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Results for “actionable alterations”

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At least 271 records · Page 15Linked to original sources
PubMed2026

Genomic Landscape of Metastatic Urothelial Cancer in a Multicenter Cohort From Argentina.

PURPOSE: The genomic landscape of advanced urothelial carcinoma (aUC) has enabled the development of targeted therapies; however, real-world data from Latin America remain limited. MATERIALS AND METHODS: We conducted a multicenter retrospective study including patients with aUC who underwent next-generation sequencing on tumor tissue. Molecular alterations were classified according to the European Society for Medical Oncology (ESMO) Scale for Clinical Actionability of Molecular Targets (ESCAT). RESULTS: A total of 107 patients were included. Overall, 68 patients (63.6%) harbored at least one potentially actionable molecular alteration. Among these, 34 patients (31.8%) exhibited ESCAT level I alterations, most commonly involving FGFR3 mutations/fusions and ERBB2 amplification. CONCLUSION: A clinically meaningful proportion of Argentine patients with aUC harbor ESCAT level I actionable alterations, supporting the incorporation of routine genomic profiling into clinical practice.

Humans↗
PubMed1987

Age-associated pharmacodynamic changes.

Many pharmacodynamic changes with age have been identified. Quite likely, they, in concert with age-associated pharmacokinetic changes and multiple drug use, are responsible for altered drug action in the elderly and an increasing incidence of adverse drug reactions with age. The pharmacodynamic changes, which can result in altered action of important drugs, can lead to major adverse clinical outcomes if not recognized, particularly in those drugs which affect the heart and the central nervous system.

Aging↗
PubMed1983

Endocrine influences on the actions of morphine. I. Alteration of target gland hormones.

There are few data concerning the effects of hormones on opiate actions. Consequently, we have studied the influences of peripheral endocrine systems upon sensitivity and tolerance to three major morphine effects: antinociception, hypothermia and catalepsy. It was found that in opiate naive animals adrenalectomy increased morphine-induced antinociception, hypothermia and catalepsy, whereas dexamethasone treatment decreased all three opiate effects. Thyroidectomy decreased the antinociceptive and cataleptic actions of morphine, but had no effect on the hypothermic response. Thyroxine treatment markedly altered the temperature response to morphine without affecting the other two actions. Control animals showed both hyperthermia and hypothermia after morphine, but animals treated chronically with thyroxine showed only hyperthermia. Alterations of the gonadal axis in males had no pronounced effects upon the actions of morphine. Further investigations demonstrated that morphine, when administered i.c.v. to thyroidectomized animals, produced responses similar to those seen after s.c. administration. During chronic studies, the only notable effects of endocrine alterations on the development of tolerance to morphine were trends toward suppression with dexamethasone treatment and trends toward augmentation after adrenalectomy. These results indicate that the actions of morphine are influenced by endocrine status. Adrenal hormones exert their effects upon the actions of morphine via peripheral metabolic alterations, whereas the effects of thyroid hormones are mediated at central sites. These results also indicate that the development of tolerance to morphine is not significantly influenced by any of the endocrine systems studied.

Adrenalectomy↗
PubMed1988

Central nervous system action of calcitonin to alter experimental gastric ulcers in rats.

The central nervous system action of calcitonin to influence various experimental models of gastric ulcers and gastric function was studied in rats fasted for 24 h. Intracisternal injection of salmon calcitonin (5 micrograms) completely suppressed gastric ulcerations induced by exposure to cold restraint stress, intracisternal injection of a stable thyrotropin-releasing hormone analogue, or peroral administration of aspirin. By contrast, intracisternal calcitonin enhanced gastric lesions elicited by peroral administration of 40% ethanol or 0.6 N HCl. Calcitonin action was dose-dependent (0.01-1 microgram) and central nervous system mediated inasmuch as intravenous calcitonin, given at a dose 50-fold higher than that effective intracisternally, did not significantly modify gastric mucosal injuries elicited by aspirin or ethanol. Intracisternal injection of calcitonin at 0.01 microgram inhibited gastric acid output by 90% in pylorus-ligated rats and suppressed gastric emptying of a liquid meal by 63%-94% in doses ranging from 0.01 to 5 micrograms. Prostaglandin generation in the gastric mucosa was not modified by intracisternal injection of calcitonin. These results demonstrate that intracisternal calcitonin acts within the brain to potently prevent ulcer formation elicited by stress, thyrotropin-releasing hormone analogue, or aspirin, but is not cytoprotective against necrotizing agents. Calcitonin action is not related to modification of gastric prostaglandin generation but it may involve the inhibition of gastric secretory and motor function.

