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1.
Ann Oncol ; 35(8): 707-717, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38729567

RESUMEN

BACKGROUND: SERENA-1 (NCT03616587) is a phase I, multi-part, open-label study of camizestrant in pre- and post-menopausal women with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer. Parts A and B aim to determine the safety and tolerability of camizestrant monotherapy and define doses for clinical evaluation. PATIENTS AND METHODS: Women aged ≥18 years with metastatic or recurrent ER+, HER2- breast cancer, refractory (or intolerant) to therapy, were assigned 25 mg up to 450 mg once daily (QD; escalation) or 75, 150, or 300 mg QD (expansion). Safety and tolerability, antitumor efficacy, pharmacokinetics, and impact on mutations in the estrogen receptor gene (ESR1m) circulating tumor (ct)DNA levels were assessed. RESULTS: By 9 March 2021, 108 patients received camizestrant monotherapy at 25-450 mg doses. Of these, 93 (86.1%) experienced treatment-related adverse events (TRAEs), 82.4% of which were grade 1 or 2. The most common TRAEs were visual effects (56%), (sinus) bradycardia (44%), fatigue (26%), and nausea (15%). There were no TRAEs grade 3 or higher, or treatment-related serious adverse events at doses ≤150 mg. Median tmax was achieved ∼2-4 h post-dose at all doses investigated, with an estimated half-life of 20-23 h. Efficacy was observed at all doses investigated, including in patients with prior cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) and/or fulvestrant treatment, with and without baseline ESR1 mutations, and with visceral disease, including liver metastases. CONCLUSIONS: Camizestrant is a next-generation oral selective ER antagonist and degrader (SERD) and pure ER antagonist with a tolerable safety profile. The pharmacokinetics profile supports once-daily dosing, with evidence of pharmacodynamic and clinical efficacy in heavily pre-treated patients, regardless of ESR1m. This study established 75-, 150-, and 300-mg QD doses for phase II testing (SERENA-2, NCT04214288 and SERENA-3, NCT04588298).


Asunto(s)
Neoplasias de la Mama , Receptor ErbB-2 , Humanos , Femenino , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/patología , Neoplasias de la Mama/genética , Persona de Mediana Edad , Receptor ErbB-2/genética , Receptor ErbB-2/antagonistas & inhibidores , Receptor ErbB-2/metabolismo , Anciano , Adulto , Receptores de Estrógenos/metabolismo , Administración Oral , Receptor alfa de Estrógeno/genética , Anciano de 80 o más Años , Dosis Máxima Tolerada , Relación Dosis-Respuesta a Droga , Azetidinas , Isoquinolinas
2.
J Vet Pharmacol Ther ; 41(2): 254-265, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29139142

RESUMEN

The safety of synthetic levothyroxine sodium tablets (Thyro-Tabs® Canine; LLOYD, Inc.) in dogs was evaluated in a randomized, sham-dose controlled, parallel-group study. Young, healthy, euthyroid Beagle dogs were randomized into four groups (four females and four males per group) and received single daily doses of 0×, 2× (0.044 mg/kg), 6× (0.132 mg/kg), or 10× (0.22 mg/kg) the labeled starting dose of 0.022 mg kg-1  day-1 for 182 days. Every 2 weeks, physical examinations, electrocardiology examinations, and sample collections for thyroid panel, hematology, serum biochemistry, coagulation panel, and urinalysis were performed. At the end of the study, the dogs were euthanized and full necropsies performed. The most overt finding was the expected dose-dependent increase in serum concentrations of total and free thyroxine with dose-dependent suppression of the hypothalamic-pituitary-thyroid axis as evidenced by decreased serum thyroid-stimulating hormone concentrations, decreased thyroid+parathyroid/body weight ratios, and a trend for decreased pituitary weight/brain weight ratios. Clinical signs of thyrotoxicosis (excitation, tachypnea, tachycardia) in the treated dogs were sporadic with no dose-response relationship. Other findings statistically associated with levothyroxine treatment were generally mild and not clinically important. In summary, doses of levothyroxine sodium up to 10× the labeled starting dose were well tolerated in healthy dogs.


