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1.
Faraday Discuss ; 2024 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-39258864

RESUMEN

Ab initio chemical shift prediction plays a central role in nuclear magnetic resonance (NMR) crystallography, and the accuracy with which chemical shifts can be predicted relative to experiment impacts the confidence with which structures can be assigned. For organic crystals, periodic density functional theory calculations with the gauge-including projector augmented wave (GIPAW) approximation and the PBE functional are widely used at present. Many previous studies have examined how using more advanced density functionals can increase the accuracy of predicted chemical shifts relative to experiment, but nearly all of those studies employed crystal structures that were optimized with generalized-gradient approximation (GGA) functionals. Here, we investigate how the accuracy of the predicted chemical shifts in organic crystals is affected by replacing GGA-level PBE-D3(BJ) crystal geometries with more accurate hybrid functional PBE0-D3(BJ) ones. Based on benchmark data sets containing 132 13C and 35 15N chemical shifts, plus case studies on testosterone, acetaminophen, and phenobarbital, we find that switching from GGA-level geometries and chemical shifts to hybrid-functional ones reduces 13C and 15N chemical shift errors by ∼40-60% versus experiment. However, most of the improvement stems from the use of the hybrid functional for the chemical shift calculations, rather than from the refined geometries. In addition, even with the improved geometries, we find that double-hybrid functionals still do not systematically increase chemical shift agreement with experiment beyond what hybrid functionals provide. In the end, these results suggest that the combination of GGA-level crystal structures and hybrid-functional chemical shifts represents a particularly cost-effective combination for NMR crystallography in organic systems.

2.
Vaccine ; 42(24): 126266, 2024 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-39232399

RESUMEN

Tuberculosis (TB) is one of the leading causes of death from infectious diseases, killing approximately 1.3 million people worldwide in 2022 alone. The current vaccine for TB contains a live attenuated bacterium, Mycobacterium bovis BCG (Bacille Calmette-Guérin). The BCG vaccine is highly effective in preventing severe forms of childhood TB but does not protect against latent infection or disease in older age groups. A new or improved BCG vaccine for prevention of pulmonary TB is urgently needed. In this study, we infected murine bone marrow derived dendritic cells from C57BL/6 mice with M. bovis BCG followed by elution and identification of BCG-derived MHC class I and class II-bound peptides using tandem mass spectrometry. We identified 1436 MHC-bound peptides of which 94 were derived from BCG. Fifty-five peptides were derived from MHC class I molecules and 39 from class II molecules. We tested the 94 peptides for their immunogenicity using IFN- γ ELISPOT assay with splenocytes purified from BCG immunized mice and 10 showed positive responses. Seven peptides were derived from MHC II and three from MHC class I. In particular, MHC class II binding peptides derived from the mycobacterial surface lipoprotein Mpt83 were highly antigenic. Further evaluations of these immunogenic BCG peptides may identify proteins useful as new TB vaccine candidates.

3.
Clin Dermatol ; 2024 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-39233021

RESUMEN

We highlight the contribution of notable Jewish women in American Dermatology. While not intended to be a thorough listing, we selected nine representatives as examples of early pioneering women in American dermatology, research, political leaders, authors and journal editors, and teachers and role models. All struggled to overcome professional barriers to women in medicine: many experienced antisemitism, especially those forced to flee Nazi Germany. Despite persecution and upending their lives, they rebuilt their careers and made outstanding contributions to dermatology.

4.
Clin Dermatol ; 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39222673

RESUMEN

Dr. Benjamin Bender (1908-1996) was a longtime Clinical Professor of Dermatology at the State University of New York Downstate College of Medicine. Some 45 years ago, he coined the eponym Bender sign, which describes the discovery of cutaneous diseases that involve the gluteal cleft by having patients bend over and then manually separating the buttocks. Bender's eponym was created as a humorous pun involving his name "Bender" with the "bending" of the patient. This contribution formally introduces this delightful eponym into the dermatology literature and highly recommends its adoption as a teaching tool to remind students of the importance of examining the intergluteal cleft area, which can often harbor a variety of skin disorders, such as psoriasis. A second Bender sign, referred to as Bender sign #2, is also presented, which describes the sparing of the nose when the face is rubbed and inflamed from neurodermatitis. This contribution pays tribute to Dr. Benjamin Bender who his students beloved as a master teacher of dermatology.

