P3119Malignancy after Heart Transplantation: Difference in incidence and prognosis between genders. Data from the Spanish post-Heart Transplant Tumor Registry

Background

Malignancy is one of the leading causes of mortality in the long term follow up after heart transplantation (HT). Male sex has been described as an independent risk factor for developing cancer in this group of patients. However, the real incidence of all type of neoplasm and its impact prognosis in mortality in both group of sex remains unknown.

Purpose

The aim of this study was to assess the incidence of malignancy and the disparity in its relative weight as a cause of death between genders.

Methods

Observational longitudinal study of heart transplant patients from the Spanish post-HT Tumor registry (SPHTTR) who underwent HT in this country from 1984 to 2017. Re-transplant, combined transplant patients and those with survival less than 3 months since HT were excluded. Incidence and mortality rates per 1000 person-year for all tumors, skin cancer (including melanoma), lymphoma and non-skin solid malignancy (NSSM) were calculated for both groups of sex. The main end-point of the study was death for any causes related to cancer following HT. Survival curves since first diagnosis of neoplasia were constructed using Kaplan Meier estimates and comparisons among genders were performed using long-rank test.

Results

A total of 5865 patients (81.6% male, 18.4% female) were included in the analysis. Incidence and mortality rates in both genders are summarized in Table 1. Total cumulative incidence rate of all tumors, non-skin solid malignancy and lung cancer were higher in men patients (All tumors: 44.8 vs 25.7 per 1000 person-year; female to male RR 0.68, 95% CI 0.60–0.78, p<0.001). Mortality rates were also higher in male patients for all types of tumors (RR 0.76, CI 95% 0.62–0.94, p=0.01) and for NSSM (RR 0.60, 95% CI 0.44–0.80, p=0.001) albeit not for cutaneous neoplasia or lymphoma. Survival curves are shown in figure 1 and display significant differences among both genders (p=0.0037).

Table 1 Type of tumor Female Male Female to Male Incidence RR Female to male mortality RR Incidence rate* Mortality rate* Incidence rate* Mortality rate* RR p-value RR p-value All tumors 25.7 (22.8–29.0) 94.0 (77.3–114.3) 44.8 (42.9–46.8) 129.6 (120.9–138.9) 0.68 (0.60–0.78) <0.001 0.76 (0.62–0.94) 0.01 Skin cancer 12.6 (10.6–15.0 63.2 (45.4–88.0) 24.4 (23.0–25.9) 70.4 (62.6–79.1) 0.62 (0.52–0.74) <0.001 0.88 (0.62–1.25) 0.481 Lymphoma 2.0 (1.3–3.0) 137.8 (80.0–237.3) 2.5 (2.1–3.0) 237.5 (187.9–300.2) 0.84 (0.52–1.36) 0.483 0.58 (0.32–1.06) 0.076 NSSM 11.1 (9.3–13.4) 125.0 (95.2–164.0) 17.5 (16.4–18.8) 234.7 (214.0–257.5) 0.75 (0.62–0.92) <0.001 0.60 (0.44–0.80 0.001 NSSM: Non-skin solid malignancy. *Per 1000 person-year.

Figure 1

Conclusions

Incidence of malignancy post-HT is higher in men than in women specially for skin cancer and de novo solid tumors. The relative weight of cancer as a cause of death was also higher in men than in women, furthermore, this could have impact prognosis in HT survivors.

Small structural changes of the imidazopyridine diacylglycerol acyltransferase 2 (DGAT2) inhibitors produce an improved safety profile

Small molecule DGAT2 inhibitors have shown promise for the treatment of metabolic diseases in preclinical models. Herein, we report the first toxicological evaluation of imidazopyridine-based DGAT2 inhibitors and show that the arteriopathy associated with imidazopyridine 1 can be mitigated with small structural modifications, and is thus not mechanism related.

