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1.
Bioanalysis ; 14(1): 7-18, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34789009

RESUMO

Aim: Development of recombinant fusion proteins as drugs poses unique challenges for bioanalysis. This paper describes a case study of a glycosylated fusion protein, where variable glycosylation, matrix interference and high sensitivity needs posed unique challenges. Results: Six different assay configurations, across four different platforms were evaluated for measurement of drug concentrations. Two platforms that achieved the assay requirements were Simoa HD-1 and immune-capture LC-MS/MS-based assay. Conclusion: Both, Simoa HD-1 and the mass spectrometry-based methods were able to detect total drug by providing the adequate matrix tolerance, required sensitivity and detection of all the various glycosylated fusion proteins to support clinical sample analysis. The mass spectrometry-based method was selected due to robustness and ease of method transfer.


Assuntos
Ensaio de Imunoadsorção Enzimática/métodos , Ácido N-Acetilneuramínico/farmacocinética , Glicosilação , Humanos
2.
MAbs ; 13(1): 1944017, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34225571

RESUMO

Bispecific antibodies (bsAbs) recognize and bind two different targets or two epitopes of the same antigen, making them an attractive diagnostic and treatment modality. Compared to the production of conventional bivalent monospecific antibodies, bsAbs require greater engineering and manufacturing. Therefore, bsAbs are more likely to differ from endogenous immunoglobulins and contain new epitopes that can increase immunogenic risk. Anti-A/B is a bsAb designed using a 'knobs-into-holes' (KIH) format. Anti-A/B exhibited an unexpectedly high immunogenicity in both preclinical and clinical studies, resulting in early termination of clinical development. Here, we used an integrated approach that combined in silico analysis, in vitro assays, and an in vivo study in non-human primates to characterize anti-A/B immunogenicity. Our findings indicated that the immunogenicity is associated with epitopes in the anti-B arm and not with mutations engineered through the KIH process. Our results showed the value of this integrated approach for performing immunogenicity risk assessment during clinical candidate selection to effectively mitigate risks during bsAb development.


Assuntos
Anticorpos Biespecíficos/imunologia , Técnicas Imunológicas/métodos , Animais , Macaca fascicularis
3.
Genet Med ; 23(9): 1673-1680, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34007000

RESUMO

PURPOSE: To evaluate the impact of technically challenging variants on the implementation, validation, and diagnostic yield of commonly used clinical genetic tests. Such variants include large indels, small copy-number variants (CNVs), complex alterations, and variants in low-complexity or segmentally duplicated regions. METHODS: An interlaboratory pilot study used synthetic specimens to assess detection of challenging variant types by various next-generation sequencing (NGS)-based workflows. One well-performing workflow was further validated and used in clinician-ordered testing of more than 450,000 patients. RESULTS: In the interlaboratory study, only 2 of 13 challenging variants were detected by all 10 workflows, and just 3 workflows detected all 13. Limitations were also observed among 11 less-challenging indels. In clinical testing, 21.6% of patients carried one or more pathogenic variants, of which 13.8% (17,561) were classified as technically challenging. These variants were of diverse types, affecting 556 of 1,217 genes across hereditary cancer, cardiovascular, neurological, pediatric, reproductive carrier screening, and other indicated tests. CONCLUSION: The analytic and clinical sensitivity of NGS workflows can vary considerably, particularly for prevalent, technically challenging variants. This can have important implications for the design and validation of tests (by laboratories) and the selection of tests (by clinicians) for a wide range of clinical indications.


Assuntos
Testes Genéticos , Sequenciamento de Nucleotídeos em Larga Escala , Criança , Variações do Número de Cópias de DNA/genética , Humanos , Mutação INDEL/genética , Projetos Piloto
4.
J Appl Lab Med ; 2(2): 138-149, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32630970

RESUMO

BACKGROUND: Next-generation sequencing (NGS) assays are highly complex tests that can vary substantially in both their design and intended application. Despite their innumerous advantages, NGS assays present some unique challenges associated with the preanalytical process, library preparation, data analysis, and reporting. According to a number of professional laboratory organization, control materials should be included both during the analytical validation phase and in routine clinical use to guarantee highly accurate results. The SeraseqTM Solid Tumor Mutation Mix AF10 and AF20 control materials consist of 26 biosynthetic DNA constructs in a genomic DNA background, each containing a specific variant or mutation of interest and an internal quality marker at 2 distinct allelic frequencies of 10% and 20%, respectively. The goal of this interlaboratory study was to evaluate the Seraseq AF10 and AF20 control materials by verifying their performance as control materials and by evaluating their ability to measure quality metrics essential to a clinical test. METHODS: Performance characteristics were assessed within and between 6 CLIA-accredited laboratories and 1 research laboratory. RESULTS: Most laboratories detected all 26 mutations of interest; however, some discrepancies involving the internal quality markers were observed. CONCLUSION: This interlaboratory study showed that the Seraseq AF10 and AF20 control materials have high quality, stability, and genomic complexity in variant types that are well suited for assisting in NGS assay analytical validation and monitoring routine clinical applications.