Animals↗
PubMed2026

Molecular and Clinical Determinants of Targeted Therapy Treatment in Biliary Tract Cancer.

PURPOSE: Actionable genomic alterations occur in all anatomic subsets of biliary tract cancer; however, targeted therapies have not shown a survival advantage over cytotoxics, and resistance mechanisms require further characterization. EXPERIMENTAL DESIGN: We analyzed a prospectively maintained cohort of 1,254 patients with histologically confirmed biliary tract cancer who underwent molecular profiling using an FDA-authorized targeted next-generation sequencing (NGS) assay. We defined actionable alterations across anatomic subsets, compared outcomes with targeted therapy versus cytotoxics, and evaluated genomic correlates of resistance using longitudinal samples. RESULTS: Overall, 59% of patients harbored at least one OncoKB alteration, and 32.2% (intrahepatic 40%, extrahepatic 15%, and gallbladder 22%) had a level 1/2 alteration. Emerging targets included KRAS alterations (17%), MTAP deletions (12.8%), MDM2 amplification (6.5%), and MET amplification (1.5%). Targeted therapy was associated with improved progression-free survival but not overall survival. Co-occurring TP53/RAS pathway and SMAD4 alterations were associated with inferior outcomes in IDH1/FGFR2-and ERBB2-driven tumors, respectively. Longitudinal profiling demonstrated ERBB2 loss in ERBB2-driven tumors, whereas IDH-, FGFR-, BRAF-, and NTRK-driven tumors retained the primary oncogenic driver. Acquired resistance was associated with alterations in RAS, MEK, MET, MYC, and CDKN2A. CONCLUSIONS: This comprehensive molecular profiling study illustrates the real-world utility and limitations of targeted NGS of biliary tract cancer and affirms the use of precision medicine in patients with these diseases. Genomic heterogeneity and therapeutic resistance observed in this study has the potential to inform ongoing drug development efforts for biliary tract cancer.

Humans↗
PubMed1979

Potential arrhythmogenic electrophysiological derangements in canine Purkinje fibers induced by lysophosphoglycerides.

We have recently detected accumulation of lysophosphoglycerides, catabolites of phospholipids, in ischemic myocardium early after coronary occlusion. In the present study we delineated effects of selected concentrations of albumin-bound lysophosphatidyl choline (LPC) comparable to those accompanying ischemia in vivo on action potentials of isolated canine Purkinje fibers. Lysophosphoglycerides induced concentration-dependent (0.75-3.0 mM) decreases in resting membrane potential, overshoot of phase 0, maximal velocity of upstroke (Vmax) of phase 0, and action potential duration. The highest concentrations (2.0-3.0 mM) induced fractionation of the action potential into several components, unresponsiveness to external stimulation, and enhanced automaticity at normal and reduced membrane potentials. LPC induced a rightward shift in the membrane response curve, a 40-fold prolongation of conduction time, and an increase in the ratio of effective refractory period to action potential duration such that the effective refractory period persisted beyond action potential duration, resulting in postrepolarization refractoriness. These electrophysiological alterations were entirely reversible after 70 minutes of perfusion without LPC, with the exception of a persistent depression in the Vmax of phase 0. Lysophosphatidyl ethanolamine (LPE) elicited alterations in action potentials indentical to those elicited by LPC. Furthermore, LPC (3.0 mM) induced comparable alterations in action potentials recorded from isolated rabbit papillary muscles. Since lysophospholipids accumulate early after myocardial ischemia, and since concentrations equivalent to those occurring in vivo induce electrophysiological alterations resembling those seen in ischemic myocardium in vivo, lysophosphoglycerides may be of major importance as biochemical mediators of malignant dysrhythmia induced by ischemia.

Action Potentials↗
PubMed2000

G-protein-modulated Ca(2+) current with slowed activation does not alter the kinetics of action potential-evoked Ca(2+) current.

