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Sadhasivam B, Manyanga J, Ganapathy V, Acharya P, Bouharati C, Chinnaiyan M, Mehta T, Mathews B, Castles S, Rubenstein DA, Tackett AP, Zhao YD, Ramachandran I, Queimado L. Exposure to Secondhand Smoke Extract Increases Cisplatin Resistance in Head and Neck Cancer Cells. Int J Mol Sci 2024; 25:1032. [PMID: 38256106 PMCID: PMC10816441 DOI: 10.3390/ijms25021032] [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: 11/30/2023] [Revised: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Chemotherapy and radiotherapy resistance are major obstacles in the long-term efficacy of head and neck squamous cell carcinoma (HNSCC) treatment. Secondhand smoke (SHS) exposure is common and has been proposed as an independent predictor of HNSCC recurrence and disease-free survival. However, the underlying mechanisms responsible for these negative patient outcomes are unknown. To assess the effects of SHS exposure on cisplatin efficacy in cancer cells, three distinct HNSCC cell lines were exposed to sidestream (SS) smoke, the main component of SHS, at concentrations mimicking the nicotine level seen in passive smokers' saliva and treated with cisplatin (0.01-100 µM) for 48 h. Compared to cisplatin treatment alone, cancer cells exposed to both cisplatin and SS smoke extract showed significantly lower cisplatin-induced cell death and higher cell viability, IC50, and indefinite survival capacity. However, SS smoke extract exposure alone did not change cancer cell viability, cell death, or cell proliferation compared to unexposed control cancer cells. Mechanistically, exposure to SS smoke extract significantly reduced the expression of cisplatin influx transporter CTR1, and increased the expression of multidrug-resistant proteins ABCG2 and ATP7A. Our study is the first to document that exposure to SHS can increase cisplatin resistance by altering the expression of several proteins involved in multidrug resistance, thus increasing the cells' capability to evade cisplatin-induced cell death. These findings emphasize the urgent need for clinicians to consider the potential role of SHS on treatment outcomes and to advise cancer patients and caregivers on the potential benefits of avoiding SHS exposure.
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Affiliation(s)
- Balaji Sadhasivam
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (B.S.); (J.M.); (V.G.); (M.C.); (T.M.); (B.M.); (S.C.)
- Department of Occupational and Environmental Health, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Jimmy Manyanga
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (B.S.); (J.M.); (V.G.); (M.C.); (T.M.); (B.M.); (S.C.)
- Department of Cell Biology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Vengatesh Ganapathy
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (B.S.); (J.M.); (V.G.); (M.C.); (T.M.); (B.M.); (S.C.)
| | - Pawan Acharya
- Department of Biostatistics, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (P.A.); (Y.D.Z.)
| | - Célia Bouharati
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (B.S.); (J.M.); (V.G.); (M.C.); (T.M.); (B.M.); (S.C.)
| | - Mayilvanan Chinnaiyan
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (B.S.); (J.M.); (V.G.); (M.C.); (T.M.); (B.M.); (S.C.)
| | - Toral Mehta
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (B.S.); (J.M.); (V.G.); (M.C.); (T.M.); (B.M.); (S.C.)
| | - Basil Mathews
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (B.S.); (J.M.); (V.G.); (M.C.); (T.M.); (B.M.); (S.C.)
| | - Samuel Castles
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (B.S.); (J.M.); (V.G.); (M.C.); (T.M.); (B.M.); (S.C.)
| | - David A. Rubenstein
- Department of Biomedical Engineering, Stony Brook University, New York City, NY 11794, USA;
| | - Alayna P. Tackett
- TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
- Division of Medical Oncology, The Ohio State University, Columbus, OH 43210, USA
| | - Yan D. Zhao
- Department of Biostatistics, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (P.A.); (Y.D.Z.)
| | - Ilangovan Ramachandran
- Department of Endocrinology, Dr. ALM Post Graduate Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai, TN 600113, India;
| | - Lurdes Queimado
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (B.S.); (J.M.); (V.G.); (M.C.); (T.M.); (B.M.); (S.C.)
- Department of Cell Biology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
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Yu J, Jiang L, Zhao L, Wang X, Yang X, Yang D, Zhuo M, Chen H, Zhao YD, Zhou F, Li Q, Zhu Z, Chu L, Ma Z, Wang Q, Qu Y, Huang W, Zhang M, Gu T, Liu S, Yang Y, Yang J, Yu H, Yu R, Zhao J, Shi A. High Dose Hyperfractionated Thoracic Radiotherapy vs. Standard Dose for Limited Stage Small-Cell Lung Cancer: A Multicenter, Open-Label Randomized, Phase 3 Trial. Int J Radiat Oncol Biol Phys 2023; 117:S1. [PMID: 37784261 DOI: 10.1016/j.ijrobp.2023.06.205] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Limited stage small-cell lung cancer (LS-SCLC) is associated with poor prognosis. We aimed to assess the efficacy and safety of high-dose, hyperfractionated thoracic radiotherapy of 54 Gy in 30 fractions compared with standard dose (45 Gy in 30 fractions) as a first-line treatment for LS-SCLC. MATERIALS/METHODS The study was an open-label, randomized, phase 3 trial, done at 16 public hospitals in China. Key inclusion criteria were patients aged 18-70 years, with previously histologically or cytologically confirmed LS-SCLC, previously untreated or received 1-2 courses of intravenous cisplatin (75 mg/m²of body-surface area, on day 1 or divided into two days of each cycle) or carboplatin (area under the curve of 5 mg/mL per min, day 1 of each cycle)and intravenous etoposide (100 mg/m²of body-surface area, on days 1-3 of each cycle), and an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.Eligible patients were randomly assigned (1:1) to receive volumetric-modulated arc radiotherapy (VMAT) of 45 Gy in 30 fractions or the simultaneous integrated boost VMAT (SIB-VMAT) of 54 Gy in 30 fractions to the primary lung tumor and lymph node metastases starting 0-42 days after the first chemotherapy course. Both groups of patients received thoracic radiotherapy twice per day and 10 fractions per week. Prophylactic cranial radiation (PCI, 25 Gy in 10 fractions) was implemented to patients with responsive disease. The primary endpoint was overall survival. Safety was analyzed in the as-treated population. RESULTS Between June 30, 2017, and April 6, 2021, 224 eligible patients were enrolled and randomly assigned to 54 Gy (n = 108) or 45 Gy (n = 116). Median follow-up for the primary analysis was 45 months (IQR 41-48). Median overall survival was significantly improved in the 54 Gy group (62.4 months) compared with the 45 Gy group (43.1 months; p = 0.001). Median progression-free survival was significantly improved in the 54 Gy group (30.5 months) compared with the 45 Gy group (16.7 months; p = 0.044). The most common grade 3-4 adverse events were neutropenia (30 [28%] of 108 patients in the 54 Gy group vs 27 [23%] of 116 patients in the 45 Gy group), neutropenic infections (6 [6%] vs 2 [2%]), thrombocytopenia (13 [12%] vs 12 [10%]), anemia (6 [6%] vs 4 [3%]), and esophagitis (1 [1%] vs 3 [3%]). Treatment-related serious adverse events occurred in 9 [8%] patients in the 54 Gy group and 16 [14%] patients in the 45 Gy group. There were one treatment-related deaths in 54 Gy group (myocardial infarction). CONCLUSION Compared with standard thoracic radiotherapy dose of 45 Gy, the high dose of 54 Gy improved overall survival and progression-free survival without increasing toxicities in patients with LS-SCLC, supporting twice-daily hyperfractionated thoracic radiotherapy of 54 Gy with concurrent chemotherapy is an alternative treatment option for LS-SCLC. This study is complete and registered with ClinicalTrials.gov, NCT03214003.
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Affiliation(s)
- J Yu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - L Jiang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - L Zhao
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. ty, Xi'an, China
| | - X Wang
- Department of Radiation Oncology, Anyang Cancer Hospital, Anyang, China
| | - X Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Medical Oncology, Peking University Cancer Hospital and Institute, Beijing, China., Beijing, China
| | - D Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - M Zhuo
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Medical Oncology, Peking University Cancer Hospital and Institute, Beijing, China., Beijing, China
| | - H Chen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Medical Oncology, Peking University Cancer Hospital and Institute, Beijing, China., Beijing, China
| | - Y D Zhao
- Department of Radiation Oncology, Anyang Tumor Hospital, Anyang, China
| | - F Zhou
- Yantai Yuhuangding Hospital, Yantai, China
| | - Q Li
- Ordos School of Clinical Medicine I.M.M.U, Ordos, China
| | - Z Zhu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - L Chu
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - Z Ma
- Chifeng Affiliated Hospital, Chifeng, China
| | - Q Wang
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institution, Chengdu, China
| | - Y Qu
- Liaoning cancer hospital & institute, Shenyang, China
| | - W Huang
- Shandong Cancer Hospital & Institute, Jinan, Shandong, China
| | - M Zhang
- Department of Radiation Oncology, Peking University People's Hospital, Beijing, China; Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China
| | - T Gu
- The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - S Liu
- Jilin Provincial Cancer Hospital, Changchun, China
| | - Y Yang
- Jilin Provincial Cancer Hospital, Changchun, China
| | - J Yang
- Department of Oncology, The first Affiliated Hospital of Xinxiang Medical University, Weihui, China
| | - H Yu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - R Yu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - J Zhao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Medical Oncology, Peking University Cancer Hospital and Institute, Beijing, China., Beijing, China
| | - A Shi
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China
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Kirvan CA, Canini H, Swedo SE, Hill H, Veasy G, Jankelow D, Kosanke S, Ward K, Zhao YD, Alvarez K, Hedrick A, Cunningham MW. Corrigendum: IgG2 rules: N-acetyl-β-D-glucosamine-specific IgG2 and Th17/Th1 cooperation may promote the pathogenesis of acute rheumatic heart disease and be a biomarker of the autoimmune sequelae of Streptococcus pyogenes. Front Cardiovasc Med 2023; 10:1267920. [PMID: 37719980 PMCID: PMC10502156 DOI: 10.3389/fcvm.2023.1267920] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/11/2023] [Indexed: 09/19/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fcvm.2022.919700.].
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Affiliation(s)
- Christine A. Kirvan
- Department of Biological Sciences, California State University, Sacramento, CA, United States
| | - Heather Canini
- Department of Biological Sciences, California State University, Sacramento, CA, United States
| | - Susan E. Swedo
- Department of Health and Human Services, Pediatrics and Developmental Neuropsychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Harry Hill
- Departments of Pediatrics, Infectious Diseases, Cardiology, and Pathology, University of Utah College of Medicine, Salt Lake City, UT, United States
| | - George Veasy
- Departments of Pediatrics, Infectious Diseases, Cardiology, and Pathology, University of Utah College of Medicine, Salt Lake City, UT, United States
| | - David Jankelow
- Division of Cardiology, University of Witwatersrand, Johannesburg, South Africa
| | - Stanley Kosanke
- Department of Comparative Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Kent Ward
- Department of Pediatrics, Division of Cardiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Yan D. Zhao
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Kathy Alvarez
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Andria Hedrick
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Madeleine W. Cunningham
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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Kirvan CA, Canini H, Swedo SE, Hill H, Veasy G, Jankelow D, Kosanke S, Ward K, Zhao YD, Alvarez K, Hedrick A, Cunningham MW. IgG2 rules: N-acetyl-β-D-glucosamine-specific IgG2 and Th17/Th1 cooperation may promote the pathogenesis of acute rheumatic heart disease and be a biomarker of the autoimmune sequelae of Streptococcus pyogenes. Front Cardiovasc Med 2023; 9:919700. [PMID: 36815140 PMCID: PMC9939767 DOI: 10.3389/fcvm.2022.919700] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 12/29/2022] [Indexed: 02/09/2023] Open
Abstract
Antecedent group A streptococcal pharyngitis is a well-established cause of acute rheumatic fever (ARF) where rheumatic valvular heart disease (RHD) and Sydenham chorea (SC) are major manifestations. In ARF, crossreactive antibodies and T cells respond to streptococcal antigens, group A carbohydrate, N-acetyl-β-D-glucosamine (GlcNAc), and M protein, respectively, and through molecular mimicry target heart and brain tissues. In this translational human study, we further address our hypothesis regarding specific pathogenic humoral and cellular immune mechanisms leading to streptococcal sequelae in a small pilot study. The aims of the study were to (1) better understand specific mechanisms of pathogenesis in ARF, (2) identify a potential early biomarker of ARF, (3) determine immunoglobulin G (IgG) subclasses directed against GlcNAc, the immunodominant epitope of the group A carbohydrate, by reaction of ARF serum IgG with GlcNAc, M protein, and human neuronal cells (SK-N-SH), and (4) determine IgG subclasses deposited on heart tissues from RHD. In 10 pediatric patients with RHD and 6 pediatric patients with SC, the serum IgG2 subclass reacted significantly with GlcNAc, and distinguished ARF from 7 pediatric patients with uncomplicated pharyngitis. Three pediatric patients who demonstrated only polymigrating arthritis, a major manifestation of ARF and part of the Jones criteria for diagnosis, lacked the elevated IgG2 subclass GlcNAc-specific reactivity. In SC, the GlcNAc-specific IgG2 subclass in cerebrospinal fluid (CSF) selectively targeted human neuronal cells as well as GlcNAc in the ELISA. In rheumatic carditis, the IgG2 subclass preferentially and strongly deposited in valve tissues (n = 4) despite elevated concentrations of IgG1 and IgG3 in RHD sera as detected by ELISA to group A streptococcal M protein. Although our human study of ARF includes a very small limited sample set, our novel research findings suggest a strong IgG2 autoantibody response against GlcNAc in RHD and SC, which targeted heart valves and neuronal cells. Cardiac IgG2 deposition was identified with an associated IL-17A/IFN-γ cooperative signature in RHD tissue which displayed both IgG2 deposition and cellular infiltrates demonstrating these cytokines simultaneously. GlcNAc-specific IgG2 may be an important autoantibody in initial stages of the pathogenesis of group A streptococcal sequelae, and future studies will determine if it can serve as a biomarker for risk of RHD and SC or early diagnosis of ARF.
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Affiliation(s)
- Christine A. Kirvan
- Department of Biological Sciences, California State University, Sacramento, CA, United States
| | - Heather Canini
- Department of Biological Sciences, California State University, Sacramento, CA, United States
| | - Susan E. Swedo
- Pediatrics and Developmental Neuropsychiatry Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, United States
| | - Harry Hill
- Departments of Pediatrics, Infectious Diseases, Cardiology, and Pathology, University of Utah College of Medicine, Salt Lake City, UT, United States
| | - George Veasy
- Departments of Pediatrics, Infectious Diseases, Cardiology, and Pathology, University of Utah College of Medicine, Salt Lake City, UT, United States
| | - David Jankelow
- Division of Cardiology, University of Witwatersrand, Johannesburg, South Africa
| | - Stanley Kosanke
- Department of Comparative Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Kent Ward
- Department of Pediatrics, Division of Cardiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Yan D. Zhao
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Kathy Alvarez
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Andria Hedrick
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Madeleine W. Cunningham
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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MacDougall K, Day S, Nipp RD, Hall S, Zhao YD, Al-Juhaishi T. Trends in the improvement in survival among patients with diffuse large B-cell lymphoma (DLBCL). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.28_suppl.147] [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: 11/20/2022] Open
Abstract
147 Background: Advances in treatment for patients with DLBCL have led to improved patient outcomes, but whether disparities exist with regards to improved survival outcomes remains understudied. We sought to describe changes in DLBCL survival rates over time and explore potential differential survival patterns by patients’ race and age. Methods: We utilized the Surveillance, Epidemiology, and End Results (SEER) database to identify patients diagnosed with DLBCL from 1980-2009 and determined 5-year survival rates for all patients, categorizing patients by year of diagnosis. We used descriptive statistics and logistic regression, adjusting for stage and year of diagnosis, to describe changes in 5-year survival rates over time by race/ethnicity and age. Results: We identified 43,564 patients with DLBCL eligible for this study (median age 67 years [ages: 18-64 = 44.2%, 65-79 = 37.1%, 80+ = 18.7%], 53% male, 40% stage III/IV). Most were White race (81.4%), followed by race/ethnic groups of Asian/Pacific Islander (API) (6.3%), Black (6.3%), Hispanic (5.4%), and American Indian/Alaska Native (AIAN) (0.05%). Overall, the 5-year survival rate improved from 35.1% in 1980 to 52.4% in 2009 across all patients (odds ratio (OR) for 5-year survival with increasing year of diagnosis = 1.05, p <.001). Patients in race/ethnic minority groups (API: OR = 0.86, p <.0001; Black: OR = 0.57, p <.0001; AIAN: OR = 0.51, p =.008) and older adults (ages 65-79: OR = 0.43, p <.0001; ages 80+: OR = 0.13, p <.0001) had worse 5-year survival rates adjusting for race, age, stage, and diagnosis year. We found consistent improvement in the odds of 5-year survival for year of diagnosis across all race and ethnicity groups (White: OR = 1.05, p <.001; API: OR = 1.04, p <.001; Black: OR = 1.06, p <.001; Hispanic: OR = 1.05, p <.005; AIAN: OR = 1.05, p <.001) and age groups (ages 18-64: OR = 1.06, p <.001; ages 65-79: OR = 1.04, p <.001; ages 80+: OR = 1.04, p <.001). Conclusions: In this analysis of SEER data, we found that patients with DLBCL experienced improvements in 5-year survival rates from 1980 to 2009, despite ongoing disparities demonstrating worse survival among patients in race/ethnic minority groups and older adults. Notably, we did not find differential improvement in the odds of 5-year survival within subgroups of race and age, underscoring the need for ongoing investigations to address disparities in cancer care delivery and outcomes.
