1
|
Fabbrini AL, Farrar AA, Brown JM, Oliveros LV, Florio J, Beacker J, Lamos L, Baran JV, Wilsey MJ. Navigating formula shortages: associations of parental perspectives on transitioning to alternative infant formulas for cow's milk protein allergy during the 2022 national formula shortage. Front Allergy 2024; 4:1333570. [PMID: 38260176 PMCID: PMC10801258 DOI: 10.3389/falgy.2023.1333570] [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: 11/05/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
The COVID-19 pandemic led to supply chain disruptions causing a severe shortage of infant formula. The shortage impacted parents of infants with cow's milk protein allergy (CMPA) who rely on specialized formulas. However, research on parent perspectives during formula shortages is limited. We aimed to understand the factors guiding parents' decisions when transitioning to alternative amino acid formula (AAF) or extensively hydrolyzed formula (eHF) during the national formula shortage. We conducted a survey using the ZSMoments platform and found that before the shortage, parents valued safety (83%), tolerability (78%), and reputability (78%) as primary factors in selecting eHFs and AAFs. Post-shortage, formula tolerability (86%), assurance (84%), and safety (80%) gained more importance. Among those switching eHF (n = 54), health care provider recommendations (81%), reputability (78%), taste (78%), and tolerability (78%) were rated as "extremely important." Among those switching AAF (n = 26), top factors included tolerability (77%), assurance (73%), safety (73%), cost-effectiveness (73%), and formula trustworthiness (73%). These data suggest that parents carefully weigh various factors when managing their child's CMPA and transitioning to different AAF or eHF options.
Collapse
Affiliation(s)
- Abigail L. Fabbrini
- Office of Medical Education, Kansas City University College of Osteopathic Medicine, Kansas City, MO, United States
| | - Andrew A. Farrar
- Office of Medical Education, Kansas City University College of Osteopathic Medicine, Kansas City, MO, United States
| | - Jerry M. Brown
- Office of Medical Education, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL, United States
| | - Lea V. Oliveros
- Office of Medical Education, Alabama College of Osteopathic Medicine, Dothan, AL, United States
| | - Jared Florio
- Office of Medical Education, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL, United States
| | - Jesse Beacker
- Office of Medical Education, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL, United States
| | - Luke Lamos
- Office of Medical Education, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL, United States
| | - Jessica V. Baran
- Office of Medical Education, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL, United States
| | - Michael J. Wilsey
- Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, FL, United States
| |
Collapse
|
2
|
Lloret J, Ganado T, Subhi I, Familiar C, Moreno L, Suárez P, Merino S. An attempt to reduce unnecessary surgical procedures... Can ultrasound characteristics help in differentiating adenoma vs carcinoma in follicular thyroid neoplasms? Radiologia (Engl Ed) 2023; 65:22-31. [PMID: 36842782 DOI: 10.1016/j.rxeng.2020.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 09/17/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND OBJECTIVES Thyroid nodules frequently require ultrasound and Fine Needle Aspiration Cytology (FNAC) evaluation. However, FNA cytology does not allow differentiation between follicular adenoma and carcinoma on Bethesda type IV lesions. This situation leads to many unnecessary surgical procedures because it is not possible to assure the benignity of the lesions, even when most of the specimens correspond to adenomas or even other benign lesions. The objective is this study is to establish if there are any US characteristics that would help us to predict the risk of malignancy of nodules with a pathological diagnosis of follicular neoplasm in order to achieve a more conservative management for non-suspicious nodules. MATERIAL AND METHODS We studied 61 nodules in 61 patients (51 women and 10 men) that underwent thyroid surgery and had histopathological results of either follicular adenoma or carcinoma. Different US characteristics of the nodules were analysed (composition, echogenicity, margin, calcification status, the presence of halo and overall observer suspicion of malignancy) and were correlated with the histopathological analysis. RESULTS We have found a statistically significant association between the presence of calcifications, ill-defined borders and overall observer suspicion or impression (defined by well-known suspicious for malignancy ultrasonographic features, such as calcification, poorly defined margin, and a markedly hypoechoic solid nodule; and benign ultrasonographic features, such as predominantly cystic echogenic composition and the presence of a perinodular hypoechogenic halo) with follicular carcinoma. However all those features have shown low sensitivities in the present study (30%, 30% and 50%, respectively). On the other hand, the absence of halo sign has shown a sensitivity of 100% and a negative predictive value (NPV) of 100% in our study. CONCLUSIONS The presence of calcifications, ill-defined borders and the overall impression or suspicion of malignancy associate with a higher risk for follicular carcinoma in Bethesda type IV thyroid nodules but their absence do not allow to predict benignity in these nodules. Inversely, when a halo sign lesion is observed, benign follicular neoplasm should be considered.
