Development of Co-Culture System of Hepatocytes with Bone Marrow Cells for Expression and Maintenance of Hepatic Functions

In this study, a co-culture system of hepatocytes and bone marrow cells (BMCs) was developed and characterized for the expression and maintenance of ammonia metabolism and albumin secretion activities. A culture medium supplemented with epidermal growth factor, insulin, L-proline, hydrocortisone and 20 % (v/v) heat-inactivated fetal bovine serum was developed. In addition to adhesive bone marrow cells, the co-existence of non-adhesive bone marrow cells was effective in expressing liver-specific functions for at least 3 weeks. On the other hand, experiments with Transwell in which cultured cells were separated by a semi-permeable membrane, suggested that soluble factors secreted by BMCs are the key components in the functional enhancement of cells. Furthermore, direct contact between hepatocytes and BMCs enhanced the formation of spheroids and the expression of liver specific functions. These results indicate that this co-culture system is promising in, for example, bioartificial liver, regenerative medicine, and liver function simulator applications.

Digoxin Transport by Renal Proximal Tubule Cells is Enhanced by Adhesive Synthetic RGD Peptide

Introduction

The dialyzer apparatus has been widely used as an artificial kidney in medical treatment. However, side effects such as amyloidosis have occurred during long-term treatment. Therefore, we focused on developing a hybrid artificial kidney with a filtration and reabsorption apparatus, but it was found that cells spread extensively and it is difficult to maintain a uniform monolayer with a regular cell shape on a collagen-coated substrate. The purpose of this study was to improve cell adhesion, uniform stable monolayer formation and active transport function by immobilization of arginine-glycine-aspartic acid (RGD) on the culture substratum.

Materials and Methods

Polycarbonate semipermeable membranes were coated with collagen, fibronectin, laminin and synthetic polypeptide, including RGD (Pronectin F). Cell adhesion and digoxin transport were estimated using a renal proximal tubule cell line that overexpressed the P-glycoprotein gene.

Results and Discussion

Under initial and confluent conditions, immobilized cell density in Pronectin F-coated wells was higher than that under other conditions. Transepithelial electrical resistance and digoxin transport activity on Pronectin F-coated membranes were the highest of all conditions. This might have been caused by uniform cell morphology and high cell density.

International trends in clozapine use: a study in 17 countries

OBJECTIVE

There is some evidence that clozapine is significantly underutilised. Also, clozapine use is thought to vary by country, but so far no international study has assessed trends in clozapine prescribing. Therefore, this study aimed to assess clozapine use trends on an international scale, using standardised criteria for data analysis.

METHOD

A repeated cross-sectional design was applied to data extracts (2005-2014) from 17 countries worldwide.

RESULTS

In 2014, overall clozapine use prevalence was greatest in Finland (189.2/100 000 persons) and in New Zealand (116.3/100 000), and lowest in the Japanese cohort (0.6/100 000), and in the privately insured US cohort (14.0/100 000). From 2005 to 2014, clozapine use increased in almost all studied countries (relative increase: 7.8-197.2%). In most countries, clozapine use was highest in 40-59-year-olds (range: 0.6/100 000 (Japan) to 344.8/100 000 (Finland)). In youths (10-19 years), clozapine use was highest in Finland (24.7/100 000) and in the publicly insured US cohort (15.5/100 000).

CONCLUSION

While clozapine use has increased in most studied countries over recent years, clozapine is still underutilised in many countries, with clozapine utilisation patterns differing significantly between countries. Future research should address the implementation of interventions designed to facilitate increased clozapine utilisation.

Health state utility values and patient-reported outcomes before and after vertebral and non-vertebral fractures in an osteoporosis clinical trial

We assessed the health state utility value (HSUV) reductions associated with vertebral fractures using data collected in the Japanese Osteoporosis Intervention Trial-03 (JOINT-03). Our analysis revealed that assessment of HSUVs after morphometric vertebral fracture is important to capture the burden of vertebral fractures.

INTRODUCTION

Evaluation of the HSUV after fracture is important to calculate the quality-adjusted life years (QALYs) of osteoporosis patients, which is essential information in the context of health economic evaluation.

