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1.
Cancer Immunol Immunother ; 73(6): 100, 2024 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-38630291

RESUMO

In multiple myeloma (MM), B cell maturation antigen (BCMA)-directed CAR T cells have emerged as a novel therapy with potential for long-term disease control. Anti-BCMA CAR T cells with a CD8-based transmembrane (TM) and CD137 (41BB) as intracellular costimulatory domain are in routine clinical use. As the CAR construct architecture can differentially impact performance and efficacy, the optimal construction of a BCMA-targeting CAR remains to be elucidated. Here, we hypothesized that varying the constituents of the CAR structure known to impact performance could shed light on how to improve established anti-BCMA CAR constructs. CD8TM.41BBIC-based anti-BCMA CAR vectors with either a long linker or a short linker between the light and heavy scFv chain, CD28TM.41BBIC-based and CD28TM.CD28IC-based anti-BCMA CAR vector systems were used in primary human T cells. MM cell lines were used as target cells. The short linker anti-BCMA CAR demonstrated higher cytokine production, whereas in vitro cytotoxicity, T cell differentiation upon activation and proliferation were superior for the CD28TM.CD28IC-based CAR. While CD28TM.CD28IC-based CAR T cells killed MM cells faster, the persistence of 41BBIC-based constructs was superior in vivo. While CD28 and 41BB costimulation come with different in vitro and in vivo advantages, this did not translate into a superior outcome for either tested model. In conclusion, this study showcases the need to study the influence of different CAR architectures based on an identical scFv individually. It indicates that current scFv-based anti-BCMA CAR with clinical utility may already be at their functional optimum regarding the known structural variations of the scFv linker.


Assuntos
Mieloma Múltiplo , Humanos , Mieloma Múltiplo/terapia , Antígeno de Maturação de Linfócitos B , Anticorpos , Antígenos CD28 , Terapia Baseada em Transplante de Células e Tecidos
2.
J Health Psychol ; : 13591053241241479, 2024 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-38581307

RESUMO

Research on meaning in life typically emphasizes the psychological aspects of quality of life, neglecting broader dimensions. Additionally, its relevance to the COVID-19 context remains limited. This study investigated the relationship of meaning in life with quality of life and sociodemographic factors related to COVID-19 pandemic in Brazil. A total of 4133 Brazilian adults completed Meaning in Life Questionnaire (MLQ), WHOQOL-BREF, WHOQOL-SRPB BREF, and sociodemographic information. Our results indicated a positive correlation between the presence of meaning and quality of life dimensions, with psychological health exhibiting the strongest relationship. We found a lower presence of meaning among individuals experiencing heightened social isolation, while vaccinated individuals exhibited a greater presence of meaning. Additionally, non-working participants reported lower presence and higher search for meaning than employed individuals, with frontline workers showing the highest search for meaning. Theoretical and practical implications of these findings are discussed.

3.
Mol Ther Methods Clin Dev ; 32(2): 101228, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38524756

RESUMO

Manufacturing of adeno-associated viruses (AAV) for gene and cell therapy applications has increased significantly and spurred development of improved mammalian and insect cell-based production systems. We developed a baculovirus-based insect cell production system-the SGMO Helper-with a novel gene architecture and greater flexibility to modulate the expression level and content of individual Rep and Cap proteins. In addition, we incorporated modifications to the AAV6 capsid sequence that improves yield, capsid integrity, and potency. Production of recombinant AAV 6 (rAAV6) using the SGMO Helper had improved yields compared to the Bac-RepCap helper from the Kotin lab. SGMO Helper-derived rAAV6 is resistant to a previously described proteolytic cleavage unique to baculovirus-insect cell production systems and has improved capsid ratios and potency, in vitro and in vivo, compared with rAAV6 produced using Bac-RepCap. Next-generation sequencing sequence analysis demonstrated that the SGMO Helper is stable over six serial passages and rAAV6 capsids contain comparable amounts of non-vector genome DNA as rAAV6 produced using Bac-RepCap. AAV production using the SGMO Helper is scalable using bioreactors and has improved yield, capsid ratio, and in vitro potency. Our studies demonstrate that the SGMO Helper is an improved platform for AAV manufacturing to enable delivery of cutting-edge gene and cell therapies.