Asunto(s)
Tiroxina/efectos adversos , Administración Oral , Animales , Enfermedades de los Perros/inducido químicamente , Perros , Relación Dosis-Respuesta a Droga , Femenino , Masculino , Comprimidos , Tirotoxicosis/inducido químicamente , Tirotoxicosis/veterinaria , Tirotropina/sangre , Tiroxina/administración & dosificación , Tiroxina/sangre
3.
Int J Obes (Lond) ; 41(3): 381-389, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-27924082

RESUMEN

BACKGROUND/OBJECTIVES: The combination of energy dense diets and reduced energy expenditure in modern society has escalated the prevalence of obesity and obesity-related comorbidities. Among these disease states, type-2 diabetics (T2D) are disproportionately associated with obesity, suggesting a shared etiology. In conjunction with defects in hormonal and inflammatory states, obesity and T2D are also characterized by dysbiosis. METHODS: We have recently described the beneficial effects of duodenal nutrient exclusion, as induced by the duodenal endoluminal sleeve (DES); including body weight loss, prevented fat mass accumulation, and improved glucose tolerance in the ZDF rat, a rodent model of obesity and type-2 diabetes (T2D). To assess the relative role of DES on hindgut microbiota in the context of these metabolic changes, we analyzed cecal samples from rats implanted with a duodenal endoluminal sleeve (DES), or a sham control of this procedure. A group of pair-fed (pf) sham controls was also included to account for changes induced by reduced body weight and food intake. RESULTS: Analysis of hindgut microbiota following DES in the ZDF rat elucidated discrete changes in several microbial populations including a reduction in Paraprevotella family members of the Clostridiales order along with an increase in Akkermansia muciniphila and species of the Allobaculum and Bifidobacterium genera. CONCLUSIONS: Altogether, these observations suggest that like Roux-en Y gastric bypass (RYGB) and Metformin, regulation of gut microbiota may be a contributing factor to the therapeutic effects of DES.


Asunto(s)
Diabetes Mellitus Tipo 2/patología , Duodeno/cirugía , Disbiosis/patología , Microbioma Gastrointestinal , Hipoglucemiantes/farmacología , Metformina/farmacología , Obesidad/patología , Animales , Modelos Animales de Enfermedad , Derivación Gástrica , Microbioma Gastrointestinal/efectos de los fármacos , Ratas , Ratas Zucker , Pérdida de Peso
4.
Genes Immun ; 17(7): 400-405, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27786174

RESUMEN

We have previously shown alterations in the composition of the gut microbiota in children with enthesitis-related arthritis (ERA). To explore the mechanisms by which an altered microbiota might predispose to arthritis, we performed metabolomic profiling of fecal samples of children with ERA. Fecal samples were collected from two cohorts of children with ERA and healthy control subjects. Nano-liquid chromatography-mass spectroscopy (LC-MS) was performed on the fecal water homogenates with identification based upon mass: charge ratios. Sequencing of the 16S ribosomal DNA (rDNA) on the same stool specimens was performed. In both sets of subjects, patients demonstrated lower diversity of ions and under-representation of multiple metabolic pathways, including the tryptophan metabolism pathway. For example, in the first cohort, out of 1500 negatively charged ions, 154 were lower in ERA patients, compared with only one that was higher. Imputed functional annotation of the 16S ribosomal DNA sequence data demonstrated significantly fewer microbial genes associated with metabolic processes in the patients compared with the controls (77 million versus 58 million, P=0.050). Diminished metabolic diversity and alterations in the tryptophan metabolism pathway may be a feature of ERA.


Asunto(s)
Artritis Juvenil/metabolismo , Heces , Microbioma Gastrointestinal , Espondiloartritis/metabolismo , Adolescente , Niño , Estudios de Cohortes , Femenino , Humanos , Masculino , Metabolómica , ARN Ribosómico 16S , Triptófano/metabolismo , Factores de Virulencia
5.
Ann Oncol ; 27(6): 1155-1160, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-27013395

RESUMEN

BACKGROUND: Over the past decade, numerous reports describe the generation and increasing utility of non-small-cell lung cancer (NSCLC) patient-derived xenografts (PDX) from tissue biopsies. While PDX have proven useful for genetic profiling and preclinical drug testing, the requirement of a tissue biopsy limits the available patient population, particularly those with advanced oligometastatic disease. Conversely, 'liquid biopsies' such as circulating tumour cells (CTCs) are minimally invasive and easier to obtain. Here, we present a clinical case study of a NSCLC patient with advanced metastatic disease, a never smoker whose primary tumour was EGFR and ALK wild-type. We demonstrate for the first time, tumorigenicity of their CTCs to generate a patient CTC-derived eXplant (CDX). PATIENTS AND METHODS: CTCs were enriched at diagnosis and again 2 months later during disease progression from 10 ml blood from a 48-year-old NSCLC patient and implanted into immunocompromised mice. Resultant tumours were morphologically, immunohistochemically, and genetically compared with the donor patient's diagnostic specimen. Mice were treated with cisplatin and pemetrexed to assess preclinical efficacy of the chemotherapy regimen given to the donor patient. RESULTS: The NSCLC CDX expressed lung lineage markers TTF1 and CK7 and was unresponsive to cisplatin and pemetrexed. Examination of blood samples matched to that used for CDX generation revealed absence of CTCs using the CellSearch EpCAM-dependent platform, whereas size-based CTC enrichment revealed abundant heterogeneous CTCs of which ∼80% were mesenchymal marker vimentin positive. Molecular analysis of the CDX, mesenchymal and epithelial CTCs revealed a common somatic mutation confirming tumour origin and showed CDX RNA and protein profiles consistent with the predominantly mesenchymal phenotype. CONCLUSIONS: This study shows that the absence of NSCLC CTCs detected by CellSearch (EpCAM(+)) does not preclude CDX generation, highlighting epithelial to mesenchymal transition and the functional importance of mesenchymal CTCs in dissemination of this disease.


