Author Interviews, Heart Disease, JAMA, UT Southwestern / 25.11.2015
PA Catheterization Use Increases in CHF Without Shock or Respiratory Failure
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Dr. Ambarish Pandey[/caption]
Ambarish
MedicalResearch.com Interview with:
Ambarish Pandey M.D.
Division of Cardiology
University of Texas Southwestern Medical Center
Dallas, TX
Medical Research: What is the background for this study? What are the main findings?
Dr. Pandey: Pulmonary artery (PA) catheters have been used for invasive bedside hemodynamic monitoring for past four decades. The ESCAPE trial, published in October 2005, demonstrated that use of Pulmonary Artery catheter was not associated with a significant improvement in clinical outcomes of patients with heart failure. Accordingly, the current ACC/AHA guidelines discourage the routine use of PA catheter for routine management of acute heart failure in absence of cardiogenic shock or respiratory failure (Class III). Despite the significant evolution of available evidence base and guideline recommendations regarding use of Pulmonary Artery catheters, national patterns of PA catheter utilization in hospitalized heart failure patients remain unknown.
In this study, we observed that use of PA catheter among patients with heart failure decline significantly in the Pre-ESCAPE era (2001 – 2006) followed by a consistent increase in its use in the Post-ESCAPE era (2007-2012). We also observed that the increase in use of Pulmonary Artery catheters is most significant among heart failure patients without underlying cardiogenic shock or respiratory failure.
Dr. Ambarish Pandey[/caption]
Ambarish
MedicalResearch.com Interview with:
Ambarish Pandey M.D.
Division of Cardiology
University of Texas Southwestern Medical Center
Dallas, TX
Medical Research: What is the background for this study? What are the main findings?
Dr. Pandey: Pulmonary artery (PA) catheters have been used for invasive bedside hemodynamic monitoring for past four decades. The ESCAPE trial, published in October 2005, demonstrated that use of Pulmonary Artery catheter was not associated with a significant improvement in clinical outcomes of patients with heart failure. Accordingly, the current ACC/AHA guidelines discourage the routine use of PA catheter for routine management of acute heart failure in absence of cardiogenic shock or respiratory failure (Class III). Despite the significant evolution of available evidence base and guideline recommendations regarding use of Pulmonary Artery catheters, national patterns of PA catheter utilization in hospitalized heart failure patients remain unknown.
In this study, we observed that use of PA catheter among patients with heart failure decline significantly in the Pre-ESCAPE era (2001 – 2006) followed by a consistent increase in its use in the Post-ESCAPE era (2007-2012). We also observed that the increase in use of Pulmonary Artery catheters is most significant among heart failure patients without underlying cardiogenic shock or respiratory failure.
Dr. Schulert[/caption]
MedicalResearch.com Interview
Grant S Schulert MD, PhD
Clinical Fellow, Division of Rheumatology
Cincinnati Childrens Hospital
Medical Research: What is the background for this study? What are the main findings?
Dr. Schulert: Influenza infection causes millions of illnesses annually, but most of those are relatively mild. In a subset of cases, patients can become critically ill, even if they are relatively young and healthy. Several previous reports had observed in these critically ill patients features of a hyperinflammatory syndrome known as HLH (hemophagocytic lymphohistiocytosis) or MAS (macrophage activation syndrome). This hyperinflammation can be triggered by other infections as well as in a subtype of juvenile arthritis, but there is also a familial form occurring in early childhood with known genetic causes. Our questions with this study were
1) how often are features consistent with HLH/MAS seen in fatal H1N1 influenza infections and
2) do patients with fatal H1N1 infection have genetic mutations associated with HLH/MAS?
Our collaborator Paul Harms, MD, and his team at the Michigan Center for Translational Pathology, University of Michigan Medical School identified 16 cases of fatal H1N1 influenza infection. Based on their clinical features, between 41-88% of these patients could be categorized as having a hyperinflammatory HLH/MAS. We then used processed tissue samples from the patients for whole exome genetic sequencing, which reads the entire genetic code of every gene in a person. Five patients carried mutations in genes which cause HLH, and several others carried mutations in genes linked to MAS. This suggests that there may be genetic risk factors for developing fatal hyperinflammatory syndromes in H1N1 infection.