Collapse
Affiliation(s)
- J Lloret
- Servicio de Radiología, Hospital Clínico San Carlos, Madrid, Spain.
| | - T Ganado
- Servicio de Radiología, Hospital Clínico San Carlos, Madrid, Spain
| | - I Subhi
- Servicio de Radiología, Hospital Clínico San Carlos, Madrid, Spain
| | - C Familiar
- Servicio de Endocrinología, Hospital Clínico San Carlos, Madrid, Spain
| | - L Moreno
- Servicio de Radiología, Hospital Clínico San Carlos, Madrid, Spain
| | - P Suárez
- Servicio de Epidemiología, Hospital Clínico San Carlos, Madrid, Spain
| | - S Merino
- Servicio de Radiología, Hospital Clínico San Carlos, Madrid, Spain
| |
Collapse
|
3
|
Micaily I, Hackbart H, Butryn M, Abu-Khalaf MM. Obesity in early onset breast cancer in African American patients. Breast J 2021; 27:603-607. [PMID: 34117672 DOI: 10.1111/tbj.14258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 11/29/2022]
Abstract
Obesity is a modifiable risk factor in breast cancer patients and is predictive of disease outcomes in early-onset breast cancer survivors. The purpose of this review is to summarize the current evidence in the association between early-onset breast cancer and obesity, specifically in African-American women. Reviewing the molecular mechanisms and social determinants of disease in this population can provide a foundation for future interventions in prevention, detection, and treatment aiming at improving outcomes for young breast cancer patients.
Collapse
Affiliation(s)
- Ida Micaily
- Department of Medical Oncology, Thomas Jefferson University, Sidney Kimmel Cancer Center at Jefferson Health, Philadelphia, Pennsylvania, USA
| | - Hannah Hackbart
- Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA
| | - Meghan Butryn
- Department of Psychology and Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA
| | - Maysa M Abu-Khalaf
- Department of Medical Oncology, Thomas Jefferson University, Sidney Kimmel Cancer Center at Jefferson Health, Philadelphia, Pennsylvania, USA
| |
Collapse
|
4
|
Schiller P, Knödler M, Berger P, Greune L, Fruth A, Mellmann A, Dersch P, Berger M, Dobrindt U. The Superior Adherence Phenotype of E. coli O104:H4 is Directly Mediated by the Aggregative Adherence Fimbriae Type I. Virulence 2021; 12:346-359. [PMID: 33356871 PMCID: PMC7834096 DOI: 10.1080/21505594.2020.1868841] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Whereas the O104:H4 enterohemorrhagic Escherichia coli (EHEC) outbreak strain from 2011 expresses aggregative adherence fimbriae of subtype I (AAF/I), its close relative, the O104:H4 enteroaggregative Escherichia coli (EAEC) strain 55989, encodes AAF of subtype III. Tight adherence mediated by AAF/I in combination with Shiga toxin 2 production has been suggested to result in the outbreak strain’s exceptional pathogenicity. Furthermore, the O104:H4 outbreak strain adheres significantly better to cultured epithelial cells than archetypal EAEC strains expressing different AAF subtypes. To test whether AAF/I expression is associated with the different virulence phenotypes of the outbreak strain, we heterologously expressed AAF subtypes I, III, IV, and V in an AAF-negative EAEC 55989 mutant and compared AAF-mediated phenotypes, incl. autoaggregation, biofilm formation, as well as bacterial adherence to HEp-2 cells. We observed that the expression of all four AAF subtypes promoted bacterial autoaggregation, though with different kinetics. Disturbance of AAF interaction on the bacterial surface via addition of α-AAF antibodies impeded autoaggregation. Biofilm formation was enhanced upon heterologous expression of AAF variants and inversely correlated with the autoaggregation phenotype. Co-cultivation of bacteria expressing different AAF subtypes resulted in mixed bacterial aggregates. Interestingly, bacteria expressing AAF/I formed the largest bacterial clusters on HEp-2 cells, indicating a stronger host cell adherence similar to the EHEC O104:H4 outbreak strain. Our findings show that, compared to the closely related O104:H4 EAEC strain 55989, not only the acquisition of the Shiga toxin phage, but also the acquisition of the AAF/I subtype might have contributed to the increased EHEC O104:H4 pathogenicity.