Asunto(s)
Biomarcadores de Tumor/genética , Carcinogénesis/genética , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Células Neoplásicas Circulantes/patología , Animales , Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Pulmón de Células no Pequeñas/patología , Cisplatino/administración & dosificación , Proteínas de Unión al ADN/genética , Transición Epitelial-Mesenquimal/genética , Humanos , Células Madre Mesenquimatosas/patología , Ratones , Mutación , Células Neoplásicas Circulantes/efectos de los fármacos , Células Madre Neoplásicas/patología , Pemetrexed/administración & dosificación , Factores de Transcripción/genética , Ensayos Antitumor por Modelo de Xenoinjerto
6.
Br J Cancer ; 108(6): 1348-57, 2013 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-23462721

RESUMEN

BACKGROUND: Surgical-pathological risk factors were evaluated by weighting the magnitude of significance of multiple risk factors correlating to survival and treatment response in cervical cancer. METHODS: Multivariate analysis was performed for survival outcomes entering seven pathological factors obtained from 540 radical hysterectomy specimens in stage IA2-IIB cervical cancer cases. Hazard ratio (HR) in each risk factor was determined, and the sum of HR scores for the corresponding risk factors was determined per case. Survival curves and postoperative treatment response (concurrent chemoradiotherapy (CCRT) vs radiotherapy alone) were evaluated based on the extent of HR-weighted scores. RESULTS: Hazard ratios for risk factors relating to disease-free survival (DFS) was: lympho-vascular space invasion 3.95, nodal metastasis 3.88, adenocarcinoma 3.40, large tumour 2.36, positive margin 1.99, deep stromal invasion 1.29, and parametria invasion 1.21. The HR-weighted scoring method showed a high predictive value for recurrence (area-under-curve 0.836, P<0.001). Hazard ratio-weighted scores were negatively correlated to DFS, and the cases with score 12.5 showed 5-year DFS rate of 23.8%. Tumours with larger score offset the benefits of CCRT over radiotherapy alone for postoperative adjuvant treatment (P<0.001). CONCLUSION: Surgical-pathological risk factors provide valuable information for survival and management of early-stage cervical cancer when number and significance of risks are weighted.


Asunto(s)
Adenocarcinoma/terapia , Carcinoma Adenoescamoso/terapia , Carcinoma de Células Escamosas/terapia , Quimioradioterapia , Histerectomía , Neoplasias del Cuello Uterino/terapia , Adenocarcinoma/mortalidad , Adenocarcinoma/patología , Carcinoma Adenoescamoso/mortalidad , Carcinoma Adenoescamoso/patología , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Quimioterapia Adyuvante , Terapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Radioterapia Adyuvante , Factores de Riesgo , Tasa de Supervivencia , Neoplasias del Cuello Uterino/mortalidad , Neoplasias del Cuello Uterino/patología
7.
J Antimicrob Chemother ; 68(6): 1406-14, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23485767

RESUMEN

OBJECTIVES: Genotypic HIV drug-resistance testing is typically 60%-65% predictive of response to combination antiretroviral therapy (ART) and is valuable for guiding treatment changes. Genotyping is unavailable in many resource-limited settings (RLSs). We aimed to develop models that can predict response to ART without a genotype and evaluated their potential as a treatment support tool in RLSs. METHODS: Random forest models were trained to predict the probability of response to ART (≤400 copies HIV RNA/mL) using the following data from 14 891 treatment change episodes (TCEs) after virological failure, from well-resourced countries: viral load and CD4 count prior to treatment change, treatment history, drugs in the new regimen, time to follow-up and follow-up viral load. Models were assessed by cross-validation during development, with an independent set of 800 cases from well-resourced countries, plus 231 cases from Southern Africa, 206 from India and 375 from Romania. The area under the receiver operating characteristic curve (AUC) was the main outcome measure. RESULTS: The models achieved an AUC of 0.74-0.81 during cross-validation and 0.76-0.77 with the 800 test TCEs. They achieved AUCs of 0.58-0.65 (Southern Africa), 0.63 (India) and 0.70 (Romania). Models were more accurate for data from the well-resourced countries than for cases from Southern Africa and India (P < 0.001), but not Romania. The models identified alternative, available drug regimens predicted to result in virological response for 94% of virological failures in Southern Africa, 99% of those in India and 93% of those in Romania. CONCLUSIONS: We developed computational models that predict virological response to ART without a genotype with comparable accuracy to genotyping with rule-based interpretation. These models have the potential to help optimize antiretroviral therapy for patients in RLSs where genotyping is not generally available.


