Patient-reported outcomes of symptom burden in patients receiving surgical or nonsurgical treatment for low-intermediate risk oropharyngeal squamous cell carcinoma: A comparative analysis of a prospective registry

Publication date: April 2019

Source: Oral Oncology, Volume 91

Author(s): Moran Amit, Kate Hutcheson, Jhankruti Zaveri, Jan Lewin, Michael E Kupferman, Amy C Hessel, Ryan P Goepfert, G. Brandon Gunn, Adam S Garden, Renata Ferraratto, C. Dave Fuller, Samantha Tam, Neil D. Gross

Abstract

Purpose

To explore treatment-related changes in symptom burden and quality of life (QOL) in oropharyngeal squamous cell cancer (OPSCC) patients treated surgically and non-surgically.

Patients and Methods

Eighty-six patients with human papillomavirus–associated OPSCC treated at the Head and Neck Center at The University of Texas MD Anderson Cancer Center were recruited to a prospective registry study between 2014 and 2016 and completed the core, head and neck-specific, and symptom interference sections of the MD Anderson symptom inventory (MDASI) multi-symptom questionnaire and the EQ-5D health status assessment as a measure of QOL at four time points.

Results

Longitudinal improvements from post-treatment nadir were observed across all groups. For patients treated with single modality, symptom interference, but not core and head and neck specific, MDASI scores were significantly better at 6 months in patients treated with surgery than radiation (P = 0.04). For patients treated with multiple modalities, scores for each of the three domains (i.e., core, head and neck -specific, and interference MDASI) were significantly better in the surgical group than the nonsurgical group at treatment completion (P = 0.0003, P = 0.0006 and P = 0.02) and 6 weeks (P = 0.001, P = 0.05 and P = 0.04), but not 6 months (P = 0.11, P = 0.16 and P = 0.040). No significant differences in EQ5D health status were observed between groups at any time point, reflecting similar overall QOL in all groups.

Conclusion

Symptom burden and QOL improves after treatment in OPSCC survivors over time regardless of whether primary surgical or nonsurgical treatment is used, although acute symptom profiles may differ.

http://bit.ly/2GM85FI

Patterns of EBV-positive cervical lymph node involvement in head and neck cancer and implications for the management of nasopharyngeal carcinoma T0 classification

Publication date: April 2019

Source: Oral Oncology, Volume 91

Author(s): Wei-Jie Luo, Yan-Fen Feng, Rui Guo, Ling-Long Tang, Lei Chen, Guan-Qun Zhou, Wen-Fei Li, Xu Liu, Ying Sun, Ai-Hua Lin, Jun Ma, Yan-Ping Mao

Abstract

Objectives

Epstein-Barr virus (EBV)-positive cervical lymph node (CLN) metastasis of unknown primary origin is classified as nasopharyngeal carcinoma (NPC) T0 by the American Joint Committee on Cancer staging manual (8th edition). We aimed to investigate the possible primary sites and patterns of EBV-positive CLN metastases and to provide implications for the management of NPC T0 classification.

Materials and methods

We retrospectively reviewed 269 patients with newly diagnosed EBV-positive CLN metastatic disease who underwent EBV detection via EBV-encoded RNA in situ hybridization. Fifteen patients with unknown primary tumors underwent follow-up after initial treatment.

Results

In patients with EBV-positive CLNs, the most common primary sites after the nasopharynx (51.7%) were the salivary gland (24.5%), lung (7.8%), oropharynx (3.3%), nasal cavity/maxillary (3.3%), oral cavity (2.2%), orbit (1.1%), and liver (0.4%). No primary site was found in 15 patients (5.6%). For salivary gland malignancies, level II and I were the most frequently involved regions. Tumors arising from the lung or liver metastasized to the lower neck (level IV, V, and VI) rather than the upper neck. After initial treatment, 2/15 patients with EBV-positive CLNs of unknown primary exhibited primary NPC and oropharyngeal tumor, respectively. Further, even without prophylactic irradiation to the nasopharynx, only one of 13 unknown primary patients developed NPC.

Conclusions

The origins of EBV-positive CLNs may not be restricted to the nasopharynx alone, and are likely to involve the head and neck or non-head and neck regions. NPC T0 classification should be cautiously assigned to such tumors.

http://bit.ly/2tz0bYx

The efficacy of cotton ball packing after endoscopic sinus surgery: A prospective, randomized, controlled trial

Publication date: Available online 17 February 2019

Source: Auris Nasus Larynx

Author(s): Seon-Lin Kim, Sung-Dong Kim, Han-Seul Na, Jae-Wook Kim, Keun-Ik Yi, Sue-Jean Mun, Kyu-Sup Cho

Abstract

Objective

The blocking of airflow into sinonasal cavity may decrease postoperative crusting and the development of adhesions. The purpose of this study was to investigate the efficacy of cotton ball packing in patients following endoscopic sinus surgery (ESS).

