Measurement of systemic oxygen consumption in patients during extracorporeal membrane oxygenation — description of a new method and the first clinical observations

Background:

Extracorporeal membrane oxygenation (ECMO) provides temporary life-saving support for patients with severe cardiac failure, but is associated with significant morbidity and mortality. While ECMO enables oxygen delivery (DO2), little is known about oxygen consumption (VO2), largely due to technical difficulties. We aimed to introduce the adaptation of respiratory mass spectrometry to measure VO2 in patients during ECMO and to use this unique model to determine the pathological dependency of VO2 on DO2 in humans.

Methods and Patients:

Respiratory mass spectrometry remains the ‘state-of-the-art’ method, allowing the highly sensitive and rapid measurement of VO2 in critically ill patients. The principle and design of the respiratory mass spectrometer are described, together with the setting up of this machine with the ECMO oxygenator and the native lungs of the patients. In two patients with severe dilated cardiomyopathy and little cardiac contraction, the decrease in pump flow and, hence, DO2 by 20% was associated with a decrease in VO2 by 5% and 8%, respectively, whereas the increase in pump flow was not associated with any significant change in VO2.

Conclusions:

The direct measurement of VO2 by respiratory mass spectrometry in ECMO patients provides a unique technique for clinical research on the metabolism and VO2-DO2 relationship in this special group of critically ill patients. Our pilot study is the first to demonstrate a pathological dependency of VO2 on DO2 in humans. Further studies are warranted with this technique to examine the changes and the factors affecting systemic oxygen transport in patients during ECMO.

Silencing of miR-148a in cancer-associated fibroblasts results in WNT10B-mediated stimulation of tumor cell motility

The tumor microenvironment has an important role in cancer progression. Here we show that miR-148a is downregulated in 15 out of 16 samples (94%) of cancer-associated fibroblasts (CAFs) compared with matched normal tissue fibroblasts (NFs) established from patients with endometrial cancer. Laser-capture microdissection of stromal cells from normal tissue and endometrial cancer confirmed this observation. Treatment of cells with 5-aza-deoxycytidine stimulated the expression of miR-148a in the majority of CAFs implicating DNA methylation in the regulation of miR-148a expression. Investigation of miR-148a function in fibroblasts demonstrated that conditioned media (CM) from CAFs overexpressing miR-148a significantly impaired the migration of five endometrial cancer cell lines without affecting their growth rates in co-culture experiments. Among predicted miR-148a target genes are two WNT family members, WNT1 and WNT10B. Activation of the WNT/β-catenin pathway in CAFs was confirmed by microarray analysis of gene expression and increased activity of the SuperTOPFlash luciferase reporter. We found elevated levels of WNT10B protein in CAFs and its level decreased when miR-148a was re-introduced by lentiviral infection. The 3'-UTR of WNT10B, cloned downstream of luciferase cDNA, suppressed luciferase activity when co-expressed with miR-148a indicating that WNT10B is a direct target of miR-148a. In contrast to the effect of miR-148a, WNT10B stimulated migration of endometrial cancer cell lines. Our findings have defined a molecular mechanism in the tumor microenvironment that is a novel target for cancer therapy.

Isradipine prevents rotenone-induced intracellular calcium rise that accelerates senescence in human neuroblastoma SH-SY5Y cells

Previous research demonstrated that rotenone (RT) induces neuronal injury partially by increasing intracellular Ca(2+) concentrations ([Ca(2+)]i), and inducing oxidative stress, leading to a neurodegenerative disorder. However, the mechanism of RT-induced injury remains elusive. Recent work revealed that Ca(2+) signaling is important for RT-induced senescence in human neuroblastoma SH-SY5Y cells. In the present study, we found that in SH-SY5Y cells, RT increased [Ca(2+)]i, senescence associated β-galactosidase activity, aggregation of lipofuscin, production of reactive oxygen species, G1/G0 cell cycle arrest, and activation of p53/p21 signaling proteins. In addition, RT decreased the expression of the signaling proteins for cell proliferation and survival, Cyclin-dependent kinase 2 (CDK2), cyclin D1, and Akt. Pretreatment of SH-SY5Y cells with isradipine, an L-type Ca(2+) channel blocker, or EGTA antagonized these effects of RT. These results suggested that application of isradipine might be a novel approach to prevent RT-induced neurodegenerative disorder such as Parkinson's disease.

