tbuckley/cabot-search huggingface dataset:
Epitranscriptomics in liver disease: Basic concepts and therapeutic potential
Authors: Zhicong Zhao, Jiaxiang Meng, Rui Su, Jun Zhang, Jianjun Chen, Xiong Ma, Qiang Xia
Journal: Journal of Hepatology (2020)

The development of next-generation sequencing technology and the discovery of specific antibodies targeting chemically modified nucleotides have paved the way for a new era of epitranscriptomics. Cellular RNA is known to dynamically and reversibly undergo different chemical modifications after transcription, such as N6-methyladenosine (m6A), N1-methyladenosine, N6,2'-O-dimethyladenosine, 5-methylcytosine, and 5-hydroxymethylcytidine, whose identity and location comprise the field of epitranscriptomics. Dynamic post-transcriptional modifications determine the fate of target RNAs by regulating various aspects of their processing, including RNA export, transcript processing, splicing, and degradation. The most abundant internal mRNA modification in eukaryotic cells is m6A, which exhibits essential roles in physiological processes, such as embryogenesis, carcinogenesis, and neurogenesis. m6A is deposited by the m6A methyltransferase complex (composed of METTL3/14/16, WTAP, KIAA1429, and RBM15/15B), erased by demethylases (FTO and ALKBH5), and recognised by binding proteins (e.g., YTHDF1/2/3, YTHDC1/2, IGF2BP1/2/3). The liver is the largest digestive and metabolic organ, and m6A modifications play unique roles in critical physiological hepatic functions and various liver diseases. This review focuses on the biological roles of m6A RNA methylation in lipid metabolism, viral hepatitis, non-alcoholic fatty liver disease, liver cancer, and tumour metastasis. In addition, we summarise the existing inhibitors targeting m6A regulators and discuss the potential of modulating m6A modifications as a therapeutic strategy.
Centromeric cohesion failure invokes a conserved choreography of chromosomal mis-segregations in pancreatic neuroendocrine tumor
Authors: Rene Quevedo, Anna Spreafico, Jeff Bruce, Arnavaz Danesh, Samah El Ghamrasni, Amanda Giesler, Youstina Hanna, Cherry Have, Tiantian Li, S. Y. Cindy Yang, Tong Zhang, Sylvia L. Asa, Benjamin Haibe-Kains, Monika Krzyzanowska, Adam C. Smith, Simron Singh, Lillian L. Siu, Trevor J. Pugh
Journal: Genome Medicine (2020)

Pancreatic neuroendocrine tumors (PANETs) are rare, slow growing cancers that often present with local and distant metastasis upon detection. PANETS contain distinct karyotypes, epigenetic dysregulation, and recurrent mutations in MEN1, ATRX, and DAXX (MAD+); however, the molecular basis of disease progression remains uncharacterized.We evaluated associations between aneuploidy and the MAD+ mutational state of 532 PANETs from 11 published genomic studies and 19 new cases using a combination of exome, targeted panel, shallow WGS, or RNA-seq. We mapped the molecular timing of MAD+ PANET progression using cellular fractions corrected for inferred tumor content.In 287 PANETs with mutational data, MAD+ tumors always exhibited a highly recurrent signature of loss of heterozygosity (LOH) and copy-number alterations affecting 11 chromosomes, typically followed by genome doubling upon metastasis. These LOH chromosomes substantially overlap with those that undergo non-random mis-segregation due to ectopic CENP-A localization to flanking centromeric regions in DAXX-depleted cell lines. Using expression data from 122 PANETs, we found decreased gene expression in the regions immediately adjacent to the centromere in MAD+ PANETs. Using 43 PANETs from AACR GENIE, we inferred this signature to be preceded by mutations in MEN1, ATRX, and DAXX. We conducted a meta-analysis on 226 PANETs from 8 CGH studies to show an association of this signature with metastatic incidence. Our study shows that MAD+ tumors are a genetically diverse and aggressive subtype of PANETs that display extensive chromosomal loss after MAD+ mutation, which is followed by genome doubling.We propose an evolutionary model for a subset of aggressive PANETs that is initiated by mutation of MEN1, ATRX, and DAXX, resulting in defects in centromere cohesion from ectopic CENP-A deposition that leads to selective loss of chromosomes and the LOH phenotype seen in late-stage metastatic PANETs. These insights aid in disease risk stratification and nominate potential therapeutic vulnerabilities to treat this disease.
Covid-19: Scotland recommends face coverings, but England does not follow suit
Authors: Elisabeth Mahase
Journal: BMJ (2020)

