Adjuvant chemotherapy-associated lipid changes in breast cancer patients A real-word retrospective analysis
MEDICINE
Authors: He, Tao; Wang, Chengshi; Tan, Qiuwen; Wang, Zhu; Li, Jiayuan; Chen, Tao; Cui, Kaijun; Wu, Yunhao; Sun, Jiani; Zheng, Danxi; Lv, Qing; Chen, Jie
Abstract
Adjuvant chemotherapy may cause alterations in serum lipids in postoperative breast cancer (BC) patients, but the specific alterations caused by different chemotherapy regimens remain unclear. The aim of this study was to investigate the status of serum lipids pre- and post-chemotherapy and to compare the side effects of different chemotherapy regimens on serum lipid. We retrospectively analysed the lipid profiles of 1934 consecutive postoperative BC patients who received one of the following chemotherapy regimens: (1) doxorubicin and cyclophosphamide followed by paclitaxel (AC-T); (2) epirubicin and cyclophosphamide followed by paclitaxel (EC-T); (3) cyclophosphamide and paclitaxel (TC); and (4) fluorouracil, cyclophosphamide, and epirubicin (FEC). The levels of triglycerides (TG), total cholesterols (TC), and low-density lipoprotein (LDL-C) were significantly elevated in patients who received chemotherapy regimens above (P < .001). With respect to different chemotherapy regimens, FEC had less side effects on lipid profiles (TG (P = .006), high-density lipoprotein (HDL-C) (P < .001), and LDL-C (P < .001)) than TC regimen and AC-T and EC-T regimen. Also, the incidence of newly diagnosed dyslipidemia after chemotherapy was lower in FEC group than TC group and AC-T and EC-T group (P < .001). Additionally, the magnitude of the alterations in lipid profiles (TG, TC, HDL-C, and LDL-C) was greater in premenopausal patients than that of the postmenopausal patients (P = .004;P P = .002;P = .003, respectively). Moreover, after adjusting for multiple baseline covariates, anthracycline-plus-taxane-based regimens (AC-T and EC-T) were still statistically associated with a high level of TG (P = .004) and a low level of HDL-C (P = .033) after chemotherapy compared with FEC regimen. Also, body mass index (BMI) > 24 was associated with abnormal lipid profiles (TG, TC, HDL-C, LDL-C) post-chemotherapy compared with BMI <= 24 (P P = .036;P = .012;P = .048, respectively). BC patients receiving chemotherapy may have elevated lipid profiles, and anthracycline-based regimen had less side effects on lipid profiles compared with regimens containing taxane. Therefore, it is necessary to take lipid metabolism into consideration when making chemotherapy decisions and dyslipidemia prevention and corresponding interventions are indispensable during the whole chemotherapy period.
Genetic and Virulence Characteristics of a Hybrid Atypical Enteropathogenic and UropathogenicEscherichia coli(aEPEC/UPEC) Strain
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
Authors: Valiatti, Tiago B.; Santos, Fernanda F.; Santos, Ana C. M.; Nascimento, Jullia A. S.; Silva, Rosa M.; Carvalho, Eneas; Sinigaglia, Rita; Gomes, Tania A. T.
Abstract
Hybrid strains ofEscherichia colicombine virulence traits of diarrheagenic (DEC) and extraintestinal pathogenicE. coli(ExPEC), but it is poorly understood whether these combined features improve the virulence potential of such strains. We have previously identified a uropathogenicE. coli(UPEC) strain (UPEC 252) harboring theeaegene that encodes the adhesin intimin and is located in the locus of enterocyte effacement (LEE) pathogenicity island. The LEE-encoded proteins allow enteropathogenicE. coli(EPEC) and enterohemorrhagicE. coli(EHEC) to form attaching and effacing (A/E) lesions in enterocytes. We sought to characterize UPEC 252 through whole-genome sequencing and phenotypic virulence assays. Genome analysis unveiled that this strain harbors a complete LEE region, with more than 97% of identity comparing to E2348/69 (EPEC) and O157:H7 Sakai (EHEC) prototype strains, which was functional, since UPEC 252 expressed the LEE-encoded proteins EspB and intimin and induced actin accumulation foci in HeLa cells. Phylogenetic analysis performed comparing 1,000 single-copy shared genes clustered UPEC 252 with atypical EPEC strains that belong to the sequence type 10, phylogroup A. Additionally, UPEC 252 was resistant to the bactericidal power of human serum and colonized cells of the urinary (T24 and HEK293-T) and intestinal (Caco-2 and LS174T) tracts. Our findings suggest that UPEC 252 is an atypical EPEC strain that emerges as a hybrid strain (aEPEC/UPEC), which could colonize new niches and potentially cause intestinal and extraintestinal infections.