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Affiliation(s)
- Kira MacDougall
- Zucker School of Medicine at Hofstra/Northwell at Staten Island University Hospital, Staten Island, NY
| | - Silas Day
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | | | - Spencer Hall
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Yan D. Zhao
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
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Kury M, Hiers RD, Zhao YD, Picolo MZD, Hsieh J, Khajotia SS, Esteban Florez FL, Cavalli V. Novel Experimental In-Office Bleaching Gels Containing Co-Doped Titanium Dioxide Nanoparticles. Nanomaterials (Basel) 2022; 12:nano12172995. [PMID: 36080033 PMCID: PMC9458163 DOI: 10.3390/nano12172995] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 05/17/2023]
Abstract
The present study reports on the development and testing of novel bleaching agents containing co-doped metaloxide nanoparticles (NP; 0%, 5%, 10% v/w) and hydrogen peroxide (HP, 0%, 6%, 15%, and 35%). Bovine blocks (n = 200, A = 36 mm2) were obtained and randomly distributed into experimental groups (n = 10/group). NPs were incorporated into gels before bleaching (3 sessions, 7 days apart, 30 min/session, irradiated with violet light-LT). Color changes (ΔE00, ΔWID), mineral content (CO32−, PO43−), and topography were assessed (spectrophotometer, ATR-FTIR, and AFM) before and after bleaching procedures (14 days). Metabolic status and three-dimensional components of non-disrupted Streptococcus mutans biofilms were investigated using a multimode reader and confocal microscopy. The results indicate that ΔE00 and ΔWID significantly increased with NPs’ concentrations and LT. The enamel’s mineral ratio was adversely impacted by HP, but alterations were less pronounced when using NP-containing gels. The enamel’s topography was not damaged by the bleaching protocols tested. The bioluminescence results show that bleaching protocols do not render latent antibacterial properties to enamel, and the confocal microscopy results demonstrate that the 3-dimensional distribution of the components was affected by the protocols. The proposed nanotechnology improved the bleaching efficacy of experimental materials independent of hydrogen peroxide or irradiation and did not adversely impact the enamel’s surface properties or its chemical content.
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Affiliation(s)
- Matheus Kury
- Division of Operative Dentistry, Department of Restorative Dentistry, Piracicaba School of Dentistry, University of Campinas, Piracicaba 13414-903, SP, Brazil
| | - Rochelle D. Hiers
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
| | - Yan D. Zhao
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Mayara Z. D. Picolo
- Division of Operative Dentistry, Department of Restorative Dentistry, Piracicaba School of Dentistry, University of Campinas, Piracicaba 13414-903, SP, Brazil
| | - Jessica Hsieh
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
| | - Sharukh S. Khajotia
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
| | - Fernando L. Esteban Florez
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
- Correspondence: (F.L.E.F.); (V.C.)
| | - Vanessa Cavalli
- Division of Operative Dentistry, Department of Restorative Dentistry, Piracicaba School of Dentistry, University of Campinas, Piracicaba 13414-903, SP, Brazil
- Correspondence: (F.L.E.F.); (V.C.)
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Nadeau HCG, Bisson C, Chen X, Zhao YD, Williams M, Edwards RK. Vaginal-perianal or vaginal-perineal compared with vaginal-rectal culture-based screening for Group B Streptococci (GBS) colonization during the third trimester of pregnancy: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2022; 22:204. [PMID: 35287615 PMCID: PMC8919537 DOI: 10.1186/s12884-022-04546-w] [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: 11/01/2021] [Accepted: 03/07/2022] [Indexed: 12/02/2022] Open
Abstract
Background Screening for maternal anogenital Group B streptococci (GBS) colonization in pregnancy with initiation of intravenous intrapartum antibiotic prophylaxis as indicated has led to a significant reduction in the incidence of neonatal GBS infection. This study aims to evaluate the agreement between vaginal-perianal or vaginal-perineal culture and the more typically used vaginal-rectal culture for screening for maternal anogenital GBS colonization in the third trimester of pregnancy. Methods Eligible English-language studies published until January 2020 were retrieved from Scopus, Web of Science, PubMed, Embase, and ClinicalTrials.gov databases. Studies were compiled that assessed for GBS colonization utilizing vaginal-perianal or vaginal-perineal culture and vaginal-rectal culture during the third trimester of pregnancy. Nonoriginal research articles and studies that did not assess pregnant patients, did not use culture-based screening, or did not compare vaginal-perianal or vaginal-perineal culture with vaginal-rectal culture were excluded. The search identified 559 articles with three prospective cohort studies that met inclusion criteria, including 643 participants. Quality was assessed using the Newcastle–Ottawa Scale, and risk of bias was assessed using the Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool. Patient characteristics and associated pain with specimen collection were abstracted. Meta-analyses of both the raw agreement and the Cohen’s kappa statistic were performed. Results Within the three included studies, the range of GBS detection was 17.6–34.0%, consistent with the anticipated prevalence of GBS colonization reported in earlier publications. For both raw agreement and Cohen’s kappa coefficient, the test for heterogeneity was not significant, indicating low heterogeneity among studies. The pooled estimate of the raw agreement was 0.97 (95%CI 0.95–0.98) and of the Cohen's kappa coefficient was 0.91 (95% CI: 0.87–0.95), indicating (according to the Landis and Koch criteria) an “almost perfect” agreement between the compared clinical tests. In the two studies that assessed procedure-related patient discomfort, vaginal-rectal swabbing caused more discomfort. Conclusion Use of vaginal-perineal culture for assessment of maternal GBS colonization is comparable to the more typically utilized vaginal-rectal culture and is associated with less discomfort.
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Affiliation(s)
- Hugh C G Nadeau
- Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, 800 Stanton L. Young Blvd, Suite 2400, Oklahoma City, OK, 73104, USA.
| | - Courtney Bisson
- Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, 800 Stanton L. Young Blvd, Suite 2400, Oklahoma City, OK, 73104, USA
| | - Xi Chen
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma City, OK, USA
| | - Yan D Zhao
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma City, OK, USA
| | - Marvin Williams
- Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, 800 Stanton L. Young Blvd, Suite 2400, Oklahoma City, OK, 73104, USA
| | - Rodney K Edwards
- Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, 800 Stanton L. Young Blvd, Suite 2400, Oklahoma City, OK, 73104, USA
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Raguraman R, Shanmugarama S, Mehta M, Elle Peterson J, Zhao YD, Munshi A, Ramesh R. Drug delivery approaches for HuR-targeted therapy for lung cancer. Adv Drug Deliv Rev 2022; 180:114068. [PMID: 34822926 PMCID: PMC8724414 DOI: 10.1016/j.addr.2021.114068] [Citation(s) in RCA: 6] [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: 10/17/2021] [Accepted: 11/18/2021] [Indexed: 01/03/2023]
Abstract
Lung cancer (LC) is often diagnosed at an advanced stage and conventional treatments for disease management have limitations associated with them. Novel therapeutic targets are thus avidly sought for the effective management of LC. RNA binding proteins (RBPs) have been convincingly established as key players in tumorigenesis, and their dysregulation is linked to multiple cancers, including LC. In this context, we review the role of Human antigen R (HuR), an RBP that is overexpressed in LC, and further associated with various aspects of LC tumor growth and response to therapy. Herein, we describe the role of HuR in LC progression and outline the evidences supporting various pharmacologic and biologic approaches for inhibiting HuR expression and function. These approaches, including use of small molecule inhibitors, siRNAs and shRNAs, have demonstrated favorable results in reducing tumor cell growth, invasion and migration, angiogenesis and metastasis. Hence, HuR has significant potential as a key therapeutic target in LC. Use of siRNA-based approaches, however, have certain limitations that prevent their maximal exploitation as cancer therapies. To address this, in the conclusion of this review, we provide a list of nanomedicine-based HuR targeting approaches currently being employed for siRNA and shRNA delivery, and provide a rationale for the immense potential therapeutic benefits offered by nanocarrier-based HuR targeting and its promise for treating patients with LC.
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Affiliation(s)
- Rajeswari Raguraman
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Santny Shanmugarama
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Graduate Program in Biomedical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Meghna Mehta
- Radiation Oncology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jo Elle Peterson
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Yan D Zhao
- Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Anupama Munshi
- Radiation Oncology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Rajagopal Ramesh
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Graduate Program in Biomedical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
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Wang XM, Wang L, Wang X, Chen JQ, Li C, Zhang WC, Ge XL, Shen WB, Hu MM, Yuan QQ, Xu YG, Hao CL, Zhou ZG, Qie S, Lu N, Han C, Pang QS, Wang P, Sun XC, Zhang KX, Li GF, Li L, Liu ML, Wang YD, Qiao XY, Zhu SC, Zhou ZM, Zhao YD, Xiao ZF. [Long-term efficacy and safety of simultaneous integrated boost radiotherapy in non-operative esophageal squamous cell carcinoma: a multicenter retrospective data analysis (3JECROG R-05)]. Zhonghua Zhong Liu Za Zhi 2021; 43:889-896. [PMID: 34407597 DOI: 10.3760/cma.j.cn112152-20190412-00234] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the survival benefits and treatment related toxic effects of simultaneous integrated boost intensity-modulated radiotherapy (SIB-RT) for non-operative esophageal squamous cell carcinoma patients. Methods: The data of 2 132 ESCC patients who were not suitable for surgery or rejected operation, and underwent radical radiotherapy from 2002 to 2016 in 10 hospitals of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG) were analyzed. Among them, 518 (24.3%) cases underwent SIB (SIB group) and 1 614 (75.7%) cases did not receive SIB (No-SIB group). The two groups were matched with 1∶2 according to propensity score matching (PSM) method (caliper value=0.02). After PSM, 515 patients in SIB group and 977 patients in No-SIB group were enrolled. Prognosis and treatment related adverse effects of these two groups were compared and the independent prognostic factor were analyzed. Results: The median follow-up time was 61.7 months. Prior to PSM, the 1-, 3-, and 5-years overall survival (OS) rates of SIB group were 72.2%, 42.8%, 35.5%, while of No-SIB group were 74.3%, 41.4%, 31.9%, respectively (P=0.549). After PSM, the 1-, 3-, and 5-years OS rates of the two groups were 72.5%, 43.4%, 36.4% and 75.3%, 41.7%, 31.6%, respectively (P=0.690). The univariate survival analysis of samples after PSM showed that the lesion location, length, T stage, N stage, TNM stage, simultaneous chemoradiotherapy, gross tumor volume (GTV) and underwent SIB-RT or not were significantly associated with the prognosis of advanced esophageal carcinoma patients who underwent radical radiotherapy (P<0.05). Cox model multivariate regression analysis showed lesion location, TNM stage, GTV and simultaneous chemoradiotherapy were independent prognostic factors of advanced esophageal carcinoma patients who underwent radical radiotherapy (P<0.05). Stratified analysis showed that, in the patients whose GTV volume≤50 cm(3), the median survival time of SIB and No-SIB group was 34.7 and 30.3 months (P=0.155), respectively. In the patients whose GTV volume>50 cm(3), the median survival time of SIB and No-SIB group was 16.1 and 20.1 months (P=0.218). The incidence of radiation esophagitis and radiation pneumonitis above Grade 3 in SIB group were 4.3% and 2.5%, significantly lower than 13.1% and 11% of No-SIB group (P<0.001). Conclusions: The survival benefit of SIB-RT in patients with locally advanced esophageal carcinoma is not inferior to non-SIB-RT, but without more adverse reactions, and shortens the treatment time. SIB-RT can be used as one option of the radical radiotherapy for locally advanced esophageal cancer.
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Affiliation(s)
- X M Wang
- Department of Radiation Oncology, Anyang Cancer Hospital, Anyang 455000, China
| | - L Wang
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - X Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J Q Chen
- Department of Radiation Oncology, Fujian Cancer Hospital/Fujian Medical University Cancer Hospital, Fuzhou 350014, China
| | - C Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W C Zhang
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer, Tianjin 300060, China
| | - X L Ge
- Department of Radiation Oncology, Jiangsu People's Hospital/the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - W B Shen
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - M M Hu
- Department of Radiation Oncology, Tengzhou Central People's Hospital, Tengzhou 277599, China
| | - Q Q Yuan
- Department of Radiation Oncology, Tengzhou Central People's Hospital, Tengzhou 277599, China
| | - Y G Xu
- Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - C L Hao
- Department of Radiation Oncology, Tengzhou Central People's Hospital, Tengzhou 277599, China
| | - Z G Zhou
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - S Qie
- Department of Radiation Oncology, Affiliated Hospital of Hebei University, Baoding 071000, China
| | - N Lu
- Department of Radiation Oncology, the 7th Medical Center of PLA Army General Hospital, Beijing 100700, China
| | - C Han
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Q S Pang
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer, Tianjin 300060, China
| | - P Wang
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer, Tianjin 300060, China
| | - X C Sun
- Department of Radiation Oncology, Jiangsu People's Hospital/the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - K X Zhang
- Department of Radiation Oncology, Tengzhou Central People's Hospital, Tengzhou 277599, China
| | - G F Li
- Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - L Li
- Department of Radiation Oncology, Tengzhou Central People's Hospital, Tengzhou 277599, China
| | - M L Liu
- Department of Radiation Oncology, Affiliated Hospital of Hebei University, Baoding 071000, China
| | - Y D Wang
- Department of Radiation Oncology, the 7th Medical Center of PLA Army General Hospital, Beijing 100700, China
| | - X Y Qiao
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - S C Zhu
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Z M Zhou
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y D Zhao
- Department of Radiation Oncology, Anyang Cancer Hospital, Anyang 455000, China
| | - Z F Xiao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Schneider BJ, Hiers RD, Currier GF, Kadioglu O, Johnston SE, Zhao YD, Esteban Florez FL, Khajotia SS. Assessment of Streptococcus mutans biofilms on orthodontic adhesives over 7 days. Am J Orthod Dentofacial Orthop 2021; 160:50-57. [PMID: 34090735 DOI: 10.1016/j.ajodo.2020.03.026] [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] [Received: 12/01/2019] [Revised: 03/01/2020] [Accepted: 03/01/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The purpose of this study was to compare the metabolism of Streptococcus mutans biofilms after 1-7 days of growth on different orthodontic adhesives. METHODS Specimens of 6 commercial orthodontic adhesives were fabricated in custom-made molds and polymerized using a light-emitting diode light-curing unit. Bioluminescent S mutans (UA159:JM10) biofilms were grown on ultraviolet-sterilized specimens for 1, 3, 5, and 7 days (n = 18 biofilms/d/product) in anaerobic conditions at 37°C. The metabolism of biofilms (relative luminescence unit [RLU]) was measured 0, 2, 4, and 6 minutes after exposure to D-luciferin solution using a microplate reader. A linear mixed-effects model was used to analyze the logarithm of RLU (log RLU). The model included fixed effects of products, days, and minutes. Tukey-Kramer post-hoc tests were then performed on the significant predictors of log RLU (α = 0.05). RESULTS Days (P <0.0001) and minutes (P <0.0001) were independent predictors of log RLU, but the products were not (P = 0.5869). After adjusting for minutes, the log RLU was analyzed with a post-hoc test, and all differences between days were significant with the exceptions of day 3 from day 5 (P = 0.0731) and day 5 from day 7 (P = 0.8802). After adjusting for day, log RLU was analyzed with a post-hoc test and all differences in minutes were significant. CONCLUSIONS No significant differences in the metabolism of S mutans biofilms were observed among the 6 orthodontic adhesives. Biofilms that were grown for 3 days demonstrated the highest levels of biofilm metabolism as evidenced by higher mean log RLU values relative to 1, 5, and 7-day growth durations.
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Affiliation(s)
- Benjamin J Schneider
- Division of Orthodontics, Department of Developmental Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, Okla
| | - Rochelle D Hiers
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, Okla
| | - G Frans Currier
- Division of Orthodontics, Department of Developmental Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, Okla
| | - Onur Kadioglu
- Division of Orthodontics, Department of Developmental Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, Okla
| | - Sarah E Johnston
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Okla
| | - Yan D Zhao
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Okla
| | - Fernando L Esteban Florez
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, Okla
| | - Sharukh S Khajotia
- Division of Dental Biomaterials, Department of Restorative Sciences, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, Okla.
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Dasari TW, Csipo T, Amil F, Lipecz A, Fulop GA, Jiang Y, Samannan R, Johnston S, Zhao YD, Silva-Palacios F, Stavrakis S, Yabluchanskiy A, Po SS. Effects of Low-Level Tragus Stimulation on Endothelial Function in Heart Failure With Reduced Ejection Fraction. J Card Fail 2021; 27:568-576. [PMID: 33387632 PMCID: PMC9473302 DOI: 10.1016/j.cardfail.2020.12.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 08/07/2020] [Revised: 12/14/2020] [Accepted: 12/21/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND Autonomic dysregulation in heart failure with reduced ejection fraction plays a major role in endothelial dysfunction. Low-level tragus stimulation (LLTS) is a novel, noninvasive method of autonomic modulation. METHODS AND RESULTS We enrolled 50 patients with heart failure with reduced ejection fraction (left ventricular ejection fraction of ≤40%) in a randomized, double-blinded, crossover study. On day 1, patients underwent 60 minutes of LLTS with a transcutaneous stimulator (20 Hz, 200 μs pulse width) or sham (ear lobule) stimulation. Macrovascular function was assessed using flow-mediated dilatation in the brachial artery and cutaneous microcirculation with laser speckle contrast imaging in the hand and nail bed. On day 2, patients were crossed over to the other study arm and underwent sham or LLTS; vascular tests were repeated before and after stimulation. Compared with the sham, LLTS improved flow-mediated dilatation by increasing the percent change in the brachial artery diameter (from 5.0 to 7.5, LLTS on day 1, P = .02; and from 4.9 to 7.1, LLTS on day 2, P = .003), compared with no significant change in the sham group (from 4.6 to 4.7, P = .84 on day 1; and from 5.6 to 5.9 on day 2, P = .65). Cutaneous microcirculation in the hand showed no improvement and perfusion of the nail bed showed a trend toward improvement. CONCLUSIONS Our study demonstrated the beneficial effects of acute neuromodulation on macrovascular function. Larger studies to validate these findings and understand mechanistic links are warranted.