Membrane-bound particles in plasma are composed of exosomes, microvesicles, and apoptotic bodies and represent ~1-2% of the total protein composition.Proteomic interrogation of this subset of plasma proteins augments the representation of tissue-specific proteins, representing a "liquid biopsy," while enabling the detection of proteins that would otherwise be beyond the dynamic range of liquid chromatography-tandem mass spectrometry in unfractionated plasma.We have developed a one-step enrichment strategy (Mag-Net) using hyper-porous strong-anion exchange magnetic microparticles to sieve membrane-bound particles from plasma.The Mag-Net method is robust, reproducible, inexpensive, and requires <100 μL plasma input.Coupled to a quantitative dataindependent mass spectrometry analytical strategy, we demonstrate that we can routinely collect results for >37,000 peptides from >4,000 plasma proteins with high precision.We demonstrate excellent quantitative accuracy and analytical reproducibility of the protocol.
Influenza infection elicits an expansion of gut population of endogenous Bifidobacterium animalis which protects mice against infection
Authors: Qiang Zhang, Jin Hu, Jia-Wu Feng, Xiao-Tong Hu, Ting Wang, Wen-Xiao Gong, Kun Huang, Yi-Xiong Guo, Zhong Zou, Xian Lin, Run Zhou, Yu-Qi Yuan, An-Ding Zhang, Hong Wei, Gang Cao, Chen Liu, Ling-Ling Chen, Mei-Lin Jin
Journal: Genome biology (2020)

Abstract Background Influenza is a severe respiratory illness that continually threatens global health. It has been widely known that gut microbiota modulates the host response to protect against influenza infection, but mechanistic details remain largely unknown. Here, we took advantage of the phenomenon of lethal dose 50 (LD 50 ) and metagenomic sequencing analysis to identify specific anti-influenza gut microbes and analyze the underlying mechanism. Results Transferring fecal microbes from mice that survive virulent influenza H7N9 infection into antibiotic-treated mice confers resistance to infection. Some gut microbes exhibit differential features to lethal influenza infection depending on the infection outcome. Bifidobacterium pseudolongum and Bifidobacterium animalis levels are significantly elevated in surviving mice when compared to dead or mock-infected mice. Oral administration of B. animalis alone or the combination of both significantly reduces the severity of H7N9 infection in both antibiotic-treated and germ-free mice. Functional metagenomic analysis suggests that B. animalis mediates the anti-influenza effect via several specific metabolic molecules. In vivo tests confirm valine and coenzyme A produce an anti-influenza effect. Conclusions These findings show that the severity of influenza infection is closely related to the heterogeneous responses of the gut microbiota. We demonstrate the anti-influenza effect of B. animalis , and also find that the gut population of endogenous B. animalis can expand to enhance host influenza resistance when lethal influenza infection occurs, representing a novel interaction between host and gut microbiota. Further, our data suggest the potential utility of Bifidobacterium in the prevention and as a prognostic predictor of influenza.
Abstract 11051: A Small-Molecule Factor XIa Inhibitor (BMS-962212) Provides Robust Antithrombotic Activity in Non-Human Primate Model of Arterial Thrombosis With Low Bleeding
Authors: Pancras C Wong, Donald J Pinto, Carol Watson
Journal: Circulation (2018)

Introduction: Factor XIa (FXIa) is a novel target for safer antithrombotic therapy. BMS-962212 is a potent (Ki = 0.7nM), selective, reversible, active-site inhibitor of human FXIa designed for pare...
Towards large-scale case-finding: training and validation of residual networks for detection of chronic obstructive pulmonary disease using low-dose CT
Authors: Lisa Y W Tang, Harvey O Coxson, Stephen Lam, Jonathon Leipsic, Roger C Tam, Don D Sin
Journal: The Lancet Digital Health (2020)