MicroRNA-34b inhibits pancreatic cancer metastasis through repressing Smad3

Pancreatic cancer is characterized by extremely poor prognosis because of early recurrence and metastasis, and increasing evidence supports the critical role of microRNA in cancer progression. Here we identified that microRNA-34b functioned as a tumor-suppressing microRNA by targeting oncogenic Smad3 in pancreatic cancer. As a hypovascular tumor with a potential endoplasmic reticulum stress microenvironment, miR-34b was silenced after ER stress inducer thapsigargin (Tg) treatment and negatively regulated by ER stress chaperone glucose regulated protein 78 (GRP78) in pancreatic cancer cells. In human specimens, we found that miR-34b was down-regulated in pancreatic cancer tissues and low level of miR-34b expression was positively correlated with tumor-node-metastasis (TNM) stage, lymph-node metastasis and overall survival. Functional assays showed that over-expression of miR-34b inhibited pancreatic cancer progression in vitro and in vivo. In addition, Smad3 was demonstrated as a direct target of miR-34b and negatively regulated by miR- 34b at mRNA and protein levels. Luciferase assays confirmed that miR-34b could directly bind to the 3'untranslated region of Smad3. An inverse correlation between miR-34b and Smad3 was observed in 64 pancreatic cancer tissues. Our findings indicate that miR-34b acts as a tumor metastasis suppressor through negatively modulating Smad3, which may provide a potential therapeutic strategy for pancreatic cancer.

Room temperature single longitudinal mode laser output at 1645 nm from a laser-diode pumped Er:YAG nonplanar ring oscillator

We report on a monolithic 1645 nm Er:YAG nonplanar ring oscillator (NPRO) resonantly pumped by a fiber-coupled laser diode. In the experiment, an up to 550 mW single frequency laser output at 1645.2 nm was obtained, corresponding to a slope efficiency of 19.1% and an absolute efficiency of 6.0%. The beam quality M2 was measured to be 2.1 at the highest output power.

Profilin 1 potentiates apoptosis induced by staurosporine in cancer cells

The correlation between the loss of Profilin 1 (Pfn1) with tumor progression indicated that Pfn1 is a tumor suppressor in human carcinoma. The molecular mechanisms underlying Pfn1 tumor suppression has yet to be elucidated. In this study, we showed that Pfn1 overexpression sensitizes cancer cells to apoptosis through the typical intrinsic apoptotic pathway. Mechanistically, the increased Pfn1 expression mediated the upregulation of p53R273H, one of the most common tumor-associated hotspot mutations of p53, with transactivation deletion in tumorigenesis and increased localization of p53R273H in cytoplasm. Further studies showed that mutant p53R273H was involved in apoptosis induced by Staurosporine (STS) via transcription-independent mitochondrial functions. We observed (i) the increased cytosolic localization of p53R273H, (ii) the activation of phosphorylation at Ser15, (iii) its mitochondrial localization; Pfn1 acted as a positive regulator of these processes. We also found that Pfn1 interacted with p53R273H and thus facilitated its exertion over the transcription-independent activity in the cytoplasm during drug action. Our results define a new function and mechanism of Pfn1 demonstrating that the combined effect with apoptotic agents led to a synergistic increase in apoptosis. In addition, p53R273H abrogating DNA binding was found to play a major role in the Pfn1- sensitized apoptosis through a transactivation-independent and cytosolic activity.

