Αρχειοθήκη ιστολογίου

Σάββατο 16 Σεπτεμβρίου 2017

A naive Bayes algorithm for tissue origin diagnosis (TOD-Bayes) of synchronous multifocal tumors in the hepatobiliary and pancreatic system

Abstract

Synchronous multifocal tumors are common in the hepatobiliary and pancreatic system but because of similarities in their histological features, oncologists have difficulty in identifying their precise tissue clonal origin through routine histopathological methods. To address this problem and assist in more precise diagnosis, we developed a computational approach for tissue origin diagnosis based on naive Bayes algorithm (TOD-Bayes) using ubiquitous RNA-Seq data. Massive tissue-specific RNA-Seq data sets were first obtained from The Cancer Genome Atlas (TCGA) and ∼1,000 feature genes were used to train and validate the TOD-Bayes algorithm. The accuracy of the model was > 95% based on 10-fold cross validation by the data from TCGA. A total of 18 clinical cancer samples (including 6 negative controls) with definitive tissue origin were subsequently used for external validation and 17 of the 18 samples were classified correctly in our study (94.4%). Furthermore, we included as cases studies seven tumor samples, taken from two individuals who suffered from synchronous multifocal tumors across tissues, where the efforts to make a definitive primary cancer diagnosis by traditional diagnostic methods had failed. Using our TOD-Bayes analysis, the two clinical test cases were successfully diagnosed as pancreatic cancer (PC) and cholangiocarcinoma (CC), respectively, in agreement with their clinical outcomes. Based on our findings, we believe that the TOD-Bayes algorithm is a powerful novel methodology to accurately identify the tissue origin of synchronous multifocal tumors of unknown primary cancers using RNA-Seq data and an important step towards more precision-based medicine in cancer diagnosis and treatment. This article is protected by copyright. All rights reserved.



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Tumor-suppressive miR-145 co-repressed by TCF4-β-catenin and PRC2 complexes forms double-negative regulation loops with its negative regulators in colorectal cancer

Abstract

The frequently dysregulated Wnt/β-catenin signaling in different malignancies, by activation of its own or orchestration with other co-factors, regulates various oncogenic or tumor-suppressive genes. Among these genes, miRNAs, which are negative posttranscriptional regulators, are also embedded in the Wnt signaling network. Different from the Wnt-induced oncogenic miRNAs, the specific mechanism underlying the Wnt-repressed tumor-suppressive miRNAs is much less understood. In the present study, firstly by analyzing a ChIP-seq dataset against TCF4, the core transcription factor for initiation of Wnt signaling in colorectal cancer (CRC) cells, we screened out several tumor-suppressive miRNAs potentially regulated by Wnt signaling. Then through siRNA mediated knock-down tests and protein and chromatin immunoprecipitations, we found the TCF4-β-catenin complex can recruit the histone trimethylation complex PRC2 as a co-repressor while binding to the TCF4-binding element (TBE) in the promoter regions of miR-145, miR-132 and miR-212. Thus, upon Wnt signaling activation, the PRC2-mediated trimethylation of histone H3 at lysine 27 increases at these promoter regions, leading to decreased miRNA levels. Furthermore, we found that by targeting TCF4 and SUZ12, the key components of the negative regulation complexes, the tumor-suppressive miR-145 co-repressed by Wnt signaling and histone trimethylation, forms double-negative regulation loops with its negative regulators in CRC cells. And the inverse associations between miR-145 and its targets/negative regulators have also been demonstrated in nude mice and clinical samples. Collectively, we elucidated the detailed molecular mechanism of how dysregulated Wnt/β-catenin signaling and tumor-suppressive miRNAs reciprocally regulate each other in CRC cells. This article is protected by copyright. All rights reserved.



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Dacomitinib-induced diarrhea: Targeting chloride secretion with crofelemer

Abstract

Dacomitinib, an irreversible small-molecule pan-ErbB TKI, has a high incidence of diarrhea which has been suggested to be due to chloride secretory mechanisms. Based on this hypothesis, crofelemer, an anti-secretory agent may be an effective intervention. T84 monolayers were treated with 1µM dacomitinib and 10µM crofelemer, and mounted into Ussing chambers for electrogenic ion analysis. Crofelemer attenuated increases in chloride secretion in cells treated with dacomitinib. Albino Wistar rats (n=48) were treated with 7.5 mg/kg dacomitinib and/or 25 mg/kg crofelemer via oral gavage for 21 days. Crofelemer significantly worsened dacomitinib-induced diarrhea (p=0.0003), and did not attenuate weight loss (p<0.0001). Sections of the ileum and colon were mounted into Ussing chambers, and secretory processes analyzed. This indicated that crofelemer lost its anti-secretory action in the presence of dacomitinib in this model. Mass spectrometry revealed that crofelemer did not change serum concentration of dacomitinib. Serum FITC dextran levels indicated that crofelemer was unable to attenuate dacomitinib-induced barrier dysfunction. Tight junction proteins were visualized with immunofluorescence. Qualitative analysis showed dacomitinib induced proteolysis of ZO-1 and occludin, and internalization of claudin-1, which was not attenuated by crofelemer. Detailed histopathological analysis showed that crofelemer was unable to attenuate dacomitinib-induced ileal damage. Crofelemer worsened dacomitinib-induced diarrhea, suggesting that antisecretory drug therapy may be ineffective in this setting. This article is protected by copyright. All rights reserved.



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Associations of alcohol intake, smoking, physical activity and obesity with survival following colorectal cancer diagnosis by stage, anatomic site and tumor molecular subtype

Abstract

The influence of lifestyle factors on survival following a diagnosis of colorectal cancer (CRC) is not well established. We examined associations between lifestyle factors measured before diagnosis and CRC survival. The Melbourne Collaborative Cohort Study collected data on alcohol intake, cigarette smoking and physical activity, and body measurements at baseline (1990-94) and wave 2 (2003-07). We included participants diagnosed to 31 August 2015 with incident stage I-III CRC within 10-years post exposure assessment. Information on tumor characteristics and vital status was obtained. Tumor DNA was tested for microsatellite instability (MSI) and somatic mutations in oncogenes BRAF (V600E) and KRAS. We estimated hazard ratios (HRs) for associations between lifestyle factors and overall and CRC-specific mortality using Cox regression. Of 724 eligible CRC cases, 339 died (170 from CRC) during follow-up (average 9.0 years). Exercise (non-occupational/leisure-time) was associated with higher CRC-specific survival for stage II (HR = 0.25, 95% CI: 0.10-0.60) but not stage I/III disease (p for interaction = .01), and possibly for colon and KRAS wild-type tumors. Waist circumference was inversely associated with CRC-specific survival (HR = 1.25 per 10 cm increment, 95% CI: 1.08-1.44), independent of stage, anatomic site and tumor molecular status. Cigarette smoking was associated with lower overall survival, with suggestive evidence of worse survival for BRAF mutated CRC, but not with CRC-specific survival. Alcohol intake was not associated with survival. Survival did not differ by MSI status. We have identified pre-diagnostic predictors of survival following CRC that may have clinical and public health relevance. This article is protected by copyright. All rights reserved.



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Erratum to “The “Crumple Zone” hypothesis: Association of frontal sinus volume and cerebral injury after craniofacial trauma” [J Craniomaxillofac Surg 45 (2017) 1094–1098]

The publisher regrets that Michael P. Grant's surname appeared incorrectly in the original article. It appears correctly above.

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Erratum

In "Development of a Global Respiratory Severity Score (GRSS) for Respiratory Syncytial Virus Infection in Infants" by Caserta et al. [J Infect Dis 2017 jiw624. doi: 10.1093/infdis/jiw624], the authors report errors in Table 3. They have revised the Global Respiratory Severity Score formula and weightings after re-analysis of the data, and report that these changes do not alter their interpretations and conclusions. The authors regret any inconvenience caused by the errors.

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2-Dose Schedule of AS04-Adjuvanted Human Papillomavirus Types 16/18 Vaccine

HPV vaccineimmunogenicitysafetyneuropsychiatric syndrome

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Reply to Poddighe

To the EditorWe thank Poddighe for the critical review of our article related to the immunogenicity and safety of the AS04-adjuvanted human papillomavirus (HPV) type 16/18 (AS04-HPV-16/18) vaccine, given as 2-dose schedules and compared to a 3-dose schedule, and for his questions related to the safety of HPV vaccine.

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Insights Into Onchocerca volvulus Population Biology Through Multilocus Immunophenotyping

Abstract
We have developed a serologically based immunophenotyping approach to study Onchocerca volvulus (Ov) population diversity. Using genomic sequence data and polymerase chain reaction–based genotyping, we identified nonsynonymous single-nucleotide polymorphisms (SNPs) in the genes of 16 major immunogenic Ov proteins: Ov-CHI-1/Ov-CHI-2, Ov16, Ov-FAR-1, Ov-CPI-1, Ov-B20, Ov-ASP-1, Ov-TMY-1, OvSOD1, OvGST1, Ov-CAL-1, M3/M4, Ov-RAL-1, Ov-RAL-2, Ov-ALT-1, Ov-FBA-1, and Ov-B8. We assessed the immunoreactivity of onchocerciasis patient sera (n = 152) from the Americas, West Africa, Central Africa, and East Africa against peptides derived from 10 of these proteins containing SNPs. Statistically significant variation in immunoreactivity among the regions was seen in SNP-containing peptides derived from 8 of 10 proteins tested: OVOC1192(1–15), OVOC9988(28–42), OVOC9225(320–334), OVOC7453(22–36), OVOC11517(14–28), OVOC3177(283–297), OVOC7911(594–608), and OVOC12628(174–188). Our data show that differences in immunoreactivity to variant antigenic peptides may be used to characterize Ov populations, thereby elucidating features of Ov population biology previously inaccessible because of the limited availability of parasite material.