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Affiliation(s)
- Tarun W Dasari
- Cardiovascular Section, Department of Internal Medicine; Heart Rhythm Institute.
| | - Tamas Csipo
- Department of Biochemistry and Molecular Biology; Section of Geriatrics, Department of Internal Medicine
| | - Faris Amil
- Cardiovascular Section, Department of Internal Medicine
| | - Agnes Lipecz
- Department of Biochemistry and Molecular Biology; Section of Geriatrics, Department of Internal Medicine
| | - Gabor A Fulop
- Department of Biochemistry and Molecular Biology; Section of Geriatrics, Department of Internal Medicine
| | | | | | - Sarah Johnston
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Yan D Zhao
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | | | - Stavros Stavrakis
- Cardiovascular Section, Department of Internal Medicine; Heart Rhythm Institute
| | - Andriy Yabluchanskiy
- Department of Biochemistry and Molecular Biology; Section of Geriatrics, Department of Internal Medicine
| | - Sunny S Po
- Cardiovascular Section, Department of Internal Medicine; Heart Rhythm Institute
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Ahmed R, Muralidharan R, Srivastava A, Johnston SE, Zhao YD, Ekmekcioglu S, Munshi A, Ramesh R. Molecular Targeting of HuR Oncoprotein Suppresses MITF and Induces Apoptosis in Melanoma Cells. Cancers (Basel) 2021; 13:cancers13020166. [PMID: 33418925 PMCID: PMC7825065 DOI: 10.3390/cancers13020166] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 12/27/2020] [Accepted: 12/29/2020] [Indexed: 01/14/2023] Open
Abstract
Simple Summary The human antigen R (HuR) protein regulates the expression of hundreds of proteins in a cell that support tumor growth, drug resistance, and metastases. HuR is overexpressed in several human cancers, including melanoma, and is a molecular target for cancer therapy. Our study objective, therefore, was to develop HuR-targeted therapy for melanoma. We identified that HuR regulates the microphthalmia-associated transcription factor (MITF) that has been implicated in both intrinsic and acquired drug resistance in melanoma and is a putative therapeutic target in melanoma. Using a gene therapeutic approach, we demonstrated silencing of HuR reduced MITF protein expression and inhibited the growth of melanoma cells but not normal melanocytes. However, combining HuR-targeted therapy with a small molecule MEK inhibitor suppressed MITF and produced a synergistic antitumor activity against melanoma cells. Our study results demonstrate that HuR is a promising target for melanoma treatment and offers new combinatorial treatment strategies for overriding MITF-mediated drug resistance. Abstract Background: Treatment of metastatic melanoma possesses challenges due to drug resistance and metastases. Recent advances in targeted therapy and immunotherapy have shown clinical benefits in melanoma patients with increased survival. However, a subset of patients who initially respond to targeted therapy relapse and succumb to the disease. Therefore, efforts to identify new therapeutic targets are underway. Due to its role in stabilizing several oncoproteins’ mRNA, the human antigen R (HuR) has been shown as a promising molecular target for cancer therapy. However, little is known about its potential role in melanoma treatment. Methods: In this study, we tested the impact of siRNA-mediated gene silencing of HuR in human melanoma (MeWo, A375) and normal melanocyte cells in vitro. Cells were treated with HuR siRNA encapsulated in a lipid nanoparticle (NP) either alone or in combination with MEK inhibitor (U0126) and subjected to cell viability, cell-cycle, apoptosis, Western blotting, and cell migration and invasion assays. Cells that were untreated or treated with control siRNA-NP (C-NP) were included as controls. Results: HuR-NP treatment significantly reduced the expression of HuR and HuR-regulated oncoproteins, induced G1 cell cycle arrest, activated apoptosis signaling cascade, and mitigated melanoma cells’ aggressiveness while sparing normal melanocytes. Furthermore, we demonstrated that HuR-NP treatment significantly reduced the expression of the microphthalmia-associated transcription factor (MITF) in both MeWo and MITF-overexpressing MeWo cells (p < 0.05). Finally, combining HuR-NP with U0126 resulted in synergistic antitumor activity against MeWo cells (p < 0.01). Conclusion: HuR-NP exhibited antitumor activity in melanoma cells independent of their oncogenic B-RAF mutational status. Additionally, combinatorial therapy incorporating MEK inhibitor holds promise in overriding MITF-mediated drug resistance in melanoma.
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Affiliation(s)
- Rebaz Ahmed
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (R.A.); (R.M.); (A.S.)
- Graduate Program in Biomedical Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Ranganayaki Muralidharan
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (R.A.); (R.M.); (A.S.)
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (Y.D.Z.); (A.M.)
| | - Akhil Srivastava
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (R.A.); (R.M.); (A.S.)
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (Y.D.Z.); (A.M.)
| | - Sarah E. Johnston
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
| | - Yan D. Zhao
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (Y.D.Z.); (A.M.)
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
| | - Suhendan Ekmekcioglu
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Anupama Munshi
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (Y.D.Z.); (A.M.)
- Department of Radiation Oncology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Rajagopal Ramesh
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (R.A.); (R.M.); (A.S.)
- Graduate Program in Biomedical Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (Y.D.Z.); (A.M.)
- Correspondence: ; Tel.: +1-405-271-6101
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Elayapillai S, Ramraj S, Benbrook DM, Bieniasz M, Wang L, Pathuri G, Isingizwe ZR, Kennedy AL, Zhao YD, Lightfoot S, Hunsucker LA, Gunderson CC. Potential and mechanism of mebendazole for treatment and maintenance of ovarian cancer. Gynecol Oncol 2020; 160:302-311. [PMID: 33131904 DOI: 10.1016/j.ygyno.2020.10.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/09/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Mebendazole and other anti-parasitic drugs are being used off-prescription based on social media and unofficial accounts of their anti-cancer activity. The purpose of this study was to conduct a controlled evaluation of mebendazole's therapeutic efficacy in cell culture and in vivo models of ovarian cancer. The majority of ovarian cancers harbor p53 null or missense mutations, therefore the effects of p53 mutations and a mutant p53 reactivator, PRIMA-1MET (APR246) on mebendazole activity were evaluated. METHODS Mebendazole was evaluated in cisplatin-resistant high grade serous stage 3C ovarian cancer patient derived xenograft (PDX) models: PDX-0003 (p53 null) and PDX-0030 (p53 positive), and on ovarian cancer cell lines: MES-OV (p53 R282W), ES2 (p53 S241F), A2780 (p53 wild type), SKOV3 parental (p53 null) and isogenic sublines, SKOV3 R273H p53 and SKOV3 R248W p53. Drug synergy and mechanisms were evaluated in cell cultures using isobolograms, clonogenic assays and western blots. Prevention of tumor establishment was studied in a MES-OV orthotopic model. RESULTS Mebendazole inhibited growth of ovarian cancer cell cultures at nanomolar concentrations and PDXs at doses up to 50 mg/kg, and reduced orthotopic tumor establishment at 50 mg/kg. The mechanism of mebendazole was associated with p53-independent induction of p21 and tubule depolymerization. PRIMA-1MET also inhibited tumor establishment and worked synergistically with mebendazole in cell culture to inhibit growth and induce intrinsic apoptosis through a p53- and tubule destabilization-independent mechanism. CONCLUSION This work demonstrates the therapeutic potential of repurposing mebendazole and supports clinical development of mebendazole for ovarian cancer therapy and maintenance.
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Affiliation(s)
- Suganthapriya Elayapillai
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City 73104, OK, USA
| | - Satishkumar Ramraj
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City 73104, OK, USA; Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City 73104, OK, USA
| | - Doris Mangiaracina Benbrook
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City 73104, OK, USA; Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City 73104, OK, USA; Center for Cancer Prevention and Drug Development, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City 73104, OK, USA; Department of Pharmaceutical Sciences, College of Pharmacy, Oklahoma City 73117, OK, USA; Department of Pathology, College of Medicine, Oklahoma City 73104, OK, USA
| | - Magdalena Bieniasz
- Patient-Derived Xenograft and Preclinical Therapeutics Core facility, Aging and Metabolism Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Lin Wang
- Patient-Derived Xenograft and Preclinical Therapeutics Core facility, Aging and Metabolism Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Gopal Pathuri
- Center for Cancer Prevention and Drug Development, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City 73104, OK, USA; Department of Pharmaceutical Sciences, College of Pharmacy, Oklahoma City 73117, OK, USA
| | - Zitha Redempta Isingizwe
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City 73104, OK, USA; Department of Pharmaceutical Sciences, College of Pharmacy, Oklahoma City 73117, OK, USA
| | - Amy L Kennedy
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City 73104, OK, USA; Department of Pathology, College of Medicine, Oklahoma City 73104, OK, USA
| | - Yan D Zhao
- Biostatistics & Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City 73104, OK, USA
| | - Stanley Lightfoot
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City 73104, OK, USA; Center for Cancer Prevention and Drug Development, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City 73104, OK, USA
| | - Lauri A Hunsucker
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City 73104, OK, USA
| | - Camille C Gunderson
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City 73104, OK, USA; Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City 73104, OK, USA.
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14
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Pelargos PE, Chakraborty AR, Adogwa O, Swartz K, Zhao YD, Smith ZA, Dunn IF, Bauer AM. An Evaluation of Neurosurgical Practices During the Coronavirus Disease 2019 Pandemic. World Neurosurg 2020; 146:e91-e99. [PMID: 33065352 PMCID: PMC7550862 DOI: 10.1016/j.wneu.2020.10.025] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 12/20/2022]
Abstract
Objective We sought to understand how the coronavirus disease 2019 pandemic has affected the neurosurgical workforce. Methods We created a survey consisting of 22 questions to assess the respondent's operative experience, location, type of practice, subspecialty, changes in clinic and operative volumes, changes to staff, and changes to income since the pandemic began. The survey was distributed electronically to neurosurgeons throughout the United States and Puerto Rico. Results Of the 724 who opened the survey link, 457 completed the survey. The respondents were from throughout the United States and Puerto Rico and represented all practices types and subspecialties. Nearly all respondents reported hospital restrictions on elective surgeries. Most reported a decline in clinic and operative volume. Nearly 70% of respondents saw a decrease in the work hours of their ancillary providers, and almost one half (49.1%) of the respondents had had to downsize their practice staff, office assistants, nurses, schedulers, and other personnel. Overall, 43.6% of survey respondents had experienced a decline in income, and 27.4% expected a decline in income in the upcoming billing cycle. More senior neurosurgeons and those with a private practice, whether solo or as part of a group, were more likely to experience a decline in income as a result of the pandemic compared with their colleagues. Conclusion The coronavirus disease 2019 pandemic will likely have a lasting effect on the practice of medicine. Our survey results have described the early effects on the neurosurgical workforce. Nearly all neurosurgeons experienced a significant decline in clinical volume, which led to many downstream effects. Ultimately, analysis of the effects of such a pervasive pandemic will allow the neurosurgical workforce to be better prepared for similar events in the future.
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Affiliation(s)
- Panayiotis E Pelargos
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Arpan R Chakraborty
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Owoicho Adogwa
- Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Karin Swartz
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Yan D Zhao
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Zachary A Smith
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Ian F Dunn
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Andrew M Bauer
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
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15
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Hu MM, Yuan QQ, Zhang XS, Yang S, Wang X, Wang L, Chen JQ, Zhang WC, Wang XM, Ge XL, Shen WB, Xu YG, Hao CL, Zhou ZG, Qie S, Lu N, Pang QS, Zhao YD, Sun XC, Li GF, Li L, Qiao XY, Liu ML, Wang YD, Li C, Zhu SC, Han C, Zhang KX, Xiao ZF. [Efficacy analysis of the radiotherapy and chemotherapy in patients with stage Ⅳ esophageal squamous carcinoma: a multicenter retrospective study of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG R-01F)]. Zhonghua Zhong Liu Za Zhi 2020; 42:676-681. [PMID: 32867461 DOI: 10.3760/cma.j.cn112152-20190327-00197] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the survival and prognostic factors of radiotherapy in patient with Ⅳ stage esophageal squamous carcinoma treated with radiation or chemoradiation. Methods: The medical records of 608 patients with stage Ⅳ esophageal squamous cell carcinoma who met the inclusion criteria in 10 medical centers in China from 2002 to 2016 were retrospectively analyzed. The overall survival and prognostic factors of all patients at 1, 3 and 5 years were analyzed. Results: The 1-, 3-, 5- year overall survival (OS) rates was 66.7%, 29.5% and 24.3% in stage ⅣA patients, and 58.8%, 29.0% and 23.5% in stage ⅣB patients. There was no statistical difference between the two groups (P=0.255). Univariate analysis demonstrated that the length of lesion, treatment plan, planned tumor target volume (PGTV) dose, subsequent chemotherapy, and degrees of anemia, radiation esophagitis, radiation pneumonia were related to the prognoses of patients with Ⅳ stage esophageal carcinomas after radiotherapy and chemotherapy (P<0.05). Multivariate analysis demonstrated that PGTV dose (OR=0.693, P=0.004), radiation esophagitis (OR=0.867, P=0.038), and radiation pneumonia (OR=1.181, P=0.004) were independent prognostic factors for OS. Conclusions: For patients with stage Ⅳ esophageal squamous cell carcinoma, chemoradiotherapy followed by sequential chemotherapy is recommended, which can extend the total survival and improve the prognosis of the patients. PGTV dose more than 60 Gy has better efficacy.
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Affiliation(s)
- M M Hu
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou, 277599, China
| | - Q Q Yuan
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou, 277599, China
| | - X S Zhang
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou, 277599, China
| | - S Yang
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou, 277599, China
| | - X Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Wang
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China
| | - J Q Chen
- Department of Radiation Oncology, Fujian Cancer Hospital/Fujian Medical University Cancer Hospital, Fuzhou 350014, China
| | - W C Zhang
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer, Tianjin 300060, China
| | - X M Wang
- Department of Radiation Oncology, Anyang Cancer Hospital, Anyang 455000, China
| | - X L Ge
- Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - W B Shen
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China
| | - Y G Xu
- Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology Beijing 100730, China
| | - C L Hao
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou, 277599, China
| | - Z G Zhou
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China
| | - S Qie
- Department of Radiation Oncology, Affiliated Hospital of Hebei University, Baoding 071000, China
| | - N Lu
- Department of Radiation Oncology, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China
| | - Q S Pang
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer, Tianjin 300060, China
| | - Y D Zhao
- Department of Radiation Oncology, Anyang Cancer Hospital, Anyang 455000, China
| | - X C Sun
- Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - G F Li
- Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology Beijing 100730, China
| | - L Li
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou, 277599, China
| | - X Y Qiao
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China
| | - M L Liu
- Department of Radiation Oncology, Affiliated Hospital of Hebei University, Baoding 071000, China
| | - Y D Wang
- Department of Radiation Oncology, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China
| | - C Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - S C Zhu
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China
| | - C Han
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China
| | - K X Zhang
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou, 277599, China
| | - Z F Xiao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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16
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Pelargos PE, Chakraborty A, Zhao YD, Smith ZA, Dunn IF, Bauer AM. An Evaluation of Neurosurgical Resident Education and Sentiment During the Coronavirus Disease 2019 Pandemic: A North American Survey. World Neurosurg 2020; 140:e381-e386. [PMID: 32512244 PMCID: PMC7274118 DOI: 10.1016/j.wneu.2020.05.263] [Citation(s) in RCA: 44] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has had a tremendous impact on the healthcare system. Owing to restrictions in elective surgery and social distancing guidelines, the training curriculum for neurosurgical trainees has been rapidly evolving. This evolution could have significant long-term effects on the training of neurosurgery residents. The objective of the present study was to assess the effects of COVID-19 on neurosurgical training programs and residents. METHODS A survey consisting of 31 questions assessing changes to resident clinical and educational workload and their sentiment regarding how these changes might affect their careers was distributed electronically to neurosurgery residents in the United States and Canada. RESULTS The survey respondents were from 29 states and Canada and were relatively evenly spread across all levels of residency. Nearly 82% reported that the inpatient and outpatient volumes had been either greatly (44.0%) or moderately (37.8%) reduced. Greater than 91% reported that their work responsibilities or access to the hospital had been reduced, with a significant reduction in work hours and a significant increase in resident didactics (P < 0.001). Senior residents expressed concern about their educational experience and their future career prospects as a result of the pandemic. CONCLUSION Universally, residents have experienced reduced work hours and a reduction in their operative case volumes. Programs have adapted by increasing didactic time and using electronic platforms. It is quite possible that this remarkable period will prompt a critical reappraisal of the pre-COVID-19 adequacy of educational content in our training programs and that the enhanced educational efforts driven by this pandemic could be lasting.
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Affiliation(s)
- Panayiotis E Pelargos
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Arpan Chakraborty
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Yan D Zhao
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Zachary A Smith
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Ian F Dunn
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Andrew M Bauer
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
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17
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Battiste JD, Ikeguchi A, Woo S, Sharan S, Zhao YD, Cohoon A, Sung S, Wright D, Teague AM, Jensen RL, Kim EH, Yang WS, Towner RA. Phase Ib clinical trial of OKN-007 in recurrent malignant glioma. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.2538] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2538 Background: Despite therapeutic advances, the median overall survival for patients with recurrent, high-grade gliomas remains poor. Thus, there is an urgent need for efficacious new therapies. The nitrone compound, OKN-007 (disodium 4-[(tert-butyl-imino) methyl] benzene-1,3-disulfonate N-oxide) is a promising novel anti-cancer agent. In orthotopic glioblastoma xenografts, OKN-007 reduces cell proliferation and angiogenesis, and increases apoptosis. Here we report on the safety, efficacy, and pharmacokinetics (PK) of OKN-007 in adults with recurrent glioma. Methods: NCT01672463 is a phase Ib trial of OKN-007 in adults with recurrent gliomas previously treated with standard therapy. Patients with recurrence, adequate performance status and organ function, receiving clinically appropriate doses of steroids, with a life expectancy greater than 8 weeks were eligible. OKN-007 was administered by IV. The study comprised a 3+3 dose escalation design followed by an expansion cohort at the maximum tolerated dose (MTD). The dose escalation drug levels were 20 (n = 3), 40 (n = 3), and 60 mg/kg (n = 3), treating on a schedule of thrice weekly for 4 weeks, then twice weekly for 4 weeks, then once weekly until progression. Drug PK was determined in the dose escalation cohorts. The expansion cohort was treated with 60 mg/kg thrice weekly for 12 weeks, then twice weekly for 12 weeks, then once weekly until recurrence (n = 6). Kaplan-Meier analysis was used to determine progression-free (PFS) and overall survival (OS). Results: Median age was 51 years (range, 25-62). No dose-limiting toxicities were observed and 60 mg/kg was chosen for the expansion dose. Of 123 adverse events (AE), 34 were deemed probably (1.6%) or possibly (26%) treatment-emergent (TEAE). The most commonly-occurring TEAE were fatigue (4.1%) and headache (3.3%). No drug-attributable grade 4 or 5 AE were observed. Grade 3 TEAE included headache, urinary tract infection, and increased prothrombin time (0.8% each). Only two grade 1 AE, hypokalemia and dizziness, were considered probably attributable to OKN-007. In patients receiving 60 mg OKN-007/kg, median PFS was 1.4 months and OS was 21 months (log rank p = 0.08 for comparison across doses). Systemic PK exposure was dose proportional. The average half-life of OKN-007 is 2.8 hours. Conclusions: OKN-007 appears safe for patients with recurrent glioma. The MTD was not reached. Our data suggest that, compared to standard therapy, OKN-007 may prolong OS in recurrent glioma. Based on new data, a trial of OKN-007 plus temozolomide is underway in patients with newly diagnosed glioblastoma (NCT03587038). Clinical trial information: NCT01672463 .
