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1.
Dis Model Mech ; 17(4)2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38666498

ABSTRACT

Degron tagging allows proteins of interest to be rapidly degraded, in a reversible and tuneable manner, in response to a chemical stimulus. This provides numerous opportunities for understanding disease mechanisms, modelling therapeutic interventions and constructing synthetic gene networks. In recent years, many laboratories have applied degron tagging successfully in cultured mammalian cells, spurred by rapid advances in the fields of genome editing and targeted protein degradation. In this At a Glance article, we focus on recent efforts to apply degron tagging in mouse models, discussing the distinct set of challenges and opportunities posed by the in vivo environment.


Subject(s)
Degrons , Proteolysis , Animals , Mice , Proteins/metabolism
2.
J Invertebr Pathol ; 198: 107908, 2023 06.
Article in English | MEDLINE | ID: mdl-36878425

ABSTRACT

Carcinus spp. are global aquatic invaders and carriers of several parasites, including a taxonomically unrecognised microsporidian recently observed from Argentina. We provide genome drafts for two parasite isolates, one from Carcinus maenas and one from Carcinus aestuarii, and use multi-gene phylogenetics and genome comparison methods to outline their similarities. Their SSU genes are 100 % similar and other genes have an average similarity of 99.31 %. We informally name the parasite Agmasoma carcini, terming the isolates Ac. var. aestuarii and Ac. var. maenas, following the wealth of genomic data available for each. This study follows on from Frizzera et al. (2021), where this parasite was first histologically identified.


Subject(s)
Brachyura , Microsporidia , Parasites , Animals , Brachyura/parasitology , Microsporidia/genetics , Argentina , Genomics
3.
Elife ; 112022 06 23.
Article in English | MEDLINE | ID: mdl-35736539

ABSTRACT

Auxin-inducible degrons are a chemical genetic tool for targeted protein degradation and are widely used to study protein function in cultured mammalian cells. Here, we develop CRISPR-engineered mouse lines that enable rapid and highly specific degradation of tagged endogenous proteins in vivo. Most but not all cell types are competent for degradation. By combining ligand titrations with genetic crosses to generate animals with different allelic combinations, we show that degradation kinetics depend upon the dose of the tagged protein, ligand, and the E3 ligase substrate receptor TIR1. Rapid degradation of condensin I and II - two essential regulators of mitotic chromosome structure - revealed that both complexes are individually required for cell division in precursor lymphocytes, but not in their differentiated peripheral lymphocyte derivatives. This generalisable approach provides unprecedented temporal control over the dose of endogenous proteins in mouse models, with implications for studying essential biological pathways and modelling drug activity in mammalian tissues.


Subject(s)
Indoleacetic Acids , Ubiquitin-Protein Ligases , Animals , Chromosomes/metabolism , Indoleacetic Acids/metabolism , Ligands , Mammals/metabolism , Mice , Proteolysis , Ubiquitin-Protein Ligases/metabolism
4.
PLoS One ; 17(3): e0265441, 2022.
Article in English | MEDLINE | ID: mdl-35298530

ABSTRACT

Formalin-Fixed Paraffin-Embedded (FFPE) tissues are routinely collected, archived, and used for clinical diagnosis, including maternal and neonatal health. Applying FFPE samples to microbiota research would be beneficial to reduce preparation, storage and costs associated with limited available frozen samples. This research aims to understand if FFPE fetal membrane samples are comparable to frozen tissues, which are the current gold standard for DNA microbiota analysis. Extracted DNA from nine matched paired patients were sequenced by Illumina sequencing of the V4 16S rRNA gene region. This included duplicate frozen amnion and chorion fetal membrane rolls or FFPE combined amniochorionic samples. Negative controls of surrounding wax blocks and DNA extraction reagents were processed alongside samples using identical methods. DNA quality and quantity was assessed by NanoDrop, agarose gel electrophoresis and Bioanalyzer. Decontam and SourceTracker were integrated into microbiota analysis to identify the presence of contaminating sources. The bacterial profile and nine genera differed between FFPE and frozen fetal membranes. There were no differences in bacterial profiles between FFPE samples and corresponding wax negative controls, with 49% of bacteria in FFPE fetal membrane samples matched to the source origin of paraffin wax, and 40% originating from DNA extraction reagent sources. FFPE samples displayed high fragmentation and low quantity of extracted DNA compared to frozen samples. The microbiota of FFPE fetal membrane samples is influenced by processing methods, with the inability to differentiate between the microbiota of the tissue sample and the surrounding wax block. Illumina sequencing results of FFPE and frozen fetal membrane samples should not be compared using the methods employed here. Variation could be influenced by limitations including storage time, DNA extraction and purification methods. To utilise FFPE fetal membrane samples in microbiota research then contamination prevention and detection methods must be included into optimised and standardised protocols, with recommendations presented here.