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Group B Streptococcus and the Vaginal Microbiota

Abstract
Background
Streptococcus agalactiae (group B Streptococcus [GBS]) is an important neonatal pathogen and emerging cause of disease in adults. The major risk factor for neonatal disease is maternal vaginal colonization. However, little is known about the relationship between GBS and vaginal microbiota.
Methods
Vaginal lavage samples from nonpregnant women were tested for GBS, and amplicon-based sequencing targeting the 16S ribosomal RNA V3–V4 region was performed.
Results
Four hundred twenty-eight of 432 samples met the high-quality read threshold. There was no relationship between GBS carriage and demographic characteristics, α-diversity, or overall vaginal microbiota community state type (CST). Within the non-Lactobacillus-dominant CST IV, GBS positive status was significantly more prevalent in CST IV-A than CST IV-B. Significant clustering by GBS status was noted on principal coordinates analysis, and 18 individual taxa were found to be significantly associated with GBS carriage by linear discriminant analysis. After adjusting for race/ethnicity, 4 taxa were positively associated with GBS, and 6 were negatively associated.
Conclusions
Vaginal microbiota CST and α-diversity are not related to GBS status. However, specific microbial taxa are associated with colonization of this important human pathogen, highlighting a potential role for the microbiota in promotion or inhibition of GBS colonization.

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Declining Transmission and Immunity to Malaria and Emerging Artemisinin Resistance in Thailand: A Longitudinal Study

Abstract
Background
Reductions in malaria transmission decrease naturally acquired immunity, which may influence the emergence of Plasmodium falciparum artemisinin-resistant phenotypes and genotypes over time.
Methods
Antibodies specific for P. falciparum antigens were determined in uncomplicated hyperparasitemic malaria patients over a 10-year period of declining malaria transmission and emerging artemisinin resistance in northwestern Thailand. We investigated the association between antibody levels and both parasite clearance time (PCt½) and artemisinin resistance–associated kelch13 genotypes over time.
Results
Immunity to P. falciparum declined prior to 2004, preceding the emergence of artemisinin resistance-associated genotypes and phenotypes (maximum mean change in antibody level per year: anti-MSP142 = −0.17; 95% confidence interval [CI] = −.31 to −.04; P = .01). In this period of declining immunity, and in the absence of kelch13 mutations, PCt½ increased. Between 2007 and 2011, levels of antibodies fluctuated, and higher antibody levels were associated with faster PCt½ (maximum yearly change in PCt½, in hours: EBA140rII = −0.39; 95% CI = −.61 to −.17; P < .001).
Conclusions
Understanding the impact of changing transmission and immunity on the emergence of artemisinin resistance is important particularly as increased malaria control and elimination activities may enhance immunological conditions for the expansion of artemisinin-resistant P. falciparum.

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Opposing Effects of Nitazoxanide on Murine and Human Norovirus

To the Editor—Norovirus is a major cause of acute gastroenteritis worldwide, and chronic infections frequently occur in immunocompromised patients. However, no US Food and Drug Administration–approved specific medication is available for treating norovirus infection. Interestingly, substantial clinical evidence has suggested that nitazoxanide, originally developed as an antiprotozoal agent, is a potential antiviral therapy for norovirus infection [1]. Both clinical trials and case studies have reported its effects on reduction of symptom duration in immunocompetent patients [2] or clearance of the infection in immunocompromised patients [3, 4]. On the contrary, a recent study in the Journal of Infectious Diseases by Kempf et al reported that nitazoxanide was not effective for treating chronic norovirus gastroenteritis in a patient with X-linked agammaglobulinemia [5]. These results have sparked concern regarding whether this drug holds promise in treating norovirus infection, indicating the need for further assessment of the efficacy and working mechanism of nitazoxanide [6].

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Intestinal Damage and Inflammatory Biomarkers in Human Immunodeficiency Virus (HIV)–Exposed and HIV-Infected Zimbabwean Infants

Abstract
Background
Disease progression is rapid in human immunodeficiency virus (HIV)–infected infants. Whether intestinal damage and inflammation underlie mortality is unknown.
Methods
We measured plasma intestinal fatty acid binding protein (I-FABP), soluble CD14 (sCD14), interleukin 6 (IL-6), and C-reactive protein (CRP) at 6 weeks and 6 months of age in 272 HIV-infected infants who either died (cases) or survived (controls), and in 194 HIV-exposed uninfected (HEU) and 197 HIV-unexposed infants. We estimated multivariable odds ratios for mortality and postnatal HIV transmission for each biomarker using logistic regression.
Results
At 6 weeks, HIV-infected infants had higher sCD14 and IL-6 but lower I-FABP than HIV-exposed and HIV-unexposed infants (P < .001). CRP was higher in HIV-exposed than HIV-unexposed infants (P = .02). At 6 months, HIV-infected infants had highest sCD14, IL-6, and CRP concentrations (P < .001) and marginally higher I-FABP than other groups (P = .07). CRP remained higher in HIV-exposed vs HIV-unexposed infants (P = .04). No biomarker was associated with mortality in HIV-infected infants, or with odds of breast-milk HIV transmission in HIV-exposed infants.
Conclusions
HIV-infected infants have elevated inflammatory markers by 6 weeks of age, which increase over time. In contrast to adults and older children, inflammatory biomarkers were not associated with mortality. HEU infants have higher inflammation than HIV-unexposed infants until at least 6 months, which may contribute to poor health outcomes.

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Genetic Profiling and Comorbidities of Zika Infection

Abstract
Background
The difficulty in distinguishing infection by Zika virus (ZIKV) from other flaviviruses is a global health concern, particularly given the high risk of neurologic complications (including Guillain-Barré syndrome [GBS]) with ZIKV infection.
Methods
We developed quantitative frameworks to compare and explore infectome, diseasome, and comorbidity of ZIKV infections. We analyzed gene expression microarray and RNA-Seq data from ZIKV, West Nile fever (WNF), chikungunya, dengue, yellow fever, Japanese encephalitis virus, GBS, and control datasets. Using neighborhood-based benchmarking and multilayer network topology, we constructed relationship networks based on the Online Mendelian Inheritance in Man database and our identified significant genes.
Results
ZIKV infections showed dysregulation in expression of 929 genes. Forty-seven genes were highly expressed in both ZIKV and dengue infections. However, ZIKV shared <15 significant transcripts with other flavivirus infections. Notably, dysregulation of MAFB and SELENBP1 was common to ZIKV, dengue, and GBS infection; ATF5, TNFAIP3, and BAMB1 were common to ZIKV, dengue, and WNF; and NAMPT and PMAlP1 were common to ZIKV, GBS, and WNF. Phylogenetic, ontologic, and pathway analyses showed that ZIKV infection most resembles dengue fever.
Conclusions
We have developed methodologies to investigate disease mechanisms and predictions for infectome, diseasome, and comorbidities quantitatively, and identified particular similarities between ZIKV and dengue infections.

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Epstein-Barr Virus Type 2 Infects T Cells in Healthy Kenyan Children

Abstract
Background
The 2 strains of Epstein-Barr virus (EBV), EBV type 1 (EBV-1) and EBV-2, differ in latency genes, suggesting that they use distinct mechanisms to establish latency. We previously reported that EBV-2 infects T cells in vitro. In this study, we tested the possibility that EBV-2 infects T cells in vivo.
Methods
Purified T-cell fractions isolated from children positive for EBV-1 or EBV-2 and their mothers were examined for the presence of EBV and for EBV type.
Results
We detected EBV-2 in all T-cell samples obtained from EBV-2–infected children at 12 months of age, with some children retaining EBV-2–positive T cells through 24 months of age, suggesting that EBV-2 persists in T cells. We were unable to detect EBV-2 in T-cell samples from mothers but could detect EBV-2 in samples of their breast milk and saliva.
Conclusions
These data suggest that EBV-2 uses T cells as an additional latency reservoir but that, over time, the frequency of infected T cells may drop below detectable levels. Alternatively, EBV-2 may establish a prolonged transient infection in the T-cell compartment. Collectively, these novel findings demonstrate that EBV-2 infects T cells in vivo and suggest EBV-2 may use the T-cell compartment to establish latency.

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HIV-Infected Children Have Elevated Levels of PD-1 + Memory CD4 T Cells With Low Proliferative Capacity and High Inflammatory Cytokine Effector Functions

Abstract
Background
During human immunodeficiency virus (HIV) disease, chronic immune activation leads to T-cell exhaustion. PD-1 identifies "exhausted" CD8 T cells with impaired HIV-specific effector functions, but its role on CD4 T cells and in HIV-infected children is poorly understood.
Methods
In a Kenyan cohort of vertically HIV-infected children, we measured PD-1+ CD4 T-cell frequencies and phenotype by flow cytometry and their correlation with HIV disease progression and immune activation. Second, in vitro CD4 T-cell proliferative and cytokine responses to HIV-specific and -nonspecific stimuli were assessed with and without PD-1 blockade.
Results
HIV-infected children have increased frequencies of PD-1+ memory CD4 T cells that fail to normalize with antiretroviral treatment. These cells are comprised of central and effector memory subsets and correlate with HIV disease progression, measured by viral load, CD4 percentage, CD4:CD8 T-cell ratio, and immune activation. Last, PD-1+ CD4 T cells predict impaired proliferative potential yet preferentially secrete the Th1 and Th17 cytokines interferon-γ and interleukin 17A, and are unresponsive to in vitro PD-1 blockade.
Conclusions
This study highlights differences in PD-1+ CD4 T-cell memory phenotype and response to blockade between HIV-infected children and adults, with implications for potential immune checkpoint therapies.

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Gene Expression Analysis Reveals Genes Common to Cerebral Malaria and Neurodegenerative Disorders

Abstract
Cerebral malaria, a reversible encephalopathy affecting young children, is a medical emergency requiring urgent clinical assessment and treatment. We performed a whole-transcriptomic analysis of blood samples from Malian children with cerebral or uncomplicated malaria. We focused on transcripts from pathways for which dysfunction has been associated with neurodegenerative disorders. We found that SNCA, SIAH2, UBB, HSPA1A, TUBB2A, and PINK1 were upregulated (fold-increases, ≥2.6), whereas UBD and PSMC5 were downregulated (fold-decreases, ≤4.39) in children with cerebral malaria, compared with those with uncomplicated malaria. These findings provide the first evidence for pathogenic mechanisms common to human cerebral malaria and neurodegenerative disorders.