Up-regulation of MBD1 promotes pancreatic cancer cell epithelial-mesenchymal transition and invasion by epigenetic down-regulation of E-cadherin

Methyl-CpG binding domain protein 1 (MBD1) has been implicated in transcriptional regulation, heterochromatin formation, genomic stability, cell-cycle progression and development. It is also predicted that MBD1 might be involved in tumor development and progression. However, whether and how MBD1 is involved in tumorigenesis, especially in pancreatic cancer (PC), is currently unknown. We found that MBD1 was significantly up-regulated in PC tissues compared with the surrounding normal tissues according to RT-PCR data. Tissue microarray (TMA) based immunohistochemical study from 58 surgically resected PC specimens indicated that higher MBD1 expression correlated with lymph node metastasis and poor survival in PC patients. Gain- and loss-of-function studies in vitro validated MBD1 as a potent oncogene promoting PC cell invasion as well as epithelial-mesenchymal transition (EMT). Mechanistically, MBD1 is associated with Twist and NAD-dependent deacetylase sirtuin-1 (SIRT1), thereby forming the Twist-MBD1-SIRT1 complex on the CDH1 promoter, which resulted in reduced E-cadherin transcription activity and increased cell EMT ability. Significantly, targeting MBD1 reversed the EMT phenotype of PC and restored sensitivity to chemotherapy. Taken together, the results of our study revealed a novel function of MBD1 in PC invasion and metastasis by providing a molecular mechanism underlying MBD1-promoted EMT. Thus MBD1 may serve as a potential therapeutic target for PC.

Galectin-1 prolongs survival of mouse liver allografts from Flt3L-pretreated donors

Liver allografts are spontaneously accepted across MHC barriers in mice. The mechanisms underlying this phenomenon remain poorly understood. Galectin-1, an endogenous lectin expressed in lymphoid organs, plays a vital role in maintaining central and peripheral tolerance. This study was to investigate the role of galectin-1 in spontaneous tolerance of liver allografts in mice, and to evaluate the therapeutic effects of galectin-1 on liver allograft rejection induced by donor Flt3L pretreatment. Blockade of the galectin-1 pathway via neutralizing antigalectin-1 mAb did not affect survival of the liver allografts from B6 donors into C3H recipients. Administration of rGal-1 significantly prolonged survival of liver allografts from Flt3L-pretreated donors and ameliorated Flt3L-triggered liver allograft rejection. This effect was associated with increased apoptosis of T cells in both allografts and spleens, decreased frequencies of Th1 and Th17 cells, decreased expression of Th1-associated cytokines (IL-12, IL-2 and IFN-γ), Th17-associated cytokines (IL-23 and IL-17) and granzyme B, in parallel with selectively increased IL-10 expression in liver allografts. In vitro, galectin-1 inhibited Flt3L-differentiated DC-mediated proliferation of allo-CD4(+) T cells and production of IFN-γ and IL-17. These data provide new evidence of the potential regulatory effects of galectin-1 in alloimmune responses in a murine model of liver transplantation.

ANXA2 remodels the microstructures of caco2 cells

ANXA2 was reported as a multiple tumors relevant gene expressed excessively in many tumor tissue types, especially in the cancers from digestion system, and its aberrant expression enhances the malignant properties of cancer cells. We suppose that the microstructure heterogeneity is important to maintain the malignancy of cancer cells, and excessive ANXA2 expression enhance the malignancy by remodeling the microstructures of cancer cells. To validate the proposal, the ANXA2-/-caco2 cell line was generated and the changes of the microstructures in the ANXA2 deleted and wild type caco2 cells were observed under fluorescence microscope, laser scanning confocal microscope and electron microscope. We found that ANXA2 deletion induced the pseudopodia shorted and spared, non-stained areas increased, mitochondria decreased, and the expression and polymerization of F-actin and β-tubulin changed. By the findings above, it is firstly reported in this paper that the ANXA2 excessive expression induces the significant changes of the microstructures in cancer cells. Combining our previous data together, our results indicate that ANXA2 excessive expression enhances the malignancy of cancers partially by remodeling the cell microstructures.

Pulsed radiofrequency treatment for idiopathic trigeminal neuralgia: a retrospective analysis of the causes for ineffective pain relief

We retrospectively analyzed the reasons for ineffective pain relief in patients with idiopathic trigeminal neuralgia (TN) who had undergone pulsed radiofrequency (PRF) treatment guided by computed tomography scan. We found that intraoperative PRF output voltage and electrical field intensity was significantly higher (p < 0.05) in the group who had received effective treatment than in the ineffective group. These findings suggest that optimizing PRF parameters and increasing the intraoperative output voltage (electric field intensity) may therefore, provide better pain relief in patients with TN.