1
|
Giron LB, Liu Q, Adeniji OS, Yin X, Kannan T, Ding J, Lu DY, Langan S, Zhang J, Azevedo JLLC, Li SH, Shalygin S, Azadi P, Hanna DB, Ofotokun I, Lazar J, Fischl MA, Haberlen S, Macatangay B, Adimora AA, Jamieson BD, Rinaldo C, Merenstein D, Roan NR, Kutsch O, Gange S, Wolinsky SM, Witt MD, Post WS, Kossenkov A, Landay AL, Frank I, Tien PC, Gross R, Brown TT, Abdel-Mohsen M. Immunoglobulin G N-glycan markers of accelerated biological aging during chronic HIV infection. Nat Commun 2024; 15:3035. [PMID: 38600088 PMCID: PMC11006954 DOI: 10.1038/s41467-024-47279-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/25/2024] [Indexed: 04/12/2024] Open
Abstract
People living with HIV (PLWH) experience increased vulnerability to premature aging and inflammation-associated comorbidities, even when HIV replication is suppressed by antiretroviral therapy (ART). However, the factors associated with this vulnerability remain uncertain. In the general population, alterations in the N-glycans on IgGs trigger inflammation and precede the onset of aging-associated diseases. Here, we investigate the IgG N-glycans in cross-sectional and longitudinal samples from 1214 women and men, living with and without HIV. PLWH exhibit an accelerated accumulation of pro-aging-associated glycan alterations and heightened expression of senescence-associated glycan-degrading enzymes compared to controls. These alterations correlate with elevated markers of inflammation and the severity of comorbidities, potentially preceding the development of such comorbidities. Mechanistically, HIV-specific antibodies glycoengineered with these alterations exhibit a reduced ability to elicit anti-HIV Fc-mediated immune activities. These findings hold potential for the development of biomarkers and tools to identify and prevent premature aging and comorbidities in PLWH.
Collapse
Affiliation(s)
| | - Qin Liu
- The Wistar Institute, Philadelphia, PA, USA
| | | | | | | | | | - David Y Lu
- The Wistar Institute, Philadelphia, PA, USA
- Cornell University, New York, NY, USA
| | | | | | | | - Shuk Hang Li
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | | | | | - Igho Ofotokun
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jason Lazar
- SUNY Downstate Health Sciences University, New York, NY, USA
| | - Margaret A Fischl
- Division of Infectious Disease, Department of Medicine, University of Miami, Miami, FL, USA
| | | | | | | | | | | | | | - Nadia R Roan
- Gladstone Institutes, San Francisco, CA, USA
- University of California San Francisco, San Francisco, CA, USA
| | - Olaf Kutsch
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | - Mallory D Witt
- Lundquist Institute of Biomedical Research at Harbor-UCLA Medical Center, Torrance, CA, USA
| | | | | | | | - Ian Frank
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Phyllis C Tien
- University of California San Francisco, San Francisco, CA, USA
| | - Robert Gross
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | | |
Collapse
|
2
|
Nie H, Saini P, Miyamoto T, Liao L, Zielinski RJ, Liu H, Zhou W, Wang C, Murphy B, Towers M, Yang T, Qi Y, Kannan T, Kossenkov A, Tateno H, Claiborne DT, Zhang N, Abdel-Mohsen M, Zhang R. Targeting branched N-glycans and fucosylation sensitizes ovarian tumors to immune checkpoint blockade. Nat Commun 2024; 15:2853. [PMID: 38565883 PMCID: PMC10987604 DOI: 10.1038/s41467-024-47069-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
Aberrant glycosylation is a crucial strategy employed by cancer cells to evade cellular immunity. However, it's unclear whether homologous recombination (HR) status-dependent glycosylation can be therapeutically explored. Here, we show that the inhibition of branched N-glycans sensitizes HR-proficient, but not HR-deficient, epithelial ovarian cancers (EOCs) to immune checkpoint blockade (ICB). In contrast to fucosylation whose inhibition sensitizes EOCs to anti-PD-L1 immunotherapy regardless of HR-status, we observe an enrichment of branched N-glycans on HR-proficient compared to HR-deficient EOCs. Mechanistically, BRCA1/2 transcriptionally promotes the expression of MGAT5, the enzyme responsible for catalyzing branched N-glycans. The branched N-glycans on HR-proficient tumors augment their resistance to anti-PD-L1 by enhancing its binding with PD-1 on CD8+ T cells. In orthotopic, syngeneic EOC models in female mice, inhibiting branched N-glycans using 2-Deoxy-D-glucose sensitizes HR-proficient, but not HR-deficient EOCs, to anti-PD-L1. These findings indicate branched N-glycans as promising therapeutic targets whose inhibition sensitizes HR-proficient EOCs to ICB by overcoming immune evasion.
Collapse
Affiliation(s)
- Hao Nie
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - Pratima Saini
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, 19104, USA
| | - Taito Miyamoto
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA, 19104, USA
| | - Liping Liao
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - Rafal J Zielinski
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - Heng Liu
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA, 19104, USA
| | - Wei Zhou
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA, 19104, USA
| | - Chen Wang
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - Brennah Murphy
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA, 19104, USA
| | - Martina Towers
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - Tyler Yang
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA, 19104, USA
| | - Yuan Qi
- Department of Bioinformatics & Computational Biology, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
| | - Toshitha Kannan
- Bioinformatics Facility, The Wistar Institute, Philadelphia, PA, 19104, USA
| | - Andrew Kossenkov
- Gene Expression and Regulation Program, The Wistar Institute, Philadelphia, PA, 19104, USA
| | - Hiroaki Tateno
- Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, 305-8566, Japan
| | - Daniel T Claiborne
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA, 19104, USA
| | - Nan Zhang
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA, 19104, USA
| | - Mohamed Abdel-Mohsen
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, 19104, USA.
| | - Rugang Zhang
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA.
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA, 19104, USA.
| |
Collapse
|
3
|
Singh S, Giron LB, Shaikh MW, Shankaran S, Engen PA, Bogin ZR, Bambi SA, Goldman AR, Azevedo JLLC, Orgaz L, de Pedro N, González P, Giera M, Verhoeven A, Sánchez-López E, Pandrea I, Kannan T, Tanes CE, Bittinger K, Landay AL, Corley MJ, Keshavarzian A, Abdel-Mohsen M. Distinct intestinal microbial signatures linked to accelerated systemic and intestinal biological aging. Microbiome 2024; 12:31. [PMID: 38383483 PMCID: PMC10882811 DOI: 10.1186/s40168-024-01758-4] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/05/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND People living with HIV (PLWH), even when viral replication is controlled through antiretroviral therapy (ART), experience persistent inflammation. This inflammation is partly attributed to intestinal microbial dysbiosis and translocation, which may lead to non-AIDS-related aging-associated comorbidities. The extent to which living with HIV - influenced by the infection itself, ART usage, sexual orientation, or other associated factors - affects the biological age of the intestines is unclear. Furthermore, the role of microbial dysbiosis and translocation in the biological aging of PLWH remains to be elucidated. To investigate these uncertainties, we used a systems biology approach, analyzing colon and ileal biopsies, blood samples, and stool specimens from PLWH on ART and people living without HIV (PLWoH) as controls. RESULTS PLWH exhibit accelerated biological aging in the colon, ileum, and blood, as measured by various epigenetic aging clocks, compared to PLWoH. Investigating the relationship between microbial translocation and biological aging, PLWH had decreased levels of tight junction proteins in the intestines, along with increased microbial translocation. This intestinal permeability correlated with faster biological aging and increased inflammation. When investigating the relationship between microbial dysbiosis and biological aging, the intestines of PLWH had higher abundance of specific pro-inflammatory bacteria, such as Catenibacterium and Prevotella. These bacteria correlated with accelerated biological aging. Conversely, the intestines of PLWH had lower abundance of bacteria known for producing the anti-inflammatory short-chain fatty acids, such as Subdoligranulum and Erysipelotrichaceae, and these bacteria were associated with slower biological aging. Correlation networks revealed significant links between specific microbial genera in the colon and ileum (but not in feces), increased aging, a rise in pro-inflammatory microbe-related metabolites (e.g., those in the tryptophan metabolism pathway), and a decrease in anti-inflammatory metabolites like hippuric acid. CONCLUSIONS We identified specific microbial compositions and microbiota-related metabolic pathways that are intertwined with intestinal and systemic biological aging. This microbial signature of biological aging is likely reflecting various factors including the HIV infection itself, ART usage, sexual orientation, and other aspects associated with living with HIV. A deeper understanding of the mechanisms underlying these connections could offer potential strategies to mitigate accelerated aging and its associated health complications. Video Abstract.
Collapse
Affiliation(s)
- Shalini Singh
- Vaccine and Immunotherapy Center, The Wistar Institute, 3601 Spruce Street, Philadelphia, PA, 19104, USA
| | - Leila B Giron
- Vaccine and Immunotherapy Center, The Wistar Institute, 3601 Spruce Street, Philadelphia, PA, 19104, USA
| | - Maliha W Shaikh
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University, Chicago, IL, USA
| | - Shivanjali Shankaran
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University, Chicago, IL, USA
- Department of Medicine, Rush University, Chicago, IL, USA
| | - Phillip A Engen
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University, Chicago, IL, USA
| | - Zlata R Bogin
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University, Chicago, IL, USA
| | - Simona A Bambi
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University, Chicago, IL, USA
| | - Aaron R Goldman
- Vaccine and Immunotherapy Center, The Wistar Institute, 3601 Spruce Street, Philadelphia, PA, 19104, USA
| | - Joao L L C Azevedo
- Vaccine and Immunotherapy Center, The Wistar Institute, 3601 Spruce Street, Philadelphia, PA, 19104, USA
| | | | | | | | - Martin Giera
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | - Aswin Verhoeven
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | - Elena Sánchez-López
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Toshitha Kannan
- Vaccine and Immunotherapy Center, The Wistar Institute, 3601 Spruce Street, Philadelphia, PA, 19104, USA
| | - Ceylan E Tanes
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kyle Bittinger
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Alan L Landay
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University, Chicago, IL, USA
- Department of Medicine, Rush University, Chicago, IL, USA
| | | | - Ali Keshavarzian
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University, Chicago, IL, USA
- Department of Medicine, Rush University, Chicago, IL, USA
| | - Mohamed Abdel-Mohsen
- Vaccine and Immunotherapy Center, The Wistar Institute, 3601 Spruce Street, Philadelphia, PA, 19104, USA.
| |
Collapse
|
4
|
Giron LB, Liu Q, Adeniji OS, Yin X, Kannan T, Ding J, Lu DY, Langan S, Zhang J, Azevedo JLLC, Li SH, Shalygin S, Azadi P, Hanna DB, Ofotokun I, Lazar J, Fischl MA, Haberlen S, Macatangay B, Adimora AA, Jamieson BD, Rinaldo C, Merenstein D, Roan NR, Kutsch O, Gange S, Wolinsky S, Witt M, Post WS, Kossenkov A, Landay A, Frank I, Tien PC, Gross R, Brown TT, Abdel-Mohsen M. Plasma Glycomic Markers of Accelerated Biological Aging During Chronic HIV Infection. bioRxiv 2023:2023.08.09.551369. [PMID: 37609144 PMCID: PMC10441429 DOI: 10.1101/2023.08.09.551369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
People with HIV (PWH) experience an increased vulnerability to premature aging and inflammation-associated comorbidities, even when HIV replication is suppressed by antiretroviral therapy (ART). However, the factors that contribute to or are associated with this vulnerability remain uncertain. In the general population, alterations in the glycomes of circulating IgGs trigger inflammation and precede the onset of aging-associated diseases. Here, we investigate the IgG glycomes of cross-sectional and longitudinal samples from 1,216 women and men, both living with virally suppressed HIV and those without HIV. Our glycan-based machine learning models indicate that living with chronic HIV significantly accelerates the accumulation of pro-aging-associated glycomic alterations. Consistently, PWH exhibit heightened expression of senescence-associated glycan-degrading enzymes compared to their controls. These glycomic alterations correlate with elevated markers of inflammatory aging and the severity of comorbidities, potentially preceding the development of such comorbidities. Mechanistically, HIV-specific antibodies glycoengineered with these alterations exhibit reduced anti-HIV IgG-mediated innate immune functions. These findings hold significant potential for the development of glycomic-based biomarkers and tools to identify and prevent premature aging and comorbidities in people living with chronic viral infections.
Collapse
Affiliation(s)
| | - Qin Liu
- The Wistar Institute, Philadelphia, PA, USA
| | | | | | | | | | - David Y. Lu
- The Wistar Institute, Philadelphia, PA, USA
- Cornell University, New York, NY, USA
| | | | | | | | - Shuk Hang Li
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | | | | | - Igho Ofotokun
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jason Lazar
- SUNY Downstate Health Sciences University, New York, NY, USA
| | | | | | | | | | | | | | | | - Nadia R. Roan
- Gladstone Institutes, San Francisco, CA, USA
- University of California San Francisco, San Francisco, CA, USA
| | - Olaf Kutsch
- University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | | | - Mallory Witt
- Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | | | | | | | - Ian Frank
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Phyllis C. Tien
- University of California San Francisco, San Francisco, CA, USA
| | - Robert Gross
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | | |
Collapse
|
5
|
Singh S, Giron LB, Shaikh MW, Shankaran S, Engen PA, Bogin ZR, Bambi SA, Goldman AR, Azevedo JLLC, Orgaz L, de Pedro N, González P, Giera M, Verhoeven A, Sánchez-López E, Pandrea IV, Kannan T, Tanes CE, Bittinger K, Landay AL, Corley MJ, Keshavarzian A, Abdel-Mohsen M. Distinct Intestinal Microbial Signatures Linked to Accelerated Biological Aging in People with HIV. Res Sq 2023:rs.3.rs-3492242. [PMID: 37961645 PMCID: PMC10635386 DOI: 10.21203/rs.3.rs-3492242/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background People with HIV (PWH), even with controlled viral replication through antiretroviral therapy (ART), experience persistent inflammation. This is partly due to intestinal microbial dysbiosis and translocation. Such ongoing inflammation may lead to the development of non-AIDS-related aging-associated comorbidities. However, there remains uncertainty regarding whether HIV affects the biological age of the intestines and whether microbial dysbiosis and translocation influence the biological aging process in PWH on ART. To fill this knowledge gap, we utilized a systems biology approach, analyzing colon and ileal biopsies, blood samples, and stool specimens from PWH on ART and their matched HIV-negative counterparts. Results Despite having similar chronological ages, PWH on ART exhibit accelerated biological aging in the colon, ileum, and blood, as measured by various epigenetic aging clocks, compared to HIV-negative controls. Investigating the relationship between microbial translocation and biological aging, PWH on ART had decreased levels of tight junction proteins in the colon and ileum, along with increased microbial translocation. This increased intestinal permeability correlated with faster intestinal and systemic biological aging, as well as increased systemic inflammation. When investigating the relationship between microbial dysbiosis and biological aging, the intestines of PWH on ART had higher abundance of specific pro-inflammatory bacterial genera, such as Catenibacterium and Prevotella. These bacteria significantly correlated with accelerated local and systemic biological aging. Conversely, the intestines of PWH on ART had lower abundance of bacterial genera known for producing short-chain fatty acids and exhibiting anti-inflammatory properties, such as Subdoligranulum and Erysipelotrichaceae, and these bacteria taxa were associated with slower biological aging. Correlation networks revealed significant links between specific microbial genera in the colon and ileum (but not in feces), increased aging, a rise in pro-inflammatory microbial-related metabolites (e.g., those in the tryptophan metabolism pathway), and a decrease in anti-inflammatory metabolites like hippuric acid and oleic acid. Conclusions We identified a specific microbial composition and microbiome-related metabolic pathways that are intertwined with both intestinal and systemic biological aging in PWH on ART. A deeper understanding of the mechanisms underlying these connections could potentially offer strategies to counteract premature aging and its associated health complications in PWH.