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Immunologic Profiling of Human Metapneumovirus for the Development of Targeted Immunotherapy

Abstract
Human metapneumovirus (hMPV) is a respiratory virus detected in ≥9% of allogeneic hematopoietic stem cell transplant (HSCT) recipients, in whom it can cause significant morbidity and mortality. Given the lack of effective antivirals, we investigated the potential for immunotherapeutic intervention, using adoptively transferred T cells. Thus, we characterized the cellular immune response to the virus and identified F, N, M2-1, M, and P as immunodominant target antigens. Reactive T cells were polyclonal (ie, they expressed CD4 and CD8), T-helper type 1 polarized, and polyfunctional (ie, they produced interferon γ, tumor necrosis factor α, granulocyte-macrophage colony-stimulating factor, and granzyme B), and they were able to kill autologous antigen-loaded targets. The detection of hMPV-specific T cells in HSCT recipients who endogenously controlled active infections support the clinical importance of T-cell immunity in mediating protective antiviral effects. Our results demonstrate the feasibility of developing an immunotherapy for immunocompromised patients with uncontrolled infections.

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Enhanced Macrophage M1 Polarization and Resistance to Apoptosis Enable Resistance to Plague

Abstract
Background
Susceptibility to infection is in part genetically driven, and C57BL/6 mice resist various pathogens through the proinflammatory response of their M1 macrophages (MPs). However, they are susceptible to plague. It has been reported elsewhere that Mus spretus SEG mice resist plague and develop an immune response characterized by a strong recruitment of MPs.
Methods
The responses of C57BL/6 and SEG MPs exposed to Yersinia pestis in vitro were examined.
Results
SEG MPs exhibit a stronger bactericidal activity with higher nitric oxide production, a more proinflammatory polarized cytokine response, and a higher resistance to Y. pestis–induced apoptosis. This response was not specific to Y. pestis and involved a reduced sensitivity to M2 polarization/signal transducer and activator of transcription 6 activation and inhibition of caspase 8. The enhanced M1 profile was inducible in C57BL/6 MPs in vitro, and when transferred to susceptible C57BL/6 mice, these MPs significantly increased survival of bubonic plague.
Conclusions
MPs can develop an enhanced functional profile beyond the prototypic M1, characterized by an even more potent proinflammatory response coordinated with resistance to killing. This programming plays a key role in the plague-resistance phenotype and may be similarly significant in other highly lethal infections, suggesting that orienting the MP response may represent a new therapeutic approach.

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The Impact of Hepatitis B Vaccine Failure on Long-term Natural Course of Chronic Hepatitis B Virus Infection in Hepatitis B e Antigen–Seropositive Children

Abstract
Background
Vaccine failure with chronic hepatitis B virus (HBV) infection still develops in children after universal hepatitis B immunization. This study aimed to investigate the natural course of chronic HBV infection in children with vaccine failure and compare it with that of nonvaccinated children.
Methods
Three hundred fifty-six hepatitis B e antigen (HBeAg)–seropositive, hepatitis B surface antigen (HBsAg) carrier children, who were followed for at least 1 year without antiviral therapy, were enrolled. These comprised 105 vaccine failure subjects who received 3 doses of HBV vaccine in infancy and 251 nonvaccinated subjects. The clinical, serologic, and virologic features were compared between the 2 groups.
Results
The cumulative HBeAg seroconversion rate was significantly lower in the vaccine failure group than in the nonvaccinated group (30.5% vs 77.7%, P < .0001). Genotype C HBV infection was more frequent in the vaccine failure group (33.7% vs 13.4%, P < .0001), and the maternal HBsAg-positive rate was higher (97.1% vs 66.4%, P < .0001). In a multivariate analysis, vaccine failure, genotype C infection, and maternal HBsAg positivity were significantly associated with delayed HBeAg seroconversion.
Conclusions
HBeAg-seropositive vaccine failure HBV-carrier children were associated with delayed HBeAg seroconversion during long-term follow-up, and more HBV genotype C infection and maternal HBsAg seropositivity.

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Erratum

In "Chronic Kidney Disease in the Aging Human Immunodeficiency Virus–Infected Population" by Jeffrey B. Kopp [J Infect Dis 2017 jix205. doi: 10.1093/infdis/jix205], the corresponding author of the article to which this editorial refers is misspelled, and should be "Kooij."

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Cloud-catching to bubble science

Many people build their careers using their knowledge and love of science – their science capital. In the latest in this series exploring the role of science capital for staff at BP, Amrita Lulla talks about her life and career

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IJMS, Vol. 18, Pages 1995: Why Ubiquitin Has Not Evolved

IJMS, Vol. 18, Pages 1995: Why Ubiquitin Has Not Evolved

International Journal of Molecular Sciences doi: 10.3390/ijms18091995

Authors: Douglas Allan James Phillips

Ubiquitin, discovered less than 50 years ago, tags thousands of diseased proteins for destruction. It is small (only 76 amino acids), and is found unchanged in mammals, birds, fish, and even worms, indicating that ubiquitin is perfect. Key features of its functionality are identified here using critical point thermodynamic scaling theory. These include synchronized pivots and hinges, a stabilizing central pivot, and Fano interference between first- and second-order elements of correlated long-range (allosteric) globular surface shape transitions. Comparison with its closest relative, 76 amino acid Nedd8, shows that the latter lacks all these features. A cracked elastic network model is proposed for the common target shared by many diseased proteins.



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Current chemotherapeutic regimens for brain metastases treatment

Abstract

Brain metastasis is a common complication in advanced systemic cancer, with an increasing incidence. The diagnosis of brain metastasis historically portended a dismal prognosis. The successful development of effective treatments for patients with brain metastasis is complicated by the differences among cancer subtypes, the limited understanding of the underlying pathophysiology of BM, the impact of the blood-brain barrier, and other factors. There is now renewed interest in treating this often devastating complication of cancer, and in understanding the underlying mechanisms of disease in this "sanctuary" site. Promising treatment strategies include brain-penetrant targeted therapies and immunotherapy, and strategies for enhanced delivery of therapy. This review highlights a selection of these approaches.



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Vemurafenib plus cobimetinib in unresectable stage IIIc or stage IV melanoma: response monitoring and resistance prediction with positron emission tomography and tumor characteristics (REPOSIT): study protocol of a phase II, open-label, multicenter study

In patients with BRAFV600 mutated unresectable stage IIIc or metastatic melanoma, molecular targeted therapy with combined BRAF/MEK-inhibitor vemurafenib plus cobimetinib has shown a significantly improved pro...

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Tartrate-resistant acid phosphatase (TRAP/ACP5) promotes metastasis-related properties via TGFβ2/TβR and CD44 in MDA-MB-231 breast cancer cells

Tartrate-resistant acid phosphatase (TRAP/ACP5), a metalloenzyme that is characteristic for its expression in activated osteoclasts and in macrophages, has recently gained considerable focus as a driver of metast...

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Unusually prolonged pemetrexed cytotoxicity in a patient with a lung adenocarcinoma: a case report

We describe a case of pemetrexed toxicities related to reabsorption by an ileal neobladder, which caused prolonged hematotoxicity and nephrotoxicity.

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Flap repair of complex pilonidal sinus: a single institution experience

Abstract

Background

Healing of pilonidal cysts after initial excision remains a vexing problem for surgeons. While simple sinus can be managed with success, recurrence of the cyst after primary excision or sizeable sinus often requires a more complex repair; however, the morbidity and ultimate success of these procedures are unknown.

Methods

A retrospective review from 2009 to 2014 of all consecutive patients undergoing surgical intervention for pilonidal cyst disease from a single institution was performed. Management of pilonidal disease after excision with flap coverage was examined. Patient demographics, co-morbidities, procedural data, and post-operative outcomes were analyzed.

Results

Twenty-one flap patients were identified. These included 15 V-Y fasciocutaneous repairs, 5 rotational flaps, and 1 Romberg flap closure. Mean BMI was 32, mean defect size was 8 cm, and the patients have had an average of 1.05 attempts prior to the excision and flap repair. The flap group demonstrated 14% recurrence rate, 33% reoperation rate, and 47% dehiscence rate. Mean time to healing was 36.4 days.

Conclusions

Flap repairs for complex pilonidal cysts have high rates of recurrence, reoperation, and wound dehiscence. However, flap patients represent a more challenging repair with long operative times, blood loss, and large sinus size. Absence of the perfect approach to managing a complex sinus necessitates a thorough description of the problem and a discussion between the surgeon and the patient about the merits of each approach before a decision is made.

Level of Evidence: Level IV, therapeutic study.



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Socioeconomic Variables of Patients with Spasmodic Dysphonia: A Preliminary Study

To characterize socioeconomic status (SES) variables of spasmodic dysphonia (SD) patients and determine their impact on voice outcomes after treatment with botulinum toxin.

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Current chemotherapeutic regimens for brain metastases treatment

Abstract

Brain metastasis is a common complication in advanced systemic cancer, with an increasing incidence. The diagnosis of brain metastasis historically portended a dismal prognosis. The successful development of effective treatments for patients with brain metastasis is complicated by the differences among cancer subtypes, the limited understanding of the underlying pathophysiology of BM, the impact of the blood-brain barrier, and other factors. There is now renewed interest in treating this often devastating complication of cancer, and in understanding the underlying mechanisms of disease in this "sanctuary" site. Promising treatment strategies include brain-penetrant targeted therapies and immunotherapy, and strategies for enhanced delivery of therapy. This review highlights a selection of these approaches.



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Does a mandibular access osteotomy improve survival in pT2 oral tongue cancers? Retrospective study at a single institution

The surgical approach to the resection of oral tongue cancers can involve transoral resection (TOR) or a temporary mandibulotomy access (TMA). There are no relevant guidelines, and the oncological safety of TOR needs consideration. The objective of this study was to investigate TMA and TOR in pT2 oral tongue cancer surgery with regard to cancer outcomes. Demographic, surgical, and histology data from primary pT2 tongue cancers were recorded and evaluated through multivariate Cox regression for local recurrence (LR), disease-free survival (DFS), and overall survival (OS).

