RESUMEN
BACKGROUND: The Micra leadless pacemaker has demonstrated favorable outcomes in global trials, but its real-world performance and safety in a Japan-specific population is unknown.MethodsâandâResults: Micra Acute Performance (MAP) Japan enrolled 300 patients undergoing Micra VR leadless pacemaker implantation in 15 centers. The primary endpoint was the acute (30-day) major complication rate. The 30-day and 6-month major complication rates were compared to global Micra studies. All patients underwent successful implantation with an average follow-up of 7.23±2.83 months. Compared with previous Micra studies, Japanese patients were older, smaller, more frequently female, and had a higher pericardial effusion risk score. 11 acute major complications were reported in 10 patients for an acute complication rate of 3.33% (95% confidence interval: 1.61-6.04%), which was in line with global Micra trials. Pericardial effusion occurred in 4 patients (1.33%; 3 major, 1 minor). No procedure or device-related deaths occurred. Frailty significantly improved from baseline to follow-up as assessed by Japan Cardiovascular Health Study criteria. CONCLUSIONS: In a Japanese cohort, implantation of the Micra leadless pacemaker had a high success rate and low major complication rate. Despite the Japan cohort being older, smaller, and at higher risk, the safety and performance was in line with global Micra trials.
Asunto(s)
Arritmias Cardíacas , Marcapaso Artificial , Femenino , Humanos , Pueblos del Este de Asia , Diseño de Equipo , Marcapaso Artificial/efectos adversos , Derrame Pericárdico/etiología , Resultado del Tratamiento , Masculino , Arritmias Cardíacas/terapiaRESUMEN
More than a million cases of cutaneous squamous cell carcinoma are diagnosed in the USA each year, and its incidence is increasing. Most of these malignancies arise from premalignant lesions, providing an opportunity for intervention before malignant progression. We previously documented how cytoplasmic mislocalization of CDC25A in premalignant and malignant skin cancers confers resistance to apoptotic cell death via a mechanism that depends on its interaction with 14-3-3ε. From these data, we hypothesized that 14-3-3ε overexpression drives skin tumor development and progression, such that targeting 14-3-3ε may be a useful strategy for skin cancer treatment. Like CDC25A, 14-3-3ε was overexpressed and mislocalized to the cytoplasm of both benign and malignant human skin cancer. Skin-targeted deletion of the 14-3-3ε gene reduced skin tumor development by 75% and blocked malignant progression. 14-3-3ε suppressed apoptosis through activation of Akt, leading to inhibition of BCL2 associated agonist of cell death and upregulation of Survivin. Using virtual tetrapeptide libraries, we developed a novel peptide that specifically blocked 14-3-3ε heterodimerization and thereby prevented its interaction with CDC25A. The peptide reduced prosurvival signaling, killed skin cancer cells and reduced skin tumor growth in xenograft. Normal skin keratinocytes were unaffected by inhibition or deletion of 14-3-3ε. Thus, targeting of 14-3-3ε dimerization is a promising strategy for the treatment of premalignant skin lesions.