Collapse
|
6
|
Miller KD, O'Connor S, Pniewski KA, Kannan T, Acosta R, Mirji G, Papp S, Hulse M, Mukha D, Hlavaty SI, Salcido KN, Bertolazzi F, Srikanth YVV, Zhao S, Wellen KE, Shinde RS, Claiborne DT, Kossenkov A, Salvino JM, Schug ZT. Acetate acts as a metabolic immunomodulator by bolstering T-cell effector function and potentiating antitumor immunity in breast cancer. Nat Cancer 2023; 4:1491-1507. [PMID: 37723305 PMCID: PMC10615731 DOI: 10.1038/s43018-023-00636-6] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/17/2023] [Indexed: 09/20/2023]
Abstract
Acetate metabolism is an important metabolic pathway in many cancers and is controlled by acetyl-CoA synthetase 2 (ACSS2), an enzyme that catalyzes the conversion of acetate to acetyl-CoA. While the metabolic role of ACSS2 in cancer is well described, the consequences of blocking tumor acetate metabolism on the tumor microenvironment and antitumor immunity are unknown. We demonstrate that blocking ACSS2, switches cancer cells from acetate consumers to producers of acetate thereby freeing acetate for tumor-infiltrating lymphocytes to use as a fuel source. We show that acetate supplementation metabolically bolsters T-cell effector functions and proliferation. Targeting ACSS2 with CRISPR-Cas9 guides or a small-molecule inhibitor promotes an antitumor immune response and enhances the efficacy of chemotherapy in preclinical breast cancer models. We propose a paradigm for targeting acetate metabolism in cancer in which inhibition of ACSS2 dually acts to impair tumor cell metabolism and potentiate antitumor immunity.
Collapse
Affiliation(s)
- Katelyn D Miller
- The Wistar Institute of Anatomy and Biology, Molecular and Cellular Oncogenesis Program, Philadelphia, PA, USA
| | - Seamus O'Connor
- The Wistar Institute of Anatomy and Biology, Molecular and Cellular Oncogenesis Program, Philadelphia, PA, USA
| | - Katherine A Pniewski
- The Wistar Institute of Anatomy and Biology, Molecular and Cellular Oncogenesis Program, Philadelphia, PA, USA
| | - Toshitha Kannan
- The Wistar Institute of Anatomy and Biology, Molecular and Cellular Oncogenesis Program, Philadelphia, PA, USA
| | - Reyes Acosta
- The Wistar Institute of Anatomy and Biology, Vaccine and Immunotherapy Center, Philadelphia, PA, USA
| | - Gauri Mirji
- The Wistar Institute of Anatomy and Biology, Immunology, Microenvironment & Metastasis Program, Philadelphia, PA, USA
| | - Sara Papp
- The Wistar Institute of Anatomy and Biology, Molecular and Cellular Oncogenesis Program, Philadelphia, PA, USA
| | - Michael Hulse
- The Wistar Institute of Anatomy and Biology, Molecular and Cellular Oncogenesis Program, Philadelphia, PA, USA
| | - Dzmitry Mukha
- The Wistar Institute of Anatomy and Biology, Molecular and Cellular Oncogenesis Program, Philadelphia, PA, USA
| | - Sabina I Hlavaty
- The Wistar Institute of Anatomy and Biology, Molecular and Cellular Oncogenesis Program, Philadelphia, PA, USA
| | - Kelsey N Salcido
- The Wistar Institute of Anatomy and Biology, Molecular and Cellular Oncogenesis Program, Philadelphia, PA, USA
| | - Fabrizio Bertolazzi
- The Wistar Institute of Anatomy and Biology, Molecular and Cellular Oncogenesis Program, Philadelphia, PA, USA
- Cellular and Molecular Biology Program, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Yellamelli V V Srikanth
- The Wistar Institute of Anatomy and Biology, Molecular and Cellular Oncogenesis Program, Philadelphia, PA, USA
| | - Steven Zhao
- Department of Cancer Biology, University of Pennsylvania, Philadelphia, PA, USA
| | - Kathryn E Wellen
- Department of Cancer Biology, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Family Cancer Research Institute, University of Pennsylvania, Philadelphia, PA, USA
| | - Rahul S Shinde
- The Wistar Institute of Anatomy and Biology, Immunology, Microenvironment & Metastasis Program, Philadelphia, PA, USA
| | - Daniel T Claiborne
- The Wistar Institute of Anatomy and Biology, Vaccine and Immunotherapy Center, Philadelphia, PA, USA
| | - Andrew Kossenkov
- The Wistar Institute of Anatomy and Biology, Molecular and Cellular Oncogenesis Program, Philadelphia, PA, USA
| | - Joseph M Salvino
- The Wistar Institute of Anatomy and Biology, Molecular and Cellular Oncogenesis Program, Philadelphia, PA, USA
| | - Zachary T Schug
- The Wistar Institute of Anatomy and Biology, Molecular and Cellular Oncogenesis Program, Philadelphia, PA, USA.
| |
Collapse
|
7
|
Indeglia A, Leung JC, Miller SA, Leu JIJ, Dougherty JF, Clarke NL, Kirven NA, Shao C, Ke L, Lovell S, Barnoud T, Lu DY, Lin C, Kannan T, Battaile KP, Yang THL, Batista Oliva I, Claiborne DT, Vogel P, Liu L, Liu Q, Nefedova Y, Cassel J, Auslander N, Kossenkov AV, Karanicolas J, Murphy ME. An African-Specific Variant of TP53 Reveals PADI4 as a Regulator of p53-Mediated Tumor Suppression. Cancer Discov 2023; 13:1696-1719. [PMID: 37140445 PMCID: PMC10326602 DOI: 10.1158/2159-8290.cd-22-1315] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/21/2023] [Accepted: 04/06/2023] [Indexed: 05/05/2023]
Abstract
TP53 is the most frequently mutated gene in cancer, yet key target genes for p53-mediated tumor suppression remain unidentified. Here, we characterize a rare, African-specific germline variant of TP53 in the DNA-binding domain Tyr107His (Y107H). Nuclear magnetic resonance and crystal structures reveal that Y107H is structurally similar to wild-type p53. Consistent with this, we find that Y107H can suppress tumor colony formation and is impaired for the transactivation of only a small subset of p53 target genes; this includes the epigenetic modifier PADI4, which deiminates arginine to the nonnatural amino acid citrulline. Surprisingly, we show that Y107H mice develop spontaneous cancers and metastases and that Y107H shows impaired tumor suppression in two other models. We show that PADI4 is itself tumor suppressive and that it requires an intact immune system for tumor suppression. We identify a p53-PADI4 gene signature that is predictive of survival and the efficacy of immune-checkpoint inhibitors. SIGNIFICANCE We analyze the African-centric Y107H hypomorphic variant and show that it confers increased cancer risk; we use Y107H in order to identify PADI4 as a key tumor-suppressive p53 target gene that contributes to an immune modulation signature and that is predictive of cancer survival and the success of immunotherapy. See related commentary by Bhatta and Cooks, p. 1518. This article is highlighted in the In This Issue feature, p. 1501.
Collapse
Affiliation(s)
- Alexandra Indeglia
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, Pennsylvania
- Graduate Group in Biochemistry and Molecular Biophysics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jessica C. Leung
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, Pennsylvania
| | - Sven A. Miller
- Program in Molecular Therapeutics, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Julia I-Ju Leu
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - James F. Dougherty
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, Pennsylvania
| | - Nicole L. Clarke
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, Pennsylvania
| | - Nicole A. Kirven
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, Pennsylvania
| | - Chunlei Shao
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, Pennsylvania
| | - Lei Ke
- Program in Molecular Therapeutics, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Scott Lovell
- Del Shankel Structural Biology Center, The University of Kansas, Lawrence, Kansas
| | - Thibaut Barnoud
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, Pennsylvania
| | - David Y. Lu
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, Pennsylvania
| | - Cindy Lin
- Program in Immunology, Microenvironment and Metastasis, The Wistar Institute, Philadelphia, Pennsylvania
| | - Toshitha Kannan
- Program in Gene Expression and Regulation, The Wistar Institute, Philadelphia, Pennsylvania
| | | | - Tyler Hong Loong Yang
- Program in Immunology, Microenvironment and Metastasis, The Wistar Institute, Philadelphia, Pennsylvania
| | - Isabela Batista Oliva
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, Pennsylvania
| | - Daniel T. Claiborne
- Program in Immunology, Microenvironment and Metastasis, The Wistar Institute, Philadelphia, Pennsylvania
| | - Peter Vogel
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Lijun Liu
- Del Shankel Structural Biology Center, The University of Kansas, Lawrence, Kansas
| | - Qin Liu
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, Pennsylvania
| | - Yulia Nefedova
- Program in Immunology, Microenvironment and Metastasis, The Wistar Institute, Philadelphia, Pennsylvania
| | - Joel Cassel
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, Pennsylvania
| | - Noam Auslander
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, Pennsylvania
| | - Andrew V. Kossenkov
- Program in Gene Expression and Regulation, The Wistar Institute, Philadelphia, Pennsylvania
| | - John Karanicolas
- Program in Molecular Therapeutics, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Maureen E. Murphy
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, Pennsylvania
| |
Collapse
|
8
|
Napoletani G, Soldan SS, Kannan T, Preston-Alp S, Vogel P, Maestri D, Caruso LB, Kossenkov A, Sobotka A, Lieberman PM, Tempera I. PARP1 Inhibition Halts EBV+ Lymphoma Progression by Disrupting the EBNA2/MYC Axis. bioRxiv 2023:2023.07.05.547847. [PMID: 37461649 PMCID: PMC10350008 DOI: 10.1101/2023.07.05.547847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
PARP1 has been shown to regulate EBV latency. However, the therapeutic effect of PARP1 inhibitors on EBV+ lymphomagenesis has not yet been explored. Here, we show that PARPi BMN-673 has a potent anti-tumor effect on EBV-driven LCL in a mouse xenograft model. We found that PARP1 inhibition induces a dramatic transcriptional reprogramming of LCLs driven largely by the reduction of the MYC oncogene expression and dysregulation of MYC targets, both in vivo and in vitro. PARP1 inhibition also reduced the expression of viral oncoprotein EBNA2, which we previously demonstrated depends on PARP1 for activation of MYC. Further, we show that PARP1 inhibition blocks the chromatin association of MYC, EBNA2, and tumor suppressor p53. Overall, our study strengthens the central role of PARP1 in EBV malignant transformation and identifies the EBNA2/MYC pathway as a target of PARP1 inhibitors and its utility for the treatment of EBNA2-driven EBV-associated cancers.
Collapse
Affiliation(s)
| | | | | | | | - Peter Vogel
- Department of Comparative Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | | | | | | | | | | | | |
Collapse
|
9
|
Stephen A, Nair S, Joshi A, Aggarwal S, Adhikari T, Diwan V, Devi KR, Mishra BK, Yadav GK, Sahu D, Gulati BK, Sharma S, Yadav J, Ovung S, Duggal C, Sharma M, Bangar SD, Rebecca PB, Rani S, Selvaraj P, Xavier GG, Peter V, Watson B, Kannan T, Asmathulla KSMD, Bhattacharya D, Turuk J, Palo SK, Kanungo S, Behera AK, Pandey AK, Zaman K, Misra B, Kumar N, Behera S, Singh R, Narain K, Kant R, Sahay S, Tiwari R, Thomas BE, Karikalan N, Panda S, Vardhana Rao MV, Ujagare D, Chinchore S. Gender differences in COVID-19 knowledge, risk perception, and public stigma among the general community: Findings from a nationwide cross-sectional study in India. Int J Disaster Risk Reduct 2023; 93:103776. [PMID: 37303828 PMCID: PMC10229202 DOI: 10.1016/j.ijdrr.2023.103776] [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] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 04/10/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023]
Abstract
Introduction Individual and community characteristics predictive of knowledge, perception, and attitude on COVID-19, specifically on gender, have not been adequately explored. Objective To examine the gender differences in COVID-19 knowledge, self-risk perception and public stigma among the general community and to understand other socio-demographic factors which were predictive of them. Method A nationally representative cross-sectional multi-centric survey was conducted among adult individuals(≥18 yrs) from the community member (N = 1978) from six states and one union territory of India between August 2020 to February 2021. The participants were selected using systematic random sampling. The data were collected telephonically using pilot-tested structured questionnaires and were analyzed using STATA. Gender-segregated multivariable analysis was conducted to identify statistically significant predictors (p < 0.05) of COVID-19-related knowledge, risk perception, and public stigma in the community. Results Study identified significant differences between males and females in their self-risk perception (22.0% & 18.2% respectively) and stigmatizing attitude (55.3% & 47.1% respectively). Highly educated males and females had higher odds of having COVID-19 knowledge (aOR: 16.83: p < 0.05) than illiterates. Highly educated women had higher odds of having self-risk perception (aOR: 2.6; p < 0.05) but lower public stigma [aOR: 0.57; p < 0.05]. Male rural residents had lower odds of having self-risk perception and knowledge [aOR: 0.55; p < 0.05 & aOR: 0.72; p < 0.05] and female rural residents had higher odds of having public stigma [aOR: 1.36; p < 0.05]. Conclusion Our study findings suggest the importance of considering thegender differentials and their background, education status and residential status in designing effective interventions to improve knowledge and reduce risk perception and stigma in the community about COVID-19.
