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1.
Ann Oncol ; 28(3): 583-589, 2017 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-27998967

RESUMEN

Background: Programmed cell death protein-1 (PD-1) blockade therapies have demonstrated durable responses and prolonged survival in a variety of malignancies. Treatment is generally well tolerated although immune-related adverse events (irAEs) can occur. Autoimmune thyroid dysfunction is among the most common irAE, but an assessment of the clinical, mechanistic, and immunologic features has not been previously described. Patient and methods: Patients with advanced non-small-cell lung cancer (NSCLC) treated with pembrolizumab at Memorial Sloan Kettering Cancer Center (n = 51) as part of KEYNOTE-001 (NCT01295827) were included. Thyroid function test and anti-thyroid antibodies were assessed prospectively at each study visit, beginning before the first treatment. Frequency of development of thyroid dysfunction, association with anti-thyroid antibodies, clinical course, and relationship with progression-free survival and overall survival to treatment with pembrolizumab was evaluated. Results: Of 51 patients treated, 3 were hypothyroid and 48 were not at baseline. Ten of 48 [21%, 95% confidence interval (CI) 10% to 35%] patients developed thyroid dysfunction requiring thyroid replacement. Anti-thyroid antibodies were present in 8 of 10 patients who developed thyroid dysfunction, compared with 3 of 38 who did not (80% versus 8%, P < 0.0001). Thyroid dysfunction occurred early (median, 42 days) in the pembrolizumab course, and a majority (6 of 10 patients) experienced brief, transient hyperthyroidism preceding the onset of hypothyroidism; no persistent hyperthyroidism occurred. Both hyperthyroidism and hypothyroidism were largely asymptomatic. Overall survival with pembrolizumab was significantly longer in subjects who developed thyroid dysfunction (hazard ratio, 0.29; 95% CI 0.09-0.94; P = 0.04). Conclusions: Thyroid dysfunction during pembrolizumab treatment of NSCLC is common and is characterized by early-onset, frequently preceded by transient hyperthyroidism, closely associated with anti-thyroid antibodies, and may be associated with improved outcomes. The presence of antibody-mediated toxicity in T-cell-directed therapy suggests an under-recognized impact of PD-1 biology in modulating humoral immunity.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/patología , Hipertiroidismo/patología , Receptor de Muerte Celular Programada 1/genética , Adolescente , Adulto , Anciano , Anticuerpos Monoclonales/administración & dosificación , Anticuerpos Monoclonales/efectos adversos , Anticuerpos Monoclonales Humanizados/administración & dosificación , Anticuerpos Monoclonales Humanizados/efectos adversos , Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Pulmón de Células no Pequeñas/inmunología , Carcinoma de Pulmón de Células no Pequeñas/patología , Supervivencia sin Enfermedad , Femenino , Humanos , Hipertiroidismo/inducido químicamente , Hipertiroidismo/genética , Hipertiroidismo/inmunología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Receptor de Muerte Celular Programada 1/inmunología , Linfocitos T/efectos de los fármacos , Linfocitos T/inmunología , Linfocitos T/patología , Glándula Tiroides/efectos de los fármacos , Glándula Tiroides/inmunología , Glándula Tiroides/patología
2.
Vet Pathol ; 52(3): 553-61, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25034110

RESUMEN

We report the identification of a novel papillomavirus, Fulmarus glacialis papillomavirus 1 (FgPV1), present within an interdigital foot mass of a Northern Fulmar (Fulmarus glacialis). The mass of interest was composed of normal stratified and keratinized epithelium and dense mesenchymal cells with central cartilaginous islands. Within the nuclei of many chondrocytes were loose aggregates or paracrystalline arrays of virions approximately 50 nm in size. Degenerate polymerase chain reaction was used to identify the virus as a putative papillomavirus, and the entire viral genome of 8132 base pairs was subsequently amplified and sequenced. Analysis revealed canonical papillomavirus architecture, including the early open reading frames E6, E7, E1, and E2 and the 2 late proteins L1 and L2. FgPV1 is most closely related to a cluster of avian and reptilian papillomaviruses as visualized by phylogenetic trees. This observation suggests that papillomavirus virion production can occur in mesenchymal cells.


Asunto(s)
Enfermedades de las Aves/virología , Aves/virología , Cartílago/virología , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/veterinaria , Animales , Secuencia de Bases , Enfermedades de las Aves/patología , Microscopía Electrónica , Datos de Secuencia Molecular , Papillomaviridae/genética , Infecciones por Papillomavirus/virología , Filogenia , Reacción en Cadena de la Polimerasa/veterinaria
3.
Vet Pathol ; 52(6): 1148-56, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25648965

