RIP3: a Molecular Switch for Necrosis and Inflammation
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Wound Classification
Wound Classification Presented by Dr. Karen Zulkowski, D.N.S., RN Montana State University Welcome! Thank you for joining this webinar about how to assess and measure a wound. 2 A Little About Myself… • Associate professor at Montana State University • Executive editor of the Journal of the World Council of Enterstomal Therapists (JWCET) and WCET International Ostomy Guidelines (2014) • Editorial board member of Ostomy Wound Management and Advances in Skin and Wound Care • Legal consultant • Former NPUAP board member 3 Today We Will Talk About • How to assess a wound • How to measure a wound Please make a note of your questions. Your Quality Improvement (QI) Specialists will follow up with you after this webinar to address them. 4 Assessing and Measuring Wounds • You completed a skin assessment and found a wound. • Now you need to determine what type of wound you found. • If it is a pressure ulcer, you need to determine the stage. 5 Assessing and Measuring Wounds This is important because— • Each type of wound has a different etiology. • Treatment may be very different. However— • Not all wounds are clear cut. • The cause may be multifactoral. 6 Types of Wounds • Vascular (arterial, venous, and mixed) • Neuropathic (diabetic) • Moisture-associated dermatitis • Skin tear • Pressure ulcer 7 Mixed Etiologies Many wounds have mixed etiologies. • There may be both venous and arterial insufficiency. • There may be diabetes and pressure characteristics. 8 Moisture-Associated Skin Damage • Also called perineal dermatitis, diaper rash, incontinence-associated dermatitis (often confused with pressure ulcers) • An inflammation of the skin in the perineal area, on and between the buttocks, into the skin folds, and down the inner thighs • Scaling of the skin with papule and vesicle formation: – These may open, with “weeping” of the skin, which exacerbates skin damage. -
Necroptosis in Intestinal Inflammation and Cancer
biomolecules Review Necroptosis in Intestinal Inflammation and Cancer: New Concepts and Therapeutic Perspectives Anna Negroni 1,* , Eleonora Colantoni 2, Salvatore Cucchiara 2 and Laura Stronati 3 1 Division of Health Protection Technologies, ENEA, 00123 Rome, Italy 2 Maternal Infantile and Urological Sciences Department, Sapienza, University of Rome, 00161 Rome, Italy; [email protected] (E.C.); [email protected] (S.C.) 3 Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; [email protected] * Correspondence: [email protected]; Tel.: +39-06-3048-3623 Received: 3 September 2020; Accepted: 8 October 2020; Published: 10 October 2020 Abstract: Necroptosis is a caspases-independent programmed cell death displaying intermediate features between necrosis and apoptosis. Albeit some physiological roles during embryonic development such tissue homeostasis and innate immune response are documented, necroptosis is mainly considered a pro-inflammatory cell death. Key actors of necroptosis are the receptor-interacting-protein-kinases, RIPK1 and RIPK3, and their target, the mixed-lineage-kinase-domain-like protein, MLKL. The intestinal epithelium has one of the highest rates of cellular turnover in a process that is tightly regulated. Altered necroptosis at the intestinal epithelium leads to uncontrolled microbial translocation and deleterious inflammation. Indeed, necroptosis plays a role in many disease conditions and inhibiting necroptosis is currently considered a promising therapeutic strategy. In this review, we focus on the molecular mechanisms of necroptosis as well as its involvement in human diseases. We also discuss the present developing therapies that target necroptosis machinery. Keywords: programmed cell death; inflammation; cancer; intestinal diseases; inhibitors 1. Introduction Cell death is crucial during the development and maintenance of tissue homeostasis in multicellular organisms. -
797 Circulating Tumor DNA and Circulating Tumor Cells for Cancer