5.
Clin Dermatol ; 2024 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-39154666

RESUMEN

During the past 125 years, three dermatologists have been nominated for the Nobel Prize in Physiology or Medicine: Albert Neisser (1855-1916), Erich Hoffmann (1868-1959), and Aaron B. Lerner (1920-2007). Neisser was nominated 22 times for his discovery of the gonococcus and for his work on the serologic testing for syphilis through complement fixation. Hoffman was nominated three times for his role in the discovery of Treponema pallidum. Lerner was nominated twice, once for his work on melanocyte-stimulating hormone and a second time for his work on melatonin. Although neither Neisser, Hoffmann, nor Lerner won the Nobel Prize, it is still a notable accomplishment that each of them was nominated multiple times for this prestigiousaward. This contribution highlights the lives and careers of these three distinguished dermatologists, including the landmark discoveries they made that led to their being nominated for a Nobel Prize.

6.
Nat Mater ; 23(9): 1159-1160, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39215160
7.
Front Fungal Biol ; 5: 1447588, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39206133

RESUMEN

There is an urgent need for new antifungal drugs to treat invasive fungal diseases. Unfortunately, the echinocandin drugs that are fungicidal against other important fungal pathogens are ineffective against Cryptococcus neoformans, the causative agent of life-threatening meningoencephalitis in immunocompromised people. Contributing mechanisms for echinocandin tolerance are emerging with connections to calcineurin signaling, the cell wall, and membrane composition. In this context, we discovered that a defect in phosphate uptake impairs the tolerance of C. neoformans to the echinocandin caspofungin. Our previous analysis of mutants lacking three high affinity phosphate transporters revealed reduced elaboration of the polysaccharide capsule and attenuated virulence in mice. We investigated the underlying mechanisms and found that loss of the transporters and altered phosphate availability influences the cell wall and membrane composition. These changes contribute to the shedding of capsule polysaccharide thus explaining the reduced size of capsules on mutants lacking the phosphate transporters. We also found an influence of the calcineurin pathway including calcium sensitivity and an involvement of the endoplasmic reticulum in the response to phosphate limitation. Furthermore, we identified membrane and lipid composition changes consistent with the role of phosphate in phospholipid biosynthesis and with previous studies implicating membrane integrity in caspofungin tolerance. Finally, we discovered a contribution of phosphate to titan cell formation, a cell type that displays modified cell wall and capsule composition. Overall, our analysis reinforces the importance of phosphate as a regulator of cell wall and membrane composition with implications for capsule attachment and antifungal drug susceptibility.

8.
Environ Res ; 260: 119797, 2024 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-39147182

RESUMEN

The Cree Peoples of the Eeyou Istchee territory (northern Québec, Canada) rely on fish as a part of their traditional and contemporary diet. Fish is a culturally significant food and a source of nutrients, but it is also the main pathway of methylmercury (MeHg) exposure for humans. Significant hydroelectric developments in this territory are responsible for increasing the concentrations of MeHg found in fish and thus increase the human exposure to this neurotoxic compound. As this is an ongoing issue, our study assessed the current MeHg fish-tissue concentrations in Eeyou Istchee and the spatial distribution of MeHg hot spots using Geographic Information Systems (GIS) to compare our results to those found in previous studies from the same region. We also performed a probabilistic hazard assessment of the exposure to MeHg from fish consumption. The GIS models indicated significant clustering of increased MeHg fish-tissue concentrations around hydroelectric reservoirs and showed higher MeHg fish-tissue concentrations around newer hydroelectric reservoirs, but a decrease in older reservoirs. Similar to past studies, we found that fish consumption continues to pose an MeHg exposure hazard for men who consume large piscivore species (i.e., lake trout, walleye, and pike), while for women, lake trout and walleye consumption constitute a hazard (any size), and pike should be consumed with caution. The hazard of exposure was mainly associated with intake rate in all cases. Lastly, we recommend monitoring MeHg fish-tissue concentrations in this region, as the MeHg tissue concentrations remain elevated, and updated consumption guidelines where and when necessitated.