Dr. Han[/caption]
MedicalResearch.com Interview with:
Xuesong Han, PhD
Director, Surveillance and Health Services Research
American Cancer Society, Inc.
Atlanta, GA 3030
Medical Research: What is the background for this study? What are the main findings?
Dr. Han: People with private insurance are more likely to be screened and more likely to be diagnosed at an early stage of cancer. An early provision of the Affordable Care Act implemented in September 2010 allows young adults to remain on their parents’ health insurance plan until age 26 years, following which there has been an increase in private insurance coverage among young adults aged 19-25 years. For young adults, the uterine cervix is the only cancer site for which screening is recommended with a starting age of 21 years, and diagnosis of cervical cancer at early stages allows use of fertility-sparing treatment.
Using data before and after the dependent coverage expansion provision of ACA, we found that compared with 26-34 year-olds who were not affected by the policy change, women 21-25 years of age experienced a net increase of 9 percentage points in early stage disease and 11.9 percentage points in receipt of fertility-sparing treatment.
MedicalResearch.com Interview with:
Dr. Ffion C Davies
Consultant in Emergency Medicine & Paediatric Lead
University Hospitals of Leicester NHS Trust
Leicester Royal Infirmary
Leicester UK
Medical Research: What is the background for this study?
Dr. Davies: This study is from the Trauma Audit Research Network data, which is a major trauma database receiving data from nearly all hospitals in England and Wales. A 2012 TARN report on major trauma in children showed a peak of injuries resulting from child abuse in the younger age group. In this study we analysed the database in more detail, in order to profile this peak of injuries from non-accidental injury (NAI).
Medical Research: What are the main findings?
Dr. Davies: The main findings are that severe injury and death resulting from non-accidental injury occurs nearly always in the under 5 year old age group, and 75% of cases are under 1 year old. This contrasts with reports in the media, whereby high profile deaths in children from non-accidental injury are often older children. This probably reflects reporting bias, because those children experienced a prolonged period of abuse, despite involvement of health and social services. Our study shows that very small infants are the most likely to die, or to sustain severe head injuries.
Dr. Palmer[/caption]
MedicalResearch.com Interview with:
Dr William L Palmer
Ms. Mewborn[/caption]
MedicalResearch.com Interview with:
Catherine Mewborn, B.A.
Neuropsychology and Memory Assessment Laboratory
Department of Psychology
University of Georgia
Medical Research: What is the background for this study?
Response: Vision and cognitive functioning both tend to decline as individuals age. Processing speed, or the speed at which an individual can process information, is particularly vulnerable to age-related declines. In previous studies, cognition has typically been measured using traditional paper-and-pencil tests; however, these tests can be quite complex and recruit many different abilities. We wanted to use a simpler test to assess processing speed in the hopes of tapping into the more basic abilities that underlie performance on more complex cognitive tasks. For this study, we chose a measure of visual processing speed called critical flicker fusion, or CFF. We tested how well CFF could predict cognition in both younger and older adults.
Medical Research: What are the main findings?
Response: As expected, younger adults had better visual processing speed than older adults. Interestingly, in both age groups, CFF significantly predicted performance on a test of executive functioning, which assess abilities such as problem-solving and shifting attention between different tasks.
Dr. NJ Scheers[/caption]
MedicalResearch.com Interview with:
N.J. Scheers, PhD
Former manager of CPSC's Infant Suffocation Project
BDS Data Analytics, Alexandria, VA
Medical Research: What is the background for this study? What are the main findings?
Dr. Scheers: There are no federal regulations for crib bumpers. The American Academy of Pediatrics, the Canadian Pediatric Society, the National Institutes of Health, and others have long recommended against crib bumper use. Crib bumper manufacturers have a long-standing voluntary safety standard aimed at making crib bumpers safe. Neither of these approaches has worked to prevent deaths from bumpers.
