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1.
Brain ; 2024 Jan 16.
Article in English | MEDLINE | ID: mdl-38226698

ABSTRACT

Loss-of-function variants in the triggering receptor expressed on myeloid cells 2 (TREM2) are responsible for a spectrum of neurodegenerative disorders. In the homozygous state, they cause severe pathologies with early onset dementia, such as Nasu-Hakola disease (NHD) and behavioral variants of frontotemporal dementia (FTD), whereas heterozygous variants increase the risk of late-onset Alzheimer's disease (AD) and FTD. For over half of TREM2 variants found in families with recessive early onset dementia, the defect occurs at the transcript level via premature termination codons or aberrant splicing. The remaining variants are missense alterations thought to affect the protein; however, the underlying pathogenic mechanism is less clear. In this work, we tested whether these disease-associated TREM2 variants contribute to the pathology via altered splicing. Variants scored by SpliceAI algorithm were tested by a full-size TREM2 splicing reporter assay in different cell lines. The effect of variants was quantified by qRT-/RT-PCR and western blots. Nanostring nCounter was used to measure TREM2 RNA in the brains of NHD patients who carried spliceogenic variants. Exon skipping events were analyzed from brain RNA-Seq datasets available through the Accelerating Medicines Partnership for Alzheimer's Disease Consortium (AMP-AD). We found that for some NHD and early onset FTD-causing variants, splicing defects were the primary cause (D134G) or likely contributor to pathogenicity (V126G and K186N). Similar but milder effects on splicing of exons 2 and 3 were demonstrated for A130V, L133L and R136W enriched in patients with dementia. Moreover, the two most frequent missense variants associated with AD/FTD risk in European and African ancestries (R62H, 1% in Caucasians, and T96K, 12% in Africans) had splicing defects via excessive skipping of exon 2 and overproduction of a potentially antagonistic TREM2 protein isoform. The effect of R62H on exon 2 skipping was confirmed in three independent brain RNA-seq datasets. Our findings revealed an unanticipated complexity of pathogenic variation in TREM2, in which effects on post-transcriptional gene regulation and protein function often coexist. This necessitates the inclusion of computational and experimental analyses of splicing and mRNA processing for a better understanding of genetic variation in disease.

2.
Support Care Cancer ; 31(5): 292, 2023 Apr 22.
Article in English | MEDLINE | ID: mdl-37086362

ABSTRACT

PURPOSE: All patients living with cancer, including those with metastatic cancer, are encouraged to be physically active. This paper examines the secondary endpoints of an aerobic exercise intervention for men with metastatic prostate cancer. METHODS: ExPeCT (Exercise, Prostate Cancer and Circulating Tumour Cells), was a multi-centre randomised control trial with a 6-month aerobic exercise intervention arm or a standard care control arm. Exercise adherence data was collected via heart rate monitors. Quality of life (FACT-P) and physical activity (self-administered questionnaire) assessments were completed at baseline, at 3 months and at 6 months. RESULTS: A total of 61 patients were included (69.4 ± 7.3 yr, body mass index 29.2 ± 5.8 kg/m2). The median time since diagnosis was 34 months (IQR 7-54). A total of 35 (55%) of participants had > 1 region affected by metastatic disease. No adverse events were reported by participants. There was no effect of exercise on quality of life (Cohen's d = - 0.082). Overall adherence to the supervised sessions was 83% (329 out of 396 possible sessions attended by participants). Overall adherence to the non-supervised home exercise sessions was 72% (months 1-3) and 67% (months 3-6). Modelling results for overall physical activity scores showed no significant main effect for the group (p-value = 0.25) or for time (p-value = 0.24). CONCLUSION: In a group of patients with a high burden of metastatic prostate cancer, a 6-month aerobic exercise intervention did not lead to change in quality of life. Further exercise studies examining the role of exercise for people living with metastatic prostate cancer are needed. TRIAL REGISTRATION: The trial was registered at clinicaltrials.gov (NCT02453139) on May 25th 2015.