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Affiliation(s)
- James D. Battiste
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Alexandra Ikeguchi
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | | | | | - Yan D. Zhao
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Andrew Cohoon
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Sarah Sung
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Deborah Wright
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - April M. Teague
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Randy L. Jensen
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
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18
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Lu N, Wang X, Li C, Wang L, Chen JQ, Zhang WC, Wang XM, Ge XL, Shen WB, Hu MM, Yuan QQ, Xu YG, Hao CL, Zhou ZG, Qie S, Xiao ZF, Zhu SC, Han C, Qiao XY, Pang QS, Wang P, Zhao YD, Sun XC, Zhang KX, Li L, Li GF, Liu ML, Wang YD. [Prognostic analysis of definitive radiotherapy for early esophageal carcinoma(T1-2N0M0): a multi-center retrospective study of Jing-Jin-ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group]. Zhonghua Zhong Liu Za Zhi 2020; 42:139-144. [PMID: 32135649 DOI: 10.3760/cma.j.issn.0253-3766.2020.02.010] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the prognostic factors of T1-2N0M0 esophageal squamous cell carcinoma (ESCC) treated with definitive radiotherapy. Methods: The clinical data of 196 patients with T1-2N0M0 ESCC who were treated with definitive radiotherapy in 10 hospitals were retrospectively analyzed. All sites were members of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG). Radiochemotherapy were applied to 78 patients, while the other 118 patients received radiotherapy only. 96 patients were treated with three-dimensional conformal radiotherapy (3DCRT) and 100 treated with intensity-modulated radiotherapy (IMRT). The median dose of plan target volume(PTV) and gross target volume(GTV) were both 60 Gy. The median follow-up time was 59.2 months. Log rank test and Cox regression analysis were used for univariat and multivariate analysis, respectively. Results: The percentage of normal lung receiving at least 20 Gy (V(20)) was (18.65±7.20)%, with average dose of (10.81±42.05) Gy. The percentage of normal heart receiving at least 30 Gy (V(30)) was (14.21±12.28)%. The maximum dose of exposure in spinal cord was (39.65±8.13) Gy. The incidence of radiation pneumonia and radiation esophagitis were 14.80%(29/196) and 65.82%(129/196), respectively. The adverse events were mostly grade 1-2, without grade 4 toxicity. Median overall survival (OS) and progression-free survival (PFS) were 70.1 months and 62.3 months, respectively. The 1-, 3- and 5-year OS rates of all patients were 75.1%、57.4% and 53.2%, respectively. The 1-, 3- and 5-year PFS rates were 75.1%、57.4% and 53.2%, respectively. Multivariate analysis demonstrated that patients'age (HR=1.023, P=0.038) and tumor diameter (HR=1.243, P=0.028)were the independent prognostic factors for OS, while tumor volume were the independent prognostic factor for PFS. Conclusions: Definitive radiotherapy is a promising therapeutic method in patients with T1-2N0M0 ESCC. Patients' age, tumor diameter and tumor volume may impact patients' prognosis.
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Affiliation(s)
- N Lu
- Department of Radiation Oncology, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China
| | - X Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - C Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Wang
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - J Q Chen
- Department of Radiation Oncology, Fujian Cancer Hospital/Fujian Medical University Cancer Hospital, Fuzhou 350014, China
| | - W C Zhang
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer, Tianjin 300060, China
| | - X M Wang
- Department 4th of Radiation Oncology, Anyang Cancer Hospital, Anyang 455000, China
| | - X L Ge
- Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - W B Shen
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - M M Hu
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou 277599, China
| | - Q Q Yuan
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou 277599, China
| | - Y G Xu
- Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - C L Hao
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou 277599, China
| | - Z G Zhou
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - S Qie
- Department of Radiation Oncology, Affiliated Hospital of Hebei University, Baoding 071000, China
| | - Z F Xiao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - S C Zhu
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - C Han
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - X Y Qiao
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Q S Pang
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer, Tianjin 300060, China
| | - P Wang
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer, Tianjin 300060, China
| | - Y D Zhao
- Department 4th of Radiation Oncology, Anyang Cancer Hospital, Anyang 455000, China
| | - X C Sun
- Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - K X Zhang
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou 277599, China
| | - L Li
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou 277599, China
| | - G F Li
- Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - M L Liu
- Department of Radiation Oncology, Affiliated Hospital of Hebei University, Baoding 071000, China
| | - Y D Wang
- Department of Radiation Oncology, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China
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Dasari TW, Patel B, Wayangankar SA, Alexander D, Zhao YD, Schlegel J, Leung C, Lozano P, Latif F, Thadani U. Prognostic Value of 6-Minute Walk Distance in Patients Undergoing Percutaneous Coronary Intervention: a Veterans Affairs Prospective Study. Tex Heart Inst J 2020; 47:10-14. [PMID: 32148446 DOI: 10.14503/thij-17-6471] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The 6-minute walk distance (6MWD) test is a useful prognostic tool in chronic heart failure. Its usefulness after percutaneous coronary intervention is unknown. In a prospective observational study, patients underwent a 6MWD test within 2 weeks after percutaneous coronary intervention. The primary endpoint was major adverse cardiovascular events (MACE) (death, acute coronary syndrome, and heart failure admission) at one year. Receiver operating characteristic curves and area under the curve were used to determine the 6MWD test's predictive power, and the Youden index was used to measure its effectiveness. A total of 212 patients were enrolled (98% men; mean age, 65 ± 9 yr). Major comorbidities were hypertension in 187 patients (88%), dyslipidemia in 186 (88%), and diabetes mellitus in 95 (45%). Among the 176 patients (83%) who completed the 6MWD test, the incidence of MACE at one year was 22% (acute coronary syndrome in 17%; heart failure admission in 4%; and death in 3%). The area under the curve for MACE was 0.59, and 6MWD was shorter for patients with MACE than for those without (290 vs 326 m; P=0.03). For 39 patients with previous heart failure who completed the 6MWD test, the area under the curve was 0.64 for MACE and 0.78 for heart failure admission. The 6MWD test predicted reasonably well the incidence of MACE one year after percutaneous coronary intervention. In a subgroup of patients with previous heart failure, it fared even better in predicting heart failure admission. Larger studies are needed to confirm these findings.
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20
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Ross CJ, Laurence DW, Hsu MC, Baumwart R, Zhao YD, Mir A, Burkhart HM, Holzapfel GA, Wu Y, Lee CH. Mechanics of Porcine Heart Valves' Strut Chordae Tendineae Investigated as a Leaflet-Chordae-Papillary Muscle Entity. Ann Biomed Eng 2020; 48:1463-1474. [PMID: 32006267 PMCID: PMC8048774 DOI: 10.1007/s10439-020-02464-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 01/23/2020] [Indexed: 11/28/2022]
Abstract
Proper blood flow through the atrioventricular heart valves (AHVs) relies on the holistic function of the valve and subvalvular structures, and a failure of any component can lead to life-threatening heart disease. A comprehension of the mechanical characteristics of healthy valvular components is necessary for the refinement of heart valve computational models. In previous studies, the chordae tendineae have been mechanically characterized as individual structures, usually in a clamping-based approach, which may not accurately reflect the in vivo chordal interactions with the leaflet insertion and papillary muscles. In this study, we performed uniaxial mechanical testing of strut chordae tendineae of the AHVs under a unique tine-based leaflet-chordae-papillary muscle testing to observe the chordae mechanics while preserving the subvalvular component interactions. Results of this study provided insight to the disparity of chordae tissue stress-stretch responses between the mitral valve (MV) and the tricuspid valve (TV) under their respective emulated physiological loading. Specifically, strut chordae tendineae of the MV anterior leaflet had peak stretches of 1.09-1.16, while peak stretches of 1.08-1.11 were found for the TV anterior leaflet strut chordae. Constitutive parameters were also derived for the chordae tissue specimens using an Ogden model, which is useful for AHV computational model refinement. Results of this study are beneficial to the eventual improvement of treatment methods for valvular disease.
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Affiliation(s)
- Colton J Ross
- Biomechanics and Biomaterials Design Laboratory (BBDL), School of Aerospace and Mechanical Engineering, The University of Oklahoma, 865 Asp Ave., Felgar Hall Rm. 219C, Norman, OK, 73019-3609, USA
| | - Devin W Laurence
- Biomechanics and Biomaterials Design Laboratory (BBDL), School of Aerospace and Mechanical Engineering, The University of Oklahoma, 865 Asp Ave., Felgar Hall Rm. 219C, Norman, OK, 73019-3609, USA
| | - Ming-Chen Hsu
- Department of Mechanical Engineering, Iowa State University, Ames, IA, 50011, USA
| | - Ryan Baumwart
- Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, 74078, USA
| | - Yan D Zhao
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Arshid Mir
- Department of Pediatric Cardiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Harold M Burkhart
- Department of Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Gerhard A Holzapfel
- Institute of Biomechanics, Graz University of Technology, Graz, Austria.,Department of Structural Engineering, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Yi Wu
- Biomechanics and Biomaterials Design Laboratory (BBDL), School of Aerospace and Mechanical Engineering, The University of Oklahoma, 865 Asp Ave., Felgar Hall Rm. 219C, Norman, OK, 73019-3609, USA
| | - Chung-Hao Lee
- Biomechanics and Biomaterials Design Laboratory (BBDL), School of Aerospace and Mechanical Engineering, The University of Oklahoma, 865 Asp Ave., Felgar Hall Rm. 219C, Norman, OK, 73019-3609, USA. .,Institute for Biomedical Engineering, Science and Technology (IBEST), The University of Oklahoma, Norman, OK, 73019, USA.
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21
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Ramraj SK, Elayapillai SP, Pelikan RC, Zhao YD, Isingizwe ZR, Kennedy AL, Lightfoot SA, Benbrook DM. Novel ovarian cancer maintenance therapy targeted at mortalin and mutant p53. Int J Cancer 2020; 147:1086-1097. [PMID: 31845320 DOI: 10.1002/ijc.32830] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 11/26/2019] [Accepted: 12/06/2019] [Indexed: 12/22/2022]
Abstract
Current ovarian cancer maintenance therapy is limited by toxicity and no proven impact on overall survival. To study a maintenance strategy targeted at missense mutant p53, we hypothesized that the release of mutant p53 from mortalin inhibition by the SHetA2 drug combined with reactivation of mutant p53 with the PRIMA-1MET drug inhibits growth and tumor establishment synergistically in a mutant-p53 dependent manner. The Cancer Genome Atlas (TCGA) data and serous ovarian tumors were evaluated for TP53 and HSPA9/mortalin status. SHetA2 and PRIMA-1MET were tested in ovarian cancer cell lines and fallopian tube secretory epithelial cells using isobolograms, fluorescent cytometry, Western blots and ELISAs. Drugs were administered to mice after peritoneal injection of MESOV mutant p53 ovarian cancer cells and prior to tumor establishment, which was evaluated by logistic regression. Fifty-eight percent of TP53 mutations were missense and there were no mortalin mutations in TCGA high-grade serous ovarian cancers. Mortalin levels were sequentially increased in serous benign, borderline and carcinoma tumors. SHetA2 caused p53 nuclear and mitochondrial accumulation in cancer, but not in healthy, cells. Endogenous or exogenous mutant p53 increased SHetA2 resistance. PRIMA-1MET decreased this resistance and interacted synergistically with SHetA2 in mutant and wild type p53-expressing cell lines in association with elevated reactive oxygen species/ATP ratios. Tumor-free rates in animals were 0% (controls), 25% (PRIMA1MET ), 42% (SHetA2) and 67% (combination). SHetA2 (p = 0.004) and PRIMA1MET (p = 0.048) functioned additively in preventing tumor development with no observed toxicity. These results justify the development of SHetA2 and PRIMA-1MET alone and in combination for ovarian cancer maintenance therapy.
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Affiliation(s)
- Satish K Ramraj
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Sugantha P Elayapillai
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Richard C Pelikan
- Genes and Human Disease Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK
| | - Yan D Zhao
- Biostatistics & Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Zitha R Isingizwe
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Amy L Kennedy
- Department of Pathology, College of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Stanley A Lightfoot
- Center for Cancer Prevention and Drug Development, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Doris M Benbrook
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK.,Center for Cancer Prevention and Drug Development, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK.,Obstetrics and Gynecologic, College of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK
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22
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Andrade D, Mehta M, Griffith J, Oh S, Corbin J, Babu A, De S, Chen A, Zhao YD, Husain S, Roy S, Xu L, Aube J, Janknecht R, Gorospe M, Herman T, Ramesh R, Munshi A. HuR Reduces Radiation-Induced DNA Damage by Enhancing Expression of ARID1A. Cancers (Basel) 2019; 11:cancers11122014. [PMID: 31847141 PMCID: PMC6966656 DOI: 10.3390/cancers11122014] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/25/2019] [Accepted: 11/29/2019] [Indexed: 12/11/2022] Open
Abstract
Tumor suppressor ARID1A, a subunit of the chromatin remodeling complex SWI/SNF, regulates cell cycle progression, interacts with the tumor suppressor TP53, and prevents genomic instability. In addition, ARID1A has been shown to foster resistance to cancer therapy. By promoting non-homologous end joining (NHEJ), ARID1A enhances DNA repair. Consequently, ARID1A has been proposed as a promising therapeutic target to sensitize cancer cells to chemotherapy and radiation. Here, we report that ARID1A is regulated by human antigen R (HuR), an RNA-binding protein that is highly expressed in a wide range of cancers and enables resistance to chemotherapy and radiation. Our results indicate that HuR binds ARID1A mRNA, thereby increasing its stability in breast cancer cells. We further find that ARID1A expression suppresses the accumulation of DNA double-strand breaks (DSBs) caused by radiation and can rescue the loss of radioresistance triggered by HuR inhibition, suggesting that ARID1A plays an important role in HuR-driven resistance to radiation. Taken together, our work shows that HuR and ARID1A form an important regulatory axis in radiation resistance that can be targeted to improve radiotherapy in breast cancer patients.
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Affiliation(s)
- Daniel Andrade
- Department of Radiation Oncology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (D.A.); (M.M.); (J.G.); (T.H.)
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (S.O.); (A.B.); (Y.D.Z.); (R.J.); (R.R.)
| | - Meghna Mehta
- Department of Radiation Oncology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (D.A.); (M.M.); (J.G.); (T.H.)
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (S.O.); (A.B.); (Y.D.Z.); (R.J.); (R.R.)
| | - James Griffith
- Department of Radiation Oncology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (D.A.); (M.M.); (J.G.); (T.H.)
| | - Sangphil Oh
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (S.O.); (A.B.); (Y.D.Z.); (R.J.); (R.R.)
- Department of Cell Biology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Joshua Corbin
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (J.C.)
| | - Anish Babu
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (S.O.); (A.B.); (Y.D.Z.); (R.J.); (R.R.)
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (J.C.)
| | - Supriyo De
- National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA; (S.D.); (M.G.)
| | - Allshine Chen
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
| | - Yan D. Zhao
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (S.O.); (A.B.); (Y.D.Z.); (R.J.); (R.R.)
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
| | - Sanam Husain
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (J.C.)
| | - Sudeshna Roy
- Division of Chemical Biology and Medicinal Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA (J.A.)
| | - Liang Xu
- Department of Molecular Biosciences, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Jeffrey Aube
- Division of Chemical Biology and Medicinal Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA (J.A.)
| | - Ralf Janknecht
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (S.O.); (A.B.); (Y.D.Z.); (R.J.); (R.R.)
- Department of Cell Biology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (J.C.)
| | - Myriam Gorospe
- National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA; (S.D.); (M.G.)
| | - Terence Herman
- Department of Radiation Oncology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (D.A.); (M.M.); (J.G.); (T.H.)
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (S.O.); (A.B.); (Y.D.Z.); (R.J.); (R.R.)
| | - Rajagopal Ramesh
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (S.O.); (A.B.); (Y.D.Z.); (R.J.); (R.R.)
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (J.C.)
- Graduate Program in Biomedical Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Anupama Munshi
- Department of Radiation Oncology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (D.A.); (M.M.); (J.G.); (T.H.)
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (S.O.); (A.B.); (Y.D.Z.); (R.J.); (R.R.)
- Correspondence: ; Tel.: +1-405-271-6102; Fax: +1-405-271-2141
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Sadhasivam B, Gunderson CC, Hahn EH, Johnston SE, Zhao YD, Ganapathy V, Queimado L. Abstract 4219: Mitochondrial DNA damage: A promising tool to screen cervical cancer risk. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-4219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Cervical cancer is the 4th most common female cancer, accounting for 500,000 new cases and 200,000 deaths across the world. 99% of cervical cancer is due to infection by human papillomavirus (HPV). The factors leading to HPV integration and induced carcinogenesis are not entirely clear, but high DNA damage levels have been proposed to play a role in HPV integration. Chronic HPV infection increases DNA damage and reduces DNA repair, leading to even higher DNA damage levels. Recently, we showed that the levels of nuclear DNA (nDNA) damage are a potential biomarker predictive of cancer risk. Mitochondrial DNA (mtDNA) damage has been reported to be more persistent than nDNA damage. We have previously demonstrated a good correlation between mtDNA and nDNA damage. Herein, we performed a pilot study to assess whether the levels of mtDNA damage can be used as a potential tool to screen cancer risk.