Medical Research: What are the main findings?
Dr. Scheers: Using data from the Consumer Product Safety Commission (CPSC), the research identified 48 deaths from crib bumpers from 1985-2012. Reports of the deaths increased significantly and were three times higher from 2006 through 2012 than in previous years.
In most of the deaths, the crib bumpers were the only source of suffocation, rebutting beliefs that other items in the cribs (comforters, pillows, blankets) caused the deaths. In other deaths, wedging occurred between the bumper and other objects such as pillows and infant recliners. All of these deaths would have been preventable if crib bumpers had not been in the cribs.
The study linked more deaths to crib bumpers than the 48 indicated in the CPSC data. A review of data from the National Center for the Review and Prevention of Child Deaths reveals reports of 32 bumper-related deaths from 37 states from 2008-2011. That puts the number of fatalities tied to crib bumpers at 77 and suggests the actual number is much higher.
The study identified 146 injuries from 1990-2012. Eleven were “near-misses” in which the babies were rescued before they died. These were near-suffocations, chokings, strangulations, and falls from infants using bumpers to climb out of the cribs. There were reports of poor bumper design, such as a lack of bottom bumper ties, or construction problems, such as bumper ties and decoration that detached.
Parents often buy bumpers to prevent slat entrapments or to prevent infants bumping their heads in the cribs. This is the first study to show that these events occurred even with a bumper present.
Dr. Kamila Mistry[/caption]
MedicalResearch.com Interview with:
Kamila B. Mistry, PhD MPH
Senior Advisor, Child Health and Quality Improvement
Agency for Healthcare Research and Quality
US Department of Health and Human Services
Rockville, MD 20857
Medical Research: What is the background for this study? What are the main findings?
Dr. Mistry: This study, conducted by researchers at the Agency for Healthcare Research and Quality (AHRQ), was seeking to explore what impact the Affordable Care Act (ACA) may have on the nation’s well-documented racial/ethnic disparities in insurance coverage, access to medical care, and preventive services utilization. We used pre-ACA (2005-2010) household data from AHRQ’s Medical Expenditure Panel Survey to examine patterns of coverage, access, and utilization, by race/ethnicity, for nonelderly adults who are targeted by ACA coverage expansion provisions.
Dr. Shadel[/caption]
MedicalResearch.com Interview with:
William G. Shadel, PhD
Associate Director, Population Health Program
Senior Behavioral Scientist
RAND Corporation
Pittsburgh, PA 15213
Medical Research: What is the background for this study? What are the main findings?
Dr. Shadel: The tobacco industry spends almost all of its multi-billion dollar advertising budget at retail point-of-sale locations. A key feature of their advertising strategy includes the tobacco power wall, a prominent behind the cashier display of hundreds of cigarette and tobacco product brands. The power wall also displays posters for those tobacco products as well as pricing information. As such, it conveys a lot of positive messages about tobacco products to consumers.
The purpose of this experiment was to evaluate whether hiding or moving the tobacco power wall from its highly conspicuous location reduced teens’ smoking risk when they shop at convenience stores. The study took place in the RAND StoreLab (RSL), a life-sized replica of a convenience store that was constructed to explore a range of options for regulating tobacco products at point-of-sale retail locations. A sample of 271 teens (ages 11-17) was randomized to one of three experimental conditions: cashier (the tobacco power wall was located in its usual location, behind the cashier); side wall (the tobacco power wall was moved from behind the cashier to an out of the way location in the RSL); and hidden (the tobacco power wall was located behind the cashier, but was hidden behind an opaque wall). After teens finished shopping in the RSL, they completed questionnaires that measured their susceptibility to future smoking.
Teens assigned to the condition where the power wall was hidden were significantly less likely to report that they would smoke in the future, compared with those that were assigned to the cashier condition. Locating the power wall to a sidewall had no effect on smoking susceptibility.