Chronic obstructive pulmonary disease (COPD) is underdiagnosed in the community. Thoracic CT scans are widely used for diagnostic and screening purposes for lung cancer. In this proof-of-concept study, we aimed to evaluate a software pipeline for the automated detection of COPD, based on deep learning and a dataset of low-dose CTs that were performed for early detection of lung cancer.We examined the use of deep residual networks, a type of artificial residual network, for the automated detection of COPD. Three versions of the residual networks were independently trained to perform COPD diagnosis using random subsets of CT scans collected from the PanCan study, which enrolled ex-smokers and current smokers at high risk of lung cancer, and evaluated the networks using three-fold cross-validation experiments. External validation was performed using 2153 CT scans acquired from a separate cohort of individuals with COPD in the ECLIPSE study. Spirometric data were used to define COPD, with stages defined according to the GOLD criteria.The best performing networks achieved an area under the receiver operating characteristic curve (AUC) of 0·889 (SD 0·017) in three-fold cross-validation experiments. When the same set of networks was applied to the ECLIPSE cohort without any modifications to the trained models, they achieved an AUC of 0·886 (0·017), a positive predictive value of 0·847 (0·056), and a negative predictive value of 0·755 (0·097), which is a greater performance than the best quantitative CT measure, the percentage of lung volumes of less than or equal to -950 Hounsfield units (AUC 0·742).Our proposed approach could identify patients with COPD among ex-smokers and current smokers without a previous diagnosis of COPD, with clinically acceptable performance. The use of deep residual networks on chest CT scans could be an effective case-finding tool for COPD detection and diagnosis, particularly in ex-smokers and current smokers who are being screened for lung cancer.Data Science Institute, University of British Columbia; Canadian Institutes of Health Research.
Retinal Vasculitis and Intraocular Inflammation after Intravitreal Injection of Brolucizumab
Authors: Caroline R. Baumal, Richard F. Spaide, Lejla Vajzovic, K. Bailey Freund, Scott D. Walter, Vishak John, Ryan Rich, Nauman Chaudhry, Rohit R. Lakhanpal, Patrick R. Oellers, Thellea K. Leveque, Bryan K. Rutledge, Mark Chittum, Tommaso Bacci, Ana Bety Enriquez, Newman J. Sund, Eric N.P. Subong, Thomas A. Albini
Journal: Ophthalmology (2020)
Single-Cell Circulating Tumor Cell Analysis Reveals Genomic Instability as a Distinctive Feature of Aggressive Prostate Cancer
Authors: Paymaneh D. Malihi, Ryon P. Graf, Angel Rodriguez, Naveen Ramesh, Jerry Lee, Ramsay Sutton, Rhett Jiles, Carmen Ruiz Velasco, Emi Sei, Anand Kolatkar, Christopher Logothetis, Nicholas E. Navin, Paul Corn, Ana M. Aparicio, Ryan Dittamore, James Hicks, Peter Kuhn, Amado J. Zurita
Journal: Clinical Cancer Research (2020)

Abstract Purpose: Aggressive variant prostate cancer (AVPC) represents a clinical subset distinguished by therapy resistance and poor prognosis, linked to combined losses of the tumor suppressor genes (TSG) PTEN, RB1, and TP53. Circulating tumor cells (CTC) provide a minimally invasive opportunity for identification and molecular characterization of AVPC. We aimed to evaluate the incidence and clinical significance of compound (2+)TSG losses and genomic instability in prostate cancer CTC, and to expand the set genomic biomarkers relevant to AVPC. Experimental Design: Genomic analysis of chromosomal copy-number alterations (CNA) at single-cell resolution was performed in CTC from patients with and without AVPC before initiating chemotherapy with cabazitaxel or cabazitaxel and carboplatin. We evaluated associations between single-CTC genomics and clinical features, progression-free survival, and overall survival. Results: A total of 257 individual CTC were sequenced from 47 patients (1–22 CTC/patient). Twenty patients (42.6%) had concurrent 2+TSG losses in at least one CTC in association with poor survival and increased genomic instability, inferred by high large-scale transitions scores. Higher LST in CTC were independent of CTC enumerated, clinically more indicative of aggressive behavior than co-occurring TSG losses, and molecularly associated with gains in chromosomal regions including PTK2, Myc, and NCOA2; increased androgen receptor expression; and BRCA2 loss. In 57 patients with matched cell-free tumor DNA data, CTC were more frequently detectable and evaluable for CNA analysis (in 73.7% vs. 42.1%, respectively). Conclusions: Our findings suggest that genomic instability in CTC is a hallmark of advanced prostate cancer aggressiveness, and support single-CTC sequencing as a compelling tool to noninvasively characterize cancer heterogeneity.
Varlociraptor: enhancing sensitivity and controlling false discovery rate in somatic indel discovery
Authors: Johannes Köster, Louis J. Dijkstra, Tobias Marschall, Alexander Schönhuth
Journal: Genome biology (2020)