Asunto(s)
Infecciones por VIH/tratamiento farmacológico , VIH/genética , Adulto , África del Sur del Sahara/epidemiología , Fármacos Anti-VIH/provisión & distribución , Fármacos Anti-VIH/uso terapéutico , Simulación por Computador , Bases de Datos Factuales , Femenino , Estudios de Seguimiento , Infecciones por VIH/virología , Inhibidores de la Proteasa del VIH/provisión & distribución , Inhibidores de la Proteasa del VIH/uso terapéutico , Recursos en Salud , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Valor Predictivo de las Pruebas , Curva ROC , Inhibidores de la Transcriptasa Inversa/provisión & distribución , Inhibidores de la Transcriptasa Inversa/uso terapéutico , Rumanía/epidemiología , Insuficiencia del Tratamiento , Carga Viral
8.
Gynecol Oncol ; 128(3): 544-51, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23262205

RESUMEN

OBJECTIVE: To profile characteristics and survival of endometrial cancer patients who develop venous thromboembolism (VTE) and to establish a predictive model of VTE in endometrial cancer. METHODS: Cases were identified using an institutional database between 2000 and 2011. VTE was correlated to clinico-pathological information and survival outcomes. Frequency and odds ratio (OR) of VTE were examined in a predictive model based on combination patterns of independent risk factors for VTE. RESULTS: VTE was seen in 42 (8.1%, 95% CI 5.8-10.5) out of 516 cases subsequent to the diagnosis of endometrial cancer. Multivariate analysis identified 4 independent risk factors for VTE: elevated CA-125 (hazard ratio [HR] 5.38, p<0.001), extrauterine disease (HR 2.87, p=0.019), thrombocytosis (HR 2.11, p=0.04), and high risk histology (serous and clear cell, HR 2.09, p=0.049). VTE was the strongest variable for decreased progression-free survival (HR 4.28) and the second strongest variable for decreased overall survival (HR 5.65) in multivariate analysis. In a predictive model of VTE, the presence of multiple risk factors was associated with significantly increased risk of VTE: frequency of VTE, 1.4% if no risk factors, 0-9.3% (OR 1.0-4.2) if a single risk factor, 11.1-25.0% (OR 9.0-24.0) if two risk factors, and 42.9-46.2% (OR 54.0-61.7) if ≥3 risk factors. CONCLUSION: VTE represents a surrogate for aggressive disease in endometrial cancer. Multiple risk factors of VTE in our predictive model demonstrated exceedingly high risk of VTE, suggesting that there may be a certain population of endometrial cancer patients who would benefit from long-term anti-coagulant prophylaxis to improve survival outcome.


Asunto(s)
Neoplasias Endometriales/sangre , Neoplasias Endometriales/complicaciones , Tromboembolia Venosa/etiología , Supervivencia sin Enfermedad , Neoplasias Endometriales/diagnóstico , Neoplasias Endometriales/tratamiento farmacológico , Femenino , Humanos , Incidencia , Persona de Mediana Edad , Modelos Estadísticos , Valor Predictivo de las Pruebas , Pronóstico , Factores de Riesgo , Análisis de Supervivencia
9.
Arch Osteoporos ; 18(1): 42, 2023 03 11.
Artículo en Inglés | MEDLINE | ID: mdl-36905559

RESUMEN

In a characterization of treatment rates and healthcare costs among patients with an osteoporotic-related fragility fracture overall and by site of care, costs were high and treatment rates were low. PURPOSE: Osteoporotic fractures can be debilitating, even fatal, among older adults. The cost of osteoporosis and related fractures is projected to increase to more than $25 billion by 2025. The objective of this analysis is to characterize disease-related treatment rates and healthcare costs of patients with an osteoporotic fragility fracture overall and by site of fracture diagnosis. METHODS: In this retrospective analysis, individuals with fragility fractures were identified in the Merative MarketScan® Commercial and Medicare Databases among women 50 years of age or older and diagnosed with fragility fracture between 1/1/2013 and 6/30/2018 (earliest fracture diagnosis = index). Cohorts were categorized by clinical site of care where the diagnosis of fragility fracture was made and were continuously followed for 12 months prior to and following index. Sites of care were inpatient admission, outpatient office, outpatient hospital, emergency room hospital, and urgent care. RESULTS: Of the 108,965 eligible patients with fragility fracture (mean age 68.8), most were diagnosed during an inpatient admission or outpatient office visit (42.7%, 31.9%). The mean annual healthcare costs among patients with fragility fracture were $44,311 (± $67,427) and were highest for those diagnosed in an inpatient setting ($71,561 ± $84,072). Compared with other sites of care at fracture diagnosis, patients diagnosed during an inpatient admission also had highest proportion of subsequent fractures (33.2%), osteoporosis diagnosis (27.7%), and osteoporosis therapy (17.2%) during follow-up. CONCLUSION: The site of care for diagnosis of fragility fracture affects treatment rates and healthcare costs. Further studies are needed to determine how attitude or knowledge about osteoporosis treatment or healthcare experiences differ at various clinical sites of care in the medical management of osteoporosis.