Methods

Thirty nine patients with chronic rhinosinusitis requiring the same extent of ESS were included. As a part of postoperative care, the patients were instructed to perform a nasal saline irrigation and apply a nasal spray in each nostril, and then informed to put a cotton ball in a one side of nostril, and the other side was kept to be empty as a control. Patients' subjective symptoms, patients' pain while receiving sinonasal cavity debridement, time required to perform debridement, and postoperative wound healing were evaluated.

Results

Although cotton ball packing resulted in less discomfort for postnasal drip, rhinorrhea, headache, and facial pain than no packing, there were no statistically significant differences between the groups. The cotton ball packing was associated with significantly less pain on while performing postoperative debridement, therefore less time was needed to perform debridement. The cotton ball packing appears to improve wound healing within the sinus cavities up to 1 month postoperatively.

Conclusion

The use of the cotton ball packing after ESS results in significantly less formation of crusts and adhesions, leading to decreasing pain and time during postoperative debridement and promoting faster wound healing.

http://bit.ly/2NbADJJ

Measuring anti-HLA antibody active concentration and affinity by surface plasmon resonance: Comparison with the luminex single antigen flow beads and T-cell flow cytometry crossmatch results

Publication date: April 2019

Source: Molecular Immunology, Volume 108

Author(s): Jonathan Visentin, Damien Le Leu, Arend Mulder, Frédéric Jambon, Laure Badier, Jar-How Lee, Gwendaline Guidicelli, Charlène Bouthemy, Mamy Ralazamahaleo, Frans Claas, Carmelo Di Primo, Jean-Luc Taupin

Abstract

Background

Although the Luminex single antigen flow beads (SAFB) and the flow cytometry crossmatch (FCXM) are the most sensitive assays used for anti-HLA antibodies characterization in transplant recipients, their semi-quantitative fluorescence read-out is not closely linked to graft outcome.

Methods

Surface plasmon resonance (SPR) was implemented to determine truly quantitative parameters of five human monoclonal anti-class I HLA antibodies (mAbs): first the active concentration and then the binding constants. The results were compared to those obtained with SAFB and T-cell FCXM (T-FCXM).

Results

The five mAbs displayed different rate and equilibrium constants for their cognate antigens. No correlation was evidenced between SAFB MFI or T-FCXM ratio and the binding parameters measured by SPR. Some mAbs amino acid substitutions within the epitope that influenced SAFB MFI resulted in affinity variations evidenced by SPR.

Conclusion

The SAFB MFI and T-FCXM ratio, both semi-quantitative parameters, only partially reflected the subtlety of the anti-HLA antibody/antigen interaction as it can be analyzed by SPR. Future clinical studies using SPR for anti-HLA antibodies characterization could bring novel insights into the understanding of HLA/anti-HLA interaction and therefore anti-HLA antibodies pathogenicity.

http://bit.ly/2BF4xBL

Heat shock protein 27 inhibits HMGB1 translocation by regulating CBP acetyltransferase activity and ubiquitination

Publication date: April 2019

Source: Molecular Immunology, Volume 108

Author(s): Xiaowen Bi, Miao Xu, Jinfei Li, Ting Huang, Baolin Jiang, Lei Shen, Lan Luo, Shixiang Liu, Zhimin Yin

Abstract

Heat-shock protein 27 (Hsp27) is a member of the small heat shock protein family that has been reported to protect cells against pro-inflammatory stresses. High mobility group box 1 (HMGB1) is a proinflammatory cytokine associated with death from sepsis and other inflammatory diseases. After being acetylated by CREB-binding protein (CBP), the transcriptional adaptor and acetyltransferase, HMGB1 translocates from the nucleus to the cytoplasm. In the present study, we investigated the effects of Hsp27 on HMGB1 translocation from the nucleus to the cytoplasm in THP-1 cells. We found that Hsp27 phosphorylation decreased LPS-induced HMGB1 acetylation and translocation from the nucleus to the cytoplasm, as well as its release from THP-1 cells. The study further showed that cytosolic non-phosphorylated Hsp27 enhanced CBP ubiquitination and degradation in LPS-unstimulated cells, which suggested that Hsp27 maintained suitable CBP levels under normal physiological conditions. After LPS stimulation, Hsp27 was phosphorylated at serine residues 15/78 and translocated from the cytoplasm into the nucleus. Consequently, LPS stimulation increased CBP levels and promoted its translocation into the nucleus. In the nucleus, Hsp27 bound to CBP and suppressed CBP acetyltransferase activity and the subsequent CBP-dependent acetylation of HMGB1. Taken together, our data demonstrated that cytosolic non-phosphorylated Hsp27 enhanced the ubiquitin-mediated degradation of CBP, while phosphorylated Hsp27 inhibited CBP acetyltransferase activity in the nucleus. By regulating CBP, Hsp27 maintained cell homeostasis and inhibited excessive inflammatory response.