RESUMEN

Equine coronavirus (ECoV) is a Betacoronavirus recently associated clinically and epidemiologically with emerging outbreaks of pyrogenic, enteric, and/or neurologic disease in horses in the United States, Japan, and Europe. We describe the pathologic, immunohistochemical, ultrastructural, and molecular findings in 2 horses and 1 donkey that succumbed to natural infection with ECoV. One horse and the donkey (case Nos. 1, 3) had severe diffuse necrotizing enteritis with marked villous attenuation, epithelial cell necrosis at the tips of the villi, neutrophilic and fibrinous extravasation into the small intestinal lumen (pseudomembrane formation), as well as crypt necrosis, microthrombosis, and hemorrhage. The other horse (case No. 2) had hyperammonemic encephalopathy with Alzheimer type II astrocytosis throughout the cerebral cortex. ECoV was detected by quantitative polymerase chain reaction in small intestinal tissue, contents, and/or feces, and coronavirus antigen was detected by immunohistochemistry in the small intestine in all cases. Coronavirus-like particles characterized by spherical, moderately electron lucent, enveloped virions with distinct peplomer-like structures projecting from the surface were detected by negatively stained transmission electron microscopy in small intestine in case No. 1, and transmission electron microscopy of fixed small intestinal tissue from the same case revealed similar 85- to 100-nm intracytoplasmic particles located in vacuoles and free in the cytoplasm of unidentified (presumably epithelial) cells. Sequence comparison showed 97.9% to 99.0% sequence identity with the ECoV-NC99 and Tokachi09 strains. All together, these results indicate that ECoV is associated with necrotizing enteritis and hyperammonemic encephalopathy in equids.


Asunto(s)
Encefalopatías/veterinaria , Infecciones por Coronavirus/veterinaria , Coronavirus/inmunología , Enteritis/veterinaria , Equidae , Enfermedades de los Caballos/patología , Animales , Secuencia de Bases , Encefalopatías/patología , Encefalopatías/virología , Coronavirus/genética , Coronavirus/aislamiento & purificación , Infecciones por Coronavirus/patología , Infecciones por Coronavirus/virología , Enteritis/patología , Enteritis/virología , Heces/virología , Femenino , Enfermedades de los Caballos/virología , Caballos , Hiperamonemia/veterinaria , Intestino Delgado/patología , Intestino Delgado/virología , Datos de Secuencia Molecular , Necrosis/veterinaria , Análisis de Secuencia de ADN/veterinaria
4.
Vet Pathol ; 50(3): 434-42, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23024139

RESUMEN

Over a period of 6 months, dozens of moon jelly (Aurelia aurita) medusae from a single-species exhibit at the California Science Center (CSC) developed exumbrellar ulcers. Ulcers were progressive, causing umbrellar creases that expanded radially to the bell rim and occasional adoral erosions that extended into gastrovascular cavities. Husbandry interventions, including addition of ultraviolet light sterilizers, repopulation with fresh cultures, and enclosure disinfection, did not arrest the recurrence of lesions. Biopsies or whole specimens representing 17 medusae (15 affected and 2 grossly unaffected) from CSC and 2 control medusae from Aquarium of the Pacific were submitted to a private diagnostic laboratory and processed for light and electron microscopy. Microscopic lesions were present in all CSC medusae and were not observed or negligible in control medusae. Lesions included ulceration, necrosis, and hyperplasia in all umbrellar layers, with most severe lesions in the exumbrella and amoebocyte infiltration in the underlying mesoglea. Special stains, electron microscopy, and fungal culture did not associate microorganisms with the lesions. Bacterial cultures from the CSC population consistently grew Shewanella and Vibrio spp, both of which were considered commensal. Trauma and environmental stress are proposed as possible causes for the ulcers.


Asunto(s)
Escifozoos/ultraestructura , Animales , California , Microscopía Electrónica , Necrosis/patología , Escifozoos/crecimiento & desarrollo , Escifozoos/microbiología , Shewanella/crecimiento & desarrollo , Úlcera/patología , Vibrio/crecimiento & desarrollo
5.
Clin Endocrinol (Oxf) ; 75(1): 112-9, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21521273

RESUMEN

OBJECTIVE: To describe the risk of structural disease recurrence in a cohort of patients with differentiated thyroid cancer selected for treatment with either thyroid lobectomy or total thyroidectomy without radioactive iodine remnant ablation (RRA). DESIGN: Retrospective review. PATIENTS: A total of 289 patients were selected for either thyroid lobectomy (n = 72) or total thyroidectomy (n = 217) without RRA and followed with modern disease detection tools in a tertiary referral centre. Most patients had papillary thyroid cancer (89%) without clinically evident lymph node metastases (91%). However, 55% (156/289) of patients had primary tumours that were >1 cm and 10% (28/289) had minor extrathyroidal extension. MEASUREMENTS: The primary endpoint was detection of recurrent/persistent structural disease. RESULTS: After a 5-year median follow-up, structural disease recurrence was detected in 2·3% (5/217) of patients treated with total thyroidectomy without RRA, and in 4·2% (3/72) of patients treated with thyroid lobectomy. Size of the primary tumour, the presence of cervical lymph node metastases and American Thyroid Association risk category were all statistically significant predictors of recurrence. Changes in serum thyroglobulin were not helpful in identifying the presence of persistent/recurrent structural disease. Importantly, 88% (7/8) of the patients that had recurrent disease were rendered clinically disease free with additional therapies. CONCLUSIONS: Initial risk stratification is able to identify a cohort of patients with differentiated thyroid cancer with a very low risk of structural disease recurrence following treatment with either thyroid lobectomy or total thyroidectomy without RRA. Our data strongly support a selective approach to the initial management of thyroid cancer.


