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Juhn YJ, Wi CI, Takahashi PY, Ryu E, King KS, Hickman JA, Yao JD, Binnicker MJ, Natoli TL, Evans TK, Sampathkumar P, Patten C, Luyts D, Pirçon JY, Damaso S, Pignolo RJ. Incidence of Respiratory Syncytial Virus Infection in Older Adults Before and During the COVID-19 Pandemic. JAMA Netw Open 2023; 6:e2250634. [PMID: 36662530 PMCID: PMC9860520 DOI: 10.1001/jamanetworkopen.2022.50634] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/20/2022] [Indexed: 01/21/2023] Open
Abstract
Importance Little is known about the burden and outcomes of respiratory syncytial virus (RSV)-positive acute respiratory infection (ARI) in community-dwelling older adults. Objective To assess the incidence of RSV-positive ARI before and during the COVID-19 pandemic, and to assess outcomes for RSV-positive ARI in older adults. Design, Setting, and Participants This was a community-based cohort study of adults residing in southeast Minnesota that followed up with 2325 adults aged 50 years or older for 2 RSV seasons (2019-2021) to assess the incidence of RSV-positive ARI. The study assessed outcomes at 2 to 4 weeks, 6 to 7 months, and 12 to 13 months after RSV-positive ARI. Exposure RSV-positive and -negative ARI. Main Outcomes and Measures RSV status was the main study outcome. Incidence and attack rates of RSV-positive ARI were calculated during each RSV season, including before (October 2019 to April 2020) and during (October 2020 to April 2021) COVID-19 pandemic, and further calculated during non-RSV season (May to September 2021) for assessing impact of COVID-19. The self-reported quality of life (QOL) by Short-Form Health Survey-36 (SF-36) and physical functional measures (eg, 6-minute walk and spirometry) at each time point was assessed. Results In this study of 2325 participants, the median (range) age of study participants was 67 (50-98) years, 1380 (59%) were female, and 2240 (96%) were non-Hispanic White individuals. The prepandemic incidence rate of RSV-positive ARI was 48.6 (95% CI, 36.9-62.9) per 1000 person-years with a 2.50% (95% CI, 1.90%-3.21%) attack rate. No RSV-positive ARI case was identified during the COVID-19 pandemic RSV season. Incidence of 10.2 (95% CI, 4.1-21.1) per 1000 person-years and attack rate of 0.42%; (95% CI, 0.17%-0.86%) were observed during the summer of 2021. Based on prepandemic RSV season results, participants with RSV-positive ARI (vs matched RSV-negative ARI) reported significantly lower QOL adjusted mean difference (limitations due to physical health, -16.7 [95% CI, -31.8 to -1.8]; fatigue, -8.4 [95% CI, -14.3 to -2.4]; and difficulty in social functioning, -11.9 [95% CI, -19.8 to -4.0] within 2 to 4 weeks after RSV-positive ARI [ie, short-term outcome]). Compared with participants with RSV-negative ARI, those with RSV-positive ARI also had lower QOL (fatigue: -4.0 [95% CI, -8.5 to -1.3]; difficulty in social functioning, -5.8 [95% CI, -10.3 to -1.3]; and limitation due to emotional problem, -7.0 [95% CI, -12.7 to -1.3] at 6 to 7 months after RSV-positive ARI [intermediate-term outcome]; fatigue, -4.4 [95% CI, -7.3 to -1.5]; difficulty in social functioning, -5.2 [95% CI, -8.7 to -1.7] and limitation due to emotional problem, -5.7 [95% CI, -10.7 to -0.6] at 12-13 months after RSV-positive ARI [ie, long-term outcomes]) independent of age, sex, race and/or ethnicity, socioeconomic status, and high-risk comorbidities. Conclusions and Relevance In this cohort study, the burden of RSV-positive ARI in older adults during the pre-COVID-19 period was substantial. After a reduction of RSV-positive ARI incidence from October 2020 to April 2021, RSV-positive ARI re-emerged during the summer of 2021. RSV-positive ARI was associated with significant long-term lower QOL beyond the short-term lower QOL in older adults.