Graphical abstract

http://bit.ly/2BDM9Jx

Cytokines use different intracellular mechanisms to upregulate the membrane expression of CX3CR1 in human monocytes

Publication date: April 2019

Source: Molecular Immunology, Volume 108

Author(s): Cecilia Analia Panek, Andrea Cecilia Bruballa, Gonzalo Ezequiel Pineda, Carlos De Brasi, Romina Jimena Fernández-Brando, María Pilar Mejías, María Victoria Ramos, Marina Sandra Palermo

Abstract

Membrane expression of fractalkine (CX₃CL1)-receptor (CX₃CR1) is relevant in monocytes (Mo) because CX₃CR1-CX₃CL1 interactions might participate on both, homeostatic and pathologic conditions. We have previously demonstrated that CX₃CR1 levels are decreased during culture and when Mo are differentiated into dendritic cells, but enhanced when differentiated into macrophages. Regarding soluble factors, lipopolysaccharide (LPS) accelerated the loss of CX₃CR1, while interleukin (IL)-10 and Interferon-gamma (IFN-γ) prevented it. However, the comprehensive knowledge about the intracellular pathways that underlay the level of CX₃CR1 expression in Mo is still incomplete.

In the current work, we studied the effect of anti-inflammatory cytokines (IL-4, IL-13, IL-10), alone or together with IFN- γ on CX₃CR1 expression. We found that only IL-10 and IFN-γ separately were able to prevent CX₃CR1 down-modulation during culture of human Mo. Besides, Mo incubated with IL-10 plus IFN-γ showed the highest CX₃CR1 expression by cell, suggesting cooperation between two different mechanism used by both cytokines. By studying intracellular mechanisms triggered by IL-10 and IFN-γ, we demonstrated that they specifically induced PI3K-dependent serine-phosphorylation of signal transducer and activator of transcription (STAT)3 or STAT1, respectively. Moreover, chemical inhibitors of STAT1 or STAT3 abrogated IFN-γ or IL-10 effects on CX₃CR1 expression. Strikingly, only IL-10 increased CX₃CR1 mRNA level, as consequence of augmenting mRNA stability. CX₃CR1 mRNA increase was PI3K-dependent, supporting the causal link between the action of IL-10 at the CX₃CR1 transcript and CX₃CR1 protein level on Mo. Thus, both cytokines up-regulate CX₃CR1 expression on human Mo by different intracellular mechanisms.

http://bit.ly/2TTJVwC

Risk factors and self‐perception for facial aging among Nepalese population

Summary

Background

Facial appearance has increasing importance to individuals and women, in particular. Till date, there are no reports of the extrinsic factors influencing skin aging in Nepalese population.

Objectives

To assess the risk factors and self‐perception for facial aging in Nepalese population.

Methods

A cross‐sectional study was conducted among 110 attendees aged 30‐70 years visiting the dermatology outpatient department of B.P. Koirala Institute of Health Sciences. An interview of the attendees was conducted to establish their perceived risk factors and age knowledge based on a questionnaire. The facial wrinkling was estimated by facial wrinkle scores using standardized visual assessment method by a dermatologist who was blinded with regard to all risk factors and age of the subjects.

Results

Around 50% of attendees were conscious about facial health, 53% perceived their facial age as their chronological age, 39% used some facial care products, and 68% were aware of the risk factors for facial aging. The major perceived risk factors were unhealthy eating habits, stress, less exercise, dehydration, diseased state and sleeping habits. A significant association was found between increasing age, place of birth in hills or mountains and sun exposure with high wrinkling score.

Conclusion

Facial skin wrinkles can be considered as a marker for intrinsic aging. Though the main factor responsible for extrinsic aging is ultraviolet radiation, identification of the factors may help in motivating the individuals for the adoption of a range of healthy behaviors for facial age in Nepalese population that may provide important public health benefits.

http://bit.ly/2DOWySC