Dr. David Katz[/caption]
MedicalResearch.com Interview with:
David L. Katz, MD, MPH, FACPM, FACP, FACLM
Director, Yale University Prevention Research Center
Griffin Hospital
President, American College of Lifestyle Medicine
Founder, True Health Initiative
Medical Research: What is the background for this study? What are the main findings?
Dr. Katz: the evidence that nuts in general, and walnuts in particular, have health promoting properties is vast and conclusive. In our own prior research, we have shown that daily ingestion of walnuts ameliorates overall cardiac risk in type 2 diabetics (
Dr. McNaughton[/caption]
MedicalResearch.com Interview with:
Candace D. McNaughton, MD MPH FACEP
Assistant Professor
Emergency Medicine Research
Department of Emergency Medicine, Research Division
Vanderbilt University Medical Center
Medical Research: What is the background for this study? What are the main findings?
Dr. McNaughton: Hypertension, or high blood pressure, affects 1/3rd of adults in the United States and more than 1 billion people worldwide. It is also the #1 risk factor for cardiovascular disease such as heart attack and stroke, so it is very important to treat.
The burden of hypertension in the emergency department is not well understood. The ER is not usually thought of as a place where perhaps we could or should be addressing hypertension; that has traditionally be left up to primary care providers. Through this study, our goals were to gain a better understanding of how many ER visits were either related to hypertension or were solely because of hypertension, and to determine whether this changed from 2006 to 2012.
We found that 
Dr. Tianhua He[/caption]
MedicalResearch.com Interview with:
Dr. Tianhua He MD
Beijing China, 100005
Medical Research: What is the background for this study? What are the main findings?
Response: The prevalence of Hepatitis C (HCV) infection is high (17%) in US prisons. And about 30% of all HCV-infected persons in US spend part of the year in correctional facilities.
However, most state prisons offer no routine screening for Hepatitis C. Undiagnosed and untreated inmates, after releasing, will contribute to the spread of the disease in society. HCV infection is now the leading cause of liver cancer, and the most common indication for liver transplant. With the recently launched highlyy effective antiviral drugs, previous studies have shown that treating infected prisoners was cost-effective. However, no studies yet have evaluated the effect of interventions including screening and treatment among prisoners on prevention of 
Dr. Gunderson[/caption]
MedicalResearch.com Interview with:
Erica P. Gunderson, PhD, MPH, MS, RD
Senior Research Scientist, Division of Research, Cardiovascular and Metabolic Conditions Section
Kaiser Permanente Northern California
Oakland, CA 94612
Medical Research: What is the background for this study?
Dr. Gunderson: Gestational diabetes mellitus (GDM) is a disorder of glucose tolerance affecting 5-9 percent of all U.S. pregnancies (approximately 250,000 annually), with a 7-fold higher risk of progression to type 2 diabetes. Strategies during the postpartum period for prevention of diabetes focus on modification of lifestyle behaviors, including dietary intake and physical activity to promote weight loss.
Lactation is a modifiable postpartum behavior that improves glucose and lipid metabolism, and increases insulin sensitivity, with favorable metabolic effects that persist post-weaning. Despite these metabolic benefits, evidence that lactation prevents type 2 diabetes remains inconclusive, particularly among women with 
Dr. Aaron White[/caption]
MedicalResearch.com Interview with:
Aaron White, PhD
Senior Scientific Advisor to the Director
Office of the Director
National Institute on Alcohol Abuse and Alcoholism
National Institutes of Health
Bethesda, MD
Medical Research: What is the background for this study? What are the main findings?
