions led to dramatic histone hypermethylation due to decreased α-ketoglutarate levels, a key cofactor for the Jumonji-domain-containing histone demethylases. Using patient-derived (V600E)BRAF melanoma cells, we found that low-glutamine-induced histone hypermethylation resulted in cancer cell dedifferentiation and resistance to BRAF inhibitor treatment, which was largely mediated by methylation on H3K27, as knockdown of the H3K27-specific demethylase KDM6B and the methyltransferase EZH2 respectively reproduced and attenuated the low-glutamine effects in vitro and in vivo. Thus, intratumoral regional variation in the nutritional microenvironment contributes to tumour heterogeneity and therapeutic response.
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Affiliation(s)
- Min Pan
- Department of Cancer Biology, Beckman Research Institute of City of Hope Cancer Center, Duarte, California 91010, USA
| | - Michael A Reid
- Department of Cancer Biology, Beckman Research Institute of City of Hope Cancer Center, Duarte, California 91010, USA
| | - Xazmin H Lowman
- Department of Cancer Biology, Beckman Research Institute of City of Hope Cancer Center, Duarte, California 91010, USA
| | - Rajan P Kulkarni
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, California 91125, USA.,Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California 90095, USA
| | - Thai Q Tran
- Department of Cancer Biology, Beckman Research Institute of City of Hope Cancer Center, Duarte, California 91010, USA
| | - Xiaojing Liu
- Department of Pharmacology and Cancer Biology, Duke University Medical School, Durham, North Carolina 27710, USA
| | - Ying Yang
- Department of Cancer Biology, Beckman Research Institute of City of Hope Cancer Center, Duarte, California 91010, USA
| | - Jenny E Hernandez-Davies
- Department of Cancer Biology, Beckman Research Institute of City of Hope Cancer Center, Duarte, California 91010, USA
| | - Kimberly K Rosales
- Department of Cancer Biology, Beckman Research Institute of City of Hope Cancer Center, Duarte, California 91010, USA
| | - Haiqing Li
- Department of Information Sciences, Beckman Research Institute of City of Hope Cancer Center, Duarte, California 91010, USA
| | - Willy Hugo
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine and Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California 90095, USA
| | - Chunying Song
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine and Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California 90095, USA
| | - Xiangdong Xu
- Department of Pathology, University of California San Diego, La Jolla, California 92093, USA
| | - Dustin E Schones
- Department of Diabetes and Metabolic Disease, Beckman Research Institute of City of Hope Cancer Center, Duarte, California 91010, USA
| | - David K Ann
- Department of Diabetes and Metabolic Disease, Beckman Research Institute of City of Hope Cancer Center, Duarte, California 91010, USA
| | - Viviana Gradinaru
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, California 91125, USA
| | - Roger S Lo
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine and Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California 90095, USA
| | - Jason W Locasale
- Department of Pharmacology and Cancer Biology, Duke University Medical School, Durham, North Carolina 27710, USA
| | - Mei Kong
- Department of Cancer Biology, Beckman Research Institute of City of Hope Cancer Center, Duarte, California 91010, USA
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34
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Sung K, Ding Y, Ma J, Chen H, Huang V, Cheng M, Yang CF, Kim JT, Eguchi D, Di Carlo D, Hsiai TK, Nakano A, Kulkarni RP. Simplified three-dimensional tissue clearing and incorporation of colorimetric phenotyping. Sci Rep 2016; 6:30736. [PMID: 27498769 PMCID: PMC4976371 DOI: 10.1038/srep30736] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [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: 04/27/2016] [Accepted: 07/04/2016] [Indexed: 11/09/2022] Open
Abstract
Tissue clearing methods promise to provide exquisite three-dimensional imaging information; however, there is a need for simplified methods for lower resource settings and for non-fluorescence based phenotyping to enable light microscopic imaging modalities. Here we describe the simplified CLARITY method (SCM) for tissue clearing that preserves epitopes of interest. We imaged the resulting tissues using light sheet microscopy to generate rapid 3D reconstructions of entire tissues and organs. In addition, to enable clearing and 3D tissue imaging with light microscopy methods, we developed a colorimetric, non-fluorescent method for specifically labeling cleared tissues based on horseradish peroxidase conversion of diaminobenzidine to a colored insoluble product. The methods we describe here are portable and can be accomplished at low cost, and can allow light microscopic imaging of cleared tissues, thus enabling tissue clearing and imaging in a wide variety of settings.
