Controlled delivery of mesenchymal stem cells and growth factors using a nanofiber scaffold for tendon repair

Outcomes after tendon repair are often unsatisfactory, despite improvements in surgical techniques and rehabilitation methods. Recent studies aimed at enhancing repair have targeted the paucicellular nature of tendon for enhancing repair; however, most approaches for delivering growth factors and cells have not been designed for dense connective tissues such as tendon. Therefore, we developed a scaffold capable of delivering growth factors and cells in a surgically manageable form for tendon repair. Platelet-derived growth factor BB (PDGF-BB), along with adipose-derived mesenchymal stem cells (ASCs), were incorporated into a heparin/fibrin-based delivery system (HBDS). This hydrogel was then layered with an electrospun nanofiber poly(lactic-co-glycolic acid) (PLGA) backbone. The HBDS allowed for the concurrent delivery of PDGF-BB and ASCs in a controlled manner, while the PLGA backbone provided structural integrity for surgical handling and tendon implantation. In vitro studies verified that the cells remained viable, and that sustained growth factor release was achieved. In vivo studies in a large animal tendon model verified that the approach was clinically relevant, and that the cells remained viable in the tendon repair environment. Only a mild immunoresponse was seen at dissection, histologically, and at the mRNA level; fluorescently labeled ASCs and the scaffold were found at the repair site 9days post-operatively; and increased total DNA was observed in ASC-treated tendons. The novel layered scaffold has the potential for improving tendon healing due to its ability to deliver both cells and growth factors simultaneously in a surgically convenient manner.

Blood screening for human immunodeficiency virus: a new algorithm to reduce the false-positive results

OBJECTIVES

The objectives to this study were to evaluate the performance of an anti-human immunodeficiency virus (HIV) blood screening test and propose a new screening algorithm for blood banks routinely using nucleic acid amplification testing (NAT) to reduce false-positive results.

BACKGROUND

Most anti-HIV enzyme-linked immunosorbent assay (ELISA) results are false-positive because of the low prevalence of HIV infection and high sensitivity of the ELISAs.

METHODS/MATERIALS

A total of 281 588 voluntary donations were collected and sera reactive on one or both anti-HIV ELISAs were confirmed by Western blot (WB) testing. All samples with nonreactive results for the two ELISAs underwent NAT. A confirmed HIV-1-positive result was defined by a reactive result on NAT or WB testing. Correlations between signal-to-cutoff ratios and the confirmed HIV-1 infection rate were analysed for each enzyme immunoassay and two-enzyme immunoassay combination. The positive predictive values (PPVs) of the current and proposed algorithms were calculated.

RESULTS

Seventy-nine donations (13·9%) were positive on WB analysis and one donation negative for anti-HIV antibody was reactive on NAT and confirmed to be a window period donation on additional follow-up testing. The PPV of the 567 donations reactive on one or two ELISAs was 13·9%. However, using the new screening algorithm, 457 donations underwent NAT immediately instead of WB testing. Only 110 donations were tested with WB and the PPV was 71·8%.

CONCLUSION

Screening for HIV is sensitive, specific and time saving for donors with this algorithm, which is suitable for HIV screening in low prevalence settings.

Physisorption of functionalized gold nanoparticles on AlGaN/GaN high electron mobility transistors for sensing applications

AlGaN/GaN high electron mobility transistors (HEMTs) were used to measure electrical characteristics of physisorbed gold nanoparticles (Au NPs) functionalized with alkanethiols with a terminal methyl, amine, or carboxyl functional group. Additional alkanethiol was physisorbed onto the NP treated devices to distinguish between the effects of the Au NPs and alkanethiols on HEMT operation. Scanning Kelvin probe microscopy and electrical measurements were used to characterize the treatment effects. The HEMTs were operated near threshold voltage due to the greatest sensitivity in this region. The Au NP/HEMT system electrically detected functional group differences on adsorbed NPs which is pertinent to biosensor applications.