Dr. White: Recent studies and anecdotal evidence suggest that alcohol use by women in the United States might be on the rise and that long-standing gender gaps in drinking and related consequences might be narrowing. Using data from the National Survey on Drug Use and Health, we found that differences in the drinking patterns of females and males ages 12+ narrowed between 2002 and 2012 for current drinking (drinking at least once in the last 30 days), number of drinking days per month, past year DSM-IV alcohol abuse, and past-year driving under the influence of alcohol. For instance, the percentage of women who drank in the previous 30 days rose from 44% to 48%, while for men the percentage decreased from 57% to 56%. Average 
Dr. Villanti[/caption]
MedicalResearch.com Interview with:
Dr. Andrea C. Villanti PhD, MPH
Director, Regulatory Science and Policy Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative
Washington, DC 20001
Medical Research: What is the background for this study? What are the main findings?
Dr. Villanti: Awareness, interest, and use of electronic cigarettes (e-cigarettes) have increased since the products were introduced in the U.S. in 2006. Between 2012 and 2013, 8.3% of young adults reported current e-cigarette use compared to 4.2% of adults overall. One factor likely driving 
Dr. Chunsheng Wang[/caption]
MedicalResearch.com Interview with:
Chunsheng Wang, MD
Department of Cardiovascular Surgery, Shanghai Cardiovascular Institution
and Zhongshan Hospital
Fudan University, Shanghai, China
Medical Research: What is the background for this study? What are the main findings?
Dr. Wang: Transcatheter aortic valve replacement (TAVR) has been widely used in high-risk patients for surgical aortic valve replacement. However, the majority of the TAVR devices were designed for aortic valve stenosis with significant valve calcification. For most of these devices, predominant aortic regurgitation remained to be a technological challenge because of questionable anchoring, which can result in a high incidence of valve migration and paravalvular leak. Consequently, the guidelines from the United States and the Europe suggest that candidates with predominant aortic regurgitation (>grade 3+) or noncalcified valve should not undergo 
Dr. Newton[/caption]
MedicalResearch.com Interview with:
Paul K Newton PhD
Professor of Aerospace & Mechanical Engineering, Mathematics, and Norris Comprehensive Cancer Center
USC Viterbi
University of Southern California
University Park Campus
Los Angeles, CA 90089-4012
Medical Research: What is the background for this study? What are the main findings?
Dr. Newton: We obtained a longitudinal data set of 446 breast cancer patients from Memorial Sloan Kettering Cancer Center, tracked from 1975 to 2009.
All of the patients had primary breast cancer at the time they entered, with no metastatic tumors. All subsequently developed metastatic breast cancer.
From this time-resolved data set, we first developed what we called tree-ring diagrams showing the full spatiotemporal patterns of progression. We then used this information
to develop a Markov chain dynamical model of metastatic breast cancer. This is a model based on the concept that where the disease currently is located strongly influences where it will spread next.
The systemic nature of metastatic breast cancer is clearly shown in these kinds of network based models.
The main findings are that survival depends very strongly on where the first metastatic tumor develops. For example, if the first metastatic tumor appears in the bone, as happens in roughly 35% of the patients, survival is much better than if it appears in the brain (less than 5% of the patients). Furthermore, for those patients with a first met to the bone, survival is far better for those who develop their next met in the lung area, as compared with those that develop it in the liver.
Metastatic sites are categorized as `spreader’ sites, or `sponge’ sites. Bone and chest wall are generally the primary spreader sites of metastatic breast cancer, dynamically involved in spreading the disease throughout the metastatic process. On the other hand, liver seems to be a key sponge site, where circulating tumor cells most likely accumulate. If one were to focus on an active therapeutic program targeting metastatic sites, most likely the spreader sites would give the most bang-for-buck in terms of survival.
Prof. Chiang[/caption]
MedicalResearch.com Interview with:
Prof. Bor-Luen Chiang
Vice Superintendent, National Taiwan University Hospital
Professor of Graduate Institute of Clinical Medicine and Pediatrics
National Taiwan University
Attending Physician, Department of Medical research
National Taiwan University Hospital and
Yung-Sen Chang, MD MPH
Attending physician, Department of Pediatrics,
Taipei City Hospital Renai Br.
Adjunct Attending Physician, Department of Pediatrics
National Taiwan University Children’s Hospital
Adjunct Instructor, School of Medicine, National Yang-Ming University
Medical Research: What is the background for this study?