Aims: (1) To measure determine whether the amount of mtDNA damage differs between cervical samples with distinct pathologies. (2) To determine whether the number of mtDNA lesions correlates with the grade of cervical dysplasia.
Methods: Ethics Committee approval and written informed consent was obtained from all participants. Samples from 25 patients were collected from the endocervix during a pelvic exam in the Dysplasia Clinic. Samples for DNA damage studies were collected by cytobrush and DNA extracted as previously reported. Demographic and risk factor data were collected through detailed questionnaires. Clinicopathologic data was abstracted from the medical chart. The amount of mtDNA damage was quantified by a long-run real-time PCR-based DNA-damage quantification (LORDQ) assay. Data were analyzed by Student's t-tests. Logistic regression analysis was done modeling the probability of having present pathology risk.
Results: Histopathological reports indicated that 9 cervical samples were normal (C0) and 16 had cervical dysplasia. Dysplasia samples were as follows: 9 low-grade squamous intraepithelial lesions (LSILs or C1) and 7 high-grade squamous intraepithelial lesions (HSILs or C2/3). The amount of mtDNA lesions per 10,000 bases were increased two-fold in LSILs or C1 cases and three-fold in HSILs or C2/3 cases when compared to C0. Regression analysis showed no significant correlation between age, race, smoking and drinking status compare with pathology risk.
Conclusion: Our data show that mtDNA damage is the lowest in patients without cervical dysplasia and increases progressively with higher grades of dysplasia and correspondent cancer risk. This pilot study shows the feasibility of the approach and stresses the potential of using mtDNA damage to predict cervical cancer risk. Measuring mtDNA damage detection by LORDQ is less time consuming and more cost-effective than the measurement of nDNA damage. Larger population studies are urgently needed to fully assess the potential of this approach for cervical cancer risk.
Citation Format: Balaji Sadhasivam, Camille C. Gunderson, Elizabeth H. Hahn, Sarah E. Johnston, Yan D. Zhao, Vengatesh Ganapathy, Lurdes Queimado. Mitochondrial DNA damage: A promising tool to screen cervical cancer risk [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4219.
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Affiliation(s)
| | | | | | | | - Yan D. Zhao
- University of Oklahoma Health Science Center, Oklahoma City, OK
| | | | - Lurdes Queimado
- University of Oklahoma Health Science Center, Oklahoma City, OK
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24
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Malla M, Johnston SE, Zhao YD, Pareek V. Survival outcomes following cytoreductive nephrectomy (CN) in patients with metastatic renal cell sarcomas (MRCS). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e22519] [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: 11/20/2022] Open
Abstract
e22519 Background: RCS are rare soft tissue sarcomas and account for 0.8-2.7% of malignant kidney tumors. Level 1 evidence guiding optimal patient management is lacking due to the rarity of this disease. Utilizing the NCDB, we analyzed prognostic factors, the current treatment patterns and outcomes in patients with RCS in the United States. Methods: The NCDB was queried from 2004- 2015 for patients diagnosed with MRCS. Baseline patient characteristics were summarized using descriptive statistics. Impact of baseline demographic, Clinicopathologic variables and treatment on overall survival (OS) was evaluated using univariate (UV) and multivariable (MV) cox proportional hazards analysis. Results: 454 patients diagnosed with MRCS between 2004- 2015 were included in this analysis. Median age at diagnosis was 63. Males (62%) had higher incidence of RCS compared with females. 86% (n = 389) were Caucasian, while only 9.5% (n = 43) were African American. Right and left kidneys were equally affected. Spindle cell sarcoma was the most common histology (n = 276). 37.5% (n = 170) underwent CN. 49% of patients received chemotherapy (n = 216) and 24% received radiation therapy (n = 109). Overall, 48% (n = 82) of patients who underwent nephrectomy had chemotherapy. Median OS was 4.5 months (3.8-5.2 mos.). On UV analysis age ≥ 55 years (HR: 1.92, p < 0.001), no systemic treatment (HR: 1.91, P < 0.01), and no CN (HR: 2.1, p < .001) had worse OS. On MV analysis, patients who did not undergo CN had significantly worsened OS compared to CN (7.56 vs 3.35 mos., HR-1.91, CI: 1.52- 2.41 p < 0.001). Patients who received chemotherapy after CN had a better OS (13.3 vs 3.7 mos., p < 0.001). Conclusions: MRCS is an aggressive malignancy with a median OS of less than 5 months. Age at diagnosis, CN and systemic therapy had a statistically significant impact on OS. Given the rarity of the tumor and inadequacy of guidelines, these results can be considered in making management decisions. We understand the limitations of a registry-based study and hence, prospective multi-national clinical trials are essential to further guide us on management of this rare tumor. [Table: see text]
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Affiliation(s)
- Midhun Malla
- Oklahoma University of Health Sciences Center, Oklahoma City, OK
| | | | - Yan D Zhao
- University of Oklahoma, Oklahoma City, OK
| | - Vipul Pareek
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
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25
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Huang JJ, Yao Y, Xia CJ, Zhao YD, Yu S, Gao Y, Ye GH, Yu LS, Fan YY. Relationship between the Number of Neutrophils and Myofibroblasts during Diabetic Wound Healing and Wound Age. Fa Yi Xue Za Zhi 2019; 35:149-153. [PMID: 31135107 DOI: 10.12116/j.issn.1004-5619.2019.02.004] [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] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Indexed: 11/30/2022]
Abstract
Abstract Objective To investigate the sequential changes of the number of neutrophils and myofibroblasts during diabetic wound healing, and discuss its application value in wound age estimation. Methods Diabetic DB mice and mice of the same age in the normal control group were selected, a wound healing model was established, wound samples were taken at different time points, while the number of neutrophils and myofibroblasts during diabetic wound healing were determined by immunohistochemical staining technique. Results The number of infiltrated neutrophils in the wounds of control and diabetic groups reached the peak respectively at 12 h and 5 d after injury. Compared with the control group, the number of neutrophils in the diabetic group decreased significantly from 6 h to 1 d after injury, but increased markedly from 5 d to 14 d. From 5 d to 10 d after injury, the average number of neutrophils at high magnification in wounds of the diabetic group was over 30, while that of neutrophils in wounds of the control group was less than 20. Myofibroblasts appeared in wounds from 3 d to 14 d after injury in the control group and from 5 d to 14 d after injury in the diabetic group. The difference in the number of myofibroblasts in wounds between control group and diabetic group from 3 to 7 d after injury had statistical significance. Conclusion In comparison with normal wound healing, the number of neutrophils and myofibroblasts during diabetic wound healing shows different sequential changes. The results of this study can provide reference for wound age estimation of patients with severe diabetes.
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Affiliation(s)
- J J Huang
- Department of Forensic Medicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Judical Forensic Center, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Institute of Forensic Science, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
| | - Y Yao
- Department of Forensic Medicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Judical Forensic Center, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Institute of Forensic Science, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
| | - C J Xia
- Department of Forensic Medicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Judical Forensic Center, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Institute of Forensic Science, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
| | - Y D Zhao
- Department of Forensic Medicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Judical Forensic Center, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Institute of Forensic Science, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
| | - S Yu
- Department of Forensic Medicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Judical Forensic Center, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Institute of Forensic Science, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
| | - Y Gao
- Department of Forensic Medicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Judical Forensic Center, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Institute of Forensic Science, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
| | - G H Ye
- Department of Forensic Medicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Judical Forensic Center, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Institute of Forensic Science, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
| | - L S Yu
- Department of Forensic Medicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Judical Forensic Center, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Institute of Forensic Science, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
| | - Y Y Fan
- Department of Forensic Medicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Judical Forensic Center, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China.,Institute of Forensic Science, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
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26
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Tucker P, Pfefferbaum B, Zhao YD, Johnston SE, Mistry A, Khan QS. Associations of biological stress markers in hurricane survivors: Heartrate variability, Interleukin-2 and Interleukin-6 in depression and PTSD. Am J Disaster Med 2019; 13:267-278. [PMID: 30821340 DOI: 10.5055/ajdm.2018.0306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Inflammatory and immunologic cytokines and vagal activity have important roles in health and mental health, and may influence each other. The authors assessed relationships of representative biomarkers linked to disaster exposure-heart rate variability (HRV) with Interleukin-2 (IL-2, cell-medicated immunity) and Interleukin-6 (IL-6, pro-inflammatory and pro-immunologic), stratified by psychiatric diagnosis. DESIGN Participants were assessed for psychiatric diagnosis, IL-2, IL-6, HRV, and HR reactivity to trauma reminders. SETTING Outpatient university psychiatry clinics in Oklahoma City and Tulsa. PARTICIPANTS Relocated Katrina survivors and demographically matched controls, not on psychiatric, cardiovascular, or inflammatory medications. MAIN OUTCOME MEASURES SCID-IV, baseline serum IL-2 and IL-6, HRV through power spectral analysis. RESULTS Survivors had higher sympathetic and lower parasympathetic activity at baseline and lower parasympathetic HR reactivity than controls, with flattened parasympathetic reactivity in the presence of depression and of post-traumatic stress disorder (PTSD). Survivors' IL-2 and IL-6 did not differ from controls and did not differ in PTSD or depression. Depressed survivors' sympathetic reactivity correlated negatively with IL-2 and parasympathetic reactivity correlated positively with IL-2. CONCLUSIONS HRV differed after hurricane exposure and with survivors& depression and/or PTSD, more sensitively capturing somatic sequelae than assessed cytokines. Higher sympathetic HR reactivity associated with lower immuno-logic IL-2 may indicate a double biological "hit" in depressed disaster survivors, possibly rendering them more vulnerable to cardiovascular and immunologic illness as well as depression. Associations of HRV with IL-2 may support reciprocal influences of cytokines and vagal activity. Lack of significant correlations of IL-6 with HRV measures is consistent with its pleiotropic role.
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Affiliation(s)
- Phebe Tucker
- Professor and Ungerman Endowed Chair, Department of Psychiatry & Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Betty Pfefferbaum
- Emeritus Professor, Department of Psychiatry & Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Yan D Zhao
- Professor, Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Sarah E Johnston
- Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Amit Mistry
- Department of Psychiatry & Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Qaiser S Khan
- Fellow in Addictions Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts
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27
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Mahmood S, Hoffman L, Ali IA, Zhao YD, Chen A, Allen K. Smart Phone/Device Application to Improve Delivery of Enteral Nutrition in Adult Patients Admitted to the Medical Intensive Care Unit. Nutr Metab Insights 2019; 12:1178638818820299. [PMID: 30643420 PMCID: PMC6322101 DOI: 10.1177/1178638818820299] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 01/01/2023] Open
Abstract
Background Resident physicians are frequently uncomfortable ordering enteral nutrition (EN) and are unaware of the variety of formulas and supplements available for different disease processes. Many depend on a clinical dietician to assist with recommending EN formulas and patient energy requirements that may not be readily available on patient admission. This creates a barrier to early initiation of EN and non-compliance with Society of Critical Care Medicine and American Society of Parenteral and Enteral Nutrition clinical guidelines. Objective Internal medicine resident physicians were provided an iPod with a smart phone/device application (EN application) to assist them in choosing EN formulas for patients during their intensive care unit (ICU) rotation. The primary outcome was improved initiation of EN within 24 hours of admission. Secondary outcomes included the following: time to initiate EN, goal calories reached, infections rates, length of stay, mortality, and concordance with clinical guidelines. Design The study is a quasi-experimental design to improve delivery of EN at an academic medical center in the medical ICU. Data were collected from a retrospective chart review to evaluate the impact of an EN application to assist resident physicians when ordering EN. Results Use of the EN application reduced the percent of patients with delayed initiation of EN from 61.2% prior to 37.5% (P < .01). The mean time to initiate EN also improved 44.5 vs 31.9 hours (P < .01). Patients were also more likely to achieve their daily caloric goal (P < .01). Conclusion The use of an EN application to assist internal medicine residents when ordering EN reduced delays in initiation of EN and improved overall delivery of EN to medical ICU patients.
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Affiliation(s)
- Sultan Mahmood
- Section of Gastroenterology, Department of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Leah Hoffman
- Department of Nutrition Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Ijlal Akbar Ali
- Internal Medicine Residency Program, Department of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Yan D Zhao
- Department of Biostatistics, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Allshine Chen
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Karen Allen
- Department of Pediatrics, the University of Oklahoma Health Sciences Center.,Pulmonary Section, Oklahoma City Veterans Affairs Medical Center, Oklahoma City, OK, USA.,College of Medicine, The University of Oklahoma, Oklahoma City, OK, USA
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28
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Gong YQ, Ai XF, Wang W, Hong XY, Liu JP, Zhou CB, Zhao Z, Lin R, He J, Chen J, Miao N, Zhao YD, Huang GD. [The application of extracorporeal membrane oxygenation in children in China]. Zhonghua Yi Xue Za Zhi 2018; 98:2110-2114. [PMID: 30032510 DOI: 10.3760/cma.j.issn.0376-2491.2018.26.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the application of extracorporeal membrane oxygenation (ECMO) in pediatrics in China as well as the outcomes. Methods: Data was conducted by questionnaire to investigate the use of ECMO in children under the age of 18 in China by June 30, 2017. All patients were divided into two age groups: pediatric patients (29 d-18 y) and neonates (1-28 d); Also by the causes of ECMO treating including cardiac, respiratory and extracorporeal cardiopulmonary resuscitation (ECPR). The form included the numbers of ECMO cases, weaned and discharged cases, according to the different ages and causes. In addition, the departments that routinely participate in ECMO management were acquired. Results: Totally 43 tertiary hospitals were enrolled, of which 30 have implemented ECMO for the children patients (comprising pediatrics and neonates), including 14 general hospitals, 5 cardiothoracic specialty hospitals and 11 children's or women and children's hospitals. ECMO for pediatrics and neonates was firstly carried out at mainland China in 2004. To the deadline of investigation, 800 patients were supported with ECMO, among which 658 were pediatrics, much more than 142 of neonates. As to pediatrics, 453 were supported with ECMO for cardiac indications with 287 (63.4%) weaned off and 215 (47.5%) survived to discharge; for respiratory causes, 79 cases were registered with 47 (59.5%) weaned off and 36 (45.6%) discharged; for ECPR, 126 were enrolled with 62 (49.2%) successfully weaned off and 48 (38.1%) discharged. In contrast, neonatal patients undergoing cardiac ECMO contained 79 cases, with 39 (49.4%) weaned off and 26 (32.9%) discharged; due to respiratory causes, 40 neonates were included, with 26 (65.0%) weaned off and 21 (52.5%) discharged; 23 neonatal patients consisted of ECPR cause and 10 (43.5%) of them successfully weaned off, but only 6 (26.1%) finally survived. Among the 30 hospitals conducted ECMO for pediatrics and neonates, the average number of departments for ECMO management is 4.03±1.87. Conclusions: Although ECMO used for children in mainland China is relatively late, a certain number of cases have been accumulated, and there is still a gap compared with the international standard. Meanwhile, each hospital has preliminarily built up its own ECMO team.
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Affiliation(s)
- Y Q Gong
- Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai 200127, China
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Panneerselvam J, Srivastava A, Muralidharan R, Wang Q, Zheng W, Zhao L, Chen A, Zhao YD, Munshi A, Ramesh R. IL-24 modulates the high mobility group (HMG) A1/miR222 /AKT signaling in lung cancer cells. Oncotarget 2018; 7:70247-70263. [PMID: 27602961 PMCID: PMC5342550 DOI: 10.18632/oncotarget.11838] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/24/2016] [Indexed: 01/10/2023] Open
Abstract
Interleukin (IL)-24, a novel tumor suppressor/cytokine exhibits antitumor activity against a broad-spectrum of human cancer cells. In a recent study, we showed that IL-24 inhibited AKT in lung cancer cells. However, the molecular mechanism of AKT inhibition by IL-24 remains elusive.The high mobility group (HMG) A1 a member of the non-histone chromosomal proteins and commonly referred to as architectural transcription factor, regulates transcription of various genes involved in cell growth and survival. Overexpression of HMGA1 has been shown to be associated with tumor progression and metastasis in several cancers, including human lung cancer. A recent study demonstrated that HMGA1 activates AKT function by reducing the activity of the protein phosphatase, phosphatase 2A subunit B (PPP2R2A) via the oncogenic micro (mi) RNA-222. Based on this report we hypothesized that IL-24-mediated AKT inhibition involved the HMGA1/miR-222 axis.To test our hypothesis, in the present study we used a H1299 lung cancer cell line that expressed exogenous human IL-24 when induced with doxycycline (DOX). Induction of IL-24 expression in the tumor cells markedly reduced HMGA1 mRNA and protein levels. Using a mechanistic approach, we found that IL-24 reduced miR-222-3p and -5p levels, as determined by qRT-PCR. Associated with HMGA1 and miR-222 inhibition was a marked increase in PPP2R2A, with a concomitant decrease in phosphorylated AKTT308/S473 expression. SiRNA-mediated knockdown of HMGA1 in combination with IL-24 significantly reduced AKT T308/S473 protein expression and greatly reduced cell migration and invasion compared with individual treatments. Further combination of IL-24 and a miR-222-3p inhibitor significantly increased PPP2R2A expression.Our results demonstrate for the first time that IL-24 inhibits AKT via regulating the HMGA1/miR-222 signaling node in human lung cancer cells and acts as an effective tumor suppressor. Thus, a therapy combining IL-24 with HMGA1 siRNA or miR-222-3p inhibitor should present effective treatment of lung cancer.
