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1.
Methods Mol Biol ; 2599: 255-270, 2023.
Article in English | MEDLINE | ID: mdl-36427155

ABSTRACT

Genetic ablation is a highly efficient method to study regeneration in vivo by stimulating tissue-specific cell death that subsequently induces regrowth and repair in a developing organism. This approach has been particularly successful in Drosophila, for which various temperature-based genetic ablation tools have been developed to explore the complexities of regeneration in larval imaginal discs. Here, we describe the use of a recently established ablation system called DUAL Control, which can be used to both characterize the damage response and genetically manipulate blastema cells to identify novel regulators of regeneration.


Subject(s)
Drosophila Proteins , Imaginal Discs , Animals , Imaginal Discs/metabolism , Drosophila/genetics , Drosophila Proteins/metabolism , Wound Healing/physiology , Larva/metabolism
2.
Br J Anaesth ; 121(1): 249-259, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29935579

ABSTRACT

BACKGROUND: Despite its designation as a 'dissociative anaesthetic,' the dissociative and psychoactive effects of ketamine remain incompletely understood. The goal of this study was to characterise the subjective experiences and accompanying EEG changes with subanaesthetic doses of ketamine. METHODS: High-density EEG was recorded in 15 human volunteers before, during, and after subanaesthetic ketamine infusion (0.5 mg kg-1 over 40 min), with self-reported measures of altered states of consciousness obtained after ketamine exposure. Sensor- and source-level EEG changes were analysed with a focus on spectral power and regional changes. RESULTS: Ketamine-induced altered states were characterised predominantly by dissociative experiences such as disembodiment and ego transcendence; sensory disturbances were also common. Ketamine broadly decreased low-frequency power, with mean reductions largest at alpha (8-12 Hz) in parietal (-0.94 dB, P<0.001) and occipital (-1.8 dB, P<0.001) channel clusters. Significant decreases in alpha were identified in the precuneus and temporal-parietal junction. CONCLUSIONS: Ketamine induces altered states of consciousness during periods of reduced alpha power in the precuneus and temporal-parietal junction. Modulation of these temporal-parietal loci are candidate mechanisms of the psychoactive effects of ketamine, given that this region is involved in multisensory integration, body representation, and consciousness.


Subject(s)
Anesthetics, Dissociative/pharmacology , Consciousness Disorders/chemically induced , Ketamine/pharmacology , Adult , Alpha Rhythm/drug effects , Anesthesia , Brain/drug effects , Brain Mapping , Ego , Electroencephalography , Female , Healthy Volunteers , Humans , Magnetic Resonance Imaging , Male , Psychometrics , Sensation Disorders/chemically induced , Sensation Disorders/psychology , Young Adult
3.
Neuroscientist ; 24(5): 501-515, 2018 10.
Article in English | MEDLINE | ID: mdl-29283020

ABSTRACT

Neural functioning and plasticity can be studied on different levels of organization and complexity ranging from the molecular and synaptic level to neural circuitry of whole brain networks. Across neuroscience different methods are being applied to better understand the role of various neurotransmitter systems in the evolution of perception and cognition. GABA is the main inhibitory neurotransmitter in the adult mammalian brain and, depending on the brain region, up to 25% of the total number of cortical neurons are GABAergic interneurons. At the one end of the spectrum, GABAergic neurons have been accurately described with regard to cell morphological, molecular, and electrophysiological properties; at the other end researchers try to link GABA concentrations in specific brain regions to human behavior using magnetic resonance spectroscopy. One of the main challenges of modern neuroscience currently is to integrate knowledge from highly specialized subfields at distinct biological scales into a coherent picture that bridges the gap between molecules and behavior. In the current review, recent findings from different fields of GABA research are summarized delineating a potential strategy to develop a more holistic picture of the function and role of GABA.


Subject(s)
Brain/cytology , Cognition/physiology , GABAergic Neurons/physiology , gamma-Aminobutyric Acid/metabolism , Animals , Humans , Neuronal Plasticity/drug effects , Neuronal Plasticity/physiology
4.
Eur J Pain ; 20(7): 1079-89, 2016 08.
Article in English | MEDLINE | ID: mdl-26773435

ABSTRACT

BACKGROUND: Fibromyalgia is a chronic widespread pain condition, with patients commonly reporting other symptoms such as sleep difficulties, memory complaints and fatigue. The use of magnetic resonance imaging (MRI) in fibromyalgia has allowed for the detection of neural abnormalities, with alterations in brain activation elicited by experimental pain and alterations in resting state connectivity related to clinical pain. METHODS: In this study, we sought to monitor state changes in resting brain connectivity following experimental pressure pain in fibromyalgia patients and healthy controls. Twelve fibromyalgia patients and 15 healthy controls were studied by applying discrete pressure stimuli to the thumbnail bed during MRI. Resting-state functional MRI scanning was performed before and immediately following experimental pressure pain. We investigated changes in functional connectivity to the thalamus and the insular cortex. RESULTS: Acute pressure pain increased insula connectivity to the anterior cingulate and the hippocampus. Additionally, we observed increased thalamic connectivity to the precuneus/posterior cingulate cortex, a known part of the default mode network, in patients but not in controls. This connectivity was correlated with changes in clinical pain. CONCLUSIONS: These data reporting changes in resting-state brain activity following a noxious stimulus suggest that the acute painful stimuli may contribute to the alteration of the neural signature of chronic pain. WHAT DOES THIS STUDY/ADD?: In this study acute pain application shows an echo in functional connectivity and clinical pain changes in chronic pain.