Collapse
Affiliation(s)
- A Stephen
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Saritha Nair
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Aparna Joshi
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, India
| | - Sumit Aggarwal
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Tulsi Adhikari
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Vishal Diwan
- Division of Environmental Monitoring & Exposure Assessment (Water & Soil), ICMR- National Institute for Research in Environmental Health, Bhopal, India
| | - Kangjam Rekha Devi
- Divison of Enteric Disease, ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, Assam, India
| | - Bijaya Kumar Mishra
- Department of Medical, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Damodar Sahu
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Bal Kishan Gulati
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Saurabh Sharma
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Jeetendra Yadav
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Senthanro Ovung
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Chetna Duggal
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, India
| | - Moina Sharma
- Department of Environmental Health & Epidemiology, ICMR- National Institute for Research in Environmental Health, Bhopal, India
| | - Sampada Dipak Bangar
- Divisions of Epidemiology and Statistics, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Pricilla B Rebecca
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - S Rani
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Pradeep Selvaraj
- Office of District Non-Communicable Disease, Directorate of Public Health and Preventive Medicine, Chennai, India
| | | | - Vanessa Peter
- Informational & Resource Centre for the Deprived Urban Communities, Chennai, India
| | - Basilea Watson
- Electronic Data Processing Unit, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - T Kannan
- Electronic Data Processing Unit, ICMR-National Institute for Research in Tuberculosis, Chennai, India
- Epidemiology and Statistics Unit, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - K S M D Asmathulla
- Integrated People Development Project Trust, Krishnagiri, Tamil Nadu, India
| | - Debdutta Bhattacharya
- Department of Microbiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Jyotirmayee Turuk
- Department of Microbiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Subrata Kumar Palo
- Department of Microbiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
- Department of Epidemiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Srikanta Kanungo
- Department of Microbiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
- Department of Epidemiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Ajit Kumar Behera
- Department of Clinical, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Kamran Zaman
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - BrijRanjan Misra
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - Niraj Kumar
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | | | - Rajeev Singh
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - Kanwar Narain
- ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, Assam, India
| | - Rajni Kant
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
- Research Management, Policy, Planning and Coordination Cell, Indian Council of Medical Research, New Delhi, India
| | - Seema Sahay
- Social &Behavioral Research, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | | | - Beena Elizabeth Thomas
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - N Karikalan
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Samiran Panda
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - M Vishnu Vardhana Rao
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Dhammsagar Ujagare
- Social &Behavioral Research, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Sneha Chinchore
- Social &Behavioral Research, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| |
Collapse
|
10
|
Zhou W, Liu H, Yuan Z, Zundell J, Towers M, Lin J, Lombardi S, Nie H, Murphy B, Yang T, Wang C, Liao L, Goldman AR, Kannan T, Kossenkov AV, Drapkin R, Montaner LJ, Claiborne DT, Zhang N, Wu S, Zhang R. Targeting the mevalonate pathway suppresses ARID1A-inactivated cancers by promoting pyroptosis. Cancer Cell 2023; 41:740-756.e10. [PMID: 36963401 PMCID: PMC10085864 DOI: 10.1016/j.ccell.2023.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 01/22/2023] [Accepted: 02/28/2023] [Indexed: 03/26/2023]
Abstract
ARID1A, encoding a subunit of the SWI/SNF complex, is mutated in ∼50% of clear cell ovarian carcinoma (OCCC) cases. Here we show that inhibition of the mevalonate pathway synergizes with immune checkpoint blockade (ICB) by driving inflammasome-regulated immunomodulating pyroptosis in ARID1A-inactivated OCCCs. SWI/SNF inactivation downregulates the rate-limiting enzymes in the mevalonate pathway such as HMGCR and HMGCS1, which creates a dependence on the residual activity of the pathway in ARID1A-inactivated cells. Inhibitors of the mevalonate pathway such as simvastatin suppresses the growth of ARID1A mutant, but not wild-type, OCCCs. In addition, simvastatin synergizes with anti-PD-L1 antibody in a genetic OCCC mouse model driven by conditional Arid1a inactivation and in a humanized immunocompetent ARID1A mutant patient-derived OCCC mouse model. Our data indicate that inhibition of the mevalonate pathway simultaneously suppresses tumor cell growth and boosts antitumor immunity by promoting pyroptosis, which synergizes with ICB in suppressing ARID1A-mutated cancers.
Collapse
Affiliation(s)
- Wei Zhou
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Heng Liu
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Zhe Yuan
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Joseph Zundell
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Martina Towers
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX 77054, USA
| | - Jianhuang Lin
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Simona Lombardi
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA; Department of Pharmacy and Biotechnology, University of Bologna, 40126, Bologna, Italy
| | - Hao Nie
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Brennah Murphy
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Tyler Yang
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Chen Wang
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Liping Liao
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Aaron R Goldman
- Molecular and Cellular Oncogenesis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Toshitha Kannan
- Bioinformatics Facility, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Andrew V Kossenkov
- Gene Expression and Regulation Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Ronny Drapkin
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Obstetrics and Gynecology, Penn Ovarian Cancer Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Luis J Montaner
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Daniel T Claiborne
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Nan Zhang
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Shuai Wu
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA
| | - Rugang Zhang
- Immunology, Microenvironment and Metastasis Program, The Wistar Institute, Philadelphia, PA 19104, USA; Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX 77054, USA.
| |
Collapse
|
11
|
Tietjen I, Schonhofer C, Sciorillo A, Naidu ME, Haq Z, Kannan T, Kossenkov AV, Rivera-Ortiz J, Mounzer K, Hart C, Gyampoh K, Yuan Z, Beattie KD, Rali T, Shuda McGuire K, Davis RA, Montaner LJ. The Natural Stilbenoid (-)-Hopeaphenol Inhibits HIV Transcription by Targeting Both PKC and NF-κB Signaling and Cyclin-Dependent Kinase 9. Antimicrob Agents Chemother 2023; 67:e0160022. [PMID: 36975214 PMCID: PMC10112218 DOI: 10.1128/aac.01600-22] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Despite effective combination antiretroviral therapy (cART), people living with HIV (PLWH) continue to harbor replication-competent and transcriptionally active virus in infected cells, which in turn can lead to ongoing viral antigen production, chronic inflammation, and increased risk of age-related comorbidities. To identify new agents that may inhibit postintegration HIV beyond cART, we screened a library of 512 pure compounds derived from natural products and identified (-)-hopeaphenol as an inhibitor of HIV postintegration transcription at low to submicromolar concentrations without cytotoxicity. Using a combination of global RNA sequencing, plasmid-based reporter assays, and enzyme activity studies, we document that hopeaphenol inhibits protein kinase C (PKC)- and downstream NF-κB-dependent HIV transcription as well as a subset of PKC-dependent T-cell activation markers, including interleukin-2 (IL-2) cytokine and CD25 and HLA-DRB1 RNA production. In contrast, it does not substantially inhibit the early PKC-mediated T-cell activation marker CD69 production of IL-6 or NF-κB signaling induced by tumor necrosis factor alpha (TNF-α). We further show that hopeaphenol can inhibit cyclin-dependent kinase 9 (CDK9) enzymatic activity required for HIV transcription. Finally, it inhibits HIV replication in peripheral blood mononuclear cells (PBMCs) infected in vitro and dampens viral reactivation in CD4+ cells from PLWH. Our study identifies hopeaphenol as a novel inhibitor that targets a subset of PKC-mediated T-cell activation pathways in addition to CDK9 to block HIV expression. Hopeaphenol-based therapies could complement current antiretroviral therapy otherwise not targeting cell-associated HIV RNA and residual antigen production in PLWH.
Collapse
Affiliation(s)
- Ian Tietjen
- The Wistar Institute, Philadelphia, Pennsylvania, USA
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Cole Schonhofer
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | | | - Maya E Naidu
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Zahra Haq
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | | | | | | | - Karam Mounzer
- Jonathan Lax Immune Disorders Treatment Center, Philadelphia Field Initiating Group for HIV-1 Trials, Philadelphia, Pennsylvania, USA
| | - Colin Hart
- The Wistar Institute, Philadelphia, Pennsylvania, USA
| | - Kwasi Gyampoh
- The Wistar Institute, Philadelphia, Pennsylvania, USA
| | - Zhe Yuan
- The Wistar Institute, Philadelphia, Pennsylvania, USA
| | - Karren D Beattie
- Griffith Institute for Drug Discovery, School of Environment and Science, Griffith University, Brisbane, Queensland, Australia
| | - Topul Rali
- School of Natural and Physical Sciences, The University of Papua New Guinea, Port Moresby, Papua New Guinea
| | | | - Rohan A Davis
- Griffith Institute for Drug Discovery, School of Environment and Science, Griffith University, Brisbane, Queensland, Australia
| | | |
Collapse
|
12
|
Gary EN, Tursi NJ, Warner BM, Cuismano G, Connors J, Parzych EM, Griffin BD, Bell MR, Ali AR, Frase D, Hojecki CE, Canziani GA, Chaiken I, Kannan T, Moffat E, Embury-Hyatt C, Wooton SK, Kossenkov A, Patel A, Kobasa D, Kutzler MA, Haddad EK, Weiner DB. Adenosine deaminase augments SARS-CoV-2 specific cellular and humoral responses in aged mouse models of immunization and challenge. Front Immunol 2023; 14:1138609. [PMID: 36999023 PMCID: PMC10043169 DOI: 10.3389/fimmu.2023.1138609] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/23/2023] [Indexed: 03/16/2023] Open
Abstract
Despite numerous clinically available vaccines and therapeutics, aged patients remain at increased risk for COVID-19 morbidity. Furthermore, various patient populations, including the aged can have suboptimal responses to SARS-CoV-2 vaccine antigens. Here, we characterized vaccine-induced responses to SARS-CoV-2 synthetic DNA vaccine antigens in aged mice. Aged mice exhibited altered cellular responses, including decreased IFNγ secretion and increased TNFα and IL-4 secretion suggestive of TH2-skewed responses. Aged mice exhibited decreased total binding and neutralizing antibodies in their serum but significantly increased TH2-type antigen-specific IgG1 antibody compared to their young counterparts. Strategies to enhance vaccine-induced immune responses are important, especially in aged patient populations. We observed that co-immunization with plasmid-encoded adenosine deaminase (pADA)enhanced immune responses in young animals. Ageing is associated with decreases in ADA function and expression. Here, we report that co-immunization with pADA enhanced IFNγ secretion while decreasing TNFα and IL-4 secretion. pADA expanded the breadth and affinity SARS-CoV-2 spike-specific antibodies while supporting TH1-type humoral responses in aged mice. scRNAseq analysis of aged lymph nodes revealed that pADA co-immunization supported a TH1 gene profile and decreased FoxP3 gene expression. Upon challenge, pADA co-immunization decreased viral loads in aged mice. These data support the use of mice as a model for age-associated decreased vaccine immunogenicity and infection-mediated morbidity and mortality in the context of SARS-CoV-2 vaccines and provide support for the use of adenosine deaminase as a molecular adjuvant in immune-challenged populations.
Collapse
Affiliation(s)
- Ebony N. Gary
- The Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Nicholas J. Tursi
- The Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Bryce M. Warner
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Gina Cuismano
- The Department of Medicine, Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine, Philadelphia, PA, United States
- The Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Jennifer Connors
- The Department of Medicine, Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine, Philadelphia, PA, United States
- The Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Elizabeth M. Parzych
- The Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Bryan D. Griffin
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Matthew R. Bell
- The Department of Medicine, Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine, Philadelphia, PA, United States
- The Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Ali R. Ali
- The Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Drew Frase
- The Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Casey E. Hojecki
- The Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Gabriela A. Canziani
- The Department of Biochemistry, Drexel University college of Medicine, Philadelphia, PA, United States
| | - Irwin Chaiken
- The Department of Biochemistry, Drexel University college of Medicine, Philadelphia, PA, United States
| | - Toshitha Kannan
- The Genomics Core, The Wistar Institute, Philadelphia, PA, United States
| | - Estella Moffat
- National Center for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, MB, Canada
| | - Carissa Embury-Hyatt
- National Center for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, MB, Canada
| | - Sarah K. Wooton
- Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Andrew Kossenkov
- The Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
- The Genomics Core, The Wistar Institute, Philadelphia, PA, United States
| | - Ami Patel
- The Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Darwyn Kobasa
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Michele A. Kutzler
- The Department of Medicine, Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine, Philadelphia, PA, United States
- The Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Elias K. Haddad
- The Department of Medicine, Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine, Philadelphia, PA, United States
- The Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA, United States
| | - David B. Weiner
- The Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| |
Collapse
|
13
|
Ramachandran G, Hemanth Kumar AK, Kannan T, Thangakunam B, Shankar D, Christopher DJ. Pharmacokinetics of rifampicin, isoniazid & pyrazinamide during daily & intermittent dosing: A preliminary study. Indian J Med Res 2023; 157:211-215. [PMID: 36861539 DOI: 10.4103/ijmr.ijmr_1835_19] [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: 03/01/2023] Open
Abstract
Background & objectives The National Tuberculosis (TB) Control Programme has transitioned from thrice-weekly to daily drug treatment regimens in India. This preliminary study was conceived to compare the pharmacokinetics of rifampicin (RMP), isoniazid (INH) and pyrazinamide (PZA) in TB patients being treated with daily and thrice weekly anti-TB treatment (ATT). Methods This prospective observational study was undertaken in 49 newly diagnosed adult TB patients receiving either daily ATT (n=22) or thrice-weekly ATT (n=27). Plasma RMP, INH and PZA were estimated by high-performance liquid chromatography. Results The peak concentration (Cmax) of RMP was significantly higher (RMP: 8.5 μg/ml vs. 5.5 μg/ml; P=0.003) and Cmax of INH was significantly lower (INH: 4.8 μg/ml vs. 10.9 μg/ml; P<0.001) in case of daily dosing compared to thrice-weekly ATT. Cmax of drugs and doses was significantly correlated. A higher proportion of patients had subtherapeutic RMP Cmax (8.0 μg/ml) during thrice-weekly compared to daily ATT (78% vs. 36%; P=0.004). Multiple linear regression analysis showed that Cmax of RMP was significantly influenced by the dosing rhythm, pulmonary TB and Cmax of INH and PZA by the mg/kg doses. Interpretation & conclusions RMP concentrations were higher and INH concentrations were lower during daily ATT, suggesting that INH doses may need to be increased in case of a daily regimen. Larger studies are, however, required using higher INH doses when monitoring for adverse drug reactions and treatment outcomes.