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Affiliation(s)
- Young J. Juhn
- Department of Pediatric and Adolescent Medicine and Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine and Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Paul Y. Takahashi
- Division of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Euijung Ryu
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Katherine S. King
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Joel A. Hickman
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Joseph D. Yao
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Matthew J. Binnicker
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Traci L. Natoli
- Department of Pediatric and Adolescent Medicine and Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Tamara K. Evans
- Department of Medicine Research, Mayo Clinic, Rochester, Minnesota
| | | | - Christi Patten
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | | | | | | | - Robert J. Pignolo
- Divisions of Hospital Internal Medicine, Endocrinology, and Geriatric Medicine and Gerontology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
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Verdoorn BP, Evans TK, Hanson GJ, Zhu Y, Langhi Prata LGP, Pignolo RJ, Atkinson EJ, Wissler‐Gerdes EO, Kuchel GA, Mannick JB, Kritchevsky SB, Khosla S, Rizza SA, Walston JD, Musi N, Lipsitz LA, Kiel DP, Yung R, LeBrasseur NK, Singh RJ, McCarthy T, Puskarich MA, Niedernhofer LJ, Robbins PD, Sorenson M, Tchkonia T, Kirkland JL. Fisetin for COVID-19 in skilled nursing facilities: Senolytic trials in the COVID era. J Am Geriatr Soc 2021; 69:3023-3033. [PMID: 34375437 PMCID: PMC8447437 DOI: 10.1111/jgs.17416] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/23/2021] [Accepted: 07/31/2021] [Indexed: 01/19/2023]
Abstract
The burden of senescent cells (SnCs), which do not divide but are metabolically active and resistant to death by apoptosis, is increased in older adults and those with chronic diseases. These individuals are also at the greatest risk for morbidity and mortality from SARS-CoV-2 infection. SARS-CoV-2 complications include cytokine storm and multiorgan failure mediated by the same factors as often produced by SnCs through their senescence-associated secretory phenotype (SASP). The SASP can be amplified by infection-related pathogen-associated molecular profile factors. Senolytic agents, such as Fisetin, selectively eliminate SnCs and delay, prevent, or alleviate multiple disorders in aged experimental animals and animal models of human chronic diseases, including obesity, diabetes, and respiratory diseases. Senolytics are now in clinical trials for multiple conditions linked to SnCs, including frailty; obesity/diabetes; osteoporosis; and cardiovascular, kidney, and lung diseases, which are also risk factors for SARS-CoV-2 morbidity and mortality. A clinical trial is underway to test if senolytics decrease SARS-CoV-2 progression and morbidity in hospitalized older adults. We describe here a National Institutes of Health-funded, multicenter, placebo-controlled clinical trial of Fisetin for older adult skilled nursing facility (SNF) residents who have been, or become, SARS-CoV-2 rtPCR-positive, including the rationale for targeting fundamental aging mechanisms in such patients. We consider logistic challenges of conducting trials in long-term care settings in the SARS-CoV-2 era, including restricted access, consent procedures, methods for obtaining biospecimens and clinical data, staffing, investigational product administration issues, and potential solutions for these challenges. We propose developing a national network of SNFs engaged in interventional clinical trials.