We have studied voltage-dependent inhibition of N-type calcium currents to investigate the effects of G-protein modulation-induced alterations in channel gating on action potential-evoked calcium current. In isolated chick ciliary ganglion neurons, GTPgammaS produced voltage-dependent inhibition that exhibited slowed activation kinetics and was partially relieved by a conditioning prepulse. Using step depolarizations to evoke calcium current, we measured tail current amplitudes on abrupt repolarization to estimate the time course of calcium channel activation from 1 to 30 ms. GTPgammaS prolonged significantly channel activation, consistent with the presence of kinetic slowing in the modulated whole cell current evoked by 100-ms steps. Since kinetic slowing is caused by an altered voltage dependence of channel activation (such that channels require stronger or longer duration depolarization to open), we asked if GTPgammaS-induced modulation would alter the time course of calcium channel activation during an action potential. Using an action potential waveform as a voltage command to evoke calcium current, we abruptly repolarized to -80 mV at various time points during the repolarization phase of the action potential. The resulting tail current was used to estimate the relative number of calcium channels that were open. Using action potential waveforms of either 2.2- or 6-ms duration at half-amplitude, there were no differences in the time course of calcium channel activation, or in the percent activation at any time point tested during the repolarization, when control and modulated currents were compared. It is also possible that modulated channels might open briefly and that these reluctant openings would effect the time course of action potential-evoked calcium current. However, when control and modulated currents were scaled to the same peak amplitude and superimposed, there was no difference in the kinetics of the two currents. Thus voltage-dependent inhibition did not alter the kinetics of action potential-evoked current. These results suggest that G-protein-modulated channels do not contribute significantly to calcium current evoked by a single action potential.

Action Potentials↗
PubMed1989

Hypothalamic action of cachectin to alter pituitary hormone release.

Cachectin (tumor necrosis factor, TNF) is a macrophage hormone which is released during infection and after injection of bacterial lipopolysaccharides. We have already demonstrated that the peptide has direct action on the pituitary to alter pituitary hormone release in vitro. To evaluate its action in vivo, we injected it into the third ventricle (3V) of conscious, male rats and measured its effect on various anterior pituitary hormones. The peptide produced an elevation in rectal temperature measurable on first measurement at 1 hour postinjection which was maintained for 3 hours. The maximal increase in body temperature was 1-1.5 degrees C and maximal effect was obtained by a dose as low as 1 ng (0.3 pmol) of the peptide. Preinjection of indomethacin into the 3V 1 hour prior to injection of TNF completely blocked the effect on body temperature without producing an alteration in rectal temperature itself which suggests that the elevation in body temperature may be mediated by prostaglandins. Following the intraventricular injection of various doses of TNF, there was no significant effect on plasma adrenocorticotropin (ACTH) except with the highest, 100 ng dose tested, which evoked a small but significant increase in plasma ACTH with a delay of 1 to 2 hours. Thus, the dose necessary to release ACTH was much higher than that required to elevate body temperature. The effect was no longer significant in indomethacin-pretreated animals suggesting a role for prostaglandins in the effect. This highest dose of intraventricularly administered TNF also produced a relatively modest, but significant, delayed increase in plasma GH.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2006

Real-time continuous glucose monitoring in pediatric patients during and after cardiac surgery.

OBJECTIVES: Given the demonstrated benefit of euglycemia in critically ill patients as well as the risk for hypoglycemia during insulin infusion in children, we sought to validate a subcutaneous sensor for real-time continuous glucose monitoring in pediatric patients during and after cardiac surgery. METHODS: Children up to 36 months of age who were undergoing cardiac bypass surgery were recruited. After anesthetic induction, a continuous glucose-monitoring system sensor (CGMS, Medtronic Minimed, Northridge, CA) was inserted subcutaneously. Sensors remained in place for up to 72 hours. Arterial blood glucose was measured intermittently in the central laboratory (Bayer Rapidlab 860, Tarrytown, NY). Sensor data, after prospective calibration with 6-hourly laboratory values using the proprietary Medtronic Minimed Guardian RT algorithm, were compared with all laboratory glucose values. Statistical analysis was performed to test whether sensor performance was affected by body temperature, inotrope dose, or body-wall edema. RESULTS: Twenty patients were enrolled in the study for a total of 40 study days and 246 paired sensor and laboratory glucose values. Consensus error grid analysis demonstrated that 72.0% of sensor value comparisons were within zone A (no effect on clinical action), and 27.6% of comparisons were within zone B (altered clinical action of little or no effect on outcome), with a mean absolute relative deviation of 17.6% for all comparisons. One comparison (0.4%) was in zone C (altered clinical action likely to affect outcome). No significant correlations were found between sensor performance and body temperature, inotrope dose, or body-wall edema. All patients tolerated the sensors well without bleeding or tissue reaction. CONCLUSIONS: Guardian RT real-time subcutaneous blood glucose measurement is safe and potentially useful for continuous glucose monitoring in critically ill children. Subcutaneous sensors performed well in the setting of hypothermia, inotrope use, and edema. These sensors facilitate identifying and following the effects of interventions to control blood glucose.

Algorithms↗
PubMedDate not supplied

[Characteristics of the super-slow electrical activity of the brain when exposed to the action of neurotropic substances altering short-term memory].

