99 research outputs found

    Cross-sectional area of the paraspinal muscles and its association with muscle strength among fighter pilots : A 5-year follow-up

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    Background: A small cross sectional area (CSA) of the paraspinal muscles may be related to low back pain among military aviators but previous studies have mainly concentrated on spinal disc degeneration. Therefore, the primary aim of the study was to investigate the changes in muscle CSA and composition of the psoas and paraspinal muscles during a 5-year follow up among Finnish Air Force (FINAF) fighter pilots. Methods: Study population consisted of 26 volunteered FINAF male fighter pilots (age: 20.6 (±0.6) at the baseline). The magnetic resonance imaging (MRI) examinations were collected at baseline and after 5 years of follow-up. CSA and composition of the paraspinal and psoas muscles were obtained at the levels of 3-4 and 4-5 lumbar spine. Maximal isometric strength tests were only performed on one occasion at baseline. Results: The follow-up comparisons indicated that the mean CSA of the paraspinal muscles increased (p <0.01) by 8% at L3-4 level and 7% at L4-5 level during the 5-year period. There was no change in muscle composition during the follow-up period. The paraspinal and psoas muscles' CSA was positively related to overall maximal isometric strength at the baseline. However, there was no association between LBP and muscle composition or CSA. Conclusions: The paraspinal muscles' CSA increased among FINAF fighter pilots during the first 5 years of service. This might be explained by physically demanding work and regular physical activity. However, no associations between muscle composition or CSA and low back pain (LBP) experienced were observed after the five-year follow-up. © 2019 The Author(s).Peer reviewe

    Precision virotherapies: Coming soon

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    Oncolytic adenovirus: strategies and insights for vector design and immuno-oncolytic applications

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    Adenoviruses (Ad) are commonly used both experimentally and clinically, including oncolytic virotherapy applications. In the clinical area, efficacy is frequently hampered by the high rates of neutralizing immunity, estimated as high as 90% in some populations that promote vector clearance and limit bioavailability for tumor targeting following systemic delivery. Active tumor targeting is also hampered by the ubiquitous nature of the Ad5 receptor, hCAR, as well as the lack of highly tumor-selective targeting ligands and suitable targeting strategies. Furthermore, significant off-target interactions between the viral vector and cellular and proteinaceous components of the bloodstream have been documented that promote uptake into non-target cells and determine dose-limiting toxicities. Novel strategies are therefore needed to overcome the obstacles that prevent efficacious Ad deployment for wider clinical applications. The use of less seroprevalent Ad serotypes, non-human serotypes, capsid pseudotyping, chemical shielding and genetic masking by heterologous peptide incorporation are all potential strategies to achieve efficient vector escape from humoral immune recognition. Conversely, selective vector arming with immunostimulatory agents can be utilized to enhance their oncolytic potential by activation of cancer-specific immune responses against the malignant tissues. This review presents recent advantages and pitfalls occurring in the field of adenoviral oncolytic therapies

    Diversity within the adenovirus fiber knob hypervariable loops influences primary receptor interactions

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    Adenovirus based vectors are of increasing importance for wide ranging therapeutic applications. As vaccines, vectors derived from human adenovirus species D serotypes 26 and 48 (HAdV-D26/48) are demonstrating promising efficacy as protective platforms against infectious diseases. Significant clinical progress has been made, yet definitive studies underpinning mechanisms of entry, infection, and receptor usage are currently lacking. Here, we perform structural and biological analysis of the receptor binding fiber-knob protein of HAdV-D26/48, reporting crystal structures, and modelling putative interactions with two previously suggested attachment receptors, CD46 and Coxsackie and Adenovirus Receptor (CAR). We provide evidence of a low affinity interaction with CAR, with modelling suggesting affinity is attenuated through extended, semi-flexible loop structures, providing steric hindrance. Conversely, in silico and in vitro experiments are unable to provide evidence of interaction between HAdV-D26/48 fiber-knob with CD46, or with Desmoglein 2. Our findings provide insight into the cell-virus interactions of HAdV-D26/48, with important implications for the design and engineering of optimised Ad-based therapeutics