Asunto(s)
Conservadores de la Densidad Ósea , Osteoporosis , Fracturas Osteoporóticas , Humanos , Femenino , Anciano , Estados Unidos , Estudios Retrospectivos , Medicare , Osteoporosis/tratamiento farmacológico , Costos de la Atención en Salud , Análisis de Datos , Conservadores de la Densidad Ósea/uso terapéutico
10.
Mol Phylogenet Evol ; 62(1): 174-90, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22001855

RESUMEN

The current morphological classification of the Demospongiae G4 clade was tested using large subunit ribosomal RNA (LSU rRNA) sequences from 119 taxa. Fifty-three mitochondrial cytochrome oxidase 1 (CO1) barcoding sequences were also analysed to test whether the 28S phylogeny could be recovered using an independent gene. This is the largest and most comprehensive study of the Demospongiae G4 clade. The 28S and CO1 genetrees result in congruent clades but conflict with the current morphological classification. The results confirm the polyphyly of Halichondrida, Hadromerida, Dictyonellidae, Axinellidae and Poecilosclerida and show that several of the characters used in morphological classifications are homoplasious. Robust clades are clearly shown and a new hypothesis for relationships of taxa allocated to G4 is proposed.


Asunto(s)
Genes Mitocondriales , Poríferos/genética , Animales , Teorema de Bayes , Código de Barras del ADN Taxonómico , Complejo IV de Transporte de Electrones/genética , Evolución Molecular , Funciones de Verosimilitud , Modelos Genéticos , Filogenia , Poríferos/anatomía & histología , Poríferos/clasificación , ARN Ribosómico 28S/genética
11.
Gynecol Oncol ; 122(2): 264-8, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21592548

RESUMEN

OBJECTIVE: The international acceptance of a universal classification system for radical hysterectomy is one of the important challenges in gynecologic oncology. The recently published classification system by Querleu and Morrow is a relevant proposal that has been well received by the professional community. However, it does not include a description of parametrial resection in three dimensions, which mostly determines post-operative morbidity. METHODS: The intention of this follow-up paper was to further develop the classification system based on the four proposed types of radical hysterectomy (A-D) into a three-dimensional model using standard anatomical landmarks for definition of resection margins in longitudinal and transverse dimensions and demonstrate it on pictures. RESULTS: Resection margins were defined in longitudinal and transverse dimensions for each suggested type of radical hysterectomy on all three parts of the parametria. Besides precise description using stable anatomical landmarks, all resection lines have been shown on intra-operative photographs. CONCLUSION: Four types of radical hysteretomy can be precisely defined on a three-dimensional anatomical template, including nerve sparing procedure. Our paper should contribute to better standardization (including nomenclature) of the radical hysterectomy, enhancing harmonization of clinical practice in gynecological oncology.


Asunto(s)
Histerectomía/clasificación , Histerectomía/métodos , Útero/anatomía & histología , Femenino , Humanos
12.
Benef Microbes ; 12(3): 239-248, 2021 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-33789551

RESUMEN

Implicated in several chronic diseases, the gastrointestinal microbiome is hypothesised to influence carcinogenesis. We compared faecal microbiota of newly diagnosed treatment-naïve overweight and obese cancer patients and matched controls. Cases were enrolled in presurgical weight-loss trials for breast (NCT02224807) and prostate (NCT01886677) cancers and had a body mass index (BMI) ≥25 kg/m2. Cancer-free controls were matched 1:1 by age (±5 years), race, gender, and BMI (±5 kg/m2). All participants provided faecal samples; isolated bacterial DNA were PCR amplified at the V4 region of the 16S rRNA gene and analysed using the QIIME pipeline. Tests compared cases versus controls, then separately by gender. Microbial alpha-diversity and beta-diversity were assessed, and relative abundance of Operational Taxonomic Units (OTU's) were compared at the genus level, with false discovery rate (FDR) correction. 22 overweight and obese cancer patients were matched with 22 cancer-free controls, with an average BMI of 30.5±4.3 kg/m2, age 54.4±5.3 years, and 54.5% were black. Fourteen matches were made between breast cancer cases and healthy female controls, and 8 matches were made with prostate cancer cases and healthy male controls. Comparison of all cases and controls revealed no differences in alpha diversity, though prostate cancer patients had higher Chao1 (P=0.006) and Observed Species (P=0.036) than cancer-free males. Beta-diversity metrics were significantly different between cases and controls (P<0.03 for all tests in whole sample and in men), though only unweighted Unifrac was different in women (P=0.005). Kruskal Wallis tests indicated significant differences among 16 genera in all matches, 9 in female, and 51 in male. This study suggests the faecal microbiota of treatment-naive breast and prostate cancer patients differs from controls, though larger samples are needed to substantiate these findings. Trial registration: NIH Clinical Trials, NCT01886677, NCT02224807, registered 26 June 2013, 25 Aug 2014 (respectively) - retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01886677; https://clinicaltrials.gov/ct2/show/NCT02224807.