Subject(s)
Formaldehyde , Microbiota , Bacteria , DNA , Extraembryonic Membranes , Humans , Infant, Newborn , Microbiota/genetics , Paraffin Embedding/methods , RNA, Ribosomal, 16S/genetics , Tissue Fixation/methods
5.
Wellcome Open Res ; 6: 3, 2021.
Article in English | MEDLINE | ID: mdl-33604454

ABSTRACT

Condensin complexes compact and disentangle chromosomes in preparation for cell division. Commercially available antibodies raised against condensin subunits have been widely used to characterise their cellular interactome. Here we have assessed the specificity of a polyclonal antibody (Bethyl A302-276A) that is commonly used as a probe for NCAPH2, the kleisin subunit of condensin II, in mammalian cells. We find that, in addition to its intended target, this antibody cross-reacts with one or more components of the SWI/SNF family of chromatin remodelling complexes in an NCAPH2-independent manner. This cross-reactivity, with an abundant chromatin-associated factor, is likely to affect the interpretation of protein and chromatin immunoprecipitation experiments that make use of this antibody probe.

6.
J Eat Disord ; 8: 35, 2020.
Article in English | MEDLINE | ID: mdl-32760588

ABSTRACT

BACKGROUND: The purpose of this study was to quantify cognitive deficits in severe anorexia nervosa (AN) before and after medical stabilization. METHODS: This was a prospective study of 40 females between the ages of 18 and 50 admitted to a medical stabilization unit with severe AN (%IBW < 70). The primary outcome of the study was change in test scores on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) at baseline and after medical stabilization. RESULTS: There were no statistically significant differences in baseline RBANS scores between AN patients overall and controls (p = 0.0940). There was a statistically significant change in RBANS from baseline 94.1 + 12.7 to medical stabilization 97.1 + 10.6 (p = 0.0173), although notably both mean values fell within the average range. There were no significant differences in baseline RBANS scores between controls and AN-BP patients (p = 0.3320) but significant differences were found between controls and AN-R patients (p = 0.0434). CONCLUSIONS: No baseline deficits in cognition were found in this sample of women with severe AN.

8.
Placenta ; 91: 43-51, 2020 02.
Article in English | MEDLINE | ID: mdl-32174306

ABSTRACT

INTRODUCTION: It is widely debated whether fetal membranes possess a genuine microbiome, and if bacterial presence and load is linked to inflammation. Chorioamnionitis is an inflammation of the fetal membranes. This research focussed on inflammatory diagnosed histological chorioamnionitis (HCA) and aimed to determine whether the bacterial load in fetal membranes correlates to inflammatory response, including histological staging and inflammatory markers in HCA. METHODS: Fetal membrane samples were collected from patients with preterm spontaneous labour and histologically phenotyped chorioamnionitis (HCA; n = 12), or preterm (n = 6) and term labour without HCA (n = 6). The bacterial profile of fetal membranes was analysed by sequencing the V4 region of the 16S rRNA gene. Bacterial load was determined using qPCR copy number/mg of tissue. The association between bacterial load and bacterial profile composition was assessed using correlation analysis. RESULTS: Bacterial load was significantly greater within HCA amnion (p = 0.002) and chorion (p = 0.042), compared to preterm birth without HCA. Increased bacterial load was positively correlated with increased histological staging (p = 0.001) and the expression of five inflammatory markers; IL8, TLR1, TLR2, LY96 and IRAK2 (p=<0.050). Bacterial profiles were significantly different between membranes with and without HCA in amnion (p = 0.012) and chorion (p = 0.001), but no differences between specific genera were detected. DISCUSSION: Inflammatory HCA is associated with infection and increased bacterial load in a dose response relationship. Bacterial load is positively correlated with HCA severity and the TLR signalling pathway. Further research should investigate the bacterial load threshold required to generate an inflammatory response in HCA.