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Affiliation(s)
- Janani Panneerselvam
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA
| | - Akhil Srivastava
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA
| | - Ranganayaki Muralidharan
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA
| | - Qi Wang
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA
| | - Wei Zheng
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA
| | - Lichao Zhao
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA
| | - Alshine Chen
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA
| | - Yan D Zhao
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA
| | - Anupama Munshi
- Department of Radiation Oncology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA
| | - Rajagopal Ramesh
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.,Graduate Program in Biomedical Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA
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Tripathi A, Johnston SE, Zhao YD, Hassan O, Thompson LF, Lalani AKA, Wei XX, Giannakis M, Signoretti S, Choueiri TK, Harshman LC. CD73 expression in primary and metastatic renal cell carcinoma (RCC). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.6_suppl.643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
643 Background: Agents targeting the PD-1 pathway have improved outcomes in RCC. CD73 may be an additional mechanism which tumors can exploit for immune evasion. It is regulated by hypoxia inducible factor (HIF) and converts AMP to adenosine. The resulting increase in extracellular adenosine can inhibit T-cell effector function. We evaluated CD73 expression in primary and metastatic tumor samples in patients with RCC. Methods: A commercial TMA (US Biomax) consisting of 31 primary clear cell RCC samples (2 with sarcomatoid features) with 8 matched and 1 unmatched metastases was used to assess CD73 expression. A genitourinary pathologist (OH) confirmed pathology and grade. Immunohistochemistry (IHC) was performed using a monoclonal anti-CD73 antibody (Cell Signaling; D7F9A). A combined score (CS: % of cells positive x intensity) was employed to quantify CD73 expression. Expression levels between matched primary and metastatic tissue was compared using Wilcoxon signed-rank test. Correlation of CD73 expression (CS > 0) in primary tumor with baseline clinical and pathologic characteristics was assessed using Kruskal-Wallis and Fisher's exact tests. Overall survival (OS) was estimated using the Kaplan-Meier method. Comparison between CD73 expression groups used log rank test. Results: CD73 expression was seen in 19% (n = 6) of primary and 66.7% (n = 6) of metastatic samples. Among matched primary and metastatic samples (n = 8 each), median CS was 25 (Q1-Q3:0-105) in metastatic samples while none of the corresponding primary samples demonstrated CD73 expression (median CS = 0, p = 0.062). CD73 expression in primary tumor samples did not correlate with baseline clinical or pathologic features. Five-year OS was 50% in patients who expressed CD73 in primary tumors compared to 84% in those who did not (p = 0.26). Conclusions: We observed a numerical increase in CD73 expression in metastatic tissue compared to primary RCC samples and worse 5 year OS. The small number of samples has limited statistical significance. Further studies are needed to examine the impact of CD73 expression on outcomes in RCC patients treated with currently approved checkpoint inhibitors and the investigational CD73 antagonists that are in early phases of development.
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Affiliation(s)
| | | | - Yan D Zhao
- University of Oklahoma, Oklahoma City, OK
| | - Oudai Hassan
- University of Oklahoma Health Sciences Center, Oklahoma, OK
| | | | | | | | | | | | - Toni K. Choueiri
- Dana-Farber Cancer Institute/ Brigham and Women’s Hospital/ Harvard Medical School, Boston, MA
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Mukherjee S, Khalid B, Ibrahimi S, Morton JM, Roman D, Zhao YD, Aljumaily R. Efficacy of PD-1/PD-L1 therapy: Do proton pump inhibitors affect the outcome? J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.5_suppl.208] [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: 11/20/2022] Open
Abstract
208 Background: Recent studies have shown that manipulating the gut microbiome modulates the efficacy of anti-PD1/PD-L1 directed therapy leading to increase in the activity of CD8+ T-cells. Proton Pump inhibitors (PPIs) affect the gut microbiome. The objective of this study was to investigate the effects of PPIs use on agents that target the PD-1/PD-L1 pathway in patients treated with these agents. Methods: We looked at the outcomes of 158 patients aged 18 years or older, treated at the University of Oklahoma Health Sciences Center between 2014 and 2016. The primary aim of this study was to investigate whether survival of patients treated with agents that target PD-1/PD-L1 pathway was affected by PPI use. The secondary objective was to identify if there is any difference in the immune related side effect profile between PPI users and non-users. The overall survival (OS) and progression free survival (PFS) were compared between PPI users and nonusers using the log-rank tests. Survival curves were generated using the Kaplan-Meyer method. The proportions of Grade 3 or 4 colitis or pneumonitis were compared between PPI users and nonusers using the Fisher’s exact test. SAS 9.4 was used for the statistical analysis and a 0.05 significance level was used. Results: The majority of patients were females (57%). The median age was 63 years. Lung cancer was the most common diagnosis (20%) followed by melanoma (20%) and ovarian cancer (12%). Nivolumab was the most commonly used agent (47%) followed by Pembrolizumab (22%), other investigational agents (22%) and Atezolizumab (7%). The median follow-up time from the date of first PPI dose was 7 months. There was no statistically significant difference in OS or PFS between PPI users and nonusers (p = 0.77). There were no significant differences in proportions of Grade 3 or 4 colitis between PPI users and nonusers (5% vs. 5.26%, p > .99). Similarly, there were no significant differences in proportions of Grade 3 or 4 pneumonitis between PPI users and nonusers (6.25% vs. 1.75%, p = 0.40). Conclusions: Use of PPI does not affect the outcome of patients receiving agents that target PD1/PD-L1 pathway. The incidence of important immune related side effects was similar between PPI users and non-users.
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Affiliation(s)
| | | | | | | | - Darwin Roman
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Yan D Zhao
- University of Oklahoma, Oklahoma City, OK
| | - Raid Aljumaily
- Stephenson Cancer Center/Oklahoma University Medical Center, Oklahoma City, OK
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Babu A, Amreddy N, Muralidharan R, Pathuri G, Gali H, Chen A, Zhao YD, Munshi A, Ramesh R. Chemodrug delivery using integrin-targeted PLGA-Chitosan nanoparticle for lung cancer therapy. Sci Rep 2017; 7:14674. [PMID: 29116098 PMCID: PMC5676784 DOI: 10.1038/s41598-017-15012-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 10/16/2017] [Indexed: 12/19/2022] Open
Abstract
In this study, we report the efficacy of RGD (arginine-glycine-aspartic acid) peptide-modified polylactic acid-co-glycolic acid (PLGA)-Chitosan nanoparticle (CSNP) for integrin αvβ3 receptor targeted paclitaxel (PTX) delivery in lung cancer cells and its impact on normal cells. RGD peptide-modified chitosan was synthesized and then coated onto PTX-PLGA nanoparticles prepared by emulsion-solvent evaporation. PTX-PLGA-CSNP-RGD displayed favorable physicochemical properties for a targeted drug delivery system. The PTX-PLGA-CSNP-RGD system showed increased uptake via integrin receptor mediated endocytosis, triggered enhanced apoptosis, and induced G2/M cell cycle arrest and more overall cytotoxicity than its non-targeted counterpart in cancer cells. PTX-PLGA-CSNP-RGD showed less toxicity in lung fibroblasts than in cancer cells, may be attributed to low drug sensitivity, nevertheless the study invited close attention to their transient overexpression of integrin αvβ3 and cautioned against corresponding uptake of toxic drugs, if any at all. Whereas, normal human bronchial epithelial (NHBE) cells with poor integrin αvβ3 expression showed negligible toxicity to PTX-PLGA-CSNP-RGD, at equivalent drug concentrations used in cancer cells. Further, the nanoparticle demonstrated its capacity in targeted delivery of Cisplatin (CDDP), a drug having physicochemical properties different to PTX. Taken together, our study demonstrates that PLGA-CSNP-RGD is a promising nanoplatform for integrin targeted chemotherapeutic delivery to lung cancer.
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Affiliation(s)
- Anish Babu
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA
| | - Narsireddy Amreddy
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA
| | - Ranganayaki Muralidharan
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA
| | - Gopal Pathuri
- Department of Pharmaceutical Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA.,Department of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA
| | - Hariprasad Gali
- Department of Pharmaceutical Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA
| | - Allshine Chen
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA
| | - Yan D Zhao
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA
| | - Anupama Munshi
- Department of Radiation Oncology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA
| | - Rajagopal Ramesh
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA. .,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA. .,Graduate Program in Biomedical Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73104, USA.
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Wang X, Wu W, Zhang W, Leland Booth J, Duggan ES, Tian L, More S, Zhao YD, Sawh RN, Liu L, Zou MH, Metcalf JP. RIG-I overexpression decreases mortality of cigarette smoke exposed mice during influenza A virus infection. Respir Res 2017; 18:166. [PMID: 28865477 PMCID: PMC5581920 DOI: 10.1186/s12931-017-0649-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 08/25/2017] [Indexed: 12/22/2022] Open
Abstract
Background Retinoic acid-inducible gene I (RIG-I) is an important regulator of virus-induced antiviral interferons (IFNs) and proinflammatory cytokines which participate in clearing viral infections. Cigarette smoke (CS) exposure increases the frequency and severity of respiratory tract infections. Methods We generated a RIG-I transgenic (TG) mouse strain that expresses the RIG-I gene product under the control of the human lung specific surfactant protein C promoter. We compared the mortality and host immune responses of RIG-I TG mice and their litter-matched wild type (WT) mice following challenge with influenza A virus (IAV). Results RIG-I overexpression increased survival of IAV-infected mice. CS exposure increased mortality in WT mice infected with IAV. Remarkably, the effect of RIG-I overexpression on survival during IAV infection was enhanced in CS-exposed animals. CS-exposed IAV-infected WT mice had a suppressed innate response profile in the lung compared to sham-exposed IAV-infected WT mice in terms of the protein concentration, total cell count and inflammatory cell composition in the bronchoalveolar lavage fluid. RIG-I overexpression restored the innate immune response in CS-exposed mice to that seen in sham-exposed WT mice during IAV infection, and is likely responsible for enhanced survival in RIG-I TG mice as restoration preceded death of the animals. Conclusions Our results demonstrate that RIG-I overexpression in mice is protective for CS enhanced susceptibility of smokers to influenza infection, and that CS mediated RIG-I suppression may be partially responsible for the increased morbidity and mortality of the mice exposed to IAV. Thus, optimizing the RIG-I response may be an important treatment strategy for CS-enhanced lung infections, particularly those due to IAV.
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Affiliation(s)
- Xiaoqiu Wang
- Pulmonary and Critical Care Division, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Wenxin Wu
- Pulmonary and Critical Care Division, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Wei Zhang
- Pulmonary and Critical Care Division, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - J Leland Booth
- Pulmonary and Critical Care Division, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Elizabeth S Duggan
- Pulmonary and Critical Care Division, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Lili Tian
- Pulmonary and Critical Care Division, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Sunil More
- The Lundberg-Kienlen Lung Biology and Toxicology Laboratory, Department of Physiological Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Yan D Zhao
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Ravindranauth N Sawh
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Veterans Affairs Medical Center, Oklahoma City, OK, USA
| | - Lin Liu
- The Lundberg-Kienlen Lung Biology and Toxicology Laboratory, Department of Physiological Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Ming-Hui Zou
- Center of Molecular and Translational Medicine, Georgia State University, Atlanta, GA, USA
| | - Jordan P Metcalf
- Pulmonary and Critical Care Division, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. .,Veterans Affairs Medical Center, Oklahoma City, OK, USA. .,Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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Gardner AW, Montgomery PS, Zhao YD, Ungvari Z, Csiszar A, Sonntag WE. Endothelial Cell Inflammation and Antioxidant Capacity are Associated With 6-Minute Walk Performance in Patients With Symptomatic Peripheral Artery Disease. Angiology 2017; 69:416-423. [PMID: 28835113 DOI: 10.1177/0003319717726934] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We determined whether 6-minute walk total distance and pain-free distance were associated with circulating biomarkers of antioxidant capacity and inflammation and with cultured endothelial cell inflammation, oxidative stress, and apoptosis in 251 patients with symptomatic peripheral artery disease (PAD). In multivariate analyses, pain-free distance during the 6-minute walk test was negatively associated with dyslipidemia ( P < .001), chronic kidney disease ( P = .004), and transient transfection, nuclear factor κ-Light-Chain-Enhancer of activated B (NF-κB) cultured endothelial cells ( P = .007) and was positively associated with height ( P = .008). Furthermore, total distance walked during the 6-minute walk test was negatively associated with cultured endothelial cell NF-κB ( P < .001), coronary artery disease ( P = .009), and body mass index ( P = .022) and was positively associated with ankle-brachial index ( P < .001), male sex ( P < .001), and hydroxyl radical antioxidant capacity ( P < .001). The 6-minute walk performance in symptomatic patients with PAD was associated with vascular biomarkers, as walking distances were negatively associated with cultured endothelial cell inflammation and positively associated with circulating antioxidant capacity. The clinical implication is that behavioral interventions designed to alleviate endothelial cell inflammation and increase circulating antioxidant capacity, such as exercise and antioxidant intake, may improve ambulation of patients with PAD during submaximal exercise that is typically performed during daily activities.
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Affiliation(s)
- Andrew W Gardner
- 1 Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA.,2 Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
| | - Polly S Montgomery
- 1 Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA
| | - Yan D Zhao
- 3 Department of Biostatistics and Epidemiology, OUHSC, Oklahoma City, OK, USA
| | - Zoltan Ungvari
- 1 Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA
| | - Anna Csiszar
- 1 Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA
| | - William E Sonntag
- 1 Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA
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Xu YF, Hannafon BN, Zhao YD, Postier RG, Ding WQ. Plasma exosome miR-196a and miR-1246 are potential indicators of localized pancreatic cancer. Oncotarget 2017; 8:77028-77040. [PMID: 29100367 PMCID: PMC5652761 DOI: 10.18632/oncotarget.20332] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 07/28/2017] [Indexed: 12/22/2022] Open
Abstract
Patients with localized pancreatic cancer (stage I and stage IIA) have a much higher survival rate than those presenting at later stages, yet early detection remains a challenge to this malignancy. The aim of this study was to evaluate whether exosome miRNA signatures are indicative of localized pancreatic cancer. Exosomes were collected from the conditioned media of pancreatic cancer cell lines and plasma samples of localized pancreatic cancer patients (Stage I-IIA, n=15), and healthy subjects (n=15). Cellular and exosome miRNAs from pancreatic cancer cell lines were profiled by next-generation small RNA sequencing. Plasma exosome miRNA expression was analyzed by qRT-PCR. We found that certain miRNAs, such as miR-196a and miR-1246, are highly enriched in pancreatic cancer exosomes. Consistently, plasma exosome miR-196a and miR-1246 levels were significantly elevated in pancreatic cancer patients as compared to healthy subjects. An analysis of the cancer subtypes indicated that plasma exosome miR-196a is a better indicator of pancreatic ductal adenocarcinoma (PDAC), whereas plasma exosome miR-1246 is significantly elevated in patients with intraductal papillary mucinous neoplasms (IPMN). In contrast, there were no differences in the plasma exosome miR-196a and miR-1246 levels between patients with pancreatic neuroendocrine tumors (NET) and healthy subjects. In conclusion, we demonstrate that certain miRNA species, such as miR-196a and miR-1246, are highly enriched in pancreatic cancer exosomes and elevated in plasma exosomes of patients with localized pancreatic cancer.
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Affiliation(s)
- Yi-Fan Xu
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, OK 73104, USA
| | - Bethany N Hannafon
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, OK 73104, USA
| | - Yan D Zhao
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, OK 73104, USA
| | - Russell G Postier
- Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, OK 73104, USA
| | - Wei-Qun Ding
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, OK 73104, USA
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Spencer CH, Rouster-Stevens K, Gewanter H, Syverson G, Modica R, Schmidt K, Emery H, Wallace C, Grevich S, Nanda K, Zhao YD, Shenoi S, Tarvin S, Hong S, Lindsley C, Weiss JE, Passo M, Ede K, Brown A, Ardalan K, Bernal W, Stoll ML, Lang B, Carrasco R, Agaiar C, Feller L, Bukulmez H, Vehe R, Kim H, Schmeling H, Gerstbacher D, Hoeltzel M, Eberhard B, Sundel R, Kim S, Huber AM, Patwardhan A. Biologic therapies for refractory juvenile dermatomyositis: five years of experience of the Childhood Arthritis and Rheumatology Research Alliance in North America. Pediatr Rheumatol Online J 2017; 15:50. [PMID: 28610606 PMCID: PMC5470177 DOI: 10.1186/s12969-017-0174-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 05/17/2017] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The prognosis of children with juvenile dermatomyositis (JDM) has improved remarkably since the 1960's with the use of corticosteroid and immunosuppressive therapy. Yet there remain a minority of children who have refractory disease. Since 2003 the sporadic use of biologics (genetically-engineered proteins that usually are derived from human genes) for inflammatory myositis has been reported. In 2011-2016 we investigated our collective experience of biologics in JDM through the Childhood Arthritis and Rheumatology Research Alliance (CARRA). METHODS The JDM biologic study group developed a survey on the CARRA member experience using biologics for Juvenile DM utilizing Delphi consensus methods in 2011-2012. The survey was completed online by the CARRA members interested in JDM in 2012. A second survey was similarly developed that provided more opportunity to describe their experiences with biologics in JDM in detail and was completed by CARRA members in Feb 2013. During three CARRA meetings in 2013-2015, nominal group techniques were used for achieving consensus on the current choices of biologic drugs. A final survey was performed at the 2016 CARRA meeting. RESULTS One hundred and five of a potential 231 pediatric rheumatologists (42%) responded to the first survey in 2012. Thirty-five of 90 had never used a biologic for Juvenile DM at that time. Fifty-five of 91 (denominators vary) had used biologics for JDM in their practice with 32%, 5%, and 4% using rituximab, etanercept, and infliximab, respectively, and 17% having used more than one of the three drugs. Ten percent used a biologic as monotherapy, 19% a biologic in combination with methotrexate (mtx), 52% a biologic in combination with mtx and corticosteroids, 42% a combination of a biologic, mtx, corticosteroids (steroids), and an immunosuppressive drug, and 43% a combination of a biologic, IVIG and mtx. The results of the second survey supported these findings in considerably more detail with multiple combinations of drugs used with biologics and supported the use of rituximab, abatacept, anti-TNFα drugs, and tocilizumab in that order. One hundred percent recommended that CARRA continue studying biologics for JDM. The CARRA meeting survey in 2016 again supported the study and use of these four biologic drug groups. CONCLUSIONS Our CARRA JDM biologic work group developed and performed three surveys demonstrating that pediatric rheumatologists in North America have been using multiple biologics for refractory JDM in numerous scenarios from 2011 to 2016. These survey results and our consensus meetings determined our choice of four biologic therapies (rituximab, abatacept, tocilizumab and anti-TNFα drugs) to consider for refractory JDM treatment when indicated and to evaluate for comparative effectiveness and safety in the future. Significance and Innovations This is the first report that provides a substantial clinical experience of a large group of pediatric rheumatologists with biologics for refractory JDM over five years. This experience with biologic therapies for refractory JDM may aid pediatric rheumatologists in the current treatment of these children and form a basis for further clinical research into the comparative effectiveness and safety of biologics for refractory JDM.