Asunto(s)
Neoplasias de la Mama/microbiología , Microbioma Gastrointestinal , Neoplasias de la Próstata/microbiología , Estudios de Casos y Controles , Heces/microbiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/microbiología , Sobrepeso/microbiología , Ensayos Clínicos Controlados Aleatorios como Asunto
13.
Artículo en Inglés | MEDLINE | ID: mdl-33548354

RESUMEN

Rett syndrome (RTT) is an X-linked neurodevelopmental disorder that is predominantly caused by alterations of the methyl-CpG-binding protein 2 (MECP2) gene. Disease severity and the presence of comorbidities such as gastrointestinal distress vary widely across affected individuals. The gut microbiome has been implicated in neurodevelopmental disorders such as Autism Spectrum Disorder (ASD) as a regulator of disease severity and gastrointestinal comorbidities. Although the gut microbiome has been previously characterized in humans with RTT compared to healthy controls, the impact of MECP2 mutation on the composition of the gut microbiome in animal models where the host and diet can be experimentally controlled remains to be elucidated. By evaluating the microbial community across postnatal development as behavioral symptoms appear and progress, we have identified microbial taxa that are differentially abundant across developmental timepoints in a zinc-finger nuclease rat model of RTT compared to WT. We have additionally identified p105 as a key translational timepoint. Lastly, we have demonstrated that fecal SCFA levels are not altered in RTT rats compared to WT rats across development. Overall, these results represent an important step in translational RTT research.


Asunto(s)
Microbioma Gastrointestinal/fisiología , Proteína 2 de Unión a Metil-CpG/genética , Mutación , Síndrome de Rett/microbiología , Animales , Modelos Animales de Enfermedad , Ácidos Grasos Volátiles/metabolismo , Femenino , Proteína 2 de Unión a Metil-CpG/metabolismo , Ratas , Síndrome de Rett/genética , Síndrome de Rett/metabolismo
14.
Neuroscience ; 459: 179-197, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33540050

RESUMEN

Intestinal microbiota are essential for healthy gastrointestinal function and also broadly influence brain function and behavior, in part, through changes in immune function. Gastrointestinal disorders are highly comorbid with psychiatric disorders, although biological mechanisms linking these disorders are poorly understood. The present study utilized rats bred for distinct emotional behavior phenotypes to examine relationships between emotionality, the microbiome, and immune markers. Prior work showed that Low Novelty Responder (LR) rats exhibit high levels of anxiety- and depression-related behaviors as well as myriad neurobiological differences compared to High Novelty Responders (HRs). Here, we hypothesized that the divergent HR/LR phenotypes are accompanied by changes in fecal microbiome composition. We used next-generation sequencing to assess the HR/LR microbiomes and then treated adult HR/LR males with an antibiotic cocktail to test whether it altered behavior. Given known connections between the microbiome and immune system, we also analyzed circulating cytokines and metabolic factors to determine relationships between peripheral immune markers, gut microbiome components, and behavioral measures. There were no baseline HR/LR microbiome differences, and antibiotic treatment disrupted the microbiome in both HR and LR rats. Antibiotic treatment exacerbated aspects of HR/LR behavior, increasing LRs' already high levels of anxiety-like behavior while reducing passive stress coping in both strains. Our results highlight the importance of an individual's phenotype to their response to antibiotics, contributing to the understanding of the complex interplay between gut microbes, immune function, and an individual's emotional phenotype.


Asunto(s)
Conducta Exploratoria , Microbiota , Animales , Antibacterianos , Ansiedad , Conducta Animal , Emociones , Masculino , Ratas
15.
Eur J Gynaecol Oncol ; 31(3): 333-5, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-21077482

RESUMEN

PURPOSE OF INVESTIGATION: Recurrent metastatic adenocarcinoma of the cervix is associated with an extremely poor prognosis. Treatment options for recurrent disease are limited and cure is extremely rare. CASE REPORT: We report a case of a 43-year-old patient with Stage IB adenocarcinoma of the cervix. She had multiple metastatic recurrence episodes salvaged with several radical surgeries, external and intraoperative irradiation, and chemotherapy over a survival period of 16 years. CONCLUSION: We conclude that long-term multi-modal salvage treatment may achieve longer survival in rare cases with recurrent metastatic adenocarcinoma of the cervix.