Asunto(s)
Proteínas 14-3-3/antagonistas & inhibidores , Antineoplásicos/farmacología , Carcinoma de Células Escamosas/tratamiento farmacológico , Neoplasias Cutáneas/tratamiento farmacológico , Fosfatasas cdc25/metabolismo , Proteínas 14-3-3/genética , Proteínas 14-3-3/metabolismo , 9,10-Dimetil-1,2-benzantraceno/administración & dosificación , 9,10-Dimetil-1,2-benzantraceno/toxicidad , Animales , Antineoplásicos/uso terapéutico , Apoptosis/efectos de los fármacos , Carcinógenos/administración & dosificación , Carcinógenos/toxicidad , Carcinoma de Células Escamosas/patología , Línea Celular Tumoral , Citoplasma/efectos de los fármacos , Citoplasma/metabolismo , Femenino , Humanos , Queratinocitos , Masculino , Ratones , Ratones Noqueados , Neoplasias Experimentales/inducido químicamente , Neoplasias Experimentales/tratamiento farmacológico , Neoplasias Experimentales/patología , Multimerización de Proteína/efectos de los fármacos , Neoplasias Cutáneas/patología , Acetato de Tetradecanoilforbol/administración & dosificación , Acetato de Tetradecanoilforbol/análogos & derivados , Acetato de Tetradecanoilforbol/toxicidad , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
p53 is an important tumor-suppressor protein that is mutated in more than 50% of cancers. Strategies for restoring normal p53 function are complicated by the oncogenic properties of mutant p53 and have not met with clinical success. To counteract mutant p53 activity, a variety of drugs with the potential to reconvert mutant p53 to an active wildtype form have been developed. However, these drugs are associated with various negative effects such as cellular toxicity, nonspecific binding to other proteins, and inability to induce a wildtype p53 response in cancer tissue. Here, we report on the effects of a curcumin analog, HO-3867, on p53 activity in cancer cells from different origins. We found that HO-3867 covalently binds to mutant p53, initiates a wildtype p53-like anticancer genetic response, is exclusively cytotoxic toward cancer cells, and exhibits high anticancer efficacy in tumor models. In conclusion, HO-3867 is a p53 mutant-reactivating drug with high clinical anticancer potential.
Asunto(s)
Apoptosis/efectos de los fármacos , Curcumina/análogos & derivados , Proteínas Mutantes/genética , Mutación , Neoplasias/patología , Piperidonas/farmacología , Proteína p53 Supresora de Tumor/genética , Animales , Antineoplásicos/farmacología , Proliferación Celular/efectos de los fármacos , Curcumina/farmacología , Femenino , Humanos , Ratones , Ratones Desnudos , Proteínas Mutantes/metabolismo , Neoplasias/tratamiento farmacológico , Neoplasias/genética , Células Tumorales Cultivadas , Proteína p53 Supresora de Tumor/metabolismo , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
Non-melanoma skin cancer frequently results from chronic exposure to ultraviolet (UV) irradiation. UV-induced DNA damage activates cell cycle arrest checkpoints through degradation of the cyclin-dependent kinase activators, the cell division cycle 25 (CDC25) phosphatases. We previously reported increased CDC25A in nonmelanoma skin cancer, but CDC25B and CDC25C had not been previously examined. Consequently, we hypothesized that increased expression of CDC25B and CDC25C increases tumor cell proliferation and skin tumor growth. We found that CDC25B and CDC25C were increased in mouse and human skin cancers. CDC25B was primarily cytoplasmic in skin and skin tumors and was significantly increased in the squamous cell carcinoma (SCC), while CDC25C was mostly nuclear in the skin, with an increased cytoplasmic signal in the premalignant and malignant tumors. Surprisingly, forced expression of CDC25B or CDC25C in cultured SCC cells did not affect proliferation, but instead suppressed apoptosis, while CDC25C silencing increased apoptosis without impacting proliferation. Targeting CDC25C to the nucleus via mutation of its nuclear export sequence, however, increased proliferation in SCC cells. Overexpression of CDC25C in the nuclear compartment did not hinder the ability of CDC25C to suppress apoptosis, neither did mutation of sites necessary for its interaction with 14-3-3 proteins. Analysis of apoptotic signaling pathways revealed that CDC25C increased activating phosphorylation of Akt on Ser473 , increased inhibitory phosphorylation of proapoptotic BAD on Ser136 , and increased the survival protein Survivin. Silencing of CDC25C significantly reduced Survivin levels. Taken together, these data suggest that increased expression of CDC25B or CDC25C are mechanisms by which skin cancers evade apoptotic cell death.