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Affiliation(s)
- Kevin Sung
- Department of Bioengineering, University of California, Los Angeles, CA 90095, Los Angeles, USA
| | - Yichen Ding
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA, CA 90095, Los Angeles, USA
| | - Jianguo Ma
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA, CA 90095, Los Angeles, USA
| | - Harrison Chen
- Department of Bioengineering, University of California, Los Angeles, CA 90095, Los Angeles, USA
| | - Vincent Huang
- Department of Molecular, Cellular, and Developmental Biology, University of California, Los Angeles, CA 90095, Los Angeles, USA
| | - Michelle Cheng
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine at UCLA, CA 90095, Los Angeles, USA
| | - Cindy F Yang
- Department of Neurobiology, David Geffen School of Medicine at UCLA, CA 90095, Los Angeles, USA
| | - Jocelyn T Kim
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, CA 90095, Los Angeles, USA
| | - Daniel Eguchi
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine at UCLA, CA 90095, Los Angeles, USA
| | - Dino Di Carlo
- Department of Bioengineering, University of California, Los Angeles, CA 90095, Los Angeles, USA.,California NanoSystems Institute, UCLA, CA 90095, Los Angeles, USA.,Jonsson Comprehensive Cancer Center, UCLA, CA 90095, Los Angeles, USA
| | - Tzung K Hsiai
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA, CA 90095, Los Angeles, USA.,California NanoSystems Institute, UCLA, CA 90095, Los Angeles, USA
| | - Atsushi Nakano
- Department of Molecular, Cellular, and Developmental Biology, University of California, Los Angeles, CA 90095, Los Angeles, USA.,Jonsson Comprehensive Cancer Center, UCLA, CA 90095, Los Angeles, USA.,Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research at UCLA, CA 90095, Los Angeles, USA
| | - Rajan P Kulkarni
- Department of Bioengineering, University of California, Los Angeles, CA 90095, Los Angeles, USA.,Division of Dermatology, Department of Medicine, David Geffen School of Medicine at UCLA, CA 90095, Los Angeles, USA.,California NanoSystems Institute, UCLA, CA 90095, Los Angeles, USA.,Jonsson Comprehensive Cancer Center, UCLA, CA 90095, Los Angeles, USA
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Pao E, Renier C, Lemaire C, Che J, Matsumoto Di Carlo M, Triboulet M, Srivinas S, Jeffrey SS, Kulkarni RP, Rettig M, Sollier E, Di Carlo D. Abstract 4967: Label-free collection of prostate circulating tumor cells using microfluidic Vortex technology. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-4967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND
Prostate cancer is among the most common cancers in men worldwide. Better markers than Prostate Specific Antigen (PSA) are still needed for the detection and monitoring of disease progression. Circulating Tumor Cells (CTCs) are shed into the blood stream from primary tumor(s) and may play key roles in the metastatic process. Liquid biopsies have emerged as a promising approach, with a correlation between the CTC numbers and patient prognosis for prostate cancer. CTCs have also been shown to enable early detection of recurrence, and could be potential candidates for guiding cancer therapy in real-time [1]. Current CTC enrichment technologies, including immuno-affinity and size-based filtration methods, have focused on high capture efficiency with sometimes tedious sample preparation and overall low purity.
METHOD
Here, we describe the use of the microfluidic Vortex Chip [2] for rapid and size-based isolation of CTCs from the blood of 23 patients with advanced prostate cancer, and 10 healthy donors; 5 being <30 years old, 5 age-matched with the patient cohort. Requiring no upstream sample preparation, blood was diluted 10-fold and processed through the highly parallelized Vortex Chip at 8 mL/min (800 μL/min whole blood). Larger cells (predominantly CTCs) were captured in microscale vortices produced on the Chip, released into a small volume and collected off-chip for CK, PSA, CD45 and DAPI immunostaining and enumeration.
RESULTS
Preliminary work with LNCaP prostate cancer cells spiked in blood showed a 29% capture efficiency and 50% purity. In vitro cell assays confirmed that cells enriched with Vortex chip were alive and proliferating for up to 7 days. For 23 patient samples, CTCs were captured (0.5 - 20 CTCs/mL) with high purity (3.6 - 72.3%), in less than 1H, without prior sample preparation. 11.5% of the cells collected were CK and PSA-negative, but some were identified as undergoing epithelial-mesenchymal transition (EMT) following staining for vimentin and N-cadherin. Few atypical cells were also isolated from age-matched healthy donors (0.7 - 2.8 CTCs/mL), while none was detected in younger healthy donors. Using a threshold calculated from the age-matched healthy donors (3.31 CTCs/mL = mean + 2CV), 70% of the patients were characterized as “positive for CTCs”. No correlation was found between CTC counts and elevated PSA level.
CONCLUSION
These results demonstrate the ability to rapidly collect pure populations of CTCs in metastatic prostate cancer, independent of surface marker expression, without prior sample preparation. Future studies will use chips with optimized capture performance, sample recycling, and will include CTC molecular analysis by targeted panel sequencing. A larger cohort of healthy donors is also being examined to determine a statistically-robust CTC baseline for this size-based capture approach.
[1] Scher Hi, et al., J. Clin. Oncol. 2015
[2] Sollier E, et al., Lab Chip 2014
Citation Format: Edward Pao, Corinne Renier, Clementine Lemaire, James Che, Melissa Matsumoto Di Carlo, Melanie Triboulet, Sandy Srivinas, Stefanie S. Jeffrey, Rajan P. Kulkarni, Matthew Rettig, Elodie Sollier, Dino Di Carlo. Label-free collection of prostate circulating tumor cells using microfluidic Vortex technology. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4967.