Asunto(s)
Procedimientos Quirúrgicos Endocrinos/estadística & datos numéricos , Recurrencia Local de Neoplasia/patología , Neoplasias de la Tiroides/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Riesgo , Neoplasias de la Tiroides/clasificación , Neoplasias de la Tiroides/patología , Tiroidectomía/estadística & datos numéricos , Resultado del Tratamiento , Adulto Joven
6.
J Exp Med ; 166(3): 711-24, 1987 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-2442288

RESUMEN

We investigated the influence of the macromolecular form of an epitope on the structure of antibody variable and constant regions expressed by the B cell population participating in an immune response to that epitope. Hybridomas were constructed from strain A/J mice undergoing either primary or secondary immune responses to p-azophenylarsonate conjugated to Brucella abortus (Ars-Bruc). We determined the sequences of the V genes expressed by hybridomas selected on the basis of expression of a single VH gene segment known to encode a large family of anti-Ars antibodies. These sequences were compared with the sequences of V genes expressed by a previously characterized panel of hybridomas isolated in the same way during the primary and secondary responses of A/J mice to Ars-KLH. The repertoire of Ars-specific V domains expressed among primary and secondary hybridomas elicited with these two forms of Ars were similar, as were the differences between primary and secondary V region somatic mutational alteration and affinity for Ars. In contrast, predominant expression of IgG2 anti-Ars antibodies was elicited in the secondary Ars-Bruc response, whereas secondary anti-Ars antibodies elicited with Ars-KLH are predominantly IgG1. Thus, differences in the macromolecular form of Ars clearly influence the isotypic profile of the anti-Ars response, but the expression, diversification, and selection of V domains elicited with this hapten are not greatly affected by such differences. Our results suggest that while isotype regulation is highly perceptive of the macromolecular form of a B cell epitope, V region regulation is primarily influenced by the molecular structure of that epitope.


Asunto(s)
Linfocitos B/inmunología , Epítopos/inmunología , Regiones Constantes de Inmunoglobulina/genética , Región Variable de Inmunoglobulina/genética , Inmunoglobulinas/genética , Animales , Antígenos/inmunología , Secuencia de Bases , Brucella abortus/inmunología , Femenino , Hibridomas/inmunología , Inmunización , Inmunización Secundaria , Regiones Constantes de Inmunoglobulina/inmunología , Inmunoglobulina G/inmunología , Región Variable de Inmunoglobulina/inmunología , Sustancias Macromoleculares , Ratones , Ratones Endogámicos A , p-Azobencenoarsonato/inmunología
7.
J Exp Med ; 170(4): 1191-209, 1989 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-2477487

RESUMEN

To determine how the memory B cell population elicited to one epitope might be used in immune responses to other, structurally related epitopes, we explored the phenomenon of original antigenic sin. Strain A/J mice reproducibly respond to immunization with p-azophenylarsonate (Ars) by production of anti-Ars antibodies encoded predominantly by a single VH gene segment (VHIdCR). The structural analogue of Ars p-azophenylsulfonate (Sulf) fails alone to elicit such V regions, but can do so in A/J mice previously immunized with Ars, providing a means to specifically examine B cells capable of responding secondarily to a crossreactive antigen (i.e., memory cells). VHIdCR-expressing hybridomas were derived from the Ars-primed, Sulf-boosted original antigenic sin response of A/J mice at various times after Ars priming, and the properties of the antibodies they express and the structure of the genes encoding these antibodies were characterized. The data obtained support the following conclusions: (a) The Ars-induced memory B cell population capable of being crossreactively stimulated by Sulf is largely formed from a small fraction of all B cells participating in the anti-Ars primary response that express somatically mutated V regions; (b) the antibody repertoire and clonal composition of this population are stable over long periods of time; (c) memory B cells are capable of clonal expansion in the absence of a high rate of V gene somatic mutation; (d) the activation requirements for clonal selection of memory, versus naive B cells appear to differ; and (e) a major fraction of Ars-induced memory B cells express either IgM or IgG3 prior to and during the initial stages of the sin response.