Collapse
Affiliation(s)
| | - Michael Knödler
- Institute of Hygiene, University of Münster , Münster, Germany
| | - Petya Berger
- Institute of Hygiene, University of Münster , Münster, Germany
| | - Lilo Greune
- Institute for Infectiology, University of Münster , Münster, Germany
| | - Angelika Fruth
- Division of Enteropathogenic Bacteria and Legionella, Robert Koch Institute , Wernigerode, Germany
| | | | - Petra Dersch
- Institute for Infectiology, University of Münster , Münster, Germany
| | - Michael Berger
- Institute of Hygiene, University of Münster , Münster, Germany
| | - Ulrich Dobrindt
- Institute of Hygiene, University of Münster , Münster, Germany
| |
Collapse
|
5
|
Lloret J, Ganado T, Subhi I, Familiar C, Moreno L, Suárez P, Merino S. An attempt to reduce unnecessary surgical procedures... Can ultrasound characteristics help in differentiating adenoma vs carcinoma in follicular thyroid neoplasms? Radiologia (Engl Ed) 2020; 65:S0033-8338(20)30159-4. [PMID: 33309397 DOI: 10.1016/j.rx.2020.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 08/27/2020] [Accepted: 09/17/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION AND OBJECTIVES Thyroid nodules frequently require ultrasound and Fine Needle Aspiration Cytology (FNAC) evaluation. However, FNA cytology does not allow differentiation between follicular adenoma and carcinoma on Bethesda type IV lesions. This situation leads to many unnecessary surgical procedures because it is not possible to assure the benignity of the lesions, even when most of the specimens correspond to adenomas or even other benign lesions. The objective in this study is to establish if there are any US characteristics that would help us to predict the risk of malignancy of nodules with a pathological diagnosis of follicular neoplasm in order to achieve a more conservative management for non-suspicious nodules. MATERIAL AND METHODS We studied 61 nodules in 61 patients (51 women and 10 men) that underwent thyroid surgery and had histopathological results of either follicular adenoma or carcinoma. Different US characteristics of the nodules were analysed (composition, echogenicity, margin, calcification status, the presence of halo and overall observer suspicion of malignancy) and were correlated with the histopathological analysis. RESULTS We have found a statistically significant association between the presence of calcifications, ill-defined borders and overall observer suspicion or impression (defined by well-known suspicious for malignancy ultrasonographic features, such as calcification, poorly defined margin, and a markedly hypoechoic solid nodule; and benign ultrasonographic features, such as predominantly cystic echogenic composition and the presence of a perinodular hypoechogenic halo) with follicular carcinoma. However all those features have shown low sensitivities in the present study (30%, 30% and 50%, respectively). On the other hand, the absence of halo sign has shown a sensitivity of 100% and a negative predictive value (NPV) of 100% in our study. CONCLUSIONS The presence of calcifications, ill-defined borders and the overall impression or suspicion of malignancy are associated with a higher risk for follicular carcinoma in Bethesda type IV thyroid nodules but their absence does not allow to predict benignity in these nodules. Inversely, when a halo sign lesion is observed, benign follicular neoplasm should be considered.
Collapse
Affiliation(s)
- J Lloret
- Servicio de Radiología, Hospital Clínico San Carlos, Madrid, España.