Subject(s)
Prostatic Neoplasms , Quality of Life , Male , Humans , Exercise , Prostatic Neoplasms/therapy , Exercise Therapy/methods , Surveys and Questionnaires
3.
BMJ Case Rep ; 15(11)2022 Nov 29.
Article in English | MEDLINE | ID: mdl-36446475

ABSTRACT

Enterobius vermicularis infection is typically observed in paediatric patients and manifests with perianal pruritus, but other manifestations or ectopic presentations have been reported in the literature. We present the case of a man in his 60ss with a large-bowel obstruction with symptoms including a 4-day history of progressive abdominal pain, distension, vomiting and absolute constipation. On examination, his abdomen was distended with tinkling bowel sounds on auscultation. Cross-sectional imaging demonstrated an obstructing mass in the distal descending colon. An emergency laparoscopic Hartmann's procedure was performed and the patient made an uneventful recovery. An intraoperative colonoscopy demonstrated numerous white threadworms in the colon. Histological analysis demonstrated a pseudotumour related to Enterobius vermicularis infection. This case represents a rare differential diagnosis for a large-bowel obstruction.


Subject(s)
Abdominal Cavity , Enterobiasis , Male , Animals , Humans , Child , Enterobius , Enterobiasis/complications , Enterobiasis/diagnosis , Enterobiasis/surgery , Colostomy , Colon
4.
J Cancer Surviv ; 2022 Nov 15.
Article in English | MEDLINE | ID: mdl-36376712

ABSTRACT

PURPOSE: To synthesize the barriers to primary care provider (PCP)-led cancer survivorship care (≤ 5 years after initial cancer treatment) experienced by healthcare systems around the world, and to explore potential solutions that would succeed within a developed country. METHODS: A scoping review of peer-reviewed articles and grey literature was conducted. Four electronic databases (Medline, Embase, Web of Science Core Collection, and Google Scholar) were searched for articles prior to April 2021. RESULTS: Ninety-seven articles published across the globe (USA, Canada, Australia, European Union, and UK) met the review inclusion/exclusion criteria. The four most frequently discussed barriers to PCP-led survivorship care in healthcare systems were as follows: (1) insufficient communication between PCPs and cancer specialists, (2) limited PCP knowledge, (3) time restrictions for PCPs to provide comprehensive survivorship care, and (4) a lack of resources (e.g., survivorship care guidelines). Potential solutions to combat these barriers were as follows: (1) improving interdisciplinary communication, (2) bolstering PCP education, and (3) providing survivorship resources. CONCLUSIONS: This scoping review identified and summarized key barriers and solutions to the provision of PCP-led cancer survivorship care. Importantly, the findings from this review provide insight and direction to guide optimization of cancer care practice within BC's healthcare system. IMPLICATIONS FOR CANCER SURVIVORS: Optimizing the PCP-led survivorship care model will be a valuable contribution to the field of cancer survivorship care and will hopefully lead to more widespread use of this model, ultimately lessening the growing demand for cancer-specific care by cancer specialists.

5.
Diagnostics (Basel) ; 12(10)2022 Sep 29.
Article in English | MEDLINE | ID: mdl-36292049

ABSTRACT

The liquid biopsy has the potential to improve patient care in the diagnostic and therapeutic setting in non-small cell lung cancer (NSCLC). Consented patients with epidermal growth factor receptor (EGFR) positive disease (n = 21) were stratified into two cohorts: those currently receiving EGFR tyrosine kinase inhibitor (TKI) therapy (n = 9) and newly diagnosed EGFR TKI treatment-naïve patients (n = 12). Plasma genotyping of cell-free DNA was carried out using the FDA-approved cobas® EGFR mutation test v2 and compared to next generation sequencing (NGS) cfDNA panels. Circulating tumor cell (CTC) numbers were correlated with treatment response and EGFR exon 20 p.T790M. The prognostic significance of the neutrophil to lymphocyte ratio (NLR) and lactate dehydrogenase (LDH) was also investigated. Patients in cohort 1 with an EGFR exon 20 p.T790M mutation progressed more rapidly than those with an EGFR sensitizing mutation, while patients in cohort 2 had a significantly longer progression-free survival (p = 0.04). EGFR exon 20 p.T790M was detected by liquid biopsy prior to disease progression indicated by computed tomography (CT) imaging. The cobas® EGFR mutation test detected a significantly greater number of exon 20 p.T790M mutations (p = 0.05). High NLR and derived neutrophil to lymphocyte ratio (dNLR) were associated with shorter time to progression and worse survival outcomes (p < 0.05). High LDH levels were significantly associated with shorter time to disease progression (p = 0.03). These data support the use of liquid biopsy for monitoring EGFR mutations and inflammatory markers as prognostic indicators in NSCLC.