Subject(s)
Acute Pain/diagnostic imaging , Acute Pain/physiopathology , Brain/physiopathology , Fibromyalgia/diagnostic imaging , Fibromyalgia/physiopathology , Magnetic Resonance Imaging , Acute Pain/etiology , Adult , Brain/diagnostic imaging , Brain Mapping , Chronic Pain/physiopathology , Female , Fibromyalgia/complications , Humans , Male , Middle Aged , Pain Measurement , Pressure , Rest
5.
Neuroimage Clin ; 6: 252-61, 2014.
Article in English | MEDLINE | ID: mdl-25379438

ABSTRACT

Fibromyalgia is a chronic pain syndrome characterized by widespread pain, fatigue, and memory and mood disturbances. Despite advances in our understanding of the underlying pathophysiology, treatment is often challenging. New research indicates that changes in functional connectivity between brain regions, as can be measured by magnetic resonance imaging (fcMRI) of the resting state, may underlie the pathogenesis of this and other chronic pain states. As such, this parameter may be able to be used to monitor changes in brain function associated with pharmacological treatment, and might also be able to predict treatment response. We performed a resting state fcMRI trial using a randomized, placebo-controlled, cross-over design to investigate mechanisms of action of milnacipran (MLN), a selective serotonin and norepinephrine reuptake inhibitor (SNRI), in fibromyalgia patients. Our aim was to identify functional connectivity patterns at baseline that would differentially predict treatment response to MLN as compared to placebo. Since preclinical studies of MLN suggest that this medication works by augmenting antinociceptive processes, we specifically investigated brain regions known to be involved in pain inhibition. 15 fibromyalgia patients completed the study, consisting of 6 weeks of drug and placebo intake (order counterbalanced) with an interspersed 2 week wash out period. As a main finding we report that reductions in clinical pain scores during MLN were associated with decreased functional connectivity between pro-nociceptive regions and antinociceptive pain regions at baseline, specifically between the rostral part of the anterior cingulate cortex (ACC) and the insular cortex (IC), as well as between the periaqueductal gray (PAG) and the IC: patients with lower preexisting functional connectivity had the greatest reduction in clinical pain. This pattern was not observed for the placebo period. However a more robust placebo response was associated with lower baseline functional connectivity between the ACC and the dorsolateral prefrontal cortex. This study indicates that ACC-IC connectivity might play a role in the mechanism of action of MLN, and perhaps more importantly fcMRI might be a useful tool to predict pharmacological treatment response.


Subject(s)
Brain/drug effects , Brain/physiopathology , Cyclopropanes/pharmacology , Cyclopropanes/therapeutic use , Fibromyalgia/drug therapy , Selective Serotonin Reuptake Inhibitors/pharmacology , Selective Serotonin Reuptake Inhibitors/therapeutic use , Adult , Brain Mapping , Cross-Over Studies , Double-Blind Method , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Milnacipran , Placebos , Rest
6.
AJNR Am J Neuroradiol ; 32(10): 1873-8, 2011.
Article in English | MEDLINE | ID: mdl-21868622

ABSTRACT

BACKGROUND AND PURPOSE: Widespread pain sensitivity in patients with FM suggests a CNS processing problem. The purpose of this study was to assess alterations in perfusion as measured by DSC in a number of brain regions implicated in pain processing between patients with FM and healthy controls. MATERIALS AND METHODS: Twenty-one patients with FM and 27 healthy controls underwent conventional MR imaging and DSC. For DSC, 12 regions of interest were placed in brain regions previously implicated in pain processing. rCBF values were calculated for each region of interest. Subjects answered mood/pain coping questionnaires and underwent clinical/experimental pain assessment. RESULTS: There were significant correlations between the thalamic rCBF values and the pain-control beliefs of FM subjects. The strength of the relationship between clinical pain measures and thalamic rCBF values increased after adjusting for pain-control beliefs. There was a significantly different distribution pattern of rCBF values across various brain regions between the FM group and the healthy controls. There was a lower degree of correlation in the FM group between the thalamic rCBF values and the other brain regions relative to the healthy controls. CONCLUSIONS: Significant correlations were found between thalamic rCBF values and pain belief values. These data suggest that there are baseline alterations of brain perfusion in patients with FM. rCBF values of the thalami exhibited lower correlations with respect to other brain regions thought to be involved in pain processing compared with those in healthy controls.