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Affiliation(s)
- CH Spencer
- 0000 0004 0392 3476grid.240344.5Nationwide Children’s Hospital and Ohio State University, Columbus, OH USA
| | - K Rouster-Stevens
- 0000 0001 0941 6502grid.189967.8Emory University School of Medicine, Atlanta, GA USA
| | - H Gewanter
- Pediatric and Adolescent Health Partners, Richmond, VA USA
| | - G Syverson
- 0000 0001 2167 3675grid.14003.36University of Wisconsin-Madison, Madison, WI USA
| | - R Modica
- 0000 0004 1936 8091grid.15276.37University of Florida, Gainesville, FL USA
| | - K Schmidt
- 0000 0001 2113 1622grid.266623.5University of Louisville, Louisville, KY USA
| | - H Emery
- 0000000122986657grid.34477.33Seattle Children’s Hospital, University of Washington, Seattle, WA USA
| | - C Wallace
- 0000000122986657grid.34477.33Seattle Children’s Hospital, University of Washington, Seattle, WA USA
| | - S Grevich
- 0000000122986657grid.34477.33Seattle Children’s Hospital, University of Washington, Seattle, WA USA
| | - K Nanda
- 0000000122986657grid.34477.33Seattle Children’s Hospital, University of Washington, Seattle, WA USA
| | - YD Zhao
- 0000000122986657grid.34477.33Seattle Children’s Hospital, University of Washington, Seattle, WA USA
| | - S Shenoi
- 0000000122986657grid.34477.33Seattle Children’s Hospital, University of Washington, Seattle, WA USA
| | - S Tarvin
- Riley Hospital for Children, Indiana University Medical Center, Indianapolis, IN India
| | - S Hong
- grid.412984.2University of Iowa Health Care, Iowa City, IA USA
| | - C Lindsley
- 0000 0001 2177 6375grid.412016.0University of Kansas Medical Center, Kansas City, KS USA
| | - JE Weiss
- 0000 0004 0407 6328grid.239835.6Sanzari Children’s Hospital, Hackensack University Medical Center, Hackensack, NJ USA
| | - M Passo
- 0000 0000 9075 106Xgrid.254567.7University of South Carolina, Charleston, SC USA
| | - K Ede
- 0000 0001 0381 0779grid.417276.1Phoenix Children’s Hospital, Phoenix, AZ USA
| | - A Brown
- 0000 0001 2200 2638grid.416975.8Texas Children’s Hospital, Houston, TX USA
| | - K Ardalan
- 0000 0004 0388 2248grid.413808.6Lurie Children’s Hospital, Chicago, IL USA
| | - W Bernal
- 0000 0001 2297 6811grid.266102.1University of California, San Francisco, San Francisco, CA USA
| | - ML Stoll
- 0000000106344187grid.265892.2University of Alabama at Birmingham, Birmingham, AL USA
| | - B Lang
- 0000 0004 1936 8200grid.55602.34WK Health Center and Dalhousie University, Halifax, NS Canada
| | - R Carrasco
- Dell Children’s Hospital, Austin, TX USA
| | - C Agaiar
- Children’s Hospital of The Kings Daughter, Norfolk, VA USA
| | - L Feller
- Inland Rheumatology, Waterville, ME USA
| | - H Bukulmez
- 0000 0001 0035 4528grid.411931.fMetro Health Medical Center and Case Western Reserve University, Cleveland, OH USA
| | - R Vehe
- 0000000419368657grid.17635.36University of Minnesota, Minneapolis, MN USA
| | - H Kim
- 0000 0001 2237 2479grid.420086.8National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD USA
| | - H Schmeling
- 0000 0004 1936 7697grid.22072.35Alberta Children’s Hospital, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - D Gerstbacher
- 0000000419368956grid.168010.eLucille Packard Children’s Hospital, Stanford University, Stanford, CA USA
| | - M Hoeltzel
- 0000000086837370grid.214458.eMott Children’s Hospital, University of Michigan, Ann Arbor, MI USA
| | - B Eberhard
- grid.415338.8Cohen Children’s Medical Center of New York, New york, USA
| | - R Sundel
- 0000 0004 0378 8438grid.2515.3Boston Children’s Hospital and Harvard Medical School, Boston, MA USA
| | - S Kim
- 0000 0001 2297 6811grid.266102.1University of California, San Francisco, San Francisco, CA USA
| | - AM Huber
- 0000 0004 1936 8200grid.55602.34WK Health Center and Dalhousie University, Halifax, NS Canada
| | - A Patwardhan
- 0000 0001 2162 3504grid.134936.aSchool of Medicine, University of Missouri, Columbia, MO USA
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Gardner AW, Montgomery PS, Zhao YD, Silva-Palacios F, Ungvari Z, Csiszar A, Sonntag WE. Association between daily walking and antioxidant capacity in patients with symptomatic peripheral artery disease. J Vasc Surg 2017; 65:1762-1768. [PMID: 28259579 DOI: 10.1016/j.jvs.2016.12.108] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 12/13/2016] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The primary aim of the study was to assess whether both the amount and pace of daily walking were associated with circulating antioxidant capacity in symptomatic patients with peripheral artery disease (PAD). METHODS Community-based walking was measured in 244 men and women who were limited by symptomatic PAD during a 1-week period in which they wore an ankle-mounted step activity monitor. Patients were further characterized by circulating antioxidant capacity with the OxiSelect (Cell Biolabs Inc, San Diego, Calif) hydroxyl radical antioxidant capacity (HORAC) activity assay. RESULTS To assess the amount of walking, patients were grouped into low (≤2440 strides/d), middle (2441-3835 strides/d), and high (>3835 strides/d) stride tertiles. HORAC was higher in the middle (P = .03) and high (P = .01) stride tertiles than in the low tertile, but there was no difference between middle and high tertiles (P = .44). To assess the pace of walking, patients were grouped into slow (<25.0 strides/min), middle (25.0-31.6 strides/min), and fast (>31.6 strides/min) cadence tertiles. HORAC was higher in the high cadence tertile than in the low (P < .01) and middle (P < .01) tertiles, but there was no difference between low and middle tertiles (P = .48). Similar findings were obtained on group differences in HORAC after adjusting for age, sex, race, and ankle-brachial index for both the amount and pace of daily walking. CONCLUSIONS Walking >2440 strides each day and walking at a cadence faster than 31.6 strides/min for 30 minutes each day are both associated with greater circulating antioxidant capacity in symptomatic patients with PAD. The clinical significance is that a home-based walking program may be one approach to increase endogenous antioxidant capacity.
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Affiliation(s)
- Andrew W Gardner
- Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Okla.
| | - Polly S Montgomery
- Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Okla
| | - Yan D Zhao
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Okla
| | - Federico Silva-Palacios
- Cardiovascular Section, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Okla
| | - Zoltan Ungvari
- Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Okla
| | - Anna Csiszar
- Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Okla
| | - William E Sonntag
- Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Okla
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Pfefferbaum RL, Pfefferbaum B, Zhao YD, Van Horn RL, McCarter GSM, Leonard MB. Assessing community resilience: A CART survey application in an impoverished urban community. Disaster Health 2017; 3:45-56. [PMID: 28229014 DOI: 10.1080/21665044.2016.1189068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 05/09/2016] [Indexed: 10/21/2022]
Abstract
This article describes an application of the Communities Advancing Resilience Toolkit (CART) Assessment Survey which has been recognized as an important community tool to assist communities in their resilience-building efforts. Developed to assist communities in assessing their resilience to disasters and other adversities, the CART survey can be used to obtain baseline information about a community, to identify relative community strengths and challenges, and to re-examine a community after a disaster or post intervention. This article, which describes an application of the survey in a community of 5 poverty neighborhoods, illustrates the use of the instrument, explicates aspects of community resilience, and provides possible explanations for the results. The paper also demonstrates how a community agency that serves many of the functions of a broker organization can enhance community resilience. Survey results suggest various dimensions of community resilience (as represented by core CART community resilience items and CART domains) and potential predictors. Correlates included homeownership, engagement with local entities/activities, prior experience with a personal emergency or crisis while living in the neighborhood, and involvement with a community organization that focuses on building safe and caring communities through personal relationships. In addition to influencing residents' perceptions of their community, it is likely that the community organization, which served as a sponsor for this application, contributes directly to community resilience through programs and initiatives that enhance social capital and resource acquisition and mobilization.
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Affiliation(s)
- Rose L Pfefferbaum
- Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Liberal Arts, Phoenix Community College, Phoenix, AZ, USA
| | - Betty Pfefferbaum
- Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Yan D Zhao
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center , Oklahoma City, OK, USA
| | - Richard L Van Horn
- Terrorism and Disaster Center, University of Oklahoma Health Sciences Center , Oklahoma City, OK, USA
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Munroe ME, Lu R, Zhao YD, Fife DA, Robertson JM, Guthridge JM, Niewold TB, Tsokos GC, Keith MP, Harley JB, James JA. Altered type II interferon precedes autoantibody accrual and elevated type I interferon activity prior to systemic lupus erythematosus classification. Ann Rheum Dis 2016; 75:2014-2021. [PMID: 27088255 PMCID: PMC4959992 DOI: 10.1136/annrheumdis-2015-208140] [Citation(s) in RCA: 165] [Impact Index Per Article: 20.6] [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: 06/26/2015] [Accepted: 12/20/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The relationship of immune dysregulation and autoantibody production that may contribute to systemic lupus erythematosus (SLE) pathogenesis is unknown. This study evaluates the individual and combined contributions of autoantibodies, type I interferon (IFN-α) activity, and IFN-associated soluble mediators to disease development leading to SLE. METHODS Serial serum specimens from 55 individuals collected prior to SLE classification (average timespan=4.3 years) and unaffected healthy controls matched by age (±5 years), gender, race and time of sample procurement were obtained from the Department of Defense Serum Repository. Levels of serum IFN-α activity, IFN-associated mediators and autoantibodies were evaluated and temporal relationships assessed by growth curve modelling, path analysis, analysis of covariance and random forest models. RESULTS In cases, but not matched controls, autoantibody specificities and IFN-associated mediators accumulated over a period of years, plateauing near the time of disease classification (p<0.001). Autoantibody positivity coincided with or followed type II IFN dysregulation, preceding IFN-α activity in growth curve models, with elevated IFN-α activity and B-lymphocyte stimulator levels occurring shortly before SLE classification (p≤0.005). Cases were distinguished by multivariate random forest models incorporating IFN-γ, macrophage chemoattractant protein (MCP)-3, anti-chromatin and anti-spliceosome antibodies (accuracy 93% >4 years pre-classification; 97% within 2 years of SLE classification). CONCLUSIONS Years before SLE classification, enhancement of the type II IFN pathway allows for accumulation of autoantibodies and subsequent elevations in IFN-α activity immediately preceding SLE classification. Perturbations in select immunological processes may help identify at-risk individuals for further clinical evaluation or participation in prospective intervention trials.
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Affiliation(s)
- Melissa E. Munroe
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Rufei Lu
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
- Medicine and Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Yan D. Zhao
- Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Dustin A. Fife
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Julie M. Robertson
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Joel M. Guthridge
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Timothy B. Niewold
- Department of Immunology and Division of Rheumatology, Mayo Clinic, Rochester, MN, USA
| | - George C. Tsokos
- Rheumatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Michael P. Keith
- Rheumatology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - John B. Harley
- Cincinnati Children’s Hospital Medical Center and US Department of Veterans Affairs Medical Center, Cincinnati, OH, USA
| | - Judith A. James
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
- Medicine and Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Algan O, Zhao YD, Herman T. Radiotherapy in Patients 70 Years and Older With Triple-Negative Breast Cancer. Clin Breast Cancer 2016; 16:e99-e106. [PMID: 27292180 DOI: 10.1016/j.clbc.2016.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 12/10/2015] [Accepted: 05/09/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the use of radiotherapy (RT) in older patients with triple-negative breast cancer (TNBC). PATIENTS AND METHODS The National Cancer Data Base (NCDB) is a comprehensive national database that captures approximately 70% of newly diagnosed cancer patients in the United States. Data for patients meeting the criteria of nonmetastatic TNBC were extracted and analyzed. RESULTS A total of 44,731 TNBC patients with indications for postoperative RT were identified. Median patient age was 59 (range, 19-90) years. Maximum RT use occurred between the ages of 46 and 70, with rapid decline in patients older than 70 years. Overall, there was a statistically significant improvement in overall survival (OS) with the addition of RT. Of the 24 variables evaluated, 23 were statistically significant on univariate analysis. On multivariate analysis a majority of these factors including facility location, age, Charlson/Deyo comorbidity condition score, and tumor characteristics (lymph node status, pathologic T stages, and use of systemic chemotherapy) remained significant. The use of RT was associated with improved OS rates in both the older (5-year OS, 66.4% vs. 42.6%, P < .001) and younger (5-year OS, 77.3% vs. 63.2%, P < .001) patient groups. CONCLUSION In this group of high-risk patients, there was decreased use of RT in older patients. In our study of a large patient population with TNBC, RT was associated with increased OS rates in both younger and older patients, and RT should be strongly considered, when indicated by clinicopathologic factors, in patients with TNBC.
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Affiliation(s)
- Ozer Algan
- Department of Radiation Oncology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
| | - Yan D Zhao
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Terence Herman
- Department of Radiation Oncology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
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Panneerselvam J, Shanker M, Jin J, Branch CD, Muralidharan R, Zhao YD, Chada S, Munshi A, Ramesh R. Phosphorylation of interleukin (IL)-24 is required for mediating its anti-cancer activity. Oncotarget 2016; 6:16271-86. [PMID: 26009991 PMCID: PMC4599269 DOI: 10.18632/oncotarget.3977] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 03/27/2015] [Accepted: 05/06/2015] [Indexed: 12/12/2022] Open
Abstract
Interleukin (IL)-24 is a tumor suppressor/cytokine gene that undergoes post-translational modifications (PTMs). Glycosylation and ubiquitination are important for IL-24 protein stabilization and degradation respectively. Little is known about IL-24 protein phosphorylation and its role in IL-24-mediated anti-tumor activities. In this study we conducted molecular studies to determine whether IL-24 phosphorylation is important for IL-24-mediated anti-cancer activity. Human H1299 lung tumor cell line that was stably transfected with a doxycycline (DOX)-inducible (Tet-on) plasmid vector carrying the cDNA of IL-24-wild-type (IL-24wt) or IL-24 with all five phosphorylation sites replaced (IL-24mt) was used in the present study. Inhibition of tumor cell proliferation, cell migration and invasion, and induction of G2/M cell cycle arrest was observed in DOX-induced IL-24wt-expressing cells but not in IL-24mt-expressing cells. Secretion of IL-24mt protein was greatly reduced compared to IL-24wt protein. Further, IL-24wt and IL-24mt proteins markedly differed in their subcellular organelle localization. IL-24wt but not IL-24mt inhibited the AKT/mTOR signaling pathway. SiRNA-mediated AKT knockdown and overexpression of myristolyated AKT protein confirmed that IL-24wt but not IL-24mt mediated its anti-cancer activity by inhibiting the AKT signaling pathway. Our results demonstrate that IL-24 phosphorylation is required for inhibiting the AKT/mTOR signaling pathway and exerting its anti-cancer activities.
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Affiliation(s)
- Janani Panneerselvam
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Manish Shanker
- Department of Thoracic & Cardiovascular Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA.,The University of Texas Dental School, Houston, Texas, USA
| | - Jiankang Jin
- Department of Thoracic & Cardiovascular Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA.,Department of Gastrointestinal Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Cynthia D Branch
- Department of Thoracic & Cardiovascular Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA.,Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ranganayaki Muralidharan
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Yan D Zhao
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | | | - Anupama Munshi
- Department of Radiation Oncology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Rajagopal Ramesh
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.,Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.,Graduate Program in Biomedical Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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Muralidharan R, Amreddy N, Babu A, Srivastava A, Panneerselvam J, Chen A, Zhao YD, Zhao L, Kompella UB, Munshi A, Ramesh R. 489. Tumor-Targeted Hursirna-Nanoparticle Delivery Inhibits Lung Tumor Growth In Vitro and In Vivo. Mol Ther 2016. [DOI: 10.1016/s1525-0016(16)33298-1] [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: 10/20/2022] Open
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Wilson CD, Safavi-Abbasi S, Sun H, Kalani MYS, Zhao YD, Levitt MR, Hanel RA, Sauvageau E, Mapstone TB, Albuquerque FC, McDougall CG, Nakaji P, Spetzler RF. Meta-analysis and systematic review of risk factors for shunt dependency after aneurysmal subarachnoid hemorrhage. J Neurosurg 2016; 126:586-595. [PMID: 27035169 DOI: 10.3171/2015.11.jns152094] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [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: 11/06/2022]
Abstract
OBJECTIVE Aneurysmal subarachnoid hemorrhage (aSAH) may be complicated by hydrocephalus in 6.5%-67% of cases. Some patients with aSAH develop shunt dependency, which is often managed by ventriculoperitoneal shunt placement. The objectives of this study were to review published risk factors for shunt dependency in patients with aSAH, determine the level of evidence for each factor, and calculate the magnitude of each risk factor to better guide patient management. METHODS The authors searched PubMed and MEDLINE databases for Level A and Level B articles published through December 31, 2014, that describe factors affecting shunt dependency after aSAH and performed a systematic review and meta-analysis, stratifying the existing data according to level of evidence. RESULTS On the basis of the results of the meta-analysis, risk factors for shunt dependency included high Fisher grade (OR 7.74, 95% CI 4.47-13.41), acute hydrocephalus (OR 5.67, 95% CI 3.96-8.12), in-hospital complications (OR 4.91, 95% CI 2.79-8.64), presence of intraventricular blood (OR 3.93, 95% CI 2.80-5.52), high Hunt and Hess Scale score (OR 3.25, 95% CI 2.51-4.21), rehemorrhage (OR 2.21, 95% CI 1.24-3.95), posterior circulation location of the aneurysm (OR 1.85, 95% CI 1.35-2.53), and age ≥ 60 years (OR 1.81, 95% CI 1.50-2.19). The only risk factor included in the meta-analysis that did not reach statistical significance was female sex (OR 1.13, 95% CI 0.77-1.65). CONCLUSIONS The authors identified several risk factors for shunt dependency in aSAH patients that help predict which patients are likely to require a permanent shunt. Although some of these risk factors are not independent of each other, this information assists clinicians in identifying at-risk patients and managing their treatment.