6.
Mol Cancer Ther ; 21(6): 999-1009, 2022 06 01.
Article in English | MEDLINE | ID: mdl-35405743

ABSTRACT

One obstacle for human solid tumor immunotherapy research is the lack of clinically relevant animal models. In this study, we sought to establish a chimeric antigen receptor (CAR) T-cell treatment model for naturally occurring canine sarcomas as a model for human CAR T-cell therapy. Canine CARs specific for B7-H3 were constructed using a single-chain variable fragment derived from the human B7-H3-specific antibody MGA271, which we confirmed to be cross-reactive with canine B7-H3. After refining activation, transduction, and expansion methods, we confirmed target killing in a tumor spheroid three-dimensional assay. We designed a B7-H3 canine CAR T-cell and achieved consistently high levels of transduction efficacy, expansion, and in vitro tumor killing. Safety of the CAR T cells were confirmed in two purposely bred healthy canine subjects following lymphodepletion by cyclophosphamide and fludarabine. Immune response, clinical parameters, and manifestation were closely monitored after treatments and were shown to resemble that of humans. No severe adverse events were observed. In summary, we demonstrated that similar to human cancers, B7-H3 can serve as a target for canine solid tumors. We successfully generated highly functional canine B7-H3-specific CAR T-cell products using a production protocol that closely models human CAR T-cell production procedure. The treatment regimen that we designed was confirmed to be safe in vivo. Our research provides a promising direction to establish in vitro and in vivo models for immunotherapy for canine and human solid tumor treatment.


Subject(s)
Receptors, Chimeric Antigen , Sarcoma , Animals , B7 Antigens , Cell Line, Tumor , Dogs , Humans , Sarcoma/drug therapy , T-Lymphocytes , Xenograft Model Antitumor Assays
7.
Nat Commun ; 13(1): 1382, 2022 03 16.
Article in English | MEDLINE | ID: mdl-35296681

ABSTRACT

Spinal cord injury chronically alters cardiac structure and function and is associated with increased odds for cardiovascular disease. Here, we investigate the cardiac consequences of spinal cord injury on the acute-to-chronic continuum, and the contribution of altered bulbospinal sympathetic control to the decline in cardiac function following spinal cord injury. By combining experimental rat models of spinal cord injury with prospective clinical studies, we demonstrate that spinal cord injury causes a rapid and sustained reduction in left ventricular contractile function that precedes structural changes. In rodents, we experimentally demonstrate that this decline in left ventricular contractile function following spinal cord injury is underpinned by interrupted bulbospinal sympathetic control. In humans, we find that activation of the sympathetic circuitry below the level of spinal cord injury causes an immediate increase in systolic function. Our findings highlight the importance for early interventions to mitigate the cardiac functional decline following spinal cord injury.


Subject(s)
Spinal Cord Injuries , Animals , Heart , Prospective Studies , Rats , Spinal Cord , Spinal Cord Injuries/complications , Sympathetic Nervous System , Ventricular Function, Left
8.
Cancers (Basel) ; 13(18)2021 Sep 18.
Article in English | MEDLINE | ID: mdl-34572916