Subject(s)
Brain Mapping/methods , Cerebrovascular Circulation , Fibromyalgia/complications , Magnetic Resonance Angiography/methods , Nerve Net/physiopathology , Pain/complications , Pain/physiopathology , Adult , Female , Fibromyalgia/physiopathology , Humans , Male , Middle Aged , Young Adult
7.
Inflammopharmacology ; 17(2): 55-67, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19340409

ABSTRACT

The existing epidemiologic literature was comprehensively reviewed to retrieve all epidemiologic studies (case control and cohort studies) that examined exposure to traditional over the counter nonsteroidal anti-inflammatory drugs (OTC NSAIDs) and the risk of cancers of the colon, breast, prostate and lung from 1980 forward. These malignancies account for more that half of all cancer deaths in the United States and the United Kingdom. Estimates of effects (relative risks or odds ratios) and 95% confidence intervals were abstracted from these reports for meta-analysis. Regular intake of OTC NSAIDs produced highly significant composite risk reductions of 43% for colon cancer, 25% for breast cancer, 28% for lung cancer, and 27% for prostate cancer. Furthermore, in a series of case control studies, daily use of a selective COX-2 inhibitor, either celecoxib or rofecoxib, significantly reduced the risk for each of these malignancies. The evidence is compelling that anti-inflammatory agents with selective or non-selective activity against cycloooxygenase- 2 (COX-2) have strong potential for the chemoprevention of cancers of the colon, breast, prostate and lung. Results confirming that COX-2 blockade is effective for cancer prevention have been tempered by observations that some selective COX-2 inhibitors pose a risk to the cardiovascular system. Nevertheless, meta-analysis of independent estimates from 72 studies provides no evidence that the selective COX-2 inhibitor, celecoxib, influences the relative risk of cardiovascular disease (composite relative risk = 0.98, 95% CI = 0.88-1.10). Molecular studies reveal that over-expression of COX-2 is a prominent feature of premalignant and malignant neoplasms. Evidence is accumulating that carcinogenesis often evolves as a progressive series of highly specific cellular and molecular changes in response to induction of constitutive over-expression of COX-2 and the prostaglandin cascade in the "inflammogenesis of cancer".


Subject(s)
Anticarcinogenic Agents/therapeutic use , Breast Neoplasms/prevention & control , Colonic Neoplasms/prevention & control , Cyclooxygenase 2 Inhibitors/therapeutic use , Lung Neoplasms/prevention & control , Prostatic Neoplasms/prevention & control , Animals , Anticarcinogenic Agents/pharmacology , Breast Neoplasms/enzymology , Colonic Neoplasms/enzymology , Cyclooxygenase 2 Inhibitors/pharmacology , Female , Humans , Lung Neoplasms/enzymology , Male , Prostatic Neoplasms/enzymology
8.
Bone Marrow Transplant ; 42(3): 159-65, 2008 Aug.
Article in English | MEDLINE | ID: mdl-18500373

ABSTRACT

Allogeneic hematopoietic stem cell transplantation (HSCT) is the only potentially curative treatment for the BM dysfunction seen in patients with Shwachman-Diamond syndrome (SDS). Historically, these patients have fared poorly with intensive conditioning regimens with increased regimen-related toxicity especially involving the heart and lungs. We report our institutional experience with a reduced-intensity-conditioning protocol in seven patients with SDS and BM aplasia or myelodysplastic syndrome/AML. The preparative regimen consisted of Campath-1H, fludarabine and melphalan. Four patients received matched related marrow and three received unrelated stem cells (two PBSCs and one marrow). All but one was 8 of 8 allele HLA matched. All patients established 100% donor-derived hematopoiesis. No patient in this cohort developed grades III-IV GVHD. One patient had grade II skin GVHD that responded to systemic corticosteroids and one had grade I skin GVHD, treated with topical corticosteroids. Two out of seven patients developed bacterial infections in the early post transplant period. Viral infections were seen in four out of seven patients and were successfully treated with appropriate antiviral therapy. All patients are currently alive. These data indicate that HSCT with reduced-intensity conditioning is feasible in patients with SDS and associated with excellent donor cell engraftment and modest morbidity.


Subject(s)
Abnormalities, Multiple/surgery , Pancreatic Diseases/surgery , Stem Cell Transplantation , Transplantation Conditioning/methods , Adult , Alemtuzumab , Antibodies, Monoclonal/therapeutic use , Antibodies, Monoclonal, Humanized , Antibodies, Neoplasm/therapeutic use , Child , Child, Preschool , Drug Therapy, Combination , Female , Graft vs Host Disease/prevention & control , Humans , Male , Melphalan/therapeutic use , Transplantation Conditioning/adverse effects , Vidarabine/analogs & derivatives , Vidarabine/therapeutic use
9.
AJNR Am J Neuroradiol ; 29(5): 913-8, 2008 May.
Article in English | MEDLINE | ID: mdl-18339723