Asunto(s)
Muerte Celular/genética , Neoplasias Cutáneas/genética , Fosfatasas cdc25/genética , Animales , Apoptosis/genética , Carcinoma de Células Escamosas/genética , Ciclo Celular/genética , Línea Celular Tumoral , Núcleo Celular/genética , Proliferación Celular/genética , Citoplasma/genética , Daño del ADN/genética , Humanos , Ratones , Ratones Transgénicos/genética , Fosforilación/genética , Transducción de Señal/genéticaRESUMEN
Aberrant subcellular localization of signaling proteins can provide cancer cells with advantages such as resistance to apoptotic cell death, increased invasiveness and more rapid proliferation. Nuclear to cytoplasmic shifts in tumor-promoting proteins can lead to worse patient outcomes, providing opportunities to target cancer-specific processes. Herein, we review the significance of dysregulated protein localization with a focus on skin cancer. Altered localization of signaling proteins controlling cell cycle progression or cell death is a common feature of cancer. In some instances, aberrant subcellular localization results in an acquired prosurvival function. Taking advantage of this knowledge reveals novel targets useful in the development of cancer therapeutics.
Asunto(s)
Transducción de Señal/fisiología , Neoplasias Cutáneas/metabolismo , Animales , Apoptosis/fisiología , Ciclo Celular/fisiología , Núcleo Celular/metabolismo , Proliferación Celular/fisiología , Citoplasma/metabolismo , HumanosRESUMEN
An accurate temporal and spatial characterization of errors is required for the efficient processing, evaluation, and assimilation of remotely-sensed surface soil moisture retrievals. However, empirical evidence exists that passive microwave soil moisture retrievals are prone to periodic artifacts which may complicate their application in data assimilation systems (which commonly treat observational errors as being temporally white). In this paper, the link between such temporally-periodic errors and spatial land surface heterogeneity is examined. Both the synthetic experiment and site-specified cases reveal that, when combined with strong spatial heterogeneity, temporal periodicity in satellite sampling patterns (associated with exact repeat intervals of the polar-orbiting satellites) can lead to spurious high frequency spectral peaks in soil moisture retrievals. In addition, the global distribution of the most prominent and consistent 8-day spectral peak in the Advanced Microwave Scanning Radiometer - Earth Observing System soil moisture retrievals is revealed via a peak detection method. Three spatial heterogeneity indicators - based on microwave brightness temperature, land cover types, and long-term averaged vegetation index - are proposed to characterize the degree to which the variability of land surface is capable of inducing periodic error into satellite-based soil moisture retrievals. Regions demonstrating 8-day periodic errors are generally consistent with those exhibiting relatively higher heterogeneity indicators. This implies a causal relationship between spatial land surface heterogeneity and temporal periodic error in remotely-sensed surface soil moisture retrievals.
RESUMEN
As a key variable in the climate system, soil moisture (SM) plays a central role in the earth's terrestrial water, energy, and biogeochemical cycles through its coupling with surface latent heat flux (LH). Despite the need to accurately represent SM/LH coupling in earth system models, we currently lack quantitative, observation-based, and unbiased estimates of its strength. Here, we utilize the triple collocation (TC) approach introduced in Crow et al. (2015) to SM and LH products obtained from multiple satellite remote sensing platforms and land surface models (LSMs) to obtain unbiased global maps of SM/LH coupling strength. Results demonstrate that, relative to coupling strength estimates acquired directly from remote sensing-based datasets, the application of TC generally enhances estimates of warm-season SM/LH coupling, especially in the western United States, the Sahel, Central Asia, and Australia. However, relative to triple collocation estimates, LSMs (still) over-predict SM/LH coupling strength along transitional climate regimes between wet and dry climates, such as the central Great Plains of North America, India, and coastal Australia. Specific climate zones with biased relations in LSMs are identified to geographically focus the re-examination of LSM parameterizations. TC-based coupling strength estimates are robust to our choice of LSM contributing SM and LH products to the TC analysis. Given their robustness, TC-based coupling strength estimates can serve as an objective benchmark for investigating model predicted SM/LH coupling.