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Affiliation(s)
| | | | | | - James Che
- 1UCLA Bioengineering, Los Angeles, CA
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Tay A, Kulkarni RP, Karimi A, Di Carlo D. Research highlights: enhancing whole genome amplification using compartmentalization. Lab Chip 2015; 15:4379-4382. [PMID: 26486454 DOI: 10.1039/c5lc90117k] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The ability to break up a larger liquid volume into an array of smaller confined volumes that do not chemically communicate is a key enabling technology driving microfluidic innovations. We highlight recent work using drop-based confinement to improve on whole genome amplification, reducing amplification bias and contaminant amplification by bringing reactions to saturation within each confined drop. We also highlight a complementary technique to target whole genome amplification to a subset of nucleic acids within a sample by combining drop-based PCR with sorting and downstream sequencing. These new approaches have the potential to enhance our ability to categorize the diversity of microorganisms (especially difficult to culture species) that contribute to complex microbial communities, and in particular assemble the individual genomes of the species involved in biologically and environmentally important microbiomes.
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Affiliation(s)
- Andy Tay
- Department of Bioengineering, University of California, Los Angeles, CA 90095, USA.
| | - Rajan P Kulkarni
- Department of Bioengineering, University of California, Los Angeles, CA 90095, USA.
| | - Armin Karimi
- Department of Bioengineering, University of California, Los Angeles, CA 90095, USA.
| | - Dino Di Carlo
- Department of Bioengineering, University of California, Los Angeles, CA 90095, USA. and California NanoSystems Institute, Los Angeles, California, USA
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Dhar M, Wong J, Karimi A, Che J, Renier C, Matsumoto M, Triboulet M, Garon EB, Goldman JW, Rettig MB, Jeffrey SS, Kulkarni RP, Sollier E, Di Carlo D. High efficiency vortex trapping of circulating tumor cells. Biomicrofluidics 2015; 9:064116. [PMID: 26697126 PMCID: PMC4684572 DOI: 10.1063/1.4937895] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 12/01/2015] [Indexed: 05/06/2023]
Abstract
Circulating tumor cells (CTCs) are important biomarkers for monitoring tumor dynamics and efficacy of cancer therapy. Several technologies have been demonstrated to isolate CTCs with high efficiency but achieve a low purity from a large background of blood cells. We have previously shown the ability to enrich CTCs with high purity from large volumes of blood through selective capture in microvortices using the Vortex Chip. The device consists of a narrow channel followed by a series of expansion regions called reservoirs. Fast flow in the narrow entry channel gives rise to inertial forces, which direct larger cells into trapping vortices in the reservoirs where they remain circulating in orbits. By studying the entry and stability of particles following entry into reservoirs, we discover that channel cross sectional area plays an important role in controlling the size of trapped particles, not just the orbital trajectories. Using these design modifications, we demonstrate a new device that is able to capture a wider size range of CTCs from clinical samples, uncovering further heterogeneity. This simple biophysical method opens doors for a range of downstream interventions, including genetic analysis, cell culture, and ultimately personalized cancer therapy.
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Affiliation(s)
| | - Jessica Wong
- Department of Bioengineering, University of California Los Angeles , 420 Westwood Plaza, Los Angeles, California 90095, USA
| | | | | | - Corinne Renier
- Vortex Biosciences, Inc. , 1455 Adams Drive, Menlo Labs, Suite 2010, Menlo Park, California 94025, USA
| | - Melissa Matsumoto
- Department of Bioengineering, University of California Los Angeles , 420 Westwood Plaza, Los Angeles, California 90095, USA
| | - Melanie Triboulet
- Department of Surgery, Stanford University School of Medicine , San Francisco, California 94305, USA
| | - Edward B Garon
- Division of Hematology-Oncology, UCLA Medical Center , Los Angeles, California 90095, USA
| | - Jonathan W Goldman
- Division of Hematology-Oncology, UCLA Medical Center , Los Angeles, California 90095, USA
| | | | - Stefanie S Jeffrey
- Department of Surgery, Stanford University School of Medicine , San Francisco, California 94305, USA
| | - Rajan P Kulkarni
- Division of Dermatology, UCLA Medical Center , Los Angeles, California 90095, USA
| | - Elodie Sollier
- Vortex Biosciences, Inc. , 1455 Adams Drive, Menlo Labs, Suite 2010, Menlo Park, California 94025, USA
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Pao E, Che J, Sollier E, King A, Fan G, Huang J, Di Carlo D, Rettig MB, Kulkarni RP. Abstract 631: Utilizing Vortex Chip for enumeration and determination of single-cell heterogeneity of circulating tumor cells in prostate cancer. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Circulating tumor cells (CTCs) are cells that break away from either the primary tumor or metastatic sites and circulate in the peripheral blood. CTCs are increasingly used as an accessible source of tumor cells (i.e. “liquid biopsy”). We are using a CTC capture technology known as the Vortex Chip, which allows for rapid isolation of highly purified CTCs in less than 1 hour. Moreover, because the Vortex Chip isolates CTCs based on their size, this platform does not require antibody based capture that can potentially bias the isolation of CTC subpopulations to cells that express a specific surface marker, like EpCAM. A new version of the Vortex Chip, Vortex HT, has been used for an increased capture of prostate CTCs.