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Impact of resveratrol on bone repair in rats exposed to cigarette smoke inhalation: histomorphometric and bone-related gene expression analysis

This study investigated the effect of resveratrol on bone healing and its influence on the gene expression of bone-related markers in rats exposed to cigarette smoke. Two calvarial defects were created in each of 60 rats, which were assigned equally (n=20) to three groups: (1) resveratrol (10mg/kg)+smoke exposure (SMK+RESV); (2) placebo+smoke exposure (SMK+PLA); or (3) placebo+no smoke exposure (NS+PLA). Substances were administered daily for 30days following surgery. Smoke inhalation was started 7days before surgery and continued for 30days after surgery.

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Otolaryngologic management of Down syndrome patients: what is new?.

Purpose of review: The management of children with Down syndrome as it pertains to the otolaryngologist continues to evolve. Obstructive sleep apnea (OSA) has dominated the recent literature, but other topics including hearing loss, swallowing, and perioperative considerations are also reported. Recent findings: The prevalence of OSA in children with Down syndrome ranges from 57 to 73% in certain cohorts, and, whereas adentonsillectomy can decrease Apnea-Hypopnea Index, up to 80% may have persistent OSA. Surgical techniques involving reduction of the base of tongue are effective for those who fail adenotonsillectomy, and it is expected that drug-induced sleep endoscopy may improve outcomes. New technology is also on the horizon that can assist with diagnosis and treatment including computational modelling and upper airway stimulation. Children with Down syndrome may not respond to medical management of eustachian tube dysfunction as well as normally developing children. In addition, there is a high prevalence of inner ear anomalies, increasing the risk for sensorineural hearing loss. Summary: Questions remain pertinent to the otolaryngologist regarding the ideal management of children with Down syndrome. Additional studies are necessary, to optimize understanding and treatment of this complex population, in particular as opportunities develop with technological advances. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Extraluminal biodegradable splint to treat upper airway anterior malacia: A preclinical proof of principle

Objective

Upper airway malacia highly complicates the treatment of benign laryngotracheal stenosis, and no ideal option is available to date. We here explore the use of extraluminal biodegradable splints in an animal model of long-segment anterior tracheomalacia (TM). We show the efficacy, as well as the tissue tolerance, of a custom-made biodegradable extraluminal device surgically inserted around the trachea.

Study Design

Preclinical animal study.

Methods

Anterior TM was induced in rabbits through an anterior neck approach by removing eight consecutive anterior tracheal rings without damaging the underlying mucosa. Malacia was corrected during the same surgery by pexy sutures, suspending the tracheal mucosa to an experimental biodegradable device. Symptoms, survival, and tissue reaction were compared to healthy and sham surgery controls.

Results

The model induced death by respiratory failure within minutes. Ten animals received the experimental treatment, and those who survived the perioperative period remained asymptomatic with a maximum follow-up of 221 days. Histological studies at programmed euthanasia showed complete degradation of the prosthesis, with significant remnant fibrosis around the trachea. However, the tracheal stiffness of test segments was comparatively less than that of control segments.

Conclusion

Extraluminal biodegradable splints rescued animals with a condition otherwise incompatible with life. It was well tolerated, leaving peritracheal fibrosis that was not as stiff as normal trachea. The external tracheal stiffening was sufficient for the test animals to live through the phase of severe acute hypercollapsibility. This represents a valid option to help pediatric patients with laryngotracheal stenosis and associated cartilaginous airway malacia.

Level of Evidence

NA. Laryngoscope, 2017



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A paradigm for evaluation and management of the maxillary sinus before dental implantation

Objectives

To determine a paradigm for evaluating and managing maxillary sinus conditions before dental implantation via preoperative sinonasal assessment.

Study Design

Prospective cohort study.

Methods

Eighty-four patients who underwent dental implantation with or without sinus augmentation were included. Maxillary sinus conditions were classified into groups 1 to 6 according to cone-beam computed tomography (CT) findings: 1) nonspecific findings, 2) solitary polyp or cyst, 3) mucosal thickening, 4) air–fluid level or fluid accumulation, 5) near-total opacification of the maxillary or other paranasal sinus, and 6) calcification spots in the maxillary sinus. Dental implantation with or without sinus augmentation was suggested with postoperative sinus observation (groups 1–3), after medication for acute sinusitis (group 4), and after comprehensive treatment of chronic or fungal sinusitis (groups 5–6). Intraoperative and postoperative sinus-related complications were recorded.

Results

Two patients (groups 1 and 3) developed acute rhinosinusitis after sinus augmentation; both recovered completely with medical treatment. Schneiderian membrane perforation occurred during sinus lift surgery in six patients (group 1): five recovered after conservative medical therapy and close observation, whereas one required endoscopic sinus surgery and recovered well. No chronic rhinosinusitis developed after dental implantation.

Conclusion

Craniofacial CT is crucial for pre-dental implantation sinonasal evaluation. The risk of dental implant-related chronic rhinosinusitis is low for patients with cysts, polyps, or mucosal thickening in the maxillary sinus. However, preventive endoscopic sinus surgery is recommended for patients with incurable chronic rhinosinusitis, fungal sinusitis, and large polyps or cysts.

Level of Evidence

4. Laryngoscope, 2017



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Ligature-induced Peri-implantitis and Periodontitis in Mice

Abstract

Aim

Peri-implantitis (PI), inflammation around dental implants, shares characteristics with periodontitis (PD). However, PI is more difficult to control, treat, and detailed pathophysiology is unclear. We aimed to compare PI and PD progression utilizing a murine model.

Materials and Methods

Four-week-old male C57BL/6J mice had their left maxillary molars extracted. Implants were placed in healed extraction sockets and osseointegrated. Ligatures were tied around the implant and second molar. Controls did not receive ligatures. Mice were sacrificed one week, one month, and three months (n≥5/group/time point) post ligature placement. Bone loss analysis was performed. Histology was performed for: hematoxylin and eosin (H&E), Tartrate Resistant Acid Phosphatase (TRAP), matrix metalloproteinase-8 (MMP-8), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), toluidine blue, and calcein.

Results

PI showed statistically greater bone loss compared to PD at one and three months. At three months, 20% of implants in PI exfoliated; no natural teeth exfoliated in PD. H&E revealed that alveolar bone surrounding implants in PI appeared less dense compared to PD. PI presented with increased osteoclasts, MMP-8, and NF-κB, compared to PD.

Conclusion

PI exhibited greater tissue and bone destruction compared to PD. Future studies will characterize the pathophysiological differences between the two conditions.

This article is protected by copyright. All rights reserved.



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Patients with acute poisoning presenting to an urban emergency department of a tertiary hospital in Tanzania

Poisoning is a major public health concern in sub-Saharan Africa, affecting patients of all age groups. Poisoned patients often present to the emergency department (ED) and prompt evaluation and appropriate ma...

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Timing rather than user traits mediates mood sampling on smartphones

Recent years have seen an increasing number of studies using smartphones to sample participants' mood states. Moods are usually collected by asking participants for their current mood or for a recollection of ...

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Characteristic of microplastics in the atmospheric fallout from Dongguan city, China: preliminary research and first evidence

Abstract

Microplastic pollution has exhibited a global distribution, including seas, lakes, rivers, and terrestrial environment in recent years. However, little attention was paid on the atmospheric environment, though the fact that plastic debris can escape as wind-blown debris was previously reported. Thus, characteristics of microplastics in the atmospheric fallout from Dongguan city were preliminarily studied. Microplastics of three different polymers, i.e., PE, PP, and PS, were identified. Diverse shapes of microplastics including fiber, foam, fragment, and film were found, and fiber was the dominant shape of the microplastics. SEM images illustrated that adhering particles, grooves, pits, fractures, and flakes were the common patterns of degradation. The concentrations of non-fibrous microplastics and fibers ranged from 175 to 313 particles/m2/day in the atmospheric fallout. Thus, dust emission and deposition between atmosphere, land surface, and aquatic environment were associated with the transportation of microplastics.



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Evidence for contrasting accumulation pattern of cadmium in relation to other elements in Senilia senilis and Tagelus adansoni from the Bijagós archipelago, Guinea-Bissau

Abstract

Shellfish harvesting in intertidal areas is a widespread and economically important activity in many countries across West Africa. However, in some areas, there is virtually no information concerning the levels of contaminants (and other elements related to nutritional aspects) in the harvested species. We collected sediments and several individuals of the West African bloody cockle Senilia senilis and of the razor clam Tagelus adansoni during the dry season of 2015 nearby three islands in the Bijagós archipelago, Guinea-Bissau. Aluminium, Ca, Fe, Mg, As, Cd, Co, Cr, Cu, Mn, Ni, Pb and Zn were determined in sediments and whole soft tissues of the two bivalves. Sediments showed uniformly low trace element concentrations, pointing to an ecosystem with low levels of trace element contamination. T. adansoni presented higher concentrations of most elements than S. senilis, with the exception of Cd that showed up to 40 times higher values in S. senilis than in T. adansoni from the same sites. Furthermore, Cd concentrations (25±8.7 mg kg−1, dw) in S. senilis are clearly above the maximum level established for human consumption. Future studies should clarify whether biological factors are the major responsible for this unusual situation.



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Morphology and size of blood cells of Rhinella arenarum (Hensel, 1867) as environmental health assessment in disturbed aquatic ecosystem from central Argentina

Abstract

Four populations of Rhinella arenarum from aquatic environments with different degrees of disturbance in central Argentina were compared to assess the ability of cytomorphology and cytomorphometry of blood cells as a hematological biomarker. A total of 93 specimens of R. arenarum (adults sexually mature) were captured during the spring. From the analysis of cell, no variations were found in terms of morphology, whereas in nuclear and cell areas and Price-Jones curves, we observed a smaller size in erythrocytes of individuals inhabiting the site most altered, "Villa Dalcar," as well as for leukocytes, lymphocytes, neutrophils, and eosinophils for the same site. This could be caused by presence of different pollutants in the lake. Furthermore, this was confirmed by the high levels of environmental variables (conductivity, total dissolved solids, and salinity) show that Villa Dalcar is the site most affected by human activities.