Asunto(s)
Linfocitos B/inmunología , Memoria Inmunológica , Animales , Especificidad de Anticuerpos , Compuestos Azo/inmunología , Secuencia de Bases , Bencenosulfonatos/inmunología , Células Clonales/inmunología , Epítopos , Genes de Inmunoglobulinas , Genes de Cambio , Hibridomas , Cadenas Pesadas de Inmunoglobulina/genética , Isotipos de Inmunoglobulinas , Región Variable de Inmunoglobulina/genética , Cadenas kappa de Inmunoglobulina/genética , Ratones , Ratones Endogámicos A , Datos de Secuencia Molecular , Mutación , p-Azobencenoarsonato/inmunología
8.
J Exp Med ; 173(3): 665-72, 1991 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-1705280

RESUMEN

Antibody variable (V) regions that initially differ from one another by only single amino acid residues at VH-D and D-JH segment junctions (termed canonical V regions) can be elicited in strain A/J mice by three different haptens. Among such V regions an amino acid substitution due to somatic mutation is recurrently observed at VH CDR2 position 58, regardless of which of these haptens is used for immunization. This substitution confers upon a canonical V region a generic increase in affinity for all the haptens. Conversely, the type of amino acid substitution at VH position 59 resulting from somatic mutation that is recurrently observed among such V regions changes with the eliciting hapten, in a manner that correlates directly with the cognate affinity increases (or decreases) for hapten conferred by the observed substitutions. This small subregion of VH CDR2 therefore plays a major role in determining both affinity and specificity for antigen. The data confirm that affinity for antigen is of pivotal importance in determining the degree of selection of different mutant forms of a V region. Moreover, during an immune response a sufficiently diverse mutant repertoire can be generated from a single canonical V region to allow adaptation to increase affinity for three different epitopes.


Asunto(s)
Epítopos/genética , Región Variable de Inmunoglobulina/genética , Secuencia de Aminoácidos , Animales , Secuencia de Bases , Southern Blotting , Epítopos/análisis , Femenino , Reordenamiento Génico , Genes de Inmunoglobulinas , Haptenos , Ratones , Ratones Endogámicos A , Datos de Secuencia Molecular , Mutagénesis Sitio-Dirigida , Sondas de Oligonucleótidos , Reacción en Cadena de la Polimerasa , ARN Mensajero/genética , Homología de Secuencia de Ácido Nucleico
9.
J Exp Med ; 174(4): 847-58, 1991 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-1919438

RESUMEN

The immunodominant CD4 T cell epitope of the bacteriophage lambda cI repressor protein in several inbred mouse strains can be represented by a peptide encompassing amino acids 12-26. Here, we show that this peptide, and a variety of its sequence variants, can induce immediate-type hypersensitivity in mice. 12-26 variants that differ by as little as single amino acid residues deviate greatly in their ability to induce hypersensitivity. Further, differences in major histocompatibility complex class II alleles appear to be as influential as changes in peptide structure in determining whether hypersensitivity is developed. The ability of a given peptide-class II combination to induce hypersensitivity correlates with production of peptide-specific antibody, but not with ability or inability to induce a T cell proliferative response. Administration of anti-interleukin 4 (IL-4) mAb prevents the development of hypersensitivity, and analysis of cytokine production by T cell hybridomas derived from peptide-immunized mice suggests that whether a given peptide-class II combination can induce hypersensitivity depends on its ability to induce IL-4 production. The data demonstrate that changes in the nature of the epitope(s) recognized by the CD4 T cell population can result in qualitative differences in the response elicited in this population, ultimately leading to dramatic quantitative and qualitative variations in the effector phase of the immune response.


Asunto(s)
Hipersensibilidad Inmediata , Complejo Mayor de Histocompatibilidad , Péptidos/inmunología , Linfocitos T/inmunología , Secuencia de Aminoácidos , Animales , Antígenos CD4/inmunología , Inmunidad Celular , Depleción Linfocítica , Ratones , Ratones Endogámicos A , Ratones Endogámicos BALB C , Ratones Endogámicos , Datos de Secuencia Molecular , Péptidos/síntesis química , Especificidad de la Especie , Relación Estructura-Actividad , Linfocitos T/efectos de los fármacos
10.
Mol Cell Biol ; 14(7): 4455-64, 1994 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-8007952

RESUMEN

Separate genetic elements (V, D, and J) encode the variable regions of lymphocyte antigen receptors. During early lymphocyte differentiation, these elements rearrange to form contiguous coding segments (VJ and VDJ) for a diverse array of variable regions. Rearrangement is mediated by a recombinase that recognizes short DNA sequences (signals) flanking V, D, and J elements. Signals flank both the 5' and 3' sides of each D element, thereby allowing assembly of a functional VDJ gene. However, in rearrangements involving the D delta 2 and J delta 1 elements of the mouse T-cell receptor delta (TCR delta) locus, we unexpectedly found that the D delta 2 element and a portion of its 5' signal are often deleted. Approximately 50% of recovered D delta 2 to J delta 1 rearrangements from thymocytes of adult wild-type mice showed such deletions. An additional 20% of the rearrangements contained standard D delta 2-J delta 1 coding junctions but showed some loss of nucleotides from the 5' D delta 2 signal. This loss was clearly associated with another event involving a site-specific cleavage at the 5' signal/coding border of D delta 2 and rejoining of the modified signal and coding ends. The abnormal loss of D delta 2 and a portion of the 5' D delta 2 signal was infrequently observed in D delta 2-to-J delta 1 rearrangements recovered from neonatal mice. The possible basis and significance of this age-dependent phenomenon are discussed.