Subject(s)
Chorioamnionitis/microbiology , Extraembryonic Membranes/microbiology , Microbiota/physiology , Adult , Bacterial Load , Female , Gestational Age , Humans , Pregnancy , Retrospective Studies
9.
PLoS Biol ; 16(12): e2005595, 2018 12.
Article in English | MEDLINE | ID: mdl-30540740

ABSTRACT

Genome editing occurs in the context of chromatin, which is heterogeneous in structure and function across the genome. Chromatin heterogeneity is thought to affect genome editing efficiency, but this has been challenging to quantify due to the presence of confounding variables. Here, we develop a method that exploits the allele-specific chromatin status of imprinted genes in order to address this problem in cycling mouse embryonic stem cells (mESCs). Because maternal and paternal alleles of imprinted genes have identical DNA sequence and are situated in the same nucleus, allele-specific differences in the frequency and spectrum of mutations induced by CRISPR-Cas9 can be unequivocally attributed to epigenetic mechanisms. We found that heterochromatin can impede mutagenesis, but to a degree that depends on other key experimental parameters. Mutagenesis was impeded by up to 7-fold when Cas9 exposure was brief and when intracellular Cas9 expression was low. In contrast, the outcome of mutagenic DNA repair was unaffected by chromatin state, with similar efficiencies of homology-directed repair (HDR) and deletion spectra on maternal and paternal chromosomes. Combined, our data show that heterochromatin imposes a permeable barrier that influences the kinetics, but not the endpoint, of CRISPR-Cas9 genome editing and suggest that therapeutic applications involving low-level Cas9 exposure will be particularly affected by chromatin status.


Subject(s)
DNA Repair/physiology , Heterochromatin/genetics , Heterochromatin/physiology , Animals , Base Sequence , CRISPR-Cas Systems/genetics , CRISPR-Cas Systems/physiology , DNA Breaks, Double-Stranded , DNA Repair/genetics , Endonucleases/metabolism , Gene Editing/methods , Genome , Mice , Mice, Inbred C57BL , Mouse Embryonic Stem Cells/physiology , Mutagenesis, Insertional , Mutagens , Mutation/genetics , Recombinational DNA Repair/physiology , Sequence Deletion
10.
Front Microbiol ; 8: 1008, 2017.
Article in English | MEDLINE | ID: mdl-28634475

ABSTRACT

The short and long-term impact of birth mode on the developing gut microbiome in neonates has potential implications for the health of infants. In term infants, the microbiome immediately following birth across multiple body sites corresponds to birth mode, with increased Bacteroides in vaginally delivered infants. We aimed to determine the impact of birth mode of the preterm gut microbiome over the first 100 days of life and following neonatal intensive care unit (NICU) discharge. In total, 867 stool samples from 46 preterm infants (21 cesarean and 25 vaginal), median gestational age 27 weeks, were sequenced (V4 region 16S rRNA gene, Illumina MiSeq). Of these, 776 samples passed quality filtering and were included in the analysis. The overall longitudinal alpha-diversity and within infant beta-diversity was comparable between cesarean and vaginally delivered infants. Vaginally delivered infants kept significantly more OTUs from 2 months of life and following NICU discharge, but OTUs lost, gained, and regained were not different based on birth mode. Furthermore, the temporal progression of dominant genera was comparable between birth modes and no significant difference was found for any genera following adjustment for covariates. Lastly, preterm gut community types (PGCTs) showed some moderate differences in very early life, but progressed toward a comparable pattern by week 5. No PGCT was significantly associated with cesarean or vaginal birth. Unlike term infants, birth mode was not significantly associated with changes in microbial diversity, composition, specific taxa, or overall microbial development in preterm infants. This may result from the dominating effects of NICU exposures including the universal use of antibiotics immediately following birth and/or the lack of Bacteroides colonizing preterm infants.