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Affiliation(s)
| | - Sam Safavi-Abbasi
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and
| | - Hai Sun
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and
| | - M Yashar S Kalani
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and
| | - Yan D Zhao
- Biostatistics and Epidemiology, University of Oklahoma, Oklahoma City, Oklahoma
| | - Michael R Levitt
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and
| | - Ricardo A Hanel
- Lyerly Neurosurgery, Baptist Hospital, Jacksonville, Florida
| | - Eric Sauvageau
- Lyerly Neurosurgery, Baptist Hospital, Jacksonville, Florida
| | | | - Felipe C Albuquerque
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and
| | - Cameron G McDougall
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and
| | - Peter Nakaji
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and
| | - Robert F Spetzler
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and
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Rao CV, Janakiram NB, Madka V, Kumar G, Scott EJ, Pathuri G, Bryant T, Kutche H, Zhang Y, Biddick L, Gali H, Zhao YD, Lightfoot S, Mohammed A. Small-Molecule Inhibition of GCNT3 Disrupts Mucin Biosynthesis and Malignant Cellular Behaviors in Pancreatic Cancer. Cancer Res 2016; 76:1965-74. [PMID: 26880801 DOI: 10.1158/0008-5472.can-15-2820] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 01/18/2016] [Indexed: 02/07/2023]
Abstract
Pancreatic cancer is an aggressive neoplasm with almost uniform lethality and a 5-year survival rate of 7%. Several overexpressed mucins that impede drug delivery to pancreatic tumors have been therapeutically targeted, but enzymes involved in mucin biosynthesis have yet to be preclinically evaluated as potential targets. We used survival data from human patients with pancreatic cancer, next-generation sequencing of genetically engineered Kras-driven mouse pancreatic tumors and human pancreatic cancer cells to identify the novel core mucin-synthesizing enzyme GCNT3 (core 2 β-1,6 N-acetylglucosaminyltransferase). In mouse pancreatic cancer tumors, GCNT3 upregulation (103-fold; P < 0.0001) was correlated with increased expression of mucins (5 to 87-fold; P < 0.04-0.0003). Aberrant GCNT3 expression was also associated with increased mucin production, aggressive tumorigenesis, and reduced patient survival, and CRISPR-mediated knockout of GCNT3 in pancreatic cancer cells reduced proliferation and spheroid formation. Using in silico small molecular docking simulation approaches, we identified talniflumate as a novel inhibitor that selectively binds to GCNT3. In particular, docking predictions suggested that three notable hydrogen bonds between talniflumate and GCNT3 contribute to a docking affinity of -8.3 kcal/mol. Furthermore, talniflumate alone and in combination with low-dose gefitinib reduced GCNT3 expression, leading to the disrupted production of mucins in vivo and in vitro Collectively, our findings suggest that targeting mucin biosynthesis through GCNT3 may improve drug responsiveness, warranting further development and investigation in preclinical models of pancreatic tumorigenesis. Cancer Res; 76(7); 1965-74. ©2016 AACR.
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Affiliation(s)
- Chinthalapally V Rao
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hem-Onc Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
| | - Naveena B Janakiram
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hem-Onc Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Venkateshwar Madka
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hem-Onc Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Gaurav Kumar
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hem-Onc Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Edgar J Scott
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Gopal Pathuri
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hem-Onc Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Taylor Bryant
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hem-Onc Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Hannah Kutche
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hem-Onc Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Yuting Zhang
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hem-Onc Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Laura Biddick
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hem-Onc Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Hariprasad Gali
- College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Yan D Zhao
- Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Stan Lightfoot
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hem-Onc Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Altaf Mohammed
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hem-Onc Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
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Abstract
Earlier studies showed that the DNA-binding protein, Bright/ARID3a bound to a subset of human and mouse immunoglobulin heavy chain promoters where it enhanced expression. Indeed, mice with transgenic expression of ARID3a in all B lymphocytes have expanded MZ B cells and produce anti-nuclear antibodies (ANAs). Consistent with our findings in mice, we observed that human systemic lupus erythematosus (SLE) patients had expanded numbers of peripheral blood ARID3a+ B cells that were associated with increased disease activity (p = 0.0038). We hypothesized that ARID3a+ naïve B cells would eventually produce autoantibodies, explaining associations between ARID3a expression and disease activity in lupus. Unlike healthy controls, ARID3a was expressed in the naïve B cell population in SLE patients, and we hypothesized that these might represent expansions of autoreactive cells. Therefore, monoclonal antibodies were generated from single-sorted naïve B cells derived from patients with normal (ARID3aN) and high (ARID3aH) numbers of ARID3a+ B cells. We found that ARID3a expression did not correlate with autoantibody expression. Furthermore, measures of antigen specificities of autoreactive antibodies did not reveal skewing toward particular proteins. These data suggest that the association of increased disease activity in SLE with numbers of ARID3a+ B lymphocytes may be mediated by an antibody-independent mechanism.
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Affiliation(s)
- Julie M. Ward
- Immunobiology and Cancer Research, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Judith A. James
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Department of Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
- Departments of Medicine and Pathology, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
| | - Yan D. Zhao
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Carol F. Webb
- Immunobiology and Cancer Research, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Author to whom correspondence should be addressed;
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Amreddy N, Muralidharan R, Babu A, Mehta M, Johnson EV, Zhao YD, Munshi A, Ramesh R. Tumor-targeted and pH-controlled delivery of doxorubicin using gold nanorods for lung cancer therapy. Int J Nanomedicine 2015; 10:6773-88. [PMID: 26604751 PMCID: PMC4631428 DOI: 10.2147/ijn.s93237] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background In lung cancer, the efficacy of conventional chemotherapy is limited due to poor drug accumulation in tumors and nonspecific cytotoxicity. Resolving these issues will increase therapeutic efficacy. Methods GNR-Dox-Tf-NPs (gold nanorod-doxorubicin-transferrin-nanoparticles) were prepared by different chemical approaches. The efficacy of these nanoparticles was carried out by cell viability in lung cancer and primary coronary artery smooth muscle cells. The receptor-mediated endocytosis studies were done with human transferrin and desferrioxamine preincubation. The GNR-Dox-Tf nanoparticles induced apoptosis, and DNA damage studies were done by Western blot, H2AX foci, and comet assay. Results We developed and tested a gold nanorod-based multifunctional nanoparticle system (GNR-Dox-Tf-NP) that carries Dox conjugated to a pH-sensitive linker and is targeted to the transferrin receptor overexpressed in human lung cancer (A549, HCC827) cells. GNR-Dox-Tf-NP underwent physicochemical characterization, specificity assays, tumor uptake studies, and hyperspectral imaging. Biological studies demonstrated that transferrin receptor-mediated uptake of the GNR-Dox-Tf-NP by A549 and HCC827 cells produced increased DNA damage, apoptosis, and cell killing compared with nontargeted GNR-Dox-NP. GNR-Dox-Tf-NP-mediated cytotoxicity was greater (48% A549, 46% HCC827) than GNR-Dox-NP-mediated cytotoxicity (36% A549, 39% HCC827). Further, GNR-Dox-Tf-NP markedly reduced cytotoxicity in normal human coronary artery smooth muscle cells compared with free Dox. Conclusion Thus, GNR-Dox-Tf nanoparticles can selectively target and deliver Dox to lung tumor cells and alleviate free Dox-mediated toxicity to normal cells.
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Affiliation(s)
- Narsireddy Amreddy
- Department of Pathology, Oklahoma City, OK, USA ; Stephenson Cancer Center, Oklahoma City, OK, USA
| | - Ranganayaki Muralidharan
- Department of Pathology, Oklahoma City, OK, USA ; Stephenson Cancer Center, Oklahoma City, OK, USA
| | - Anish Babu
- Department of Pathology, Oklahoma City, OK, USA ; Stephenson Cancer Center, Oklahoma City, OK, USA
| | - Meghna Mehta
- Stephenson Cancer Center, Oklahoma City, OK, USA ; Department of Radiation Oncology University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | | | - Yan D Zhao
- Stephenson Cancer Center, Oklahoma City, OK, USA ; Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Anupama Munshi
- Stephenson Cancer Center, Oklahoma City, OK, USA ; Department of Radiation Oncology University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Rajagopal Ramesh
- Department of Pathology, Oklahoma City, OK, USA ; Stephenson Cancer Center, Oklahoma City, OK, USA ; Graduate Program in Biomedical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Gardner AW, Waldstein SR, Montgomery PS, Zhao YD. Effect of cognitive status on exercise performance and quality of life in patients with symptomatic peripheral artery disease. J Vasc Surg 2015; 63:98-104. [PMID: 26474509 DOI: 10.1016/j.jvs.2015.08.064] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 08/13/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND We determined whether scores on a cognitive screening measure were associated with the primary outcome measure of peak walking time (PWT) and with secondary outcome measures related to mobility, community-based ambulation, health-related quality of life (QoL), and vascular function in patients with claudication and peripheral artery disease (PAD). METHODS Gross cognitive status of 246 PAD patients was assessed with the Mini-Mental State Examination (MMSE) questionnaire. Patients were grouped according to whether they had a perfect MMSE score of 30 points (n = 123) or whether they missed one or more points (n = 123). Patients were characterized on numerous outcomes, including PWT during a treadmill test and QoL. RESULTS Compared with the group with the higher MMSE scores, there was a trend for lower PWT in the group with the lower MMSE scores (P = .06) after adjusting for age, sex, race, and education level (model 1), which became significant (380 ± 250 seconds vs 460 ± 270 seconds; P < .05) after adjusting for model 1 plus coronary artery disease, chronic obstructive pulmonary disease, and arthritis (model 2). Multiple domains of QoL were lower (P < .05) in the group with the lower MMSE scores after adjusting for model 1, but only mental health remained lower (75 ± 20% vs 80 ± 5%; P = .02) after further adjustment with model 2. CONCLUSIONS In symptomatic patients with PAD, lower cognitive screening scores were associated with greater ambulatory impairment than in patients with higher MMSE scores. Furthermore, worse cognitive status was associated with lower scores in multiple dimensions of health-related QoL, all of which except mental health were explained by the comorbid conditions of coronary artery disease, chronic obstructive pulmonary disease, and arthritis. The clinical significance is that there is a need for enhanced cognitive and mental health screening as potential indicators of poor outcome among symptomatic patients with PAD. Furthermore, patients identified as having worse cognitive status might be in greatest need of intervention to improve ambulation and QoL related to mental health.
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Affiliation(s)
- Andrew W Gardner
- Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, Oklahoma City, Okla.
| | - Shari R Waldstein
- Department of Psychology, University of Maryland Baltimore County, Baltimore, Md
| | - Polly S Montgomery
- Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, Oklahoma City, Okla
| | - Yan D Zhao
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, Okla
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Kang SA, Hasan N, Mann AP, Zheng W, Zhao L, Morris L, Zhu W, Zhao YD, Suh KS, Dooley WC, Volk D, Gorenstein DG, Cristofanilli M, Rui H, Tanaka T. Blocking the adhesion cascade at the premetastatic niche for prevention of breast cancer metastasis. Mol Ther 2015; 23:1044-1054. [PMID: 25815697 PMCID: PMC4817749 DOI: 10.1038/mt.2015.45] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [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: 09/08/2014] [Accepted: 03/08/2015] [Indexed: 02/08/2023] Open
Abstract
Shear-resistant adhesion and extravasation of disseminated cancer cells at the target organ is a crucial step in hematogenous metastasis. We found that the vascular adhesion molecule E-selectin preferentially promoted the shear-resistant adhesion and transendothelial migration of the estrogen receptor (ER)(-)/CD44(+) hormone-independent breast cancer cells, but not of the ER(+)/CD44(-/low) hormone-dependent breast cancer cells. Coincidentally, CD44(+) breast cancer cells were abundant in metastatic lung and brain lesions in ER(-) breast cancer, suggesting that E-selectin supports hematogenous metastasis of ER(-)/CD44(+) breast cancer. In an attempt to prevent hematogenous metastasis through the inhibition of a shear-resistant adhesion of CD44(+) cancer cells to E-selectin-expressing blood vessels on the premetastatic niche, an E-selectin targeted aptamer (ESTA) was developed. We demonstrated that a single intravenous injection of ESTA reduced metastases to a baseline level in both syngeneic and xenogeneic forced breast cancer metastasis models without relocating the site of metastasis. The effect of ESTA was absent in E-selectin knockout mice, suggesting that E-selectin is a molecular target of ESTA. Our data highlight the potential application of an E-selectin antagonist for the prevention of hematogenous metastasis of ER(-)/CD44(+) breast cancer.
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Affiliation(s)
- Shin-Ae Kang
- Department of Pathology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Nafis Hasan
- Department of Pharmaceutical Sciences, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Aman P Mann
- Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Wei Zheng
- Department of Pathology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Lichao Zhao
- Department of Pathology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Lynsie Morris
- Department of Pathology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Weizhu Zhu
- Department of Pathology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Yan D Zhao
- Department of Pathology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - K Stephen Suh
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersy, USA
| | - William C Dooley
- Department of Pathology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - David Volk
- Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - David G Gorenstein
- Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Massimo Cristofanilli
- Department of Cancer Biology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Hallgeir Rui
- Department of Cancer Biology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Takemi Tanaka
- Department of Pathology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
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Affiliation(s)
- Sultan Mahmood
- Section of Digestive Diseases and Nutrition, Inflammatory Bowel Disease Center, University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Salman Nusrat
- Section of Digestive Diseases and Nutrition, Inflammatory Bowel Disease Center, University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Amber Crosby
- Section of Digestive Diseases and Nutrition, Inflammatory Bowel Disease Center, University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Yan D Zhao
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Tauseef Ali
- Section of Digestive Diseases and Nutrition, Inflammatory Bowel Disease Center, University of Oklahoma, Oklahoma City, Oklahoma, USA
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Panneerselvam J, Jin J, Shanker M, Lauderdale J, Bates J, Wang Q, Zhao YD, Archibald SJ, Hubin TJ, Ramesh R. IL-24 inhibits lung cancer cell migration and invasion by disrupting the SDF-1/CXCR4 signaling axis. PLoS One 2015; 10:e0122439. [PMID: 25775124 PMCID: PMC4361489 DOI: 10.1371/journal.pone.0122439] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 02/11/2015] [Indexed: 01/17/2023] Open
Abstract
Background The stromal cell derived factor (SDF)-1/chemokine receptor (CXCR)-4 signaling pathway plays a key role in lung cancer metastasis and is molecular target for therapy. In the present study we investigated whether interleukin (IL)-24 can inhibit the SDF-1/CXCR4 axis and suppress lung cancer cell migration and invasion in vitro. Further, the efficacy of IL-24 in combination with CXCR4 antagonists was investigated. Methods Human H1299, A549, H460 and HCC827 lung cancer cell lines were used in the present study. The H1299 lung cancer cell line was stably transfected with doxycycline-inducible plasmid expression vector carrying the human IL-24 cDNA and used in the present study to determine the inhibitory effects of IL-24 on SDF-1/CXCR4 axis. H1299 and A549 cell lines were used in transient transfection studies. The inhibitory effects of IL-24 on SDF1/CXCR4 and its downstream targets were analyzed by quantitative RT-PCR, western blot, luciferase reporter assay, flow cytometry and immunocytochemistry. Functional studies included cell migration and invasion assays. Principal Findings Endogenous CXCR4 protein expression levels varied among the four human lung cancer cell lines. Doxycycline-induced IL-24 expression in the H1299-IL24 cell line resulted in reduced CXCR4 mRNA and protein expression. IL-24 post-transcriptionally regulated CXCR4 mRNA expression by decreasing the half-life of CXCR4 mRNA (>40%). Functional studies showed IL-24 inhibited tumor cell migration and invasion concomitant with reduction in CXCR4 and its downstream targets (pAKTS473, pmTORS2448, pPRAS40T246 and HIF-1α). Additionally, IL-24 inhibited tumor cell migration both in the presence and absence of the CXCR4 agonist, SDF-1. Finally, IL-24 when combined with CXCR4 inhibitors (AMD3100, SJA5) or with CXCR4 siRNA demonstrated enhanced inhibitory activity on tumor cell migration. Conclusions IL-24 disrupts the SDF-1/CXCR4 signaling pathway and inhibits lung tumor cell migration and invasion. Additionally, IL-24, when combined with CXCR4 inhibitors exhibited enhanced anti-metastatic activity and is an attractive therapeutic strategy for lung metastasis.
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Affiliation(s)
- Janani Panneerselvam
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Jiankang Jin
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Manish Shanker
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Jason Lauderdale
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Jonathan Bates
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Qi Wang
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Yan D. Zhao
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | | | - Timothy J. Hubin
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
- Department of Chemistry, Southwestern Oklahoma State University, Weatherford, Oklahoma, United States of America
| | - Rajagopal Ramesh
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
- Graduate Program in Biomedical Sciences, Oklahoma City, Oklahoma, United States of America
- * E-mail: (RR)
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