Further studies to evaluate methods of leucoreduction to prevent alloimmune platelet refractoriness and induce tolerance in a dog platelet transfusion model.

Three leucoreduction filters were evaluated – when used alone or combined with centrifuge leucoreduction (C-LR) – to prevent alloimmune platelet refractoriness in a dog platelet transfusion model.
Donor platelet-rich plasma (PRP) or buffy coat (BC) platelets were either filter leucoreduced (F-LR) or F-LR/C-LR, (51) Cr radiolabelled and transfused. Weekly transfusions were given for up to 8 weeks or until platelet refractoriness. Recipients who accepted treated transfusions were then given non-leucoreduced (non-LR) platelets to determine whether donor-specific tolerance had been induced.
Acceptance of F-LR PRP transfusions ranged from 29% to 66%. F-LR/C-LR transfusions prepared from PRP were accepted by 92%, from BC by 63% and from pooled PRP by 75% of recipients (p=NS); overall acceptance rate of F-LR/C-LR transfusions was 83%. Tolerance to subsequent non-LR transfusions occurred in 45% of the F-LR-/C-LR-accepting recipients unrelated to DR-B compatibility between donors and recipients (P = 0·18).
In a dog platelet transfusion model, acceptance of donor platelets required combining F-LR with C-LR as apparently each process removes different immunizing WBCs.
© 2016 International Society of Blood Transfusion.

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Revisiting dosing regimen using PK/PD modeling: the MODEL1 phase I/II trial of docetaxel plus epirubicin in metastatic breast cancer patients.

The MODEL1 trial is the first model-driven phase I/II dose-escalation study of densified docetaxel plus epirubicin administration in metastatic breast cancer patients, a regimen previously known to induce unacceptable life-threatening toxicities. The primary objective was to determine the maximum tolerated dose of this densified regimen. Study of the efficacy was a secondary objective. Her2-negative, hormone-resistant metastatic breast cancer patients were treated with escalating doses of docetaxel plus epirubicin every 2 weeks for six cycles with granulocyte colony stimulating factor support. A total of 16 patients were treated with total doses ranging from 85 to 110 mg of docetaxel plus epirubicin per cycle. Dose escalation was controlled by a non-hematological toxicity model. Dose densification was guided by a model of neutrophil kinetics, able to optimize docetaxel plus epirubicin dosing with respect to pre-defined acceptable levels of hematological toxicity while ensuring maximal efficacy. The densified treatment was safe since hematological toxicity was much lower compared to previous findings, and other adverse events were consistent with those observed with this regimen. The maximal tolerated dose was 100 mg given every 2 weeks. The response rate was 45 %; median progression-free survival was 10.4 months, whereas 54.6 months of median overall survival was achieved. The optimized docetaxel plus epirubicin dosing regimen led to fewer toxicities associated with higher efficacy as compared with standard or empirical densified dosing. This study suggests that model-driven dosage adjustment can lead to improved efficacy-toxicity balance in patients with cancer when several anticancer drugs are combined.

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FUJIFILM AND NATIONAL BREAST CANCER FOUNDATION CELEBRATE INSTALL OF MAMMOGRAPHY SYSTEM AT WHITE MEMORIAL MEDICAL CENTER

On March 24, 2016 White Memorial Medical Center, a member of the Adventist Health System and a 353-bed hospital in downtown Los Angeles, reported the installation of a new mammography system donated by FUJIFILM Medical Systems U.S.A., Inc. and National Breast Cancer Foundation (NBCF) on March 23, 2016 (Press release, Fujifilm, MAR 24, 2016, View Source [SID:1234509930]). A ceremony unveiled Fujifilm’s Aspire Cristalle at White Memorial Medical Center that will help meet the screening needs of women and assist medical professionals in the early detection and diagnosis of breast cancer.

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"We are pleased to be working with National Breast Cancer Foundation and White Memorial Medical Center to make a contribution that will have both immediate and long-term impacts on improving breast health care in the community," said Johann Fernando, Chief Operating Officer, FUJIFILM Medical Systems U.S.A., Inc.

According to the National Cancer Institute, 1 in 8 women will be diagnosed with breast cancer in their lifetime. Early detection and treatment are among the most effective ways to overcome cancer. The latest technology at White Memorial Medical Center will assist radiologists in screening and diagnosis of breast cancer.

"The incredible support we receive from National Breast Cancer Foundation makes a big difference at White Memorial Medical Center," said John Raffoul, President and CEO, White Memorial Medical Center. "This year alone, thanks to support from NBCF and other generous donors, we will be able to provide more than 2,300 free clinical breast exams/mammograms to underserved women of our community, of whom 45 will unfortunately test positive for cancer. This state-of-the-art equipment from Fujifilm will literally allow us to save the lives of women when we can diagnose them at an early stage of breast cancer. We are blessed to have these incredible partners supporting our hospital."

Since 2006, Fujifilm has donated $1.6 million to NBCF. The support has allowed NBCF to provide thousands of mammograms and early detection services to women in all 50 states and helped ensure that those facing breast cancer have access to quality healthcare.

