The adequacy of tissue microarrays in the assessment of inter- and intra-tumoural heterogeneity of infiltrating lymphocyte burden in leiomyosarcoma

The characterisation and clinical relevance of tumour-infiltrating lymphocytes (TILs) in leiomyosarcoma (LMS), a subtype of soft tissue sarcoma that exhibits histological heterogeneity, is not established. The use of tissue microarrays (TMA) in studies that profile TIL burden is attractive but given the potential for intra-tumoural heterogeneity to introduce sampling errors, the adequacy of this approach is undetermined. In this study, we assessed the histological inter- and intra-tumoural heterogeneity in TIL burden within a retrospective cohort of primary LMS specimens. Using a virtual TMA approach, we also analysed the optimal number of TMA cores required to provide an accurate representation of TIL burden in a full tissue section. We establish that LMS have generally low and spatially homogenous TIL burdens, although a small proportion exhibit higher levels and more heterogeneous distribution of TILs. We show that a conventional and practical number (e.g. ≤3) of TMA cores is adequate for correct ordinal categorisation of tumours with high or low TIL burden, but that many more cores (≥11) are required to accurately estimate absolute TIL numbers. Our findings provide a benchmark for the design of future studies aiming to define the clinical relevance of the immune microenvironments of LMS and other sarcoma subtypes.

Embryonal and Alveolar Rhabdomyosarcoma in Adults: Real-Life Data From a Tertiary Sarcoma Centre

AIMS

Embryonal and alveolar rhabdomyosarcoma (ERMS, ARMS) are subtypes of RMS that mainly occur in children, with relatively good outcomes. The incidence in adults is extremely low and survival is significantly worse compared with children. Data are scarce and literature generally combines all RMS subtypes, including pleomorphic RMS, which primarily occurs in adults and behaves more like undifferentiated pleomorphic sarcoma. The aim of this study was to evaluate patient and tumour characteristics, outcome and prognostic factors in adult patients with ERMS and ARMS.

MATERIALS AND METHODS

All adult (18 years or older) ERMS and ARMS patients (presenting 1990-2016) were identified from a prospectively maintained database and were included in this analysis.

RESULTS

Overall, 66 patients were included (42 men, 24 women). The median age at presentation was 28 years (range 18-71). The median overall survival for all ARMS (n = 42) and ERMS (n = 24) patients was 18 months, with a 5-year overall survival rate of 27%. Patients presenting with localised disease (n = 38, 58%) and metastatic disease (n = 25, 42%), had a 5-year overall survival rate of 36% and 11%, respectively. In univariate analysis we found alveolar subtype, fusion gene positivity, infiltrative tumour and metastatic presentation to be negative prognostic factors.

CONCLUSION

Survival in adult ERMS and ARMS patients is poor and the current data may be useful in the design of trials with novel agents. Ideally, paediatric and adult oncologists should set up trials together to get a better understanding of biological, genetic and clinically relevant factors in this disease.

The growth of turkeys 1. Growth of the body and feathers and the chemical composition of growth

1. The potential growth of modern turkey genotypes was measured using male and female BUT 6 (BUT) and Hybrid Converter (HYB) strains. At one-day-old, 720 male and 960 female poults were randomly allocated to 48 littered pens in two houses with 30 males or 40 females of each strain per pen. Five feeds of decreasing protein content were fed to both sexes during the growing period. 2. Birds were weighed at 1, 7, 14, 21, 35, 56, 77, 119 d (males only), 126 d (females only) and 140 d (males only) and, on each occasion, six birds were selected and removed for carcass analysis. 3. Growth was similar in both strains, but the growth rate of females appeared to decline relative to the earlier trajectory after 70 d, and this tendency being greater in HYB females. 4. HYB birds of both sexes had more feathers than BUT to 77 d, but thereafter these differences were non-significant. A single allometry between feather and body protein weight was observed over all genotypes with no differences apparent between sexes within strains. The Gompertz curve adequately described the growth of body protein, water and ash. 5. Body lipid (g/100g bodyweight) declined in the early stages of growth. This might reflect an energy deficiency in the diet or might indicate that the present description of lipid growth does not apply in turkeys as it does in other species. 6. Whereas the description of body growth, feather growth and the chemical components of growth given in this paper may not fully reflect the true potential of the genotypes used, nevertheless they provide useful information regarding the latest genotypes available in the turkey industry. Some of the observations suggested that current performance might be improved if further research is conducted regarding dietary energy transactions.