RESUMEN
A steady rise in fires in the Western United States, coincident with intensifying droughts, imparts substantial modifications to the underlying vegetation, hydrology and overall ecosystem. Drought can compound the ecosystem disturbance caused by fire, although how these compound effects on hydrologic and ecosystem recovery vary among ecosystems is poorly understood. Here we use remote sensing-derived high-resolution evapotranspiration (ET) estimates from before and after 1,514 fires to show that ecoregions dominated by grasslands and shrublands are more susceptible to drought, which amplifies fire-induced ET decline and, subsequently, shifts water flux partitioning. In contrast, severely burned forests recover from fire slowly or incompletely, but are less sensitive to dry extremes. We conclude that moisture limitation caused by droughts influences the dynamics of water balance recovery in post-fire years. This finding explains why moderate to extreme droughts aggravate impacts on the water balance in non-forested vegetation, while moisture accessed by deeper roots in forests helps meet evaporative demands unless severe burns disrupt internal tree structure and deplete fuel load availability. Our results highlight the dominant control of drought on altering the resilience of vegetation to fires, with critical implications for terrestrial ecosystem stability in the face of anthropogenic climate change in the West.
Asunto(s)
Ecosistema , Incendios , Estados Unidos , Sequías , Bosques , AguaRESUMEN
BACKGROUND: Cryoballoon ablation for treatment of atrial fibrillation (AF) reduces procedure times, but limited data is available about its impact on electrophysiology (EP) lab efficiency in Central and Eastern Europe (CEE). Using CEE-specific procedure data, the present study modeled cryoballoon ablation procedures on EP lab resource consumption to improve efficiency. METHODS: A discrete event simulation model was developed to assess EP efficiency with cryoballoon ablation. Model inputs were taken from CEE sites within the Cryo Global Registry, namely Czech Republic, Hungary, Poland, Serbia, and Slovakia. The main endpoints were percentage of days that resulted in overtime and percentage of days with time for one extra simple EP procedure. Use of the 'figure of 8' (Fo8) closure technique to reduce procedure time was also examined. RESULTS: The mean lab occupancy time across all CEE sites was 133 ± 47 minutes (min: 104 minutes, max:181 minutes). Cryoballoon ablation in the base-case scenario resulted in 14.6% of days with overtime and 64.8% of days with time for an extra simple EP procedure. Use of the Fo8 closure technique enhanced these values to 5.5% and 85.3%, respectively. Model endpoints were most sensitive to changes in lab occupancy times and overtime start time. CONCLUSIONS: In this CEE-specific analysis of EP lab efficiency it was found that 3 cryoballoon ablation procedures could be performed in 1 lab day, leaving time for a 4th simple EP procedure on most days. As such, use cryoballoon ablation for PVI is an effective way to improve EP lab efficiency.
RESUMEN
Background: Remote monitoring of cardiac implantable electric devices improves patient outcomes and experiences. Alert-based systems notify physicians of clinical or device issues in near real-time, but their effectiveness is contingent upon device connectivity. Objective: To assess patient connectivity by analyzing alert transmission times from patient transceivers to the CareLink network. Methods: Alert transmissions were retrospectively gathered from a query of the United States de-identified Medtronic CareLink database. Alert transmission time was defined as the duration from alert occurrence to arrival at the CareLink network and was analyzed by device type, alert event, and alert type. Using data from previous studies, we computed the benefit of daily connectivity checks. Results: The mean alert transmission time was 14.8 hours (median = 6 hours), with 90.9% of alert transmissions received within 24 hours. Implantable pulse generators (17.0 ± 40.2 hours) and cardiac resynchronization therapy-pacemakers (17.2 ± 42.5 hours) had longer alert transmission times than implantable cardioverter-defibrillators (13.7 ± 29.5 hours) and cardiac resynchronization therapy-defibrillators (13.5 ± 30.2 hours), but the median time was 6 hours for all 4 device types. There were differences in alert times between specific alert events. Based on our data and previous studies, daily connectivity checks could improve daily alert transmission success by 8.5% but would require up to nearly 800 additional hours of staff time on any given day. Conclusion: Alert transmission performance from Medtronic devices was satisfactory, with some delays likely underscored by patient connectivity issues. Daily connectivity checks could provide some improvement in transmission success at the expense of increased clinic burden.