Medical Policy Circulating Tumor DNA and Circulating Tumor Cells for Cancer Management (Liquid Biopsy) Table of Contents • Policy: Commercial • Coding Information • Information Pertaining to All Policies • Policy: Medicare • Description • References • Authorization Information • Policy History • Endnotes Policy Number: 797 BCBSA Reference Number: 2.04.141 Related Policies Biomarkers for the Diagnosis and Cancer Risk Assessment of Prostate Cancer, #336 Policy1 Commercial Members: Managed Care (HMO and POS), PPO, and Indemnity Plasma-based comprehensive somatic genomic profiling testing (CGP) using Guardant360® for patients with Stage IIIB/IV non-small cell lung cancer (NSCLC) is considered MEDICALLY NECESSARY when the following criteria have been met: Diagnosis: • When tissue-based CGP is infeasible (i.e., quantity not sufficient for tissue-based CGP or invasive biopsy is medically contraindicated), AND • When prior results for ALL of the following tests are not available: o EGFR single nucleotide variants (SNVs) and insertions and deletions (indels) o ALK and ROS1 rearrangements o PDL1 expression. Progression: • Patients progressing on or after chemotherapy or immunotherapy who have never been tested for EGFR SNVs and indels, and ALK and ROS1 rearrangements, and for whom tissue-based CGP is infeasible (i.e., quantity not sufficient for tissue-based CGP), OR • For patients progressing on EGFR tyrosine kinase inhibitors (TKIs). If no genetic alteration is detected by Guardant360®, or if circulating tumor DNA (ctDNA) is insufficient/not detected, tissue-based genotyping should be considered. Other plasma-based CGP tests are considered INVESTIGATIONAL. CGP and the use of circulating tumor DNA is considered INVESTIGATIONAL for all other indications. 1 The use of circulating tumor cells is considered INVESTIGATIONAL for all indications. -
A 10 Year Cross Sectional Multicentre Study of Infected Pancreatic Necrosis
JOP. J Pancreas (Online) 2021 Jan 30; 22(1): 11-20. ORIGINAL PAPER A 10 Year Cross Sectional Multicentre Study of Infected Pancreatic Necrosis. Trends in Management and an Analysis of Factors Predicting Mortality for Interventions in Infected Pancreatic Necrosis Johann Faizal Khan1, Suryati Mokhtar1, Krishnan Raman1, Harjit Singh1, Leow Voon Meng 2,3, Manisekar K Subramaniam1,2 1 2 Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Selayang Hospital, Selangor, Malaysia 3Department of General Surgery, Division of Hepatopancreatobiliary Surgery, Sultanah Bahiyah Hospital, Kedah, Malaysia Malaysia Advanced Medical and Dental Institute (AMDI), Science University of Malaysia (USM), Penang, ABSTRACT Objective To identify trends in management and analyse outcomes of patients undergoing interventions for infected pancreatic necrosis Method A cross sectional study of patients undergoing intervention for IPN with specific reference to factors predictive of mortality. between 2009-2018 were performed at two of the largest hepatopancreatobiliary centres in Malaysia. FinalResults outcome A measuretotal number of complete of 65 resolution was compared against mortality (D). Head to head comparison of percutaneous catheter drainage alone versus Videoscopic Assisted Retroperitoneal Debridement was performed based on final predictive factor on mortality. patients with IPN were identified. Data from 59/65 patients were analysed for final outcome of death (D) versus complete resolution. 6 patients were omitted due to incomplete data -
Fabienne Le Cann
ANNÉE 2017 THÈSE / UNIVERSITÉ DE RENNES 1 sous le sceau de l’Université Bretagne Loire En Cotutelle Internationale avec l’Université de Gand, Belgique pour le grade de DOCTEUR DE L’UNIVERSITÉ DE RENNES 1 Mention : Biologie Ecole doctorale Vie Agro Santé présentée par Fabienne Le Cann Préparée à l’unité de recherche UMR Inserm U1085 IRSET Institut de Recherche en Santé Environnement et Travail UFR Sciences de la Vie et de l’Environnement Thèse soutenue à Rennes Caractérisation de le 2 juin 2017 nouveaux inhibiteurs devant le jury composé de : Mojgan DJAVAHERI-MERGNY de la kinase RIPK1 et CR INSERM, Université de Bordeaux / rapporteur Alicia TORRIGLIA de la nécroptose DR INSERM, Université de Paris Descartes, UPMC / rapporteur Sandy ADJEMIAN-CATANI Junior Scientist, Université de Gand / rapporteur Sandrine RUCHAUD CR CNRS, Sorbonne Universités, UPMC Paris VI / examinateur Tom VANDEN BERGHE Senior Scientist, Université de Gand / examinateur Georges BAFFET DR INSERM, Université de Rennes 1 / examinateur, Président de jury Peter VANDENABEELE Pr, Dr, Université de Gand / co-directeur de thèse Marie-Thérèse DIMANCHE-BOITREL DR INSERM, Université de Rennes 1 / co-directrice de thèse ANNÉE 2017 Fabienne Le Cann Thesis submitted in partial fulfillment of the requirements for the degree of DOCTOR IN BIOLOGY from Rennes 1 University & DOCTOR OF SCIENCES: Biochemistry and Biotechnology from Ghent University Academic year 2016-2017 Rennes 1 University – Faculty of Sciences in Health and Environment under seal of University Bretagne Loire Ghent University -