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Affiliation(s)
- Brandon P. Verdoorn
- Robert and Arlene Kogod Center on AgingMayo ClinicRochesterMinnesotaUSA
- Division of Geriatrics and GerontologyMayo ClinicRochesterMinnesotaUSA
| | - Tamara K. Evans
- Robert and Arlene Kogod Center on AgingMayo ClinicRochesterMinnesotaUSA
| | - Gregory J. Hanson
- Robert and Arlene Kogod Center on AgingMayo ClinicRochesterMinnesotaUSA
- Division of Geriatrics and GerontologyMayo ClinicRochesterMinnesotaUSA
| | - Yi Zhu
- Robert and Arlene Kogod Center on AgingMayo ClinicRochesterMinnesotaUSA
| | | | - Robert J. Pignolo
- Robert and Arlene Kogod Center on AgingMayo ClinicRochesterMinnesotaUSA
- Division of Geriatrics and GerontologyMayo ClinicRochesterMinnesotaUSA
| | - Elizabeth J. Atkinson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences ResearchMayo ClinicRochesterMinnesotaUSA
| | | | - George A. Kuchel
- University of Connecticut Center on Aging, UConn HealthFarmingtonConnecticutUSA
| | | | - Stephen B. Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's PreventionWinston‐SalemNorth CarolinaUSA
| | - Sundeep Khosla
- Robert and Arlene Kogod Center on AgingMayo ClinicRochesterMinnesotaUSA
- Division of Endocrinology, Department of MedicineMayo ClinicRochesterMinnesotaUSA
| | - Stacey A. Rizza
- Division of Infectious Diseases, Department of MedicineMayo ClinicRochesterMinnesotaUSA
| | - Jeremy D. Walston
- Department of Medicine, Division of Geriatric Medicine and GerontologyJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Nicolas Musi
- Barshop Institute for Longevity and Aging StudiesUniversity of Texas Health Science Center at San AntonioSan AntonioTexasUSA
| | - Lewis A. Lipsitz
- Hinda and Arthur Marcus Institute for Aging ResearchHebrew SeniorLifeBostonMassachusettsUSA
- Division of GerontologyBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Douglas P. Kiel
- Hinda and Arthur Marcus Institute for Aging ResearchHebrew SeniorLifeBostonMassachusettsUSA
- Division of GerontologyBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Raymond Yung
- Geriatrics Center and Institute of GerontologyUniversity of MichiganAnn ArborMichiganUSA
- VA Ann Arbor Geriatrics ResearchEducation and Clinical CenterAnn ArborMichiganUSA
- Department of Internal Medicine Division of Geriatric and Palliative MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Nathan K. LeBrasseur
- Robert and Arlene Kogod Center on AgingMayo ClinicRochesterMinnesotaUSA
- Department of Physical Medicine and RehabilitationMayo ClinicRochesterMinnesotaUSA
| | - Ravinder J. Singh
- Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Teresa McCarthy
- Institute on the Biology of Aging and Metabolism, Department of Biochemistry, Molecular Biology and BiophysicsUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Michael A. Puskarich
- Institute on the Biology of Aging and Metabolism, Department of Biochemistry, Molecular Biology and BiophysicsUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Laura J. Niedernhofer
- Institute on the Biology of Aging and Metabolism, Department of Biochemistry, Molecular Biology and BiophysicsUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Paul D. Robbins
- Institute on the Biology of Aging and Metabolism, Department of Biochemistry, Molecular Biology and BiophysicsUniversity of MinnesotaMinneapolisMinnesotaUSA
| | | | - Tamara Tchkonia
- Robert and Arlene Kogod Center on AgingMayo ClinicRochesterMinnesotaUSA
| | - James L. Kirkland
- Robert and Arlene Kogod Center on AgingMayo ClinicRochesterMinnesotaUSA
- Division of Geriatrics and GerontologyMayo ClinicRochesterMinnesotaUSA
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3
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Juhn YJ, Wi CI, Ryu E, Sampathkumar P, Takahashi PY, Yao JD, Binnicker MJ, Natoli TL, Evans TK, King KS, Volpe S, Pirçon JY, Silvia Damaso, Pignolo RJ. Adherence to Public Health Measures Mitigates the Risk of COVID-19 Infection in Older Adults: A Community-Based Study. Mayo Clin Proc 2021; 96:912-920. [PMID: 33714601 PMCID: PMC7768210 DOI: 10.1016/j.mayocp.2020.12.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/21/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the prevalence and characteristics of coronavirus disease 2019 (COVID-19) cases during the reopening period in older adults, given that little is known about the prevalence of COVID-19 after the stay-at-home order was lifted in the United States, nor the actual effects of adherence to recommended public health measures (RPHM) on the risk of COVID-19. PATIENTS AND METHODS This was a cross-sectional study nested in a parent prospective cohort study, which followed a population-based sample of 2325 adults 50 years and older residing in southeast Minnesota to assess the incidence of viral infections. Participants were instructed to self-collect both nasal and oropharyngeal swabs, which were tested by reverse transcription polymerase chain reaction-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) assay between May 8, 2020, and June, 30, 2020. We assessed the prevalence of COVID-19 cases and characteristics of study subjects. RESULTS A total of 1505 eligible subjects participated in the study whose mean age was 68 years, with 885 (59%) women, 32 (2%) racial/ethnic minorities, and 906 (60%) with high-risk conditions for influenza. The prevalence of other Coronaviridae (human coronavirus [HCoV]-229E, HCoV-NL63, and HCoV-OC43) during the 2019 to 2020 flu season was 109 (7%), and none tested positive for SARS-CoV-2. Almost all participants reported adhering to the RPHM (1,488 [99%] for social distancing, 1,438 [96%] for wearing mask in a public space, 1,476 [98%] for hand hygiene, and 1,441 (96%) for staying home mostly). Eighty-six percent of participants resided in a single-family home. CONCLUSION We did not identify SARS-COV-2 infection in our study cohort. The combination of participants' behavior in following the RPHM and their living environment may considerably mitigate the risk of COVID-19.