4.
Brain Res ; 1828: 148771, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38242525

RESUMO

Sepsis is a life-threatening condition induced by a deregulated host response to infection. Post-sepsis injury includes long-term cognitive impairment, whose neurobiological mechanisms and effective treatment remain unknown. The present study was designed to determine the potential effects of cannabidiol (CBD) in a sepsis-associated encephalopathy (SAE) model and explore if peroxisome proliferator activated receptor gamma (PPARγ) is the putative mechanism underpinning the beneficial effects. SAE was induced in Wistar rats by cecal ligation and puncture (CLP) or sham (control). CLP rats received vehicle, CBD (10 mg/kg), PPARγ inhibitor (GW9662 - 1 mg/kg), or GW9662 (1 mg/kg) + CBD (10 mg/kg) intraperitoneally for ten days. During this period, the survival rate was recorded, and at the end of 10 days, a memory test was performed, and the prefrontal cortex and hippocampus were removed to verify brain-derived neurotrophic factor (BDNF), cytokines (IL-1ß, IL-6 and IL-10), myeloperoxidase activity, nitrite nitrate concentration, and lipid and protein carbonylation and catalase activity. Septic rats presented cognitive decline and an increase in mortality following CLP. Only CBD alone improved the cognitive impairment, which was accompanied by restoration of BDNF, reduced neuroinflammation, and oxidative stress, mainly in the hippocampus. This study shows that CLP induces an increase in brain damage and CBD has neuroprotective effects on memory impairment and neurotrophins, as well as against neuroinflammation and oxidative stress, and is mediated by PPARγ activation.


Assuntos
Anilidas , Canabidiol , Disfunção Cognitiva , Encefalopatia Associada a Sepse , Sepse , Ratos , Animais , PPAR gama/metabolismo , Canabidiol/farmacologia , Canabidiol/metabolismo , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Ratos Wistar , Doenças Neuroinflamatórias , Encéfalo/metabolismo , Encefalopatia Associada a Sepse/tratamento farmacológico , Encefalopatia Associada a Sepse/metabolismo , Sepse/complicações , Sepse/tratamento farmacológico , Sepse/metabolismo , Antioxidantes/farmacologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/complicações , Modelos Animais de Doenças
5.
Psicothema ; 36(1): 46-54, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38227299

RESUMO

BACKGROUND: In this study, we examined whether a persuasive message in favor of a pro-environmental proposal could influence attitude change through a self-validation process when individuals were told that the source of the proposal belonged to their ingroup (vs. their outgroup). METHOD: Participants read a message that advocated for the use of solar power. Immediately following the message, participants were asked to list their thoughts regarding the persuasive proposal. A thought favorability index was created for each participant. Following the thought-listing task, participants received the experimental manipulation (i.e., ingroup vs. outgroup source) based on the minimal group paradigm, after which they reported their attitudes towards the proposal. RESULTS: A regression analysis showed the predicted interaction between thought favorability and type of source (i.e., ingroup vs. outgroup) on attitudes towards the solar power proposal. According to our expectations, thought favorability was a better predictor of attitudes for participants in the ingroup (vs. outgroup) source condition. CONCLUSIONS: Attitudes can be polarized as a function of ingroup versus outgroup differentiation through a self-validation process.


Assuntos
Energia Solar , Humanos , Comunicação Persuasiva
6.
Psicothema (Oviedo) ; 36(1): 46-54, 2024. graf
Artigo em Inglês | IBECS | ID: ibc-229721

RESUMO

Background: In this study, we examined whether a persuasive message in favor of a pro-environmental proposal could influence attitude change through a self-validation process when individuals were told that the source of the proposal belonged to their ingroup (vs. their outgroup). Method: Participants read a message that advocated for the use of solar power. Immediately following the message, participants were asked to list their thoughts regarding the persuasive proposal. A thought favorability index was created for each participant. Following the thought-listing task, participants received the experimental manipulation (i.e., ingroup vs. outgroup source) based on the minimal group paradigm, after which they reported their attitudes towards the proposal. Results: A regression analysis showed the predicted interaction between thought favorability and type of source (i.e., ingroup vs. outgroup) on attitudes towards the solar power proposal. According to our expectations, thought favorability was a better predictor of attitudes for participants in the ingroup (vs. outgroup) source condition. Conclusions: Attitudes can be polarized as a function of ingroup versus outgroup differentiation through a self-validation process.(AU)