| | - T Ganado
- Servicio de Radiología, Hospital Clínico San Carlos, Madrid, España
| | - I Subhi
- Servicio de Radiología, Hospital Clínico San Carlos, Madrid, España
| | - C Familiar
- Servicio de Endocrinología, Hospital Clínico San Carlos, Madrid, España
| | - L Moreno
- Servicio de Radiología, Hospital Clínico San Carlos, Madrid, España
| | - P Suárez
- Servicio de Epidemiología, Hospital Clínico San Carlos, Madrid, España
| | - S Merino
- Servicio de Radiología, Hospital Clínico San Carlos, Madrid, España
| |
Collapse
|
6
|
Murphy TE, McAvay GJ, Allore HG, Stamm JA, Simonelli PF. Contributions of COPD, asthma, and ten comorbid conditions to health care utilization and patient-centered outcomes among US adults with obstructive airway disease. Int J Chron Obstruct Pulmon Dis 2017; 12:2515-2522. [PMID: 28883718 PMCID: PMC5574692 DOI: 10.2147/copd.s139948] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Among persons with obstructive airway disease, the relative contributions of chronic obstructive pulmonary disease (COPD), asthma, and common comorbid conditions to health care utilization and patient-centered outcomes (PCOs) have not been previously reported. Methods We followed a total of 3,486 persons aged ≥40 years with COPD, asthma, or both at baseline, from the Medical Expenditure Panel Survey (MEPS) cohorts enrolled annually from 2008 through 2012 for 1 year. MEPS is a prospective observational study of US households recording self-reported COPD, asthma, and ten medical conditions: angina, arthritis, cancer, coronary heart disease, cognitive impairment, diabetes, hypertension, lung cancer, myocardial infarction, and stroke/transient ischemic attack. We studied the separate contributions of these conditions to health care utilization (all-cause and respiratory disease hospitalization, any emergency department [ED] visit, and six or more outpatient visits) and PCOs (seven or more days spent in bed due to illness, incident loss of mobility, and incident decline in self-perceived health). Results COPD made the largest contributions to all-cause and respiratory disease hospitalization and ED visits, while arthritis made the largest contribution to outpatient health care. Arthritis and COPD, respectively, made the greatest contributions to the PCOs. Conclusion COPD made the largest and second largest contributions to health care utilization and PCOs among US adults with obstructive airway disease. The twelve medical conditions collectively accounted for between 52% and 61% of the health care utilization outcomes and between 53% and 68% of the PCOs. Cognitive impairment, diabetes, hypertension, and stroke also made significant contributions.
Collapse
Affiliation(s)
- Terrence E Murphy
- Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Gail J McAvay
- Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Heather G Allore
- Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Jason A Stamm
- Department of Internal Medicine, Section of Thoracic Medicine, Geisinger Medical Center, Danville, PA, USA
| | - Paul F Simonelli
- Department of Internal Medicine, Section of Thoracic Medicine, Geisinger Medical Center, Danville, PA, USA
| |
Collapse
|
7
|
Gupta D, Sharma M, Sarkar S, Thapa BR, Chakraborti A. Virulence determinants in enteroaggregative Escherichia coli from North India and their interaction in in vitro organ culture system. FEMS Microbiol Lett 2016; 363:fnw189. [PMID: 27493010 DOI: 10.1093/femsle/fnw189] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2016] [Indexed: 11/13/2022] Open
Abstract
Enteroaggregative Escherichia coli (EAEC) is an important diarrhoeal pathogen causing diseases in multiple epidemiological and clinical settings. In developing countries like India, diarrhoeal diseases are one of the major killers among paediatric population and oddly, few studies are available from Indian paediatric population on the variability of EAEC virulence genes. In this study, we examined the distribution of plasmid and chromosomal-encoded virulence determinants in EAEC isolates, and analysed cytokines response generated against EAEC with specific aggregative adherence fimbriae (AAF) type in duodenal biopsies using in vitro organ culture (IVOC) mimicking in vivo conditions. Different virulence marker combinations among strains were reflected as a function of specific adhesins signifying EAEC heterogeneity. fis gene emerged as an important genetic marker apart from aggA and aap Further, EAEC infection in IVOC showed upregulation of IL-8, IL-1β, IL-6, TNF-α and TLR-5 expression. EAEC with AAFII induced significant TLR-5 and IL-8 response, conceivably owing to more pathogenicity markers. This study sheds light on the pattern of EAEC pathotypes prevalent in North Indian paediatric population and highlights the presence of unique virulence combinations in pathogenic strains. Thus, evident diversity in EAEC virulence and multifaceted bacteria-host crosstalk can provide useful insights for the strategic management of diarrhoeal diseases in India, where diarrhoeal outbreaks are more frequent.