ABSTRACT

BACKGROUND AND PURPOSE: Widespread pain sensitivity in patients with fibromyalgia (FM) suggests a central nervous system (CNS)-processing problem. Therefore, it is conceivable that metabolic alterations exist in pain-processing brain regions of people with FM compared with healthy controls (HC) and that such metabolic data could correlate with clinical symptoms. The purpose of this study was to test these hypotheses using proton MR spectroscopy ((1)H-MR spectroscopy). MATERIALS AND METHODS: There were 21 patients with FM and 27 HC who underwent conventional structural MR imaging and additional 2D-chemical shift imaging (CSI) MR-spectroscopy sequences. For the 2D-CSI spectroscopy, larger volumes of interest (VOIs) were centered at the level of the basal ganglia and the supraventricular white matter. Within these larger areas, 16 smaller voxels were placed in a number of regions previously implicated in pain processing. N-acetylaspartate (NAA)/creatine(Cr), choline (Cho)/Cr and NAA/Cho ratios were calculated for each voxel. Subjects underwent clinical and experimental pain assessment. RESULTS: Mean metabolite ratios and ratio variability for each region were analyzed by using repeated-measures analysis of variance (ANOVA). Correlations between clinical symptoms and metabolite ratios were assessed. Cho/Cr variability in the right dorsolateral prefrontal cortex (DLPFC) was significantly different in the 2 groups; a significant correlation between Cho/Cr in this location and clinical pain was present in the FM group. Evoked pain threshold correlated significantly with NAA/Cho ratios in the left insula and left basal ganglia. CONCLUSION: Our data suggest that there are baseline differences in the variability of brain metabolite relative concentrations between patients with FM and HC, especially in the right DLPFC. Furthermore, there are significant correlations between metabolite ratios and clinical and experimental pain parameters in patients with FM.


Subject(s)
Brain/metabolism , Fibromyalgia/diagnosis , Fibromyalgia/metabolism , Magnetic Resonance Spectroscopy/methods , Protons , Severity of Illness Index , Adult , Female , Humans , Male , Middle Aged , Reference Values , Reproducibility of Results , Sensitivity and Specificity , Statistics as Topic
10.
Curr Pain Headache Rep ; 6(5): 370-4, 2002 Oct.
Article in English | MEDLINE | ID: mdl-12357980

ABSTRACT

Complementary medical therapies are commonly used for the treatment and management of myofascial pain. No universally accepted therapy for this condition exists; consequently, patients often seek alternative and complementary therapies. Many complementary treatments are available.This article focuses on acupuncture, biofeedback, ultrasound, lasers, and massage. Although anecdotally claimed as effective, most of these modalities have not been rigorously investigated because of poor research quality. Appropriate controls, sample sizes, and blinding measures are often lacking. Despite these issues, the trend toward efficacy exists and further examination is warranted.


Subject(s)
Complementary Therapies , Myofascial Pain Syndromes/therapy , Humans
11.
Leukemia ; 16(4): 594-600, 2002 Apr.
Article in English | MEDLINE | ID: mdl-11960338

ABSTRACT

Despite prolonged therapy (18 months), children with advanced non-lymphoblastic, non-Hodgkin's lymphoma (NHL) treated on previous Children's Cancer Group (CCG) trials achieved less than a 60% 5-year event-free survival (EFS). In this study we piloted a shorter but more intensive protocol ('Orange') to determine the feasibility, safety, and efficacy of this alternative treatment approach. Thirty-nine children received a CHOP-based induction, etoposide/ifosfamide consolidation, DECAL (dexamethasone, etoposide, cisplatin, cytosine arabinoside (Ara-C) and L-asparaginase) intensification, and either one or two similar but less intense maintenance courses. Patients were stratified to standard-risk (5 months) vs high-risk (7 months) treatment. High risk was defined as either bone marrow disease, CNS disease, mediastinal mass > or = one-third thoracic diameter at T5 and/or LDH > or =2 times institutional upper limits of normal. All other patients were considered to be standard risk. Results were compared with the previous CCG NHL study (CCG-503). Sixteen and 23 patients were considered standard- vs. high-risk, respectively. The 5-year EFS and overall survival (OS) were 77 +/- 7% and 80 +/- 7%, respectively. The 5-year EFS and OS were significantly better in the standard- vs. high-risk subgroups (100% vs. 61 +/- 11%) (P < 0.003) and (100% vs. 65 +/- 11%) (P < 0.01), respectively. Lactate dehydrogenase (LDH) > or =2 x normal (NL) was associated with significantly poorer outcomes (LDH > or =2 x NL vs. <2 x NL) (5-year EFS: 55 +/- 12% vs. 100%) (P < 0.0004). This CCG hybrid regimen, 'Orange', of short and more intensive therapy resulted in a significant improvement in outcomes compared with the previous CCG trial of more prolonged but less intense therapy. This regimen that deletes high-dose methotrexate, if confirmed in a larger trial, could be considered as an alternative treatment approach in children without high tumor burdens (LDH <2 x NL) and Murphy stage III disease.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Lymphoma, Non-Hodgkin/drug therapy , Adolescent , Adult , Child , Child, Preschool , Disease-Free Survival , Female , Follow-Up Studies , Humans , L-Lactate Dehydrogenase/metabolism , Lymphoma, Non-Hodgkin/enzymology , Lymphoma, Non-Hodgkin/pathology , Male , Methotrexate/administration & dosage , Neoplasm Staging , Pilot Projects , Prognosis , Treatment Outcome
12.
Exp Hematol ; 29(11): 1336-46, 2001 Nov.
Article in English | MEDLINE | ID: mdl-11698130