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Affiliation(s)
- Young J Juhn
- Department of Pediatric and Internal Medicine, Mayo Clinic, Rochester, MN.
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | - Paul Y Takahashi
- Division of Community Internal Medicine, Mayo Clinic, Rochester, MN
| | - Joseph D Yao
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | | | - Traci L Natoli
- Department of Medicine Research, Mayo Clinic, Rochester, MN
| | - Tamara K Evans
- Department of Medicine Research, Mayo Clinic, Rochester, MN
| | - Katherine S King
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | | | | | - Robert J Pignolo
- Division of Geriatric Medicine and Gerontology, Mayo Clinic, Rochester, MN.
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4
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Hickson LJ, Langhi Prata LGP, Bobart SA, Evans TK, Giorgadze N, Hashmi SK, Herrmann SM, Jensen MD, Jia Q, Jordan KL, Kellogg TA, Khosla S, Koerber DM, Lagnado AB, Lawson DK, LeBrasseur NK, Lerman LO, McDonald KM, McKenzie TJ, Passos JF, Pignolo RJ, Pirtskhalava T, Saadiq IM, Schaefer KK, Textor SC, Victorelli SG, Volkman TL, Xue A, Wentworth MA, Wissler Gerdes EO, Allison DB, Dickinson SL, Ejima K, Atkinson EJ, Lenburg M, Zhu Y, Tchkonia T, Kirkland JL. Corrigendum to 'Senolytics decrease senescent cells in humans: Preliminary report from a clinical trial of Dasatinib plus Quercetin in individuals with diabetic kidney disease' EBioMedicine 47 (2019) 446-456. EBioMedicine 2020; 52:102595. [PMID: 31982828 PMCID: PMC6994619 DOI: 10.1016/j.ebiom.2019.12.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- LaTonya J Hickson
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States; Division of Geriatric Medicine and Gerontology, Department of Medicine, Mayo Clinic, Rochester, MN, United States; Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Larissa G P Langhi Prata
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States
| | - Shane A Bobart
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Tamara K Evans
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States; Department of Medicine Clinical Trials Unit, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Nino Giorgadze
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States
| | - Shahrukh K Hashmi
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States; Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Sandra M Herrmann
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Michael D Jensen
- Division of Endocrinology, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Qingyi Jia
- Division of Endocrinology, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Kyra L Jordan
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Todd A Kellogg
- Department of Surgery, Mayo Clinic, Rochester, MN, United States
| | - Sundeep Khosla
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States; Division of Endocrinology, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Daniel M Koerber
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States
| | - Anthony B Lagnado
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
| | - Donna K Lawson
- Division of Hospital Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Nathan K LeBrasseur
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States; Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Kathleen M McDonald
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States; Office of Research Regulatory Support, Mayo Clinic, Rochester, MN, United States
| | | | - João F Passos
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
| | - Robert J Pignolo
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States; Division of Geriatric Medicine and Gerontology, Department of Medicine, Mayo Clinic, Rochester, MN, United States; Division of Endocrinology, Department of Medicine, Mayo Clinic, Rochester, MN, United States; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States; Division of Hospital Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Tamar Pirtskhalava
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States
| | - Ishran M Saadiq
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Kalli K Schaefer
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States
| | - Stephen C Textor
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Stella G Victorelli
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
| | - Tammie L Volkman
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States; Department of Medicine Clinical Trials Unit, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Ailing Xue
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States
| | - Mark A Wentworth
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States; Office of Research Regulatory Support, Mayo Clinic, Rochester, MN, United States
| | - Erin O Wissler Gerdes
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States; Department of Medicine Clinical Trials Unit, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - David B Allison
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University - Bloomington, Bloomington, IN, United States
| | - Stephanie L Dickinson
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University - Bloomington, Bloomington, IN, United States
| | - Keisuke Ejima
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University - Bloomington, Bloomington, IN, United States
| | - Elizabeth J Atkinson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Marc Lenburg
- Section of Computational Biomedicine, Boston University School of Medicine, Boston, MA, United States
| | - Yi Zhu
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States
| | - Tamara Tchkonia
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States.