Collapse
Affiliation(s)
- Deepika Gupta
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Monica Sharma
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Subendu Sarkar
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - B R Thapa
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Anuradha Chakraborti
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| |
Collapse
|
8
|
Gupta D, Sarkar S, Sharma M, Thapa BR, Chakraborti A. Inhibition of enteroaggregative Escherichia coli cell adhesion in-vitro by designed peptides. Microb Pathog 2016; 98:23-31. [PMID: 27338495 DOI: 10.1016/j.micpath.2016.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 06/08/2016] [Accepted: 06/14/2016] [Indexed: 11/23/2022]
Abstract
Enteroaggregative Escherichia coli (EAEC) bears remarkable capacity to adhere the host intestinal mucosal surface and results in acute or persistent childhood diarrhea worldwide. In this study, an attempt has been made to inhibit EAEC cell adherence in-vitro using synthetic peptides. E. coli isolates (n = 54) were isolated from the stool samples of clinically diagnosed pediatric diarrheal patients. 92.8% isolates showed different types of aggregative adherence patterns with HEp-2 cells. AAF-II (Aggregative Adherence Fimbriae-II) EAEC exhibited the maximum ability to form biofilm and intracellular survival. Peptides were designed against the high antigenic epitopic regions of AAF-II adhesin of EAEC O42 using prediction algorithms like BcePred and ProPred software to block the EAEC cell adhesion in-vitro. Peptides P2 (DITITPATNRDVNV) and P3 (MRIKAWGEANHGQL) demonstrated higher inhibition of EAEC cell adhesion than P1 (GMQGSITPAIPLRPG). Interestingly, increasing the pre-incubation time of the peptides with HEp-2 cells from 1 h to 2 h showed the maximum inhibition. The data suggested the potential role of P2 and P3 peptides in successfully blocking the binding of AAF-II EAEC with HEp-2 cell receptors. Hence, the peptides may be efficacious in designing new chemotherapeutic for the management of EAEC mediated diarrhea.
Collapse
|
9
|
Koch SC, Kuper J, Gasteiger KL, Simon N, Strasser R, Eisen D, Geiger S, Schneider S, Kisker C, Carell T. Structural insights into the recognition of cisplatin and AAF-dG lesion by Rad14 (XPA). Proc Natl Acad Sci U S A 2015; 112:8272-7. [PMID: 26100901 DOI: 10.1073/pnas.1508509112] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Nucleotide excision repair (NER) is responsible for the removal of a large variety of structurally diverse DNA lesions. Mutations of the involved proteins cause the xeroderma pigmentosum (XP) cancer predisposition syndrome. Although the general mechanism of the NER process is well studied, the function of the XPA protein, which is of central importance for successful NER, has remained enigmatic. It is known, that XPA binds kinked DNA structures and that it interacts also with DNA duplexes containing certain lesions, but the mechanism of interactions is unknown. Here we present two crystal structures of the DNA binding domain (DBD) of the yeast XPA homolog Rad14 bound to DNA with either a cisplatin lesion (1,2-GG) or an acetylaminofluorene adduct (AAF-dG). In the structures, we see that two Rad14 molecules bind to the duplex, which induces DNA melting of the duplex remote from the lesion. Each monomer interrogates the duplex with a β-hairpin, which creates a 13mer duplex recognition motif additionally characterized by a sharp 70° DNA kink at the position of the lesion. Although the 1,2-GG lesion stabilizes the kink due to the covalent fixation of the crosslinked dG bases at a 90° angle, the AAF-dG fully intercalates into the duplex to stabilize the kinked structure.
Collapse
|
10
|
Murphy SJ, Hart SN, Lima JF, Kipp BR, Klebig M, Winters JL, Szabo C, Zhang L, Eckloff BW, Petersen GM, Scherer SE, Gibbs RA, McWilliams RR, Vasmatzis G, Couch FJ. Genetic alterations associated with progression from pancreatic intraepithelial neoplasia to invasive pancreatic tumor. Gastroenterology 2013; 145:1098-1109.e1. [PMID: 23912084 PMCID: PMC3926442 DOI: 10.1053/j.gastro.2013.07.049] [Citation(s) in RCA: 138] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 07/12/2013] [Accepted: 07/29/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Increasing grade of pancreatic intraepithelial neoplasia (PanIN) has been associated with progression to pancreatic ductal adenocarcinoma (PDAC). However, the mechanisms that control progression from PanINs to PDAC are not well understood. We investigated the genetic alterations involved in this process. METHODS Genomic DNA samples from laser-capture microdissected PDACs and adjacent PanIN2 and PanIN3 lesions from 10 patients with pancreatic cancer were analyzed by exome sequencing. RESULTS Similar numbers of somatic mutations were identified in PanINs and tumors, but the mutational load varied greatly among cases. Ten of the 15 isolated PanINs shared more than 50% of somatic mutations with associated tumors. Mutations common to tumors and clonally related PanIN2 and PanIN3 lesions were identified as genes that could promote carcinogenesis. KRAS and TP53 frequently were altered in PanINs and tumors, but few other recurrently modified genes were detected. Mutations in DNA damage response genes were prevalent in all samples. Genes that encode proteins involved in gap junctions, the actin cytoskeleton, the mitogen-activated protein kinase signaling pathway, axon guidance, and cell-cycle regulation were among the earliest targets of mutagenesis in PanINs that progressed to PDAC. CONCLUSIONS Early stage PanIN2 lesions appear to contain many of the somatic gene alterations required for PDAC development.