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Cadmium losses in overland flow from an agricultural soil

Abstract

Cadmium (Cd) transport in overland flow from agricultural soils is potentially important when trying to predict future soil Cd concentrations, but at present there is little information on the magnitude of loss from this pathway. This study measured Cd concentrations and fluxes in overland flow from a catchment where cattle winter-grazed a forage crop (kale) (Brassica oleracea) in year one and measurements continued in year two when the catchment was returned to pasture and grazed by sheep. Flow-weighted mean concentrations (FWMC) of total, particulate and dissolved Cd in overland flow events from the forage crop were 0.49, 0.41 and 0.08 μg L−1, respectively. In contrast, no dissolved Cd was detected in overland flow from pasture, with a FWMC of total Cd of 0.09 μg L−1. In line with the Cd concentrations, total Cd fluxes were greater from the forage crop (0.06 g Cd ha−1 year−1) than from pasture (0.04 g Cd ha−1 year−1). Cadmium losses in overland flow were relatively minor compared with those reported for other pathways such as plant uptake or subsurface flow. Further, compared to the amount of Cd that is currently added to soil in a maintenance application of phosphate fertiliser (30 kg P ha−1 year−1) which is on average 5.5 g Cd ha−1, Cd losses in overland flow represented < 1% of inputs. Measurement of Cd losses in overland flow should be undertaken at other sites to confirm the low Cd losses found in this study, along with the distribution between dissolved and particulate fractions.



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Internal phosphorus load in a Mexican reservoir through sediment speciation analysis

Abstract

Since the sequential extraction of phosphorus (P) in sediment makes it possible to determine the P potentially available for release, in this paper, we evaluate the fractions of P in sediment profiles from Valle de Bravo reservoir, a eutrophic lake in central Mexico to determine the contributions of each fraction to the internal P load (IPL). The P fractionation scheme employs sequential extractions of sediment with O2-free water (MilliQ), bicarbonate-dithionite (BD), sodium hydroxide (NaOH), hydrochloric acid (HCl), and potassium persulfate (K2S2O8-) to obtain five P fractions. A monitoring of redox potential (Eh), pH, and total phosphorus (TP) in the bottom water of the reservoir indicated variations of these parameters during the year, observing that as Eh decreased, the P concentration increased, it was also observed that when increasing pH, P concentration also increased. Analyzing the behavior of fractions of P in sediment profiles, we found that the dominant fractions are those bound to iron and aluminum oxides, corresponding to approximately 50% of total P since P concentrations of these fractions were twice as high in the top 5 cm of the sediment profiles and decreased with increasing depth. Considering the variations of Eh and pH in the bottom water of the reservoir and that these parameters are factors that control the release of P with the fractions of P bound to Fe/Mn and Al/Fe oxides, we concluded that these fractions contribute most to P potentially available for release in the reservoir, representing a possible IPL of 23.5 ± 1.4 t/year.



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Coupling population dynamics with earth system models: the POPEM model

Abstract

Precise modeling of CO2 emissions is important for environmental research. This paper presents a new model of human population dynamics that can be embedded into ESMs (Earth System Models) to improve climate modeling. Through a system dynamics approach, we develop a cohort-component model that successfully simulates historical population dynamics with fine spatial resolution (about 1°×1°). The population projections are used to improve the estimates of CO2 emissions, thus transcending the bulk approach of existing models and allowing more realistic non-linear effects to feature in the simulations. The module, dubbed POPEM (from Population Parameterization for Earth Models), is compared with current emission inventories and validated against UN aggregated data. Finally, it is shown that the module can be used to advance toward fully coupling the social and natural components of the Earth system, an emerging research path for environmental science and pollution research.



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Modeling the pH and temperature dependence of aqueousphase hydroxyl radical reaction rate constants of organic micropollutants using QSPR approach

Abstract

Designing of advanced oxidation process (AOP) requires knowledge of the aqueous phase hydroxyl radical (OH) reactions rate constants (k OH), which are strictly dependent upon the pH and temperature of the medium. In this study, pH- and temperature-dependent quantitative structure-property relationship (QSPR) models based on the decision tree boost (DTB) approach were developed for the prediction of k OH of diverse organic contaminants following the OECD guidelines. Experimental datasets (n = 958) pertaining to the k OH values of aqueous phase reactions at different pH (n = 470; 1.4 × 106 to 3.8 × 1010 M−1 s−1) and temperature (n = 171; 1.0 × 107 to 2.6 × 1010 M−1 s−1) were considered and molecular descriptors of the compounds were derived. The Sanderson scale electronegativity, topological polar surface area, number of double bonds, and halogen atoms in the molecule, in addition to the pH and temperature, were found to be the relevant predictors. The models were validated and their external predictivity was evaluated in terms of most stringent criteria parameters derived on the test data. High values of the coefficient of determination (R 2) and small root mean squared error (RMSE) in respective training (> 0.972, ≤ 0.12) and test (≥ 0.936, ≤ 0.16) sets indicated high generalization and predictivity of the developed QSPR model. Other statistical parameters derived from the training and test data also supported the robustness of the models and their suitability for screening new chemicals within the defined chemical space. The developed QSPR models provide a valuable tool for predicting the OH reaction rate constants of emerging new water contaminants for their susceptibility to AOPs.



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Effects of phoxim-induced hepatotoxicity on SD rats and the protection of vitamin E

Abstract

Currently, public pay more attention to the adverse effect of organophosphate pesticides on human and animal health and on the environment in developing nations. Vitamin E may protect the hepatocyte and increase the function of liver. The study was to investigate the effects of phoxim-induced hepatotoxicity on Sprague Dawley (SD) rats and the protection of vitamin E. SD rats received by gavage 180 mg kg−1 (per body weight) of phoxim, 200 mg kg−1 (per body weight) of vitamin E, and phoxim + vitamin E. The results showed that exposure to phoxim elevated liver coefficient; glutamyl transpeptidase (GGT), aspartate aminotransferase, alkaline phosphatase, total bilirubin, total bile acid, and alanine aminotransferase in the serum; ROS in the liver; and the expression of p53, Bax, CYP2E1, ROS, caspase-9, caspase-8, and caspase-3, while phoxim caused a reduction of total protein, albumin, and cholinesterase in the serum; acetylcholinesterase, total antioxidant capacity, glutathione peroxidase, and glutathione in the liver; and the expression of Bcl-2. Vitamin E modified the phoxim-induced hepatotoxicity by reducing the GGT in the serum, malondialdehyde in the liver, and the expression of CYP2E1 significantly. There were no significant changes of globulin in the serum, the activity of catalase in the liver, as well as expression levels of Fas and Bad in the liver. Overall, subacute exposure to phoxim induced hepatic injury, oxidative stress damage, and cell apoptosis. Vitamin E modified phoxim-induced hepatotoxicity slightly. And, vitamin E minimized oxidative stress damage and ultrastructural changes in rat hepatocytes notably.



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Prim-O-glucosylcimifugin induces cell cycle arrest and apoptosis in acute lymphoblastic leukemia cells

imagePrim-O-glucosylcimifugin is a major constituent in Radix Saposhnikovia that has been long used for the treatment of pyrexia, rheumatism, and cancer in traditional Chinese medicine. However, the molecular and cellular mechanisms remain unknown regarding the therapeutic effect of prim-O-lucosylcimifugin. Here, we investigated the effects of prim-O-glucosylcimifugin on cell cycle progression and apoptosis in human acute lymphoblastic leukemia cells. Prim-O-glucosylcimifugin treatment resulted in marked increases in cell apoptosis and cell cycle arrest at the G2/M phase. Mechanistically, prim-O-glucosylcimifugin induced the degradation of β-tubulin and downregulated phosphorylated CDK1 levels, a molecular indicator in the G2/M cell cycle arrest. Furthermore, activation of caspase-3, caspase-8, and caspase-9 was involved in the prim-O-glucosylcimifugin-induced apoptosis. Our study reveals the anticancer activity of prim-O-glucosylcimifugin and the potential underlying mechanisms.

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Liver X receptors agonist T0901317 downregulates matrix metalloproteinase-9 expression in non-small-cell lung cancer by repressing nuclear factor-κB

imageThe liver X receptors (LXRs) is an important component of the nuclear receptor (NR) superfamily. Previous studies have shown that the LXRs possessed antitumor activity in various types of tumor cells. However, the complicated mechanisms underlying the antitumor activity remain largely unexplored. In this study, we incubated A549 cells with the compound T0901317, a specific LXRs agonist, for 24 h. The MTT assay was used to assess cell viability. Transwell assays were used to evaluate cell migration and invasion. The shRNA was utilized for RNA interference. The target gene and protein expression levels were assessed using reverse transcription-PCR and western blot assay. The DNA-binding activity of nuclear factor κB (NF-κB) was examined using electrophoretic mobility shift assays. Luciferase reporter assay was used to detect the binding of NF-κB to the matrix metalloproteinase-9 (MMP-9) promoter. We found that T0901317 inhibited the invasion and migration of A549 cells in a dose-dependent manner. Meanwhile, we further indicated that activation of LXRβ, one subtype of LXRs, can downregulate MMP-9 expression. More importantly, activation of LXRβ triggered by T0901317 inhibited the invasion and metastasis of A549 cells by repressing NF-κB/MMP-9 signaling pathway. Taken together, our study shows that activation of LXRs triggered by T0901317 inhibits the invasion and metastasis of human non-small-cell lung cancer by repressing the NF-κB/MMP-9 signaling pathway.

