Advances in the treatment of pancreatic neuroendocrine tumours

Pancreatic neuroendocrine tumours (pNETs) are relatively rare and generally felt to follow an indolent course. But poorly differentiated tumours can behave aggressively with 5-year survival ranging from 31% to 48%. Recent data suggest that patients with pNETs may derive benefit from treatment targeting the molecular changes expressed in this tumour group. This article describes advances in the treatment of unresectable pNETs that have led to a doubling of progression free survival.

Hydrogen-rich saline protects immunocytes from radiation-induced apoptosis

Background

Radiation often causes depletion of immunocytes in tissues and blood, which results in immunosuppression. Molecular hydrogen (H₂) has been shown in recent studies to have potential as a safe and effective radioprotective agent through scavenging free radicals. This study was designed to test the hypothesis that H₂ could protect immunocytes from ionizing radiation (IR).

Material/Methods

H₂ was dissolved in physiological saline or medium using an apparatus produced by our department. A 2-[6-(4′-hydroxy) phenoxy-3H-xanthen-3-on-9-yl] benzoate (HPF) probe was used to detect intracellular hydroxyl radicals (•OH). Cell apoptosis was evaluated by annexin V-FITC and Propidium iodide (PI) staining as well as the caspase 3 activity. Finally, we examined the hematological changes using an automatic Sysmex XE 2100 hematology analyzer.

Results

We demonstrated H₂-rich medium pretreatment reduced •OH level in AHH-1 cells. We also showed H₂ reduced radiation-induced apoptosis in thymocytes and splenocytes in living mice. Radiation-induced caspase 3 activation was also attenuated by H₂ treatment. Finally, we found that H₂ rescued the radiation-caused depletion of white blood cells (WBC) and platelets (PLT).

Conclusions

This study suggests that H₂ protected the immune system and alleviated the hematological injury induced by IR.

Disruption of Type-I IFN pathway ameliorates preservation damage in mouse orthotopic liver transplantation via HO-1 dependent mechanism

Ischemia/reperfusion injury (IRI) remains unresolved problem in clinical organ transplantation. We analyzed the role of Type-I interferon (IFN) pathway in a clinically relevant murine model of extended hepatic cold preservation followed by orthotopic liver transplantation (OLT). Livers from Type-I IFN receptor (IFNAR) knockout (KO) or wild-type (WT) mice (C57/BL6) were harvested, preserved at 4°C in UW solution for 20 h and transplanted to groups of syngeneic IFNAR KO or WT recipients. Liver graft but not recipient IFNAR deficiency was required to consistently ameliorate IRI in OLTs. Indeed, disruption of Type-I IFN signaling decreased serum alanine aminotransferase (sALT) levels (p < 0.001), diminished Suzuki's score of histological OLT damage (p < 0.01) and improved 14-day survival (from 42%[5/12] in WT to 92%[11/12] in IFNAR KO; p < 0.05). Unlike in WT group, IFNAR deficiency attenuated OLT expression of TNF-α, IL-1β, IL-6, MCP-1, CXCL-10, ICAM-1; diminished infiltration by macrophages/PMNs; and enhanced expression of antioxidant HO-1/Nrf2. The frequency of TUNEL+ apoptotic cells and caspase-3 activity/expression selectively decreased in IFNAR KO group. Small interfering (si)RNA-directed targeting of HO-1 restored cardinal features of liver IRI in otherwise resistant IFNAR-deficient OLTs. Thus, intact Type-I IFN signaling is required for hepatic IRI, whereas HO-1 is needed for cytoprotection against innate immunity-dominated organ preservation damage in IFNAR-deficient liver transplants.

Hydrogen-rich saline protects spermatogenesis and hematopoiesis in irradiated BALB/c mice

Background

Recent studies show that molecular hydrogen (dihydrogen, H₂) has potential as an effective and safe radioprotective agent through reducing oxidative stress. The aim of this study was to investigate whether H₂ is able to protect spermatogenesis and hematopoiesis from radiation-induced injuries.

Material/Methods

H₂ was dissolved in physiological saline using an apparatus produced by our department. ⁶⁰Co-gamma rays in the irradiation centre were used for irradiation. Spermatid head counts and histological analysis were used to evaluate spermatogenesis. Endogenous hematopoietic spleen colony formation (endoCFUs), bone marrow nucleated cells (BMNC) and peripheral blood (PB) leukocytes were used to evaluate hemopoiesis.

Results

This study demonstrates that treating mice with H₂ before ionizing radiation (IR) can increase the spermatid head count and protect seminiferous epithelium from IR. This study also demonstrates that H₂ could significantly increase the number of endoCFUs, BMNC and PB leukocyte.

Conclusions

This study suggests that hydrogen-rich saline could partially protect spermatogenesis and hematopoiesis in irradiated mice.