Collapse
Affiliation(s)
- Stephen J. Murphy
- Department of Molecular Medicine, Mayo Clinic, Rochester,
Minnesota 55905, USA
| | - Steven N. Hart
- Department of Health Sciences Research, Mayo Clinic,
Rochester, Minnesota 55905, USA
| | - Joema Felipe Lima
- Department of Molecular Medicine, Mayo Clinic, Rochester,
Minnesota 55905, USA
| | - Benjamin R. Kipp
- Department of Laboratory Medicine and Pathology, Mayo
Clinic, Rochester, Minnesota 55905, USA
| | - Mitchell Klebig
- Department of Laboratory Medicine and Pathology, Mayo
Clinic, Rochester, Minnesota 55905, USA
| | - Jennifer L Winters
- Department of Laboratory Medicine and Pathology, Mayo
Clinic, Rochester, Minnesota 55905, USA
| | - Csilla Szabo
- University of Delaware, Department of Biological Sciences,
Newark, DE 19716, USA
| | - Lizhi Zhang
- Department of Laboratory Medicine and Pathology, Mayo
Clinic, Rochester, Minnesota 55905, USA
| | - Bruce W. Eckloff
- Medical Genomics Facility, Mayo Clinic, Rochester,
Minnesota 55905, USA
| | - Gloria M. Petersen
- Department of Health Sciences Research, Mayo Clinic,
Rochester, Minnesota 55905, USA
| | - Steven E. Scherer
- Human Genome Sequencing Center, Baylor College of Medicine,
Houston, Texas 77030, USA
| | - Richard A. Gibbs
- Human Genome Sequencing Center, Baylor College of Medicine,
Houston, Texas 77030, USA
| | | | - George Vasmatzis
- Department of Molecular Medicine, Mayo Clinic, Rochester,
Minnesota 55905, USA ,Corresponding Authors: Fergus J. Couch, Mayo
Clinic, Stabile Building, 200 First St., SW, Rochester, MN 55905, Phone: (507)
284-3623, Fax: (507) 538-1937, George Vasmatzis, Mayo Clinic, Medical Sciences
Building, 200 First St., SW, Rochester, MN 55905, Phone: (507) 266-4617, Fax:
(507) 266-1163
| | - Fergus J. Couch
- Department of Health Sciences Research, Mayo Clinic,
Rochester, Minnesota 55905, USA,Department of Laboratory Medicine and Pathology, Mayo
Clinic, Rochester, Minnesota 55905, USA,Corresponding Authors: Fergus J. Couch, Mayo
Clinic, Stabile Building, 200 First St., SW, Rochester, MN 55905, Phone: (507)
284-3623, Fax: (507) 538-1937, George Vasmatzis, Mayo Clinic, Medical Sciences
Building, 200 First St., SW, Rochester, MN 55905, Phone: (507) 266-4617, Fax:
(507) 266-1163
| |
Collapse
|
11
|
Tsukano H, Horie M, Honma Y, Ohga S, Hishida R, Takebayashi H, Takahashi S, Shibuki K. Age-related deterioration of cortical responses to slow FM sounds in the auditory belt region of adult C57BL/6 mice. Neurosci Lett 2013; 556:204-9. [PMID: 24161895 DOI: 10.1016/j.neulet.2013.10.015] [Citation(s) in RCA: 7] [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: 07/05/2013] [Revised: 09/13/2013] [Accepted: 10/07/2013] [Indexed: 11/27/2022]
Abstract
To compare age-related deterioration of neural responses in each subfield of the auditory cortex in C57BL/6 mice, we evaluated amplitudes of tonal responses in young (5-11 weeks old) and adult (16-23 weeks old) groups using transcranial flavoprotein fluorescence imaging. Cortical responses to 20-kHz amplitude-modulated (AM) sounds, which were mainly found in the anterior auditory field (AAF) and the primary auditory cortex (AI) of the core region, were not markedly different between the two groups. In contrast, cortical responses to direction reversal of slow frequency-modulated (FM) sounds, which were mainly found in the ultrasonic field (UF), were significantly disrupted in the adult group compared with those in the young group. To investigate the mechanisms underlying such age-related deterioration, biotinylated dextran amine (BDA) was injected into UF. The number of retrograde labeled neurons in the dorsal division of the medial geniculate body (MGd) was markedly reduced in the adult group compared with that in the young group. These results strongly suggest that cortical responses to FM direction reversal in UF of adult C57BL/6 mice are mainly deteriorated by loss of non-lemniscal thalamic inputs from MGd to UF due to aging.