11.
PLoS Genet ; 13(4): e1006677, 2017 04.
Article in English | MEDLINE | ID: mdl-28384324

ABSTRACT

Long noncoding RNAs (lncRNAs) have been implicated in various biological functions including the regulation of gene expression, however, the functionality of lncRNAs is not clearly understood and conflicting conclusions have often been reached when comparing different methods to investigate them. Moreover, little is known about the upstream regulation of lncRNAs. Here we show that the short isoform (p52) of a transcriptional co-activator-PC4 and SF2 interacting protein (Psip1), which is known to be involved in linking transcription to RNA processing, specifically regulates the expression of the lncRNA Hottip-located at the 5' end of the Hoxa locus. Using both knockdown and knockout approaches we show that Hottip expression is required for activation of the 5' Hoxa genes (Hoxa13 and Hoxa10/11) and for retaining Mll1 at the 5' end of Hoxa. Moreover, we demonstrate that artificially inducing Hottip expression is sufficient to activate the 5' Hoxa genes and that Hottip RNA binds to the 5' end of Hoxa. By engineering premature transcription termination, we show that it is the Hottip lncRNA molecule itself, not just Hottip transcription that is required to maintains active expression of posterior Hox genes. Our data show a direct role for a lncRNA molecule in regulating the expression of developmentally-regulated mRNA genes in cis.


Subject(s)
Adaptor Proteins, Signal Transducing/genetics , Homeodomain Proteins/genetics , RNA, Long Noncoding/genetics , Transcription Factors/genetics , Transcription, Genetic , Adaptor Proteins, Signal Transducing/biosynthesis , Cell Proliferation/genetics , Gene Expression Regulation, Developmental , Gene Knockdown Techniques , Homeobox A10 Proteins , Humans , RNA Processing, Post-Transcriptional/genetics , RNA, Long Noncoding/biosynthesis , Transcription Factors/biosynthesis
12.
Wellcome Open Res ; 2: 83, 2017.
Article in English | MEDLINE | ID: mdl-34541330

ABSTRACT

Background: Trimethylation at histone H3 at lysine 36 (H3K36me3) is associated with expressed gene bodies and recruit proteins implicated in transcription, splicing and DNA repair. PC4 and SF2 interacting protein ( PSIP1/LEDGF) is a transcriptional coactivator, possesses a  H3K36me3 reader PWWP domain. Alternatively spliced isoforms of PSIP1 binds to H3K36me3 and suggested to function as adaptor proteins to recruit transcriptional modulators, splicing factors and proteins that promote homology directed repair (HDR), to H3K36me3 chromatin. Methods: We performed chromatin immunoprecipitation of H3K36me3 followed by quantitative mass spectrometry to identify proteins associated with H3K36 trimethylated chromatin in mouse embryonic stem cells (mESCs). Furthermore, we performed stable isotope labelling with amino acids in cell culture (SILAC) for a longer isoform of PSIP1 (p75) and MOF/KAT8 in mESCs and mouse embryonic fibroblasts (MEFS). Results: Proteomic analysis of H3K36me3 chromatin show association of proteins involved in transcriptional elongation, RNA processing and DNA repair with H3K36me3 chromatin. Furthermore, we show DNA repair proteins like PARP1, gamma H2A.X, XRCC1, DNA ligase 3, SPT16, Topoisomerases and BAZ1B are predominant interacting partners of PSIP1/p75. We validated the association of PSIP1/p75 with gamma H2A.X, an early marker of DNA damage and also demonstrated accumulation of damaged DNA in PSIP1 knockout MEFs. Conclusions: In contrast to the previously demonstrated role of H3K36me3 and PSIP1/p75 in promoting HDR in mammals, our data supports the wider role of H3K36me3 and PSIP1 in maintaining the genome integrity by recruiting several DNA repair proteins to transcribed gene bodies.