Methods: The Vortex HT Chip was fabricated using standard lithographic techniques with polydimethylsiloxane (PDMS) polymer. Samples were run using a syringe pump setup to deliver blood to the chip at a constant flow rate, with large cells (including CTCs) trapped in the vortices present within each chamber. Trapped cells were released using PBS rinse buffer and available for immunofluorescence staining (CK, PSA, CD45, DAPI) or other downstream analysis. Individual cells could also be isolated for total RNA amplification and RNA sequencing.
Results: With the new HT chip design, we achieved greater than 10,000-fold enrichment of the cells and an overall purity of greater than 50%. Individual CTCs from patients with advanced metastatic castration resistant prostate cancer (mCRPC) were isolated, immunostained and enumerated: among 13 patients, 100% had more than 1.5 CTCs/mL, while among 9 healthy donors, all had less than 1.5 CTCs/mL; we thus set 1.5 CTC/mL as the cutoff. Proof-of-principle single-cell RNA seq transcriptome analysis was performed on cells isolated from the chip. We isolated three CTCs from two distinct patients and performed RNA sequencing and compared the results to single cell RNA sequencing of three VCaP cell-line cells.
Conclusions: The Vortex Chip HT design has been successfully applied to prostate cancer with an increased throughput. CTCs have been collected from patient samples within less than 1 hour. The individual cells have sufficient RNA for individual single cell RNA seq analysis. Further optimization of these techniques will be necessary to validate these methods and to gain additional insight into heterogeneity of prostate cancer as reflected in CTCs.
Citation Format: Edward Pao, James Che, Elodie Sollier, Andrew King, Guoping Fan, Jiaoti Huang, Dino Di Carlo, Matthew B. Rettig, Rajan P. Kulkarni. Utilizing Vortex Chip for enumeration and determination of single-cell heterogeneity of circulating tumor cells in prostate cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 631. doi:10.1158/1538-7445.AM2015-631
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Chung J, Ou X, Kulkarni RP, Yang C. Counting White Blood Cells from a Blood Smear Using Fourier Ptychographic Microscopy. PLoS One 2015; 10:e0133489. [PMID: 26186353 PMCID: PMC4506059 DOI: 10.1371/journal.pone.0133489] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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: 11/02/2014] [Accepted: 06/28/2015] [Indexed: 11/18/2022] Open
Abstract
White blood cell (WBC) count is a valuable metric for assisting with diagnosis or prognosis of various diseases such as coronary heart disease, type 2 diabetes, or infection. Counting WBCs can be done either manually or automatically. Automatic methods are capable of counting a large number of cells to give a statistically more accurate reading of the WBC count of a sample, but the specialized equipment tends to be expensive. Manual methods are inexpensive since they only involve a conventional light microscope setup. However, it is more laborious and error-prone because the small field-of-view (FOV) of the microscope necessitates mechanical scanning of a specimen for counting an adequate number of WBCs. Here, we investigate the use of Fourier ptychographic microscopy (FPM) to bypass these issues of the manual methods. With a 2x objective, FPM can provide a FOV of 120 mm2 with enhanced resolution comparable to that of a 20x objective, which is adequate for non-differentially counting WBCs in just one FOV. A specialist was able to count the WBCs in FPM images with 100% accuracy compared to the count as determined from conventional microscope images. An automatic counting algorithm was also developed to identify WBCs from FPM's captured images with 95% accuracy, paving the way for a cost-effective WBC counting setup with the advantages of both the automatic and manual counting methods.
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Affiliation(s)
- Jaebum Chung
- Department of Electrical Engineering, California Institute of Technology, Pasadena, California, United States of America
- * E-mail:
| | - Xiaoze Ou
- Department of Electrical Engineering, California Institute of Technology, Pasadena, California, United States of America
| | - Rajan P. Kulkarni
- Division of Dermatology, University of California Los Angeles, Los Angeles, California, United States of America
| | - Changhuei Yang
- Department of Electrical Engineering, California Institute of Technology, Pasadena, California, United States of America
- Department of Bioengineering, California Institute of Technology, Pasadena, California, United States of America
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Ra SH, Su A, Li X, Zhou J, Cochran AJ, Kulkarni RP, Binder SW. Keratoacanthoma and squamous cell carcinoma are distinct from a molecular perspective. Mod Pathol 2015; 28:799-806. [PMID: 25676557 DOI: 10.1038/modpathol.2015.5] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/06/2014] [Accepted: 12/09/2014] [Indexed: 12/23/2022]
Abstract
Keratoacanthoma is a controversial entity. Some consider keratoacanthoma as a variant of squamous cell carcinoma, whereas others see it as a distinct self-resolving squamoproliferative lesion. Our objective is to examine the relationship of keratoacanthoma with squamous cell carcinoma and normal skin by using DNA microarrays. DNA microarray studies were performed on formalin-fixed and paraffin-embedded blocks from ten cases of actinic keratoacanthoma utilizing the U133plus2.0 array. These results were compared with our previously developed microarray database of ten squamous cell carcinoma and ten normal skin samples. Keratoacanthoma demonstrated 1449 differentially expressed genes in comparison with squamous cell carcinoma (>5-fold change: P<0.01) with 908 genes upregulated and 541 genes downregulated. Keratoacanthoma showed 2435 differentially expressed genes in comparison with normal skin (>5-fold change: P<0.01) with 1085 genes upregulated and 1350 genes downregulated. The most upregulated genes, comparing keratoacanthoma with normal skin included MALAT1, S100A8, CDR1, TPM4, and CALM1. The most downregulated genes included SCGB2A2, DCD, THRSP, ADIPOQ, adiponectin, and ADH1B. The molecular biological pathway analysis comparing keratoacanthoma with normal skin showed that cellular development, cellular growth and proliferation, cell death/apoptosis, and cell cycle pathways are prominently involved in the pathogenesis of keratoacanthoma. The most enriched canonical pathways were clathrin-mediated endocytosis signaling, molecular mechanisms of cancer and integrin signaling. The distinctive gene expression profile of keratoacanthoma reveals that it is molecularly distinct from squamous cell carcinoma. The molecular pathways and genes differentially expressed in comparing keratoacanthoma with normal skin suggest that keratoacanthoma is a neoplasm that can regress due to upregulation of the cell death/apoptosis pathway.