| | - James L Kirkland
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, United States; Division of Geriatric Medicine and Gerontology, Department of Medicine, Mayo Clinic, Rochester, MN, United States; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States; Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, United States.
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5
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Hickson LJ, Langhi Prata LGP, Bobart SA, Evans TK, Giorgadze N, Hashmi SK, Herrmann SM, Jensen MD, Jia Q, Jordan KL, Kellogg TA, Khosla S, Koerber DM, Lagnado AB, Lawson DK, LeBrasseur NK, Lerman LO, McDonald KM, McKenzie TJ, Passos JF, Pignolo RJ, Pirtskhalava T, Saadiq IM, Schaefer KK, Textor SC, Victorelli SG, Volkman TL, Xue A, Wentworth MA, Wissler Gerdes EO, Zhu Y, Tchkonia T, Kirkland JL. Senolytics decrease senescent cells in humans: Preliminary report from a clinical trial of Dasatinib plus Quercetin in individuals with diabetic kidney disease. EBioMedicine 2019; 47:446-456. [PMID: 31542391 PMCID: PMC6796530 DOI: 10.1016/j.ebiom.2019.08.069] [Citation(s) in RCA: 617] [Impact Index Per Article: 123.4] [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: 07/31/2019] [Revised: 08/16/2019] [Accepted: 08/29/2019] [Indexed: 01/01/2023] Open
Abstract
Background Senescent cells, which can release factors that cause inflammation and dysfunction, the senescence-associated secretory phenotype (SASP), accumulate with ageing and at etiological sites in multiple chronic diseases. Senolytics, including the combination of Dasatinib and Quercetin (D + Q), selectively eliminate senescent cells by transiently disabling pro-survival networks that defend them against their own apoptotic environment. In the first clinical trial of senolytics, D + Q improved physical function in patients with idiopathic pulmonary fibrosis (IPF), a fatal senescence-associated disease, but to date, no peer-reviewed study has directly demonstrated that senolytics decrease senescent cells in humans. Methods In an open label Phase 1 pilot study, we administered 3 days of oral D 100 mg and Q 1000 mg to subjects with diabetic kidney disease (N = 9; 68·7 ± 3·1 years old; 2 female; BMI:33·9 ± 2·3 kg/m2; eGFR:27·0 ± 2·1 mL/min/1·73m2). Adipose tissue, skin biopsies, and blood were collected before and 11 days after completing senolytic treatment. Senescent cell and macrophage/Langerhans cell markers and circulating SASP factors were assayed. Findings D + Q reduced adipose tissue senescent cell burden within 11 days, with decreases in p16INK4A-and p21CIP1-expressing cells, cells with senescence-associated β-galactosidase activity, and adipocyte progenitors with limited replicative potential. Adipose tissue macrophages, which are attracted, anchored, and activated by senescent cells, and crown-like structures were decreased. Skin epidermal p16INK4A+ and p21CIP1+ cells were reduced, as were circulating SASP factors, including IL-1α, IL-6, and MMPs-9 and −12. Interpretation “Hit-and-run” treatment with senolytics, which in the case of D + Q have elimination half-lives <11 h, significantly decreases senescent cell burden in humans. Fund NIH and Foundations. ClinicalTrials.gov Identifier: NCT02848131. Senescence, Frailty, and Mesenchymal Stem Cell Functionality in Chronic Kidney Disease: Effect of Senolytic Agents.