The growth of turkeys 2. Body components and allometric relationships

1. The relationships between the main components of the body and body protein among males and females of BUT 6 (BUT) and Hybrid Converter (HYB) turkey strains were examined. 2. The weights of breast meat, breast skin, drumstick meat, drumstick skin, thigh meat, thigh skin and wing-plus-skin as well as the head, neck, feet, blood, heart, liver and gizzard were measured at different stages of growth after which all components of each bird were minced together in order to determine the feather-free body protein weight of each bird sampled. Using the weights of the components and the protein content of each bird the allometric relationships between the components and body protein were determined and then compared for each strain x sex combination. 3. By excluding the breast weights at day-old and at 7 d, the remaining points produced an acceptable allometric relationship (R² = 0.992). Thigh weight could be predicted for all strain x sex combinations using one allometric equation, as could drumstick skin weight. Breast and thigh skin weights differed between males and females. Females of the HYB strain exhibited heavier drumstick and wing-plus-skin weights at a given body protein weight than the other three strain x sex combinations. These differences in both the constant term and regression coefficient in the allometric equations between genotypes are probably due to differences in the amount of lipid that is deposited in these tissues. 4. Sexes differed in the allometric relationships for head, feet, heart and liver, while breeds differed in gizzard weight. A common relationship between the four genotypes could be used to predict the weight of blood in the carcass. 5. The allometric equations fitted to the data in this trial enable the accurate prediction of the weights of the different physical components given the weight of body protein.

The use of laser-based diagnostics for the rapid identification of infectious agents in human blood

AIMS

To investigate the use of a laser-based method of detection as a potential diagnostic test for the rapid identification of infectious agents in human blood.

METHODS AND RESULTS

In this study, the successful differentiation of blood spiked with viruses, bacteria or protozoan parasites to clinically relevant levels is demonstrated using six blood types (O+, O-, AB+, A+, A-, B+) using blood from different individuals with blood samples prepared in two different laboratories. Experiments were performed using various compositions of filters, experimental set-ups and experimental parameters for spectral capture.

CONCLUSIONS

The potential for developing a laser-based diagnostic instrument to detect the presence of parasites, bacteria and viruses in human blood capable of providing analysis results within minutes was demonstrated.

SIGNIFICANCE AND IMPACT OF THE STUDY

There is an ongoing need for clinical diagnostics to adapt to newly emerging agents and to screen simultaneously for multiple infectious agents. A laser-based approach can achieve sensitive, multiplex detection with minimal sample preparation and provide rapid results (within minutes). These properties along with the flexibility to add new agent detection by simply adjusting the detection programming make it a promising tool for clinical diagnosis.

VIVD: Virtual in vitro distribution model for the mechanistic prediction of intracellular concentrations of chemicals in in vitro toxicity assays

In vitro toxicity testing routinely uses nominal treatment concentrations as the driver for measured toxicity endpoints. However, test compounds can bind to the plastic of culture vessels or interact with culture media components, such as lipids and albumin. Additionally, volatile compounds may partition into the air above culture media. These processes reduce the free concentrations of compound to which cells are exposed. Models predicting the freely dissolved concentrations by accounting for these interactions have been published. However, these have only been applied to neutral compounds or assume no differential ionisation of test compounds between the media and cell cytoplasm. Herein, we describe an in vitro distribution model, based on the Fick-Nernst Planck equation accounting for differential compound ionisation in culture medium and intracellular water. The model considers permeability of ionised and unionised species and accounts for membrane potential in the partitioning of ionised moieties. By accounting for lipid and protein binding in culture medium, binding to cell culture plastic, air-partitioning, and lipid binding in the cell, the model can predict chemical concentrations (free and total) in medium and cells. The model can improve in vitro in vivo extrapolation of toxicity endpoint by determining intracellular concentrations for translation to in vivo.

