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Treatment of advanced colorectal cancer (CRC) is impacted by tumour heterogeneity and the development of drug resistance. Cancer stem cells (CSCs) are a subpopulation of tumour cells with the ability to self-renew and evade current treatments. This has led to the implication of CSCs in tumour recurrence. Our laboratory used serial colonosphere culture to enrich for CSCs from two human CRC cell lines, HCT116 and SW480. The expression of CSC markers was assessed via flow cytometry and RT-qPCR. The effect of chemotherapy on self-renewal and drug resistance-related gene expression was also examined. The sphere formation assay enriched for cells with higher levels of the CSC markers CD44, CD166 and EpCAM. Chemotherapy treatment significantly reduced sphere and colony formation in parental cell lines. Treatment also altered the expression of the drug-resistance related genes ABCB1, ABCG2 and ALDH3A1. These data provide evidence that chemotherapy influences the colorectal cancer stem cell phenotype through reducing the ability to self-renew and altering the expression of multi- drug resistance genes.

Purpose: This study reports on the prevalence and impact of pain in individuals with different chronic respiratory diseases attending pulmonary rehabilitation (PR). Method: A retrospective review of medical records data was conducted for 488 participants who had attended a PR programme over a 2-year period. Data on pain and medication history taken from multidisciplinary medical records, together with participant demographics and PR outcomes, were extracted. We compared pain among participants with different types of chronic respiratory disease. Results: The overall prevalence of pain was 77%, with a significantly higher prevalence among individuals with obstructive lung diseases (80%) compared with restrictive lung diseases (69%; p = 0.04). Some participants (17%) who took pain medications did not discuss pain with their clinicians. The presence of pain and different reporting of pain did not have a negative impact on the PR programme completion rate ( p = 0.74), improvements in exercise capacity ( p = 0.51), or health-related quality of life (all four chronic respiratory disease questionnaire domains, p>0.05). Conclusions: The prevalence of pain is high among individuals with chronic respiratory disease attending PR. The presence or absence of pain was not negatively associated with the programme completion rate or PR outcomes; therefore, pain should not deter clinicians from referring patients to PR.

Background The presence of comorbid conditions could impact performance in pulmonary rehabilitation (PR) programmes. We aimed to compare the comorbidity prevalence among those with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) and evaluate the impact on PR response. Methods We performed a retrospective cohort study, recording comorbidities for all patients with COPD or ILD referred to PR. Participants were classified as responders to PR if they met the minimal important difference for exercise capacity and health-related quality of life (HRQoL). The prevalence of comorbidities and impact on PR outcomes were compared by lung disease and by sex using a univariate analysis and multivariate logistic regression. Results The mean number of comorbidities was similar among those with COPD (3.3±2.1, n=242) and ILD (3.2±1.9, n=66) (p>0.05). Females had a higher number of comorbidities than males in both COPD (p=0.001) and ILD (p=0.017) populations. Circulatory (64%) and endocrine/metabolic (45%) conditions were most common in COPD. In ILD, digestive (55%) and circulatory (53%) comorbidities were most prevalent. In people with ILD, those over 65 years, with musculoskeletal/connective tissue disease or circulatory disease were less likely to obtain meaningful improvements in exercise capacity. There was no impact of comorbidities on exercise capacity in COPD or on HRQoL in ILD. Conclusions The majority of patients with COPD or ILD enrolled in PR programmes have multiple comorbidities that may affect improvements in exercise capacity. PR programmes may be less effective for older adults with ILD and comorbid circulatory or musculoskeletal disease., Comorbidities are common in people with chronic lung disease and can affect their ability to exercise. People with COPD have a similar comorbidity profile to people with interstitial lung disease (ILD). People with ILD and musculoskeletal disease or circulatory conditions are less likely to improve their exercise capacity after pulmonary rehabilitation. http://bit.ly/2p8WSIn