ABSTRACT

Interactions between circulating tumour cells (CTCs) and platelets are thought to inhibit natural killer(NK)-cell-induced lysis. We attempted to correlate CTC numbers in men with advanced prostate cancer with platelet counts and circulating lymphocyte numbers. Sixty-one ExPeCT trial participants, divided into overweight/obese and normal weight groups on the basis of a BMI ≥ 25 or <25, were randomized to participate or not in a six-month exercise programme. Blood samples at randomization, and at three and six months, were subjected to ScreenCell filtration, circulating platelet counts were obtained, and flow cytometry was performed on a subset of samples (n = 29). CTC count positively correlated with absolute total lymphocyte count (r2 = 0.1709, p = 0.0258) and NK-cell count (r2 = 0.49, p < 0.0001). There was also a positive correlation between platelet count and CTC count (r2 = 0.094, p = 0.0001). Correlation was also demonstrated within the overweight/obese group (n = 123, p < 0.0001), the non-exercise group (n = 79, p = 0.001) and blood draw samples lacking platelet cloaking (n = 128, p < 0.0001). By flow cytometry, blood samples from the exercise group (n = 15) had a higher proportion of CD3+ T-lymphocytes (p = 0.0003) and lower proportions of B-lymphocytes (p = 0.0264) and NK-cells (p = 0.015) than the non-exercise group (n = 14). These findings suggest that CTCs engage in complex interactions with the coagulation cascade and innate immune system during intravascular transit, and they present an attractive target for directed therapy at a vulnerable stage in metastasis.

9.
Am J Physiol Heart Circ Physiol ; 321(4): H716-H727, 2021 10 01.
Article in English | MEDLINE | ID: mdl-34448635

ABSTRACT

Spinal cord injury (SCI) impairs the cardiovascular responses to postural challenge, leading to the development of orthostatic hypotension (OH). Here, we apply lower body negative pressure (LBNP) to rodents with high-level SCI to demonstrate the usefulness of LBNP as a model for experimental OH studies, and to explore the effect of simulated OH on cardiovascular and cerebrovascular function following SCI. Male Wistar rats (n = 34) were subjected to a sham or T3-SCI surgery and survived into the chronic period postinjury (i.e., 8 wk). Cardiac function was tracked via ultrasound pre- to post-SCI to demonstrate the clinical utility of our model. At study termination, we conducted left-ventricular (LV) catheterization and insonated the middle cerebral artery to investigate the hemodynamic, cardiac, and cerebrovascular response to a mild dose of LBNP that is sufficient to mimic clinically defined OH in rats with T3-SCI but not sham animals. In response to mimicked OH, there was a greater decline in stroke volume, cardiac output, maximal LV pressure, and blood pressure in SCI compared with sham (P < 0.034), whereas heart rate was increased in sham but decreased in SCI (P < 0.029). SCI animals also had an exaggerated reduction in peak, minimum and mean middle cerebral artery flow, for a given change in blood pressure, in response to LBNP (P < 0.033), implying impaired dynamic cerebral autoregulation. Using a preclinical SCI model of OH, we demonstrate that complete high thoracic SCI impairs the cardiac response to OH and disrupts dynamic cerebral autoregulation.NEW & NOTEWORTHY This is the first use of LBNP to interrogate the cardiac and cerebrovascular responses to simulated OH in a preclinical study of SCI. Here, we demonstrate the utility of our simulated OH model and use it to demonstrate that SCI impairs the cardiac response to simulated OH and disrupts dynamic cerebrovascular autoregulation.


Subject(s)
Cerebrovascular Circulation , Hemodynamics , Hypotension, Orthostatic/physiopathology , Middle Cerebral Artery/physiopathology , Spinal Cord Injuries/physiopathology , Spinal Cord/physiopathology , Ventricular Function, Left , Adaptation, Physiological , Animals , Disease Models, Animal , Hypotension, Orthostatic/etiology , Lower Body Negative Pressure , Male , Rats, Wistar , Spinal Cord Injuries/complications , Thoracic Vertebrae , Time Factors
10.
Stem Cell Res Ther ; 12(1): 321, 2021 06 05.
Article in English | MEDLINE | ID: mdl-34090485

ABSTRACT

The human fetal liver is a critical organ for prenatal hematopoiesis, the study of which offers insights into niche signals that regulate the fates of hematopoietic stem and progenitor cells (HSPCs) during fetal development. Here, we demonstrate that human fetal liver endothelium uniquely supports the maturation and expansion of multilineage HSPCs. Specifically, co-culture of fetal liver-derived immature CD43+CD45- hematopoietic cells with human fetal liver endothelial cells (ECs) led to a profound increase in the numbers of phenotypic CD45+CD34+ HSPCs and multilineage colony-forming progenitors generated in vitro, when compared to co-culture with ECs derived from other organs. We further identified a supportive role for EC-derived WNT5A in this process via gain- and loss-of-function studies within ECs. Our study emphasizes the importance of the organ-specific endothelial niche in supporting hematopoietic development and provides novel insight into signals that may facilitate HSPC expansion in vitro for clinical applications.