Asunto(s)
Peces , Compuestos de Metilmercurio , Contaminantes Químicos del Agua , Compuestos de Metilmercurio/análisis , Quebec , Humanos , Animales , Medición de Riesgo , Masculino , Femenino , Contaminantes Químicos del Agua/análisis , Contaminación de Alimentos/análisis , Sistemas de Información Geográfica
9.
Front Digit Health ; 6: 1403457, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39184339

RESUMEN

Cardiovascular diseases (CVDs) are a global burden that requires attention. For the detection and diagnosis of CVDs, the 12-lead ECG is a key tool. With technological advancements, ECG devices are becoming smaller and available for home use. Most of these devices contain a limited number of leads and are aimed to detect atrial fibrillation (AF). To investigate whether a four-electrode arrangement could provide enough information to diagnose other CVDs, further research is necessary. At the University Medical Center Utrecht in a multidisciplinary team, we developed the miniECG, a four-electrode ECG handheld system for scientific research in clinical environments (TRL6). This paper describes the process followed during the development of the miniECG. From assembling a multidisciplinary team, which includes engineers, cardiologists, and clinical physicians to the contribution of team members in the design input, design, and testing for safety and functionality of the device. Finally, we detail how the development process was composed by iterative design steps based on user input and intended use evolution. The miniECG is a device compliant for scientific research with patients within Dutch Medical Centers. We believe that hospital-based development led to a streamlined process, which could be applied for the design and development of other technologies used for scientific research in clinical environments.

10.
Cell Metab ; 36(7): 1619-1633.e5, 2024 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-38959864

RESUMEN

Population-level variation and mechanisms behind insulin secretion in response to carbohydrate, protein, and fat remain uncharacterized. We defined prototypical insulin secretion responses to three macronutrients in islets from 140 cadaveric donors, including those with type 2 diabetes. The majority of donors' islets exhibited the highest insulin response to glucose, moderate response to amino acid, and minimal response to fatty acid. However, 9% of donors' islets had amino acid responses, and 8% had fatty acid responses that were larger than their glucose-stimulated insulin responses. We leveraged this heterogeneity and used multi-omics to identify molecular correlates of nutrient responsiveness, as well as proteins and mRNAs altered in type 2 diabetes. We also examined nutrient-stimulated insulin release from stem cell-derived islets and observed responsiveness to fat but not carbohydrate or protein-potentially a hallmark of immaturity. Understanding the diversity of insulin responses to carbohydrate, protein, and fat lays the groundwork for personalized nutrition.


Asunto(s)
Diabetes Mellitus Tipo 2 , Secreción de Insulina , Insulina , Islotes Pancreáticos , Proteómica , Humanos , Diabetes Mellitus Tipo 2/metabolismo , Masculino , Femenino , Insulina/metabolismo , Islotes Pancreáticos/metabolismo , Persona de Mediana Edad , Nutrientes/metabolismo , Adulto , Glucosa/metabolismo , Anciano , Ácidos Grasos/metabolismo
11.
Nat Microbiol ; 9(8): 2084-2098, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38956248

RESUMEN

The fungal pathogen Cryptococcus neoformans is well adapted to its host environment. It has several defence mechanisms to evade oxidative and nitrosative agents released by phagocytic host cells during infection. Among them, melanin production is linked to both fungal virulence and defence against harmful free radicals that facilitate host innate immunity. How C. neoformans manipulates its redox environment to facilitate melanin formation and virulence is unclear. Here we show that the antioxidant glutathione is inextricably linked to redox-active processes that facilitate melanin and titan cell production, as well as survival in macrophages and virulence in a murine model of cryptococcosis. Comparative metabolomics revealed that disruption of glutathione biosynthesis leads to accumulation of reducing and acidic compounds in the extracellular environment of mutant cells. Overall, these findings highlight the importance of redox homeostasis and metabolic compensation in pathogen adaptation to the host environment and suggest new avenues for antifungal drug development.


Asunto(s)
Criptococosis , Cryptococcus neoformans , Glutatión , Macrófagos , Melaninas , Oxidación-Reducción , Cryptococcus neoformans/patogenicidad , Cryptococcus neoformans/metabolismo , Cryptococcus neoformans/genética , Animales , Glutatión/metabolismo , Virulencia , Ratones , Criptococosis/microbiología , Melaninas/metabolismo , Melaninas/biosíntesis , Macrófagos/microbiología , Macrófagos/metabolismo , Macrófagos/inmunología , Modelos Animales de Enfermedad , Regulación Fúngica de la Expresión Génica , Femenino
12.
Endocrinology ; 165(8)2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38970533