Antecedentes: En la presente investigación, examinamos si un mensaje persuasivo a favor de una propuesta pro-ambiental puede influir en el cambio de actitudes a través de un proceso de auto-validación cuando a los participantes se les dice que el emisor de la propuesta pertenece a su endogrupo (vs. su exogrupo). Método: Los participantes leyeron un mensaje que abogaba por el uso de la energía solar. Inmediatamente después del mensaje, se pidió a los participantes que listaran sus pensamientos con respecto a la propuesta persuasiva. Se creó un índice de favorabilidad de los pensamientos para cada participante. Después de esta tarea, los participantes recibieron la manipulación experimental (i.e., emisor del endogrupo vs. exogrupo) basada en el paradigma del grupo mínimo. Finalmente, informaron de sus actitudes hacia la propuesta. Resultados: Un análisis de regresión mostró la interacción esperada entre la favorabilidad del pensamiento y el tipo de emisor (endogrupo vs. exogrupo) sobre las actitudes hacia el uso de energía solar. Como se hipotetizó, la favorabilidad del pensamiento fue un mejor predictor de las actitudes para los participantes en la condición de endogrupo (vs. exogrupo). Conclusiones: Las actitudes pueden polarizarse en función de la diferenciación entre endogrupo y exogrupo mediante un proceso de auto-validación.(AU)


Assuntos
Humanos , Masculino , Feminino , Energia Solar , Metacognição , Conservação dos Recursos Naturais , Saúde Ambiental , Identificação Social
7.
Microvasc Res ; 151: 104621, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37918521

RESUMO

Stroke is the second leading cause of death globally and the major cause of long-term disability. Among the types of strokes, ischemic stroke, which occurs due to obstruction of blood vessels responsible for cerebral irrigation, is considered the most prevalent, accounting for approximately 86 % of all stroke cases. This interruption of blood supply leads to a critical pathophysiological mechanism, including oxidative stress and neuroinflammation which are responsible for structural alterations of the blood-brain barrier (BBB). The increased BBB permeability associated with cerebral ischemia-reperfusion may contribute to a worse outcome after stroke. Thus, this narrative review aims to update the pathophysiological mechanisms involved in the increase in BBB permeability and to list the possible therapeutic strategies.


Assuntos
Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Humanos , Barreira Hematoencefálica , Permeabilidade
8.
Plants (Basel) ; 12(10)2023 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-37653934

RESUMO

Climate change is expected to impact both the population structure and geographic distribution of plants. Species distribution models are widely used to assess range shifts and the vulnerability of plants to climate change. Despite the abundance of modeling studies, little is known about how existing populations respond to climate change. We investigated the demographic structure and vulnerability to climate change in Anemone moorei, a sub-shrub with a highly restricted distribution in a biodiversity hotspot. We improved the distribution knowledge through intensive field work. We conducted a census of stem length as a proxy for age for all known populations. We used ensemble forecasting to project distributions considering 10 future climate scenarios and developed a novel climate change vulnerability index for the species' distribution. We found that the mean stem length decreases and the proportion of young plants increases, while the size of fruiting plants decreases as A. moorei faces greater climate change vulnerability. We interpret these results as evidence for the onset of recent adaptation to climate change, consisting of reduced adult longevity and an earlier onset of reproduction. As a result of these changes, the proportion of juveniles in the population increases.

9.
Pers Soc Psychol Bull ; : 1461672231192827, 2023 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-37644690

RESUMO

The present research examines the effect of holistic-analytic thinking style on causal responsibility. Across seven studies (N = 4,103), participants' thinking style was either measured or manipulated. Then, the valence or number of consequences varied in several scenarios involving a cause-consequence relationship. As a dependent measure, participants indicated the degree of responsibility attributed to the cause mentioned in each scenario. The results revealed that holistic (vs. analytic) participants assigned more responsibility to the cause when the consequences presented were a combination of positive and negative outcomes (vs. univalent), and when multiple (vs. single) consequences were triggered in the scenario. To explore the explanatory factor for these results, a final study manipulated the complexity of the consequences, along with the number. The results of this research suggested that holistic (vs. analytic) individuals consider the degree of complexity of consequences to establish causal attribution.