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Affiliation(s)
- Seong H Ra
- 1] San Diego Pathology Medical Group, San Diego, CA, USA [2] Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Albert Su
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Xinmin Li
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Jaime Zhou
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Alistair J Cochran
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Rajan P Kulkarni
- Department of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Scott W Binder
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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41
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Dudani JS, Gossett DR, Tse HTK, Lamm RJ, Kulkarni RP, Carlo DD. Rapid inertial solution exchange for enrichment and flow cytometric detection of microvesicles. Biomicrofluidics 2015; 9:014112. [PMID: 25713694 PMCID: PMC4320146 DOI: 10.1063/1.4907807] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 01/29/2015] [Indexed: 05/04/2023]
Abstract
Exosomes, nanosized membrane-bound vesicles released by cells, play roles in cell signaling, immunology, virology, and oncology. Their study, however, has been hampered by difficulty in isolation and quantification due to their size and the complexity of biological samples. Conventional approaches to improved isolation require specialized equipment and extensive sample preparation time. Therefore, isolation and detection methods of exosomes will benefit biological and clinical studies. Here, we report a microfluidic platform for inline exosome isolation and fluorescent detection using inertial manipulation of antibody-coated exosome capture beads from biological fluids.
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Affiliation(s)
- Jaideep S Dudani
- Department of Bioengineering, University of California, Los Angeles , Los Angeles, California 90095, USA
| | | | | | - Robert J Lamm
- Department of Bioengineering, University of California, Los Angeles , Los Angeles, California 90095, USA
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Yang B, Treweek JB, Kulkarni RP, Deverman BE, Chen CK, Lubeck E, Shah S, Cai L, Gradinaru V. Single-cell phenotyping within transparent intact tissue through whole-body clearing. Cell 2014; 158:945-958. [PMID: 25088144 DOI: 10.1016/j.cell.2014.07.017] [Citation(s) in RCA: 651] [Impact Index Per Article: 65.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 07/13/2014] [Accepted: 07/15/2014] [Indexed: 01/08/2023]
Abstract
Understanding the structure-function relationships at cellular, circuit, and organ-wide scale requires 3D anatomical and phenotypical maps, currently unavailable for many organs across species. At the root of this knowledge gap is the absence of a method that enables whole-organ imaging. Herein, we present techniques for tissue clearing in which whole organs and bodies are rendered macromolecule-permeable and optically transparent, thereby exposing their cellular structure with intact connectivity. We describe PACT (passive clarity technique), a protocol for passive tissue clearing and immunostaining of intact organs; RIMS (refractive index matching solution), a mounting media for imaging thick tissue; and PARS (perfusion-assisted agent release in situ), a method for whole-body clearing and immunolabeling. We show that in rodents PACT, RIMS, and PARS are compatible with endogenous-fluorescence, immunohistochemistry, RNA single-molecule FISH, long-term storage, and microscopy with cellular and subcellular resolution. These methods are applicable for high-resolution, high-content mapping and phenotyping of normal and pathological elements within intact organs and bodies.
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Affiliation(s)
- Bin Yang
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Jennifer B Treweek
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Rajan P Kulkarni
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA; Division of Dermatology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Benjamin E Deverman
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Chun-Kan Chen
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Eric Lubeck
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Sheel Shah
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Long Cai
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Viviana Gradinaru
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA.