ABSTRACT

BACKGROUND: Autologous bone marrow transplantation is an important therapy for patients with acute myelogenous leukemia (AML). However, leukemia in the graft may contribute to posttransplant relapse. Treatment of the graft with 4-hydroperoxycyclophosphamide (4HC) is sometimes used to decrease numbers of infused leukemia cells (4HC purging). No large controlled trials evaluating efficacy and toxicity of 4HC purging are reported. METHODS: We studied 294 patients reported to the Autologous Blood and Marrow Registry receiving either a 4HC-purged (n = 211) or unpurged (n = 83) autograft for AML in first (n = 209) or second (n = 85) remission. Analyses were restricted to patients transplanted less than 6 months after achieving remission. Using Cox proportional hazards regression, we compared time to treatment failure (death or relapse, inverse of leukemia-free survival) after 4HC-purged vs unpurged transplants while controlling for important prognostic factors. RESULTS: Median duration of posttransplant neutropenia was 40 (range, 10-200) days after 4HC-purged transplants and 29 (9-97) days after unpurged transplants (p < 0.01). Transplant-related mortality was similar in the two groups. In multivariate analysis, patients receiving 4HC-purged transplants had lower risks of treatment failure than those receiving unpurged transplants (relative risk, 0.69, p = 0.12 in the first posttransplant year; relative risk, 0.28, p < 0.0001 thereafter). Adjusted three-year probabilities of leukemia-free survival (95% confidence interval) were 56% (47-64%) and 31% (18-45%) after 4HC-purged and unpurged transplants in first remission, respectively. Corresponding probabilities in second remission were 39% (25-53%) and 10% (1-29%). CONCLUSION: Grafts purged with 4HC are associated with higher leukemia-free survival after autologous bone marrow transplants for AML.


Subject(s)
Bone Marrow Purging/methods , Bone Marrow Transplantation/methods , Cyclophosphamide/analogs & derivatives , Leukemia, Myeloid/therapy , Acute Disease , Adolescent , Adult , Americas/epidemiology , Bone Marrow Transplantation/mortality , Child , Child, Preschool , Disease-Free Survival , Female , Graft Survival , Humans , Infant , Leukemia, Myeloid/mortality , Leukemia, Myeloid/pathology , Life Tables , Male , Middle Aged , Prognosis , Proportional Hazards Models , Registries , Remission Induction , Retrospective Studies , Risk , Survival Analysis , Transplantation, Autologous , Treatment Outcome
13.
Int J Oncol ; 19(3): 445-9, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11494020

ABSTRACT

Pulmonary adenocarcinoma (PAC) is the leading type of lung cancer and is highly resistant to conventional cancer therapy. A better understanding of the regulatory mechanisms which control the growth of this deadly malignancy are urgently needed to develop more effective cancer intervention strategies. Recent studies have shown that PAC frequently overexpresses cyclooxygenase-2 (COX-2). This enzyme converts arachidonic acid (AA) into several metabolites, some of which have been identified as modulators of mitogenesis and apoptosis. Accordingly, the AA cascade and COX-2 are currently widely studied as potential targets for lung cancer prevention. Recent studies by our research group have shown that cell lines derived from human PACs express beta1- and beta2-adrenergic receptors, which regulate the release of AA and DNA synthesis. Moreover, we have demonstrated that an antagonist for beta-adrenergic receptors or aspirin inhibited the development of experimentally induced PAC in a hamster model. These findings suggest that beta-adrenergic receptors may serve as upstream regulators of AA and COX-2-mediated PAC growth. However, no information is currently available on the expression of beta-adrenergic receptors and its possible correlation with the expression of COX-2 in tissue samples from human PAC, casting some doubt on the significance of these findings in vitro and in an animal model. In the current study, we have therefore analyzed tissue samples of human PACs for the expression of beta1-and beta2-adrenergic receptors as well as COX-2 by reverse transcription polymerase chain reaction (RT-PCR) or immunohistochemistry. Our data show that seven out of eight samples co-expressed COX-2 and one or both of these beta-adrenergic receptors, supporting the experimental evidence for a functional link between these neurotransmitter receptors and the AA cascade in the regulation of human PAC.