10.
J Gastrointest Surg ; 27(11): 2388-2395, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37537494

RESUMO

BACKGROUND: Incisional hernia (IH) is common after major abdominal surgery; however, the incidence after hepatectomy for cancer has not been described. We analyzed incidence of and risk factors for IH after hepatectomy for colorectal liver metastases (CLM). METHODS: Patients who underwent open hepatectomy with midline or reverse-L incision for CLM at a single institution between 2010 and 2018 were retrospectively analyzed. Postoperative CT scans were reviewed to identify IH and the time from hepatectomy to hernia. Cumulative IH incidence was calculated using competing risk analysis. Risk factors were assessed using Cox proportional hazards model analysis. The relationship between IH incidence and preoperative body mass index (BMI) was estimated using a generalized additive model. RESULTS: Among 470 patients (median follow-up: 16.9 months), IH rates at 12, 24, and 60 months were 41.5%, 51.0%, and 59.2%, respectively. Factors independently associated with IH were surgical site infection (HR: 1.54, 95% CI 1.16-2.06, P = 0.003) and BMI > 25 kg/m2 (HR: 1.94, 95% CI 1.45-2.61, P < 0.001). IH incidence was similar in patients undergoing midline and reverse-L incisions and patients who received and did not receive a bevacizumab-containing regimen. The 1-year IH rate increased with increasing number of risk factors (zero: 22.2%; one: 46.8%; two: 60.3%; P < 0.001). Estimated IH incidence was 10% for BMI of 15 kg/m2 and 80% for BMI of 40 kg/m2. CONCLUSION: IH is common after open hepatectomy for CLM, particularly in obese patients and patients with surgical site infection. Surgeons should consider risk-mitigation strategies, including alternative fascial closure techniques.


Assuntos
Neoplasias Colorretais , Hérnia Incisional , Neoplasias Hepáticas , Humanos , Hérnia Incisional/epidemiologia , Hérnia Incisional/etiologia , Hérnia Incisional/cirurgia , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Hepatectomia/efeitos adversos , Estudos Retrospectivos , Incidência , Fatores de Risco , Neoplasias Hepáticas/complicações , Neoplasias Colorretais/cirurgia , Neoplasias Colorretais/patologia
11.
J Hematol Oncol ; 16(1): 88, 2023 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-37525244

RESUMO

BACKGROUND: BCMA-directed CAR T-cell therapy (CAR-T) has altered the treatment landscape of relapsed/refractory (r/r) multiple myeloma, but is hampered by unique side effects that can lengthen hospital stays and increase morbidity. Hematological toxicity (e.g. profound and prolonged cytopenias) represents the most common grade ≥ 3 toxicity and can predispose for severe infectious complications. Here, we examined the utility of the CAR-HEMATOTOX (HT) score to predict toxicity and survival outcomes in patients receiving standard-of-care idecabtagene vicleucel and ciltacabtagene autoleucel. METHODS: Data were retrospectively collected from 113 r/r multiple myeloma patients treated between April 2021 and July 2022 across six international CAR-T centers. The HT score-composed of factors related to hematopoietic reserve and baseline inflammatory state-was determined prior to lymphodepleting chemotherapy. RESULTS: At lymphodepletion, 63 patients were HTlow (score 0-1) and 50 patients were HThigh (score ≥ 2). Compared to their HTlow counterparts, HThigh patients displayed prolonged severe neutropenia (median 9 vs. 3 days, p < 0.001), an increased severe infection rate (40% vs. 5%, p < 0.001), and more severe ICANS (grade ≥ 3: 16% vs. 0%, p < 0.001). One-year non-relapse mortality was higher in the HThigh group (13% vs. 2%, p = 0.019) and was predominantly attributable to fatal infections. Response rates according to IMWG criteria were higher in HTlow patients (≥ VGPR: 70% vs. 44%, p = 0.01). Conversely, HThigh patients exhibited inferior progression-free (median 5 vs. 15 months, p < 0.001) and overall survival (median 10.5 months vs. not reached, p < 0.001). CONCLUSIONS: These data highlight the prognostic utility of the CAR-HEMATOTOX score for both toxicity and treatment response in multiple myeloma patients receiving BCMA-directed CAR-T. The score may guide toxicity management (e.g. anti-infective prophylaxis, early G-CSF, stem cell boost) and help to identify suitable CAR-T candidates.