Asunto(s)
Envejecimiento/inmunología , Eliminación de Gen , Reordenamiento Génico de la Cadena delta de los Receptores de Antígenos de los Linfocitos T , Receptores de Antígenos de Linfocitos T gamma-delta/genética , Linfocitos T/inmunología , Envejecimiento/genética , Animales , Animales Recién Nacidos , Secuencia de Bases , Diferenciación Celular , ADN/genética , Desarrollo Embrionario y Fetal/inmunología , Variación Genética , Ratones , Ratones Endogámicos , Ratones SCID , Datos de Secuencia Molecular , Especificidad de la Especie , Linfocitos T/citología , Linfocitos T/metabolismo , Timo/crecimiento & desarrollo , Timo/inmunología
11.
Biochim Biophys Acta ; 883(3): 552-8, 1986 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-3019419

RESUMEN

Human hepatoma cell (HepG2) or rabbit hepatocyte monolayers were incubated with [35S]methionine in presence or absence of tunicamycin, a potent inhibitor of asparagine-linked glycosylation. The 35S-labeled nonglycosylated and control fibrinogens purified from the media were used to evaluate the influence of the oligosaccharide on the catabolic properties of this glycoprotein. Plasmin, pronase, cathepsin D or cathepsin B each degraded the nonglycosylated and control fibrinogens similarly, as evidenced by the release of trichloroacetic acid-soluble radioactivity and by SDS-polyacrylamide gel electrophoresis and autoradiography of plasmic digests. Nonglycosylated and control fibrin clots also showed no differences in susceptibility to plasmic digestion. The two forms of fibrinogen demonstrated the same plasma half-life in rabbits. These data indicate that the oligosaccharide does not influence the proteolytic stability or the in vivo plasma survival of fibrinogen, and suggest that other biochemical determinants may influence the catabolic properties of this molecule.


Asunto(s)
Fibrinógeno/metabolismo , Hígado/metabolismo , Tunicamicina/farmacología , Animales , Coagulación Sanguínea , Carcinoma Hepatocelular/metabolismo , Humanos , Hidrólisis , Neoplasias Hepáticas , Metionina/metabolismo , Oligosacáridos/fisiología , Conejos
12.
Arch Intern Med ; 147(8): 1390-2, 1987 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-3632148

RESUMEN

The potential desorption of aspirin from activated charcoal was investigated in eight patients in a randomized cross-over study. Despite prebinding of aspirin, systemic absorption did occur. Desorption from activated charcoal was characterized by a peak salicylate concentration that was 16% of control and a time to peak salicylate concentration that was delayed in the study group. Bioavailability of aspirin from activated charcoal described by area under the curve was 19% of control. Elimination half-lives were similar in both groups until 12 hours after ingestion, but after 12 hours the half-life of the study group was prolonged while salicylate concentrations were undetectable in the control group. Fifteen percent to 20% of aspirin prebound to charcoal may desorb leading to systemic absorption. Furthermore, release from activated charcoal is initially delayed then sustained through 30 hours.


Asunto(s)
Aspirina/metabolismo , Carbón Orgánico , Adsorción , Adulto , Disponibilidad Biológica , Femenino , Semivida , Humanos , Absorción Intestinal , Masculino , Distribución Aleatoria , Factores de Tiempo
13.
Clin Oncol (R Coll Radiol) ; 27(4): 187-96, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25576353

RESUMEN

AIMS: Retrospective analyses from first-line clinical studies in advanced non-small cell lung cancer (NSCLC) have reported conflicting results on progression-free survival (PFS) and overall survival benefits with the addition of bevacizumab to chemotherapy in elderly patients. Here we report effectiveness and safety outcomes by age subgroup for patients with NSCLC in the ARIES observational cohort study. MATERIALS AND METHODS: ARIES enrolled patients with advanced non-squamous NSCLC who received first-line bevacizumab-containing treatment per physician's choice. Kaplan-Meier estimates were used to calculate medians and 95% confidence intervals for PFS and overall survival for patients aged <65, ≥65, <75 and ≥75 years. RESULTS: In total, 1967 patients receiving first-line treatment with bevacizumab and chemotherapy were enrolled. The median PFS and overall survival values were 6.4 (95% confidence interval = 6.0-6.8) and 14.2 (95% confidence interval = 12.7-15.2) months for patients aged <65 years, respectively, and 6.8 (95% confidence interval = 6.3-7.0) and 12.1 (95% confidence interval = 11.4-13.1) months for patients ≥65 years, respectively. For patients <75 years, the median PFS and overall survival values were 6.6 (95% confidence interval = 6.3-6.9) and 13.5 (95% confidence interval = 12.6-14.5) months, respectively, and 6.6 (95% confidence interval = 5.9-7.1) and 11.6 (95% confidence interval = 10.0-12.5) months, respectively, for patients ≥75 years. Incidence proportions of bevacizumab-associated adverse events were generally similar across all age groups. CONCLUSIONS: Data from the ARIES study suggest that treatment with bevacizumab in combination with chemotherapy is a viable first-line treatment option for elderly bevacizumab-eligible patients with advanced non-squamous NSCLC.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Neoplasias Pulmonares/tratamiento farmacológico , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Bevacizumab/administración & dosificación , Estudios de Cohortes , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Estudios Retrospectivos , Resultado del Tratamiento
14.
J Bone Miner Res ; 16(9): 1665-73, 2001 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-11547836