RESUMEN
Scavenger receptors clear pathogens, transport lipid, and mediate polyanionic ligand uptake in macrophages, but their expression and role in the skin are poorly understood. Although the epidermal barrier typically excludes nucleic acid entry, topically applied, spherically arranged oligonucleotide nanoconjugates (spherical nucleic acids [SNAs]) penetrate mouse skin, three-dimensional (3D) skin equivalents, and human skin. We explored the mechanism of SNA uptake in normal human epidermal keratinocytes and 3D skin equivalents. Normal human epidermal keratinocytes and 3D raft treatment with SR-A inhibitors reduced SNA uptake by >80%. The human epidermis expresses SR-As SCARA3 and, to a lesser extent, MARCO. Simultaneous lentiviral knockdown of SCARA3 and MARCO reduced SNA uptake in normal human epidermal keratinocytes and 3D rafts after topical application, affirming a role for SR-As in SNA uptake and 3D raft penetration. Incubation of normal human epidermal keratinocytes at 4oC or with sodium azide prevented SNA uptake, suggesting active endocytosis. Endocytosis inhibitors, immunofluorescence, immunoprecipitation, and knockdown studies localized functional SR-As to FLOT-1-containing lipid rafts throughout the epidermis and CAV-1-containing rafts only in the upper epidermis. These studies suggest a central role for SR-A complexes in epidermal lipid rafts in mediating the uptake of nucleic acidâladen nanoparticles.
Asunto(s)
Epidermis/metabolismo , Proteínas de Choque Térmico/metabolismo , Microdominios de Membrana/metabolismo , Ácidos Nucleicos/farmacocinética , Receptores Inmunológicos/metabolismo , Receptores Depuradores de Clase A/metabolismo , Células Cultivadas , Endocitosis , Técnicas de Silenciamiento del Gen , Proteínas de Choque Térmico/genética , Humanos , Queratinocitos/citología , Proteínas de la Membrana/metabolismo , Nanopartículas , Ácidos Nucleicos/administración & dosificación , Cultivo Primario de Células/métodos , Receptores Inmunológicos/genética , Receptores Depuradores de Clase A/genéticaRESUMEN
Spherical nucleic acids (SNAs) are nanostructures consisting of nucleic acids in a spherical configuration, often around a nanoparticle core. SNAs are advantageous as gene-regulating agents compared to conventional gene therapy owing to their low toxicity, enhanced stability, uptake by virtually any cell, and ability to penetrate the epidermal barrier. In this review we: (i) describe the production, structure and properties of SNAs; (ii) detail the mechanism of SNA uptake in keratinocytes, regulated by scavenger receptors; and (iii) report how SNAs have been topically applied and intralesionally injected for skin disorders. Specialized SNAs called nanoflares can be topically applied for gene-based diagnosis (scar vs. normal tissue). Topical SNAs directed against TNFα and interleukin-17A receptor reversed psoriasis-like disease in mouse models and have been tested in Phase 1 human trials. Furthermore, SNAs targeting ganglioside GM3 synthase accelerate wound healing in diabetic mouse models. Most recently, SNAs targeting toll-like receptor 9 are being used in Phase 2 human trials via intratumoral injection to induce immune responses in Merkel cell and cutaneous squamous cell carcinoma. Overall, SNAs are a valuable tool in bench-top and clinical research, and their advantageous properties, including penetration into the epidermis after topical delivery, provide new opportunities for targeted therapies.
RESUMEN
Non-melanoma skin cancer is the most common form of cancer worldwide. We previously documented an anti-apoptotic role for CDC25A in cutaneous squamous cell carcinoma (SCC), an activity dependent on its association with 14-3-3 proteins. We hypothesized that targeting CDC25A-14-3-3ε interactions may be an effective strategy for inducing skin cancer cell apoptosis. Co-immunoprecipitation revealed that CDC25A associated with 14-3-3ε, 14-3-3γ and 14-3-3ζ in SCC cells but not normal keratinocytes. 14-3-3ε and CDC25A activated Akt/BAD/Survivin pro-survival signaling. To target the interaction of 14-3-3ε with CDC25A for cancer therapy, we developed two novel phospho-peptides, pS and pT, corresponding to each of the 14-3-3 binding sites of CDC25A, to specifically interfere with 14-3-3ε binding to CDC25A. Peptides pT (IC50 = 22.1 µM), and pS (IC50 = 29 µM) induced SCC cell death and blocked 14-3-3ε binding to CDC25A. pS or pT treatment of SCC xenografts increased apoptotic cell death and decreased pro-survival P-Akt (S473) and Survivin, demonstrating the effectiveness of the peptides in vivo. These findings lay a framework for the further development of peptides to target 14-3-3ε-CDC25A interactions for skin cancer treatment.