Asunto(s)
Adenocarcinoma/terapia , Recurrencia Local de Neoplasia/terapia , Neoplasias del Cuello Uterino/terapia , Adenocarcinoma/mortalidad , Adenocarcinoma/secundario , Adulto , Terapia Combinada , Femenino , Humanos , Recurrencia Local de Neoplasia/mortalidad , Neoplasias del Cuello Uterino/mortalidad , Neoplasias del Cuello Uterino/patología
16.
Science ; 219(4590): 1337-9, 1983 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-6402817

RESUMEN

Rejection of mouse pancreatic islet allografts occurred in a high percentage of donor recipient combinations identical for H-21-region antigens and differing at H-2K and H-2K + H-2D without I-region disparities. The results suggest that disparities in major histocompatibility complex antigens of class I (H-2K and H-2D) alone are capable of eliciting islet allograft rejection, and that lack of a stimulus from class II (I-region) alloantigens does not ensure permanent islet allograft survival.


Asunto(s)
Rechazo de Injerto , Antígenos H-2/inmunología , Antígenos de Histocompatibilidad Clase II/inmunología , Trasplante de Islotes Pancreáticos , Animales , Complejo Mayor de Histocompatibilidad , Ratones , Linfocitos T/inmunología
17.
Gynecol Oncol ; 114(1): 64-8, 2009 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-19411097

RESUMEN

OBJECTIVES: Analyze morbidity and survival after pelvic exenteration (PE) of gynecological malignancies. METHODS: We reviewed 106 consecutive patients with gynecologic malignancies who underwent PE from June 1996 to April 2007 at the Division of Gynecology, European Institute of Oncology (IEO), Milan. RESULTS: PE was performed for cancer of the cervix (62 patients), vagina (21 patients), vulva (9 patients), endometrium (9 patients), ovary (4 patients) and 1 uterine sarcoma. Mean age was 53.6 (30-78) years. 97% of the patients received radiotherapy before PE and 3 patients had PE as primary treatment. We performed 53 anterior, 48 total and 5 posterior PE. Median operation time, estimated blood loss and hospital stay were respectively 490 (200-780) minutes, 1240 (300-6500) ml and 21.6 (11-55) days. No residual tumor was left in 93% of the patients. Median follow-up was 22.3 (1.6-117) months. There were no post-operative deaths (<30 days from surgery) nor intra-operative mortality. Total morbidity rate was 66%; 48% of patients had early complications (<30 days after PE) whereas 52 patients (48.5%) had late complications; 70% of these occurred to the urinary tract and 25% were due to bowel occlusions or fistulas. Overall survival was 52%, 35%, 19% and 16% respectively for cervical, endometrial, vaginal and vulvar cancer. CONCLUSIONS: PE is a feasible technique with no post-operative mortality and high percentage of long-survivors, although the morbidity rate still remains significantly high. Careful patient selection, pre- and post-operative care and optimal surgical skills in a Gynecologic Oncologic Center are the cornerstones to further improve quality of life and survival for these patients.


Asunto(s)
Exenteración Pélvica/métodos , Adulto , Anciano , Terapia Combinada , Neoplasias Endometriales/radioterapia , Neoplasias Endometriales/cirugía , Femenino , Humanos , Italia , Persona de Mediana Edad , Neoplasias Ováricas/radioterapia , Neoplasias Ováricas/cirugía , Exenteración Pélvica/efectos adversos , Estudios Retrospectivos , Tasa de Supervivencia , Sobrevivientes , Neoplasias del Cuello Uterino/radioterapia , Neoplasias del Cuello Uterino/cirugía , Neoplasias Vaginales/radioterapia , Neoplasias Vaginales/cirugía , Neoplasias de la Vulva/radioterapia , Neoplasias de la Vulva/cirugía
18.
Avian Pathol ; 38(5): 333-40, 2009 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19937520