Subject(s)
Endothelial Cells , Hematopoiesis , Cell Differentiation , Female , Hematopoietic Stem Cells , Humans , Liver , Pregnancy , Wnt-5a Protein/genetics
11.
BMJ Case Rep ; 14(12)2021 Dec 31.
Article in English | MEDLINE | ID: mdl-34972783

ABSTRACT

A 72-year-old man was referred to our urology outpatient department with a left hemi-scrotal swelling increasing in size over a matter of weeks, initially suspicious for a left hydrocoele. Initial investigation with ultrasound (US) identified a heterogenous enlargement of the left testis and epididymis with a soft tissue mass extending through the inguinal canal. Subsequent CT detected this soft tissue mass to extend along the left gonadal vein to the level of the left renal vein. A biopsy of the retroperitoneal mass confirmed a diagnosis of diffuse large B-cell lymphoma. Immunohistochemical staining further categorised this lymphoma as double expressor but not double hit.Through multidisciplinary team involvement the patient was treated with combination steroids and chemotherapy. Given the scrotal involvement this was considered a sanctuary site for chemotherapy therefore the patient also received radiotherapy to the scrotum. He recovered well following his treatment. This case highlights how early specialist referral can identify rare variants of disease. Essential preoperative imaging with US prior to treating a presumed hydrocoele prevented inappropriate surgical excision. A multidisciplinary team approach improved the patient's outcome and is hoped to have improved his chances of recurrence-free survival.


Subject(s)
Genital Diseases, Male , Lymphoma, Large B-Cell, Diffuse , Testicular Hydrocele , Aged , Humans , Lymphoma, Large B-Cell, Diffuse/diagnostic imaging , Lymphoma, Large B-Cell, Diffuse/therapy , Male , Scrotum , Testicular Hydrocele/diagnosis , Ultrasonography
12.
Hematol Oncol Stem Cell Ther ; 14(4): 343-347, 2021 Dec.
Article in English | MEDLINE | ID: mdl-32209310

ABSTRACT

Here we describe a rare case of renal myeloid sarcoma, first discovered incidentally on routine urine analysis, which is one of the first of it's kind to be reported. We describe the vanishingly rare phenomenon of renal myeloid sarcoma presenting without haematological manifestation while also highlighting the often inevitable transformative nature of the disease. We also describe the unusual immunohistochemistry findings, in particular the cytokeratin expression, that is not usually typical of such cases. We briefly discuss use of PET-CT for the disease response monitoring. We summarize treatment that has included palbociclib, use of which was previously reported only in small series of patients with AML with KMT2A mutation.


Subject(s)
Leukemia, Myeloid, Acute , Sarcoma, Myeloid , Humans , Keratins , Kidney Neoplasms , Leukemia, Myeloid, Acute/drug therapy , Positron Emission Tomography Computed Tomography , Sarcoma, Myeloid/diagnosis , Sarcoma, Myeloid/drug therapy , Soft Tissue Neoplasms
13.
Carcinogenesis ; 42(3): 395-404, 2021 04 17.
Article in English | MEDLINE | ID: mdl-32940666