RESUMEN

The experimental work characterizing the anabolic effect of parathyroid hormone (PTH) in bone has been performed in nonmurine ovariectomized (OVX) animals, mainly rats. A major drawback of these animal models is their inaccessibility to genetic manipulations such as gene knockout and overexpression. Therefore, this study on PTH anabolic activity was carried out in OVX mice that can be manipulated genetically in future studies. Adult Swiss-Webster mice were OVX, and after the fifth postoperative week were treated intermittently with human PTH(1-34) [hPTH(1-34)] or vehicle for 4 weeks. Femoral bones were evaluated by microcomputed tomography (microCT) followed by histomorphometry. A tight correlation was observed between trabecular density (BV/TV) determinations made by both methods. The BV/TV showed >60% loss in the distal metaphysis in 5-week and 9-week post-OVX, non-PTH-treated animals. PTH induced a approximately 35% recovery of this loss and a approximately 40% reversal of the associated decreases in trabecular number (Tb.N) and connectivity. PTH also caused a shift from single to double calcein-labeled trabecular surfaces, a significant enhancement in the mineralizing perimeter and a respective 2- and 3-fold stimulation of the mineral appositional rate (MAR) and bone formation rate (BFR). Diaphyseal endosteal cortical MAR and thickness also were increased with a high correlation between these parameters. These data show that OVX osteoporotic mice respond to PTH by increased osteoblast activity and the consequent restoration of trabecular network. The Swiss-Webster mouse model will be useful in future studies investigating molecular mechanisms involved in the pathogenesis and treatment of osteoporosis, including the mechanisms of action of known and future bone antiresorptive and anabolic agents.


Asunto(s)
Fémur/efectos de los fármacos , Osteoporosis Posmenopáusica/patología , Teriparatido/farmacología , Animales , Modelos Animales de Enfermedad , Femenino , Fémur/patología , Fémur/fisiopatología , Humanos , Ratones , Osteoporosis Posmenopáusica/tratamiento farmacológico , Osteoporosis Posmenopáusica/fisiopatología , Ovariectomía , Teriparatido/administración & dosificación , Teriparatido/uso terapéutico
15.
J Comp Neurol ; 229(2): 271-8, 1984 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-6501603

RESUMEN

The nucleus ambiguus is a brainstem structure which sends projections through the vagus nerve to the viscera, primarily heart, lung, and gut. The anatomical relationship between the nucleus ambiguus and other brain structures has not been elucidated nor has the cardiac region been identified physiologically in rats. We have attempted to clarify which areas of the nucleus ambiguus are cardioinhibitory and to determine other regions of the brain which send direct projections to this physiologically identified cardiac region. Stimulating electrodes were positioned stereotaxically in the medulla of anesthetized rats. Small currents were passed through the electrodes to locate regions in the ventrolateral medulla which slowed heart rate. In each rat, the area found was small (less than 200 micron in diameter), very specific, and located in the rostral portion of the nucleus ambiguus. Micro-quantities of horseradish peroxidase were then iontophoretically ejected into this brainstem area; 24-72 hours following the HRP injection, the rats were processed for HRP reaction product using the tetramethybenzidine method. The major brain area which sent projections to the rostral nucleus ambiguus was the ipsilateral medial subnucleus of the solitary tract. A few labeled cells were found in the ipsilateral ventrolateral subnucleus of the solitary tract, parabrachial complex, the paraventricular nucleus of the hypothalamus, and the contralateral nucleus ambiguus. Control injections in reticular areas surrounding the rostral nucleus ambiguus showed no label in the medial solitary nucleus.


Asunto(s)
Corazón/inervación , Bulbo Raquídeo/anatomía & histología , Nervio Vago/anatomía & histología , Animales , Fibras Autónomas Preganglionares/fisiología , Mapeo Encefálico , Potenciales Evocados , Frecuencia Cardíaca , Bulbo Raquídeo/fisiología , Núcleo Hipotalámico Paraventricular/anatomía & histología , Puente/anatomía & histología , Ratas , Nervio Vago/fisiología
16.
J Comp Neurol ; 314(2): 201-16, 1991 Dec 08.
Artículo en Inglés | MEDLINE | ID: mdl-1723992

RESUMEN

Retrograde tracing with true blue (TB) and diamidino yellow (DY) and anterograde tracing with either wheatgerm agglutinin-conjugated horseradish peroxidase (WGA-HRP) or Phaseolus vulgaris leucoagglutinin (PHA-L) were employed to investigate the projections from trigeminal nucleus principalis (PrV) and trigeminal subnucleus interpolaris (SpI) to their targets in the medial ventral posterior (VPM) and posterior (POm) nuclei of the thalamus. Many more cells in both PrV and SpI were labeled by tracer injections into VPM than into POm. Only a very small number of double-labeled neurons were observed in either PrV or SpI. However, a significantly higher percentage of SpI cells projected to POm or to both POm and VPM than was the case for PrV. Anterograde tracing with WGA-HRP showed that the projections from both PrV and SpI to VPM were much denser than those from the same nuclei to POm. Small injections of PHA-L into either PrV or SpI produced a focus of fairly dense labeling in VPM and much more diffuse terminal labeling in POm. These anatomical data provide evidence for two separate trigeminothalamic pathways, one originating from PrV and the second originating from SpI. Both of these pathways converge and diverge at the thalamic level. That is, information from the PrV pathway and from the SpI pathway are both provided to VPM in a morphologically restricted fashion and to POm in a morphologically widespread fashion.