Collapse
Affiliation(s)
- Geetha Ramachandran
- Department of Biochemistry & Clinical Pharmacology, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - A K Hemanth Kumar
- Department of Clinical Pharmacology, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - T Kannan
- Department of Statistics (Epidemiology Unit), ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - Deepa Shankar
- Department of Pulmonary Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | | |
Collapse
|
14
|
Leung JC, Leu JIJ, Indeglia A, Kannan T, Clarke NL, Kirven NA, Dweep H, Garlick D, Barnoud T, Kossenkov AV, George DL, Murphy ME. Common activities and predictive gene signature identified for genetic hypomorphs of TP53. Proc Natl Acad Sci U S A 2023; 120:e2212940120. [PMID: 36749725 PMCID: PMC9962931 DOI: 10.1073/pnas.2212940120] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/05/2023] [Indexed: 02/08/2023] Open
Abstract
Missense mutations that inactivate p53 occur commonly in cancer, and germline mutations in TP53 cause Li Fraumeni syndrome, which is associated with early-onset cancer. In addition, there are over two hundred germline missense variants of p53 that remain uncharacterized. In some cases, these germline variants have been shown to encode lesser-functioning, or hypomorphic, p53 protein, and these alleles are associated with increased cancer risk in humans and mouse models. However, most hypomorphic p53 variants remain un- or mis-classified in clinical genetics databases. There thus exists a significant need to better understand the behavior of p53 hypomorphs and to develop a functional assay that can distinguish hypomorphs from wild-type p53 or benign variants. We report the surprising finding that two different African-centric genetic hypomorphs of p53 that occur in distinct functional domains of the protein share common activities. Specifically, the Pro47Ser variant, located in the transactivation domain, and the Tyr107His variant, located in the DNA binding domain, both share increased propensity to misfold into a conformation specific for mutant, misfolded p53. Additionally, cells and tissues containing these hypomorphic variants show increased NF-κB activity. We identify a common gene expression signature from unstressed lymphocyte cell lines that is shared between multiple germline hypomorphic variants of TP53, and which successfully distinguishes wild-type p53 and a benign variant from lesser-functioning hypomorphic p53 variants. Our findings will allow us to better understand the contribution of p53 hypomorphs to disease risk and should help better inform cancer risk in the carriers of p53 variants.
Collapse
Affiliation(s)
- Jessica C. Leung
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, PA19104
| | - Julia I-Ju Leu
- Department of Genetics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA19104
| | - Alexandra Indeglia
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, PA19104
- Graduate Group in Biochemistry and Molecular Biophysics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA19104
| | - Toshitha Kannan
- Program in Gene Expression and Regulation, The Wistar Institute, Philadelphia, PA19104
| | - Nicole L. Clarke
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, PA19104
| | - Nicole A. Kirven
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, PA19104
| | - Harsh Dweep
- Program in Gene Expression and Regulation, The Wistar Institute, Philadelphia, PA19104
| | | | - Thibaut Barnoud
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, PA19104
| | - Andrew V. Kossenkov
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, PA19104
| | - Donna L. George
- Department of Genetics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA19104
| | - Maureen E. Murphy
- Program in Molecular and Cellular Oncogenesis, The Wistar Institute, Philadelphia, PA19104
| |
Collapse
|
15
|
Tursi NJ, Xu Z, Helble M, Walker S, Liaw K, Chokkalingam N, Kannan T, Wu Y, Tello-Ruiz E, Park DH, Zhu X, Wise MC, Smith TRF, Majumdar S, Kossenkov A, Kulp DW, Weiner DB. Engineered antibody cytokine chimera synergizes with DNA-launched nanoparticle vaccines to potentiate melanoma suppression in vivo. Front Immunol 2023; 14:1072810. [PMID: 36911698 PMCID: PMC9997082 DOI: 10.3389/fimmu.2023.1072810] [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: 10/17/2022] [Accepted: 01/30/2023] [Indexed: 02/25/2023] Open
Abstract
Cancer immunotherapy has demonstrated great promise with several checkpoint inhibitors being approved as the first-line therapy for some types of cancer, and new engineered cytokines such as Neo2/15 now being evaluated in many studies. In this work, we designed antibody-cytokine chimera (ACC) scaffolding cytokine mimetics on a full-length tumor-specific antibody. We characterized the pharmacokinetic (PK) and pharmacodynamic (PD) properties of first-generation ACC TA99-Neo2/15, which synergized with DLnano-vaccines to suppress in vivo melanoma proliferation and induced significant systemic cytokine activation. A novel second-generation ACC TA99-HL2-KOA1, with retained IL-2Rβ/γ binding and attenuated but preserved IL-2Rα binding, induced lower systemic cytokine activation with non-inferior protection in murine tumor studies. Transcriptomic analyses demonstrated an upregulation of Type I interferon responsive genes, particularly ISG15, in dendritic cells, macrophages and monocytes following TA99-HL2-KOA1 treatment. Characterization of additional ACCs in combination with cancer vaccines will likely be an important area of research for treating melanoma and other types of cancer.
Collapse
Affiliation(s)
- Nicholas J Tursi
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Ziyang Xu
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Michaela Helble
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Susanne Walker
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Kevin Liaw
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Neethu Chokkalingam
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Toshitha Kannan
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Yuanhan Wu
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Edgar Tello-Ruiz
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Daniel H Park
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Xizhou Zhu
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Megan C Wise
- Inovio Pharmaceuticals, Bluebell, PA, United States
| | | | - Sonali Majumdar
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Andrew Kossenkov
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - Daniel W Kulp
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| | - David B Weiner
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, United States
| |
Collapse
|
16
|
Mirji G, Worth A, Bhat S, Sayed M, Kannan T, Goldman A, Tang HY, Liu Q, Auslander N, Dang C, Abdel-Mohsen M, Kossenkov A, Stanger B, Shinde R. Abstract C023: A microbiome-produced metabolite drives immunostimulatory macrophages and boosts response to immune checkpoint inhibitors in pancreatic cancer. Cancer Res 2022. [DOI: 10.1158/1538-7445.panca22-c023] [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: 11/17/2022]
Abstract
Abstract
The composition of the gut microbiome controls innate and adaptive immunity and has emerged as a key regulator of tumor growth and the success of immune checkpoint blockade (ICB) therapy. However, the underlying mechanisms remain unclear. Pancreatic ductal adenocarcinoma (PDAC) tends to be refractory to therapy, including ICB. We found that the gut microbe-derived metabolite trimethylamine N-oxide (TMAO) enhances anti-tumor immunity to PDAC. Delivery of TMAO given intraperitoneally or via dietary choline supplement to PDAC-bearing mice reduces tumor growth and is associated with an immunostimulatory tumor-associated macrophage (TAM) phenotype and activated effector T cell response in the tumor microenvironment. Mechanistically, TMAO signals through potentiating type-I interferon (IFN) pathway and confers anti-tumor effects in a type-I IFN dependent manner. Notably, delivering TMAO-primed macrophages alone produced similar anti-tumor effects. Combining TMAO with ICB (anti-PD1 and/or anti-Tim3) significantly reduced tumor burden and improved survival beyond TMAO or ICB alone. Finally, the levels of trimethylamine (TMA)-producing bacteria and of CutC gene expression correlate with improved survivorship and response to anti-PD1 in cancer patients. Together, our study identifies the gut microbial metabolite TMAO as an important driver of anti-tumor immunity and lays the groundwork for new therapeutic strategies.
Citation Format: Gauri Mirji, Alison Worth, Sajad Bhat, Mohamed Sayed, Toshitha Kannan, Aaron Goldman, Hsin-Yao Tang, Qin Liu, Noam Auslander, Chi Dang, Mohamed Abdel-Mohsen, Andrew Kossenkov, Ben Stanger, Rahul Shinde. A microbiome-produced metabolite drives immunostimulatory macrophages and boosts response to immune checkpoint inhibitors in pancreatic cancer [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer; 2022 Sep 13-16; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2022;82(22 Suppl):Abstract nr C023.
Collapse
Affiliation(s)
| | | | - Sajad Bhat
- 1The Wistar Institute, Philadelphia, PA,
| | | | | | | | | | - Qin Liu
- 1The Wistar Institute, Philadelphia, PA,
| | | | - Chi Dang
- 1The Wistar Institute, Philadelphia, PA,
| | | | | | - Ben Stanger
- 2University of Pennsylvania, Philadelphia, PA
| | | |
Collapse
|
17
|
Adhikari T, Aggarwal S, Nair S, Joshi A, Diwan V, Stephen A, Devi KR, Kumar Mishra B, Yadav GK, Bangar SD, Sahu D, Yadav J, Ovung S, Gulati BK, Sharma S, Singh C, Duggal C, Sharma M, Ujagare D, Padmakar Chinchore S, Rebecca PB, Rani S, Selvaraj P, Xavier GG, Peter V, Watson B, Kannan T, Asmathulla KSM, Bhattacharya D, Turuk J, Palo SK, Kanungo S, Kumar Behera A, Pandey AK, Zaman K, Misra BR, Kumar N, Behera SP, Singh R, Narain K, Kant R, Sahay S, Tiwari RR, Thomas BE, Rao MVV. Factors associated with COVID-19 stigma during the onset of the global pandemic in India: A cross-sectional study. Front Public Health 2022; 10:992046. [PMID: 36311615 PMCID: PMC9615248 DOI: 10.3389/fpubh.2022.992046] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/27/2022] [Indexed: 01/26/2023] Open
Abstract
Objective To assess factors associated with COVID-19 stigmatizing attitudes in the community and stigma experiences of COVID-19 recovered individuals during first wave of COVID-19 pandemic in India. Methods A cross-sectional study was conducted in 18 districts located in 7 States in India during September 2020 to January 2021 among adults > 18 years of age selected through systematic random sampling. Data on socio demographic and COVID-19 knowledge were collected from 303 COVID-19 recovered and 1,976 non-COVID-19 infected individuals from community using a survey questionnaire. Stigma was assessed using COVID-19 Stigma Scale and Community COVID-19 Stigma Scale developed for the study. Informed consent was sought from the participants. Univariate and multivariate binary logistic regression analysis were conducted. Results Half of the participants (51.3%) from the community reported prevalence of severe stigmatizing attitudes toward COVID-19 infected while 38.6% of COVID-19 recovered participants reported experiencing severe stigma. Participants from the community were more likely to report stigmatizing attitudes toward COVID-19 infected if they were residents of high prevalent COVID-19 zone (AOR: 1.5; CI: 1.2-1.9), staying in rural areas (AOR: 1.5; CI:1.1-1.9), belonged to the age group of 18-30 years (AOR: 1.6; CI 1.2-2.0), were male (AOR: 1.6; CI: 1.3-1.9), illiterate (AOR: 2.7; CI: 1.8-4.2), or living in Maharashtra (AOR: 7.4; CI: 4.8-11.3). COVID-19 recovered participants had higher odds of experiencing stigma if they had poor knowledge about COVID-19 transmission (AOR: 2.8; CI: 1.3-6.3), were staying for 6-15 years (AOR: 3.24; CI: 1.1-9.4) in the current place of residence or belonged to Delhi (AOR: 5.3; CI: 1.04-26.7). Conclusion Findings indicated presence of stigmatizing attitudes in the community as well as experienced stigma among COVID-19 recovered across selected study sites in India during the first wave of COVID-19 pandemic. Study recommends timely dissemination of factual information to populations vulnerable to misinformation and psychosocial interventions for individuals affected by stigma.