13.
Genes Dev ; 30(19): 2173-2186, 2016 Oct 01.
Article in English | MEDLINE | ID: mdl-27737961

ABSTRACT

Chromosomal instability is a hallmark of cancer, but mitotic regulators are rarely mutated in tumors. Mutations in the condensin complexes, which restructure chromosomes to facilitate segregation during mitosis, are significantly enriched in cancer genomes, but experimental evidence implicating condensin dysfunction in tumorigenesis is lacking. We report that mice inheriting missense mutations in a condensin II subunit (Caph2nes) develop T-cell lymphoma. Before tumors develop, we found that the same Caph2 mutation impairs ploidy maintenance to a different extent in different hematopoietic cell types, with ploidy most severely perturbed at the CD4+CD8+ T-cell stage from which tumors initiate. Premalignant CD4+CD8+ T cells show persistent catenations during chromosome segregation, triggering DNA damage in diploid daughter cells and elevated ploidy. Genome sequencing revealed that Caph2 single-mutant tumors are near diploid but carry deletions spanning tumor suppressor genes, whereas P53 inactivation allowed Caph2 mutant cells with whole-chromosome gains and structural rearrangements to form highly aggressive disease. Together, our data challenge the view that mitotic chromosome formation is an invariant process during development and provide evidence that defective mitotic chromosome structure can promote tumorigenesis.


Subject(s)
Adenosine Triphosphatases/genetics , DNA-Binding Proteins/genetics , Genomic Instability/genetics , Lymphoma, T-Cell/genetics , Multiprotein Complexes/genetics , Mutation, Missense/genetics , Thymus Neoplasms/genetics , Adenosine Triphosphatases/metabolism , Anaphase , Animals , Cells, Cultured , Chromosome Structures/genetics , DNA-Binding Proteins/metabolism , Female , Lymphoma, T-Cell/physiopathology , Male , Metaphase , Mice , Multiprotein Complexes/metabolism , Thymocytes/pathology , Thymus Neoplasms/physiopathology
14.
Nat Genet ; 48(6): 681-6, 2016 06.
Article in English | MEDLINE | ID: mdl-27089178

ABSTRACT

Histone acetylation is generally associated with active chromatin, but most studies have focused on the acetylation of histone tails. Various histone H3 and H4 tail acetylations mark the promoters of active genes. These modifications include acetylation of histone H3 at lysine 27 (H3K27ac), which blocks Polycomb-mediated trimethylation of H3K27 (H3K27me3). H3K27ac is also widely used to identify active enhancers, and the assumption has been that profiling H3K27ac is a comprehensive way of cataloguing the set of active enhancers in mammalian cell types. Here we show that acetylation of lysine residues in the globular domain of histone H3 (lysine 64 (H3K64ac) and lysine 122 (H3K122ac)) marks active gene promoters and also a subset of active enhancers. Moreover, we find a new class of active functional enhancers that is marked by H3K122ac but lacks H3K27ac. This work suggests that, to identify enhancers, a more comprehensive analysis of histone acetylation is required than has previously been considered.


Subject(s)
Enhancer Elements, Genetic , Histones/metabolism , Acetylation , Chromatin Immunoprecipitation , Embryonic Stem Cells/cytology , Gene Expression Regulation , Histones/chemistry , Humans , K562 Cells , Lysine/metabolism
16.
Sci Justice ; 55(3): 181-8, 2015 May.
Article in English | MEDLINE | ID: mdl-25934370

ABSTRACT

Forensic anthropologists are frequently confronted with the need to interpret burnt bone. Regardless of the context, one of the key factors for the correct interpretation of the remains and a reconstruction of the incidents leading to incineration is the estimation of the maximum exposure temperature. The recent years have seen an influx in experimental research focusing on temperature estimation, spanning from colour assessment, mechanical strength measurements, histology and structural observations, biochemical changes and crystallinity studies, vastly advancing the understanding of heat induced changes in bone, thus facilitating a more accurate interpretation. This paper draws together and evaluates all currently available methodologies for temperature estimation.