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Sollier E, Go DE, Che J, Gossett DR, O'Byrne S, Weaver WM, Kummer N, Rettig M, Goldman J, Nickols N, McCloskey S, Kulkarni RP, Di Carlo D. Size-selective collection of circulating tumor cells using Vortex technology. Lab Chip 2014; 14:63-77. [PMID: 24061411 DOI: 10.1039/c3lc50689d] [Citation(s) in RCA: 344] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
A blood-based, low cost alternative to radiation intensive CT and PET imaging is critically needed for cancer prognosis and management of its treatment. "Liquid biopsies" of circulating tumor cells (CTCs) from a relatively non-invasive blood draw are particularly ideal, as they can be repeated regularly to provide up to date molecular information about the cancer, which would also open up key opportunities for personalized therapies. Beyond solely diagnostic applications, CTCs are also a subject of interest for drug development and cancer research. In this paper, we adapt a technology previously introduced, combining the use of micro-scale vortices and inertial focusing, specifically for the high-purity extraction of CTCs from blood samples. First, we systematically varied parameters including channel dimensions and flow rates to arrive at an optimal device for maximum trapping efficiency and purity. Second, we validated the final device for capture of cancer cell lines in blood, considering several factors, including the effect of blood dilution, red blood cell lysis and cell deformability, while demonstrating cell viability and independence on EpCAM expression. Finally, as a proof-of-concept, CTCs were successfully extracted and enumerated from the blood of patients with breast (N = 4, 25-51 CTCs per 7.5 mL) and lung cancer (N = 8, 23-317 CTCs per 7.5 mL). Importantly, samples were highly pure with limited leukocyte contamination (purity 57-94%). This Vortex approach offers significant advantages over existing technologies, especially in terms of processing time (20 min for 7.5 mL of whole blood), sample concentration (collecting cells in a small volume down to 300 μL), applicability to various cancer types, cell integrity and purity. We anticipate that its simplicity will aid widespread adoption by clinicians and biologists who desire to not only enumerate CTCs, but also uncover new CTC biology, such as unique gene mutations, vesicle secretion and roles in metastatic processes.
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Affiliation(s)
- Elodie Sollier
- Department of Bioengineering, University of California, 420 Westwood Plaza, 5121 Engineering V, P.O. Box 951600, Los Angeles, CA 90095, USA.
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Weaver WM, Tseng P, Kunze A, Masaeli M, Chung AJ, Dudani JS, Kittur H, Kulkarni RP, Di Carlo D. Advances in high-throughput single-cell microtechnologies. Curr Opin Biotechnol 2013; 25:114-23. [PMID: 24484889 DOI: 10.1016/j.copbio.2013.09.005] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Revised: 08/30/2013] [Accepted: 09/08/2013] [Indexed: 12/31/2022]
Abstract
Micro-scale biological tools that have allowed probing of individual cells--from the genetic, to proteomic, to phenotypic level--have revealed important contributions of single cells to direct normal and diseased body processes. In analyzing single cells, sample heterogeneity between and within specific cell types drives the need for high-throughput and quantitative measurement of cellular parameters. In recent years, high-throughput single-cell analysis platforms have revealed rare genetic subpopulations in growing tumors, begun to uncover the mechanisms of antibiotic resistance in bacteria, and described the cell-to-cell variations in stem cell differentiation and immune cell response to activation by pathogens. This review surveys these recent technologies, presenting their strengths and contributions to the field, and identifies needs still unmet toward the development of high-throughput single-cell analysis tools to benefit life science research and clinical diagnostics.
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Affiliation(s)
- Westbrook M Weaver
- Department of Bioengineering, University of California, Los Angeles, United States
| | - Peter Tseng
- Department of Bioengineering, University of California, Los Angeles, United States
| | - Anja Kunze
- Department of Bioengineering, University of California, Los Angeles, United States
| | - Mahdokht Masaeli
- Department of Bioengineering, University of California, Los Angeles, United States
| | - Aram J Chung
- Department of Bioengineering, University of California, Los Angeles, United States
| | - Jaideep S Dudani
- Department of Bioengineering, University of California, Los Angeles, United States
| | - Harsha Kittur
- Department of Bioengineering, University of California, Los Angeles, United States
| | | | - Dino Di Carlo
- Department of Bioengineering, University of California, Los Angeles, United States; California NanoSystems Institute, University of California, Los Angeles, United States.
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Sollier E, Che J, Go DE, Weaver WM, Kummer N, Rettig M, Goldman J, Nickols N, Di Carlo D, Kulkarni RP. Abstract A197: Size-selective isolation of viable and pure CTCs for molecular analysis using vortex technology. Mol Cancer Ther 2013. [DOI: 10.1158/1535-7163.targ-13-a197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Circulating tumor cells (CTCs) are cancer cells shed from a primary tumor, which enter the bloodstream and have the potential to metastasize. The detection and isolation of CTCs in bodily fluids can aid in cancer prognosis, characterizing genetic mutations for targeted therapies, and studying the biological mechanisms of metastasis. CTCs are very rare; there may only be tens of CTCs among millions of white blood cells and billions of red blood cells in one milliliter of blood. Current approaches for CTC isolation each have unique advantages and disadvantages: these techniques are often limited by speed, variable gene expression for immunocapture, long sample preparation steps, cost, and ability to deliver viable cells at high purity.
Here, we use of arrays of microscale laminar fluid vortices to quickly isolate CTCs from large volumes of blood at high purity and without labels. Under high flow rates, large cells (> 15 μm) become stably trapped in laminar microvortices that form in simple rectangular reservoirs, while smaller red and white blood cells pass through. The large cancer cells are maintained in the microvortices, allowing for solution exchange, followed by release on lowering flow rate. The device is able to purify, enrich, and release a small volume (∼300 μL) of concentrated, viable cancer cells from blood at high throughput, concentration, and purity.