RESUMEN

An experimental study was conducted to assess the effect of a live Mycoplasma synoviae vaccine (Vaxsafe MS; Bioproperties Pty Ltd, Ringwood, Victoria, Australia) on M. synoviae-induced eggshell apex abnormalities (EAA). Four experimental groups of specified-pathogen-free white laying hens were made. All groups were inoculated with infectious bronchitis virus D1466 at 18 weeks of age. One group did not receive further treatment (non-vaccinated non-challenged (NVNC)). Two groups were vaccinated at 14 weeks of age against M. synoviae, and one of these groups was also challenged with an EAA-inducing M. synoviae strain 5 days after infectious bronchitis virus challenge (vaccinated non-challenged (VNC) and vaccinated challenged group (VC), respectively). The fourth group was not vaccinated but was challenged with M. synoviae (non-vaccinated challenged (NVC)). Eggs with EAA eggs were produced only in the NVC and VC groups. However, the proportion of eggs with EAA and the mean daily production of eggs with EAA per chicken was significantly lower (P<0.05) in the VC group (88/741 (11.9%) and 0.09+/-0.01 eggs per hen) compared with the NVC group (148/646 (22.9%) and 0.14+/-0.01 eggs per hen). The mean daily egg production per chicken was significantly lower in the NVC group (0.48+/-0.03 eggs) compared with that of the NVNC group (0.60+/-0.03 eggs), but not significantly different from other groups. The eggshell strength of eggs with EAA (22.8 N) was significantly lower (P<0.05) than non-affected eggs from the other groups (33.7 to 39.5 N). Furthermore, the eggshell strength of non-affected eggs in the NVC group was significantly lower (P<0.05) compared with that of non-affected eggs from the flock of origin (33.7 versus 41.2 N), but not different from the other groups. It can be concluded from the present study that vaccination with a live M. synoviae vaccine reduces the occurrence of M. synoviae-induced EAA significantly.


Asunto(s)
Vacunas Bacterianas , Infecciones por Coronavirus/veterinaria , Cáscara de Huevo/anomalías , Virus de la Bronquitis Infecciosa , Infecciones por Mycoplasma/veterinaria , Mycoplasma synoviae/inmunología , Enfermedades de las Aves de Corral/prevención & control , Crianza de Animales Domésticos , Animales , Pollos , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/inmunología , Cáscara de Huevo/efectos de los fármacos , Cáscara de Huevo/inmunología , Huevos , Femenino , Infecciones por Mycoplasma/etiología , Infecciones por Mycoplasma/inmunología , Infecciones por Mycoplasma/prevención & control , Enfermedades de las Aves de Corral/inmunología , Vacunas Atenuadas
19.
Vet Microbiol ; 136(1-2): 61-8, 2009 Apr 14.
Artículo en Inglés | MEDLINE | ID: mdl-19046834

RESUMEN

Using published primers, detection of Mycoplasma synoviae and strain identification using the vlhA gene sequence was attempted. However, of 21 M. synoviae strains examined, three could not be amplified, so a new reverse primer was designed with a target in the conserved region of the vlhA gene. This allowed all 21 M. synoviae strains, a further nine strains and also material from 11 swab samples from M. synoviae-positive birds, to produce a PCR product, suggesting that the method could also be suitable for clinical specimens. The protocol was then tested on the type strains of M. synoviae and the other 22 recognised avian Mycoplasma species, with amplification of M. synoviae only. Further testing demonstrated that this PCR was equally or more sensitive than other PCR tests used to detect M. synoviae. Subsequent DNA sequence analysis of the PCR product based on percent similarity and evolutionary relationship appeared to be a useful tool for strain differentiation.


Asunto(s)
Proteínas Bacterianas/genética , Lectinas/genética , Infecciones por Mycoplasma/veterinaria , Mycoplasma synoviae/genética , Mycoplasma synoviae/aislamiento & purificación , Reacción en Cadena de la Polimerasa/veterinaria , Enfermedades de las Aves de Corral/microbiología , Secuencia de Aminoácidos , Animales , Proteínas Bacterianas/química , Secuencia de Bases , Pollos , ADN Bacteriano/química , ADN Bacteriano/genética , Lectinas/química , Datos de Secuencia Molecular , Infecciones por Mycoplasma/diagnóstico , Infecciones por Mycoplasma/microbiología , Reacción en Cadena de la Polimerasa/métodos , Enfermedades de las Aves de Corral/diagnóstico , Sensibilidad y Especificidad , Alineación de Secuencia , Análisis de Secuencia de ADN
20.
Theriogenology ; 71(1): 149-65, 2009 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-18986694

RESUMEN

Artificial insemination technology has revolutionized the domestic cattle breeding industry and allowed for the dissemination of valuable genetics worldwide. This technology has been adapted for use in many other taxa for the conservation of threatened and endangered species, but its use for the genetic management of small populations of deer, antelope and other non-domestic bovids has met numerous challenges and limited success. In practice, adaptation of domestic bovine AI protocols to other artiodactylids for genetic management has been limited by: (1) a lack of understanding of species-specific reproductive characteristics; (2) the inability to minimize handling stress; (3) pregnancy losses; and (4) regulatory challenges in semen importation. To date, AI protocols have been developed for seven species of cervid and 14 species of non-domestic bovids; recent developments in this technology has allowed greater use of AI for dissemination of genetics in farmed deer species. However, despite decades of research in the use of assisted reproduction for the conservation of antelope and other non-domestic bovids, even this simplest technique has not been used repeatedly for genetic management.


Asunto(s)
Artiodáctilos , Inseminación Artificial/veterinaria , Animales , Animales Salvajes , Artiodáctilos/genética , Artiodáctilos/fisiología
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