Collapse
Affiliation(s)
- Hiroaki Tsukano
- Department of Neurophysiology, Brain Research Institute, Niigata University, 1-757 Asahi-machi, Chuo-ku, Niigata 951-8585, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
|
13
|
Berni Canani R, Nocerino R, Terrin G, Frediani T, Lucarelli S, Cosenza L, Passariello A, Leone L, Granata V, Di Costanzo M, Pezzella V, Troncone R. Formula selection for management of children with cow's milk allergy influences the rate of acquisition of tolerance: a prospective multicenter study. J Pediatr 2013; 163:771-7.e1. [PMID: 23582142 DOI: 10.1016/j.jpeds.2013.03.008] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Revised: 01/25/2013] [Accepted: 03/06/2013] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To prospectively evaluate the effect of different dietary management strategies on the rate of acquisition of tolerance in children with cow's milk allergy (CMA). STUDY DESIGN Otherwise healthy children (aged 1-12 months) diagnosed with CMA were prospectively evaluated. The study population was divided into 5 groups based upon the formula used for management: (1) extensively hydrolyzed casein formula ([EHCF], n = 55); (2) EHCF + Lactobacillus rhamnosus GG [LGG], n = 71); (3) hydrolyzed rice formula (RHF, n = 46); (4) soy formula (n = 55); and (5) amino acid based formula (n = 33). A food challenge was performed after 12 months to assess acquisition of tolerance. RESULTS Two hundred sixty children were evaluated (167 male, 64.2%; age 5.92 months, 95% CI 5.48-6.37; body weight 6.66 kg, 95% CI 6.41-6.91; IgE-mediated CMA 111, 42.7%). The rate of children acquiring oral tolerance after 12 months was significantly higher (P < .05) in the groups receiving EHCF (43.6%) or EHCF + LGG (78.9%) compared with the other groups: RHF (32.6%), soy formula (23.6%), and amino acid based formula (18.2%). Binary regression analysis coefficient (B) revealed that the rate of patients acquiring tolerance at the end of the study was influenced by 2 factors: (1) IgE-mediated mechanism (B -2.05, OR 0.12, 95% CI 0.06-0.26; P < .001); and (2) formula choice, such that those receiving either EHCF (B 1.48, OR 4.41, 95% CI 1.44-13.48; P = .009) or EHCF + LGG (B 3.35, OR 28.62, 95% CI 8.72-93.93; P < .001). CONCLUSIONS EHCF accelerates tolerance acquisition in children with CMA if compared with other dietetic choices. This effect is augmented by LGG.
Collapse
|
14
|
Fragkaki AG, Georgakopoulos C, Sterk S, Nielen MWF. Sports doping: emerging designer and therapeutic β2-agonists. Clin Chim Acta 2013; 425:242-58. [PMID: 23954776 DOI: 10.1016/j.cca.2013.07.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 07/30/2013] [Accepted: 07/31/2013] [Indexed: 12/12/2022]
Abstract
Beta2-adrenergic agonists, or β2-agonists, are considered essential bronchodilator drugs in the treatment of bronchial asthma, both as symptom-relievers and, in combination with inhaled corticosteroids, as disease-controllers. The use of β2-agonists is prohibited in sports by the World Anti-Doping Agency (WADA) due to claimed anabolic effects, and also, is prohibited as growth promoters in cattle fattening in the European Union. This paper reviews the last seven-year (2006-2012) literature concerning the development of novel β2-agonists molecules either by modifying the molecule of known β2-agonists or by introducing moieties producing indole-, adamantyl- or phenyl urea derivatives. New emerging β2-agonists molecules for future therapeutic use are also presented, intending to emphasize their potential use for doping purposes or as growth promoters in the near future.