5.
J Mol Diagn ; 18(6): 882-889, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27639548

RESUMO

Diagnostic next-generation sequencing (NGS)-based gene panels are increasingly used for prevalent disorders with genetic and clinical heterogeneity. Clinical development, validation, and quality management of these panels ideally includes reference samples containing prevalent pathogenic variants; however, clinical domain expertise to select appropriate variants may not be present, samples are often not publicly available, and their inclusion is associated with added cost. Expert-designed, multiplexed controls can remedy some of these challenges. One approach relies on spiking biosynthetic fragments carrying desired variants into human genomic DNA. We piloted the utility of this approach for hypertrophic cardiomyopathy. Data from >3000 previously sequenced probands were used to select 10 common pathogenic and/or technically challenging variants in the top hypertrophic cardiomyopathy genes. Multiplexed controls were constructed across a range of ideal and realistic allelic fractions for heterozygous germline variants. NGS was performed in quadruplicate, and results were compared with diagnostic NGS data for the source patient samples. Overall, results were indistinguishable from patient-derived data with variants being detected at or reasonably close to the targeted allelic fraction ratios. The exception was a common 25-bp deletion in MYBPC3, underscoring the importance of including such variants in test development. These controls may be an attractive addition to the repertoire of materials for development, validation, and quality monitoring of clinical NGS assays.


Assuntos
Cardiomiopatia Hipertrófica/diagnóstico , Cardiomiopatia Hipertrófica/genética , Sequenciamento de Nucleotídeos em Larga Escala , Padrões de Referência , Alelos , Frequência do Gene , Marcadores Genéticos , Testes Genéticos/métodos , Testes Genéticos/normas , Variação Genética , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Sequenciamento de Nucleotídeos em Larga Escala/normas , Humanos , Mutação
6.
J Invest Dermatol ; 134(4): 1108-1118, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24157461

RESUMO

Tumor-associated macrophages (TAMs) have essential roles in tumor progression and metastasis. Tumor cells recruit myeloid progenitors and monocytes to the tumor site, where they differentiate into TAMs; however, this process is not well studied in humans. Here we show that human CD7, a T-cell and NK cell receptor, is highly expressed by monocytes and macrophages. Expression of CD7 decreases in M-CSF-differentiated macrophages and in melanoma-conditioned medium-induced macrophages (MCMI/Mφ) in comparison to monocytes. A ligand for CD7, SECTM1 (secreted and transmembrane protein 1), is highly expressed in many tumors, including melanoma cells. We show that SECTM1 binds to CD7 and significantly increases monocyte migration by activation of the PI3K (phosphatidylinositol 3'-kinase) pathway. In human melanoma tissues, tumor-infiltrating macrophages expressing CD7 are present. These melanomas, with CD7-positive inflammatory cell infiltrations, frequently highly express SECTM1, including an N-terminal, soluble form, which can be detected in the sera of metastatic melanoma patients but not in normal sera. Taken together, our data demonstrate that CD7 is present on monocytes and tumor macrophages and that its ligand, SECTM1, is frequently expressed in corresponding melanoma tissues, possibly acting as a chemoattractant for monocytes to modulate the melanoma microenvironment.


Assuntos
Antígenos CD7/metabolismo , Regulação Neoplásica da Expressão Gênica , Proteínas de Membrana/metabolismo , Monócitos/citologia , Fosfatidilinositol 3-Quinases/metabolismo , Apoptose , Diferenciação Celular , Movimento Celular , Proliferação de Células , Fatores Quimiotáticos/química , Meios de Cultivo Condicionados/química , Progressão da Doença , Humanos , Interferon-alfa/metabolismo , Ligantes , Fator Estimulador de Colônias de Macrófagos/metabolismo , Macrófagos/citologia , Macrófagos/metabolismo , Melanócitos/citologia , Melanócitos/metabolismo , Melanoma/metabolismo , Metástase Neoplásica , Inibidores de Proteassoma/química , Estrutura Terciária de Proteína , Transdução de Sinais
7.
Bioanalysis ; 5(9): 1025-40, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23641694

RESUMO

BACKGROUND: Antibody-drug conjugates (ADCs) combine the characteristics of large-molecule biologics and small-molecule drugs and are heterogeneous mixtures that can biotransform in vivo, resulting in additional complexity. ADC bioanalytical strategies require novel analytical methods, as well as existing large- and small-molecule methods. Because ADCs in late-stage clinical development are relatively new, regulatory guidelines and standard industry best practices for developing strategies for bioanalytical PK assays are still being established. RESULTS: A PK assay strategy was developed that included comprehensive novel reagent and assay characterization approaches for the ADC ado-trastuzumab emtansine (T-DM1). CONCLUSION: The bioanalytical strategy was successfully applied to the drug development of T-DM1 and ensured that key analytes were accurately measured in support of nonclinical and clinical development.


