Publications by authors named "Kate Tatham"

Article Synopsis
  • About 20% of sepsis cases involve cancer patients, highlighting the need for their inclusion in sepsis trials.
  • Many of these patients are often excluded from such trials, but the specific reasons for this exclusion are unclear.
  • The authors argue that the lack of cancer patient representation in sepsis research limits the applicability of trial results and advocate for broader inclusion to improve management strategies for sepsis in these patients.
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  • - Patients with blood cancers have a weakened immune response to the Omicron variants of SARS-CoV-2.
  • - The study shows that Sotrovimab, a monoclonal antibody treatment, continues to effectively neutralize all examined Omicron subvariants.
  • - These findings highlight the need for close monitoring and potential treatment strategies for immunocompromised patients during the pandemic.
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Background & Aims: AXL and MERTK expression on circulating monocytes modulated immune responses in patients with cirrhosis (CD14HLA-DRAXL) and acute-on-chronic liver failure (CD14MERTK). AXL expression involved enhanced efferocytosis, sustained phagocytosis, but reduced tumor necrosis factor-α/interleukin-6 production and T-cell activation, suggesting a homeostatic function. Axl was expressed on murine airway in tissues contacting the external environment, but not interstitial lung- and tissue-resident synovial lining macrophages.

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Article Synopsis
  • Advances in data-driven techniques have improved the understanding and treatment of sepsis, particularly in areas like early recognition and personalizing medical care.* -
  • Researchers are focusing on discovering biomarkers and digital signatures to enhance the diagnosis and management of sepsis sub-types, which could lead to better clinical outcomes.* -
  • The review discusses various machine learning methods, including supervised and unsupervised approaches, that have been applied to develop diagnostic tools and identify important biomarkers for sepsis.*
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Patients with blood cancer continue to have a greater risk of inadequate immune responses following three COVID-19 vaccine doses and risk of severe COVID-19 disease. In the context of the CAPTURE study (NCT03226886), we report immune responses in 80 patients with blood cancer who received a fourth dose of BNT162b2. We measured neutralizing antibody titers (NAbTs) using a live virus microneutralization assay against wild-type (WT), Delta, and Omicron BA.

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Article Synopsis
  • Immune checkpoint inhibitors (ICIs) are becoming a standard treatment for many types of cancer but can lead to immune-related adverse events (irAEs) like fever, which might indicate systemic immune activation (SIA or HLH).
  • A study reviewed patients at the Royal Marsden Hospital between May 2014 and November 2019, identifying those who experienced fever or chills after starting ICIs for clinical data collection.
  • Three patients were diagnosed with SIA/HLH, showing symptoms typically 10 days after starting treatment, and they were treated primarily with high-dose steroids, while additional therapies were considered for those who didn’t respond.
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Article Synopsis
  • * Out of those tested, 118 had COVID-19, with 94 showing symptoms and only 2 fatalities, revealing high levels of S1-reactive and neutralizing antibodies against the virus.
  • * Immune responses varied, particularly with hematological cancer patients showing unique challenges but still managing clinical recovery, highlighting the need for more research on immune durability against different SARS-CoV-2 variants.
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Article Synopsis
  • The CAPTURE study evaluated COVID-19 immunity in 585 cancer patients after receiving two doses of either BNT162b2 or AZD1222 vaccines, revealing seroconversion rates of 85% for those with solid tumors and 59% for those with hematological malignancies.
  • Patients with hematological cancers had significantly lower levels of detectable neutralizing antibodies (NAbT) against SARS-CoV-2 variants compared to those with solid tumors and healthy individuals.
  • Previous COVID-19 infections increased NAb responses, particularly against variants, but treatment with anti-CD20 medications correlated with undetectable NAbT, highlighting important considerations for cancer patient management during the pandemic.
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CAPTURE (NCT03226886) is a prospective cohort study of COVID-19 immunity in patients with cancer. Here we evaluated 585 patients following administration of two doses of BNT162b2 or AZD1222 vaccines, administered 12 weeks apart. Seroconversion rates after two doses were 85% and 59% in patients with solid and hematological malignancies, respectively.