The vortex chip successfully separated a variety of cancer cell lines from blood (∼20% capture efficiency), including those from melanoma, ovarian, breast, lung, and prostate cancer cell lines, with ∼10,000 fold enrichment. Captured cells remained viable and could be cultured off-chip. Finally, CTCs were successfully extracted and enumerated from the blood of patients with breast (N=4, 25-51 CTCs per 7.5 mL) and lung (N=8, 23-317 CTCs per 7.5 mL) cancers, and their sizes were measured. Importantly, samples were highly pure with limited leukocyte contamination (purity 57-94%). Preliminary comparisons with FDA-approved CellSearch system highlighted improved results for CTC enumeration from breast and lung samples.
Cells isolated from the vortex chip can also be utilized for downstream molecular analysis. We successfully utilized a qPCR-based approach to detect specific KRAS point mutations from lung cancer cells spiked into pleural fluids and then isolated using the vortex chip and demonstrated improved detection sensitivity. The high purity of our approach should allow for improved molecular sequencing results, and additional molecular analyses of CTCs from patient blood samples are underway, utilizing next generation transcriptome sequencing technologies.
This vortex approach offers significant advantages over existing technologies, especially in terms of processing time, low cost, simplicity, cell integrity and purity. The ability to obtain viable CTCs provides flexible opportunities for the clinicians and biologists who desire to not only enumerate CTCs, but also uncover new CTC biology, such as unique gene mutations, vesicle secretion and roles in metastatic processes.
Citation Information: Mol Cancer Ther 2013;12(11 Suppl):A197.
Citation Format: Elodie Sollier, James Che, Derek E. Go, Westbrook M. Weaver, Nicolas Kummer, Matthew Rettig, Jonathan Goldman, Nicholas Nickols, Dino Di Carlo, Rajan P. Kulkarni. Size-selective isolation of viable and pure CTCs for molecular analysis using vortex technology. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr A197.
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Che J, Mach AJ, Go DE, Talati I, Ying Y, Rao J, Kulkarni RP, Di Carlo D. Microfluidic purification and concentration of malignant pleural effusions for improved molecular and cytomorphological diagnostics. PLoS One 2013; 8:e78194. [PMID: 24205153 PMCID: PMC3810139 DOI: 10.1371/journal.pone.0078194] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [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: 05/22/2013] [Accepted: 09/09/2013] [Indexed: 11/19/2022] Open
Abstract
Evaluation of pleural fluids for metastatic cells is a key component of diagnostic cytopathology. However, a large background of smaller leukocytes and/or erythrocytes can make accurate diagnosis difficult and reduce specificity in identification of mutations of interest for targeted anti-cancer therapies. Here, we describe an automated microfluidic system (Centrifuge Chip) which employs microscale vortices for the size-based isolation and concentration of cancer cells and mesothelial cells from a background of blood cells. We are able to process non-diluted pleural fluids at 6 mL/min and enrich target cells significantly over the background; we achieved improved purity in all patient samples analyzed. The resulting isolated and viable cells are readily available for immunostaining, cytological analysis, and detection of gene mutations. To demonstrate the utility towards aiding companion diagnostics, we also show improved detection accuracy of KRAS gene mutations in lung cancer cells processed using the Centrifuge Chip, leading to an increase in the area under the curve (AUC) of the receiver operating characteristic from 0.90 to 0.99. The Centrifuge Chip allows for rapid concentration and processing of large volumes of bodily fluid samples for improved cytological diagnosis and purification of cells of interest for genetic testing, which will be helpful for enhancing diagnostic accuracy.
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Affiliation(s)
- James Che
- Department of Bioengineering, University of California Los Angeles, Los Angeles, California, United States of America
- * E-mail: (JC); (JR); (RK); (DD)
| | - Albert J. Mach
- Department of Bioengineering, University of California Los Angeles, Los Angeles, California, United States of America
| | - Derek E. Go
- Department of Bioengineering, University of California Los Angeles, Los Angeles, California, United States of America
| | - Ish Talati
- Department of Bioengineering, University of California Los Angeles, Los Angeles, California, United States of America
| | - Yong Ying
- Department of Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, California, United States of America
| | - Jianyu Rao
- Department of Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, California, United States of America
- * E-mail: (JC); (JR); (RK); (DD)
| | - Rajan P. Kulkarni
- Division of Dermatology, UCLA Medical Center, Los Angeles, California, United States of America
- * E-mail: (JC); (JR); (RK); (DD)
| | - Dino Di Carlo
- Department of Bioengineering, University of California Los Angeles, Los Angeles, California, United States of America
- * E-mail: (JC); (JR); (RK); (DD)
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Wettstein ZS, Fleming M, Chang AY, Copenhaver DJ, Wateska AR, Bartsch SM, Lee BY, Kulkarni RP. Total economic cost and burden of dengue in Nicaragua: 1996-2010. Am J Trop Med Hyg 2012; 87:616-22. [PMID: 22890033 DOI: 10.4269/ajtmh.2012.12-0146] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The burden of dengue in Nicaragua has been steadily rising during the last three decades; however, there have been few efforts to quantify the burden (measured in disability-adjusted life years [DALYs]) and cost to society. Using primary data from the Nicaraguan Ministry of Health (MINSA), the total cost and burden of dengue were calculated from 1996 to 2010. Total costs included both direct costs from medical expenditures and prevention activities and indirect costs from lost productivity. The annual disease burden ranged from 99 to 805 DALYs per million, with a majority associated with classic dengue fever. The total cost was estimated to be US$13.5 million/year (range: US$5.1-27.6 million). This analysis can help improve allocation of dengue control resources in Nicaragua and the region. As one of the most comprehensive analyses of its type to date in Nicaragua and Latin America, this study can serve as a model to determine the burden and cost of dengue.