Abstract Accurate discovery of somatic variants is of central importance in cancer research. However, count statistics on discovered somatic insertions and deletions (indels) indicate that large amounts of discoveries are missed because of the quantification of uncertainties related to gap and alignment ambiguities, twilight zone indels, cancer heterogeneity, sample purity, sampling, and strand bias. We provide a unifying statistical model whose dependency structures enable accurate quantification of all inherent uncertainties in short time. Consequently, false discovery rate (FDR) in somatic indel discovery can now be controlled at utmost accuracy, increasing the amount of true discoveries while safely suppressing the FDR.
Edwin Maynard McIlrath
Authors: B E Kelly, C S McKinstry
Journal: BMJ (2020)

Edwin Maynard McIlrath (“Teddy”) was educated at the Royal Belfast Academical Institution followed by Methodist College Belfast. His radiological training was in Northern Ireland, University College Hospital, London (1963), and Ulleval Hospital, Oslo, Norway, and University Hospital, Lund, Sweden) (both 1966), where he became enthused with the embryonic discipline that would become interventional radiology.

On returning to Belfast, Teddy was appointed as consultant radiologist to the Royal Victoria Hospital in 1966.

He was an innovator and made important contributions to both diagnostic and interventional radiology. Like others in the department during the Troubles, he was instrumental in the accurate diagnoses of bomb blast and gunshot injuries that were then all too common. The occasional suspect package was also x rayed, luckily without incident.

Teddy was unfailingly kind to the hospital’s house staff and also protected his radiological registrars in …
The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study
Authors: Qian Liu, Dan Luo, Joan E Haase, Qiaohong Guo, Xiao Qin Wang, Shuo Liu, Lin Xia, Zhongchun Liu, Jiong Yang, Bing Xiang Yang
Journal: The Lancet Global Health (2020)

In the early stages of the outbreak of coronavirus disease 2019 (COVID-19) in Hubei, China, the local health-care system was overwhelmed. Physicians and nurses who had no infectious disease expertise were recruited to provide care to patients with COVID-19. To our knowledge, no studies on their experiences of combating COVID-19 have been published. We aimed to describe the experiences of these health-care providers in the early stages of the outbreak.We did a qualitative study using an empirical phenomenological approach. Nurses and physicians were recruited from five COVID-19-designated hospitals in Hubei province using purposive and snowball sampling. They participated in semi-structured, in-depth interviews by telephone from Feb 10 to Feb 15, 2020. Interviews were transcribed verbatim and analysed using Haase's adaptation of Colaizzi's phenomenological method.We recruited nine nurses and four physicians. Three theme categories emerged from data analysis. The first was "being fully responsible for patients' wellbeing-'this is my duty'". Health-care providers volunteered and tried their best to provide care for patients. Nurses had a crucial role in providing intensive care and assisting with activities of daily living. The second category was "challenges of working on COVID-19 wards". Health-care providers were challenged by working in a totally new context, exhaustion due to heavy workloads and protective gear, the fear of becoming infected and infecting others, feeling powerless to handle patients' conditions, and managing relationships in this stressful situation. The third category was "resilience amid challenges". Health-care providers identified many sources of social support and used self-management strategies to cope with the situation. They also achieved transcendence from this unique experience.The intensive work drained health-care providers physically and emotionally. Health-care providers showed their resilience and the spirit of professional dedication to overcome difficulties. Comprehensive support should be provided to safeguard the wellbeing of health-care providers. Regular and intensive training for all health-care providers is necessary to promote preparedness and efficacy in crisis management.National Key R&D Program of China, Project of Humanities and Social Sciences of the Ministry of Education in China.
Pearls and Pitfalls in Interpretation of 68Ga-DOTATOC PET Imaging
Authors: Asma Bashir, Helle Broholm, Erik Clasen-Linde, Mark B. Vestergaard, Ian Law
Journal: Clinical Nuclear Medicine (2020)