Assuntos
Anticorpos Monoclonais Humanizados/análise , Anticorpos Monoclonais/análise , Ensaio de Imunoadsorção Enzimática , Imunoconjugados/análise , Maitansina/análogos & derivados , Ado-Trastuzumab Emtansina , Anticorpos Monoclonais/farmacocinética , Anticorpos Monoclonais Humanizados/metabolismo , Anticorpos Monoclonais Humanizados/farmacocinética , Cromatografia Líquida , Desenho de Fármacos , Imunoconjugados/farmacocinética , Espectrometria de Massas , Maitansina/análise , Maitansina/metabolismo , Maitansina/farmacocinética , Trastuzumab
8.
Am J Public Health ; 103(6): 1022-5, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23597378

RESUMO

Racial/ethnic and socioeconomic disparities regarding untreated oral disease exist for older adults, and poor oral health diminishes quality of life. The ElderSmile program integrated screening for diabetes and hypertension into its community-based oral health activities at senior centers in northern Manhattan. The program found a willingness among minority seniors (aged ≥ 50 years) to be screened for primary care sensitive conditions by dental professionals and a high level of unrecognized disease (7.8% and 24.6% of ElderSmile participants had positive screening results for previously undiagnosed diabetes and hypertension, respectively). Dental professionals may screen for primary care-sensitive conditions and refer patients to health care providers for definitive diagnosis and treatment. The ElderSmile program is a replicable model for community-based oral and general health screening.


Assuntos
Diabetes Mellitus/diagnóstico , Promoção da Saúde/métodos , Hipertensão/diagnóstico , Programas de Rastreamento , Grupos Minoritários , Doenças da Boca/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , População Negra , Serviços de Saúde Comunitária , Serviços de Saúde Bucal , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/etnologia , Feminino , Educação em Saúde , Hispânico ou Latino , Humanos , Hipertensão/epidemiologia , Hipertensão/etnologia , Masculino , Pessoa de Meia-Idade , Doenças da Boca/diagnóstico , Doenças da Boca/etnologia , Cidade de Nova Iorque/epidemiologia , Saúde Bucal , Fatores Socioeconômicos , Inquéritos e Questionários , População Branca
9.
Breast Cancer Res Treat ; 134(2): 583-93, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22644656

RESUMO

We studied resistance to endocrine and HER2-targeted therapies using a xenograft model of estrogen receptor positive (ER)/HER2-overexpressing breast cancer. Here, we report a novel phenotype of drug resistance in this model. MCF7/HER2-18 xenografts were treated with endocrine therapy alone or in combination with lapatinib and trastuzumab (LT) to inhibit HER2. Archival tumor tissues were stained with hematoxylin and eosin and with mucicarmine. RNA extracted from tumors at early time points and late after acquired resistance were analyzed for mucin4 (MUC4) expression by microarray and quantitative reverse transcriptase-PCR. Protein expression of the MUC4, ER, and HER2 signaling pathways was measured by immunohistochemistry and western blotting. The combination of the potent anti-HER2 regimen LT with either tamoxifen (Tam + LT) or estrogen deprivation (ED + LT) can cause complete eradication of ER-positive/HER2-overexpressing tumors in mice. Tumors developing resistance to this combination, as well as those acquiring resistance to endocrine therapy alone, exhibited a distinct histological and molecular phenotype-a striking increase in mucin-filled vacuoles and upregulation of several mucins including MUC4. At the onset of resistance, MUC4 mRNA and protein were increased. These tumors also showed upregulation and reactivation of HER2 signaling, while losing ER protein and the estrogen-regulated gene progesterone receptor. Mucins are upregulated in a preclinical model of ER-positive/HER2-overexpressing breast cancer as resistance develops to the combination of endocrine and anti-HER2 therapy. These mucin-rich tumors reactivate the HER2 pathway and shift their molecular phenotype to become more ER-negative/HER2-positive.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Neoplasias da Mama/metabolismo , Resistencia a Medicamentos Antineoplásicos , Mucina-4/metabolismo , Receptor ErbB-2/metabolismo , Receptores de Estrogênio/metabolismo , Animais , Anticorpos Monoclonais Humanizados/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Linhagem Celular Tumoral , Antagonistas de Estrogênios/administração & dosagem , Feminino , Expressão Gênica , Humanos , Lapatinib , Camundongos , Camundongos Nus , Terapia de Alvo Molecular , Mucina-4/genética , Análise de Sequência com Séries de Oligonucleotídeos , Fenótipo , Quinazolinas/administração & dosagem , Transdução de Sinais , Estatísticas não Paramétricas , Tamoxifeno/administração & dosagem , Transcriptoma , Trastuzumab , Carga Tumoral , Regulação para Cima , Ensaios Antitumorais Modelo de Xenoenxerto
10.
J Leukoc Biol ; 91(3): 449-59, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22184754