Collapse
Affiliation(s)
- Tulsi Adhikari
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Sumit Aggarwal
- Division of Epidemiology and Communicable Diseases (ECD), Indian Council of Medical Research, New Delhi, India
| | - Saritha Nair
- ICMR-National Institute of Medical Statistics, New Delhi, India,*Correspondence: Saritha Nair
| | - Aparna Joshi
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
| | - Vishal Diwan
- Division of Environmental Monitoring and Exposure Assessment (Water and Soil), ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
| | - A. Stephen
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - K. Rekha Devi
- Enteric Disease Division, ICMR-Regional Medical Research Center, NE Region, Dibrugarh, Assam, India
| | - Bijaya Kumar Mishra
- Medical Department, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | | | - Sampada Dipak Bangar
- Division of Epidemiology and Biostatistics, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Damodar Sahu
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Jeetendra Yadav
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Senthanro Ovung
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | | | - Saurabh Sharma
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Charan Singh
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Chetna Duggal
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
| | - Moina Sharma
- Department of Environmental Health and Epidemiology, ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
| | - Dhammasagar Ujagare
- Division of Social and Behavioral Research, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Sneha Padmakar Chinchore
- Division of Social and Behavioral Research, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Pricilla B. Rebecca
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - S. Rani
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Pradeep Selvaraj
- Office of District Non-Communicable Disease, Directorate of Public Health and Preventive Medicine, Chennai, Tamil Nadu, India
| | | | - Vanessa Peter
- Information and Resource Center for the Deprived Urban Communities, Chennai, Tamil Nadu, India
| | - Basilea Watson
- Electronic Data Processing Unit (EDP), ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - T. Kannan
- Epidemiology Statistics Unit, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - Debdutta Bhattacharya
- Department of Microbiology, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Jyotirmayee Turuk
- Department of Microbiology, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Subrata Kumar Palo
- Department of Epidemiology, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Srikanta Kanungo
- Department of Epidemiology, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Ajit Kumar Behera
- Clinical Department, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | | | - Kamran Zaman
- ICMR-Regional Medical Research Center, Gorakhpur, Uttar Pradesh, India
| | - Brij Ranjan Misra
- ICMR-Regional Medical Research Center, Gorakhpur, Uttar Pradesh, India
| | - Niraj Kumar
- ICMR-Regional Medical Research Center, Gorakhpur, Uttar Pradesh, India
| | | | - Rajeev Singh
- ICMR-Regional Medical Research Center, Gorakhpur, Uttar Pradesh, India
| | - Kanwar Narain
- ICMR-Regional Medical Research Center, NE Region, Dibrugarh, Assam, India
| | - Rajni Kant
- ICMR-Regional Medical Research Center, Gorakhpur, Uttar Pradesh, India,Research Management, Policy, Planning and Coordination Cell, Indian Council of Medical Research, New Delhi, India
| | - Seema Sahay
- Division of Social and Behavioral Research, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Rajnarayan R. Tiwari
- ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
| | - Beena Elizabeth Thomas
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | |
Collapse
|
18
|
Mirji G, Worth A, Bhat SA, Sayed ME, Kannan T, Goldman AR, Tang HY, Liu Q, Auslander N, Dang CV, Abdel-Mohsen M, Kossenkov A, Stanger BZ, Shinde RS. The microbiome-derived metabolite TMAO drives immune activation and boosts responses to immune checkpoint blockade in pancreatic cancer. Sci Immunol 2022; 7:eabn0704. [PMID: 36083892 PMCID: PMC9925043 DOI: 10.1126/sciimmunol.abn0704] [Citation(s) in RCA: 74] [Impact Index Per Article: 37.0] [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] [Indexed: 01/12/2023]
Abstract
The composition of the gut microbiome can control innate and adaptive immunity and has emerged as a key regulator of tumor growth, especially in the context of immune checkpoint blockade (ICB) therapy. However, the underlying mechanisms for how the microbiome affects tumor growth remain unclear. Pancreatic ductal adenocarcinoma (PDAC) tends to be refractory to therapy, including ICB. Using a nontargeted, liquid chromatography-tandem mass spectrometry-based metabolomic screen, we identified the gut microbe-derived metabolite trimethylamine N-oxide (TMAO), which enhanced antitumor immunity to PDAC. Delivery of TMAO intraperitoneally or via a dietary choline supplement to orthotopic PDAC-bearing mice reduced tumor growth, associated with an immunostimulatory tumor-associated macrophage (TAM) phenotype, and activated effector T cell response in the tumor microenvironment. Mechanistically, TMAO potentiated the type I interferon (IFN) pathway and conferred antitumor effects in a type I IFN-dependent manner. Delivering TMAO-primed macrophages intravenously produced similar antitumor effects. Combining TMAO with ICB (anti-PD1 and/or anti-Tim3) in a mouse model of PDAC significantly reduced tumor burden and improved survival beyond TMAO or ICB alone. Last, the levels of bacteria containing CutC (an enzyme that generates trimethylamine, the TMAO precursor) correlated with long-term survival in patients with PDAC and improved response to anti-PD1 in patients with melanoma. Together, our study identifies the gut microbial metabolite TMAO as a driver of antitumor immunity and lays the groundwork for potential therapeutic strategies targeting TMAO.
Collapse
Affiliation(s)
- Gauri Mirji
- Immunology, Microenvironment & Metastasis Program, The Wistar Institute, Philadelphia, PA, USA
| | - Alison Worth
- Immunology, Microenvironment & Metastasis Program, The Wistar Institute, Philadelphia, PA, USA
| | - Sajad Ahmad Bhat
- Immunology, Microenvironment & Metastasis Program, The Wistar Institute, Philadelphia, PA, USA
| | - Mohamed El Sayed
- Immunology, Microenvironment & Metastasis Program, The Wistar Institute, Philadelphia, PA, USA
| | - Toshitha Kannan
- Bioinformatics Facility, The Wistar Institute, Philadelphia, PA, USA
| | - Aaron R Goldman
- Proteomics and Metabolomics Facility, The Wistar Institute, Philadelphia, PA, USA
| | - Hsin-Yao Tang
- Proteomics and Metabolomics Facility, The Wistar Institute, Philadelphia, PA, USA
| | - Qin Liu
- Molecular and Cellular Oncogenesis Program, The Wistar Institute, Philadelphia, PA, USA
| | - Noam Auslander
- Molecular and Cellular Oncogenesis Program, The Wistar Institute, Philadelphia, PA, USA
| | - Chi V Dang
- Molecular and Cellular Oncogenesis Program, The Wistar Institute, Philadelphia, PA, USA
- Ludwig Institute for Cancer Research, New York, NY USA
| | - Mohamed Abdel-Mohsen
- Immunology, Microenvironment & Metastasis Program, The Wistar Institute, Philadelphia, PA, USA
- Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, PA, USA
| | - Andrew Kossenkov
- Bioinformatics Facility, The Wistar Institute, Philadelphia, PA, USA
| | - Ben Z Stanger
- Abramson Family Cancer Research Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Cell & Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Institute for Regenerative Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rahul S Shinde
- Immunology, Microenvironment & Metastasis Program, The Wistar Institute, Philadelphia, PA, USA
| |
Collapse
|
19
|
Balaji S, Ravi Kumar D, Sangamithrai D, Radhika G, Kannan T, Nagarajan P, Thiagarajan V, RadhaKrishnan A, Padmapriyadarsini C, Shanmugam S. Comparison of performance indicators of MGIT primary culture to assess the impact of implementation of ISO 15189:2012 standards. Indian J Tuberc 2022; 69:371-373. [PMID: 35760491 DOI: 10.1016/j.ijtb.2022.03.020] [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: 02/11/2022] [Accepted: 03/25/2022] [Indexed: 06/15/2023]
Abstract
Performance indicators are key component and plays a major role for monitoring and continuous quality improvement of the test results. The NABL certificate of accreditation is issued in accordance with the standard ISO 15189:2012 requirements. As part of the accreditation process, the laboratory has acquired knowledge and implemented the quality system procedures. Present study analyzed the impact of the accreditation process on the "performance indicators" of MGIT primary culture and found that performance indicators have been improved significantly after implementation of NABL for almost all indicators which clearly indicate the importance of accreditation and implementation of quality procedures for reliability of valid test results.
Collapse
Affiliation(s)
- S Balaji
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - D Ravi Kumar
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Devi Sangamithrai
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - G Radhika
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - T Kannan
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - P Nagarajan
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - V Thiagarajan
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - A RadhaKrishnan
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | | | | |
Collapse
|
20
|
Murphy M, Leung J, Leu J, Indeglia A, Clarke N, Kannan T, Kirven N, Barnoud T, Kossenkov A, George DL. The genetics of tumor suppression by p53. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.0i212] [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: 11/11/2022]
Affiliation(s)
| | | | - Julia Leu
- University of PennsylvaniaPhiladelphiaPA
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Nair S, Joshi A, Aggarwal S, Adhikari T, Mahajan N, Diwan V, Stephen A, Devi KR, Mishra BK, Yadav GK, Kohli R, Sahu D, Gulati BK, Sharma S, Yadav J, Ovung S, Duggal C, Sharma M, Bangar SD, Andhalkar R, Rebecca PB, Rani S, Selvaraj P, Xavier GG, Peter V, Watson B, Kannan T, Md Asmathulla KS, Bhattacharya D, Turuk J, Palo SK, Kanungo S, Behera AK, Pandey AK, Zaman K, Misra BR, Kumar N, Behera SP, Singh R, Sarkar AH, Narain K, Kant R, Sahay S, Tiwari RR, Thomas BE, Panda S, Vardhana Rao MV. Development & validation of scales to assess stigma related to COVID-19 in India. Indian J Med Res 2022; 155:156-164. [PMID: 35859441 PMCID: PMC9552373 DOI: 10.4103/ijmr.ijmr_2455_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background & objectives COVID-19 pandemic has triggered social stigma towards individuals affected and their families. This study describes the process undertaken for the development and validation of scales to assess stigmatizing attitudes and experiences among COVID-19 and non-COVID-19 participants from the community. Methods COVID-19 Stigma Scale and Community COVID-19 Stigma Scale constituting 13 and six items, respectively, were developed based on review of literature and news reports, expert committee evaluation and participants' interviews through telephone for a multicentric study in India. For content validity, 61 (30 COVID-19-recovered and 31 non-COVID-19 participants from the community) were recruited. Test-retest reliability of the scales was assessed among 99 participants (41 COVID-19 recovered and 58 non-COVID-19). Participants were administered the scale at two-time points after a gap of 7-12 days. Cronbach's alpha, overall percentage agreement and kappa statistics were used to assess internal consistency and test-retest reliability. Results Items in the scales were relevant and comprehensible. Both the scales had Cronbach's α above 0.6 indicating moderate-to-good internal consistency. Test-retest reliability assessed using kappa statistics indicated that for the COVID-19 Stigma Scale, seven items had a moderate agreement (0.4-0.6). For the Community COVID-19 Stigma Scale, four items had a moderate agreement. Interpretation & conclusions Validity and reliability of the two stigma scales indicated that the scales were comprehensible and had moderate internal consistency. These scales could be used to assess COVID-19 stigma and help in the development of appropriate stigma reduction interventions for COVID-19 infected, and mitigation of stigmatizing attitudes in the community.
Collapse
Affiliation(s)
- Saritha Nair
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Aparna Joshi
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
| | - Sumit Aggarwal
- Division of Epidemiology & Communicable Diseases, Planning and Coordination Cell, Indian Council of Medical Research, New Delhi, India
| | - Tulsi Adhikari
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Nupur Mahajan
- Division of Epidemiology & Communicable Diseases, Planning and Coordination Cell, Indian Council of Medical Research, New Delhi, India
| | - Vishal Diwan
- Division of Environmental Monitoring & Exposure Assessment (Water & Soil), ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
| | - A Stephen
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - K Rekha Devi
- Divison of Enteric Disease, ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, Assam, India
| | - Bijaya Kumar Mishra
- Department of Medical, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Rewa Kohli
- Division of Social & Behavioral Research, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Damodar Sahu
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | | | - Saurabh Sharma
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Jeetendra Yadav
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Senthanro Ovung
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Chetna Duggal
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
| | - Moina Sharma
- Department of Environmental Health & Epidemiology, ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
| | - Sampada Dipak Bangar
- Division of Epidemiology and Statistics, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Rushikesh Andhalkar
- Division of Epidemiology and Statistics, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Pricilla B Rebecca
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - S Rani
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Pradeep Selvaraj
- Office of District Non-Communicable Disease, Directorate of Public Health and Preventive Medicine, Loyala College, Chennai, Tamil Nadu, India
| | - Gladston G Xavier
- Department of Social Work, Loyala College, Chennai, Tamil Nadu, India
| | - Vanessa Peter
- Informational & Resource Centre for the Deprived Urban Communities, Chennai, Tamil Nadu, India
| | - Basilea Watson
- Electronic Data Processing Unit, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - T Kannan
- Epidemiology and Statistics Unit, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - K S Md Asmathulla
- Integrated People Development Project Trust, Krishnagiri, Tamil Nadu, India
| | - Debdutta Bhattacharya
- Department of Microbiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Jyotirmayee Turuk
- Department of Microbiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Subrata Kumar Palo
- Department of Epidemiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Srikanta Kanungo
- Department of Epidemiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Ajit Kumar Behera
- Department of Clinical, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Kamran Zaman
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - Brij Ranjan Misra
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - Niraj Kumar
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | | | - Rajeev Singh
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - Abu Hasan Sarkar
- Divison of Enteric Disease, ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, Assam, India
| | - Kanwar Narain
- ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, Assam, India
| | - Rajni Kant
- Research Management, Policy, Planning and Coordination Cell, Indian Council of Medical Research, New Delhi; ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - Seema Sahay
- Division of Social & Behavioral Research, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | | | - Beena Elizabeth Thomas
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Samiran Panda
- Division of Epidemiology & Communicable Diseases, Planning and Coordination Cell, Indian Council of Medical Research, New Delhi, India
| | | |
Collapse
|
22
|
Gomathi NS, Singh M, Singh UB, Myneedu VP, Chauhan DS, Sarin R, Mohan A, Bhatnagar A, Khangembam JS, Kannan T, Rao MVV, Logani J, Dey B, Gangakhedkar RR, Swaminathan S, Tripathy S. Multicentric validation of indigenous molecular test Truenat™ MTB for detection of Mycobacterium tuberculosis in sputum samples from presumptive pulmonary tuberculosis patients in comparison with reference standards. Indian J Med Res 2021; 152:378-385. [PMID: 33380702 PMCID: PMC8061602 DOI: 10.4103/ijmr.ijmr_2539_19] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background & objectives: Early case detection is essential to interrupt transmission and to prevent further spread of tuberculosis (TB) in high endemic settings. Nucleic acid amplification tests (NAATs) with visual read-outs are ideal as point-of-care tests. Truenat™ MTB is an indigenous chip-based NAAT for detection of Mycobacterium tuberculosis, which involves extraction of DNA and real-time polymerase chain reaction (PCR) using portable, automated, battery-operated instruments. The current multicentric study was aimed to evaluate Truenat for detection of MTB in sputum samples obtained from patients with presumptive pulmonary TB with reference to culture as gold standard and Xpert as a comparator. Methods: The study was conducted at four sites, namely ICMR-National Institute for Research in Tuberculosis, Chennai; All India Institute of Medical Sciences, New Delhi; ICMR-National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra; and National Institute of TB and Respiratory Diseases, New Delhi. Patients suspected to have TB were screened for eligibility. Two sputum samples were collected from each patient. Tests included smear, Xpert and Truenat directly from the sputum sample and culture by Lowenstein-Jensen (L-J) medium and MGIT960 from decontaminated pellets. Sample used for Truenat assay was coded. Resolution of Truenat false positives was done using an in-house PCR with TRC4 primers. Results: The study enrolled 2419 presumptive TB patients after screening 2465 patients, and 3541 sputum samples were collected from the enrolled patients. Results of 2623 samples were available for analysis. Truenat showed a positivity rate of 48.5 per cent as compared to 37.0 per cent by Xpert. The sensitivities of Truenat and Xpert were was 88.3 and 79.7 per cent, respectively in comparison with culture. Interpretation & conclusions: Truenat MTB identified more positives among culture-confirmed samples than Xpert and had higher sensitivity. In addition, other advantageous operational features of Truenat MTB were identified which would be useful in field settings.
