[New idea of treatment of heart failure with traditional Chinese medical]

To discuss the potential role of medicinal herbs, especially those with effect of strengthening Qi, in the treatment of chronic heart failure (CHF) via modulating myocardial substrate metabolism. The relationships among heart failure, myocardial energetic metabolism and herbal medicine were analyzed in detail through reviewing and summarizing the accumulating knowledge and recent findings on myocardial metabolism, heart failure and herbal medicine. Either energy lack or abnormal energetic metabolism is one of the main causes to the initiation and development of heart failure. Recent studies suggest that the cardiac function in the patients with CHF could be improved by inhibiting the energy production from metabolism of fatty acid and enhancing the energy production from glucose metabolism. The concept of Qi in Chinese medicine is very close to the energy in western medicine. The decoction of Chinese medicine containing herbal medicine with effect of strengthening Qi and the herbal medicine themselves and their components were evidenced to be effective in improvement of heart failure and regulation of both lipid and glucose metabolism; more importantly, all these herbal medicine contain the multi-sugar which can be metabolized into single unit of sugar which may be metabolized as a substrate by myocardium and potentially produce the cardioprotective effect. Therefore, we may find out a novel way to explain why the herbal medicine with effect of strengthening Qi can improve cardiac function in patients with CHF. In other words, regulating myocardial metabolism is one of the mechanisms underlying the cardioprotection produced by herbal medicine with effect of strengthening Qi in the treatment of heart failure.

Bax dimerizes via a symmetric BH3:groove interface during apoptosis

During apoptotic cell death, Bax and Bak change conformation and homo-oligomerize to permeabilize mitochondria. We recently reported that Bak homodimerizes via an interaction between the BH3 domain and hydrophobic surface groove, that this BH3:groove interaction is symmetric, and that symmetric dimers can be linked via the α6-helices to form the high order oligomers thought responsible for pore formation. We now show that Bax also dimerizes via a BH3:groove interaction after apoptotic signaling in cells and in mitochondrial fractions. BH3:groove dimers of Bax were symmetric as dimers but not higher order oligomers could be linked by cysteine residues placed in both the BH3 and groove. The BH3:groove interaction was evident in the majority of mitochondrial Bax after apoptotic signaling, and correlated strongly with cytochrome c release, supporting its central role in Bax function. A second interface between the Bax α6-helices was implicated by cysteine linkage studies, and could link dimers to higher order oligomers. We also found that a population of Bax:Bak heterodimers generated during apoptosis formed via a BH3:groove interaction, further demonstrating that Bax and Bak oligomerize via similar mechanisms. These findings highlight the importance of BH3:groove interactions in apoptosis regulation by the Bcl-2 protein family.

A prospective, multicenter trial of complementary and alternative medicine (CAM) utilization by patients undergoing definitive breast radiotherapy

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Background: A substantial number of breast cancer (BC) pts use complementary and alternative medicines (CAM), but there is a paucity of data on CAM specifically during radiation therapy (RT). The purpose of this study was to prospectively assess the utilization of CAM during RT for BC pts.

Methods: 456 pts w/stage 0-III BC were accrued from 5 RT centers from 9/07-2/09. Participating MDs were advised not to discuss CAM. A validated survey instrument was administered during the last week of RT under guidance of a study nurse, which included demographics, details regarding types/doses/frequency of CAM and skin assessments by pt and nurse.