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Geraniin inhibits migration and invasion of human osteosarcoma cancer cells through regulation of PI3K/Akt and ERK1/2 signaling pathways

imageGeraniin, an active compound isolated from Geranium sibiricum, was found to inhibit proliferation and induce apoptosis of tumor cells. However, the antimetastatic effects of geraniin remain elusive. Our study found the potential antitumor mechanisms of geraniin through inhibiting the migration and invasion of human osteosarcoma U2OS cells. The western blot, gelatin zymography, and reversed transcription-PCR analysis showed that geraniin suppressed matrix metalloproteinase-9 (MMP-9) expression in a concentration-dependent manner. Geraniin potently suppressed the phosphorylation of extracellular signal regulating kinase (ERK)1/2, phosphatidylinositide-3-kinase (PI3K), and Akt, but did not affect phosphorylation of p38 mitogen-activated protein kinase and c-Jun N-terminal kinase. Furthermore, when transforming growth factor-β1 (TGF-β1) was used as an agonist, geraniin inhibited TGF-β1-mediated cell invasion and upregulation of MMP-9. These results suggested that geraniin inhibited U2OS cell migration and invasion by reducing the expression of MMP-9 through the PI3K/Akt and ERK1/2 signaling pathways.

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Prediction of severe toxicity in adult patients under treatment with 5-fluorouracil: a prospective cohort study

image5-Fluorouracil (5-FU) has long been used for the treatment of gastrointestinal tumors harboring interindividual variability in both the pharmacokinetic and the pharmacogenetic profiles, which in turn may lead to life-threatening toxicities. We carried out a prospective cohort study of adult patients initiating treatment with 5-FU between 2013 and 2015. Primary exposures of interest were the methylenetetrahydrofolate reductase single nucleotide polymorphism in exons 4 and 7 and 5′-untranslated region-thymidylate synthase VNTR genotypes, in addition to baseline clinical and demographic variables. The primary outcome was the time to the occurrence of severe toxicity. We used a Cox regression model to evaluate patients' survival and toxicity experience and its association with baseline characteristics and a priori determined genetic polymorphisms. A total of 197 patients were included, 40.1% developed severe toxicity during follow-up. Variables that were significantly associated with developing severe toxicity were the European Organization for Research and Treatment of Cancer functional score [hazard ratio (HR): 0.98; 95% confidence interval (CI): 0.97–0.99]; type of tumor [anus (HR: 2.50; 95% CI: 1.07–5.82), head and neck/esophagus/stomach (HR: 2.95; 95% CI: 1.64–5.33)] and 5-FU continuous infusion regimens over 4–5 days (HR: 9.35; 95% CI: 2.68–32.59). We found a significant association between baseline functional status, type of tumor and continuous infusion regimens and the occurrence of severe toxicity during the follow-up of patients receiving 5-FU. No association was found with the genotypic variants evaluated. Future validation and modeling of an everyday easy-to-use score to predict toxicity among these subgroup of patients remains warranted.

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Andrographolide enhances cisplatin-mediated anticancer effects in lung cancer cells through blockade of autophagy

imageLung cancer is the most common cause of cancer-related death worldwide and the platinum-based drugs such as cisplatin have been used as the first line of the treatment. However, the clinical effectiveness of such chemotherapy is limited by intrinsic or acquired resistance. In this study, we found that cisplatin induced autophagy that attenuated the sensitivity of both A549 and Lewis lung cancer (LLC) cells to cisplatin. In contrast, the clinical drug andrographolide (Andro) suppressed autophagy and enhanced cisplatin-mediated apoptosis in these cells. Using two murine lung cancer models, including a subcutaneously inoculated LLC model and an orthotopic LLC implantation model, we investigated the therapeutic efficacy of the combined treatment of cisplatin and Andro. Compared with the sole cisplatin treatment, combining cisplatin with Andro potentially inhibited tumor growth, reduced the incidence of lung metastases, and relieved renal tubular damage. Moreover, the combined treatment prolonged the life span of tumor-bearing mice. TUNEL and immunohistochemistry assays showed the increase in apoptotic cells and the decrease in both conversion of LC3B-I to LC3B-II and Atg5 protein expression in the tumor tissues from mice with the combined treatment. These results suggest that Andro offers an ideal candidate of autophagy inhibitors in clinical application, and combination of cisplatin with Andro could be a promising strategy for the treatment of lung cancer.

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Tumour growth increased following antiangiogenic interruption: the challenge of tumour evaluation

imageVascular endothelial growth factor inhibitors, led by bevacizumab, are considered the cornerstone of the therapy in metastatic colorectal carcinoma. We present the case of a patient with metastatic colorectal cancer who experienced rapid tumour growth with liver broad invasion after the withdrawal of an antivascular endothelial growth factor therapy, aflibercept. The rebound effect caused by the residual tumour inducing a regrowth after an initial controlled disease has already been stressed in mice and metastatic colorectal cancer patients following bevacizumab interruption. The use of liver volume evaluation was consistent with the Response Evaluation Criteria in Solid Tumours 1.1 criteria evaluation and might be a useful tool in patients with more than a half liver invasion. We describe for the first time the case of a major liver disease progression, confirmed by Response Evaluation Criteria in Solid Tumours 1.1 criteria and liver volume evaluation, after an antiangiogenic interruption in second line.

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Screening of medicinal plant phytochemicals as natural antagonists of p53–MDM2 interaction to reactivate p53 functioning

imageIn most types of cancer, overexpression of murine double minute 2 (MDM2) often leads to inactivation of p53. The crystal structure of MDM2, with a 109-residue amino-terminal domain, reveals that MDM2 has a core hydrophobic region to which p53 binds as an amphipathic α helix. The interface depends on the steric complementarity between MDM2 and the hydrophobic region of p53. Especially, on p53's triad, amino acids Phe19, Trp23 and Leu26 bind to the MDM2 core. Results from studies suggest that the structural motif of both p53 and MDM2 can be attributed to similarities in the amphipathic α helix. Thus, in the current investigation it is hypothesized that the similarity in the structural motif might be the cause of p53 inactivation by MDM2. Hence, molecular docking and phytochemical screening approaches are appraised to inhibit the hydrophobic cleft of MDM2 and to stop p53–MDM2 interaction, resulting in reactivation of p53 activity. For this purpose, a library of 2295 phytochemicals were screened against p53–MDM2 to find potential candidates. Of these, four phytochemicals including epigallocatechin gallate, alvaradoin M, alvaradoin E and nordihydroguaiaretic acid were found to be potential inhibitors of p53–MDM2 interaction. The screened phytochemicals, derived from natural extracts, may have negligible side effects and can be explored as potent antagonists of p53–MDM2 interactions, resulting in reactivation of the normal transcription of p53.

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Codelivery of salinomycin and docetaxel using poly(D,L-lactic-co-glycolic acid)-poly(ethylene glycol) nanoparticles to target both gastric cancer cells and cancer stem cells

imageCancer stem cells (CSCs) in gastric cancer (GC) have been established recently as key therapeutic targets for the successful treatment of GC. Emerging evidence suggests that both CSCs and cancer cells should be eradicated to achieve optimal therapeutic efficacy. In the present study, salinomycin, which has been reported to kill CSCs, was used in combination with docetaxel, a chemotherapeutic drug that is used as first-line therapy in GC, to eradicate both GC stem cells (SCs) and cancer cells. Salinomycin and docetaxel were loaded separately into poly(D,L-lactic-co-glycolic acid)-poly(ethylene glycol) nanoparticles of ∼140 nm with a narrow size distribution, high drug loading, and sustained drug release. GC SCs were isolated by magnetic-activated cell sorting on the basis of CD44 expression as the CSC phenotype. CD44+ GC SCs showed the characteristics of CSCs, including increased SC gene expression, tumorsphere formation capacity, and tumorigenicity in nude mice. We found that both salinomycin and salinomycin-loaded nanoparticles (salinomycin-NPs) could selectively eradicate GC SCs, as reflected by reduced tumorsphere formation capacity and the frequency of CD44+ GC cells, whereas docetaxel and docetaxel-loaded nanoparticles (docetaxel-NPs) could significantly eradicate GC cells. In nude mice bearing GC xenografts, salinomycin-NPs and salinomycin significantly decreased the intratumor population of GC SCs. Notably, salinomycin-NPs combined with docetaxel-NPs suppressed tumor growth more effectively than did salinomycin combined with docetaxel, single salinomycin-NPs, or docetaxel-NPs. Therefore, salinomycin-NPs combined with docetaxel-NPs represent a promising strategy for the treatment of GC by eradicating both GC SCs and cancer cells.

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Treatment with abiraterone in metastatic castration-resistant prostate cancer patients progressing after docetaxel: a retrospective study

imageThe aim of this study was to evaluate abiraterone's efficacy in Italian patients affected with metastatic prostate cancer progressing after treatment with docetaxel. We conducted a retrospective analysis of 60 patients. Prostate-specific antigen (PSA) reduction in serum was the primary endpoint for evaluating the efficacy of abiraterone in combination with prednisone treatment, whereas reduced pain, safety, progression-free survival, response rate, and overall survival (OS) were secondary endpoints. A significant correlation was noticed between PSA response and OS. Further, the Index Bravais–Pearson (r) correlation allowed us to observe a significant negative interdependence between PSA response and reduction in pain of 0.57 (95% confidence interval: −0.30 to 0.80) (P=0.005). Meanwhile, regression analysis revealed that PSA levels are predictive of OS. There was a positive correlation with OS, which showed a value of R2 to 0.50 with a slope of 1.44 (P=0.0021). Abiraterone is a well-tolerated and effective treatment modality for patients affected with metastatic castration-resistant prostate cancer. The drug has a better tolerability profile, gives significant pain relief, and increases the survival rate.