Prof. Chang: Sleep disturbance is a common disorder in the children with atopic dermatitis (AD) (reported in 47 to 60%), but no effective way of managing this problem had been established. In our preceding study, we found that lower nocturnal melatonin level was significantly associated with sleep disturbance in the patients with AD. Melatonin is a hormone secreted by the pineal gland which plays an important role in sleep regulation. In addition to sleep-inducing effects, melatonin also has anti-inflammatory and immunomodulatory properties which might be helpful for the management o fatopic dermatitis. Furthermore, melatonin has an excellent safety profile with minimal adverse effects, making it a good choice for children. Therefore, we aimed to evaluate whether melatonin is effective for improving the sleep problems and the dermatitis severity in children with 
Imre Noth, M.D.[/caption]
MedicalResearch.com Interview with:
Imre Noth, M.D.
Professor of Medicine and Director of the Interstitial Lung Disease Programme
The University of Chicago
Medical Research: What is the background for this study? What are the main findings?
Dr. Noth: In 2014, OFEV® (nintedanib) became one of the first FDA-approved drug treatments for idiopathic pulmonary fibrosis (IPF), a rare and serious lung disease that causes permanent scarring of the lungs. In this post-marketing surveillance study in the United States, treatment with OFEV in the real-world clinical setting showed a safety profile consistent with that observed in clinical trials supporting its approval by the FDA.
Post-marketing surveillance of the safety and tolerability of OFEV in the United States has been collected in the Boehringer Ingelheim drug safety and reporting database since OFEV was first approved on October 15, 2014. Until May 31, 2015, 3,838 people were treated with OFEV for a length of time ranging from 14 to 265 days (on average 88 days). The most frequently reported side effects were gastrointestinal in nature and included diarrhea, nausea, vomiting and decreased appetite. Diarrhea was the most frequently reported individual side effect, occurring at a similar frequency to that observed in the clinical trials supporting approval. No new safety concerns were identified.
Dr. Nesper[/caption]
MedicalResearch.com Interview with:
Arica Nesper, MD, MAS
Resident Physician
Stanford/Kaiser Emergency Medicine Residency
Stanford University Medical Center
Department of Emergency Medicine
Stanford
Medical Research: What is the background for this study? What are the main findings?
Dr. Nesper: Patients with severe mental illness are a distinct demographic in the emergency department. Unfortunately, resources to help these vulnerable patients are frequently the target of funding cuts. We aimed to describe the effect of these cuts on our emergency department and the care provided to our patients. In this study we evaluated data from before our county mental health facility cut its inpatient capacity by half and closed its outpatient unit, and compared this data with data collected after this closure. We found that the mean number of daily psychiatric consultations in our emergency department more than tripled and that the average length of stay for these patients increased by nearly eight hours. These two data combined demonstrate a five-fold increase in daily emergency department bed hours for psychiatric patients, placing a significant strain on the emergency department and demonstrating a delay in definitive care provided to these vulnerable patients.
Dr. Kenworthy[/caption]
MedicalResearch.com Interview with:
Lauren Kenworthy, PhD
Associate professor of Neurology, Pediatrics, and Psychiatry
George Washington University School of Medicine
Director of the Center for Autism Spectrum Disorders
Children’s National Health System
Medical Research: What is the background for this study? What are the main findings?
Dr. Kenworthy: Connectivity among brain regions may account for variability in autism outcomes not explained by age or behavioral measures, according to a study. We have previously shown that behavioral assessments of intelligence, baseline adaptive behavior and executive functions in people with autism can explain some of the variation in outcomes and function, but we have not been able to explain all of the variance in outcome (e.g. Pugliese et al 2015a, 2015b).
In this study, we found that 44% of the study group experienced significant change in scores on adaptive behavior between the initial scan and follow-up. Connectivity between three resting-state networks, including the salience network, the default-mode network, and the frontoparietal task control network, was linked not only to future autistic behaviors but also to changes in autistic and adaptive behaviors over the post-scan period. Further, connectivity involving the salience network and associated brain regions was associated with improvement in adaptive behaviors, with 100% sensitivity and around 71% precision.