RESUMEN

Dietary carbohydrates raise blood glucose levels, and limiting carbohydrate intake improves glycemia in patients with type 2 diabetes. Low carbohydrate intake (< 25 g) allows the body to utilize fat as its primary fuel. As a consequence of increased fatty acid oxidation, the liver produces ketones to serve as an alternative energy source. ß-Hydroxybutyrate (ßHB) is the most abundant ketone. While ßHB has a wide range of functions outside of the pancreas, its direct effects on islet cell function remain understudied. We examined human islet secretory response to acute racemic ßHB treatment and observed increased insulin secretion at a low glucose concentration of 3 mM. Because ßHB is a chiral molecule, existing as both R and S forms, we further studied insulin and glucagon secretion following acute treatment with individual ßHB enantiomers in human and C57BL/6J mouse islets. We found that acute treatment with R-ßHB increased insulin secretion and decreased glucagon secretion at physiological glucose concentrations in both human and mouse islets. Proteomic analysis of human islets treated with R-ßHB over 72 hours showed altered abundance of proteins that may promote islet cell health and survival. Collectively, our data show that physiological concentrations of ßHB influence hormone secretion and signaling within pancreatic islets.


Asunto(s)
Ácido 3-Hidroxibutírico , Glucagón , Secreción de Insulina , Insulina , Islotes Pancreáticos , Ratones Endogámicos C57BL , Ácido 3-Hidroxibutírico/farmacología , Animales , Humanos , Glucagón/metabolismo , Secreción de Insulina/efectos de los fármacos , Islotes Pancreáticos/metabolismo , Islotes Pancreáticos/efectos de los fármacos , Ratones , Insulina/metabolismo , Masculino , Glucosa/metabolismo , Femenino
13.
Ecol Evol ; 14(7): e11542, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38979004

RESUMEN

Strawberry or red leopards are a rare colour morph of leopard (Panthera pardus) characterised by spot markings that are red or brown instead of black, thought to be a result of a mutation in the tyrosinase-related protein (TYRP1) gene. We report the first record of this phenotype on the African continent outside of South Africa, from Selous Game Reserve in southern Tanzania. One female leopard with strawberry colouration was documented out of 373 individual leopards (0.3%) identified through camera trap surveys conducted from 2020 to 2022 over a combined area of more than 4600 km2 in the Nyerere-Selous landscape.

14.
bioRxiv ; 2024 Jun 22.
Artículo en Inglés | MEDLINE | ID: mdl-38948734

RESUMEN

Comprehensive molecular and cellular phenotyping of human islets can enable deep mechanistic insights for diabetes research. We established the Human Islet Data Analysis and Sharing (HI-DAS) consortium to advance goals in accessibility, usability, and integration of data from human islets isolated from donors with and without diabetes at the Alberta Diabetes Institute (ADI) IsletCore. Here we introduce HumanIslets.com, an open resource for the research community. This platform, which presently includes data on 547 human islet donors, allows users to access linked datasets describing molecular profiles, islet function and donor phenotypes, and to perform various statistical and functional analyses at the donor, islet and single-cell levels. As an example of the analytic capacity of this resource we show a dissociation between cell culture effects on transcript and protein expression, and an approach to correct for exocrine contamination found in hand-picked islets. Finally, we provide an example workflow and visualization that highlights links between type 2 diabetes status, SERCA3b Ca2+-ATPase levels at the transcript and protein level, insulin secretion and islet cell phenotypes. HumanIslets.com provides a growing and adaptable set of resources and tools to support the metabolism and diabetes research community.

15.
Sci Rep ; 14(1): 17285, 2024 07 27.
Artículo en Inglés | MEDLINE | ID: mdl-39068210

RESUMEN

With their long lives and extreme reproductive output, social insect queens have escaped the classic trade-off between fecundity and lifespan, but evidence for a trade-off between fecundity and immunity has been inconclusive. This is in part because pathogenic effects are seldom decoupled from effects of immune induction. We conducted parallel, blind virus infection experiments in the laboratory and in the field to interrogate the idea of a reproductive immunity trade-off in honey bee (Apis mellifera) queens and to better understand how these ubiquitous stressors affect honey bee queen health. We found that queens injected with infectious virus had smaller ovaries and were less likely to recommence egg-laying than controls, while queens injected with UV-inactivated virus displayed an intermediate phenotype. In the field, heavily infected queens had smaller ovaries and infection was a meaningful predictor of whether supersedure cells were observed in the colony. Immune responses in queens receiving live virus were similar to queens receiving inactivated virus, and several of the same immune proteins were negatively associated with ovary mass in the field. This work supports the hypothesized relationship between virus infection and symptoms associated with queen failure and suggests that a reproductive-immunity trade-off is partially, but not wholly responsible for these effects.