Superslow electrical activity was studied after the action of neurotropic drugs on curarized rabbits with gold electrodes implanted in the deep brain structures. Intramuscular administration of 1/5 mg/kg dose of ethimizol, of 5 mg/kg of ethipyrol, or of 1/5 mg/kg of metamizyl led to a reciprocity of the oscillation amplitudes between the field CA-3 of the dorsal hippocampus and the medial nuclear groups of the reticular formation. Ethimizol and ethipyrol, though producing a similar final effect, act differently on the duration and phases of slow oscillations. Micropolarization of the dorsal hippocampus field CA-3 with a 2.5 microampere current lengthened the action of the neurotropic drugs, up to six hours in the case of ethimyzol. A mathematical vector analysis has shown that the angle of the wave amplitude vector in space depends both on the characteristics of the neurotropic drug and the excitability level of field CA-3 of the dorsl hippo-campus. A slow electrical potential reflecting the capacity of the electric field of a brain structure is likely to be one the major components controlling the conformation position of the receptor proteins.

Animals↗
PubMed1989

Altered electrical response to caffeine exposure in hypertrophied rat myocardium.

We investigated the electrophysiological effects of cardiac hypertrophy induced by different experimental models. Comparison of the action potentials of hypertrophied and control rat hearts reveals a pronounced prolongation of the action potential for all types of hypertrophy. This prolongation affects the entire repolarization phase of the action potential 8 days after severe aortic constriction, after 8 days of isoproterenol treatment (5 mg/kg per day), and 3 months after an aortocaval fistula. The electrical changes associated with myocardial hypertrophy induced by pressure overload (aortic constriction) were compared with those resulting from volume overload (aortocaval fistula). Our results show that action potential alterations depend on the nature, duration, and severity of the work load. Thus, pressure overload is more potent to induce these modifications. In the hearts subjected to pressure overload, action potential alterations appear more rapidly and are more marked for the same degree of hypertrophy than those of the volume-hypertrophied myocardium. Furthermore, such data also demonstrate that the early alteration of the action potential during the development of compensatory hypertrophy is a prolongation of the later phase of repolarization (phase 3), without prolongation of the other repolarization phases (1 and 2). This change appears 3 days after aortic constriction, 1 month after coronary artery ligation (in the healthy part of the left ventricle), and 1 month after an aortocaval fistula.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1992

The L type calcium current in single hypertrophied cardiomyocytes isolated from the right ventricle of ferret heart.

OBJECTIVE: The aim was to study L type calcium current alterations in relation to the action potential lengthening induced by hypertrophy in isolated cardiomyocytes from the right ventricle of ferret. METHODS: Chronic pulmonary artery constriction was established in adult male ferrets under anaesthesia. Sham operated animals were used as controls. Four to six weeks later the heart was excised and treated with a mixed collagenase-elastase solution to isolate the right ventricular myocytes. The calcium current was investigated in control and hypertrophied cells with the whole cell configuration of the patch clamp technique. The validity of the model was tested by analysis of the structural and passive electrical characteristics of the cells, which were enzymatically isolated from right ventricles previously overloaded (4 to 6 weeks) by clipping the pulmonary artery. RESULTS: Isolated cells from right ventricles submitted to a chronic pressure overload had well preserved cellular integrity suggesting the absence of myocardial failure. This compensated form of hypertrophy was characterised by a dilated transverse tubular system, which could explain the increased membrane capacity. Such cells developed a prolonged action potential with a less pronounced fast repolarisation phase inducing a higher plateau phase. When studied in physiological Tyrode solution the density and kinetics of the L type calcium current were not apparently modified, but a significant decrease in density was unmasked when sodium and potassium currents were suppressed by external and internal substitution of sodium and potassium by tetraethyl ammonium. CONCLUSIONS: The decrease in L type calcium current cannot be involved in the lengthening of action potential observed on hypertrophied myocytes, but it could account for the depressed contractile activity. A noticeable decrease of the transient outward current is suggested to explain the action potential alterations.

Action Potentials↗
PubMed1990

Alteration of topoisomerase II action is a possible molecular mechanism of HL-60 cell differentiation.

The inhibition of differentiation and persistence of proliferation in cell transformation is probably not only caused by the mutation of single genes. An additional mechanism of transcriptional control, not only of single genes but of gene programs, is possibly the alteration of the topoisomerases. These enzymes regulate the conformation of DNA by twisting and unwinding the double strands. As has been shown previously, only the genes located in relaxed DNA areas are transcribed and, therefore, the topoisomerases can be described as a gene regulation device. We present the hypothesis that topoisomerase II action is not only altered in, but also necessary for, HL-60 granulocytic cell differentiation. Thus, alteration of topoisomerases may well be a molecular mechanism of cellular differentiation.

Binding Sites↗