Dr. Klebanoff[/caption]
MedicalResearch.com Interview with:
Mark A. Klebanoff, MD
Center for Perinatal Research
The Research Institute
Nationwide Children's Hospital
Medical Research: What is the background for this study? What are the main findings?
Dr. Klebanoff: Caffeine is among the substances most commonly consumed by pregnant women. There are numerous sources of caffeine in the diet—regular (non-decaf) coffee, regular tea, many soft drinks, 
Dr. Raymond Lam[/caption]
MedicalResearch.com Interview with:
Raymond W. Lam, MD, FRCPC
Professor and Associate Head for Research
Department of Psychiatry, University of British Columbia
Director, Mood Disorders Centre, Djavad Mowafaghian Centre for Brain Health
Executive Chair, Canadian Network for Mood and Anxiety Treatments (CANMAT)
Vancouver, BC, Canada
Medical Research: What is the background for this study?
Dr. Lam: Our multicentre team studied the effects of bright light therapy for nonseasonal depression. Light therapy is a non-pharmacological approach that has been studied as a treatment for seasonal affective disorder (SAD, or "winter depression"), but only a small number of studies has explored the use of light therapy in treating nonseasonal depression.
Clinical depression, known formally as Major Depressive Disorder (MDD) is the most common psychiatric disorder and one of the most common medical conditions worldwide. At any given time, at least 1 person in 20 (5% of the general population) is experiencing MDD, which will become the second-leading cause of disability worldwide by 2020, according to the World Health Organization.
Dr. Orian-Rousseau[/caption]
MedicalResearch.com Interview with:
Prof. Dr. Véronique Orian-Rousseau
Group Leader
Karlsruher Institut für Technologie (KIT)
Institut für Toxikologie und Genetik (ITG)
Campus Nord
Karlsruhe Germany
Medical Research: What is the background for this study? What are the main findings?
Response: Our group is working on the role of cell adhesion molecules in development and in tumor progression and metastasis. One protein in focus is CD44, a molecule that controls proliferation, differentiation and survival of cells. We have shown that one member of this family, namely CD44v6 acts as a co-receptor for receptor tyrosine kinases (RTKs) such as MET and VEGFR-2. CD44v6 has a dual function. It controls both the activation and signaling from the RTKs. We have identified a sequence in CD44v6 that is crucial for its function as a co-receptor. From this sequence we made a peptide that inhibits MET and VEGFR2 activation and signaling.
The CD44v6 peptide was used in several independent mouse models of pancreatic cancer including the transgenic PDAC mouse model. It could inhibit the growth of the primary tumor, metastasis and in addition could eliminate already established metastases.
In addition, we could show that MET and CD44v6 expression correlates with poor prognosis and metastasis in a cohort of pancreatic cancer patients.
Dr. González-Pacheco[/caption]
MedicalResearch.com Interview with:
Dr. Héctor González-Pacheco MD
Coronary Care Unit, National Institute of Cardiology
Mexico City, Mexico
Medical Research: What is the background for this study?
Dr. González-Pacheco: Epidemiological studies have provided robust evidence for an inverse correlation between plasma levels of high-density lipoprotein cholesterol (HDL-C) and cardiovascular risk. At hospital admission, a high percentage of patients with an acute coronary syndrome (ACS) have low HDL-C levels. Currently, the association of very low levels of HDL-C with early mortality in patients with ACS is still a topic of considerable interest. However, the possible mechanisms are not clear. Since an acute coronary syndrome induces an inflammatory response, and several chronic systemic diseases and acute critical illnesses with clear pro-inflammatory components have been associated with significantly reduced HDL-C levels, and investigators have shown an inverse correlation between HDL-C levels and the levels of pro-inflammatory cytokines, we hypothesized that reduced HDL-C levels in