Evaluating Necroptosis Competency in Malignant Melanoma
Evaluating necroptosis competency in malignant melanoma Von der Fakultät 4: Energie-, Verfahrens- und Biotechnik der Universität Stuttgart zur Erlangung der Würde eines Doktors der Naturwissenschaften (Dr. rer. nat.) Genehmigte Abhandlung Vorgelegt von Biswajit Podder, M.Sc. aus Narsingdi, Bangladesh Hauptberichter: Prof. Dr. Markus Morrison Mitberichter: Prof. Dr. Jochen Utikal, Universität Heidelberg Prüfungsvorsitzender: Prof. Dr. Roland Kontermann Tag der mündlichen Prüfung: 18.06.2020 Institut für Zellbiologie und Immunologie der Universität Stuttgart Stuttgart, 2020 I II Declarations according to § 2 of the doctoral degree regulations: Eidesstattliche Erklärung Hiermit versichere ich, dass ich diese Arbeit selbst verfasst und dabei keine anderen als die angegeben Quellen und Hilfsmittel verwendet habe. Declaration of Authorship I hereby certify that this Dissertation is entirely my own work, apart from where otherwise indicated. Passages and ideas from other sources have been clearly indicated. Biswajit Podder Stuttgart, 10th of July 2020 III IV This thesis is dedicated to three million freedom fighters who sacrifice their lives for my beloved country Bangladesh “There will be obstacles. There will be doubters. There will be mistakes. But with hard work, there are no limits.” —Michael Phelps I VI Research outputs Journal Article: Podder B., Guttà C., Rožanc J., Gerlach E., Feoktistova M., Panayotova-Dimitrova D, Alexopoulos LG., Leverkus M., Rehm M., TAK1 suppresses RIPK1-dependent cell death and is associated With disease progression in melanoma Cell death and differentiation; 12 February 2019.1 doi: 0.1038/s41418-019-0315-8 Rožanc J., Sakellaropoulos T., Antoranz A., Guttà C., Podder B., Vetma V., Rufo N., Agostinis P., Pliaka V., Sauter T., Kulms D., Rehm M., Alexopoulos LG., Phosphoprotein patterns predict trametinib responsiveness and optimal trametinib sensitisation strategies in melanoma. -
Targeting RIP Kinases in Chronic Inflammatory Disease
biomolecules Review Targeting RIP Kinases in Chronic Inflammatory Disease Mary Speir 1,2, Tirta M. Djajawi 1,2 , Stephanie A. Conos 1,2, Hazel Tye 1 and Kate E. Lawlor 1,2,* 1 Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, VIC 3168, Australia; [email protected] (M.S.); [email protected] (T.M.D.); [email protected] (S.A.C.); [email protected] (H.T.) 2 Department of Molecular and Translational Science, Monash University, Clayton, VIC 3168, Australia * Correspondence: [email protected]; Tel.: +61-85722700 Abstract: Chronic inflammatory disorders are characterised by aberrant and exaggerated inflam- matory immune cell responses. Modes of extrinsic cell death, apoptosis and necroptosis, have now been shown to be potent drivers of deleterious inflammation, and mutations in core repressors of these pathways underlie many autoinflammatory disorders. The receptor-interacting protein (RIP) kinases, RIPK1 and RIPK3, are integral players in extrinsic cell death signalling by regulating the production of pro-inflammatory cytokines, such as tumour necrosis factor (TNF), and coordinating the activation of the NOD-like receptor protein 3 (NLRP3) inflammasome, which underpin patholog- ical inflammation in numerous chronic inflammatory disorders. In this review, we firstly give an overview of the inflammatory cell death pathways regulated by RIPK1 and RIPK3. We then discuss how dysregulated signalling along these pathways can contribute to chronic inflammatory disorders of the joints, skin, and gastrointestinal tract, and discuss the emerging evidence for targeting these RIP kinases in the clinic. Keywords: apoptosis; necroptosis; RIP kinases; chronic inflammatory disease; tumour necrosis factor; Citation: Speir, M.; Djajawi, T.M.; interleukin-1 Conos, S.A.; Tye, H.; Lawlor, K.E. -
WA Coding Rule 1215/07 Skin Ulcer Necrosis Versus Gangrene