Collapse
Affiliation(s)
- N S Gomathi
- Department of Bacteriology, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Manjula Singh
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Urvashi B Singh
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - V P Myneedu
- Department of Microbiology, National Institute of Tuberculosis & Other Respiratory Diseases, New Delhi, India
| | - D S Chauhan
- Department of Microbiology & Molecular Biology, ICMR-National JALMA Institute of Leprosy & Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
| | - Rohit Sarin
- National Institute of Tuberculosis & Other Respiratory Diseases, New Delhi, India
| | - Anant Mohan
- Department of Pulmonary Medicine & Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Anuj Bhatnagar
- Department of Chest & TB, National Institute of Tuberculosis & Other Respiratory Diseases, New Delhi, India
| | - Jiten Singh Khangembam
- Department of Pulmonary Medicine & Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - T Kannan
- Statistics Section, Epidemiology Unit, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - M V V Rao
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Jyoti Logani
- Department of Biotechnology, Ministry of Science & Technology, Government of India, New Delhi, India
| | - Bindu Dey
- Department of Biotechnology, Ministry of Science & Technology, Government of India, New Delhi, India
| | - Raman R Gangakhedkar
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | | | - Srikanth Tripathy
- ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| |
Collapse
|
23
|
Gomathi NS, Singh M, Myneedu VP, Chauhan DS, Tripathy S, Sarin R, Mohan A, Bhatnagar A, Khangembam JS, Kannan T, V Rao MV, Logani J, Dey B, Gangakhedkar RR, Swaminathan S, Singh UB. Validation of an indigenous assay for rapid molecular detection of rifampicin resistance in presumptive multidrug-resistant pulmonary tuberculosis patients. Indian J Med Res 2021; 152:482-489. [PMID: 33707390 PMCID: PMC8157890 DOI: 10.4103/ijmr.ijmr_2557_19] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background & objectives: There is a need for an affordable, easy, high-sensitivity test usable at the peripheral health facility for diagnosis of drug-resistant (DR) tuberculosis (TB) to interrupt disease transmission. Nucleic acid amplification tests (NAATs) for early detection of DR-TB are ideal to bring testing near to the patient. Truenat™ MTB (Mycobacterium tuberculosis) and Truenat™ MTB-RIF (rifampicin) is an indigenous chip-based real-time polymerase chain reaction (PCR) based test for detection of multidrug-resistant (MDR) TB. The test involves extraction of DNA using automated, battery operated Trueprep instrument and real-time PCR performed on the Truelab analyzer. We report here multicentric validation of Truenat MTB-RIF for detection of DR-TB in suspected DR-TB patients. Methods: Consecutive patients aged 18-65 yr, with symptoms suggestive of TB and with a history of previous treatment, reporting to the National TB Elimination Programme (NTEP) clinics under four national institutes, namely AIIMS (All India Institute of Medical Sciences, New Delhi), NITRD (National Institute of Tuberculosis and Respiratory Diseases, New Delhi), NIRT (National Institute for Research in Tuberculosis, Chennai) and ICMR-National JALMA Institute for Leprosy and other Mycobacterial Diseases, Agra, were included in the study. Two sputum samples (one spot and one morning) were collected from each patient, after obtaining informed written consent. The samples were subjected to smear, GeneXpert and MGIT 960 culture (and drug susceptibility testing to RIF) (surrogate for MDR-TB) to serve as reference tests. The samples were coded to ensure blinding and subjected to Truenat MTB-RIF. Truenat MTB-RIF Version 1.5 was used for testing 1084 samples for RIF resistance, while Version 2.0 was used to test another 1201 samples. Results: Truenat MTB-RIF Version 1.5 in comparison with comprehensive laboratory reference standards yielded sensitivity and specificity of 76.2 and 94.7 per cent, respectively for the detection of RIF resistance in 1084 samples, collected across four sites. Based on the analysis of discordant samples, Version 2.0 of Truenat was developed by the manufacturer and this was further tested on additional 1201 samples, yielding a sensitivity of 87.5 per cent and specificity of 99.5 per cent. Interpretation & conclusions: Multicentric trial of Truenat™ MTB-RIF demonstrated a great potential of this point of care NAAT for detection of MDR-TB. The test would be useful in limited resource settings and inaccessible areas without need for any additional infrastructure.
Collapse
Affiliation(s)
- N S Gomathi
- Department of Bacteriology, Epidemiology Unit, Chennai, Tamil Nadu, India
| | - Manjula Singh
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - V P Myneedu
- Department of Microbiology, National Institute of Tuberculosis & Other Respiratory Diseases, New Delhi, India
| | - D S Chauhan
- Department of Microbiology & Molecular Biology, ICMR-National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
| | - Srikanth Tripathy
- ICMR-National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Rohit Sarin
- National Institute of Tuberculosis & Other Respiratory Diseases, New Delhi, India
| | - Anant Mohan
- Department of Pulmonary Medicine & Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Anuj Bhatnagar
- Department of Chest & TB, Rajan Babu Institute of Pulmonary Medicine and Tuberculosis, New Delhi, India
| | | | - T Kannan
- Statistics Section, Epidemiology Unit, ICMR-National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - M V V Rao
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Jyoti Logani
- Department of Biotechnology, Ministry of Science & Technology, New Delhi, India
| | - Bindu Dey
- Department of Biotechnology, Ministry of Science & Technology, New Delhi, India
| | - R R Gangakhedkar
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | | | - Urvashi B Singh
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
24
|
Dolla CK, Padma Priyadarshini C, Bhavani PK, Kannan T, Kumaravel P, Devika K. Roaming homeless persons, India-Pulmonary tuberculosis. Indian J Tuberc 2021; 68:279-280. [PMID: 33845965 DOI: 10.1016/j.ijtb.2020.08.013] [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] [Received: 05/31/2020] [Accepted: 08/21/2020] [Indexed: 10/23/2022]
Affiliation(s)
| | | | | | - T Kannan
- Statistics Dept, ICMR-NIRT, India
| | | | - K Devika
- Bacteriology Dept, ICMR-NIRT, India
| |
Collapse
|
25
|
Gangadhar K, Edukondala Nayak R, Venkata Subba Rao M, Kannan T. Nodal/Saddle Stagnation Point Slip Flow of an Aqueous Convectional Magnesium Oxide–Gold Hybrid Nanofluid with Viscous Dissipation. Arab J Sci Eng 2021. [DOI: 10.1007/s13369-020-05195-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
26
|
Gangadhar K, Bhanu Lakshmi K, Kannan T, Chamkha AJ. Entropy Generation in Magnetized Bioconvective Nanofluid Flow Along a Vertical Cylinder with Gyrotactic Microorganisms. j nanofluids 2020. [DOI: 10.1166/jon.2020.1758] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This paper presents the analysis of thermal optimization in magnetic materials based on the entropy generation in a mixed convective MHD flow of an electrically conductive nano liquid having motile microorganisms together with a vertical cylinder. By using the convection boundary condition,
the process of heat transport is examined in detail. With coupled linear boundary conditions the related equations (continuity, momentuum and energy) are reduced to five ODE’s. The RKF-4,5 method by shooting algorithm was employed to examine variation of physical parameters under study.
The resuts of vital physical parameters on the wall friction, Nusselt number, mass flux, wall of motile microorganism flux, along with velocity profiles, temperature, concentration of nanopar-ticles, and density of motile microbes, were studied in detail. It is detected that heat transport
rate is 0.81% greater for cylindrical surface compared to flat plate surface.
Collapse
Affiliation(s)
- K. Gangadhar
- Department of Mathematics, Acharya Nagarjuna University Campus, Ongole 523001, Andhra Pradesh, India
| | - K. Bhanu Lakshmi
- Department of Mathematics, Lakireddy Balireddy College of Engineering, L.B. Reddy Nagar, Mylavaram 521230, Andhra Pradesh, India
| | - T. Kannan
- Department of Mathematics, School of Humanities and Sciences, SASTRA Deemed University, Thanjavur 613401, TN, India
| | - Ali J. Chamkha
- Faculty of Engineering, Kuwait College of Science and Engineering, Doha District, 35004, Kuwait
| |
Collapse
|
27
|
Richard K, Schonhofer C, Giron LB, Rivera-Ortiz J, Read S, Kannan T, Kinloch NN, Shahid A, Feilcke R, Wappler S, Imming P, Harris M, Brumme ZL, Brockman MA, Mounzer K, Kossenkov AV, Abdel-Mohsen M, Andrae-Marobela K, Montaner LJ, Tietjen I. The African natural product knipholone anthrone and its analogue anthralin (dithranol) enhance HIV-1 latency reversal. J Biol Chem 2020; 295:14084-14099. [PMID: 32788215 DOI: 10.1074/jbc.ra120.013031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 02/12/2020] [Revised: 08/06/2020] [Indexed: 12/12/2022] Open
Abstract
A sterilizing or functional cure for HIV is currently precluded by resting CD4+ T cells that harbor latent but replication-competent provirus. The "shock-and-kill" pharmacological ap-proach aims to reactivate provirus expression in the presence of antiretroviral therapy and target virus-expressing cells for elimination. However, no latency reversal agent (LRA) to date effectively clears viral reservoirs in humans, suggesting a need for new LRAs and LRA combinations. Here, we screened 216 compounds from the pan-African Natural Product Library and identified knipholone anthrone (KA) and its basic building block anthralin (dithranol) as novel LRAs that reverse viral latency at low micromolar concentrations in multiple cell lines. Neither agent's activity depends on protein kinase C; nor do they inhibit class I/II histone deacetylases. However, they are differentially modulated by oxidative stress and metal ions and induce distinct patterns of global gene expression from established LRAs. When applied in combination, both KA and anthralin synergize with LRAs representing multiple functional classes. Finally, KA induces both HIV RNA and protein in primary cells from HIV-infected donors. Taken together, we describe two novel LRAs that enhance the activities of multiple "shock-and-kill" agents, which in turn may inform ongoing LRA combination therapy efforts.
Collapse
Affiliation(s)
- Khumoekae Richard
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Cole Schonhofer
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | | | | | - Silven Read
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | | | - Natalie N Kinloch
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.,British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Aniqa Shahid
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.,British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Ruth Feilcke
- Institut für Pharmazie, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Simone Wappler
- Institut für Pharmazie, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Peter Imming
- Institut für Pharmazie, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Marianne Harris
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Zabrina L Brumme
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.,British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Mark A Brockman
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.,British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.,Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Karam Mounzer
- Jonathan Lax Immune Disorders Treatment Center, Philadelphia Field Initiating Group for HIV-1 Trials, Philadelphia, Pennsylvania, USA
| | | | | | | | | | - Ian Tietjen
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada .,Wistar Institute, Philadelphia, Pennsylvania, USA
| |
Collapse
|
28
|
Shah I, Kumar Das S, Shetty NS, Kannan T, Ramachandran G, Kumar AH. Pharmacokinetics of isoniazid in children with tuberculosis-A comparative study at two doses. Pediatr Pulmonol 2020; 55:660-665. [PMID: 31909887 DOI: 10.1002/ppul.24624] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/22/2019] [Indexed: 11/06/2022]
Abstract
AIM To compare the pharmacokinetics of isoniazid (INH) at doses 5 and 10 mg/kg/day. METHODS INH concentrations were estimated by high-performance liquid chromatography in 24 Indian children aged 1 to 15 years on antituberculosis therapy. Blood samples were collected at 0, 2, 4, 6, 8 hours after administration of INH. Patients were randomly given INH at 5 or 10 mg/kg/day and maximum concentrations (Cmax ) and area under the curve (AUC(0-8) ) were determined in each group. The 2-hour concentration of INH was used as Cmax for this study. RESULTS Mean (standard deviation) Cmax was reached in 2 hours and was 2.68 ± 1.19 µg/mL in 5 mg/kg/day group and 8.86 ± 3.94 µg/mL in 10 mg/kg/day group (P < .05). The normal therapeutic range at 2-hour concentrations for INH in adults achieving good clinical response is between 3 and 5 µg/mL. Among 5 mg/kg/day, only 4 (33%) patients had INH concentrations within the 2-hour concentrations therapeutic range whereas in 10 mg/kg/day group, 11 (91%) patients achieved Cmax higher than the 2-hour concentrations therapeutic range and 1 (9%) patient had Cmax within the 2-hour concentrations therapeutic range. The mean AUC(0-8) in 5 mg/kg/day group was 10.04 ± 6.12 and 35.93 ± 25.37 µg·h/mL in 10 mg/kg/day group (P = .0001). CONCLUSION Children on daily INH 10 mg/kg/day have higher AUC and Cmax than the required therapeutic range whereas over 65% of children with daily 5 mg/kg/day INH therapy failed to achieve the optimal therapeutic range.
Collapse
Affiliation(s)
- Ira Shah
- Pediatric TB Clinic, Department of Pediatric Infectious Diseases, B J Wadia Hospital for Children, Mumbai, India
| | - Sajal Kumar Das
- Pediatric TB Clinic, Department of Pediatric Infectious Diseases, B J Wadia Hospital for Children, Mumbai, India
| | - Naman S Shetty
- Pediatric TB Clinic, Department of Pediatric Infectious Diseases, B J Wadia Hospital for Children, Mumbai, India
| | - T Kannan
- Department of Clinical Pharmacology, National Institute for Research in Tuberculosis, Chennai, India
| | - Geetha Ramachandran
- Department of Clinical Pharmacology, National Institute for Research in Tuberculosis, Chennai, India
| | - Ak Hemanth Kumar
- Department of Clinical Pharmacology, National Institute for Research in Tuberculosis, Chennai, India
| |
Collapse
|
29
|
Muniyandi M, Karikalan N, Kannan T, Saravanan B, Vidhya P, Rajendran K. TB diagnostic cascade among patients registered under the Revised National TB Control Programme in Chennai, South India. Trop Med Int Health 2020; 25:612-617. [PMID: 32034975 DOI: 10.1111/tmi.13380] [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] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To discern and quantify the TB diagnostic cascade among patients registered under the Revised National TB Control Programme, Chennai city, Tamil Nadu, South India. METHODS This cross-sectional study was conducted in metropolitan Chennai from February 2017 to March 2018. We interviewed TB patients retrospectively on their diagnostic attempt in different health facilities. RESULTS Of 455 TB patients, only 4.4% received their diagnosis at their first health facility. Of 1250 visits to health facilities, the vast majority (79.4 vs. 20.6%) was in the public rather than the private sector. 56% of patients went to a public facility as the first point of care, of whom 1.6% shifted to private facilities subsequently. The remaining 54.4% shifted between up to five government health facilities. Male patients and those with a higher family income were more likely to shift from private to public. CONCLUSION Most shifts between diagnostic facilities occurred in the public sector. This necessitates interventions at public health facilities for strengthening and extending services to TB patients at their first point of care.