RESUMO

CD7 is a cell-surface molecule, expressed on T lymphocytes and NK cells, which functions as a costimulatory receptor for T cell proliferation. SECTM1 has been proposed as a ligand for CD7. However, the expression pattern of this molecule in human immune cells and role in human T cell function remain unclear. In the present study, using human rSECTM1, we demonstrate that SECTM1 strongly costimulates CD4 and CD8 T cell proliferation and induces IFN-γ production, likely via a CD7-dependent mechanism. In addition, SECTM1 synergizes with suboptimal anti-CD28 to strongly augment T cell functions. We found a robust induction of IL-2 production when SECTM1 and anti-CD28 signals were present with TCR ligation. Furthermore, addition of SECTM1 into a MLR significantly enhanced proliferation of alloantigen-activated T cells, whereas blockade of SECTM1 inhibited T cell proliferation in a two-way MLR assay. Simultaneously blocking the effect of SECTM1, along with CTLA-4/Fc, diminishes two-way MLR. Finally, we demonstrated that expression of SECTM1 is not detected in monocytes and imMoDCs at the protein level. However, it is strongly induced by IFN-γ in monocytes and imMoDCs, and this induction is STAT1-dependent. These results indicate that SECTM1 is a broadly expressed, IFN-γ-inducible molecule, which functions as a potent costimulatory ligand for T cell activation and is synergistic with anti-CD28.


Assuntos
Antígenos CD28/metabolismo , Ativação Linfocitária , Proteínas de Membrana/metabolismo , Linfócitos T/metabolismo , Antígenos CD7/metabolismo , Sequência de Bases , Antígenos CD28/imunologia , Antígeno CTLA-4/metabolismo , Perfilação da Expressão Gênica , Células HEK293 , Humanos , Fragmentos Fc das Imunoglobulinas/metabolismo , Interferon gama/farmacologia , Células Jurkat , Ligantes , Ativação Linfocitária/efeitos dos fármacos , Ativação Linfocitária/imunologia , Teste de Cultura Mista de Linfócitos , Proteínas de Membrana/genética , Motivos de Nucleotídeos , Regiões Promotoras Genéticas , RNA Mensageiro/análise , Fator de Transcrição STAT1/metabolismo , Transdução de Sinais/efeitos dos fármacos , Linfócitos T/efeitos dos fármacos , Linfócitos T/imunologia
11.
Breast Cancer Res ; 13(4): R84, 2011 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-21884573

RESUMO

INTRODUCTION: The overexpression of human epidermal growth factor receptor (HER)-2 in 20% of human breast cancers and its association with aggressive growth has led to widespread use of HER2-targeted therapies, such as trastuzumab (T) and lapatinib (L). Despite the success of these drugs, their efficacy is limited in patients whose tumors demonstrate de novo or acquired resistance to treatment. The ß1 integrin resides on the membrane of the breast cancer cell, activating several elements of breast tumor progression including proliferation and survival. METHODS: We developed a panel of HER2-overexpressing cell lines resistant to L, T, and the potent LT combination through long-term exposure and validated these models in 3D culture. Parental and L/T/LT-resistant cells were subject to HER2 and ß1 integrin inhibitors in 3D and monitored for 12 days, followed by quantification of colony number. Parallel experiments were conducted where cells were either stained for Ki-67 and Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) or harvested for protein and analyzed by immunoblot. Results were subjected to statistical testing using analysis of variance and linear contrasts, followed by adjustment with the Sidak method. RESULTS: Using multiple cell lines including BT474 and HCC1954, we reveal that in L and LT resistance, where phosphorylation of EGFR/HER1, HER2, and HER3 are strongly inhibited, kinases downstream of ß1 integrin--including focal adhesion kinase (FAK) and Src--are up-regulated. Blockade of ß1 by the antibody AIIB2 abrogates this up-regulation and functionally achieves significant growth inhibition of L and LT resistant cells in 3D, without dramatically affecting the parental cells. SiRNA against ß1 as well as pharmacologic inhibition of FAK achieve the same growth inhibitory effect. In contrast, trastuzumab-resistant cells, which retain high levels of phosphorylated EGFR/HER1, HER2, and HER3, are only modestly growth-inhibited by AIIB2. CONCLUSIONS: Our data suggest that HER2 activity, which is suppressed in resistance involving L but not T alone, dictates whether ß1 mediates an alternative pathway driving resistance. Our findings justify clinical studies investigating the inhibition of ß1 or its downstream signaling moieties as strategies to overcome acquired L and LT resistance.