WA Coding Rules are a requirement of the Clinical Coding Policy MP0056/17 Western Australian Coding Rule 1215/07 Skin ulcer necrosis versus gangrene WA Coding Rule 0110/06 Skin ulcer necrosis versus gangrene is superseded by ACCD Coding Rule Skin necrosis (Ref No: Q2659) effective 1 January 2014; (log in to view on the ACCD CLIP portal). DECISION WA Coding Rule 0110/06 Skin ulcer necrosis versus gangrene is retired. [Effective 01 Jan 2014, ICD-10-AM/ACHI/ACS 8th Ed.] Page 1 of 3 © Department of Health WA 2018 WA Coding Rules are a requirement of the Clinical Coding Policy MP0056/17 Western Australian Coding Rule 0110/06 Skin ulcer necrosis versus gangrene Q. Often with traumatic wounds or infection there will be documentation of devitalized tissue or necrotic wound edges or just some mention of necrotic tissue, the extent of the necrosis usually not known. No mention of gangrene. The ICD 10 indexing for necrosis defaults to coding R02. For cases with documentation of necrosis irrespective of the extent of necrosis and definitely no mention of gangrene is the coder to assign the code R02 or if documentation suggests the amount of necrosis is small and confined to edges should this be considered part of the traumatic wound and the code not assigned? Necrosis is commonly documented in the patient records with traumatic wounds, burns, pressure sores etc. Necrosis due to lack of oxygen such as with a MI would be considered part of the MI code as would any necrosis with infection in pneumonia. Gangrene would seem to be a complication of necrotic tissue. -
Molecular Pathological Epidemiology in Diabetes Mellitus and Risk of Hepatocellular Carcinoma
Submit a Manuscript: http://www.wjgnet.com/esps/ World J Hepatol 2016 September 28; 8(27): 1119-1127 Help Desk: http://www.wjgnet.com/esps/helpdesk.aspx ISSN 1948-5182 (online) DOI: 10.4254/wjh.v8.i27.1119 © 2016 Baishideng Publishing Group Inc. All rights reserved. REVIEW Molecular pathological epidemiology in diabetes mellitus and risk of hepatocellular carcinoma Chun Gao Chun Gao, Department of Gastroenterology, China-Japan logy and epidemiology, and investigates the relationship Friendship Hospital, Ministry of Health, Beijing 100029, China between exogenous and endogenous exposure factors, tumor molecular signatures, and tumor initiation, progres- Author contributions: Gao C conceived the topic, performed sion, and response to treatment. Molecular epidemiology research, retrieved concerned literatures and wrote the paper. broadly encompasses MPE and conventional-type mole- cular epidemiology. Hepatocellular carcinoma (HCC) Supported by Beijing NOVA Programme of Beijing Municipal is the third most common cause of cancer-associated Science and Technology Commission, No. Z13110.7000413067. death worldwide and remains as a major public health Conflict-of-interest statement: No conflict of interest. challenge. Over the past few decades, a number of epidemiological studies have demonstrated that diabetes Open-Access: This article is an open-access article which was mellitus (DM) is an established independent risk factor selected by an in-house editor and fully peer-reviewed by external for HCC. However, how DM affects the occurrence and -
Salivary Gland – Necrosis
Salivary Gland – Necrosis Figure Legend: Figure 1 Salivary gland - Necrosis in a male F344/N rat from a subchronic study. There is necrosis of the acinar cells (arrow) with inflammation. Figure 2 Salivary gland - Necrosis in a male F344/N rat from a subchronic study. There is necrosis of the acinar cells (arrow) with chronic active inflammation. Figure 3 Salivary gland - Necrosis in a female F344/N rat from a subchronic study. There is necrosis of an entire lobe of the salivary gland (arrow), consistent with an infarct. Figure 4 Salivary gland - Necrosis in a female F344/N rat from a subchronic study. There is necrosis of all the components of the salivary gland (consistent with an infarct), with inflammatory cells, mostly neutrophils. Comment: Necrosis may be characterized either by scattered single-cell necrosis or by locally extensive areas of necrosis involving contiguous cells or structures. Single-cell necrosis can present as cell shrinkage, condensation of nuclear chromatin and cytoplasm, convolution of the cell, and the presence of apoptotic bodies. Acinar necrosis can present as focal to multifocal areas characterized by 1 Salivary Gland – Necrosis tissue that is paler than the surrounding viable tissue, consisting of swollen cells with variable degrees of eosinophilia, hyalinized cytoplasm, vacuolated cytoplasm, nuclear pyknosis, karyolysis, and/or karyorrhexis with associated cellular debris (Figure 1 and Figure 2). Secondary inflammation is common. Infarction (Figure 3 and Figure 4) is characterized by a focal to focally extensive area of salivary gland necrosis. One cause of necrosis, inflammation, and atrophy of the salivary gland in the rat is an active sialodacryoadenitis virus infection, but this virus does not affect the mouse salivary gland. -