    Evaluation of CD46 re-targeted adenoviral vectors for clinical ovarian cancer intraperitoneal therapy

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    Ovarian cancer accounts for >140 000 deaths globally each year. Typically, disease is asymptomatic until an advanced, incurable stage. Although response to cytotoxic chemotherapy is frequently observed, resistance to conventional platinum-based therapies develop rapidly. Improved treatments are therefore urgently required. Virotherapy offers great potential for ovarian cancer, where the application of local, intraperitoneal delivery circumvents some of the limitations of intravenous strategies. To develop effective, adenovirus (Ad)-based platforms for ovarian cancer, we profiled the fluid and cellular components of patient ascites for factors known to influence adenoviral transduction. Levels of factor X (FX) and neutralizing antibodies (nAbs) in ascitic fluid were quantified and tumor cells were assessed for the expression of coxsackie virus and adenovirus receptor (CAR) and CD46. We show that clinical ascites contains significant levels of FX but consistently high CD46 expression. We therefore evaluated in vitro the relative transduction of epithelial ovarian cancers (EOCs) by Ad5 (via CAR) and Ad5 pseudotyped with the fiber of Ad35 (Ad5T*F35++) via CD46. Ad5T*F35++ achieved significantly increased transduction in comparison to Ad5 (P<0.001), independent of FX and nAb levels. We therefore propose selective transduction of CD46 over-expressing EOCs using re-targeted, Ad35-pseudotyped Ad vectors may represent a promising virotherapy for ovarian cance

    Automated text message enhanced monitoring versus routine monitoring in early rheumatoid arthritis: a randomized trial

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    OBJECTIVE:Frequent monitoring of early rheumatoid arthritis (RA) patients is required for achieving good outcomes. We studied the influence of text message (SMS) enhanced monitoring on early RA outcomes.METHODS:We randomized 166 early, disease-modifying antirheumatic drug naive RA patients to SMS-enhanced follow-up or routine care. All patients attended visits at 0, 3, and 6 months, and a follow-up visit at 12 months. Treatment was at the physicians' discretion. The intervention included 13 SMSs during weeks 0-24 with questions concerning medication problems (yes/no) and disease activity (patient global assessment [PGA], scale 0-10). If response SMSs indicated medication problems or PGA exceeded predefined thresholds the patients were contacted. Primary outcome was 6-month Boolean remission (no swollen or tender joints, normal CRP). Quality of life (QOL, Short Form 36) and 28-joint disease activity scores (DAS28) were assessed.RESULTS:Six and 12-month follow-up data were available for 162 and 157 patients. In the intervention group, 47% (38/82) of the patients reported medication problems and 49% (40/82) of the patients reported SMS-PGAs above the alarm limit. Remission rates in the intervention and control groups were 51% and 42% at 6 months (p=0.34); and 57% and 43% at 12 months (p=0.17). The respective DAS28 scores were 1.92±1.12 and 2.22±1.11 at 6 months (p=0.09); and 1.79±0.91 and 2.08±1.22 at 12 months (p=0.28). No differences in QOL were observed.CONCLUSION:The study failed the primary outcome despite a trend favoring the intervention group. This may be explained by the notably high overall remission rates. This article is protected by copyright. All rights reserved.</p

    Incorporation of peptides targeting EGFR and FGFR1 into the adenoviral fibre knob domain, and their evaluation as targeted cancer therapies