Assuntos
Mieloma Múltiplo , Receptores de Antígenos Quiméricos , Humanos , Mieloma Múltiplo/tratamento farmacológico , Receptores de Antígenos Quiméricos/uso terapêutico , Antígeno de Maturação de Linfócitos B , Prognóstico , Estudos Retrospectivos , Imunoterapia Adotiva
12.
Plant Foods Hum Nutr ; 78(3): 526-532, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37466823

RESUMO

Ilex paraguariensis is a native tree from South America known for the presence of bioactive compounds, and its processed leaves are consumed as hot and cold infusions. After harvest (step 1), the leaves are subjected to flame blanching to inactive the enzymes (step 2), followed by drying and milling (step 3). The impacts of I. paraguariensis processing on leaf composition were investigated by extracting the major compounds (chlorogenic and isochlorogenic acids (3-CQA, 4-CQA, 5-CQA, 3,4-DQA, 3,5-DQA and 4,5-DQA), p-coumaric acid, caffeine and rutin) using different ratios of ethanol and water as extraction solvent (EW 25:75, 50:50, and 75:25 (w/w)). The solvent ratio of EW 50:50 was more effective in extracting the chlorogenic acids isomers, with retention of chlorogenic acids of 3463, 9485, and 9516 µg mL- 1 for steps 1, 2, and 3, respectively. Rutin and p-coumaric acid exhibited similar behavior with the increment of processing steps; however, p-coumaric acid was only detected in steps 2 and 3 for the solvent ratios EW 50:50 and 25:50. The caffeine extraction from I. paraguariensis varied from 936 to 1170 µg mL- 1 for all processing steps, with emphasis on its concentration extracted in step 1. The evolution of processing steps led to a higher retention of phenolic compounds from I. paraguariensis, which was not observed when using different solvent ratios, and the solvent ratio EW 50:50 was more effective for the extraction of chlorogenic acids. The successful extraction of chlorogenic acids from I. paraguariensis in this study proved to be a promising alternative for the use of yerba mate beyond the cuia cup.


Assuntos
Ilex paraguariensis , Cafeína , Extratos Vegetais , Rutina , Solventes
13.
Heliyon ; 9(6): e16336, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37346359

RESUMO

The aim of this study was to analyze the financial and economic risks of tilapia cage culture across different production water volumes (m³). The production water volumes evaluated were 10 to 50 thousand m³ (Small Volume, SV), 51 to 150 thousand m³ (Medium Volume, MV), 151 to 300 thousand m³ (Large Volume, LV), and >301 thousand m³ (Extra-Large Volume, ELV). Productivity and economic data were obtained from a commercial Nile tilapia cage farm with 232 net cages installed in a neotropical reservoir, in Brazil, from 2017 to 2019. Cost and profitability analyses, economic feasibility, and risk and sensitivity analyses were performed using a Monte Carlo simulation. The implementation of commercial tilapia cage farming relies mainly on feed prices. The initial investment demand is proportional to the size of the farms. On the other hand, MV, LV, and ELV tilapia farms showed the lowest financial risks despite the higher investments. These farms presented a medium-low risk at ≈39% probability, whereas the SV farm presented a medium to medium-high risk at 51.17% probability. Thus, fish farms with a production volume above 51 thousand m³ tend to be more profitable and have a ≈36% probability of low financial and economic risk with a Payback period of fewer than 10 years, mainly due to the lower feed costs per mass of fish produced. This study assists investors in choosing a better path toward a more viable and profitable activity.