Targeting RIPK1 for the Treatment of Human Diseases INAUGURAL ARTICLE
Targeting RIPK1 for the treatment of human diseases INAUGURAL ARTICLE Alexei Degtereva,1, Dimitry Ofengeimb,1, and Junying Yuanc,2 aDepartment of Developmental, Molecular and Chemical Biology, Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA 02445; bRare and Neurologic Disease Research Therapeutic Area, Sanofi US, Framingham, MA 01701; and cDepartment of Cell Biology, Harvard Medical School, Boston, MA 02115 This contribution is part of the special series of Inaugural Articles by members of the National Academy of Sciences elected in 2017. Edited by Don W. Cleveland, University of California, San Diego, La Jolla, CA, and approved April 8, 2019 (received for review January 21, 2019) RIPK1 kinase has emerged as a promising therapeutic target for carrying different RIPK1 kinase dead knock-in mutations, including the treatment of a wide range of human neurodegenerative, D138N, K45A, K584R, and ΔG26F27,aswellasRIPK3orMLKL autoimmune, and inflammatory diseases. This was supported by knockout mutations, show no abnormality in development or in the extensive studies which demonstrated that RIPK1 is a key mediator adult animals (6–10). Thus, necroptosis might be predominantly of apoptotic and necrotic cell death as well as inflammatory path- activated under pathological conditions, which makes inhibiting ways. Furthermore, human genetic evidence has linked the dysre- this pathway an attractive option for the treatment of chronic gulation of RIPK1 to the pathogenesis of ALS as well as other human diseases. inflammatory and neurodegenerative diseases. Importantly, unique Necroptosis was first defined by a series of small-molecule allosteric small-molecule inhibitors of RIPK1 that offer high selectivity inhibitors (necrostatins), including Nec-1/Nec-1s, Nec-3, Nec-4, have been developed. -
RIP1, a Kinase on the Crossroads of a Cell's Decision to Live Or
Cell Death and Differentiation (2007) 14, 400–410 & 2007 Nature Publishing Group All rights reserved 1350-9047/07 $30.00 www.nature.com/cdd Review RIP1, a kinase on the crossroads of a cell’s decision to live or die N Festjens1,2, T Vanden Berghe1, S Cornelis1 and P Vandenabeele*,1 Binding of inflammatory cytokines to their receptors, stimulation of pathogen recognition receptors by pathogen-associated molecular patterns, and DNA damage induce specific signalling events. A cell that is exposed to these signals can respond by activation of NF-jB, mitogen-activated protein kinases and interferon regulatory factors, resulting in the upregulation of antiapoptotic proteins and of several cytokines. The consequent survival may or may not be accompanied by an inflammatory response. Alternatively, a cell can also activate death-signalling pathways, resulting in apoptosis or alternative cell death such as necrosis or autophagic cell death. Interplay between survival and death-promoting complexes continues as they compete with each other until one eventually dominates and determines the cell’s fate. RIP1 is a crucial adaptor kinase on the crossroad of these stress-induced signalling pathways and a cell’s decision to live or die. Following different upstream signals, particular RIP1-containing complexes are formed; these initiate only a limited number of cellular responses. In this review, we describe how RIP1 acts as a key integrator of signalling pathways initiated by stimulation of death receptors, bacterial or viral infection, genotoxic stress and T-cell homeostasis. Cell Death and Differentiation (2007) 14, 400–410. doi:10.1038/sj.cdd.4402085 Receptor interacting protein (RIP) kinases constitute a family sufficient for interaction of RIP1 with RIP3.1 RIP4 (DIK/PKK) of seven members, all of which contain a kinase domain (KD) and RIP5 (SgK288) are characterized by the presence of (Figure 1a).