Subject(s)
Bone and Bones/pathology , Burns/pathology , Fires , Bone and Bones/physiology , Color , Crystallization , Forensic Anthropology , Humans , Microscopy , Microscopy, Electron, Scanning , Microscopy, Electron, Transmission , Shear Strength , Spectroscopy, Fourier Transform Infrared , Spectrum Analysis, Raman , Temperature , X-Ray Diffraction
17.
Nucleic Acids Res ; 42(14): 9021-32, 2014 Aug.
Article in English | MEDLINE | ID: mdl-25056311

ABSTRACT

Trithorax and polycomb group proteins are generally thought to antagonize one another. The trithorax family member MLL (myeloid/lymphoid or mixed-lineage leukemia) is presumed to activate Hox expression, counteracting polycomb-mediated repression. PC4 and SF2 interacting protein 1 (PSIP1)/p75, also known as LEDGF, whose PWWP domain binds to H3K36me3, interacts with MLL and tethers MLL fusion proteins to HOXA9 in leukaemias. Here we show, unexpectedly, that Psip1/p75 regulates homeotic genes by recruiting not only MLL complexes, but also the polycomb group protein Bmi1. In Psip1(-/-) cells binding of Mll1/2, Bmi1 and the co-repressor Ctbp1 at Hox loci are all abrogated and Hoxa and Hoxd mRNA expression increased. Our data not only reveal a potential mechanism of action for Psip1 in the regulation of Hox genes but also suggest an unexpected interplay between proteins usually considered as transcriptional activators and repressors.


Subject(s)
Adaptor Proteins, Signal Transducing/metabolism , Gene Expression Regulation , Genes, Homeobox , Histone-Lysine N-Methyltransferase/metabolism , Myeloid-Lymphoid Leukemia Protein/metabolism , Polycomb Repressive Complex 1/metabolism , Proto-Oncogene Proteins/metabolism , Transcription Factors/metabolism , Adaptor Proteins, Signal Transducing/genetics , Adaptor Proteins, Signal Transducing/physiology , Alcohol Oxidoreductases/metabolism , Animals , Cells, Cultured , DNA-Binding Proteins/metabolism , Histone-Lysine N-Methyltransferase/genetics , Homeodomain Proteins/genetics , Homeodomain Proteins/metabolism , Mice , Myeloid-Lymphoid Leukemia Protein/genetics , Repressor Proteins/metabolism , Transcription Factors/genetics , Transcription Factors/physiology
18.
Genome Res ; 23(12): 2053-65, 2013 Dec.
Article in English | MEDLINE | ID: mdl-23990607

ABSTRACT

Compared with histone H3, acetylation of H4 tails has not been well studied, especially in mammalian cells. Yet, H4K16 acetylation is of particular interest because of its ability to decompact nucleosomes in vitro and its involvement in dosage compensation in flies. Here we show that, surprisingly, loss of H4K16 acetylation does not alter higher-order chromatin compaction in vivo in mouse embryonic stem cells (ESCs). As well as peaks of acetylated H4K16 and KAT8 histone acetyltransferase at the transcription start sites of expressed genes, we report that acetylation of H4K16 is a new marker of active enhancers in ESCs and that some enhancers are marked by H3K4me1, KAT8, and H4K16ac, but not by acetylated H3K27 or EP300, suggesting that they are novel EP300 independent regulatory elements. Our data suggest a broad role for different histone acetylation marks and for different histone acetyltransferases in long-range gene regulation.