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    Oncolytic virotherapies based on Adenovirus 5 (Ad5) hold promise as adjunctive cancer therapies; however their efficacy when delivered systemically is hampered by poor target cell specificity and pre-existing anti-Ad5 immunity. Ovarian cancer represents a promising target for virotherapy, since the virus can be delivered locally into the peritoneal cavity. Both Epidermal Growth Factor Receptor (EGFR) and Fibroblast Growth Factor Receptor 1 (FGFR1) are over-expressed in the majority of human tumours, including ovarian cancer. To generate adenoviral vectors with improved tumour specificity, we generated a panel of Ad5 vectors with altered tropism for EGFR and FGFR, rather than the natural Ad5 receptor, hCAR. We have included mutations within AB loop the viral fibre knob (KO1 mutation) to preclude interaction with, hCAR, combined with insertions in the HI loop to incorporate peptides that bind either EGFR (peptide YHWYGYTPQNVI, GE11) or FGFR1 (peptides MQLPLAT, M* and LSPPRYP, LS). Viruses were produced to high titres, and the integrity of the fibre protein was validated by Western blotting. The KO1 mutation efficiently ablated hCAR interactions, and significantly increased transduction was observed in hCARlow/EGFRhigh cell lines using Ad5.GE11, whilst transduction levels using Ad5.M* or Ad5.LS were not increased. In the presence of physiological concentrations of human blood clotting factor X (hFX), significantly increased levels of transduction via the hFX-mediated pathway were observed in cell lines, but not in primary tumour cells derived from epithelial ovarian cancer (EOC) ascites samples. Ad5 mediated transduction of EOC cells were completely abolished by the presence of 2.5% serum from patients, whilst surprisingly, incorporation of the GE11 peptide resulted in significant evasion of neutralisation in the same samples. We thus speculate that incorporation of the YHWYGYTPQNVI dodecapeptide within the fibre knob domain may provide a novel means of circumventing pre-existing Ad5 immunity that warrants further investigation

    Pc1-Pc2 waves and energetic particle precipitation during and after magnetic storms: superposed epoch analysis and case studies

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    Magnetic pulsations in the Pc1-Pc2 frequency range (0.1-5 Hz) are often observed on the ground and in the Earth's magnetosphere during the aftermath of geomagnetic storms. Numerous studies have suggested that they may play a role in reducing the fluxes of energetic ions in the ring current; more recent studies suggest they may interact parasitically with radiation belt electrons as well. We report here on observations during 2005 from search coil magnetometers and riometers installed at three Antarctic stations, Halley (-61.84 degrees magnetic latitude, MLAT), South Pole (-74.18 degrees MLAT), and McMurdo (-79.96 degrees MLAT), and from energetic ion detectors on the NOAA Polar-orbiting Operational Environment Satellites (POES). A superposed epoch analysis based on 13 magnetic storms between April and September 2005 as well as case studies confirm several earlier studies that show that narrowband Pc1-Pc2 waves are rarely if ever observed on the ground during the main and early recovery phases of magnetic storms. However, intense broadband Pi1-Pi2 ULF noise, accompanied by strong riometer absorption signatures, does occur during these times. As storm recovery progresses, the occurrence of Pc1-Pc2 waves increases, at first in the daytime and especially afternoon sectors but at essentially all local times later in the recovery phase (typically by days 3 or 4). During the early storm recovery phase the propagation of Pc1-Pc2 waves through the ionospheric waveguide to higher latitudes was more severely attenuated. These observations are consistent with suggestions that Pc1-Pc2 waves occurring during the early recovery phase of magnetic storms are generated in association with plasmaspheric plumes in the noon-to-dusk sector, and these observations provide additional evidence that the propagation of waves to ground stations is inhibited during the early phases of such storms. Analysis of 30- to 250-keV proton data from four POES satellites during the 24-27 August and 18-19 July 2005 storm intervals showed that the location of the inner edge of the ring current matched well with the plasmapause model of O'Brien and Moldwin (2003). However, the POES data showed no evidence of the consequences of electromagnetic ion cyclotron waves (localized proton precipitation) during main and early recovery phase. During later stages of the recovery phase, when such precipitation was observed, it was coincident with intense wave events at Halley, and it occurred at L shells near or up to 1 RE outside the modeled plasmapause but well equatorward of the isotropy boundary
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