Assuntos
Antineoplásicos/farmacologia , Neoplasias da Mama/tratamento farmacológico , Integrina beta1/metabolismo , Quinazolinas/farmacologia , Anticorpos/farmacologia , Anticorpos Monoclonais Humanizados/farmacologia , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Linhagem Celular Tumoral , Proliferação de Células , Resistencia a Medicamentos Antineoplásicos , Receptores ErbB/metabolismo , Quinase 1 de Adesão Focal/metabolismo , Humanos , Integrina beta1/genética , Integrina beta1/imunologia , Lapatinib , Fosforilação/efeitos dos fármacos , RNA Interferente Pequeno , Receptor ErbB-2/metabolismo , Receptores de Estrogênio/metabolismo , Transdução de Sinais/efeitos dos fármacos , Trastuzumab , Regulação para Cima , Quinases da Família src/metabolismo
12.
Breast Cancer Res ; 13(2): 307, 2011 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-21575280

RESUMO

Estrogen receptor α (ER) is a major driver of breast cancer and the target of endocrine therapy. Full disclosure of the cofactors regulating ER interactions with chromatin and its transcriptional regulatory activity is still elusive. Novel genome-wide profiling tools have mapped ER binding events in breast cancer cells and delineated cofactors important in ER activity. Among these, the Forkhead protein FOXA1 is emerging as a key factor dictating global chromatin structure and the transcriptional function of ER in breast and non-breast cancer cells. The significance of FOXA1 in the chromatin interactions and transcriptional regulation of both estrogen- and tamoxifen-bound ER, and in supporting tamoxifen-resistant cell growth, may impact current endocrine therapies.


Assuntos
Neoplasias da Mama/genética , Cromatina/metabolismo , Fator 3-alfa Nuclear de Hepatócito/genética , Receptores de Estrogênio/genética , Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/metabolismo , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Feminino , Estudo de Associação Genômica Ampla , Fator 3-alfa Nuclear de Hepatócito/metabolismo , Humanos , Receptores de Estrogênio/metabolismo , Tamoxifeno/uso terapêutico , Transcrição Gênica
13.
Clin Cancer Res ; 17(6): 1351-61, 2011 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-21138857

RESUMO

PURPOSE: We have shown that incomplete blockade of the human epidermal growth factor (HER) pathway is a mechanism of resistance to treatment with trastuzumab (T) in HER2-overexpressing tumor xenografts. We now investigate whether the addition of lapatinib (L), a dual HER1/2 kinase inhibitor, to T results in more potent inhibition of the pathway and therefore inhibition of tumor growth, and whether reduced dose and intermittent treatment with the combination is equally effective. EXPERIMENTAL DESIGN: Nude mice bearing HER2-overexpressing MCF7/HER2-18 or BT-474 xenograft tumors were treated with L and T, alone or in various combinations with other HER inhibitors. L + T for short duration (14 and 42 days), intermittent administration (14 days on/off), and reduced dosing (half dose) was also investigated. Inhibition of tumor growth, downstream signaling, proliferation, and induction of apoptosis were assessed. All statistical tests were two-sided. RESULTS: L + T was the most effective regimen in both MCF7/HER2-18 and BT-474 xenografts with complete regression (CR) of tumor observed in all mice. Intermittent and reduced dose treatment (½ dose) resulted in high rates of CR and low rates of tumor recurrence that were comparable to full dose continuous treatment. L + T resulted in significantly reduced downstream signaling and proliferation, and increased apoptosis. CONCLUSIONS: L + T is a potent and effective combination even when given in reduced dose or intermittent schedule potentially resulting in lower toxicity and reduced cost if translated to patients. These findings warrant timely clinical testing.