Down-regulation of TCF21 is associated with poor survival in clear cell renal cell carcinoma

Transcription factor 21 (TCF21) has been identified as a candidate tumor suppressor at 6q23-q24 that is epigenetically inactivated in many types of human cancers. We recently found that TCF21 methylation level was significantly increased in clear cell renal cell carcinoma (ccRCC). The purpose of this study was to investigate the prognostic impact of TCF21 expression in ccRCC and analyze the relationship between TCF21 expression and methylation level. We used real-time PCR and immunohistochemical staining to detect the expression of TCF21, and used methylation specific-PCR (MS-PCR) to determine the methylation status of TCF21 in ccRCC samples and cell line 786-O. The results showed that TCF21 expression level in ccRCC samples was significantly lower than in normal adjacent tissue samples (NAT samples). The Kaplan-Meier survival analysis demonstrated that TCF21 was a significant prognosticator of cancer-specific survival (p=0.001). Furthermore, the DNA demethylating agent 5'-azacytidine restored part of TCF21 expression by suppressing TCF21 methylation in 786-O. The methylation level of TCF21 in ccRCC samples was much higher than in NAT samples. These results suggest that the expression of TCF21 was an independent prognostic factor for poor survival in patients with ccRCC. Aberrant methylation was an important reason for the down-regulation the expression of TCF21, and may be associated with tumorigenesis in ccRCC.

Abstract P5-15-05: Budget impact analysis of everolimus for estrogen receptor positive, human epidermal growth factor receptor-2 negative metastatic breast cancer patients in the United States

BACKGROUND: A phase III randomized clinical trial demonstrated significantly longer progression-free survival of everolimus and exemestane combination therapy compared to exemestane alone in postmenopausal women with estrogen receptor positive (ER+), human epidermal growth factor receptor-2 negative (HER2−) metastatic breast cancer (MBC) who failed letrozole or anastrozole. This study estimates the budget impact of adding everolimus as the first or second treatment after failure of letrozole or anastrozole for post-menopausal, ER+ HER2− MBC patients from a third-party payer perspective in the United States.

METHODS: Pharmacy and medical budget impacts were estimated over the first year of everolimus use in this indication. Published epidemiology data were used to estimate target population size. Market share was assumed to be divided between exemestane, fulvestrant and tamoxifen before everolimus entry based on market research data on file. Market share of combination therapy of everolimus and exemestane was assumed to increase linearly during the one-year period and replace 10% of overall market share by the end of the year, proportional to the pre-entry market share distribution of the other three treatments. Pharmacy budget inputs (wholesale acquisition cost of the therapies, daily dose, treatment duration, dispensing fee and copayment) were obtained from published and unpublished sources. Patients were assumed to be on treatment until progression or death. Medical costs were estimated as the average costs before and after progression, weighted by time in each state and adjusted for survival. Pre- and post-progression costs, time to progression and survival rates were derived from published literature. Compliance was assumed to be 100% until progression and adverse events were not considered. All costs were reported in 2011 US dollars.

RESULTS: In a hypothetical health plan with 1 million members, there would be 72 patients expected to use one of the study drugs (exemestane, tamoxifen, fulvestrant or everolimus+exemestane) as the first treatment option immediately after letrozole or anastrozole failure, and 159 expected to use one of the study drugs as the second treatment option after letrozole or anastrozole failure. For the first treatment option after letrozole or anastrozole failure, total budget impact was $0.013 per member per month (PMPM), including a $0.017 PMPM increase to the pharmacy budget and $0.004 PMPM decrease to the medical budget one year after everolimus entry. For the second treatment option after letrozole or anastrozole failure, total budget impact was $0.029 PMPM, including a $0.037 PMPM increase to the pharmacy budget and $0.009 PMPM decrease to the medical budget one year after everolimus entry. Total budget impact was $0.042 PMPM, including a $0.055 PMPM increase to the pharmacy budget and $0.013 PMPM decrease to the medical budget one year after everolimus entry.

CONCLUSION: Use of everolimus for ER+, HER2− MBC is expected to reduce the medical budget due to improved efficacy but increase the pharmacy budget due to higher drug cost. The total budget impact is relatively small.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-15-05.