Asunto(s)
Ovario , Virosis , Animales , Abejas/virología , Abejas/fisiología , Abejas/inmunología , Femenino , Ovario/virología , Virosis/inmunología , Reproducción , Oviposición , Fertilidad
16.
Phys Med Biol ; 69(17)2024 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-39084657

RESUMEN

Objective.A robotic needle implant device for MR-guided high-dose-rate (HDR) prostate brachytherapy was developed. This study aimed to assess the feasibility and spatial accuracy of HDR brachytherapy using the robotic device, for a single intraprostatic target point.Approach.Five patients were treated from November 2019-June 2022 with the robot. The robot fits a 1.5 T MR scanner and the needle can be shifted and angulated. An intraprocedural MR scan was fused with the diagnostic MR and one preplanned needle position was selected for robotic insertion. The needle entry point and angles were set for a needle tip target point within the intraprostatic target volume. The needle was tapped stepwise towards the target point pneumatically. Final needle position was verified with MR, followed by plan optimization and dose delivery. Any remaining planned needles were inserted manually. Needle tip to geometrical target error (NTG-error) was defined as the deviation of the actual tip position relative to the predefined geometric target point, using MR-coordinates. Needle tip to treatment target error (NTT-error) was defined as the deviation of the actual tip position relative to the treatment target point, using fused MR-images pre- and post-needle implantation taking into account prostate deformation. Difference between NTT-error and NTG-error and fiducial marker shifts indicated prostate movement. For determining prostate deformation, the Jaccard index and prostate volumes were assessed.Main results.The robotic device was able to tap the needle to the planned depth for all patients. Mean robotic procedure duration was 142 min. NTG-error was 3.2 (range 1.1-6.7) mm and NTT-error 4.5 (range 2.6-9.6) mm. Marker displacements were smaller than 3 mm. No treatment-related acute toxicity was reported. Feasibility of needle placement within the prostate was considered adequate.Significance.MR-guided robotic needle insertion is feasible with a mean geometric accuracy of 3.2 mm and <3 mm prostate movement.


Asunto(s)
Braquiterapia , Imagen por Resonancia Magnética , Agujas , Neoplasias de la Próstata , Dosificación Radioterapéutica , Radioterapia Guiada por Imagen , Robótica , Masculino , Humanos , Braquiterapia/instrumentación , Braquiterapia/métodos , Neoplasias de la Próstata/radioterapia , Neoplasias de la Próstata/diagnóstico por imagen , Robótica/instrumentación , Radioterapia Guiada por Imagen/métodos , Radioterapia Guiada por Imagen/instrumentación , Prueba de Estudio Conceptual , Dosis de Radiación , Próstata/efectos de la radiación , Próstata/diagnóstico por imagen , Procedimientos Quirúrgicos Robotizados/instrumentación , Procedimientos Quirúrgicos Robotizados/métodos
17.
Personal Disord ; 15(5): 361-370, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39073373

RESUMEN

Traditional personality disorders (PDs; e.g., Diagnostic and Statistical Manual of Mental Disorders, fifth edition [DSM-5] Section II PDs), as well as dimensional traits (e.g., alternative model for PD [AMPD]), offer unique advantages in personality pathology assessment. However, very little is known about how these systems compare in predicting observable behavior. This study compares self-report ratings of PD symptoms (i.e., Structured Clinical Interview for DSM-IV PD) with self-reports of AMPD traits (i.e., Personality Inventory for DSM-5) in predicting clinical outcomes, 1 year later, via three different methods: (a) naturalistically observed psychosocial functioning (i.e., electronically activated recorder [EAR]), (b) informant-reported interpersonal functioning (i.e., Inventory of Interpersonal Problems-32), and (c) self-reported suicidality (SI), depression, anxiety, and substance use symptoms (i.e., Psychiatric Diagnostic Screening Questionnaire). Data were analyzed from 72 individuals in current or recent psychiatric treatment meeting diagnosis for at least one PD. Results showed that DSM Section II PD and AMPD ratings yielded meaningful and comparable predictions of naturalistically observed EAR variables and informant-rated interpersonal functioning. The AMPD appeared to offer slight advantages in the prediction of EAR-observed negative affect, hostile words, and informant-rated interpersonal functioning, with clearer advantages at the facet level. Overall, these results provide tentative evidence that both DSM Section II PD and AMPD systems show meaningful links with clinical outcomes measured via multiple methods 1 year later, but with clearer advantages for the AMPD at the facet level. Moreover, results show that the EAR is a viable method for capturing naturalistically observed clinically meaningful, in vivo behavior of individuals exhibiting maladaptive personality patterns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Manual Diagnóstico y Estadístico de los Trastornos Mentales , Relaciones Interpersonales , Trastornos de la Personalidad , Humanos , Trastornos de la Personalidad/diagnóstico , Femenino , Masculino , Adulto , Adulto Joven , Persona de Mediana Edad , Autoinforme , Funcionamiento Psicosocial , Inventario de Personalidad/normas
18.
J Econ Entomol ; 117(4): 1324-1335, 2024 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-38877967