Subject(s)
Adenocarcinoma/metabolism , Isoenzymes/metabolism , Lung Neoplasms/metabolism , Prostaglandin-Endoperoxide Synthases/metabolism , Receptors, Adrenergic, beta-1/metabolism , Receptors, Adrenergic, beta-2/metabolism , Cyclooxygenase 2 , DNA Primers/chemistry , Epithelial Cells/pathology , Humans , Immunoenzyme Techniques , Isoenzymes/genetics , Membrane Proteins , Paraffin Embedding , Prostaglandin-Endoperoxide Synthases/genetics , RNA, Messenger/metabolism , Receptors, Adrenergic, beta-1/genetics , Receptors, Adrenergic, beta-2/genetics , Reverse Transcriptase Polymerase Chain Reaction
14.
Biol Blood Marrow Transplant ; 7(4): 208-15, 2001.
Article in English | MEDLINE | ID: mdl-11349807

ABSTRACT

Patients with aplastic anemia who do not have suitably HLA-matched, related donors generally receive immunosuppressive treatment as first-line therapy and are considered for transplantation from an unrelated donor only if they fail to respond to immunosuppressive treatment. In this setting, rates of transplantation-related morbidity and mortality have been high. We conducted a prospective study to determine the minimal dose of total body irradiation (TBI) sufficient to achieve sustained engraftment when it is used in combination with 3 cycles of 30 mg/kg of antithymocyte globulin (ATG) and 4 cycles of 50 mg/kg of cyclophosphamide (CY). We also wanted to determine the tolerability and toxicity of the regimen. The starting dosage of TBI was 3 x 200 cGy given over 2 days following CY/ATG. The TBI dose was to be escalated in increments of 200 cGy if graft failure occurred in the absence of prohibitive toxicity, and de-escalated for toxicity in the absence of graft failure. Twenty-one female and 29 male patients aged 1.3 to 46.5 years (median age, 14.4 years) underwent transplantation at 14 medical centers. The time interval from diagnosis to transplantation was 2.8 to 264 months (median, 14.5 months). All patients had been transfused multiple times and all had received 1 to 11 courses (median, 4 courses) of immunosuppressive treatment and other modalities of treatment. In 38 cases, the donors were HLA-A, -B and -DR phenotypically matched with the patients, and, in 12 cases, the donor phenotype differed from that of the recipient by 1 HLA antigen. Recipients of mismatched transplants were considered separately for TBI dose modification, and this study is still ongoing. Seven patients did not tolerate ATG and were prepared with 6 x 200 cGy of TBI plus 120 mg/kg of CY. Of the HLA-matched recipients prepared with CY/ATG/TBI, all 20 who received 3 x 200 or 2 x 200 cGy of TBI achieved engraftment, and 10 are alive. Of the 13 patients who received 1 x 200 cGy of TBI, 1 failed to engraft, and 8 are alive. Each of 10 patients who received an HLA-nonidentical transplant achieved engraftment, and 3 of 6 who were given 3 x 200 cGy of TBI, and 4 of 4 who were given 2 x 200 cGy are alive. Pulmonary toxicity occurred in 8 of 30 patients who were given 3 x 200 or 2 x 200 cGy of TBI concurrently with ATG and CY at 200 mg/kg, and in 2 of 13 patients who received 1 x 200 cGy of TBI, a pattern that suggests a decrease in toxicity with TBI dose de-escalation. Overall, the highest probability of survival (73%) was observed among patients who underwent transplantation within 1 year of diagnosis, compared with patients who underwent transplantation after a longer period of disease. In addition, younger patients (aged < or = 20 years) were more likely to survive than older patients (aged > 20 years). Thus, for patients with an HLA-matched, unrelated donor, a TBI dose of 200 cGy (in combination with CY/ATG) was sufficient to allow for engraftment without inducing prohibitive toxicity. As in previous studies, patient age and pretransplantation disease duration remain important prognostic factors.


Subject(s)
Anemia, Aplastic/therapy , Bone Marrow Transplantation , Tissue Donors , Transplantation Conditioning , Whole-Body Irradiation , Adolescent , Adult , Anemia, Aplastic/drug therapy , Anemia, Aplastic/mortality , Antilymphocyte Serum/therapeutic use , Bone Marrow Transplantation/mortality , Cyclophosphamide , Dose-Response Relationship, Radiation , Female , Graft Survival , Graft vs Host Disease/mortality , Graft vs Host Disease/prevention & control , Histocompatibility , Humans , Immunosuppressive Agents/therapeutic use , Infections/etiology , Infections/mortality , Lung Diseases/etiology , Lung Diseases/mortality , Male , Middle Aged , Multiple Organ Failure/etiology , Multiple Organ Failure/mortality , Prospective Studies , Radiation Injuries/etiology , Radiotherapy Dosage , Salvage Therapy , Survival Rate , T-Lymphocytes , Transplantation Conditioning/adverse effects , Transplantation Conditioning/mortality , Treatment Outcome , Whole-Body Irradiation/adverse effects , Whole-Body Irradiation/mortality
15.
Oncol Rep ; 8(3): 655-7, 2001.
Article in English | MEDLINE | ID: mdl-11295097