Results: 360 pts were eligible for analysis (79%); median age 57 yrs; stage 0-II, 91%; white race 89%; chemotherapy 39%; hormone therapy (HT) w/ RT, 26%; > college education, 59%. CAM was reported in 54% (n = 195), of which 72% reported programs/activities (i.e., Reiki, healing touch, visualization, etc.), and 66% oral/topical CAM. Only 16% reported counseling prior to starting CAM. CAM use did not differ by ethnicity, chemotherapy or stage (all p > 0.05), but correlated significantly with higher education level (p = 0.0001) and inversely correlated w/ HT/RT (p = 0.015). There was a trend towards CAM use in younger pts (p = 0.069). On MVA, education (RC: 1.859; OR: 6.417, 95% CI: 2.023, 20.357, p = 0.002) and HT/RT (RC: -0.530, OR: 0.589, 95% CI: 0.357, 0.970, p = 0.038) independently predicted for CAM use. Rationale for oral/topical: 32% “improve their chance of cure”; 24% “provide treatment-related symptom relief”. For programs/activities: 31% “relaxation/stress reduction”; 11% “reduces treatment-related symptoms”. Despite these beliefs, there were no significant differences between the perception of the pts to nursing skin assessment score as a function of CAM use (p = 0.497).

Conclusions: To our knowledge, this is the first and largest prospective study of CAM during RT for BC pts. Given the high prevalence of undocumented CAM use during RT, questions regarding CAM should be considered during consultation and weekly tx visits. A better understanding of CAM practices during RT will facilitate evaluation of potential interactions of CAM and RT for BC.

Ginseng derivative ocotillol enhances neuronal activity through increased glutamate release: a possible mechanism underlying increased spontaneous locomotor activity of mice

Ginsenosides are the main active ingredients in ginseng and have recently been reported to have beneficial effects on the CNS. Ocotillol is a derivate of pseudoginsenoside-F11, which is an ocotillol-type ginsenoside found in American ginseng. We examined the effects of ocotillol (a) on neuronal activity of projection neurons, mitral cells (MC), in a mouse olfactory bulb brain slice preparation using whole-cell patch-clamp recording, and (b) on animal behavior by measuring locomotor activity of mice in vivo. Ocotillol displayed an excitatory effect on spontaneous action potential firing and depolarized the membrane potential of MCs. The effect was concentration-dependent, with an EC(50) of 4 μM. In the presence of blockers of ionotropic glutamatergic and GABAergic synaptic transmission (6-cyano-7-nitroquinoxaline-2,3-dione [CNQX], 10 μM; D-AP5, 50 μM; gabazine, 5 μM), the excitatory effect of ocotillol on firing was abolished. Further experiments showed that the ocotillol-induced neuronal excitation persisted in the presence of GABA(A) receptor antagonist gabazine but was eliminated by applying AMPA/kainate receptor antagonist CNQX and N-methyl-d-aspartate (NMDA) receptor antagonist D-AP5, suggesting that ionotropic glutamate transmission was involved in mediating the effects of ocotillol. Bath application of ocotillol evoked an inward current as well as an increased frequency of spontaneous glutamatergic excitatory postsynaptic currents (EPSCs). Both the inward current and sEPSCs could be blocked by ionotropic glutamate receptor antagonists CNQX and D-AP5. These results indicate that the excitatory action of ocotillol on MCs was mediated by enhanced glutamate release. Behavioral experiments demonstrated that ocotillol increased locomotor activities of mice. Our results suggest that ocotillol-evoked neuronal excitability was mediated by increased release of glutamate, which may be responsible for the increased spontaneous locomotor activities in vivo.

Enhanced antitumor effects of tumor antigen-pulsed dendritic cells by their transfection with GM-CSF gene

To investigate the biological characterization and antitumor activities of GM-CSF gene-transfected dendritic cells, the splenic dendritic cells were infected with GM-CSF recombinant replication-deficient adenovirusesin vitro. Their enhanced expression of B7 was demonstrated by FACS analysis, and more potent stimulatory activity was confirmed by allogeneic MLR. Immunization of dendritic cells pulsed with irradiated B16 melanoma cells induced significant CTL and enabled host to resist the challenge of wild-type B16 cells. When they were transfected with GM-CSF gene subsequently, the induced CTL activity was higher, and the produced protection against B16 cell challenge and therapeutic effect on the mice with preestablished pulmonary metastases more effective. These data suggest that the dendritic cells pulsed with tumor antigen then transfected with GM-CSF gene can be used as an effective vaccine in tumor immunotherapy.