ABSTRACT

OBJECTIVES: Cancer patient outcomes and selection for novel therapies are heavily influenced by the immune contexture of the tumor microenvironment. Esophageal cancer is associated with poor outcomes. In contrast to colorectal cancer, where the immunoscore is increasingly used in prognostic staging, little is known about the immune cell populations in esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (SCC), and their clinical significance. METHODS: Tissue microarrays were constructed from resected tumor tissue of 72 EAC patients and 23 SCC patients. Immunohistochemical staining of CD3, CD8, CD56, CD68, CD45RO, CD69, IFN-γ, IL-10, IL-4, IL-17, TGF-ß, FOXP3 and CD107a was performed. Positivity was examined in both the stromal and epithelial compartments. Statistical analysis was performed to identify differences in immune cell infiltration and functional phenotypes between cancer subtypes and tissue compartments. RESULTS: This study identified that esophageal tumors are enriched with CD45RO+ and CD8+ cells and such positivity is significantly higher in SCC compared with EAC. Furthermore, the expression of CD45RO positively correlates with that of CD8 within the tumors of both patient cohorts, suggesting a dominance of memory cytotoxic T cells. This is supported by strong positivity of degranulation marker CD107a in the stromal compartment of EAC and SCC tumors. Cytokine staining revealed a mixed pro- and anti-inflammatory profile within EAC tumors. CONCLUSIONS: Esophageal tumors are enriched with memory cytotoxic T cells. Applying these measurements to a larger cohort will ascertain the clinical utility of assessing specific lymphocyte infiltrates in EAC and SCC tumors with regards to future immunotherapy use, patient prognosis and outcomes.


Subject(s)
Adenocarcinoma/immunology , Biomarkers, Tumor/analysis , Esophageal Neoplasms/immunology , Esophageal Squamous Cell Carcinoma/immunology , Lymphocytes, Tumor-Infiltrating/metabolism , T-Lymphocytes, Cytotoxic/metabolism , Adenocarcinoma/diagnosis , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/metabolism , Cell Degranulation/immunology , Diagnosis, Differential , Esophageal Neoplasms/diagnosis , Esophageal Neoplasms/pathology , Esophageal Neoplasms/surgery , Esophageal Squamous Cell Carcinoma/diagnosis , Esophageal Squamous Cell Carcinoma/pathology , Esophageal Squamous Cell Carcinoma/surgery , Esophagectomy , Esophagus/immunology , Esophagus/pathology , Esophagus/surgery , Female , Humans , Immunologic Memory , Immunophenotyping , Leukocyte Common Antigens/analysis , Leukocyte Common Antigens/metabolism , Lymphocytes, Tumor-Infiltrating/immunology , Male , Middle Aged , Prognosis , T-Lymphocytes, Cytotoxic/immunology , Tissue Array Analysis , Tumor Microenvironment/immunology
14.
PLoS One ; 15(12): e0243928, 2020.
Article in English | MEDLINE | ID: mdl-33338056

ABSTRACT

BACKGROUND: Circulating tumour cells (CTCs) represent a morphologically distinct subset of cancer cells, which aid the metastatic spread. The ExPeCT trial aimed to examine the effectiveness of a structured exercise programme in modulating levels of CTCs and platelet cloaking in patients with metastatic prostate cancer. METHODS: Participants (n = 61) were randomised into either standard care (control) or exercise arms. Whole blood was collected for all participants at baseline (T0), three months (T3) and six months (T6), and analysed for the presence of CTCs, CTC clusters and platelet cloaking. CTC data was correlated with clinico-pathological information. RESULTS: Changes in CTC number were observed within group over time, however no significant difference in CTC number was observed between groups over time. Platelet cloaking was identified in 29.5% of participants. A positive correlation between CTC number and white cell count (WCC) was observed (p = 0.0001), in addition to a positive relationship between CTC clusters and PSA levels (p = 0.0393). CONCLUSION: The presence of platelet cloaking has been observed in this patient population for the first time, in addition to a significant correlation between CTC number and WCC. TRIAL REGISTRATION: ClincalTrials.gov identifier NCT02453139.


Subject(s)
Biomarkers, Tumor/blood , Blood Platelets/metabolism , Neoplastic Cells, Circulating/metabolism , Prostatic Neoplasms/blood , Aged , Blood Platelets/pathology , Cell Count , Humans , Male , Neoplasm Metastasis , Neoplastic Cells, Circulating/pathology , Prognosis , Prostatic Neoplasms/genetics , Prostatic Neoplasms/pathology
15.
J Am Vet Med Assoc ; 256(6): 681-686, 2020 Mar 15.
Article in English | MEDLINE | ID: mdl-32125244