Collapse
Affiliation(s)
- M Muniyandi
- Department of Health Economics, Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - N Karikalan
- Department of Health Economics, Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - T Kannan
- Department of Statistics, Epidemiology Unit, Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - B Saravanan
- Department of Health Economics, Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - P Vidhya
- Department of Health Economics, Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - K Rajendran
- Department of Statistics, Epidemiology Unit, Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| |
Collapse
|
30
|
Geriki S, Bitla AR, SrinivasaRao PVLN, Hulikal N, Yootla M, Sachan A, Amancharla Yadagiri L, Asha T, Manickavasagam M, Kannan T, Kumari AP. Association of single nucleotide polymorphisms of adiponectin and leptin genes with breast cancer. Mol Biol Rep 2019; 46:6287-6297. [PMID: 31538300 DOI: 10.1007/s11033-019-05070-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 01/18/2019] [Accepted: 09/10/2019] [Indexed: 01/26/2023]
Abstract
Single nucleotide polymorphisms (SNPs) in adiponectin gene [rs1501299 (+276G/T) and rs266729 (-11377C/G)] and one SNP of leptin gene [rs7799039 (-2548G/A)] are known to influence plasma levels of adiponectin and leptin respectively. Literature is scarce on the association of adiponectin gene polymorphism rs266729 with breast cancer. The present study was taken up to study these polymorphisms and their association with breast cancer. Ninety-three patients diagnosed with malignant breast cancer were included as cases along with 186 age matched healthy controls. Adiponectin +276G/T, -11377C/G and leptin -2548G/A polymorphism were studied using polymerase chain reaction (PCR) based restriction fragment length polymorphism (RFLP). Adipokine levels in blood were measured using enzyme linked immunosorbent assay. Adiponectin +276G/T and leptin -2548G/A showed a significant increased risk for breast cancer even after adjusting for confounding variables like present age, age at menarche, age at first child birth and age at menopause. In the subset analysis, based on menopausal state, stronger association was observed between SNP in adiponectin gene +276G/T with the breast cancer in post-menopausal women after adjusting for all other variables. No association was found with adiponectin -11377C/G. No association of the gene polymorphisms with adipokine levels was observed. Also, no significant association was seen for the effect of gene-environment interaction i.e. presence of polymorphism with obesity and menopausal state for any of the SNPs studied. Adiponectin +276G/T is strongly associated with breast cancer in postmenopausal women while leptin -2548G/A polymorphisms is significantly associated with breast cancer irrespective of the menopausal state in south Indian subjects.
Collapse
Affiliation(s)
- Sarvari Geriki
- Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | - Aparna R Bitla
- Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences, Tirupati, India.
| | - P V L N SrinivasaRao
- Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | - Narendra Hulikal
- Department of Surgical Oncology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | - Mutheeswaraiah Yootla
- Department of Surgery, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | - Alok Sachan
- Department of Endocrinology and Metabolism, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | | | - T Asha
- Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | - M Manickavasagam
- Department of Medical Oncology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | - T Kannan
- Department of Medical Oncology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | - Aruna P Kumari
- Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| |
Collapse
|
31
|
Kumar AKH, Chandrasekaran V, Kannan T, Lavanya J, Swaminathan S, Ramachandran G. Intrapatient variability in plasma rifampicin & isoniazid in tuberculosis patients. Indian J Med Res 2018; 147:287-292. [PMID: 29923518 PMCID: PMC6022390 DOI: 10.4103/ijmr.ijmr_1961_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background & objectives: Large variability in anti-tuberculosis (TB) drug concentrations between patients is known to exist. However, limited information is available on intrapatient drug levels during the course of anti-TB treatment (ATT). This study was conducted to evaluate intrapatient variability in plasma rifampicin (RMP) and isoniazid (INH) concentrations during ATT at start of the treatment, at the end of intensive phase (IP) of ATT and at the end of ATT in adult TB patients being treated in the Revised National TB Control Programme (RNTCP). Methods: Adult TB patients (n=485), receiving thrice-weekly ATT in the RNTCP, were studied. Two-hour post-dosing concentrations of RMP and INH were determined at month 1, end of IP and end of ATT, after directly observed drug administration. Drug concentrations were estimated by high-performance liquid chromatography. Results: The median (inter-quartile range) RMP concentrations during the first month, at end of IP and end of ATT were 2.1 (0.4-5.0), 2.4 (0.6-5.5) and 2.2 (0.5-5.3) μg/ml, respectively. The corresponding INH concentrations were 7.1 (4.2-9.9), 7.2 (3.9-10.9) and 6.7 (3.9-9.5) μg/ml. None of the differences in drug concentrations obtained at different time points during ATT were significant. RMP and INH concentrations at different time points were significantly correlated. Age and body mass index caused significant variability in drug concentrations. Interpretation & conclusions: Plasma RMP and INH estimations in adult TB patients at two hours after drug administration remained unaltered during ATT. Clinicians can consider testing drug concentrations at any time point during ATT. These findings may assume significance in the context of therapeutic drug monitoring of anti-TB drug concentrations.
Collapse
Affiliation(s)
- A K Hemanth Kumar
- Department of Biochemistry & Clinical Pharmacology; ICMR-National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - V Chandrasekaran
- Department of Biochemistry & Clinical Pharmacology; ICMR-National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - T Kannan
- Department of Biochemistry & Clinical Pharmacology; ICMR-National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - J Lavanya
- District TB Officer, Chennai Corporation, Chennai, India
| | - Soumya Swaminathan
- ICMR-National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Geetha Ramachandran
- Department of Biochemistry & Clinical Pharmacology; ICMR-National Institute for Research in Tuberculosis (NIRT), Chennai, India
| |
Collapse
|
32
|
Hemanth Kumar AK, Ramesh K, Kannan T, Sudha V, Haribabu H, Lavanya J, Swaminathan S, Ramachandran G. N-acetyltransferase gene polymorphisms & plasma isoniazid concentrations in patients with tuberculosis. Indian J Med Res 2018; 145:118-123. [PMID: 28574024 PMCID: PMC5460557 DOI: 10.4103/ijmr.ijmr_2013_15] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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] [Indexed: 12/18/2022] Open
Abstract
Background & objectives: Variations in the N-acetyltransferase (NAT2) gene among different populations could affect the metabolism and disposition of isoniazid (INH). This study was performed to genotype NAT2 gene polymorphisms in tuberculosis (TB) patients from Chennai, India, and compare plasma INH concentrations among the different genotypes. Methods: Adult patients with TB treated in the Revised National TB Control Programme (RNTCP) in Chennai, Tamil Nadu, were genotyped for NAT2 gene polymorphism, and two-hour post-dosing INH concentrations were compared between the different genotypes. Plasma INH was determined by high-performance liquid chromatography. Genotyping of the NAT2 gene polymorphism was performed by real-time polymerase chain reaction method. Results: Among the 326 patients genotyped, there were 189 (58%), 114 (35%) and 23 (7%) slow, intermediate and fast acetylators, respectively. The median two-hour INH concentrations in slow, intermediate and fast acetylators were 10.2, 8.1 and 4.1 μg/ml, respectively. The differences in INH concentrations among the three genotypes were significant (P<0.001). Interpretation & conclusions: Genotyping of TB patients from south India for NAT2 gene polymorphism revealed that 58 per cent of the study population comprised slow acetylators. Two-hour INH concentrations differed significantly among the three genotypes.
Collapse
Affiliation(s)
- A K Hemanth Kumar
- Department of Biochemistry & Clinical Pharmacology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - K Ramesh
- HIV/AIDS Division, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - T Kannan
- Department of Statistics, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - V Sudha
- Department of Biochemistry & Clinical Pharmacology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Hemalatha Haribabu
- HIV/AIDS Division, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - J Lavanya
- District TB Officer, Chennai Corporation, Chennai, India
| | | | - Geetha Ramachandran
- Department of Biochemistry & Clinical Pharmacology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| |
Collapse
|
33
|
Velayutham B, Nair D, Kannan T, Padmapriyadarsini C, Sachdeva KS, Bency J, Klinton JS, Haldar S, Khanna A, Jayasankar S, Swaminathan S. Factors associated with sputum culture conversion in multidrug-resistant pulmonary tuberculosis. Int J Tuberc Lung Dis 2018; 20:1671-1676. [PMID: 27931345 DOI: 10.5588/ijtld.16.0096] [Citation(s) in RCA: 15] [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] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Sputum culture conversion in pulmonary multidrug-resistant tuberculosis (MDR-TB) is important to make treatment-related decisions and prevent transmission of disease. OBJECTIVE To identify factors associated with sputum culture conversion, and to determine time to culture conversion and the impact of culture conversion on successful treatment outcomes in MDR-/rifampicin (RMP) resistant TB. METHOD Retrospective analysis of data from treatment cards and registers of MDR-/RMP-resistant patients initiated on treatment under India's Revised National TB Control Programme in Delhi, West Bengal and Kerala from January 2009 to December 2011. Proportions were calculated and logistic regression analysis was performed. RESULTS Of 836 patients, 787 were analysed, 651 (83%) of whom experienced culture conversion: respectively 57%, 73% and 79% culture converted by month 3, 4 and 6 of treatment. The median time to culture conversion was 91.3 days. Patients with body mass index (BMI) 16 kg/m2 (OR 0.403, P = 0.001) and 1618 kg/m2 (OR 0.519, P = 0.039) were less likely to have culture conversion. High rates of culture conversion were observed in patients with successful treatment outcomes compared to those without treatment success (462/469, 99% vs. 183/311, 59%; P 0.0001). CONCLUSION Low BMI is associated with poor sputum culture conversion in MDR-/RMP-resistant TB patients. Lack of culture conversion can impact successful treatment outcomes.
Collapse
Affiliation(s)
- B Velayutham
- National Institute for Research in Tuberculosis, Chennai
| | - D Nair
- National Institute for Research in Tuberculosis, Chennai
| | - T Kannan
- National Institute for Research in Tuberculosis, Chennai
| | | | - K S Sachdeva
- Central TB Division, Ministry of Health and Family Welfare, New Delhi
| | - J Bency
- National Institute for Research in Tuberculosis, Chennai
| | - J S Klinton
- National Institute for Research in Tuberculosis, Chennai
| | - S Haldar
- State TB Cell-West Bengal, Central TB Division, Kolkata
| | - A Khanna
- State TB Cell-Delhi, Central TB Division, New Delhi
| | - S Jayasankar
- State TB Cell-Kerala, Central TB Division, Thiruvananthapuram
| | - S Swaminathan
- Indian Council of Medical Research, New Delhi, India
| |
Collapse
|
34
|
Hemanth Kumar AK, Kannan T, Chandrasekaran V, Sudha V, Vijayakumar A, Ramesh K, Lavanya J, Swaminathan S, Ramachandran G. Pharmacokinetics of thrice-weekly rifampicin, isoniazid and pyrazinamide in adult tuberculosis patients in India. Int J Tuberc Lung Dis 2018; 20:1236-41. [PMID: 27510252 DOI: 10.5588/ijtld.16.0048] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To study the pharmacokinetics of rifampicin (RMP), isoniazid (INH) and pyrazinamide (PZA) in adult tuberculosis (TB) patients and examine factors that influence drug pharmacokinetics. METHODS Adult TB patients (n = 101) receiving thrice-weekly anti-tuberculosis treatment in the Revised National TB Control Programme (RNTCP) were studied. The study was conducted at steady state after directly observed drug administration. RMP, INH and PZA concentrations were estimated using high-performance liquid chromatography and NAT2 genotyping by real-time polymerase chain reaction. RESULTS RMP peak concentration (Cmax) was sub-therapeutic (<8 μg/ml) in 88% of the patients. The Cmax of RMP, INH and PZA at 2 h was observed in respectively 83.2%, 97.0% and 92.1% of the patients. The Cmax and area under the curve from 0 to 8 h (AUC0-8) of PZA was lower in TB patients with diabetes mellitus than in non-diabetics. Significant associations were observed between the Cmax and the AUC0-8 of RMP, INH and PZA with drug doses; RMP with category of treatment; INH with smoking, body mass index and N-acetyl transferase 2 genotype; and PZA with sex and smoking. CONCLUSIONS Several risk factors for drug concentration variations were identified. Two-hour post-dosing drug concentrations mimicked Cmax. A high proportion of TB patients had RMP Cmax below the expected range, which is a matter of concern.