14.
Microbiol Spectr ; 11(3): e0351922, 2023 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-37227304

RESUMO

Saccharomyces kudriavzevii is a cold-tolerant species identified as a good alternative for industrial winemaking. Although S. kudriavzevii has never been found in winemaking, its co-occurrence with Saccharomyces cerevisiae in Mediterranean oaks is well documented. This sympatric association is believed to be possible due to the different growth temperatures of the two yeast species. However, the mechanisms behind the cold tolerance of S. kudriavzevii are not well understood. In this work, we propose the use of a dynamic genome-scale model to compare the metabolic routes used by S. kudriavzevii at two temperatures, 25°C and 12°C, to decipher pathways relevant to cold tolerance. The model successfully recovered the dynamics of biomass and external metabolites and allowed us to link the observed phenotype with exact intracellular pathways. The model predicted fluxes that are consistent with previous findings, but it also led to novel results which we further confirmed with intracellular metabolomics and transcriptomic data. The proposed model (along with the corresponding code) provides a comprehensive picture of the mechanisms of cold tolerance that occur within S. kudriavzevii. The proposed strategy offers a systematic approach to explore microbial diversity from extracellular fermentation data at low temperatures. IMPORTANCE Nonconventional yeasts promise to provide new metabolic pathways for producing industrially relevant compounds and tolerating specific stressors such as cold temperatures. The mechanisms behind the cold tolerance of S. kudriavzevii or its sympatric relationship with S. cerevisiae in Mediterranean oaks are not well understood. This study proposes a dynamic genome-scale model to investigate metabolic pathways relevant to cold tolerance. The predictions of the model would indicate the ability of S. kudriavzevii to produce assimilable nitrogen sources from extracellular proteins present in its natural niche. These predictions were further confirmed with metabolomics and transcriptomic data. This finding suggests that not only the different growth temperature preferences but also this proteolytic activity may contribute to the sympatric association with S. cerevisiae. Further exploration of these natural adaptations could lead to novel engineering targets for the biotechnological industry.


Assuntos
Saccharomyces cerevisiae , Vinho , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/metabolismo , Temperatura Baixa , Fermentação , Redes e Vias Metabólicas/genética
15.
Cancer Immunol Res ; 11(6): 707-719, 2023 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-37040425

RESUMO

Although CD19-directed chimeric antigen receptor T-cell therapy (CD19.CAR-T) has proven clinical efficacy for multiple refractory B-cell malignancies, over 50% of patients ultimately relapse. Recent evidence has underlined the critical role of the host in determining treatment responses. In this retrospective observational study of 106 patients with relapsed/refractory large B-cell lymphoma receiving standard-of-care CD19.CAR-T, we analyzed the impact of immunometabolic host features and detailed body composition measurements on post-CAR T clinical outcomes. We extracted muscle and adipose tissue distributions from prelymphodepletion CT images and assessed laboratory-based immuno-nutritional scores. Early responders displayed increased total abdominal adipose tissue deposits (TAT: 336 mm3 vs. 266 mm3, P = 0.008) and favorable immuno-nutritional scores compared to nonresponding patients. On univariate Cox regression analysis, visceral fat distribution, sarcopenia, and nutritional indices significantly impacted both progression-free (PFS) and overall survival (OS). Patients with a low skeletal muscle index (SMI; e.g.<34.5), a sarcopenia indicator, exhibited poor clinical outcomes (mOS 3.0 months vs. 17.6 months, log-rank P = 0.0026). Prognostically adverse immuno-nutritional scores were linked to inferior survival [low PNI: HROS, 6.31; 95% confidence interval (CI), 3.35-11.90; P < 0.001]. In a multivariable analysis adjusting for baseline Eastern Cooperative Oncology Group performance status, C-reactive protein, and lactate dehydrogenase, increased TAT was independently associated with improved clinical outcomes (adjusted HROS, 0.27; 95% CI, 0.08-0.90; P = 0.03). We noted particularly favorable treatment outcomes in patients with both increased abdominal fat and muscle mass (TAThigh/SMIhigh: 1-year PFS 50%, 1-year OS 83%). These real-world data provide evidence for a role of body composition and immuno-nutritional status in the context of CD19.CAR-T and suggest that the obesity paradox may extend to modern T cell-based immunotherapies. See related Spotlight by Nawas and Scordo, p. 704.


Assuntos
Linfoma de Células B , Receptores de Antígenos Quiméricos , Sarcopenia , Humanos , Imunoterapia Adotiva/métodos , Sarcopenia/etiologia , Sarcopenia/terapia , Distribuição Tecidual , Recidiva Local de Neoplasia , Antígenos CD19
16.
Hemasphere ; 7(4): e858, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37038465

