13 research outputs found

    Predicting oral anticoagulant response using a pharmacodynamic model

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    We developed a pharmacokinetic and pharmacodynamic model of warfarin absorption, metabolism, and anticoagulant action appropriate for guiding anticoagulant therapy. The model requires only two independently adjustable parameters to describe warfarin's effect on individual patients. For any given individual, these parameters are rapidly and inexpensively identified using a computer program based on the model. Test data were generated by superimposing Gaussian noise on dose-response curves calculated with the model. Then the computer program was applied to the test data. Future prothrombin complex activities (PCA's) and maintenance doses were predicted accurately early in the course of drug administration. In addition, the program accurately predicted PCA response in two groups of normal volunteers.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44006/1/10439_2006_Article_BF02363455.pd

    Activating mutations in RRAS underlie a phenotype within the RASopathy spectrum and contribute to leukaemogenesis

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    Item does not contain fulltextRASopathies, a family of disorders characterized by cardiac defects, defective growth, facial dysmorphism, variable cognitive deficits and predisposition to certain malignancies, are caused by constitutional dysregulation of RAS signalling predominantly through the RAF/MEK/ERK (MAPK) cascade. We report on two germline mutations (p.Gly39dup and p.Val55Met) in RRAS, a gene encoding a small monomeric GTPase controlling cell adhesion, spreading and migration, underlying a rare (2 subjects among 504 individuals analysed) and variable phenotype with features partially overlapping Noonan syndrome, the most common RASopathy. We also identified somatic RRAS mutations (p.Gly39dup and p.Gln87Leu) in 2 of 110 cases of non-syndromic juvenile myelomonocytic leukaemia, a childhood myeloproliferative/myelodysplastic disease caused by upregulated RAS signalling, defining an atypical form of this haematological disorder rapidly progressing to acute myeloid leukaemia. Two of the three identified mutations affected known oncogenic hotspots of RAS genes and conferred variably enhanced RRAS function and stimulus-dependent MAPK activation. Expression of an RRAS mutant homolog in Caenorhabditis elegans enhanced RAS signalling and engendered protruding vulva, a phenotype previously linked to the RASopathy-causing SHOC2(S2G) mutant. Overall, these findings provide evidence of a functional link between RRAS and MAPK signalling and reveal an unpredicted role of enhanced RRAS function in human disease
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