Collapse
Affiliation(s)
- A G Fragkaki
- Doping Control Laboratory of Athens, Olympic Athletic Center of Athens "Spyros Louis", Kifisias 37, 15123 Maroussi, Greece.
| | | | | | | |
Collapse
|
15
|
Bosch J, Luchini A, Pichini S, Tamburro D, Fredolini C, Liotta L, Petricoin E, Pacifici R, Facchiano F, Segura J, Garaci E, Gutiérrez-Gallego R. Analysis of urinary human growth hormone (hGH) using hydrogel nanoparticles and isoform differential immunoassays after short recombinant hGH treatment: preliminary results. J Pharm Biomed Anal 2013; 85:194-7. [PMID: 23954438 DOI: 10.1016/j.jpba.2013.07.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 07/15/2013] [Accepted: 07/19/2013] [Indexed: 11/28/2022]
Abstract
Successful application clinical-grade human growth hormone (hGH) immunoassays to the discovery of illegal doping cases has been rare. Indeed, the preferred biological matrix in doping control is urine, where the estimated baseline concentration of hGH falls well below the linear range and sensitivity threshold of all commercially available immunoassays, including hGH isoform differential immunoassays which can discriminate pituitary endogenous hGH from recombinant hGH. We employed hydrogel nanoparticles as a pre-processing step that concentrate urinary hGH into the linear range of isoform differential immunoassays. We explored the characteristics of immunoassays in urine spiked with both phGH or rhGH, after pre-treatment with the nanoparticles. Subsequently, pre-treatment was applied to urine obtained from 3 healthy volunteers administered during three days with daily subcutaneous injections of 0.026 mg/kg/day rhGH, Genotonorm(®). Linearity between both rhGH and phGH concentrations in urine measured by a chemoluminescent assay (Immulite) and in the particle eluate was evident for differential immunoassays (R square higher than 0.999). In case of treated individuals the recombinant/pituitary concentration ratios remained above the established World Anti-Doping Agency (WADA) criterion for hGH misuse up to 24h after the last administration dose, using both assays for volunteer 1 and 2 while in case of volunteer 3 results were inconclusive. The use of nanoparticles appears to open the possibility of assessing rhGH misuse in urine.
Collapse
Affiliation(s)
- Jaume Bosch
- Bioanalysis Group IMIM-Parc Salut Mar and Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona Biomedical Research Park (PRBB), Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Lin FG, Galindo-Leon EE, Ivanova TN, Mappus RC, Liu RC. A role for maternal physiological state in preserving auditory cortical plasticity for salient infant calls. Neuroscience 2013; 247:102-16. [PMID: 23707982 DOI: 10.1016/j.neuroscience.2013.05.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [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: 03/05/2013] [Revised: 05/05/2013] [Accepted: 05/07/2013] [Indexed: 11/20/2022]
Abstract
A growing interest in sensory system plasticity in the natural context of motherhood has created the need to investigate how intrinsic physiological state (e.g., hormonal, motivational, etc.) interacts with sensory experience to drive adaptive cortical plasticity for behaviorally relevant stimuli. Using a maternal mouse model of auditory cortical inhibitory plasticity for ultrasonic pup calls, we examined the role of pup care versus maternal physiological state in the long-term retention of this plasticity. Very recent experience caring for pups by Early Cocarers, which are virgins, produced stronger call-evoked lateral-band inhibition in auditory cortex. However, this plasticity was absent when measured post-weaning in Cocarers, even though it was present at the same time point in Mothers, whose pup experience occurred under a maternal physiological state. A two-alternative choice phonotaxis task revealed that the same animal groups (Early Cocarers and Mothers) demonstrating stronger lateral-band inhibition also preferred pup calls over a neutral sound, a correlation consistent with the hypothesis that this inhibitory mechanism may play a mnemonic role and is engaged to process sounds that are particularly salient. Our electrophysiological data hint at a possible mechanism through which the maternal physiological state may act to preserve the cortical plasticity: selectively suppressing detrimental spontaneous activity in neurons that are responsive to calls, an effect observed only in Mothers. Taken together, the maternal physiological state during the care of pups may help maintain the memory trace of behaviorally salient infant cues within core auditory cortex, potentially ensuring a more rapid induction of future maternal behavior.
Collapse
Affiliation(s)
- F G Lin
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 315 Ferst Drive, Atlanta, GA 30332, USA
| | | | | | | | | |
Collapse
|