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Serotonin transporter binding in major depressive disorder: impact of serotonin system anatomy

Bartlett, Elizabeth A; Zanderigo, Francesca; Shieh, Denise; Miller, Jeffrey; Hurley, Patrick; Rubin-Falcone, Harry; Oquendo, Maria A; Sublette, M Elizabeth; Ogden, R Todd; Mann, J John
Serotonin transporter (5-HTT) binding deficits are reported in major depressive disorder (MDD). However, most studies have not considered serotonin system anatomy when parcellating brain regions of interest (ROIs). We now investigate 5-HTT binding in MDD in two novel ways: (1) use of a 5-HTT tract-based analysis examining binding along serotonergic axons; and (2) using the Copenhagen University Hospital Neurobiology Research Unit (NRU) 5-HT Atlas, based on brain-wide binding patterns of multiple serotonin receptor types. [11C]DASB 5-HTT PET scans were obtained in 60 unmedicated participants with MDD in a current depressive episode and 31 healthy volunteers (HVs). Binding potential (BPP) was quantified with empirical Bayesian estimation in graphical analysis (EBEGA). Within the [11C]DASB tract, the MDD group showed significantly lower BPP compared with HVs (p = 0.02). This BPP diagnosis difference also significantly varied by tract location (p = 0.02), with the strongest MDD binding deficit most proximal to brainstem raphe nuclei. NRU 5-HT Atlas ROIs showed a BPP diagnosis difference that varied by region (p < 0.001). BPP was lower in MDD in 3/10 regions (p-values < 0.05). Neither [11C]DASB tract or NRU 5-HT Atlas BPP correlated with depression severity, suicidal ideation, suicide attempt history, or antidepressant medication exposure. Future studies are needed to determine the causes of this deficit in 5-HTT binding being more pronounced in proximal axon segments and in only a subset of ROIs for the pathogenesis of MDD. Such regional specificity may have implications for targeting antidepressant treatment, and may extend to other serotonin-related disorders.
PMCID:9616969
PMID: 35487966
ISSN: 1476-5578
CID: 5838092

Diagnosis, grading and management of toxicities from immunotherapies in children, adolescents and young adults with cancer

Ragoonanan, Dristhi; Khazal, Sajad J; Abdel-Azim, Hisham; McCall, David; Cuglievan, Branko; Tambaro, Francesco Paolo; Ahmad, Ali Haider; Rowan, Courtney M; Gutierrez, Cristina; Schadler, Keri; Li, Shulin; Di Nardo, Matteo; Chi, Linda; Gulbis, Alison M; Shoberu, Basirat; Mireles, Maria E; McArthur, Jennifer; Kapoor, Neena; Miller, Jeffrey; Fitzgerald, Julie C; Tewari, Priti; Petropoulos, Demetrios; Gill, Jonathan B; Duncun, Christine N; Lehmann, Leslie E; Hingorani, Sangeeta; Angelo, Joseph R; Swinford, Rita D; Steiner, Marie E; Hernandez Tejada, Fiorela N; Martin, Paul L; Auletta, Jeffery; Choi, Sung Won; Bajwa, Rajinder; Dailey Garnes, Natalie; Kebriaei, Partow; Rezvani, Katayoun; Wierda, William G; Neelapu, Sattva S; Shpall, Elizabeth J; Corbacioglu, Selim; Mahadeo, Kris M
Cancer immunotherapies are associated with remarkable therapeutic response rates but also with unique and severe toxicities, which potentially result in rapid deterioration in health. The number of clinical applications for novel immune effector-cell therapies, including chimeric antigen receptor (CAR)-expressing cells, and other immunotherapies, such as immune-checkpoint inhibitors, is increasing. In this Consensus Statement, members of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Hematopoietic Cell Transplantation-Cancer Immunotherapy (HCT-CI) Subgroup, Paediatric Diseases Working Party (PDWP) of the European Society of Blood and Marrow Transplantation (EBMT), Supportive Care Committee of the Pediatric Transplantation and Cellular Therapy Consortium (PTCTC) and MD Anderson Cancer Center CAR T Cell Therapy-Associated Toxicity (CARTOX) Program collaborated to provide updated comprehensive recommendations for the care of children, adolescents and young adults receiving cancer immunotherapies. With these recommendations, we address emerging toxicity mitigation strategies, we advocate for the characterization of baseline organ function according to age and discipline-specific criteria, we recommend early critical care assessment when indicated, with consideration of reversibility of underlying pathology (instead of organ failure scores) to guide critical care interventions, and we call for researchers, regulatory agencies and sponsors to support and facilitate early inclusion of young patients with cancer in well-designed clinical trials.
PMID: 33608690
ISSN: 1759-4782
CID: 4793992

Author Correction: Diagnosis, grading and management of toxicities from immunotherapies in children, adolescents and young adults with cancer

Ragoonanan, Dristhi; Khazal, Sajad J; Abdel-Azim, Hisham; McCall, David; Cuglievan, Branko; Tambaro, Francesco Paolo; Ahmad, Ali Haider; Rowan, Courtney M; Gutierrez, Cristina; Schadler, Keri; Li, Shulin; Di Nardo, Matteo; Chi, Linda; Gulbis, Alison M; Shoberu, Basirat; Mireles, Maria E; McArthur, Jennifer; Kapoor, Neena; Miller, Jeffrey; Fitzgerald, Julie C; Tewari, Priti; Petropoulos, Demetrios; Gill, Jonathan B; Duncan, Christine N; Lehmann, Leslie E; Hingorani, Sangeeta; Angelo, Joseph R; Swinford, Rita D; Steiner, Marie E; Tejada, Fiorela N Hernandez; Martin, Paul L; Auletta, Jeffery; Choi, Sung Won; Bajwa, Rajinder; Garnes, Natalie Dailey; Kebriaei, Partow; Rezvani, Katayoun; Wierda, William G; Neelapu, Sattva S; Shpall, Elizabeth J; Corbacioglu, Selim; Mahadeo, Kris M
PMID: 33731864
ISSN: 1759-4782
CID: 4817932