Impact of a novel mutation in the 5'-flanking region of natriuretic peptide precursor B gene on the antihypertensive effects of sodium nitroprusside in patients with hypertension

Our aim was to identify the possible mutations of the natriuretic peptide precursor B (NPPB) gene in a family with hereditary hypertension, and determine whether the mutations are associated with the antihypertensive effect of sodium nitroprusside. The subjects included one family with hereditary hypertension, 36 cases of sporadic hypertension and 120 healthy controls. The 5'-flanking sequence of NPPB was amplified with PCR, and the presence of mutations was analyzed by direct sequencing. Patients with hypertension were treated with sodium nitroprusside and blood pressure data and serum B-type natriuretic peptide (BNP) levels were measured. A novel complex mutation in 5'-flanking sequence of the NPPB gene was detected in three patients (II 2, III 2, and III 5) of the hypertension family, which included c.-1195_ -1176 insert 5'-CCTTCTTTCTTTCTTTCTTT-3', c.-1208 T>A, c.-1214 T>C, and c.-1216 T>A. Patients with this mutation were less sensitive to sodium nitroprusside treatment. Sporadic hypertension patients (without NPPB gene mutation) and patients with the c.-1181 T>A point mutation were sensitive to sodium nitroprusside treatment. BNP levels of patients with the complex mutation were significantly lower than that of sporadic hypertension patients and c.-1181 T>A mutation patients before and during the early stage of sodium nitroprusside treatment. The complex mutation of the NPPB gene might be an etiological factor of hereditary malignant hypertension, and it is associated with low sensitivity to the antihypertensive effect of sodium nitroprusside.

Maternal obesity and venous thromboembolism

The incidence of obesity in pregnancy has increased rapidly in the last decade. Obesity is a risk factor for venous thromboembolism outside of pregnancy and previous studies of maternal death in the UK have identified obesity as a risk factor in pregnancy. As a result the Royal College of Obstetricians and Gynaecologists have targeted obesity as a risk factor in evaluation of the need for thromboprophylaxis in pregnancy. This article highlights the evidence that obesity increases the risk of venous thromboembolism in pregnancy and the puerperium, discusses thromboprophylaxis and appropriate dosing in obese parturients and details the anaesthetic implications of the 2009 Royal College of Obstetricians and Gynaecologists' guidelines. More clinical studies are required to clarify the appropriate dose of low-molecular-weight heparin in an obese parturient.

The diagnostic accuracy of chromoendoscopy for dysplasia in ulcerative colitis: meta-analysis of six randomized controlled trials

AIM

The diagnostic accuracy of chromoendoscopy for dysplasia in ulcerative colitis (UC) was systematically evaluated.

METHOD

  Original studies in any language were searched from PubMed and Embase. Meta-analysis of prospective studies that compared chromoendoscopy with histological diagnosis was carried out. Sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated for each study and pooled together; summary receiver operating characteristic (ROC) and subgroup analyses were performed, while the quality of the study and heterogeneity were assessed.

RESULTS

Six randomized controlled trials were included, which used methylene blue or indigo carmine dye spray. The meta-analysis demonstrated a pooled sensitivity of 83.3% (95% confidence interval (CI), 35.9-99.6%), specificity of 91.3% (95% CI, 43.8-100%), and DOR of 17.544 (95% CI, 1.245-247.14). Subgroup analyses revealed that both the methylene blue dye spray subgroup and the unspecified endoscopist subgroup include the same studies, and their pooled sensitivity and specificity were 0.737 and 0.917, respectively. The other subgroup, which used indigo carmine dye spray, had overall higher sensitivity (0.930) and lower specificity (0.910).

CONCLUSION

Chromoendoscopy has medium to high sensitivity and a high diagnostic accuracy for dysplastic lesions in UC.