Assuntos
Anticorpos Monoclonais/farmacologia , Neoplasias da Mama/patologia , Quinazolinas/farmacologia , Receptor ErbB-2/genética , Animais , Anticorpos Monoclonais Humanizados , Antineoplásicos/farmacologia , Apoptose , Linhagem Celular Tumoral , Regulação Neoplásica da Expressão Gênica , Genes erbB-2/genética , Humanos , Lapatinib , Camundongos , Camundongos Nus , Transplante de Neoplasias , Receptor ErbB-2/metabolismo , Trastuzumab , Resultado do Tratamento
14.
Aesthet Surg J ; 30(3): 404-8, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20601564

RESUMO

BACKGROUND: Capsular contracture (CC) is one of the most common complications of breast augmentation surgery. Leukotrienes are implicated in the inflammatory cascade and have been postulated to be involved in the formation of CC. Therefore, leukotriene antagonists Accolate and Singulair have been prescribed by plastic surgeons off-label to treat and prevent CC. To date, there are no studies investigating the efficacy of Singulair on CC. OBJECTIVE: The authors retrospectively review a series of patients treated with Singulair to determine whether it improves CC after breast implant surgery. METHODS: Nineteen patients treated with Singulair by the senior surgeon (NH) after implant placement from March 2006 to November 2009 were included in this study. Follow-up on Singulair efficacy was obtained by a combination of office chart review and standardized telephone questionnaire. Results were characterized as complete improvement, improvement, no change, or worse. RESULTS: Seventeen patients presented with CC resulting from a variety of breast operations. Two patients who had a history of recurrent CC were prescribed Singulair prophylactically immediately after surgery. Twenty-one breasts with existing CC were included in the total. Two (11%) patients became worse, three (16%) patients had no change, five (26%) improved, seven (37%) completely improved, and two (11%) were prevented from having CC formation. CONCLUSION: Our preliminary study shows that Singulair improves CC. Breasts with mild CC (Baker score < III) appeared to have better improvement with Singulair compared to those with more severe contracture (Baker score III and IV). Singulair is well tolerated with minimal side effects and can be administered to patients after breast implant surgery to improve CC.


Assuntos
Acetatos/uso terapêutico , Implante Mamário/efeitos adversos , Contratura/tratamento farmacológico , Antagonistas de Leucotrienos/uso terapêutico , Quinolinas/uso terapêutico , Acetatos/efeitos adversos , Acetatos/farmacologia , Adolescente , Adulto , Implantes de Mama/efeitos adversos , Contratura/etiologia , Ciclopropanos , Feminino , Seguimentos , Humanos , Antagonistas de Leucotrienos/efeitos adversos , Antagonistas de Leucotrienos/farmacologia , Pessoa de Meia-Idade , Uso Off-Label , Complicações Pós-Operatórias/tratamento farmacológico , Quinolinas/efeitos adversos , Quinolinas/farmacologia , Recidiva , Estudos Retrospectivos , Índice de Gravidade de Doença , Sulfetos , Resultado do Tratamento
15.
Cancer Biol Ther ; 8(22): 2186-93, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19923910

RESUMO

The cancer stem cell hypothesis suggests that rare populations of tumor-initiating cells may be resistant to therapy, lead to tumor relapse and contribute to poor prognosis for cancer patients. We previously demonstrated the feasibility of p53 pathway restoration in p53-deficient tumor cell populations using small molecules including ellipticine or its derivatives. We now establish a single cell p53-regulated green fluorescent protein (EGFP)-reporter system in human DLD1 colon tumor cells expressing mutant p53 protein. We use these p53-EGFP reporter DLD1 cells to investigate the status of p53 transcriptional activity in putative colon cancer stem cell populations following exposure to p53 pathway-restoring drugs and/or classical chemotherapy. We demonstrate induction of p53-specific EGFP reporter fluorescence following overexpression of p53 family member p73 by an Adenovirus vector. We further show that p53-reporter activity is induced in DLD1 putative cancer stem cell side-populations analyzed by their Hoechst dye efflux properties following treatment with the p53 pathway restoring drug ellipticine. Combination of ellipticine with the cytotoxic agent 5-fluorouracil resulted in increased cytotoxicity as compared to either agent alone and this was associated with depletion of putative cancer stem cell populations as compared with 5-FU alone treatment. Our results support the feasibility of therapeutic targeting of mutant p53 in putative cancer stem cells as well as the potential to enhance cytotoxic chemotherapy.