Abstract DOTA-D-Phe 1 -Tyr 3 -octreotide labeled with 68 Ga ( 68 Ga-DOTATOC) is the commonly used PET tracer for imaging meningioma because of its high affinity to somatostatin receptor subtype 2 (SSTR2) and an established imaging modality for planning radiation and radionuclide therapy. However, SSTR2 is not an exclusive marker for meningioma, and not all meningiomas express high levels of SSTR2. The SSTR2 expression has been reported in other intracranial tumors, for example, glioma, pituitary adenoma, medullablastoma, primitive neuroectodermal tumors, and hemangioblastoma leading to a significant risk of misinterpretation of PET/CT findings. We present 2 cases with similar 68 Ga-DOTATOC uptakes in 2 distinct etiologies, for example, cerebral lymphoma and meningioma.
DGKA Provides Platinum Resistance in Ovarian Cancer Through Activation of c-JUN–WEE1 Signaling
Authors: Jie Li, Chaoyun Pan, Austin C. Boese, JiHoon Kang, Anna D. Umano, Kelly R. Magliocca, Wenqing Yang, Yu Zhang, Sagar Lonial, Lingtao Jin, Sumin Kang
Journal: Clinical Cancer Research (2020)

Although platinum compounds are the first-line treatment for ovarian cancer, the majority of patients relapse and develop resistance to treatment. However, the mechanism underlying resistance is unclear. The goal of our study is to decipher the mechanism by which a metabolic kinase, diacylglycerol kinase alpha (DGKA), confers platinum resistance in ovarian cancer.Metabolic kinase RNAi synthetic lethal screening was used to identify a cisplatin resistance driver in ovarian cancer. DGKA variants were used to demonstrate the need for DGKA activity in cisplatin resistance. Phospho-proteomic and genomic screens were performed to identify downstream effectors of DGKA. Therapeutic efficacy of targeting DGKA was confirmed and clinical relevance of DGKA signaling was validated using ovarian cancer patient-derived tumors that had different responses to platinum-based therapy.We found that platinum resistance was mediated by DGKA and its product, phosphatidic acid (PA), in ovarian cancer. Proteomic and genomic screens revealed that DGKA activates the transcription factor c-JUN and consequently enhances expression of a cell-cycle regulator, WEE1. Mechanistically, PA facilitates c-JUN N-terminal kinase recruitment to c-JUN and its nuclear localization, leading to c-JUN activation upon cisplatin exposure. Pharmacologic inhibition of DGKA sensitized ovarian cancer cells to cisplatin treatment and DGKA-c-JUN-WEE1 signaling positively correlated with platinum resistance in tumors derived from patients with ovarian cancer.Our study demonstrates how the DGKA-derived lipid messenger, PA, contributes to cisplatin resistance by intertwining with kinase and transcription networks, and provides preclinical evidence for targeting DGKA as a new strategy in ovarian cancer treatment to battle cisplatin resistance.
Ectopic Tcf1 expression instills a stem-like program in exhausted CD8+ T cells to enhance viral and tumor immunity
Authors: Qiang Shan, Sheng’en Hu, Xia Chen, Derek B. Danahy, Vladimir P. Badovinac, Chongzhi Zang, Hai-Hui Xue
Journal: Cellular and Molecular Immunology (2020)
COPD sputum eosinophils: relationship to blood eosinophils and the effect of inhaled PDE4 inhibition
Authors: Dave Singh, Henrik Watz, Kai Michael Beeh, Oliver Kornmann, Brian Leaker, Brendan Colgan, Germano Lucci, Aida Emirova, Marie Anna Nandeuil, Debora Santoro, Deborah Balzano, Mirco Govoni
Journal: European Respiratory Journal (2020)

<b>PDE4 inhibition reduces sputum eosinophils in those COPD patients with higher eosinophil counts. This evidence supports an effect of PDE4 inhibitors on eosinophilic inflammation.</b>https://bit.ly/3airXw7
The Effect of Tranexamic Acid on Blood Loss and Maternal Outcome in the Treatment of Persistent Postpartum Hemorrhage: A Nationwide Retrospective Cohort Study
Authors: Ada Gillissen, Dacia Henriquez, Thomas van den Akker, C Caram-Deelder, Merlijn Wind, Joost Zwart, Jos van Roosmalen, Jeroen C.J. Eikenboom, Kitty Bloemenkamp, Anske G van der Bom
Journal: Blood (2017)
Association of Renin-Angiotensin System Inhibitors With Severity or Risk of Death in Patients With Hypertension Hospitalized for Coronavirus Disease 2019 (COVID-19) Infection in Wuhan, China
Authors: Juyi Li, Xiufang Wang, Jian Chen, Hongmei Zhang, Aiping Deng
Journal: JAMA Cardiology (2020)

