Joint ABS-UKCGG-CanGene-CanVar consensus regarding the use of CanRisk in clinical practice.

BACKGROUND: The CanRisk tool, which operationalises the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) is used by Clinical Geneticists, Genetic Counsellors, Breast Oncologists, Surgeons and Family History Nurses for breast cancer risk assessments both nationally and internationally. There are currently no guidelines with respect to the day-to-day clinical application of CanRisk and differing inputs to the model can result in different recommendations for practice. METHODS: To address this gap, the UK Cancer Genetics Group in collaboration with the Association of Breast Surgery and the CanGene-CanVar programme held a workshop on 16th of May 2023, with the aim of establishing best practice guidelines. RESULTS: Using a pre-workshop survey followed by structured discussion and in-meeting polling, we achieved consensus for UK best practice in use of CanRisk in making recommendations for breast cancer surveillance, eligibility for genetic testing and the input of available information to undertake an individualised risk assessment. CONCLUSIONS: Whilst consensus recommendations were achieved, the meeting highlighted some of the barriers limiting the use of CanRisk in clinical practice and identified areas that require further work and collaboration with relevant national bodies and policy makers to incorporate wider use of CanRisk into routine breast cancer risk assessments.

Adiponectin links adipose tissue function and monocyte inflammatory responses during bovine metabolic stress.

The periparturient period of dairy cows is characterized by intense lipid mobilization from adipose tissue leading to increased plasma concentrations of nonesterified fatty acids (NEFA). High NEFA are a predisposing factor for inflammatory based diseases. A major component of these diseases is uncontrolled macrophage/monocyte inflammatory responses. Changes in the endocrine activity of adipose tissue during the periparturient period could impact macrophage function by modifying the secretion of adipokines including adiponectin. Currently, the effects of adiponectin on monocyte activation in dairy cattle are unknown. In humans and rodents, this adipokine regulates monocyte phenotype and alterations in its plasma levels are linked with the development of inflammatory diseases. The objectives of this study were to establish associations between plasma adiponectin expression dynamics and different markers of lipid mobilization during the periparturient period of dairy cows and to characterize the effects of adiponectin on the inflammatory response of bovine monocytes. Plasma adiponectin, NEFA, BHB, albumin, and subcutaneous and retroperitoneal fat depots depth were measured during the periparturient period of dairy cows. In vitro, bovine monocytes were cultured with adiponectin to assess changes in pro-inflammatory responses following LPS stimulation. Results from this study demonstrate that alterations in plasma adiponectin levels in periparturient cattle are inversely correlated with the concentrations of plasma NEFA, an important marker of lipid mobilization. Furthermore, adiponectin exposure significantly decreased monocyte expression of TNFα after LPS stimulation thus markedly reducing their inflammatory response. Reduced plasma adiponectin during the periparturient period could predispose dairy cows to the development of uncontrolled monocyte inflammatory responses.