Homogeneous acylation of eucalyptus wood at room temperature in dimethyl sulfoxide/N-methylimidazole

Succinoylation and benzoylation of ball-milled eucalyptus wood using succinic anhydride and benzoyl chloride as acylating reagent, respectively, were investigated at room temperature using dimethyl sulfoxide/N-methylimidazole (DMSO/NMI) as reaction medium without additional catalysts. The effects of the corresponding acylating reagent dosage (1-5:1 for succinoylation and 0.5-5:1 for benzoylation) and reaction time (0.35-5h for succinoylation and 0.5-3h for benzoylation) on the extent of acylation, measured by weight percent gain (WPG), were studied. WPG of succinoylation and benzoylation was in the range of 70.8-144.7% and 17.3-43.1%, respectively. The efficiency of acylation at room temperature significantly increased in DMSO/NMI compared with ionic liquid 1-butyl-3-methylimidazolium chloride because of the role of NMI as solvent, base and catalyst. Fourier transform infrared (FT-IR), and solid-state cross-polarization/magic-angle spinning (CP/MAS) (13)C nuclear magnetic resonance (NMR) spectroscopy studies provided evidence for the occurrence of succinoylation and benzoylation reactions and the attachment of functional groups via ester bonds.

Association of interleukin-18 promoter polymorphisms with chronic obstructive pulmonary disease in male smokers

Chronic obstructive pulmonary disease (COPD) is considered a complex genetic disorder and it is expected that many genes play a role in the pathogenesis of this disease. Previous studies have reported that several variations within the interleukin (IL)-18 gene promoter region have been associated with different inflammatory diseases such as asthma. However, the association of IL-18 promoter polymorphisms with COPD has not been studied yet. We then performed a prospective case-control study to explore this association in male smokers of Chinese Han people. Our study recruited 112 COPD cases and 105 healthy controls matched for age. The genotyping of IL-18 promoter polymorphisms (-607 C/A and -137 G/C) was performed using TaqMan single nucleotide polymorphism genotyping assays. The frequencies of the alleles and genotypes in patients and controls were compared. We found that the frequency of IL-18 -607 C allele was significantly increased in patients with COPD (odds ratio (OR) = 1.48, 95% confidence interval (CI) = 1.01-2.15, P = 0.04). The frequency of IL-18 -607 C allele was significantly higher in the GOLD (Global initiative for Obstructive Lung Disease) 3-4 group compared with the GOLD 1-2 group (OR=2.06, 95% CI = 1.21-3.51, P = 0.01). There were no significant differences in the frequencies of the alleles and genotypes of IL-18 -137 G/C polymorphism between the patients and healthy smokers or between GOLD 3-4 group and GOLD 1-2 group. Our study revealed that the IL-18 -607 C/A polymorphism was associated with COPD susceptibility and severity of airflow limitation in male smokers of Chinese Han people.

Icariin stimulates the proliferation of rat Sertoli cells in an ERK1/2-dependent manner in vitro

Icariin (ICA), a major constituent of flavonoids from the Chinese medical herb Epimedium brevicornum Maxim, is found to be protective for male reproductive ability, with the underlying mechanism largely unknown. Our study here investigated the effects of ICA on Sertoli cells, which act as nurse cells for the germ cells developing. Icariin was found to stimulate Sertoli cell proliferation in a dose-dependent manner. Further study revealed that Icariin induced an obvious phosphorylation of ERK in Sertoli cells. Inhibition of activation of ERK by the ERK inhibitor U0126 nearly blocked the Icariin-induced proliferation of Sertoli cells. Taken together, our results suggest that Icariin promotes the proliferation of Sertoli cells in vitro by activating the ERK1/2 signal pathway, which might at least partially, explain the protective role of Icariin on male reproductive ability.

CuAAC click chemistry accelerates the discovery of novel chemical scaffolds as promising protein tyrosine phosphatases inhibitors

Protein tyrosine phosphatases (PTPs) are crucial regulators for numerous biological processes in nature. The dysfunction and overexpression of many PTP members have been demonstrated to cause fatal human diseases such as cancers, diabetes, obesity, neurodegenerative diseases and autoimmune disorders. In the past decade, considerable efforts have been devoted to the production of PTPs inhibitors by both academia and the pharmaceutical industry. However, there are only limited drug candidates in clinical trials and no commercial drugs have been approved, implying that further efficient discovery of novel chemical entities competent for inhibition of the specific PTP target in vivo remains yet a challenge. In light of the click-chemistry paradigm which advocates the utilization of concise and selective carbon-heteroatom ligation reactions for the modular construction of useful compound libraries, the Cu(I)-catalyzed azidealkyne 1,3-dipolar cycloaddition reaction (CuAAC) has fueled enormous energy into the modern drug discovery. Recently, this ingenious chemical ligation tool has also revealed efficacious and expeditious in establishing large combinatorial libraries for the acquisition of novel PTPs inhibitors with promising pharmacological profiles. We thus offer here a comprehensive review highlighting the development of PTPs inhibitors accelerated by the CuAAC click chemistry.

