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      Metabolic Abnormalities Detected in Phase II Evaluation of Doxycycline in Dogs with Multicentric B-Cell Lymphoma

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          Abstract

          Doxycycline has antiproliferative effects in human lymphoma cells and in murine xenografts. We hypothesized that doxycycline would decrease canine lymphoma cell viability and prospectively evaluated its clinical tolerability in client-owned dogs with spontaneous, nodal, multicentric, substage a, B-cell lymphoma, not previously treated with chemotherapy. Treatment duration ranged from 1 to 8 weeks (median and mean, 3 weeks). Dogs were treated with either 10 ( n = 6) or 7.5 ( n = 7) mg/kg by mouth twice daily. One dog had a stable disease for 6 weeks. No complete or partial tumor responses were observed. Five dogs developed grade 3 and/or 4 metabolic abnormalities suggestive of hepatopathy with elevations in bilirubin, ALT, ALP, and/or AST. To evaluate the absorption of oral doxycycline in our study population, serum concentrations in 10 treated dogs were determined using liquid chromatography tandem mass spectrometry. Serum levels were variable and ranged from 3.6 to 16.6 µg/ml (median, 7.6 µg/ml; mean, 8.8 µg/ml). To evaluate the effect of doxycycline on canine lymphoma cell viability in vitro, trypan blue exclusion assay was performed on canine B-cell lymphoma cell lines (17-71 and CLBL) and primary B-cell lymphoma cells from the nodal tissue of four dogs. A doxycycline concentration of 6 µg/ml decreased canine lymphoma cell viability by 80%, compared to matched, untreated, control cells (mixed model analysis, p < 0.0001; Wilcoxon signed rank test, p = 0.0313). Although the short-term administration of oral doxycycline is not associated with the remission of canine lymphoma, combination therapy may be worthwhile if future research determines that doxycycline can alter cell survival pathways in canine lymphoma cells. Due to the potential for metabolic abnormalities, close monitoring is recommended with the use of this drug in tumor-bearing dogs. Additional research is needed to assess the tolerability of chronic doxycycline therapy.

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          Sample size tables for exact single-stage phase II designs.

          R A'Hern (2001)
          Tables for single-phase II trials based on the exact binomial distribution are presented. These are preferable to those generated using Fleming's design, which are based on the normal approximation and can give rise to anomalous results. For example, if the upper success rate is accepted, the lower success rate, which the trial is designed to reject, may be included in the final confidence interval for the proportion being estimated. Copyright 2001 John Wiley & Sons, Ltd.
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            Classification of canine malignant lymphomas according to the World Health Organization criteria.

            A study was carried out to test the accuracy and consistency of veterinary pathologists, not specialists in hematopathology, in applying the World Health Organization (WHO) system of classification of canine lymphomas. This study represents an initiative of the ACVP Oncology Committee, and the classification has been endorsed by the World Small Animal Veterinary Association (WASVA). Tissue biopsies from cases of canine lymphoma were received from veterinary oncologists, and a study by pathologists given only signalment was carried out on 300 cases. Twenty pathologists reviewed these 300 cases with each required to choose a diagnosis from a list of 43 B and T cell lymphomas. Three of the 20 were hematopathologists who determined the consensus diagnosis for each case. The 17 who formed the test group were experienced but not specialists in hematopathology, and most were diplomates of the American or European Colleges of Veterinary Pathology. The overall accuracy of the 17 pathologists on the 300 cases was 83%. When the analysis was limited to the 6 most common diagnoses, containing 80% of all cases, accuracy rose to 87%. In a test of reproducibility enabled by reintroducing 5% of cases entered under a different identity, the overall agreement between the first and second diagnosis ranged from 40 to 87%. The statistical review included 43,000 data points for each of the 20 pathologists.
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              Tetracyclines: a pleitropic family of compounds with promising therapeutic properties. Review of the literature.

              There must be something unique about a class of drugs (discovered and developed in the mid-1940s) where there are more than 130 ongoing clinical trials currently listed. Tetracyclines were developed as a result of the screening of soil samples for antibiotic organisms. The first of these compounds chlortetracycline was introduced in 1948. Soon after their development tetracyclines were found to be highly effective against various pathogens including rickettsiae, Gram-positive, and Gram-negative bacteria, thus, becoming a class of broad-spectrum antibiotics. The mechanism of action of tetracyclines is thought to be related to the inhibition of protein synthesis by binding to the 30S bacterial ribosome. Tetracyclines are also an effective anti-malarial drug. Over time, many other "protective" actions have been described for tetracyclines. Minocycline, which can readily cross cell membranes, is known to be a potent anti-apoptotic agent. Its mechanism of action appears to relate to specific effects exerted on apoptosis signaling pathways. Another tetracycline, doxycycline is known to exert antiprotease activities. Doxycycline can inhibit matrix metalloproteinases, which contribute to tissue destruction activities in diseases such as gingivitis. A large body of literature has provided additional evidence for the "beneficial" actions of tetracyclines, including their ability to act as oxygen radical scavengers and anti-inflammatory agents. This increasing volume of published work and ongoing clinical trials supports the notion that a more systematic examination of their possible therapeutic uses is warranted. This review provides a summary of tetracycline's multiple mechanisms of action and while using the effects on the heart as an example, this review also notes their potential to benefit patients suffering from various pathologies such as cancer, Rosacea, and Parkinson's disease.
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                Author and article information

                Contributors
                URI : http://frontiersin.org/people/u/499109
                URI : http://frontiersin.org/people/u/528262
                URI : http://frontiersin.org/people/u/423248
                Journal
                Front Vet Sci
                Front Vet Sci
                Front. Vet. Sci.
                Frontiers in Veterinary Science
                Frontiers Media S.A.
                2297-1769
                26 February 2018
                2018
                : 5
                : 25
                Affiliations
                [1] 1Department of Clinical Sciences, College of Veterinary Medicine, Cornell University , Ithaca, NY, United States
                [2] 2College of Veterinary Medicine, Cornell University , Ithaca, NY, United States
                [3] 3Department of Biomedical Genetics, University of Rochester Medical Center , Rochester, NY, United States
                [4] 4Wilmot Cancer Institute, University of Rochester Medical Center , Rochester, NY, United States
                Author notes

                Edited by: Bruno Cozzi, Università degli Studi di Padova, Italy

                Reviewed by: Luca Aresu, Università degli Studi di Torino, Università degli Studi di Padova, Italy; Robert Friis, University of Bern, Switzerland

                *Correspondence: Kelly R. Hume, krh73@ 123456cornell.edu

                Present address: Lucia Borlle, Department of Animal Science, College of Agriculture and Life Sciences, Cornell University, Ithaca, NY, United States

                Specialty section: This article was submitted to Comparative and Clinical Medicine, a section of the journal Frontiers in Veterinary Science

                Article
                10.3389/fvets.2018.00025
                5834767
                590c03eb-9289-47e9-bd9c-28f18c0f0817
                Copyright © 2018 Hume, Sylvester, Borlle, Balkman, McCleary-Wheeler, Pulvino, Casulo and Zhao.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 24 November 2017
                : 07 February 2018
                Page count
                Figures: 2, Tables: 3, Equations: 0, References: 56, Pages: 11, Words: 8368
                Funding
                Funded by: College of Veterinary Medicine, Cornell University 10.13039/100006471
                Funded by: National Institutes of Health 10.13039/100000002
                Award ID: R24 GM082910
                Categories
                Veterinary Science
                Original Research

                dogs,hematopoietic neoplasm,tetracycline toxicity,doxycycline,lymphoma

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