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Affiliation(s)
- LaTonya J Hickson
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America; Division of Geriatric Medicine and Gerontology, Department of Medicine, Mayo Clinic, United States of America; Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, United States of America
| | - Larissa G P Langhi Prata
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America
| | - Shane A Bobart
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, United States of America
| | - Tamara K Evans
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America; Department of Medicine Clinical Trials Unit, Department of Medicine, Mayo Clinic, United States of America
| | - Nino Giorgadze
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America
| | - Shahrukh K Hashmi
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America; Division of Hematology, Department of Medicine, Mayo Clinic, United States of America
| | - Sandra M Herrmann
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, United States of America
| | - Michael D Jensen
- Division of Endocrinology, Department of Medicine, Mayo Clinic, United States of America
| | - Qingyi Jia
- Division of Endocrinology, Department of Medicine, Mayo Clinic, United States of America
| | - Kyra L Jordan
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, United States of America
| | - Todd A Kellogg
- Department of Surgery, Mayo Clinic, United States of America
| | - Sundeep Khosla
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America; Division of Endocrinology, Department of Medicine, Mayo Clinic, United States of America
| | - Daniel M Koerber
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America
| | - Anthony B Lagnado
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America; Department of Physiology and Biomedical Engineering, Mayo Clinic, United States of America
| | - Donna K Lawson
- Division of Hospital Medicine, Department of Medicine, Mayo Clinic, United States of America
| | - Nathan K LeBrasseur
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America; Department of Physiology, Mayo Clinic, United States of America; Department of Physical Medicine and Rehabilitation, Mayo Clinic, United States of America
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, United States of America
| | - Kathleen M McDonald
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America; Office of Research Regulatory Support, Mayo Clinic, United States of America
| | | | - João F Passos
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America; Department of Physiology and Biomedical Engineering, Mayo Clinic, United States of America
| | - Robert J Pignolo
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America; Division of Geriatric Medicine and Gerontology, Department of Medicine, Mayo Clinic, United States of America; Division of Endocrinology, Department of Medicine, Mayo Clinic, United States of America; Division of Hospital Medicine, Department of Medicine, Mayo Clinic, United States of America; Department of Physiology, Mayo Clinic, United States of America
| | - Tamar Pirtskhalava
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America
| | - Ishran M Saadiq
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, United States of America
| | - Kalli K Schaefer
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America
| | - Stephen C Textor
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, United States of America
| | - Stella G Victorelli
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America; Department of Physiology and Biomedical Engineering, Mayo Clinic, United States of America
| | - Tammie L Volkman
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America; Department of Medicine Clinical Trials Unit, Department of Medicine, Mayo Clinic, United States of America
| | - Ailing Xue
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America
| | - Mark A Wentworth
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America; Office of Research Regulatory Support, Mayo Clinic, United States of America
| | - Erin O Wissler Gerdes
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America; Department of Medicine Clinical Trials Unit, Department of Medicine, Mayo Clinic, United States of America
| | - Yi Zhu
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America
| | - Tamara Tchkonia
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America.
| | - James L Kirkland
- Cellular Senescence and Translation and Pharmacology Programs, Robert and Arlene Kogod Center on Aging, Mayo Clinic, United States of America; Division of Geriatric Medicine and Gerontology, Department of Medicine, Mayo Clinic, United States of America; Division of Hospital Medicine, Department of Medicine, Mayo Clinic, United States of America; Division of General Internal Medicine, Department of Medicine, Mayo Clinic, United States of America.
