H S M Kort, J-W J Lammers, S N W Vorrink, T Troosters
Introduction
Chronic Obstructive Pulmonary Disease (COPD) is a disabling airway disease with variable extrapulmonary effects that may contribute to disease severity in individual patients (Rabe et al. 2007). The world health organization predicts that COPD will become the third leading cause of death worldwide by 2030. Patients with COPD demonstrate reduced levels of spontaneous daily physical activity (DPA) compared with healthy controls (Pitta et al. 2005). This results in a higher risk of hospital admission and shorter survival (Pitta et al. 2006). Pulmonary rehabilitation can help to improve the DPA level, however, obtained benefits decline after 1–2 years (Foglio et al. 2007).
Purpose
In order to maintain DPA in COPD patients after rehabilitation, we developed a mobile phone application. This application measures DPA as steps per day, measured by the accelerometer of the smartphone, and shows the information to the patient via the display of the mobile phone. A physiotherapist can monitor the patient via a secure website where DPA measurements are visible for all patients. Here, DPA goals can be adjusted and text messages sent.
Method
Three pilot studies were performed with healthy students and COPD patients to test the application for usability, user friendliness and reliability with questionnaires and focus groups. Subjects also wore a validated accelerometer. For the Randomized Controlled Trial (RCT) 140 COPD patients will be recruited in Dutch physiotherapy practises. They will be randomised in an intervention group that receives the smartphone for 6 months and a control group. Measurements include lungfunction, dyspnea, and exercise capacity and are held at 0, 3, 6 and 12 months.
Results and Discussion
The application was found to be useful, easy to learn and use. Subjects had no problems with health care professionals seeing information on their physical activity performance. They do find it important to be able to determine who can see the information. Correlations between the accelerometer and the measurements on DPA of the smartphone for steps per hour were 0.69 and 0.70 for pilot studies 1 (students) and 2 (COPD patients) respectively. The version of the application in pilot study 3 contained an error, which made correlations with the accelerometer unusable. The RCT study is now being executed.
Tejaswini Subbannayya, Nandini A. Sahasrabuddhe, Arivusudar Marimuthu, Santosh Renuse, Gajanan Sathe, Srinivas M. Srikanth, Mustafa A. Barbhuiya, Bipin Nair, Juan Carlos Roa, Rafael Guerrero-Preston, H. C. Harsha, David Sidransky, Akhilesh Pandey, T. S. Keshava Prasad and Aditi Chatterjee
Proteomic profiling of gallbladder cancer secretome – a source for circulatory biomarker discovery
Gallbladder cancer (GBC) is the fifth most common cancer of the gastrointestinal tract and one of the common malignancies that occur in the biliary tract (Misra et al. 2006; Lazcano-Ponce et al. 2001). It has a poor prognosis with survival of less than 5 years in 90% of the cases (Misra et al. 2003). The etiology is ill-defined. Several risk factors have been reported including cholelithiasis, obesity, female gender and exposure to carcinogens (Eslick 2010; Kumar et al. 2006). Poor prognosis in GBC is mainly due to late presentation of the disease and lack of reliable biomarkers for early diagnosis. This emphasizes the need to identify and characterize cancer biomarkers to aid in the diagnosis and prognosis of GBC. Secreted proteins are an important class of molecules which can be detected in body fluids and has been targeted for biomarker discovery. There are challenges faced in the proteomic interrogation of body fluids especially plasma such as low abundance of tumor secreted proteins, high complexity and high abundance of other proteins that are not released by the tumor cells (Tonack et al. 2009). Profiling of conditioned media from the cancer cell lines can be used as an alternate means to identify secreted proteins from tumor cells (Kashyap et al. 2010; Marimuthu et al. 2012). We analyzed the invasive property of 7 GBC cell lines (SNU-308, G-415, GB-d1, TGBC2TKB, TGBC24TKB, OCUG-1 and NOZ). Four cell lines were selected for analysis of the cancer secretome based on the invasive property of the cells. We employed isobaric tags for relative and absolute quantitation (iTRAQ) labeling technology coupled with high resolution mass spectrometry to identify and characterize secretome from the panel of 4GBC cancer cells mentioned above. In total, we have identified around 2,000 proteins of which 175 were secreted at differential abundance across all the four cell lines. This secretome analysis will act as a reservoir of candidate biomarkers. Currently, we are investigating and validating these candidate markers from GBC cell secretome. Through this study, we have shown mass spectrometry-based quantitative proteomic analysis as a robust approach to investigate secreted proteins in cancer cells.