"Through the donation of the Aspire Cristalle mammography system, Fujifilm will provide life-saving mammograms to women throughout the Los Angeles area," said Janelle Hail, NBCF Co-Founder & CEO. "We thank them for their partnership and support of our mission of Helping Women Now to those affected by breast cancer."

Over 9,000 worldwide facilities trust Fujifilm’s full-field digital mammography solutions, making Fujifilm the most popular digital mammography system provider in the world. To learn more about Fujifilm’s women’s health care products, please visit www.fujifilmhealthcare.com

Idiopathic Acquired Osteosclerosis in a Middle-Aged Woman with Systemic Lupus Erythematosus.

Widely distributed osteosclerosis is an unusual radiographic finding with multiple causes. A 42-year-old pre-menopausal Spanish woman gradually acquired dense bone diffusely affecting her axial skeleton and focally affecting her proximal long bones. Systemic lupus erythematosus diagnosed in adolescence had been well controlled. She had not fractured or received antiresorptive therapy, and was hepatitis C virus antibody negative. Family members had low bone mass. Lumbar spine BMD measured by dual-photon absorptiometry at age 17 years, while receiving glucocorticoids, was 79% the average value of age-matched controls. From ages 30 to 37 years, DXA BMD z-scores steadily increased in her lumbar spine from +3.8 to +7.9, and femoral neck from -1.4 to -0.7. Serum calcium and phosphorus levels were consistently normal, 25OHD <20 ng/mL, and PTH sometimes slightly increased. Her reduced eGFR was 38-55 mls/min. Hypocalciuria likely reflected positive mineral balance. During increasing BMD, turnover markers (serum bone-ALP, PINP, osteocalcin, and CTX, and urinary NTX) were 1.6- to 2.8-fold above the reference limits. Those of bone formation seemed increased more than those of resorption. FGF-23 was slightly elevated, perhaps from kidney disease. Serum OPG and TGFβ1 levels were normal, but sclerostin (SOST) and RANKL were elevated. Serum multiplex biomarker profiling confirmed a high level of SOST and RANKL, whereas DKK-1 seemed low. Matrix metalloproteinases-3 and -7 were elevated. Iliac crest biopsy revealed tetracycline labels, no distinction between thick trabeculae and cortical bone, absence of peritrabecular fibrosis, few osteoclasts, and no mastocytosis. Then, for the past three years, BMD z-scores steadily decreased. Skeletal fluorosis, mastocytosis, myelofibrosis, hepatitis C-associated osteosclerosis, multiple myeloma, and aberrant phosphate homeostasis did not explain her osteosclerosis. Mutation analysis of the LRP5, LRP4, SOST, and osteopetrosis genes was negative. Microarray showed no notable copy number variation. Perhaps her osteosclerosis reflected an interval of autoimmune-mediated resistance to SOST and/or RANKL. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.

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NF-κB transcriptional activation by TNFα requires phospholipase C, extracellular signal-regulated kinase 2 and poly(ADP-ribose) polymerase-1.

The nuclear enzyme poly(ADP-ribose) polymerase-1 (PARP-1) is required for pro-inflammatory effects of TNFα. Our previous studies demonstrated that PARP-1 mediates TNFα-induced NF-κB activation in glia. Here, we evaluated the mechanisms by which TNFα activates PARP-1 and PARP-1 mediates NF-κB activation.
Primary cultures of mouse cortical astrocytes and microglia were treated with TNFα and suitable signaling pathway modulators (pharmacological and molecular). Outcome measures included calcium imaging, PARP-1 activation status, NF-κB transcriptional activity, DNA damage assesment and cytokine relesease profiling.
TNFα induces PARP-1 activation in the absence of detectable DNA strand breaks, as measured by the PANT assay. TNFα-induced transcriptional activation of NF-κB requires PARP-1 enzymatic activity. Enzymatic activation of PARP-1 by TNFα was blocked in Ca(2+)-free medium, by Ca(2+) chelation with BAPTA-AM, and by D609, an inhibitor of phoshatidyl choline-specific phospholipase C (PC-PLC), but not by thapsigargin or by U73112, an inhibitor of phosphatidyl inisitol-specific PLC (PI -PLC). A TNFR1 blocking antibody reduced Ca(2+) influx and PARP-1 activation. TNFα-induced PARP-1 activation was also blocked by siRNA downregulation of ERK2 and by PD98059, an inhibitor of the MEK / ERK protein kinase cascade. Moreover, TNFα-induced NF-κB (p65) transcriptional activation was absent in cells expressing PARP-1 that lacked ERK2 phosphorylation sites, while basal NF-κB transcriptional activation increased in cells expressing PARP-1 with a phosphomimetic substitution at an ERK2 phophorylation site.
These results suggest that TNFα induces PARP-1 activation through a signaling pathway involving TNFR1, Ca(2+) influx, activation of PC-PLC, and activation of the MEK1 / ERK2 protein kinase cascade. TNFα-induced PARP-1 activation is not associated with DNA damage, but ERK2 mediated phosphorylation of PARP-1.

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