ABSTRACT

Recent human epidemiologic studies suggest that non-steroidal anti-inflammatory drugs (NSAIDs) have preventive effects against cancers of the colon, breast, and prostate. Laboratory and animal studies also provide evidence of antineoplastic effects of NSAIDs against a variety of solid tumors, including skin cancer. We studied the effects of NSAIDs on malignant melanoma in women utilizing a case control experimental design involving 110 women with histologically proven malignant melanoma, and 609 female controls frequency matched to the cases on age, and place of residence. We observed a significant decrease in the relative risk (RR) of malignant melanoma with regular intake of common over the counter NSAIDs such as aspirin and ibuprofen (RR = 0.45, 95% CI = 0.22-0.92, p < 0.05). Adjustment for sun exposure did not change the magnitude of the estimate. Our results are the first to show that NSAIDs may have value in the chemoprevention of malignant melanoma.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Aspirin/administration & dosage , Ibuprofen/administration & dosage , Melanoma/prevention & control , Skin Neoplasms/prevention & control , Case-Control Studies , Female , Humans , Melanoma/epidemiology , Middle Aged , Risk Factors , Skin Neoplasms/epidemiology
16.
Anticancer Res ; 21(5): 3425-32, 2001.
Article in English | MEDLINE | ID: mdl-11848504

ABSTRACT

Recent chemopreventive studies in our laboratories showed that the COX-2 inhibitor, celecoxib, inhibited the induction of mammary cancer by 7,12-dimethylbenz(a)anthracene (DMBA). In this study, we examined the relative chemopreventive effect of varying doses of celecoxib on the development and growth of DMBA-induced rat mammary tumors. At 10 days prior to receiving a single intragastric dose of 15 mg DMBA/rat, female Sprague-Dawley rats were fed a control chow diet or diets containing 250, 500, 1000 or 1500 ppm celecoxib until termination of the experiment. Administration of increasing doses of celecoxib inhibited mammary tumor incidence and multiplicity as well as tumor volume in a dose-dependent manner. At 122 days post DMBA-intubation, mammary tumor incidence was 100% in the control rats compared to 80%, 50%, 45% and 25% in rats receiving 250, 500, 1000 or 1500 ppm celecoxib, respectively (p<0.001). Similarly, tumor multiplicity and tumor volume were significantly reduced by increasing the dose of celecoxib from 250 to 1500 ppm in the diet. The control rats had an average of 3.46 tumors/rat compared to 1.80, 1.00, 0.75 and 0.50 tumors/rat in animals receiving 250, 500, 1000 or 1500 ppm celecoxib, respectively (p<0.001). Average tumor volumes in rats fed 250, 500, 1000 or 1500 ppm celecoxib were 0.42, 0.34, 0.31 and 0.16 cm3 compared to 1.29 cm3 in the control rats (p<0.001). There was a concomitant increase in the steady-state serum concentration of celecoxib with the dose. These results indicate that, in this rat model, the chemopreventive effect of celecoxib against breast cancer is dose-dependent and that celecoxib is effective even at lower dose levels.


Subject(s)
Anticarcinogenic Agents/pharmacology , Cyclooxygenase Inhibitors/pharmacology , Mammary Neoplasms, Experimental/prevention & control , Sulfonamides/pharmacology , 9,10-Dimethyl-1,2-benzanthracene/antagonists & inhibitors , Animals , Carcinogens/antagonists & inhibitors , Celecoxib , Cyclooxygenase 2 , Cyclooxygenase 2 Inhibitors , Dose-Response Relationship, Drug , Female , Isoenzymes/antagonists & inhibitors , Isoenzymes/biosynthesis , Mammary Neoplasms, Experimental/chemically induced , Mammary Neoplasms, Experimental/enzymology , Mammary Neoplasms, Experimental/pathology , Prostaglandin-Endoperoxide Synthases/biosynthesis , Pyrazoles , Rats , Rats, Sprague-Dawley
17.
Oncol Rep ; 7(6): 1377-81, 2000.
Article in English | MEDLINE | ID: mdl-11032948

ABSTRACT

Epidemiological and experimental studies have shown that non-steroidal anti-inflammatory drugs (NSAIDs) reduce the relative risk of human cancer, including breast cancer. Recently, research studies in our laboratories have shown that the selective cyclooxygenase-2 (COX-2) blocker, Celecoxib, given daily in the diet, significantly inhibited the induction of rat mammary tumors by 7, 12-dimethylbenz(a)anthracene (DMBA). These studies were extended to evaluate Celecoxib for its effectiveness as an antineoplastic agent in this rat mammary tumor model. We examined the growth inhibitory effects of Celecoxib, given daily in the diet, on the volume and the number of established mammary tumors, vis-a-vis the cancer load (CL). Tumors continued to grow actively in control rats fed chow diet only. In contrast, the Celecoxib-supplemented diet (1500 mg/kg diet) significantly decreased the size of the mammary tumors in rats over the 6 week treatment period, resulting in an average reduction in tumor volume of approximately 32%, relative to the baseline volume (p<0.04). At the end of the 6 week treatment period, average tumor volume was 1.45 cm3 and 0.13 cm3 in the control and Celecoxib treated rats respectively. Tumor regression occurred in 90% of the rats. In addition, new tumors continued to emerge in the control group, in contrast to their significantly decreasing numbers in the Celecoxib treated group over the same time period (p<0.05). These results indicate that Celecoxib has significant antineoplastic activity, in addition to its anticarcinogenic effects.


Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Agents/pharmacology , Cyclooxygenase Inhibitors/pharmacology , Isoenzymes/antagonists & inhibitors , Mammary Neoplasms, Experimental/drug therapy , Sulfonamides/pharmacology , 9,10-Dimethyl-1,2-benzanthracene , Adenocarcinoma/chemically induced , Adenocarcinoma/pathology , Animals , Body Weight/drug effects , Carcinogens , Celecoxib , Cyclooxygenase 2 , Cyclooxygenase 2 Inhibitors , Eating/drug effects , Female , Mammary Neoplasms, Experimental/chemically induced , Mammary Neoplasms, Experimental/pathology , Prostaglandin-Endoperoxide Synthases , Pyrazoles , Rats , Rats, Sprague-Dawley
18.
Cancer Res ; 60(8): 2101-3, 2000 Apr 15.
Article in English | MEDLINE | ID: mdl-10786667

ABSTRACT

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been observed to reduce the relative risk of breast cancer. This prompted our investigation of the chemopreventive potential of celecoxib, a specific cyclooxygenase 2 blocker, against mammary carcinogenesis induced by 7,12-dimethyl-benz(a)anthracene in female Sprague Dawley rats. Treatment with celecoxib was examined and compared to treatment with the general NSAID, ibuprofen, and to a control group receiving only dimethylbenz(a)anthracene. Dietary administration of celecoxib (1500 ppm) produced striking reductions in the incidence, multiplicity, and volume of breast tumors relative to the control group (68%, 86%, and 81%, respectively; P < 0.001). Ibuprofen also produced significant effects, but of lesser magnitude (40%, 52%, and 57%, respectively; P < 0.001). These results help confirm the chemopreventive activity of NSAIDs against breast cancer and provide the first evidence that a cyclooxygenase 2 blocking agent, celecoxib, possesses strong chemopreventive activity against mammary carcinogenesis.


Subject(s)
Anticarcinogenic Agents/therapeutic use , Cyclooxygenase Inhibitors/therapeutic use , Isoenzymes/pharmacology , Mammary Neoplasms, Animal/pathology , Mammary Neoplasms, Animal/prevention & control , Prostaglandin-Endoperoxide Synthases/pharmacology , Sulfonamides/therapeutic use , 9,10-Dimethyl-1,2-benzanthracene/toxicity , Animals , Anticarcinogenic Agents/adverse effects , Anticarcinogenic Agents/blood , Anticarcinogenic Agents/pharmacology , Body Weight/drug effects , Celecoxib , Cyclooxygenase 2 , Cyclooxygenase 2 Inhibitors , Cyclooxygenase Inhibitors/adverse effects , Cyclooxygenase Inhibitors/blood , Cyclooxygenase Inhibitors/pharmacology , Female , Ibuprofen/adverse effects , Ibuprofen/blood , Ibuprofen/pharmacology , Ibuprofen/therapeutic use , Isoenzymes/metabolism , Mammary Neoplasms, Animal/chemically induced , Mammary Neoplasms, Animal/drug therapy , Prostaglandin-Endoperoxide Synthases/metabolism , Pyrazoles , Rats , Rats, Sprague-Dawley , Substrate Specificity , Sulfonamides/adverse effects , Sulfonamides/blood , Sulfonamides/pharmacology
19.
WMJ ; 99(8): 34-8, 2000 Nov.
Article in English | MEDLINE | ID: mdl-11149256

ABSTRACT

In recent years, a considerable amount of basic laboratory investigation has been targeted toward understanding the relationship between environmental contaminants and cellular endocrine function. A number of environmental contaminants are now known to alter endocrine physiology without acting as classic toxicants. Hence, a new field of inquiry has emerged within the discipline of environmental toxicology, the study of endocrine disrupting chemicals (EDCs). Pesticides represent one of the better studied groups of EDCs. As the tools of molecular biology become increasingly sophisticated, our ability to understand the endocrine effects of these compounds continues to broaden at a remarkable rate. Still, clinical data linking them to derangements in human endocrine function have been quite limited. While the scientific community awaits further epidemiological assessment of the impact of pesticides on public health, responsible land management practices should be employed in an effort to reduce the burden of these chemicals ultimately reaching our water supply.


Subject(s)
Endocrine System/drug effects , Fungicides, Industrial/pharmacology , Herbicides/pharmacology , Insecticides/pharmacology , Humans
20.
Oncol Rep ; 7(1): 169-70, 2000.
Article in English | MEDLINE | ID: mdl-10601612

ABSTRACT

We examined the association of prostate cancer and non-steroidal anti-inflammatory drugs (NSAIDs) in a case control study of 417 prostate cancer patients and 420 group-matched control subjects. Regular daily use of over the counter NSAIDs, ibuprofen or aspirin, was associated with a 66% reduction in prostate cancer risk (odds ratio = 0.34, 95% confidence interval = 0.23-0.58, p<0.01). The risk of prostate cancer was also significantly reduced in men who reported taking prescription NSAIDs (odds ratio = 0.35, 95% confidence interval = 0.15-0.84, p<0.05). These results suggest that NSAIDs may have value in the chemoprevention of prostate cancer.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Prostatic Neoplasms/prevention & control , Case-Control Studies , Humans , Male , Middle Aged
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