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Kulkarni RP, Ituarte PHG, Gunderson D, Yeh MW. Clinical pathways improve hospital resource use in endocrine surgery. J Am Coll Surg 2010; 212:35-41. [PMID: 21123093 DOI: 10.1016/j.jamcollsurg.2010.09.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Revised: 09/19/2010] [Accepted: 09/21/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Clinical pathways are increasingly adopted to streamline care after elective surgery. Here, we describe novel clinical pathways developed for endocrine operations (ie, unilateral thyroid lobectomy, total thyroidectomy, parathyroidectomy) and evaluate their effects on economic end points at a major academic hospital. STUDY DESIGN Length of stay (LOS), hospital charges, and hospital costs for 681 patients undergoing elective endocrine surgery during a 30-month period were compared between patients managed with or without a specific pathway. Hospital costs were subcategorized by cost center. The analysis arms were conducted concurrently to control for institutional effects and end points were adjusted for demographic factors and comorbidity. RESULTS Clinical pathways were observed to significantly reduce LOS, charges, and costs for endocrine procedures. LOS was reduced for thyroid lobectomy (nonpathway 1.6 days versus pathway 1.0; p < 0.001), total thyroidectomy (2.8 versus 1.1; p < 0.0001), and parathyroidectomy (1.6 versus 1.1; p < 0.001). Nonpathway patients were 6.2 times more likely to be admitted to the intensive care unit than pathway patients (p < 0.05). Clinical pathways reduced total charges from $21,941 to $17,313 for all cases (21% reduction; p < 0.0001), with 47% of savings attributable to reduced LOS. Significant improvements were observed for laboratory use (73% reduction; p < 0.0001) and nonroutine medication administration (73% reduction; p < 0.0001). The readmission rate within 72 hours of discharge was not significantly lower in the pathway group. CONCLUSIONS Implementation of clinical pathways improves efficiency of care after elective endocrine surgery without adversely affecting safety or quality. Because these system measures optimize resource use, they represent an important component of high-volume subspecialty surgical services.
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Affiliation(s)
- Rajan P Kulkarni
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Chang AY, Parrales ME, Jimenez J, Sobieszczyk ME, Hammer SM, Copenhaver DJ, Kulkarni RP. Combining Google Earth and GIS mapping technologies in a dengue surveillance system for developing countries. Int J Health Geogr 2009; 8:49. [PMID: 19627614 PMCID: PMC2729741 DOI: 10.1186/1476-072x-8-49] [Citation(s) in RCA: 117] [Impact Index Per Article: 7.8] [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: 05/27/2009] [Accepted: 07/23/2009] [Indexed: 12/02/2022] Open
Abstract
Background Dengue fever is a mosquito-borne illness that places significant burden on tropical developing countries with unplanned urbanization. A surveillance system using Google Earth and GIS mapping technologies was developed in Nicaragua as a management tool. Methods and Results Satellite imagery of the town of Bluefields, Nicaragua captured from Google Earth was used to create a base-map in ArcGIS 9. Indices of larval infestation, locations of tire dumps, cemeteries, large areas of standing water, etc. that may act as larval development sites, and locations of the homes of dengue cases collected during routine epidemiologic surveying were overlaid onto this map. Visual imagery of the location of dengue cases, larval infestation, and locations of potential larval development sites were used by dengue control specialists to prioritize specific neighborhoods for targeted control interventions. Conclusion This dengue surveillance program allows public health workers in resource-limited settings to accurately identify areas with high indices of mosquito infestation and interpret the spatial relationship of these areas with potential larval development sites such as garbage piles and large pools of standing water. As a result, it is possible to prioritize control strategies and to target interventions to highest risk areas in order to eliminate the likely origin of the mosquito vector. This program is well-suited for resource-limited settings since it utilizes readily available technologies that do not rely on Internet access for daily use and can easily be implemented in many developing countries for very little cost.
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Affiliation(s)
- Aileen Y Chang
- Department of Vector-Borne Disease, Nicaraguan Ministry of Health, Managua, Nicaragua.
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Kulkarni RP, Sacoolidge JC, Chiu MW. Clinicopathologic challenge. Int J Dermatol 2009; 48:695-6. [PMID: 19570073 DOI: 10.1111/j.1365-4632.2009.04088.x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Rajan P Kulkarni
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
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