RESUMEN

Highbush blueberry pollination depends on managed honey bees (Apis mellifera) L. for adequate fruit sets; however, beekeepers have raised concerns about the poor health of colonies after pollinating this crop. Postulated causes include agrochemical exposure, nutritional deficits, and interactions with parasites and pathogens, particularly Melisococcus plutonius [(ex. White) Bailey and Collins, Lactobacillales: Enterococcaceae], the causal agent of European foulbrood disease, but other pathogens could be involved. To broadly investigate common honey bee pathogens in relation to blueberry pollination, we sampled adult honey bees from colonies at time points corresponding to before (t1), during (t2), at the end (t3), and after (t4) highbush blueberry pollination in British Columbia, Canada, across 2 years (2020 and 2021). Nine viruses, as well as M. plutonius, Vairimorpha ceranae, and V. apis [Tokarev et al., Microsporidia: Nosematidae; formerly Nosema ceranae (Fries et al.) and N. apis (Zander)], were detected by PCR and compared among colonies located near and far from blueberry fields. We found a significant interactive effect of time and blueberry proximity on the multivariate pathogen community, mainly due to differences at t4 (corresponding to ~6 wk after the beginning of the pollination period). Post hoc comparisons of pathogens in near and far groups at t4 showed that detections of sacbrood virus (SBV), which was significantly higher in the near group, not M. plutonius, was the primary driver. Further research is needed to determine if the association of SBV with highbush blueberry pollination is contributing to the health decline that beekeepers observe after pollinating this crop.


Asunto(s)
Arándanos Azules (Planta) , Polinización , Animales , Abejas/virología , Abejas/parasitología , Arándanos Azules (Planta)/virología , Colombia Británica , Virus ARN/fisiología
19.
Clin Dermatol ; 2024 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-38944247
20.
Eur Urol Oncol ; 2024 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-38926066

RESUMEN

BACKGROUND AND OBJECTIVE: Abiraterone acetate (abiraterone) plus prednisone is approved for the treatment of metastatic castration-resistant prostate cancer (mCRPC). Our aim was to evaluate the efficacy and safety of pembrolizumab plus abiraterone in mCRPC. METHODS: In cohort D of the phase 1b/2 KEYNOTE-365 study (NCT02861573), patients were chemotherapy-naïve, had disease progression ≤6 mo before screening, and had either not received prior next-generation hormonal agents for mCRPC or had received prior enzalutamide for mCRPC and had disease progression or became intolerant to enzalutamide. Patients received pembrolizumab 200 mg intravenously every 3 wk plus abiraterone 1000 mg orally once daily and prednisone 5 mg orally twice daily. The primary endpoints were safety, prostate-specific antigen (PSA) response rate, and objective response rate (ORR) according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) by blinded independent central review (BICR). Secondary endpoints included radiographic progression-free survival (rPFS) according to Prostate Cancer Clinical Trials Working Group 3-modified RECIST v1.1 by BICR and overall survival (OS). KEY FINDINGS AND LIMITATIONS: For the 103 patients who were treated, median follow-up was 28 mo (interquartile range 26-31). The confirmed PSA response rate was 56% (58/103 patients). The ORR for patients with RECIST v1.1-measurable disease was 16% (6/37 patients). Median rPFS was 15 mo (95% confidence interval 9.2-22) and median OS was 30 mo (95% confidence interval 23-not reached); the estimated 24-mo OS rate was 58%. In total, 91% of patients experienced treatment-related adverse events, and 39% experienced grade 3-5 events. Grade 3/4 elevation of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) was observed in 12% and 6.8% of patients, respectively. One patient died due to treatment-related myasthenic syndrome. Study limitations include the single-arm design. CONCLUSIONS: Pembrolizumab plus abiraterone and prednisone demonstrated antitumor activity and acceptable safety in patients with chemotherapy-naïve mCRPC. Higher incidence of grade 3/4 elevated ALT/AST occurred than was reported for the individual agents. PATIENT SUMMARY: For patients with metastatic castratation-resistant prostate cancer, the drug combination of pembrolizumab plus abiraterone and prednisone showed antitumor activity and acceptable safety.

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