Human Vascular Microphysiological System for in vitro Drug Screening

In vitro human tissue engineered human blood vessels (TEBV) that exhibit vasoactivity can be used to test human toxicity of pharmaceutical drug candidates prior to pre-clinical animal studies. TEBVs with 400–800 μM diameters were made by embedding human neonatal dermal fibroblasts or human bone marrow-derived mesenchymal stem cells in dense collagen gel. TEBVs were mechanically strong enough to allow endothelialization and perfusion at physiological shear stresses within 3 hours after fabrication. After 1 week of perfusion, TEBVs exhibited endothelial release of nitric oxide, phenylephrine-induced vasoconstriction, and acetylcholine-induced vasodilation, all of which were maintained up to 5 weeks in culture. Vasodilation was blocked with the addition of the nitric oxide synthase inhibitor L-N^G-Nitroarginine methyl ester (L-NAME). TEBVs elicited reversible activation to acute inflammatory stimulation by TNF-α which had a transient effect upon acetylcholine-induced relaxation, and exhibited dose-dependent vasodilation in response to caffeine and theophylline. Treatment of TEBVs with 1 μM lovastatin for three days prior to addition of Tumor necrosis factor – α (TNF-α) blocked the injury response and maintained vasodilation. These results indicate the potential to develop a rapidly-producible, endothelialized TEBV for microphysiological systems capable of producing physiological responses to both pharmaceutical and immunological stimuli.

Interpretation of correlations between nuclear observables in rare-earth nuclei

We have recently obtained the optimal core-cluster decompositions for an extensive set of heavy even-even nuclei in the rare-earth region. The core-cluster charge products thus deduced are found to be closely correlated with the corresponding B(E2) values. We investigate here the strong resemblance of these correlations to the corresponding Casten plots, and find that the cluster model also predicts a further correlation between core-cluster charge products and the nuclear excitation energies, suggesting a new form of Casten plot for these energies.

Monarch butterflies (Danaus plexippus L.) use a magnetic compass for navigation

Fall migratory monarch butterflies, tested for their directional responses to magnetic cues under three conditions, amagnetic, normal, and reversed magnetic fields, showed three distinct patterns. In the absence of a magnetic field, monarchs lacked directionality as a group. In the normal magnetic field, monarchs oriented to the southwest with a group pattern typical for migrants. When the horizontal component of the magnetic field was reversed, the butterflies oriented to the northeast. In contrast, nonmigratory monarchs lacked directionality in the normal magnetic field. The results are a direct demonstration of magnetic compass orientation in migratory insects.

Silane-coated silica particle colloid processing of human sperm

PURPOSE

The purpose of this study was to determine differences in the quality of human sperm processed through different lots of silane-coated silica particle colloid solutions. The objectives were to compare (a) sperm kinematic parameters, (b) the sperm acrosome status, (c) the membrane integrity of the head and tail regions, (d) the DNA normality, and (e) the heat-inducible hyperactivation motility after processing sperm through either a Silane-coated silica particle colloid solution, a Percoll solution, or a simple centrifuge sperm wash (control).

METHODS

Sperm cells were derived from pooled cryopreserved-thawed specimens of several donors (n = 10). The pooled sperm were divided and processed through either the centrifuge wash, the 90:47% two-layer Percoll, or one of three lots of silane-coated silica particle colloidal solutions from three vendors. Aliquots of sperm cells were analyzed using the Hamilton-Thorn HTM-C motility analyzer for differences in kinematics and hyperactivation. Sperm were also analyzed for membrane integrity at both head and tail regions, normal morphology, acrosome status, and viability. Sperm undergoing apoptosis were determined using the acridine orange stain. Processed sperm were also incubated at 40 degrees C for 4 hr and the quality of the sperm was assessed using the heat-induced hyperactivation and motility parameter.

RESULTS

The data showed that after sperm processing, the number of sperm recovered was higher for the three lots of colloids (silane-coated silica particle colloid solutions) compared with Percoll processing. Total sperm motility was higher in the colloidal washes compared with the control. There were no differences in motility between Percoll- and colloid-processed sperm. In contrast, the percentages of sperm exhibiting progressive motility or hyperactivation varied among the different lots of colloid solutions. The Percoll wash solution yielded the highest percentage of sperm with intact tail membranes, whereas some lots of colloid solutions disrupted sperm head membranes. The percentages of sperm undergoing apoptosis varied for the different lots of colloid solutions. There was a marked increase in hyperactivation associated with one colloid solution after heat induction.

CONCLUSIONS

The results demonstrated variability in the different lots of silane-coated silica particle colloid solutions for processing sperm. Each lot of colloid solution excelled at improving different sperm parameters. The silane-coated silica particle colloid solutions were shown to be effective in recovering motile sperm compared with Percoll but the types of motility and sperm quality varied for the different lots of colloid solutions. Due to the variability in lots of silane-coated silica colloid solutions, reported studies based on only one lot or one source of colloid solution may be difficult to interpret. Furthermore, it may be advantageous to select the best lot of silane-coated silica particle colloid solution to produce the highest number of sperm exhibiting the ideal parameters for use in assisted reproduction technologies.