Interleukin-21 is upregulated in hepatitis B-related acute-on-chronic liver failure and associated with severity of liver disease

The immune mechanism(s) that lead to hepatitis B-related acute-on-chronic liver failure (HB-ACLF) are poorly understood. Interleukin-21 is a newly discovered cytokine that is involved in autoimmune and inflammatory diseases. Its potential role in HB-ACLF remains unknown. The serum levels of 12 immune cytokines measured by cytometric bead arrays and the frequency of IL-21-secreting CD4+ T cells in peripheral blood mononuclear cells (PBMC) measured by intracellular cytokine staining were compared in moderate chronic hepatitis B (M-CHB, n = 20), severe chronic hepatitis B (S-CHB, n = 20), HB-ACLF (n = 39) and healthy controls (n = 10). PBMC from M-CHB patients or healthy subjects were stimulated with rhIL-21 in vitro, and cytokines in supernatants were measured by FlowCytomix. The frequencies of IL-21-secreting CD4+ T cells were higher in HB-ACLF (both P < 0.001) and S-CHB (P = 0.002 and 0.001) as compared to M-CHB patients and controls. Serum IL-21 levels were highest (P < 0.001) in HB-ACLF and positively associated with high MELD score (P = 0.001) and mortality (P = 0.038). Recovery from HB-ACLF was associated with reduced serum IL-21 levels (P = 0.003) and lower CD4+ IL-21(+) T-cell frequency (P = 0.006). The secretions of IL-1β (P < 0.001), IL-6 (P < 0.001), IL-10 (P < 0.001), IFN-γ (P = 0.001) and TNF-α (P = 0.042) from PBMC were significantly increased with rhIL-21 stimulation. In summary, IL-21 has a causal role in the development of severe liver inflammation, which is upregulated in HB-ACLF and associated with severity of liver disease.

Effect of O2 on the adsorption of SO2 on carbon-supported Pt electrocatalysts

Adsorption of SO(2) in the presence of O(2) on Pt/C catalysts often used as electrocatalysts has been investigated by temperature programmed desorption (TPD) and X-ray photoelectron spectroscopy (XPS). The amounts of SO(2) adsorption on Pt/C in the presence of O(2) were much higher than those in the absence of O(2) (SO(2)-N(2)) and from the carbon support (Vulcan XC-72) alone. Adsorption is dependent on oxygen concentration over the range 0-20% but reaches saturation at 20% O(2). The spillover of SO(2) from Pt to the carbon support has been proposed for 10, 20, and 40% Pt loadings, characterized by desorption temperatures of approximately 150 and 260 °C for SO(2) adsorbed on Pt and carbon, respectively. Adsorbed Pt-S, C-S, C-SO(x), and Pt-SO(4) species were identified by XPS as S-containing species on both Pt and carbon. Both TPD and XPS indicate that the carbon support plays a major role in SO(2) adsorption, primarily as SO(x) (x = 3, 4). The bonding of S and SO(x) on the carbon support was strong enough that back diffusion to the Pt surface did not occur.

Recovery of alumina and alkali in Bayer red mud by the formation of andradite-grossular hydrogarnet in hydrothermal process

Bayer red mud (RM) is an alumina refinery waste product rich in aluminum oxides and alkalis which are present primarily in the form of sodium hydro-aluminosilicate desilication product (DSP). A hydrothermal process was employed to recover alumina and alkali from "Fe-rich" and "Fe-lean" RM, the two representative species of RM produced in China. The hydrothermal process objective phase is andradite-grossular hydrogarnet characterized by the isomorphic substitution of Al and Fe. Batch experiments were used to evaluate the main factors influencing the recovery process, namely reaction temperature, caustic ratio (molar ratio of Na(2)O to Al(2)O(3) in sodium solution), sodium concentration and residence time. The results revealed that the Na(2)O content of 0.5 wt% and A/S of 0.3 (mass ratio of Al(2)O(3) to SiO(2)) in leached residue could be achieved with Fe-rich RM under optimal conditions. However, the hydrothermal treatment of Fe-lean RM proved less successful unless the reaction system was enriched with iron. Subsequent experiments examined the effects of the ferric compound's content and type on the substitution ratio.