RESUMO

Early fever after chimeric antigen receptor T-cell (CAR-T) therapy can reflect both an infection or cytokine release syndrome (CRS). Identifying early infections in the setting of CRS and neutropenia represents an unresolved clinical challenge. In this retrospective observational analysis, early fever events (day 0-30) were characterized as infection versus CRS in 62 patients treated with standard-of-care CD19.CAR-T for relapsed/refractory B-cell non-Hodgkin lymphoma. Routine serum inflammatory markers (C-reactive protein [CRP], interleukin-6 [IL-6], procalcitonin [PCT]) were recorded daily. Exploratory plasma proteomics were performed longitudinally in 52 patients using a multiplex proximity extension assay (Olink proteomics). Compared with the CRSonly cohort, we noted increased event-day IL-6 (median 2243 versus 64 pg/mL, P = 0.03) and particularly high PCT levels (median 1.6 versus 0.3 µg/L, P < 0.0001) in the patients that developed severe infections. For PCT, an optimal discriminatory threshold of 1.5 µg/L was established (area under the receiver operating characteristic curve [AUCROC] = 0.78). Next, we incorporated day-of-fever PCT levels with the patient-individual CAR-HEMATOTOX score. In a multicenter validation cohort (n = 125), we confirmed the discriminatory capacity of this so-called HT10 score for early infections at first fever (AUCROC = 0.87, P < 0.0001, sens. 86%, spec. 86%). Additionally, Olink proteomics revealed pronounced immune dysregulation and endothelial dysfunction in patients with severe infections as evidenced by an increased ANGPT2/1 ratio and an altered CD40/CD40L-axis. In conclusion, the high discriminatory capacity of the HT10 score for infections highlights the advantage of dynamic risk assessment and supports the incorporation of PCT into routine inflammatory panels. Candidate markers from Olink proteomics may further refine risk-stratification. If validated prospectively, the score will enable risk-adapted decisions on antibiotic use.

17.
Eur J Cancer ; 184: 151-171, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36931074

RESUMO

BACKGROUND: Imbalanced body composition is mechanistically connected to dysregulated immune activities. Whether overweight/obesity or sarcopenia has an impact on treatment results in cancer patients undergoing immune checkpoint inhibitor (ICI) therapy is currently under debate. We aimed to answer if survival rates and occurrence of immune-related adverse events (irAEs) were different in obese or sarcopenic patients. METHODS: A systematic search was conducted in PubMed, Embase and CENTRAL for all records published until July 2022 using specific search terms for body composition in combination with terms for ICI regimens. Two authors screened independently. All studies that reported on body mass index or sarcopenia measures were selected for further analysis. RESULTS: 48 studies reporting on overweight/obesity comprising of 19,767 patients, and 32 studies reporting on sarcopenia comprising of 3193 patients fulfilled the inclusion criteria. In the entire cohort, overweight/obesity was significantly associated with better progression-free survival (PFS; p = 0.009) and overall survival (OS; p <0.00001). Subgroup analyses stratified by sex revealed that overweight/obese males had the strongest survival benefit (PFS: p = 0.05; OS: p = 0.0005), and overweight/obese female patients did not show any. However, overweight/obese patients of both sexes had a higher risk to develop irAEs grade ≥3 (p = 0.0009). Sarcopenic patients showed significantly shorter PFS (p <0.0001) and OS (p <0.0001). The frequency of irAEs did not differ between sarcopenic and non-sarcopenic patients. CONCLUSION: This meta-analysis suggests that body composition is associated in a sex-specific manner with survival and irAEs in cancer patients undergoing ICI treatment.


Assuntos
Neoplasias , Sarcopenia , Masculino , Humanos , Feminino , Inibidores de Checkpoint Imunológico/efeitos adversos , Sobrepeso , Sarcopenia/induzido quimicamente , Obesidade/complicações , Obesidade/epidemiologia , Composição Corporal
18.
Sensors (Basel) ; 23(6)2023 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-36992059

RESUMO

This paper presents an automated Non-Destructive Testing (NDT) system for the in-service inspection of orbital welds on tubular components operating at temperatures as high as 200 °C. The combination of two different NDT methods and respective inspection systems is here proposed to cover the detection of all potential defective weld conditions. The proposed NDT system combines ultrasounds and Eddy current techniques with dedicated approaches for dealing with high temperature conditions. Phased array ultrasound was employed, searching for volumetric defects within the weld bead volume while Eddy currents were used to look for surface and sub-surface cracks. The results from the phased array ultrasound results showed the effectiveness of the cooling mechanisms and that temperature effects on sound attenuation can be easily compensated for up to 200 °C. The Eddy current results showed almost no influence when temperatures were raised up to 300 °C.