Sensitivity and specificity of microRNA-122 for liver disease in dogs

BACKGROUND

Current tests for diagnosing liver disease in dogs are sub-optimal. MicroRNA-122 (miR-122) is a sensitive and specific biomarker of liver injury in humans and rodents. Circulating miR-122 could have utility in identifying dogs with liver disease.

OBJECTIVE

Establish the reference interval for miR-122 in healthy dogs and determine performance in a range of dog breeds with liver disease and control animals with non-liver disease.

ANIMALS

Stored serum from 120 healthy dogs, 100 dogs with non-liver diseases, and 30 dogs with histologically confirmed liver disease was analyzed.

METHODS

Retrospective study. Medical records of dogs with liver disease, non-liver disease and healthy dogs were reviewed. Serum miR-122 concentrations were measured by PCR and compared with the characteristics of the dogs and their conventional clinical measurements.

RESULTS

In healthy dogs the 2.5th, 50th, and 97.5th quartiles of miR-122 were 110 (90% CI 80-114), 594 (505-682), and 3312 (2925-5144) copies/μL, respectively. There was no difference between healthy dogs and dogs with non-liver disease (median ± IQR: healthy dogs 609 [327-1014] copies/μL; non-liver disease 607 [300-1351] copies/μL). miR-122 was higher in dogs with liver disease (11 332 [4418-20 520] copies/μL, P < .001 compared to healthy dogs). miR-122 identified dogs with liver disease with high accuracy (receiver operating characteristic area under curve for comparison with healthy dogs: 0.93 [95% CI 0.86-0.99]). The upper limit of normal for healthy dogs (3312 copies/μL) had a sensitivity of 77% and specificity of 97% for identifying liver disease.

CONCLUSION AND CLINICAL IMPORTANCE

Liver disease can be sensitively and specifically diagnosed in dogs by measurement of miR-122.

Impact of the Spinal Instability Neoplastic Score on Surgical Referral Patterns and Outcomes

Background

The Spinal Instability Neoplastic Score (sins) was developed to identify patients with spinal metastases who may benefit from surgical consultation. We aimed to assess the distribution of sins in a population-based cohort of patients undergoing palliative spine radiotherapy (rt) and referral rates to spinal surgery pre-rt. Secondary outcomes included referral to a spine surgeon post-rt, overall survival, maintenance of ambulation, need for re-intervention, and presence of spinal adverse events.

Methods

We retrospectively reviewed ct simulation scans and charts of consecutive patients receiving palliative spine rt between 2012 and 2013. Data were analyzed using Student's t-test, Chi-squared, Fisher's exact, and Kaplan-Meier log-rank tests. Patients were stratified into low (<7) and high (≥7) sins groups.

Results

We included 195 patients with a follow-up of 6.1 months. The median sins was 7. The score was 0 to 6 (low, no referral recommended), 7 to 12 (intermediate, consider referral), and 13 to 18 (high, referral suggested) in 34%, 59%, and 7% of patients, respectively. Eleven patients had pre-rt referral to spine surgery, with a surgery performed in 0 of 1 patient with sins 0 to 6, 1 of 7 with sins 7 to 12, and 1 of 3 with sins 13 to 18. Seven patients were referred to a surgeon post-rt with salvage surgery performed in two of those patients. Primary and secondary outcomes did not differ between low and high sins groups.

Conclusion

Higher sins was associated with pre-rt referral to a spine surgeon, but most patients with high sins were not referred. Higher sins was not associated with shorter survival or worse outcome following rt.

Improved Antiviral Activity of a Polyamide Against High-Risk Human Papillomavirus Via N-Terminal Guanidinium Substitution

We report the synthesis of two novel pyrrole-imidazole polyamides with N-terminal guanidinium or tetramethylguanidinium groups and evaluate their antiviral activity against three cancer-causing human papillomavirus strains. Introduction of guanidinium improves antiviral activity when compared to an unsubstituted analog, especially in IC₉₀ values. These substitutions change DNA-binding preferences, while binding affinity remains unchanged.