Subject(s)
Chromatin/genetics , Chromatin/metabolism , E1A-Associated p300 Protein/metabolism , Embryonic Stem Cells/metabolism , Enhancer Elements, Genetic , Histone Acetyltransferases/metabolism , Histones/metabolism , Acetylation , Animals , Cells, Cultured , Dosage Compensation, Genetic , Epigenesis, Genetic , Gene Expression Profiling , Gene Expression Regulation, Developmental , Histone Acetyltransferases/genetics , In Situ Hybridization, Fluorescence , Mice , Oligonucleotide Array Sequence Analysis , Transcription Initiation Site
19.
J Neurotrauma ; 23(9): 1295-303, 2006 Sep.
Article in English | MEDLINE | ID: mdl-16958582

ABSTRACT

The aim of this study was to quantify the potential reduction in sample size that can be achieved by adjustment for predictors of outcome in traumatic brain injury (TBI) trials. We used individual patient data from seven therapeutic phase III randomized clinical trials (RCTs; n = 6166) in moderate or severe TBI, and three TBI surveys (n = 2238). The primary outcome was the dichotomized Glasgow Outcome Scale at 6 months (favorable/unfavorable). Baseline predictors of outcome considered were age, motor score, pupillary reactivity, computed tomography (CT) classification, traumatic subarachnoid hemorrhage, hypoxia, hypotension, glycemia, and hemoglobin. We calculated the potential sample size reduction obtained by adjustment of a hypothetical treatment effect for one to seven predictors with logistic regression models. The distribution of predictors was more heterogeneous in surveys than in trials. Adjustment of the treatment effect for the strongest predictors (age, motor score, and pupillary reactivity) yielded a reduction in sample size of 16-23% in RCTs and 28-35% in surveys. Adjustment for seven predictors yielded a reduction of about 25% in most studies: 20-28% in RCTs and 32-39% in surveys. A major reduction in sample size can be obtained with covariate adjustment in TBI trials. Covariate adjustment for strong predictors should be incorporated in the analysis of future TBI trials.


Subject(s)
Brain Injuries/therapy , Health Surveys , Outcome Assessment, Health Care , Randomized Controlled Trials as Topic , Sample Size , Age Factors , Glasgow Outcome Scale , Humans , Motor Activity , Reflex, Pupillary
20.
J Clin Oncol ; 24(21): 3401-7, 2006 Jul 20.
Article in English | MEDLINE | ID: mdl-16849754

ABSTRACT

PURPOSE: Eicosapentaenoic acid (EPA) has been proposed to have specific anticachectic effects. This trial compared EPA diethyl ester with placebo in cachectic cancer patients for effects on weight and lean body mass. PATIENTS AND METHODS: Five hundred eighteen weight-losing patients with advanced gastrointestinal or lung cancer were studied in a multicenter, double-blind, placebo controlled trial. Patients were randomly assigned to receive a novel preparation of pure EPA at a dose of 2 g or 4 g daily or placebo (2g EPA, n = 175; 4 g EPA, n = 172; placebo, n = 171). Patients were assessed at 4 weeks and 8 weeks. RESULTS: The groups were well balanced at baseline. Mean weight loss at baseline was 18% (n = 518). Over the 8-week treatment period, both intention-to-treat analysis and per protocol analysis revealed no statistically significant improvements in survival, weight, or other nutritional variables. There was, however, a trend in favor of EPA with analysis of the primary end point, weight, at 8 weeks showing a borderline, nonsignificant treatment effect (P = .066). Relative to placebo, mean weight increased by 1.2 kg with 2 g EPA (95% CI, 0 kg to 2.3 kg) and by 0.3 kg with 4 g EPA (-0.9 kg to 1.5 kg). CONCLUSION: The results indicate no statistically significant benefit from single agent EPA in the treatment of cancer cachexia. Future studies should concentrate on other agents or combination regimens.


Subject(s)
Cachexia/drug therapy , Cachexia/etiology , Eicosapentaenoic Acid/analogs & derivatives , Neoplasms/complications , Adult , Aged , Analysis of Variance , Body Composition , Body Mass Index , Body Weight , Double-Blind Method , Eicosapentaenoic Acid/therapeutic use , Female , Humans , Karnofsky Performance Status , Male , Middle Aged , Quality of Life , Surveys and Questionnaires , Survival Analysis
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