ABSTRACT

OBJECTIVE: To assess reliability of the Schirmer tear test-1 (STT-1) for measurement of tear production in cats in various environments, investigate whether sympathetic stimulation impacts measurements, and determine whether meaningful conclusions regarding lacrimation in cats can be drawn from STT-1 measurements obtained with STT strip placement for < 1 minute. ANIMALS: 176 cats examined in a private practice (n = 100), a feral cat clinic (56), or a veterinary teaching hospital (20). PROCEDURES: The STT-1 was performed in both eyes of each cat. Measurements were recorded at 10- or 30-second intervals for 1 minute. Cats at the teaching hospital were tested once in a quiet examination room (unstimulated conditions) and once in the same room with loud prerecorded noises (stimulated conditions), with a 30-minute interval between tests and evaluation of cats' heart rates before and after STT-1. Data were analyzed with parametric statistical tools and a nonlinear mixed-effect model. RESULTS: 30- and 60-second STT-1 measurements were significantly correlated (r = 0.94). The STT-1 measurements did not differ under nonstimulated versus stimulated conditions, despite significant changes in heart rates that indicated sympathetic stimulation. A hyperbolic model of STT-1 kinetics was validated, allowing for extrapolation of measurements obtained in < 60 seconds and generation of reference values (95% predictive intervals) for various test durations. Median (95% predictive interval) 30- and 60-second STT-1 measurements were 9.1 mm (4.8 to 15.6 mm) and 14.3 mm (8.2 to 22.3 mm), respectively. CONCLUSIONS AND CLINICAL RELEVANCE: The STT-1 was a reliable diagnostic test in all settings; results were not affected by sympathetic stimulation, and a shorter duration of testing could be considered in selected cases.


Subject(s)
Lacrimal Apparatus , Tears , Animals , Cats , Diagnostic Techniques, Ophthalmological , Physical Examination , Reproducibility of Results
17.
Blood ; 134(2): 186-198, 2019 07 11.
Article in English | MEDLINE | ID: mdl-31010849

ABSTRACT

Myeloid neoplasms, including myelodysplastic syndromes (MDS), are genetically heterogeneous disorders driven by clonal acquisition of somatic mutations in hematopoietic stem and progenitor cells (HPCs). The order of premalignant mutations and their impact on HPC self-renewal and differentiation remain poorly understood. We show that episomal reprogramming of MDS patient samples generates induced pluripotent stem cells from single premalignant cells with a partial complement of mutations, directly informing the temporal order of mutations in the individual patient. Reprogramming preferentially captured early subclones with fewer mutations, which were rare among single patient cells. To evaluate the functional impact of clonal evolution in individual patients, we differentiated isogenic MDS induced pluripotent stem cells harboring up to 4 successive clonal abnormalities recapitulating a progressive decrease in hematopoietic differentiation potential. SF3B1, in concert with epigenetic mutations, perturbed mitochondrial function leading to accumulation of damaged mitochondria during disease progression, resulting in apoptosis and ineffective erythropoiesis. Reprogramming also informed the order of premalignant mutations in patients with complex karyotype and identified 5q deletion as an early cytogenetic anomaly. The loss of chromosome 5q cooperated with TP53 mutations to perturb genome stability, promoting acquisition of structural and karyotypic abnormalities. Reprogramming thus enables molecular and functional interrogation of preleukemic clonal evolution, identifying mitochondrial function and chromosome stability as key pathways affected by acquisition of somatic mutations in MDS.


Subject(s)
Cellular Reprogramming , Clonal Evolution/genetics , Hematopoietic Stem Cells/pathology , Myelodysplastic Syndromes/genetics , Pluripotent Stem Cells/pathology , Humans
18.
Am J Dermatopathol ; 41(5): 378-381, 2019 May.
Article in English | MEDLINE | ID: mdl-30371512

ABSTRACT

Chronic lymphoproliferative disorder of natural killer cells (CLPDNK) is a rare heterogenous indolent disorder comprising a persistent peripheral blood cell count of more than ≥2 × 10/L natural killer cells for over 6 months. We report an unusual case of cutaneous neural infiltration as a manifestation of CLPDNK. A 52-year-old woman with a background of CLPDNK was referred to dermatology with a painful rash primarily affecting her back. Skin biopsies revealed a neurotropic atypical lymphoid infiltration. Results of immunohistochemistry studies showed CD8, CD56, granzyme B, perforin positivity, and CD3 negativity in keeping with an atypical neurotropic lymphoid infiltrate consistent with cutaneous involvement by the patient's known CLPDNK. Cutaneous lesions and peripheral neuropathy in patients with CLPDNK have been reported; however, the involvement of cutaneous peripheral nerves as described in our case has not been reported before.