Retinal vascular changes following intravitreal ranibizumab injections for neovascular AMD over a 1-year period

PURPOSE

To assess retinal vascular calibre changes in eyes with neovascular age-related macular degeneration (AMD), treated with intravitreal anti-vascular endothelial growth factor agents, over a 1-year period and compare any such changes to untreated fellow eyes.

METHODS

Treatment naïve patients with neovascular AMD received three consecutive intravitreal injections of ranibizumab, followed by a pro re nata dosing regimen up to 1 year, with the aim of maintaining a 'fluid-free' macula. Retinal arteriolar and venular calibre was measured from digital fundus photographs at baseline and at three monthly intervals to 1 year, and summarised as central retinal artery equivalent (CRAE) and central retinal venular equivalent (CRVE), respectively.

RESULTS

A total of 53 injected eyes and 41 fellow, non-injected eyes were analysed. At baseline, there were no differences in retinal vascular calibre between injected and non-injected eyes (mean CRAE (SD) 144.93 (14.07) vs 145.74 (13.10) μm, P=0.80 and mean CRVE (SD) 216.23 (25.93) vs 219.91 (22.82) μm, P=0.53). Over a 12-month period, retinal venular calibre dilatation occurred in injected eyes (mean CRVE change +5.71 (14.71) μm, P=0.007), with no change in retinal arterioles, +0.69 (14.71) μm, P=0.68. In non-injected eyes, arteriolar narrowing occurred as a whole, mean CRAE change -4.20 (7.00) μm, P=0.001, over 12 months, with a trend for narrowing in venules, -2.16 (11.56) μm, P=0.28. In injected eyes, after controlling for covariates, the changes in CRVE over 12 months mirrored improvements in macular thickness, -0.06 (-0.005, -0.11) μm, P=0.04, and visual acuity, +9.66 (-0.30, +19.32) μm, P=0.06.

CONCLUSION

Intravitreal ranibizumab significantly dilated retinal venules after a 1-year period.

SU-E-I-08: KV XVI Cone Beam-CT Dose Measurement Using Gafchromic XRQA2 Film

PURPOSE

To study the effect of different filters on the dose response curves of the Gafchromic XRQA2 film. To measure the kV XVI cone-beam CT (CBCT) surface dose received during 3D and 4D imaging protocols in three body regions (head and neck, chest and pelvis).

METHODS

GafChromic XR- QA2 film (International Specialty Products, Wayne, NJ) dose response curves were generated for three irradiation settings: 100 kVp S20/F0; 120 kVp S20/F0 and 120 kVp S20/F1(F1 is a Bowtie filter). Film pieces were irradiated in air by the X-ray Volume Imager (XVI) mounted on the Elekta Synergy linear accelerator (Elekta, Crawley, UK) and their responses were correlated to air kerma measurements. To measure the CBCT surface dose, film pieces were taped on the surface of a male Alderson Rando Phantom (Alderson Research Laboratories, Inc., Long Island City, New York) at four different places (Anterior, Posterior, Right Lateral, Left Lateral).

RESULTS

The dose response curves of XRQA2 film generated with F1 and F0 filters were found to differ by 5 to 7% when the air kerma changed between 2 and 5 cGy. This was less than the observed difference (more than 15%, especially at low air kerma) in the dose response curves when different energies (100 and 120 kVp) and same filter were used. Surface dose ranged between 0.02 cGy and 4.99 cGy. The lowest average surface dose (0.05 cGy) was observed when the fast head and neck protocol was used, whilst the highest average surface dose (3.06 cGy) was noticed when the chest m² 0 protocol was used.

CONCLUSIONS

Filters seem to have less effect on the dose response of the film compared with energy. Gafchromic XRQA2 film was used successfully to measure the XVI CBCT surface dose. The dose was found to vary from one imaging protocol to another, with 4D protocols not necessarily delivering more doses.