Asunto(s)
Vías Aferentes/anatomía & histología , Neuronas/citología , Ratas Endogámicas/anatomía & histología , Núcleos Talámicos/anatomía & histología , Núcleos del Trigémino/anatomía & histología , Vibrisas/inervación , Vías Aferentes/fisiología , Animales , Transporte Axonal , Peroxidasa de Rábano Silvestre , Microscopía Fluorescente , Neuronas/fisiología , Fitohemaglutininas , Ratas , Núcleos Talámicos/citología , Núcleos Talámicos/fisiología , Núcleos del Trigémino/fisiología , Aglutinina del Germen de Trigo-Peroxidasa de Rábano Silvestre Conjugada , Aglutininas del Germen de Trigo
17.
J Comp Neurol ; 314(2): 217-36, 1991 Dec 08.
Artículo en Inglés | MEDLINE | ID: mdl-1723993

RESUMEN

Extracellular recording, intracellular recording, intracellular horseradish peroxidase injection, and receptive field mapping techniques were employed to evaluate the physiological and morphological properties of medial ventral posterior nucleus (VPM) and posterior nucleus (POm) neurons in normal adult rats. Overall, we physiologically characterized 148 VPM and 121 POm neurons. Over 82% of the VPM cells were excited only by deflection of one or more mystacial vibrissae, 10% were activated by displacement of guard hairs, and the remainder were either excited by indentation of the skin or were unresponsive. Less than 40% of the POm cells were activated by vibrissa deflection, 18% were excited by displacement of guard hairs, and another 17% were unresponsive. Most of the rest of the POm cells were excited by stimulation of skin, mucosa, or activation of muscle-related afferents. Small percentages of POm cells responded only to noxious stimulation, were classified as having a wide dynamic range, or were inhibited by peripheral stimulation. Electrical stimulation of either PrV or SpI activated most neurons in both VPM and POm. This excitation was almost invariably followed by a long-lasting hyperpolarization which was generally strong enough to prevent responses to either electrical stimuli delivered in the brainstem or mechanical stimulation of the periphery. The receptive fields of vibrissa-sensitive cells in POm were generally much larger than those of cells in VPM. Data obtained with extracellular recording indicated that VPM and POm cells responded to an average of 1.4 and 4.0 vibrissae, respectively. Intracellular recording from smaller samples of VPM and POm cells demonstrated the existence of inputs that were insufficient to produce spikes from the cell, but did yield epsp's. When both sub- and suprathreshold excitation were considered, the average number of vibrissa in the receptive field of a VPM cell was 2.7 and the value for POm cells became 7.8. HRP-filled neurons recovered in POm (N = 20) generally had much larger dendritic arbors than neurons in VPM (N = 31). For the former cells, the size of the dendritic tree was significantly correlated with the number of vibrissa to which the cell responded; for the latter neurons, it was not.


Asunto(s)
Vías Aferentes/fisiología , Neuronas/fisiología , Ratas Endogámicas/fisiología , Núcleos Talámicos/fisiología , Vibrisas/inervación , Vías Aferentes/anatomía & histología , Animales , Transporte Axonal , Mapeo Encefálico , Dendritas/fisiología , Dendritas/ultraestructura , Estimulación Eléctrica , Electrofisiología/métodos , Potenciales Evocados , Femenino , Peroxidasa de Rábano Silvestre , Masculino , Mucosa Nasal/inervación , Neuronas/citología , Estimulación Física , Ratas , Núcleos Talámicos/anatomía & histología , Núcleos Talámicos/citología
18.
J Comp Neurol ; 289(4): 641-56, 1989 Nov 22.
Artículo en Inglés | MEDLINE | ID: mdl-2592602