Subject(s)
Killer Cells, Natural/pathology , Lymphoproliferative Disorders/pathology , Peripheral Nervous System Neoplasms/pathology , Skin/pathology , Female , Humans , Middle Aged
19.
PLoS One ; 13(4): e0195082, 2018.
Article in English | MEDLINE | ID: mdl-29617409

ABSTRACT

Vasculature is an interface between the circulation and the hematopoietic tissue providing the means for hundreds of billions of blood cells to enter the circulation every day in a regulated fashion. The precise mechanisms that control the interactions of hematopoietic cells with the vessel wall are largely undefined. Here, we report on the development of an in vitro 3D human marrow vascular microenvironment (VME) to study hematopoietic trafficking and the release of blood cells, specifically platelets. We show that mature megakaryocytes from aspirated marrow as well as megakaryocytes differentiated in culture from CD34+ cells can be embedded in a collagen matrix containing engineered microvessels to create a thrombopoietic VME. These megakaryocytes continue to mature, penetrate the vessel wall, and release platelets into the vessel lumen. This process can be blocked with the addition of antibodies specific for CXCR4, indicating that CXCR4 is required for megakaryocyte migration, though whether it is sufficient is unclear. The 3D marrow VME system shows considerable potential for mechanistic studies defining the role of marrow vasculature in thrombopoiesis. Through a stepwise addition or removal of individual marrow components, this model provides potential to define key pathways responsible for the release of platelets and other blood cells.


Subject(s)
Cellular Microenvironment , Microvessels/metabolism , Thrombopoiesis/physiology , Antibodies/immunology , Antigens, CD34/metabolism , Blood Platelets/cytology , Blood Platelets/metabolism , Bone Marrow Cells/cytology , Cell Culture Techniques , Cell Movement , Cells, Cultured , Human Umbilical Vein Endothelial Cells , Humans , Megakaryocytes/cytology , Megakaryocytes/metabolism , Microscopy, Confocal , Microscopy, Electron , Receptors, CXCR4/immunology , Stromal Cells/cytology , Stromal Cells/metabolism
20.
Article in English | MEDLINE | ID: mdl-29610093

ABSTRACT

Recent advances in computational methods, materials science, and new manufacturing processes are resulting in an unprecedented design flexibility which is driving the geometrical complexity of the components found in modern structures and machines. For safety-critical components, the geometrical complexity poses a significant challenge to the sensitivity of the existing nondestructive evaluation (NDE) methods available for the detection of manufacturing defects or damage that develops while a component is in service. Although X-ray computed tomography is the primary NDE method used to test these parts in current industrial practice, it is widely recognized that it has limited sensitivity to critical defects, such as cracks, especially in the presence of large size parts made of dense materials. The lack of sensitive NDE methods represents a major technology gap that could impede the acceptance of rapidly developing technologies, such as 3-D printing, for the production of safety-critical components. This paper attempts to bridge this gap by exploring the possibility of inspecting a complex-shaped part with ultrasonic waves after it has been encapsulated in ice, under the paradigm of what can be defined as cryo-ultrasonic NDE. The underpinning hypothesis is that through ice encapsulation a complex-shaped part can be transformed into a simple-shaped solid whose volume can be probed with ultrasonic waves, which are known to be highly sensitive to both pores and crack-like defects and over a wide range of material properties. Damage detection is then performed by analyzing cross-sectional images of the ice-encapsulated part obtained by applying migration methods to the ultrasonic signals measured by an array of transducers. This paper lays the foundation for cryo-ultrasonic NDE and presents the first experimental results demonstrating the possibility of imaging defects through multiple ice-metal interfaces. This paves the way to the detection of defects in complex-shaped parts containing internal vanes which have so far limited the use of conventional NDE methods.

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