Assuntos
Adenocarcinoma/patologia , Antineoplásicos/farmacologia , Neoplasias do Colo/patologia , Elipticinas/farmacologia , Fluoruracila/farmacologia , Genes p53 , Proteínas de Neoplasias/fisiologia , Células-Tronco Neoplásicas/efeitos dos fármacos , Antineoplásicos/administração & dosagem , Proteínas de Ligação a DNA/fisiologia , Sinergismo Farmacológico , Elipticinas/administração & dosagem , Fluoruracila/administração & dosagem , Genes Reporter , Genes Sintéticos , Vetores Genéticos/farmacologia , Humanos , Mutação , Proteínas de Neoplasias/biossíntese , Proteínas de Neoplasias/genética , Células-Tronco Neoplásicas/metabolismo , Proteínas Nucleares/fisiologia , Pirimidinas/farmacologia , Receptores do Ligante Indutor de Apoptose Relacionado a TNF/biossíntese , Receptores do Ligante Indutor de Apoptose Relacionado a TNF/genética , Proteínas Recombinantes de Fusão/fisiologia , Proteína Tumoral p73 , Proteína Supressora de Tumor p53/deficiência , Proteína Supressora de Tumor p53/fisiologia , Proteínas Supressoras de Tumor/fisiologia
17.
Biomaterials ; 29(27): 3671-3682, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18565578

RESUMO

Dendritic cell vaccines, in which antigen-loaded dendritic cells (DCs) are injected directly into patients to trigger immune responses, are in development as a treatment for cancer and some infectious diseases. In this study, we tested the concept of delivering DCs in an injectable hydrogel matrix, with the aim of harboring dendritic cells for prolonged time periods at a defined site and trapping/concentrating factors secreted by DCs to establish an inflammatory milieu in situ. To achieve these goals, a self-gelling formulation of alginate was developed, obtained by mixing calcium-loaded alginate microspheres with soluble alginate solution and dendritic cells, a formulation that rapidly gelled in vivo. When injected subcutaneously in mice, these alginate 'vaccination nodes' containing activated DCs attracted both host dendritic cells and a large number of T cells to the injection sites over a week in vivo, while some of the inoculated DCs trafficked to the draining lymph nodes. Using an adoptive transfer model to track a defined population of T cells responding to immunization with antigen-loaded DCs, we show that DC/alginate immunization led to recruitment of activated antigen-specific T cells to the alginate matrix, in a manner dependent on the presence of the DCs. This gel/DC immunization system may thus be of interest for immunotherapy to direct the accumulation of immune cells at solid tumors or infection sites in the presence of supporting factors co-delivered by the hydrogel matrix.


Assuntos
Alginatos , Células Dendríticas , Imunoterapia , Vacinas/administração & dosagem , Animais , Citometria de Fluxo , Géis , Ácido Glucurônico , Ácidos Hexurônicos , Camundongos , Camundongos Endogâmicos C57BL
18.
Plast Reconstr Surg ; 121(2): 411-423, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18300957

RESUMO

BACKGROUND: Liposuction-derived stem cells (processed lipoaspirate) have recently been shown to be capable of differentiating into bone. Most studies on osteoblastic growth and differentiation have been conducted in a conventional two-dimensional culture system; however, in native bone, osteoblasts are situated in a three-dimensional configuration. There have been limited studies of processed lipoaspirate behavior in three-dimensional systems. The authors studied the influence a three-dimensional scaffold has on the expression of genes related to osteogenesis and angiogenesis in processed lipoaspirate cells. METHODS: One million processed lipoaspirate cells were seeded onto two-dimensional poly(l-lactide-co-glycolide) films or in three-dimensional poly(l-lactide-co-glycolide) scaffolds and incubated in osteogenic medium up to 21 days. RNA was extracted and analyzed with quantitative real-time polymerase chain reaction. RESULTS: When an inert three-dimensional poly(l-lactide-co-glycolide) scaffold was introduced, the pattern and sequence of gene expression changed significantly. Processed lipoaspirate cells cultured onto three-dimensional scaffolds had increased expression of interleukin-8 and vascular endothelial growth factor compared with two-dimensional controls at early time points. Osteogenesis markers-alkaline phosphatase, collagen type I, osteocalcin, osteonectin, and osteopontin-were significantly up-regulated in three-dimensional cultures relative to two-dimensional controls after 24 hours and persisted throughout the 21 days. CONCLUSIONS: In human processed lipoaspirate cells, the introduction of a three-dimensional scaffold significantly enhances gene markers of angiogenesis and osteogenesis. On three-dimensional scaffolds, processed lipoaspirate cells first up-regulate genes involved with vascular ingrowth and then those involved in bone formation. We believe these differences will significantly impact the design of a bone graft substitute for clinical application.