First Report of Ziziphus jujuba Wilt Caused by Fusarium oxysporum in China

Chinese jujube (Ziziphus jujuba Mill.) is widely planted in Xinjiang Province of China for fruit and as an effective herbal remedy. Wilt symptoms were observed on field-grown Z. jujuba during the spring and fall of 2010 and 2011. Diseased plants exhibited symptoms including wilted leaves, stunted growth, extensive brown discoloration on stems, and eventually death. In severe cases, approximately 60% of the plants in the field died. Repeated isolations from discolored stem vascular tissues were made on potato dextrose agar (PDA) after disinfestation in 1% HgCl₂ for 1 min and dipping in 70% ethanol for 10 s. Petri dishes were then incubated in complete darkness at 26°C for 7 days. All colonies on PDA had pale pink-salmon-colored mycelia. Macroconidia were mostly three to five septate, slightly curved, and ranged from 2.9 to 11.9 × 29.5 to 45 μm. Microconidia were abundant, generally single celled, oval to kidney shaped, and ranged from 2.5 to 5 × 7.5 to 11.5 μm in false heads on short monophialides. Chlamydospores were single or in pairs and profusely distributed. These characteristics were similar to those of Fusarium oxysporum (2). The internal transcribed spacer (ITS) rDNA region was amplified with primers ITS1/ITS4 and sequenced (1). BLASTn analysis of the sequence (GenBank Accession No. JQ039331) showed a 99% homology with several isolates of F. oxysporum in the GenBank database. Pathogenicity tests were conducted on healthy, 2-month-old seedlings and 1-month-old rooted cuttings of Z. jujuba under greenhouse conditions. Plants were inoculated with sterilized mixtures of wheat and barley seeds (1:1) that were incubated in a F. oxysporum isolate spore suspension (1 × 10⁷ conidia/ml) at 25°C for 7 to 10 days. The seeds (3 g per plant) were placed around the collar of each healthy plant under the soil surface and incubated at 25 to 28°C in a greenhouse. Control plants were sown in sterile soil without inoculated seeds. In 3 weeks, inoculated plants developed leaf wilt and chlorosis, stunted growth, brown discolored vascular tissue on stems, and finally died, which is similar to that observed in the field. F. oxysporum was reisolated from the stems of diseased plants, confirming Koch's postulates. Control seedlings were symptom free. F. oxysporum has been known to cause wilt disease on cotton and tomato in Xinjiang Province (3). However, to our knowledge, this is the first report of a natural occurrence of Chinese jujube wilt disease on commercial fields caused by F. oxysporum in China. References: (1) G. M. Arruda et al. Plant Pathol. 54:53, 2005. (2) J. F. Leslie and B. A. Summerell. The Fusarium Laboratory Manual. Blackwell Publishing, Ames, IA, 2006. (3) F. X. Tian et al. Acta Phytopathol. Sin. 11:27, 1981.

Signal transducer and activator of transcription 3 (STAT3) gene polymorphisms are associated with treatment outcomes in acute myeloid leukemia

INTRODUCTION

In the Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway, STAT3 is one of the most prominent prognosis factors for cancer and leukemia. STAT3 activation might promote cellular transformation and therefore have an important role in human tumors. This study aimed to investigate the relationship between STAT3 polymorphisms and treatment response of acute myeloid leukemia (AML) in the Chinese population.

METHODS

Three single-nucleotide polymorphisms (SNPs) were tested in 130 patients with AML. Genomic DNA was isolated from peripheral blood and assayed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS).

RESULTS

The results of response to chemotherapy showed that there were strong relationships between unfavorable cytogenetics, partial remission (and even no remission), and GG genotype frequency in rs9909659 (P = 0.01 and 0.03). Patients younger than 45 years were associated significantly with GA/AA genotype (P = 0.01).

CONCLUSIONS

The results of this study suggest that the GG genotype in rs9909659 might confer increased resistance to standard chemotherapy.

A comparison of slaughter performance and meat quality of pigs immunised with a gonadotrophin-releasing factor vaccine against boar taint with physically castrated pigs

The objective of this study was to evaluate the effect of vaccination against gonadotropin-releasing factor (GnRF) on carcass characteristics and meat quality and back fat quality. In total, 400 healthy male pigs were randomly assigned into two treatment groups: physically castrated males (CM) and vaccinated males (IM). CM pigs were physically castrated within 3 days of age. IM pigs received the GnRF vaccine twice, at 14 and 21 weeks of age. At the end of the experiment, 20 pigs of each treatment were weighed individually and slaughtered at 25 weeks of age. The longissimus muscle was collected to evaluate the meat quality including pH, drip loss, shear force, cooking loss, intramuscular fat, fatty acid composition and inosine monophosphate. Subcutaneous fat was sampled to evaluate fatty acid composition. IM pigs had a lower dressing percentage and were leaner (P < 0.01). The inosine monophosphate content was higher in pork from IM pigs than from CM pigs (P < 0.05). IM pigs had a higher content of polyunsaturated fatty acids in longissimus muscles than CM pigs (P < 0.01), mostly because of the higher linoleic acid content (P < 0.01). IM pigs had higher levels of unsaturated fatty acids in subcutaneous fat than CM pigs (P < 0.01), mostly because of the higher linoleic acid and linolenic acid (P < 0.01) and the lower myristic acid content (P < 0.01). There were no adverse effects of the GnRF vaccine on slaughter performance and meat quality of pigs. These results suggest that GnRF vaccine administered to pigs increases the inosine monophosphate content in longissimus muscles and the content of polyunsaturated fatty acids in longissimus muscles and back fat. Consequently, vaccination with Improvac for boar taint control will provide a good alternative to physical castration of male pigs.