RESUMEN
Characterizing the terrestrial carbon, water and energy cycles depends strongly on a capacity to accurately reproduce the spatial and temporal dynamics of land surface evaporation. For this, and many other reasons, monitoring terrestrial evaporation across multiple space and time scales has been an area of focused research for many decades. Much of this activity has been supported by developments in satellite remote sensing, which have been leveraged to deliver new process insights, model development and methodological improvements. In this Special Issue, published contributions explored a range of research topics directed towards the enhanced estimation of terrestrial evaporation. Here we summarize these cutting-edge efforts and provide an overview of some of the state-of-the-art approaches for retrieving this key variable. Some perspectives on outstanding challenges, issues, and opportunities are also presented.
RESUMEN
Global food production depends upon many factors that Earth observing satellites routinely measure about water, energy, weather, and ecosystems. Increasingly sophisticated, publicly-available satellite data products can improve efficiencies in resource management and provide earlier indication of environmental disruption. Satellite remote sensing provides a consistent, long-term record that can be used effectively to detect large-scale features over time, such as a developing drought. Accuracy and capabilities have increased along with the range of Earth observations and derived products that can support food security decisions with actionable information. This paper highlights major capabilities facilitated by satellite observations and physical models that have been developed and validated using remotely-sensed observations. Although we primarily focus on variables relevant to agriculture, we also include a brief description of the growing use of Earth observations in support of aquaculture and fisheries.
RESUMEN
A newly developed microwave (MW) land surface temperature (LST) product is used to substitute thermal infrared (TIR) based LST in the Atmosphere Land Exchange Inverse (ALEXI) modelling framework for estimating ET from space. ALEXI implements a two-source energy balance (TSEB) land surface scheme in a time-differential approach, designed to minimize sensitivity to absolute biases in input records of LST through the analysis of the rate of temperature change in the morning. Thermal infrared (TIR) retrievals of the diurnal LST curve, traditionally from geostationary platforms, are hindered by cloud cover, reducing model coverage on any given day. This study tests the utility of diurnal temperature information retrieved from a constellation of satellites with microwave radiometers that together provide 6-8 observations of Ka-band brightness temperature per location per day. This represents the first ever attempt at a global implementation of ALEXI with MW-based LST and is intended as the first step towards providing all-weather capability to the ALEXI framework. The analysis is based on 9-year long, global records of ALEXI ET generated using both MW and TIR based diurnal LST information as input. In this study, the MW-LST sampling is restricted to the same clear sky days as in the IR-based implementation to be able to analyse the impact of changing the LST dataset separately from the impact of sampling all-sky conditions. The results show that long-term bulk ET estimates from both LST sources agree well, with a spatial correlation of 92% for total ET in the Europe/Africa domain and agreement in seasonal (3-month) totals of 83-97 % depending on the time of year. Most importantly, the ALEXI-MW also matches ALEXI-IR very closely in terms of 3-month inter-annual anomalies, demonstrating its ability to capture the development and extent of drought conditions. Weekly ET output from the two parallel ALEXI implementations is further compared to a common ground measured reference provided by the FLUXNET consortium. Overall, the two model implementations generate similar performance metrics (correlation and RMSE) for all but the most challenging sites in terms of spatial heterogeneity and level of aridity. It is concluded that a constellation of MW satellites can effectively be used to provide LST for estimating ET through ALEXI, which is an important step towards all-sky satellite-based retrieval of ET using an energy balance framework.