Assuntos
Adipócitos/citologia , Neovascularização Fisiológica/genética , Osteogênese/genética , RNA/genética , Regulação para Cima , Adipócitos/metabolismo , Fosfatase Alcalina/biossíntese , Fosfatase Alcalina/genética , Biomarcadores , Colágeno Tipo I/biossíntese , Colágeno Tipo I/genética , Humanos , Interleucina-8/biossíntese , Interleucina-8/genética , Osteocalcina/biossíntese , Osteocalcina/genética , Osteonectina/biossíntese , Osteonectina/genética , Osteopontina/biossíntese , Osteopontina/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Alicerces Teciduais , Fator A de Crescimento do Endotélio Vascular/biossíntese , Fator A de Crescimento do Endotélio Vascular/genética
19.
Plast Reconstr Surg ; 121(2): 424-434, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18300958

RESUMO

BACKGROUND: Surface topography is important in the creation of a scaffold for tissue engineering. Chemical etching of poly(l-lactide-co-glycolide) with sodium hydroxide has been shown to enhance adhesion and function of numerous cell types. The authors investigated the effects of sodium hydroxide pretreatment of three-dimensional poly(l-lactide-co-glycolide) scaffolds on the adhesion, differentiation, and proliferation of MC3T3-E1 murine preosteoblasts. METHODS: MC3T3-E1 cells were seeded onto three-dimensional poly(l-lactide-co-glycolide) scaffolds with and without 1 M sodium hydroxide pretreatment. Cells were then cultured in osteogenic medium and harvested at varying time points for RNA extraction. Quantitative real-time reverse-transcriptase polymerase chain reaction was performed to measure mRNA expression of several osteogenic marker genes. In addition, cell numbers were determined at varying time points during the culture period. All experiments were performed in triplicate. RESULTS: Pretreatment of three-dimensional poly(l-lactide-co-glycolide) scaffolds with sodium hydroxide resulted in statistically significant up-regulation of mRNA expression of alkaline phosphatase, bone sialoprotein, osteocalcin, and vascular endothelial growth factor during the first 10 days of culture. Histologic analysis demonstrated a striking increase in mineralized cell matrix deposition in the sodium hydroxide-treated group. Cell number was statistically higher in the sodium hydroxide-treated group immediately after cell seeding, suggesting improved adhesion. During the first 24 hours of culture, cells grew faster in the control group than in the sodium hydroxide-treated group. CONCLUSIONS: Chemical etching of poly(l-lactide-co-glycolide) scaffolds with sodium hydroxide strongly influences the behavior of MC3T3-E1 preosteoblasts in vitro by enhancing adhesion and differentiation and slowing proliferation. Sodium hydroxide treatment may represent a simple and inexpensive way of improving scaffolds for use in bone tissue engineering.


Assuntos
Cáusticos/farmacologia , Ácido Láctico/farmacologia , Osteoblastos/citologia , Osteogênese/genética , Ácido Poliglicólico/farmacologia , Polímeros/farmacologia , Hidróxido de Sódio/farmacologia , Células-Tronco/citologia , Animais , Materiais Biocompatíveis/farmacologia , Diferenciação Celular/efeitos dos fármacos , Diferenciação Celular/genética , Proliferação de Células , Portadores de Fármacos , Expressão Gênica/efeitos dos fármacos , Sialoproteína de Ligação à Integrina , Camundongos , Osteoblastos/efeitos dos fármacos , Osteoblastos/metabolismo , Osteogênese/efeitos dos fármacos , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , RNA Mensageiro/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sialoglicoproteínas/biossíntese , Sialoglicoproteínas/genética , Células-Tronco/efeitos dos fármacos , Engenharia Tecidual , Alicerces Teciduais
20.
Lab Chip ; 7(6): 756-62, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17538718

RESUMO

The encapsulation of mammalian cells within the bulk material of microfluidic channels may be beneficial for applications ranging from tissue engineering to cell-based diagnostic assays. In this work, we present a technique for fabricating microfluidic channels from cell-laden agarose hydrogels. Using standard soft lithographic techniques, molten agarose was molded against a SU-8 patterned silicon wafer. To generate sealed and water-tight microfluidic channels, the surface of the molded agarose was heated at 71 degrees C for 3 s and sealed to another surface-heated slab of agarose. Channels of different dimensions were generated and it was shown that agarose, though highly porous, is a suitable material for performing microfluidics. Cells embedded within the microfluidic molds were well distributed and media pumped through the channels allowed the exchange of nutrients and waste products. While most cells were found to be viable upon initial device fabrication, only those cells near the microfluidic channels remained viable after 3 days, demonstrating the importance of a perfused network of microchannels for delivering nutrients and oxygen to maintain cell viability in large hydrogels. Further development of this technique may lead to the generation of biomimetic synthetic vasculature for tissue engineering, diagnostics, and drug screening applications.


Assuntos
Materiais Biocompatíveis/química , Hidrogel de Polietilenoglicol-Dimetacrilato/química , Microfluídica/métodos , Engenharia Tecidual/métodos , Animais , Sobrevivência Celular/fisiologia , Fluoresceína-5-Isotiocianato , Camundongos , Sefarose/química , Silício/química , Propriedades de Superfície , Temperatura , Fatores de Tempo
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