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Article Synopsis
  • * A high percentage (83%) of patients developed S1-reactive antibodies, but neutralizing antibody levels against virus variants (Alpha, Beta, Delta) were significantly lower, despite stable levels over time.
  • * The study indicated that while most patients had detectable SARS-CoV-2-specific T cells and antibody responses, those with blood cancers exhibited weaker immune responses linked to their specific conditions and treatments, yet they still showed some compensatory immune activity.
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Purpose: We sought to examine changes in acute respiratory distress syndrome (ARDS) management over a 12-year period of two successive randomized trials.

Methods: Analyses included baseline data, from eligible patients, prior to influence of trial protocols, and daily study data, from randomized patients, of variables not determined by trial protocols. Mixed linear regressions examined changes in practice year-on-year.

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Purpose: The trajectory of mechanically ventilated patients with coronavirus disease 2019 (COVID-19) is essential for clinical decisions, yet the focus so far has been on admission characteristics without consideration of the dynamic course of the disease in the context of applied therapeutic interventions.

Methods: We included adult patients undergoing invasive mechanical ventilation (IMV) within 48 h of intensive care unit (ICU) admission with complete clinical data until ICU death or discharge. We examined the importance of factors associated with disease progression over the first week, implementation and responsiveness to interventions used in acute respiratory distress syndrome (ARDS), and ICU outcome.

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Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited.

Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19.

Design, Setting, And Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin.

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Article Synopsis
  • - The project aimed to update research priorities in intensive care by including insights from clinicians and academics, in contrast to the 2014 James Lind Alliance process which primarily involved patient/public input.
  • - A survey conducted by the National Institute for Health Research (NIHR) gathered responses from 94 intensive care professionals, generating 203 research questions with key themes including case selection, ventilation, and sepsis.
  • - The diverse input from the survey can help shape future research agendas and funding initiatives by NIHR, ensuring that a wide range of critical topics are considered in intensive care research.
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Ancient organisms have a combined coagulation and immune system, and although links between inflammation and hemostasis exist in mammals, they are indirect and slower to act. Here we investigated direct links between mammalian immune and coagulation systems by examining cytokine proproteins for potential thrombin protease consensus sites. We found that interleukin (IL)-1α is directly activated by thrombin.

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Human mesenchymal stem/stromal cells (MSCs) have been reported to produce an M2-like, alternatively activated phenotype in macrophages. In addition, MSCs mediate effective bacterial clearance in pre-clinical sepsis models. Thus, MSCs have a paradoxical antimicrobial and anti-inflammatory response that is not understood.

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Rationale: Primary graft dysfunction in lung transplant recipients derives from the initial, largely leukocyte-dependent, ischaemia-reperfusion injury. Intravascular lung-marginated monocytes have been shown to play key roles in experimental acute lung injury, but their contribution to lung ischaemia-reperfusion injury post transplantation is unknown.

Objective: To define the role of donor intravascular monocytes in lung transplant-related acute lung injury and primary graft dysfunction.

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The lung has a unique structure consisting of three functionally different compartments (alveolar, interstitial, and vascular) situated in an extreme proximity. Current methods to localize lung leukocytes using bronchoalveolar lavage and/or lung perfusion have significant limitations for determination of location and phenotype of leukocytes. Here we present a novel method using in vivo antibody labeling to enable accurate compartmental localization/quantification and phenotyping of mouse lung leukocytes.

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Article Synopsis
  • Lung transplantation can help patients with severe lung disease, but faces challenges like a lack of donors, lung inflammation, and injury during surgery.
  • Ex vivo lung perfusion is a new method being tested in clinical trials to improve lung transplantation outcomes by overcoming these issues.
  • This research focuses on understanding the cellular and molecular processes involved in primary graft dysfunction, specifically looking at how pulmonary inflammation affects lung transplants using a specialized lung model.
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Objectives: Ventilator-induced lung injury has substantive impact on mortality of patients with acute respiratory distress syndrome. Although low tidal volume ventilation has been shown to reduce mortality, clinical benefits of open-lung strategy are controversial. In this study, we investigated the impact of two distinct forms of ventilator-induced lung injury, i.

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Margination and activation of monocytes within the pulmonary microcirculation contribute substantially to the development of acute lung injury in mice. The enhanced LPS-induced TNF expression exhibited by Gr-1(high) compared with Gr-1(low) monocytes within the lung microvasculature suggests differential roles for these subsets. We investigated the mechanisms responsible for such heterogeneity of lung-marginated monocyte proinflammatory response using a combined in vitro and in vivo approach.

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