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Artemisinin disrupts androgen responsiveness of human prostate cancer cells by stimulating the 26S proteasome-mediated degradation of the androgen receptor protein

imageAndrogen receptor (AR) expression and activity is highly linked to the development and progression of prostate cancer and is a target of therapeutic strategies for this disease. We investigated whether the antimalarial drug artemisinin, which is a sesquiterpene lactone isolated from the sweet wormwood plant Artemisia annua, could alter AR expression and responsiveness in cultured human prostate cancer cell lines. Artemisinin treatment induced the 26S proteasome-mediated degradation of the receptor protein, without altering AR transcript levels, in androgen-responsive LNCaP prostate cancer cells or PC-3 prostate cancer cells expressing exogenous wild-type AR. Furthermore, artemisinin stimulated AR ubiquitination and AR receptor interactions with the E3 ubiquitin ligase MDM2 in LNCaP cells. The artemisinin-induced loss of AR protein prevented androgen-responsive cell proliferation and ablated total AR transcriptional activity. The serine/threonine protein kinase AKT-1 was shown to be highly associated with artemisinin-induced proteasome-mediated degradation of AR protein. Artemisinin treatment activated AKT-1 enzymatic activity, enhanced receptor association with AKT-1, and induced AR serine phosphorylation. Treatment of LNCaP cells with the PI3-kinase inhibitor LY294002, which inhibits the PI3-kinase-dependent activation of AKT-1, prevented the artemisinin-induced AR degradation. Furthermore, in transfected receptor-negative PC-3 cells, artemisinin failed to stimulate the degradation of an altered receptor protein (S215A/S792A) with mutations in its two consensus AKT-1 serine phosphorylation sites. Taken together, our results indicate that artemisinin induces the degradation of AR protein and disrupts androgen responsiveness of human prostate cancer cells, suggesting that this natural compound represents a new potential therapeutic molecule that selectively targets AR levels.

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CXCR4 blockade with AMD3100 enhances Taxol chemotherapy to limit ovarian cancer cell growth

imageThe standard of care for ovarian cancer includes initial treatment with chemotherapy. Despite initial efficacy, over 70% of patients develop recurrence; thus, there is a need to identify novel approaches that can improve therapeutic outcomes. We evaluated AMD3100 (Plerixafor), an FDA-approved CXCR4 inhibitor, as a potential adjunctive therapy for low-dose Taxol (Paclitaxel) by assessing the impact on in-vitro ovarian cancer cell proliferation. Proliferation was a measure for both human TOV-112D and murine ID8 ovarian cancer cells incubated with AMD3100 and Taxol, either individually or in combination. Impact of treatment was first determined for the simultaneous administration of AMD3100 and Taxol. We next assessed a sequential application of AMD3100 pretreatment, followed by AMD3100, Taxol, or a combination to test for sensitization to Taxol. In addition, we measured the impact of AMD3100 and Taxol, individually and in combination, on colony formation, an in-vitro model assay of tumor growth. Expression data, as measured by flow cytometry, show that both ID8 and TOV-112D cells are positive for CXCR4, CXCR7, and CXCL12. Combination treatment with AMD3100 (≤10 μmol/l) sensitized both ID8 and TOV-112D cells to low concentrations of Taxol (≤5 nmol/l), limiting cell proliferation and colony formation in vitro. Pretreatment with AMD3100 significantly increased the sensitivity of human ovarian cancer to low-dose Taxol or the combination of AMD3100 and Taxol, although this effect was not evident in murine cells. Importantly, for both human and murine cells, incubation with a combination of AMD3100 and Taxol had the largest impact on limiting cell proliferation. AMD3100 in combination with low-dose Taxol offers improved efficacy and the potential of reduced toxicity for the treatment of ovarian cancer.

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Biomarker levels in gingival crevicular fluid of generalized aggressive periodontitis patients after non-surgical periodontal treatment

Abstract

Objectives

The aim of this study was to assess the effects of non-surgical periodontal treatment on gingival crevicular fluid (GCF) cytokines in patients with generalized aggressive periodontitis (GAgP), in relation to clinical parameters.

Materials and methods

Data were obtained from 16 GAgP patients and 15 periodontally healthy controls. Periodontal parameters and GCF biomarker levels were evaluated at baseline and repeated 3 and 6 months after treatment for GAgP subjects. Moderate and deep pocket sites were analyzed separately. The amount of interleukin (IL)-1β, IL-9, tumor necrosis factor (TNF)-α, platelet-derived growth factor (PDGF-bb), and vascular endothelial growth factor (VEGF) were measured using a highly specific and sensitive multiplex bead immunoassay.

Results

At baseline, cytokine levels in the moderate and deep pocket sites of GAgP patients were higher than those of the healthy control sites. In GAgP group, periodontal treatment led to improvement in all examined clinical parameters and resulted in a statistically significant reduction in the total amounts of IL-1β, VEGF, and TNF-α, in comparison to baseline, already 3 months after therapy in both moderate and deep pocket sites and of PDGF-bb in deep sites (p < 0.01). At the concentration level, only IL-1β and VEGF were affected.

Conclusion

Non-surgical treatment of GAgP provided significant clinical benefits leading to a marked decrease in the GCF levels of some pro-inflammatory and pro-angiogenic cytokines, but not of IL-9 and PDGF-bb.

Clinical relevance

Although the periodontal therapy successfully decreased clinical signs of inflammation, the GCF levels of some inflammatory cytokines were still elevated.



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IJERPH, Vol. 14, Pages 1073: Relationships of Sexual Dysfunction with Depression and Acceptance of Illness in Women and Men with Type 2 Diabetes Mellitus

IJERPH, Vol. 14, Pages 1073: Relationships of Sexual Dysfunction with Depression and Acceptance of Illness in Women and Men with Type 2 Diabetes Mellitus

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph14091073

Authors: Ewelina Bąk Czeslaw Marcisz Sylwia Krzemińska Dorota Dobrzyn-Matusiak Agnieszka Foltyn Agnieszka Drosdzol-Cop

An increased prevalence of sexual disorders has been reported in patients with type 2 diabetes. The aim of this study is the assessment of the influence of the psychical condition, the concentration of glycated hemoglobin, the duration of diabetes, the body mass index, the age, and the subjective acceptance of the illness on sexual disorders occurring in women and men with type 2 diabetes. The study enrolled 215 patients (114 women and 101 men) with type 2 diabetes and 183 controls. Sexuality was determined in all of the studied subjects using: the Female Sexual Function Index (FSFI) in women and the International Index of Erectile Function (IIEF) in men. The occurrence of depression symptoms was determined using the Beck Depression Inventory (BDI), whereas the acceptance of the illness in diabetic patients using the Acceptance of Illness Scale (AIS). A sexual dysfunction was found in 68% of the studied diabetic women and 17% of controls. The point values of all the examined FSFI domains were significantly lower in women with diabetes than in controls (p &lt; 0.001). Erectile disorders occurred in 82% of the studied men with diabetes and in 41% of the controls (p &lt; 0.001). The point values of all the domains of FSFI and IIEF demonstrated a significantly negative correlation with the total BDI score, which was higher in patients with diabetes than in patients without diabetes, and a positive correlation with the total AIS score (p &lt; 0.001). The occurrence of sexual dysfunction in patients with diabetes correlated with the age and the duration of diabetes. We conclude that sexual disorders in patients with type 2 diabetes demonstrate the correlation with the occurrence of depression and the acceptance of their illness. Sexual disorders in diabetic patients occur more frequently in older patients and in those with a longer duration of diabetes.



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IJERPH, Vol. 14, Pages 1075: Food Shopping and Acquisition Behaviors in Relation to BMI among Residents of Low-Income Communities in South Carolina

IJERPH, Vol. 14, Pages 1075: Food Shopping and Acquisition Behaviors in Relation to BMI among Residents of Low-Income Communities in South Carolina

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph14091075

Authors: Angela Liese Xiaonan Ma Brent Hutto Patricia Sharpe Bethany Bell Sara Wilcox

Low-income areas in which residents have poor access to healthy foods have been referred to as "food deserts." It is thought that improving food access may help curb the obesity epidemic. Little is known about where residents of food deserts shop and if shopping habits are associated with body mass index (BMI). We evaluated the association of food shopping and acquisition (e.g., obtaining food from church, food pantries, etc.) with BMI among 459 residents of low-income communities from two South Carolina counties, 81% of whom lived in United States Department of Agriculture-designated food deserts. Participants were interviewed about food shopping and acquisition and perceptions of their food environment, and weight and height were measured. Distances to food retail outlets were determined. Multivariable linear regression analysis was employed. Our study sample comprising largely African-American women had an average BMI of 32.5 kg/m2. The vast majority of study participants shopped at supermarkets (61%) or supercenters/warehouse clubs (27%). Shopping at a supercenter or warehouse club as one's primary store was significantly associated with a 2.6 kg/m2 higher BMI compared to shopping at a supermarket, independent of demographics, socioeconomics, physical activity, and all other food shopping/acquisition behaviors. Persons who reported shopping at a small grocery store or a convenience or dollar store as their tertiary store had a 2.6 kg/m2 lower BMI. Respondents who perceived lack of access to adequate food shopping in their neighborhoods as a problem had higher BMI. Living in a food desert census tract was not significantly associated with BMI. Other shopping attributes, including distance to utilized and nearest grocery stores, were not independently associated with BMI. These findings call into question the idea that poor spatial access to grocery stores is a key underlying factor affecting the obesity epidemic. Future research should consider assessing foods purchased and dietary intake within a comprehensive study of food shopping behaviors and health outcomes among persons living in food deserts.



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Cancers, Vol. 9, Pages 125: Integrin Activation Contributes to Lower Cisplatin Sensitivity in MV3 Melanoma Cells by Inducing the Wnt Signalling Pathway

Cancers, Vol. 9, Pages 125: Integrin Activation Contributes to Lower Cisplatin Sensitivity in MV3 Melanoma Cells by Inducing the Wnt Signalling Pathway

Cancers doi: 10.3390/cancers9090125

Authors: Maria Piva Bastian Jakubzig Gerd Bendas

Background: integrins have been associated with the development of chemotherapy resistant tumour cells, mostly those of hematopoietic origin, by mediating the binding to the extracellular matrix. The relevance for solid tumour cells and the underlying mechanisms remain elusive. Methods: using MTT assays, we detected the loss in cisplatin sensitivity of human MV3 melanoma cells upon integrin activation. Underlying cellular pathways were evaluated by flow cytometry. A crosstalk between integrin activation and the canonical wnt signalling pathway was tested by measuring β-catenin activity. Results: MV3 cells display a higher resistance against cisplatin cytotoxicity when cellular integrins were activated by manganese or collagen. Proteome profiler array showed a deregulation of the integrin expression pattern by cisplatin. Integrin activation by manganese induces the phosphorylation of PI3K/AKT. The inhibition of PI3K using BEZ235 strongly increases cell sensitivity to cisplatin, blocking manganese and collagen effects. PI3K/AKT activates wnt signalling by blocking Gsk3-β, which was confirmed by β-catenin up-regulation and nuclear localization. Integrins did not affect E-cadherin expression levels, thus endothelial to mesenchymal transition (EMT) can be excluded. Conclusion: This is the first report on an integrin/wnt signalling activation axis addressing the consequences for chemotherapy sensitiveness of melanoma cells, which thus offers novel therapeutic targets for approaches to interfere with chemoresistance.