Collapse
Affiliation(s)
| | - T Kannan
- National Institute for Research in Tuberculosis, Chennai, India
| | | | - V Sudha
- National Institute for Research in Tuberculosis, Chennai, India
| | - A Vijayakumar
- National Institute for Research in Tuberculosis, Chennai, India
| | - K Ramesh
- National Institute for Research in Tuberculosis, Chennai
| | | | - S Swaminathan
- National Institute for Research in Tuberculosis, Chennai, India
| | - G Ramachandran
- National Institute for Research in Tuberculosis, Chennai, India
| |
Collapse
|
35
|
Nammalwar P, Narasimhan V, Kannan T, Morapakala S. Non-invasive Glaucoma Screening Using Ocular Thermal Image Classification. CIT 2017. [DOI: 10.20532/cit.2017.1003412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
36
|
Ragunath S, Velmurugan C, Kannan T. Optimization of tribological behavior of nano clay particle with sisal/jute/glass/epoxy polymer hybrid composites using RSM. POLYM ADVAN TECHNOL 2017. [DOI: 10.1002/pat.4066] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- S. Ragunath
- Mechanical Engineering; SVS College of Engineering; Myleripalayam via Coimbatore Tamil Nadu India
| | - C. Velmurugan
- Mechanical Engineering; Kumaraguru College of Technology; Coimbatore Tamil Nadu India
| | - T. Kannan
- Mechanical Engineering; SVS College of Engineering; Myleripalayam via Coimbatore Tamil Nadu India
| |
Collapse
|
37
|
Nair D, Velayutham B, Kannan T, Tripathy JP, Harries AD, Natrajan M, Swaminathan S. Predictors of unfavourable treatment outcome in patients with multidrug-resistant tuberculosis in India. Public Health Action 2017; 7:32-38. [PMID: 28775941 DOI: 10.5588/pha.16.0055] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [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: 07/24/2016] [Accepted: 11/13/2016] [Indexed: 11/10/2022] Open
Abstract
Setting: India has one of the highest global rates of multidrug-resistant tuberculosis (MDR-TB), which is associated with poor treatment outcomes. A better understanding of the risk factors for unfavourable outcomes is needed. Objectives: To describe 1) the demographic and clinical characteristics of MDR-TB patients registered in three states of India during 2009-2011, 2) treatment outcomes, and 3) factors associated with unfavourable outcomes. Design: A retrospective cohort study involving a record review of registered MDR-TB patients. Results: Of 788 patients, 68% were male, 70% were aged 15-44 years, 90% had failed previous anti-tuberculosis treatment or were retreatment smear-positive, 60% had a body mass index < 18.5 kg/m2 and 72% had additional resistance to streptomycin and/or ethambutol. The median time from sputum collection to the start of MDR-TB treatment was 128 days (IQR 103-173). Unfavourable outcomes occurred in 40% of the patients, mostly from death or loss to follow-up. Factors significantly associated with unfavourable outcomes included male sex, age ⩾ 45 years, being underweight and infection with the human immunodeficiency virus. Adverse drug reactions were reported in 24% of patients, with gastrointestinal disturbance, psychiatric morbidity and ototoxicity the most common. Conclusion: Long delays from sputum collection to treatment initiation using conventional methods, along with poor treatment outcomes, suggest the need to scale up rapid diagnostic tests and shorter regimens for MDR-TB.
Collapse
Affiliation(s)
- D Nair
- Department of Clinical Research, National Institute for Research in Tuberculosis, Chennai, India
| | - B Velayutham
- Department of Clinical Research, National Institute for Research in Tuberculosis, Chennai, India
| | - T Kannan
- Department of Clinical Research, National Institute for Research in Tuberculosis, Chennai, India
| | - J P Tripathy
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India
| | - A D Harries
- The Union, Paris, France.,London School of Hygiene & Tropical Medicine, London, UK
| | - M Natrajan
- Department of Clinical Research, National Institute for Research in Tuberculosis, Chennai, India
| | - S Swaminathan
- Indian Council of Medical Research, New Delhi, India
| |
Collapse
|
38
|
Ramesh K, Hemanth Kumar AK, Kannan T, Vijayalakshmi R, Sudha V, Manohar Nesakumar S, Bharathiraja T, Lavanya J, Swaminathan S, Ramachandran G. SLCO1B1 gene polymorphisms do not influence plasma rifampicin concentrations in a South Indian population. Int J Tuberc Lung Dis 2016; 20:1231-5. [DOI: 10.5588/ijtld.15.1007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
39
|
Vaitheeswaran K, Subbiah M, Ramakrishnan R, Kannan T. A comparison of ordinal logistic regression models using Classical and Bayesian approaches in an analysis of factors associated with diabetic retinopathy. J Appl Stat 2016. [DOI: 10.1080/02664763.2016.1140725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- K. Vaitheeswaran
- Manonmaniam Sundaranar University, Tirunelvelli, Tamil Nadu, India
- National Center for Disease Informatics and Research (ICMR), Bangalore, Karnataka, India
| | - M. Subbiah
- Department of Mathematics, L.N Government College, Ponneri, Tamil Nadu, India
| | - R. Ramakrishnan
- National Institute of Epidemiology (ICMR), Ayapakkam, Chennai, Tamil Nadu, India
| | - T. Kannan
- National Institute for Research in Tuberculosis (ICMR), Chetpet, Chennai, Tamil Nadu, India
| |
Collapse
|
40
|
Abstract
OBJECTIVES To present the case histories and management by LASER tympanic neurectomy of two patients who presented with pain as their only symptom after cochlear implantation, avoiding the need for device removal. CLINICAL PRESENTATION Two of our patients presented with otalgia, which appeared 6 months after cochlear implantation and resulted in their refusing to use the device. The pain was not controlled by repeated remapping or medical management. Neither patient showed evidence of infection or inflammation around their device. X-rays showed that there were no extracochlear electrodes or evidence of extrusion. One patient had current leakage from two electrodes, which were switched off, but the pain persisted. INTERVENTION Both patients received an intratympanic injection of 1 ml of 0.5% Bupivacaine to anaesthetize the tympanic plexus in the middle ear and were then observed for a day, found to have relief of their pain and were able to use the implant with audiological benefit for this short time, until the effect of the anaesthetic had worn off. Therefore we planned and performed a tympanic neurectomy on both patients using CO2 laser. CONCLUSION Tympanic neurectomy removed the pain in two cochlear implant patients who presented with pain which was present only when the implant was switched on.
Collapse
Affiliation(s)
- V Anand
- a Department of Otorhinolaryngology and Head and Neck Surgery , MCV Memorial ENT Trust Hospital , Pollachi , Tamil Nadu , India
| | - M Kiruthiga Devi
- a Department of Otorhinolaryngology and Head and Neck Surgery , MCV Memorial ENT Trust Hospital , Pollachi , Tamil Nadu , India
| | - T Kannan
- a Department of Otorhinolaryngology and Head and Neck Surgery , MCV Memorial ENT Trust Hospital , Pollachi , Tamil Nadu , India
| | - S Chenniappan
- a Department of Otorhinolaryngology and Head and Neck Surgery , MCV Memorial ENT Trust Hospital , Pollachi , Tamil Nadu , India
| |
Collapse
|
41
|
Bandodkar A, William B, Kannan T, Prasad A, Bharathidasan M, Jayaprakash R, George R. Intra-articular Injection of Ascorbic Acid and Dexamethasone for Management of Osteoarthritis in Dogs. ACTA ACUST UNITED AC 2016. [DOI: 10.9734/arrb/2016/23345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
42
|
Selvakumar N, Kumar V, Balaji S, Prabuseenivasan S, Radhakrishnan R, Sekar G, Chandrasekaran V, Kannan T, Thomas A, Arunagiri S, Dewan P, Swaminathan S. High rates of ofloxacin resistance in Mycobacterium tuberculosis among both new and previously treated patients in Tamil Nadu, South India. PLoS One 2015; 10:e0117421. [PMID: 25738956 PMCID: PMC4349813 DOI: 10.1371/journal.pone.0117421] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 09/29/2014] [Accepted: 12/22/2014] [Indexed: 11/18/2022] Open
Abstract
Periodic drug resistance surveillance provides useful information on trends of drug resistance and effectiveness of tuberculosis (TB) control measures. The present study determines the prevalence of drug resistance among new sputum smear positive (NSP) and previously treated (PT) pulmonary TB patients, diagnosed at public sector designated microscopy centers (DMCs) in the state of Tamil Nadu, India. In this single-stage cluster-sampling prevalence survey, 70 of 700 DMCs were randomly selected using a probability-proportional to size method. A cluster size of 24 for NSP and a varying size of 0 to 99 for PT cases were fixed for each selected DMC. Culture and drug susceptibility testing was done on Lowenstein-Jensen medium using the economic variant of proportion sensitivity test for isoniazid (INH), rifampicin (RMP), ofloxacin (OFX) and kanamycin (KAN). Human Immunodeficiency Virus (HIV) status was collected from patient records. From June 2011 to August 2012, 1524 NSP and 901 PT patients were enrolled. Any RMP resistance and any INH resistance were observed in 2.6% and 15.1%, and in 10.4% and 30% respectively in NSP and PT cases. Among PT patients, multi drug resistant TB (MDR-TB) was highest in the treatment failure (35%) group, followed by relapse (13%) and treatment after default (10%) groups. Extensively drug resistant TB (XDRTB) was seen in 4.3% of MDR-TB cases. Any OFX resistance was seen in 10.4% of NSP, 13.9% of PT and 29% of PT MDR-TB patients. The HIV status of the patient had no impact on drug resistance levels. RMP resistance was present in 2.6% of new and 15.1% of previously treated patients in Tamil Nadu. Rates of OFX resistance were high among NSP and PT patients, especially among those with MDR-TB, a matter of concern for development of new treatment regimens for TB.
Collapse
Affiliation(s)
- N. Selvakumar
- National Institute for Research in Tuberculosis (Indian Council of Medical Research), Chennai, India
| | - Vanaja Kumar
- National Institute for Research in Tuberculosis (Indian Council of Medical Research), Chennai, India
| | - S. Balaji
- National Institute for Research in Tuberculosis (Indian Council of Medical Research), Chennai, India
| | - S. Prabuseenivasan
- National Institute for Research in Tuberculosis (Indian Council of Medical Research), Chennai, India
| | - R. Radhakrishnan
- National Institute for Research in Tuberculosis (Indian Council of Medical Research), Chennai, India
| | - Gomathi Sekar
- National Institute for Research in Tuberculosis (Indian Council of Medical Research), Chennai, India
| | - V. Chandrasekaran
- National Institute for Research in Tuberculosis (Indian Council of Medical Research), Chennai, India
| | - T. Kannan
- National Institute for Research in Tuberculosis (Indian Council of Medical Research), Chennai, India
| | - Aleyamma Thomas
- National Institute for Research in Tuberculosis (Indian Council of Medical Research), Chennai, India
| | - S. Arunagiri
- State TB Cell, Government of Tamil Nadu, Chennai, India
| | | | - Soumya Swaminathan
- National Institute for Research in Tuberculosis (Indian Council of Medical Research), Chennai, India
- * E-mail:
| |
Collapse
|
43
|
Pramesh CS, Badwe RA, Borthakur BB, Chandra M, Raj EH, Kannan T, Kalwar A, Kapoor S, Malhotra H, Nayak S, Rath GK, Sagar TG, Sebastian P, Sarin R, Shanta V, Sharma SC, Shukla S, Vijayakumar M, Vijaykumar DK, Aggarwal A, Purushotham A, Sullivan R. Delivery of affordable and equitable cancer care in India. Lancet Oncol 2014; 15:e223-33. [DOI: 10.1016/s1470-2045(14)70117-2] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
44
|
Chowhan AK, Reddy MK, Javvadi V, Kannan T. Extrarenal teratoid Wilms' tumour. Singapore Med J 2011; 52:e134-e137. [PMID: 21731985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We report an unusual case of extrarenal teratoid Wilms' tumour in a 15-month-old male child. The tumour was retroperitoneal in location and consisted of triphasic Wilms' tumour elements, along with the presence of heterologous components. The heterologous teratoid elements were composed of predominantly glandular epithelium with the presence of focal skeletal muscle, adipose and neuroglial tissues. Although extrarenal Wilms' tumours have been documented in the literature, only a few cases have been noted to date. We present the relevant clinical, radiological, histomorphological, histochemical and immunohistochemical features of this rare tumour, and discuss the various theories of its histogenesis.
Collapse
Affiliation(s)
- A K Chowhan
- Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati 517507, Andhra Pradesh, India.
| | | | | | | |
Collapse
|
45
|
Sivakumar V, Krishna KC, Sivaramakrishna G, Kumar PM, Kannan T, Reddy KM. Posttransplant lymphoproliferative disease presenting as jejunal perforation. Indian J Nephrol 2009; 19:82. [PMID: 20368932 PMCID: PMC2847816 DOI: 10.4103/0971-4065.53330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
46
|
Kannan T, Hillermann C. 170. Postoperative Pain Relief Following Joint Replacement Surgery. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
47
|
Verma H, Kannan T. Synthesis of tri-block copolymers through reverse atom transfer radical polymerization of methyl methacrylate using polyurethane macroiniferter. EXPRESS POLYM LETT 2008. [DOI: 10.3144/expresspolymlett.2008.70] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
48
|
Abstract
Several newer isosteric analogues of glycosyl phosphates, namely of glycosyl phosphoramidates, were synthesized in good yields using Staudinger reaction of their corresponding azides with trimethyl phosphite followed by de-O-acetylation. The structure and conformation of the fully protected analogue synthesized, namely 2,3,4,6-tetra-O-acetyl-beta-D-glucopyranosyl bismethoxyphosphoramidate, was established by X-ray crystallography.
Collapse
Affiliation(s)
- T Kannan
- Department of Chemistry, Indian Institute of Technology Madras, Chennai 600 036, India
| | | | | | | |
Collapse
|
49
|
Rahmatullah SI, Khan IA, Nair VM, Kannan T, Vasavada BC, Sacchi TJ. Separate origins of all three major coronary arteries from the right sinus of Valsalva: a rare coronary artery anomaly. Cardiology 1998; 90:72-4. [PMID: 9693176 DOI: 10.1159/000006821] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [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] [Indexed: 11/19/2022]
Abstract
The origination of all three major coronary arteries from three separate ostia in the right sinus of Valsalva is an exceedingly rare coronary anomaly. Few radiographic and clinical details of this anomaly are available in the literature. We describe this anomaly in a patient with acute myocardial infarction who remained asymptomatic until the 8th decade of her life. Atherosclerotic narrowing of the normally originating right coronary artery caused the acute myocardial infarction. Anomalous left anterior descending and left circumflex arteries were free of any significant obstruction.
Collapse
Affiliation(s)
- S I Rahmatullah
- Division of Cardiology, Department of Medicine, Long Island College Hospital, Brooklyn, NY, USA
| | | | | | | | | | | |
Collapse
|
50
|
Abstract
Nasopharyngeal carcinoma (NPC) is one of the most difficult diseases to diagnose at an early stage. The clinical presentation of 122 patients with confirmed NPC is described and the findings analysed. The common modes of presentation and cases where detailed nasopharyngeal examination need to be performed are highlighted. We emphasize the importance of health education and training for primary care physicians for early detection of these cases.
Collapse
Affiliation(s)
- R Indudharan
- Department of Otorhinolaryngology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | | | | | | |
Collapse
|