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Croghan IT, Viker SD, Limper AH, Evans TK, Cornell AR, Ebbert JO, Gertz MA. Developing a clinical trial unit to advance research in an academic institution. Contemp Clin Trials 2015; 45:270-276. [PMID: 26454064 DOI: 10.1016/j.cct.2015.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 08/25/2015] [Revised: 10/01/2015] [Accepted: 10/04/2015] [Indexed: 11/28/2022]
Abstract
Research, clinical care, and education are the three cornerstones of academic health centers in the United States. The research climate has always been riddled with ebbs and flows, depending on funding availability. During a time of reduced funding, the number and scope of research studies have been reduced, and in some instances, a field of study has been eliminated. Recent reductions in the research funding landscape have led institutions to explore new ways to continue supporting research. Mayo Clinic in Rochester, MN has developed a clinical trial unit within the Department of Medicine, which provides shared resources for many researchers and serves as a solution for training and mentoring new investigators and study teams. By building on existing infrastructure and providing supplemental resources to existing research, the Department of Medicine clinical trial unit has evolved into an effective mechanism for conducting research. This article discusses the creation of a central unit to provide research support in clinical trials and presents the advantages, disadvantages, and required building blocks for such a unit.
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Affiliation(s)
- Ivana T Croghan
- Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Steven D Viker
- Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Andrew H Limper
- Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Tamara K Evans
- Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Alissa R Cornell
- Department of System and Procedures, Research and Education Unit, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Jon O Ebbert
- Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Morie A Gertz
- Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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7
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Abstract
Insulin has been isolated from ostrich pancreas by a procedure of acid ethanol extraction, adsorption onto SP-Sephadex, gel permeation chromatography and HPLC. The primary structure of the ostrich insulin is identical to that reported for the chicken hormone. The isoelectric point as determined by polyacrylamide gel isoelectric focusing was significantly higher than that of the bovine hormone.
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Affiliation(s)
- T K Evans
- Department of Biochemistry, University of Port Elizabeth, Republic of South Africa
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8
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Evans P, Evans TK, Davis SJ, Hullin DA. Interference by immunoglobulins with the Becton-Dickinson "Simultrac" immunoradiometric assay for thyrotropin. Clin Chem 1988. [DOI: 10.1093/clinchem/34.4.774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- P Evans
- Dept. of Biochem., East Glamorgan General Hospital, Pontypridd, U.K
| | - T K Evans
- Dept. of Biochem., East Glamorgan General Hospital, Pontypridd, U.K
| | - S J Davis
- Dept. of Biochem., East Glamorgan General Hospital, Pontypridd, U.K
| | - D A Hullin
- Dept. of Biochem., East Glamorgan General Hospital, Pontypridd, U.K
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9
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Evans P, Evans TK, Davis SJ, Hullin DA. Interference by immunoglobulins with the Becton-Dickinson "Simultrac" immunoradiometric assay for thyrotropin. Clin Chem 1988; 34:774. [PMID: 3359626] [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: 01/05/2023]
Affiliation(s)
- P Evans
- Dept. of Biochem., East Glamorgan General Hospital, Pontypridd, U.K
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Abstract
The records of 125 consecutive patients with unresectable pancreatic cancer treated between 1958 and 1979 were evaluated to determine the benefit or morbidity of gastroenterostomy performed on a routine basis. One hundred three patients had no evidence of gastric outlet obstruction from tumor extension as determined at the time of initial operation. Fifty-seven of these patients underwent biliary diversion as their only operative procedure. The morbidity and mortality in this group was 31 and 14 percent, respectively. Six of these 57 patients required decompressing gastroenterostomy at a later date to relieve gastric outlet obstruction. Forty-six patients underwent both biliary and prophylactic gastric outlet diversion with a 15 percent mortality rate and a 46 percent incidence of morbidity. The most common complication in this group was delayed gastric emptying (14 percent). These findings, and the high incidence of delayed gastric emptying after gastroenterostomy and the relatively infrequent occurrence of gastric outlet obstruction (11 percent) after initial biliary diversion, suggest that gastroenterostomy should be performed on a selective basis only.
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