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Diversity and dynamics stability of bacterial community in traditional solid-state fermentation of Qishan vinegar

Abstract

Qishan vinegar is a typical Chinese fermented cereal product that is prepared using traditional solid-state fermentation (SSF) techniques. The final qualities of the vinegar produced are closely related to the multiple bacteria present during SSF. In the present study, the dynamics of microbial communities and their abundance in Daqu and vinegar Pei were investigated by the combination of high throughput sequencing and quantitative PCR. Results showed that the Enterobacteriales members accounted for 94.7%, 94.6%, and 92.2% of total bacterial sequences in Daqu Q3, Q5, and Q10, respectively. Conversely, Lactobacillales and Rhodospirillales dominated during the acetic acid fermentation (AAF) stage, corresponding to the quantitative PCR results. Lactobacillus, Acetobacter, Weissella, Leuconostoc and Bacillus were the dominant and characteristic bacterial genera of Qishan vinegar during AAF process. Redundancy analysis suggested that Lactobacillales and Rhodospirillales had a positive correlation with humidity and acidity, respectively. These results confirmed that the bacterial community structure could be affected by physiochemical factors, which determined the unique bacterial composition at different fermentation stages and showed batch-to-batch consistency and stability. Therefore, the conformity of bacterial community succession with physiochemical parameters guaranteed the final quality of Qishan vinegar products. This study provided a scientific perspective for the uniformity and stability of Qishan vinegar, and might aid in controlling the manufacturing process.



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Παρασκευή 15 Σεπτεμβρίου 2017

IJMS, Vol. 18, Pages 1991: Identification of Circulating miRNAs Differentially Regulated by Opioid Treatment

IJMS, Vol. 18, Pages 1991: Identification of Circulating miRNAs Differentially Regulated by Opioid Treatment

International Journal of Molecular Sciences doi: 10.3390/ijms18091991

Authors: Kaoru Toyama Naoki Kiyosawa Kenji Watanabe Hitoshi Ishizuka

Emerging evidence demonstrates functional contributions of microRNAs (miRNAs) to μ-opioid receptor (MOR) signaling, but the information so far has been mostly limited to their intracellular regulatory mechanisms. The present study aimed to investigate changes in plasma miRNA profiles elicited by opioid treatment in blood samples collected from clinical studies. Healthy male subjects were orally administered with hydromorphone or oxycodone and blood samples were collected at a specified time after the drug treatment. A total of 179 plasma miRNAs were measured using multiplex qRT-PCR. Nine and seventeen miRNAs were commonly upregulated (let-7a-5p, miR-423-3p, miR-199a-3p, miR-146a-5p, miR-23b-3p, miR-24-3p, miR-221-3p, miR-223-3p, and miR-146b-5p) and downregulated (miR-144-3p, miR-215, miR-363-3p, etc.), respectively, following opioid treatment. The MOR signaling-associated miRNAs, namely let-7 family miRNAs (i.e., let-7d-5p, let-7f-5p, let-7c, let-7e-5p), miR-103a-3p, miR-339-3p, miR-146a-5p, miR-23b-3p, miR-23a-3p, and miR-181a-5p, were differentially expressed following drug treatment. These differentially expressed miRNAs are circulating biomarker candidates that can be used to evaluate MOR stimulation and serve as novel clinical diagnostic tools for improving clinical outcomes.



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Bioprospecting of Novel and Bioactive Compounds from Marine Actinomycetes Isolated from South China Sea Sediments

Abstract

Marine actinomycetes are less investigated compared to terrestrial strains as potential sources of natural products. To date, few investigations have been performed on culturable actinomycetes associated with South China Sea sediments. In the present study, twenty-eight actinomycetes were recovered from South China Sea sediments after dereplication by traditional culture-dependent method. The 16S rRNA gene sequences analyses revealed that these strains related to five families and seven genera. Twelve representative strains possessed at least one of the biosynthetic genes coding for polyketide synthase I, II, and nonribosomal peptide synthetase. Four strains had anti-Mycobacterium phlei activities and five strains had activities against methicillin-resistant Staphylococcus aureus. 10 L-scale fermentation of strains Salinispora sp. NHF45, Nocardiopsis sp. NHF48, and Streptomyces sp. NHF86 were carried out for novel and bioactive compounds discovery. Finally, we obtained a novel α-pyrone compound from marine Nocardiopsis sp. NHF48, an analogue of paulomenol from marine Streptomyces sp. NHF86 and a new source of rifamycin B, produced by Salinispora sp. NHF45. The present study concluded that marine actinomycetes, which we isolated from South China Sea sediments, will be a suitable source for the development of novel and bioactive compounds.



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Prostate cancer screening by prostate-specific antigen (PSA); a relevant approach for the small population of the Cayman Islands

Abstract

Introduction

The common tool for diagnosing prostate cancer is prostate-specific antigen (PSA), but the high sensitivity and low specificity of PSA testing are the problems in clinical practice. There are no proper guidelines to investigate the suspected prostate cancer in the Cayman Islands. We correlated PSA levels with the incidence of prostate cancers by tissue diagnosis and proposed logical protocol for prostate screening by using PSA test in this small population.

Materials and methods

A total of 165 Afro Caribbean individuals who had prostate biopsy done after the investigations for PSA levels from year 2005 to 2015 were studied retrospectively. The patients were divided into subgroups by baseline PSA levels as follows: <4, 4.1–10, 10.1–20, 20.1–50, 50.1–100, and >100 ng/mL and were correlated to the age and presence of cancer.

Results and discussion

Benign lesions had lower PSA levels compared to cancer which generally had higher values. Only three cases that had less than 4 ng/mg were turned out to be malignant. When PSA value was more than 100 ng/mL, all the cases were malignant. Between PSA values of 4–100 ng/mL, the probability of cancer diagnosis was 56.71% (76 cancers out of 134 in this range). Limitation of PSA testing has the risk of over diagnosis and the resultant negative biopsies owing to poor specificity. Whereas the cutoff limit for cancer diagnosis still remains 4 ng/mL from our study, most of the patients can be assured of benign lesion below this level and thus morbidity associated with the biopsy can be prevented. When the PSA value is greater than 100 ng, biopsy procedure was mandatory as there were 100% cancers above this level.

Summary

On the background of vast literature linking PSA to prostate cancer and its difficulty in implementing in clinical practice, we studied literature of this conflicting and complex topic and tried to bring relevant protocols to the small population of Cayman Islands for the screening of prostate cancer. In this study, a total of 165 Afro Caribbean individuals who had prostate biopsy done after the investigations for PSA levels from year 2005 to 2015 were studied retrospectively. As a result of this research work, it can be concluded that a benign diagnosis can be given with a fair certainty when the PSA was below 4 ng/mL and a level of 100 ng/mL can be very unfavorable for the patients. This study helped to solidify the cancer screening protocols in Cayman Islands.

Conclusion

The PSA level can reassure and educate the patients towards the diagnosis of cancer of prostate in Cayman Islands. Benign diagnosis can be given with a fair certainty when the PSA was below 4 ng/mL and a level of 100 ng/mL can be very unfavorable for the patients. This study helped to solidify the cancer screening protocols in Cayman.



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Evaluating the impact of a walking program in a disadvantaged area: using the RE-AIM framework by mixed methods

The positive health impact of physical activity (PA) is well known, yet a large proportion of the world's population remains sedentary. General PA programs are common as health promotion initiatives. However, ...

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Effectiveness of a 16-month multi-component and environmental school-based intervention for recovery of poor income overweight/obese children and adolescents: study protocol of the health multipliers program

Excess of weight is a serious public health concern in almost all countries, afflicting people of different ages and socioeconomic backgrounds. Studies have indicated the need for developing treatment strategi...

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Chemotherapy for advanced HER2-negative breast cancer: can one algorithm fit all?

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Publication date: Available online 15 September 2017
Source:Cancer Treatment Reviews
Author(s): F. Miglietta, M.V. Dieci, G. Griguolo, V. Guarneri, P.F. Conte
HER2negative (HER2-) metastatic breast cancer (MBC) represents a challenging scenario for clinicians due to its great biological and clinical heterogeneity. Although management of HER2-MBC currently relies on several options, CT still remains a worthwhile strategy to be exploited. However, to date, there is not an univoque algorithm capable of guiding the choice of the proper CT agent/regimen, sequence and duration. Evidence from randomized clinical trials (RCT) and meta-analyses can actually help guiding the decision making process, however the definition of a standard of care for all HER2-MBC patients may be impractical, also in the light of the identification of new promising molecular and immunotherapeutic agents. The purpose of this work is to review available evidence on the role of CT for HER2-MBC with particular emphasis on the need to outline personalized therapeutic strategies for each patient.



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Policies and strategies to facilitate secondary use of research data in the health sciences



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Ethics in Social Networking and Business 2: The Future and Changing Paradigms


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The aim of this book is to describe the methodology of conducting the THEDRE research "Traceable Human Experiment Design Research". It applies to Research in Human Centered Informatics (RICH). These are areas of computer research that integrate users to build scientific knowledge and supporting tools for this research. As an example, we can mention the relevant fields such as Information Systems (IS), Human Machine Interfaces



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Academic Entrepreneurship: How to Bring Your Scientific Discovery to a Successful Commercial Product


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The pathway to bringing laboratory discoveries to market is poorly understood and generally new to many academics. This book serves as an easy-to-read roadmap for translating technology to a product launch – guiding university faculty and graduate students on launching a start-up company.

•    Addresses a growing trend of academic faculty commercializing their discoveries, especially those supported by the National Science Foundation and National Institutes

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