Various novel erythromycin derivatives obtained by different modifications: recent advance in macrolide antibiotics

The rapid emergence of drug resistance intensified the search for new antimicrobial agents, leading to lots of novel derivatives obtained from 14- and 15-membered macrolides by chemical modifications. Many of them exhibited enhanced antibacterial activity and expanded antibacterial spectrum. Especially some of them were found to be potent for the treatment of multi-drug-resistant bacterial infections. Besides, the other biological effects of macrolide derivatives were also found. In this article, we reviewed the recent advance in the novel macrolide derivatives designed by different structural modifications on erythronolide skeleton, cladinose and desosamine in the structures.

Innate Defence Regulator Peptides as a Novel Anti-infective Strategy (94.2)

The therapy of bacterial infections is under great threat as multiple antibiotic resistance increases and there is a paucity of new antibiotic discovery and development. Synthetic Innate Defence Regulator (IDR) peptides, which mimic natural host defence (antimicrobial) peptides, have been designed as a novel anti-infective strategy, working by selectively boosting innate immune protective mechanisms while dampening potentially harmful inflammation. These peptides can resolve serious infections in animal models. The optimal method of use of these peptides was evaluated here using an animal model infection by one of the highly resistant bacteria (Superbugs) afflicting our society, Staphylococcus aureus. A luminescent version of this bacterium was utilized to follow the kinetics of infection non-invasively using IVIS imaging. Protection was achieved by both prophylactic and therapeutic administration. Investigation of the mechanism of protection by examining cells infiltrating the infection site and cytokines/chemokines revealed remarkable parallels between in vitro action of the peptides in primary human cells and these animal models. System biology approaches such as Microarray and InnateDB are being utilized to decipher the complex. This has revealed several receptors, signaling pathways, transcription factors and effector proteins involved in the modulation by peptides of innate immunity.

Synthetic cationic peptide IDR-1002 provides protection against bacterial infections through chemokine induction and enhanced leukocyte recruitment

With the rapid rise in the incidence of multidrug resistant infections, there is substantial interest in host defense peptides as templates for production of new antimicrobial therapeutics. Natural peptides are multifunctional mediators of the innate immune response, with some direct antimicrobial activity and diverse immunomodulatory properties. We have previously developed an innate defense regulator (IDR) 1, with protective activity against bacterial infection mediated entirely through its effects on the immunity of the host, as a novel approach to anti-infective therapy. In this study, an immunomodulatory peptide IDR-1002 was selected from a library of bactenecin derivatives based on its substantially more potent ability to induce chemokines in human PBMCs. The enhanced chemokine induction activity of the peptide in vitro correlated with stronger protective activity in vivo in the Staphylococcus aureus-invasive infection model, with a >5-fold reduction in the protective dose in direct comparison with IDR-1. IDR-1002 also afforded protection against the Gram-negative bacterial pathogen Escherichia coli. Chemokine induction by IDR-1002 was found to be mediated through a Gi-coupled receptor and the PI3K, NF-kappaB, and MAPK signaling pathways. The protective activity of the peptide was associated with in vivo augmentation of chemokine production and recruitment of neutrophils and monocytes to the site of infection. These results highlight the importance of the chemokine induction activity of host defense peptides and demonstrate that the optimization of the ex vivo chemokine-induction properties of peptides is a promising method for the rational development of immunomodulatory IDR peptides with enhanced anti-infective activity.