19.
Chem Sci ; 14(3): 458-484, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36741524

RESUMO

Despite their rapid emergence as the dominant paradigm for electrochemical energy storage, the full promise of lithium-ion batteries is yet to be fully realized, partly because of challenges in adequately resolving common degradation mechanisms. Positive electrodes of Li-ion batteries store ions in interstitial sites based on redox reactions throughout their interior volume. However, variations in the local concentration of inserted Li-ions and inhomogeneous intercalation-induced structural transformations beget substantial stress. Such stress can accumulate and ultimately engender substantial delamination and transgranular/intergranular fracture in typically brittle oxide materials upon continuous electrochemical cycling. This perspective highlights the coupling between electrochemistry, mechanics, and geometry spanning key electrochemical processes: surface reaction, solid-state diffusion, and phase nucleation/transformation in intercalating positive electrodes. In particular, we highlight recent findings on tunable material design parameters that can be used to modulate the kinetics and thermodynamics of intercalation phenomena, spanning the range from atomistic and crystallographic materials design principles (based on alloying, polymorphism, and pre-intercalation) to emergent mesoscale structuring of electrode architectures (through control of crystallite dimensions and geometry, curvature, and external strain). This framework enables intercalation chemistry design principles to be mapped to degradation phenomena based on consideration of mechanics coupling across decades of length scales. Scale-bridging characterization and modeling, along with materials design, holds promise for deciphering mechanistic understanding, modulating multiphysics couplings, and devising actionable strategies to substantially modify intercalation phase diagrams in a manner that unlocks greater useable capacity and enables alleviation of chemo-mechanical degradation mechanisms.

20.
Am Surg ; 89(1): 98-107, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33877925

RESUMO

BACKGROUND: Chemotherapy is associated with postoperative ventral incisional hernia (PVIH) after right hemicolectomy (RHC) for colon cancer, and abdominal wall closure technique may affect PVIH. We sought to identify clinical predictors of PVIH. METHODS: We retrospectively analyzed patients who underwent RHC for colon cancer from 2008-2018 and later developed PVIH. Time to PVIH was analyzed with Kaplan-Meier analysis, clinical predictors were identified with multivariable Cox proportional hazards modeling, and the probability of PVIH given chemotherapy and the suture technique was estimated with Bayesian analysis. RESULTS: We identified 399 patients (209 no adjuvant chemotherapy and 190 adjuvant chemotherapy), with an overall PVIH rate of 38%. The 5-year PVIH rate was 55% for adjuvant chemotherapy, compared with 38% for none (log-rank P < .05). Adjuvant chemotherapy (hazard ratio [HR] 1.65, 95% confidence interval [CI] 1.18-2.31, P < .01), age (HR .99, 95% CI .97-1.00, P < .01), body mass index (HR 1.02, 95% CI 1.00-1.04, P < .01), and neoadjuvant chemotherapy (HR 1.92, 95% CI 1.21-3.00, P < .01) were independently associated with PVIH. Postoperative ventral incisional hernia was more common overall in patients who received adjuvant chemotherapy (46% compared with 30%, P < .01). In patients who received adjuvant chemotherapy, the probability of PVIH for incision closure with #1 running looped polydioxanone was 42%, compared with 59% for incision closure with #0 single interrupted polyglactin 910. DISCUSSION: Exposure to chemotherapy increases the probability of PVIH after RHC, and non-short stitch incision closure further increases this probability, more so than age or body mass index. The suture technique deserves further study as a modifiable factor in this high-risk population.


Assuntos
Parede Abdominal , Técnicas de Fechamento de Ferimentos Abdominais , Neoplasias do Colo , Hérnia Ventral , Hérnia Incisional , Humanos , Hérnia Incisional/epidemiologia , Hérnia Incisional/cirurgia , Hérnia Incisional/etiologia , Parede Abdominal/cirurgia , Estudos Retrospectivos , Teorema de Bayes , Técnicas de Fechamento de Ferimentos Abdominais/efeitos adversos , Hérnia Ventral/cirurgia , Hérnia Ventral/etiologia , Técnicas de Sutura , Neoplasias do Colo/tratamento farmacológico , Neoplasias do Colo/cirurgia
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