RESUMEN

Anterograde tracing with Phaseolus vulgaris leucoagglutinin (PHA-L) and intra-axonal recording and injection techniques were employed to describe the projection from the trigeminal (V) brainstem complex to the deep laminae of the superior colliculus (SC) in the hamster and the rat. The organization of these projections was the same in the two species. Deposits of PHA-L into V nucleus principalis (PrV) produced labelled axons and boutonlike swellings in the lower stratum griseum intermediale (SGI) and upper stratum album intermedium (SAI) in the SC bilaterally. Plots of boutonlike swellings indicated that the terminals of this projection were arrayed in clusters. Nucleus principalis also projected to the stratum griseum profundum (SGP) and stratum album profundum (SAP). This deeper projection did not terminate in clusters and it was most prominent in the lateral SC. The ipsilateral PrV-SC projection appeared to arise mainly from axons that recrossed the midline at the level of the SC commissure. Reconstruction of individual PHA-L labelled fibers demonstrated that single axons gave rise to terminals on both sides of the midline. Deposits of PHA-L into V subnucleus interpolaris (SpI) yielded results that were identical to those obtained with PrV injections with one exception: none of these deposits produced any labelled terminals in the ipsilateral SC. Deposits of PHA-L into V subnucleus caudalis (SpC) produced only sparse labelling in SC. Most labelled swellings were located in the SGP and SAP and they were visible only in the SC contralateral to the PHA-L injection site. Single axons arising from cells in SpI were recorded and injected with horseradish peroxidase (HRP) in the hamster's SC. These fibers all responded to stimulation of multiple mystacial vibrissae and gave rise to 2-5 clusters of bouton-like swellings in the lower SGI and upper SAI.


Asunto(s)
Colículos Superiores/citología , Nervio Trigémino/citología , Núcleos del Trigémino/citología , Potenciales de Acción , Animales , Cricetinae , Femenino , Masculino , Fitohemaglutininas , Ratas , Ratas Endogámicas , Colículos Superiores/fisiología , Núcleos del Trigémino/fisiología
19.
J Comp Neurol ; 283(1): 54-70, 1989 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-2732361

RESUMEN

Anterograde tracing with Phaseolus vulgaris leucoagglutinin (PHA-L) was employed to describe the projection from the superficial to the deep layers of the hamster's superior colliculus (SC). Deposits of PHA-L in the stratum griseum superficiale (SGS) resulted in labelled terminal swellings in the stratum opticum and all of the deep laminae (the stratum griseum intermediate [SGI], stratum albumin intermedium [SAI], stratum griseum profundum [SGP], and stratum albumin profundum [SAP]). Labelled terminals were also visible in the periaqueductal gray (PAG). Reconstructions of individual axons showed that many collateral in the deep laminae arose from axons that projected to targets outside the colliculus. The projection from the superficial to the deep laminae had a loose topographic organization, and the trajectories of interlaminar axons were generally deflected laterally from "projection" lines that were orthogonal to the SC surface. Physiological recording and receptive field mapping were used to determine actual projection lines, which connect neurons in the superficial and deep layers that have receptive fields with the same elevation. These projection lines closely matched the trajectory of the pathway from the superficial to the deep laminae.


Asunto(s)
Cricetinae/anatomía & histología , Colículos Superiores/citología , Animales , Femenino , Masculino , Vías Nerviosas/anatomía & histología , Fitohemaglutininas
20.
J Comp Neurol ; 208(3): 239-54, 1982 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-7119160

RESUMEN

Anterograde and retrograde tracing techniques were employed to delineate the organization of a visual cortical input to the deep layers of the hamster's superior colliculus which may be mediated by links in the striatum and substantia nigra. Autoradiographic experiments showed that areas 17, 18a, and the cortex medial to area 17 (areas 18b and 29) all projected to the dorsocaudal part of the ipsilateral striatum. This projection was organized so that the rostrocaudal axis of the visual cortex was represented along the antero posterior axis of the striatum. Large posterior neocortical injections which included all of these areas also revealed a weak, crossed corticostriatal pathway. Such injections also demonstrated clear discontinuities in the terminal distribution of the visual corticostriatal projection, similar to those which have been noted after injections of tracers into the motor and premotor cortices. Retrograde tracing experiments showed that the cells of origin of the visual cortical projections to the striatum were medium-sized pyramidal neurons located primarily in the upper portion of lamina V. Anterograde transport of [3H]-leucine and HRP showed that the portion of the striatum heavily innervated by the visual cortex projected to the part of substantial nigra, pars reticulata immediately adjacent to the cerebral peduncle. Injections in the rostral striatum labeled more medial portions of this nucleus. The cells of origin of the striatonigral pathway measured between 13 and 20 micrometers in diameter and they were located primarily in the dorsal and lateral parts of the striatum. Anterograde tracing after substantia nigra, pars reticulata injections revealed a projection to both superior colliculi. The uncrossed pathway terminated primarily as a series of patches throughout the mediolateral and rostrocaudal extents of the lower stratum griseum intermediale and stratum album intermedium. Labeling was also visible in the lateral portion of the stratum griseum profundum. The crossed nigrotectal pathway terminated primarily in the rostrolateral stratum griseum profundum. The cells of origin of the nigrocollicular pathway were fusiform or multipolar cells and were located primarily adjacent to the cerebral peduncle throughout the rostral half of the substantias nigra, par reticulata.


Asunto(s)
Cuerpo Estriado/anatomía & histología , Colículos Superiores/anatomía & histología , Corteza Visual/anatomía & histología , Animales , Autorradiografía , Cricetinae , Dominancia Cerebral/fisiología , Peroxidasa de Rábano Silvestre , Fibras Nerviosas/ultraestructura , Neuronas/ultraestructura , Sustancia Negra/anatomía & histología , Vías Visuales/anatomía & histología
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