Data are lacking whether patients with hypertension who are taking angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) have increased severity or risk of mortality during hospitalization for coronavirus disease 2019 (COVID-19).
이뇨제 치료에 반응도가 낮은 간경변 환자군에서의 Furosemide 투여 후 요 나트륨 측정의 의의
Authors: 조현석, 박근태, 김영훈, 심성곤, 김진배, 이오영, 최호순, 함준수, 이민호
Journal: Clinical and Molecular Hepatology (2003)

목적: 복수는 간경변 환자의 가장 흔한 합병증 중 하나이며, 이 중에 5-10%는 내과적인 치료에 반응을 하지 않는 난치성 복수(refractory ascites)이다. 난치성 복수는 간경변 환자에서 불량한 예후를 의미하며, 정확한 진단이 환자의 향후 치료계획 수립에 중요하다. 본 연구에서는 furosemide 정맥 단독 투여 후 요 나트륨을 측정하는 것이 외래에서 치료하는 복수환자에서 난치성 복수의 정의에 맞게 이뇨제 용량을 증량하기 어려울 경우 환자의 현재 이뇨제 치료에 대한 반응도를 감별 진단할 수 있는 기준이 될 수 있는지를 알아보고자 하였다. 대상과 방법: 본원 외래에서 복수 치료를 위해 입원한 간경변증 환자 16명을 대상으로 하였고, 복수의 이뇨제에 대한 반응에 따라 치료 반응이 좋았던 복수 환자군과 치료 반응도가 낮았던 복수 환자군으로 분류하였다. 입원 당일 일반 혈액검사와 생화학적 간기능검사 등의 기본검사를 시행하였다. 연구 시작 후 3일간 모든 이뇨제의 사용을 중단하였고, 연구 3일째 24시간 요량, 요 나트륨양, 요 단백양을 측정하였으며, 연구 4일째 혈청 항이뇨호르몬, 혈청 레닌 활성도, 혈청 알도스테론 등을 측정하고, furosemide 80 mg을 정맥 투여한 후 8시간 동안의 요 나트륨양을 측정하였다. 결과: 간경변증 환자 16명중 이뇨제 치료에 반응이 좋았던 복수 환자군은 8명이었고, 치료 반응도가 낮았던 복수 환자군은 8명이었다. 평균 연령, 성별, 간경변의 원인 및 정도, 일반혈액검사, 전해질검사, 생화학적 간기능검사, 혈액응고검사 등에서는 두 군간에 통계적으로 유의한 차이는 없었다. 그러나 연구 4일째 시행한 혈청 레닌 활성도에서는 두 군간에 유의한 차이가 없었으나 혈청 알도스테론이 치료 반응이 좋았던 복수 환자군에 비해 치료 반응도가 낮았던 복수 환자군에서 높았다(15.6?.7 vs 48.8?.9 ng/ dL, p<0.05). 연구 4일째 furosemide 80 mg을 정맥 투여한 후 8시간 요량과 요 나트륨양은, 치료 반응도가 낮았던 복수 환자군에서 치료에 반응이 좋았던 복수 환자군에 비해 통계적으로 의미있게 낮았다(1297.5?0.9 vs 2003.7?14.6 mL, p<0.005, 77.3?.2 vs 211.8?2.6 mEq, p<0.001). 결론: Furosemide 80 mg 정맥 투여 후 8시간 동안의 요 나트륨양의 측정은 외래에서 이뇨제 치료에 반응도가 낮은 복수 환자의 감별을 위한 중요한 진단 방법으로 활용할 수 있을 것으로 판단된다. 그러나 앞으로 이뇨제에 대한 약동학적 차이에 대한 연구, 혈청 알도스테론과 난치성 복수와의 관계에 대한 연구 및 국내의 더 많은 대상군을 통한 이뇨제 치료 반응도의 지표에 대한 연구가 필요할 것으로 생각된다.