METHODS

JOINT-03 study patients were aged ≥65 years and treated with risedronate and vitamin K₂ or risedronate alone. Radiographic information and patient-reported outcomes measured by EQ-5D and a visual analogue scale (VAS) were assessed at registration and followed up after 6, 12, and 24 months. According to differences among the dates of these assessments and the radiographic information, we classified the follow-up HSUVs calculated based on EQ-5D results into before or after fracture categories regardless of clinical symptoms.

RESULTS

Among 2922 follow-up HSUVs, 201 HSUVs were categorized as HSUVs that were observed after incident vertebral fractures on X-ray films. The median time from the detection of an incident vertebral fracture until the EQ-5D assessment was 53 days (25th percentile, 0 day; 75th percentile, 357 days). The impact of incident vertebral fractures on HSUVs was quantified as -0.03. Among the five health profile domains on the EQ-5D, an incident vertebral fracture had significant effects on anxiety/depression, self-care, and usual activities.

CONCLUSIONS

The results suggest that incident morphometric vertebral fracture was associated with impairment of the HSUV for patients with osteoporosis not only immediately but also several months after the fracture.

Diabetes mellitus and risk of early-onset Alzheimer's disease: a population-based case-control study

BACKGROUND AND PURPOSE

Previous studies have reported that diabetes is a risk factor for both all-cause and vascular dementia; however, diabetes as a risk factor for Alzheimer's disease (AD) remains controversial. Therefore, the aim was to elucidate the association between diabetes and early-onset AD.

METHODS

A case-control study was conducted using a population-based database that included medical and pharmacy claims and insurance eligibility data, from beneficiaries of corporate employees and their dependent family members. Cases were aged 40-64 years and were first prescribed medications for AD between 2005 and 2016. Up to four controls matched for age, sex and hospital type were included for each case. Data were analyzed using conditional logistic regression and compared between the sexes.

RESULTS

Data from 371 patients with AD (mean age 56.3 ± 5.3 years; 48% female) and 1484 controls were analyzed. Use of antidepressants, antipsychotics and antithrombotics during the index month was higher amongst patients with AD (19.4%, 34.5% and 11.3%, respectively) than amongst controls (2.9%, 10.3% and 7.3%, respectively). Our findings suggest no evidence for an association between diabetes and risk of early-onset AD (adjusted odds ratio 1.31; 95% confidence interval 0.90-1.92). In the subgroup analyses, adjusted odds ratios in patients with diabetes were 0.73 (95% confidence interval 0.38-1.39) and 1.68 (95% confidence interval 1.06-2.67) for female and male patients, respectively.

CONCLUSIONS

There is no apparent association between diabetes and risk of early-onset AD in the total study population, although a weak association was observed amongst male patients.

Comparison of the quantitative analysis performance between pulsed voltage atom probe and pulsed laser atom probe

The difference in quantitative analysis performance between the voltage-mode and laser-mode of a local electrode atom probe (LEAP3000X HR) was investigated using a Fe-Cu binary model alloy. Solute copper atoms in ferritic iron preferentially field evaporate because of their significantly lower evaporation field than the matrix iron, and thus, the apparent concentration of solute copper tends to be lower than the actual concentration. However, in voltage-mode, the apparent concentration was higher than the actual concentration at 40K or less due to a detection loss of matrix iron, and the concentration decreased with increasing specimen temperature due to the preferential evaporation of solute copper. On the other hand, in laser-mode, the apparent concentration never exceeded the actual concentration, even at lower temperatures (20K), and this mode showed better quantitative performance over a wide range of specimen temperatures. These results indicate that the pulsed laser atom probe prevents both detection loss and preferential evaporation under a wide range of measurement conditions.

Mutual relationships between structural and functional changes in a PsbM-deletion mutant of photosystem II

Photosystem II (PSII) is a membrane protein complex that performs light-induced electron transfer and oxygen evolution from water. PSII consists of 19 or 20 subunits in its crystal form and binds various cofactors such as chlorophyll a, plastoquinone, carotenoid, and lipids. After initial light excitation, the charge separation produces an electron, which is transferred to a plastoquinone molecule (Q_A) and then to another plastoquinone (Q_B). PsbM is a low-molecular-weight subunit with one transmembrane helix, and is located in the monomer–monomer interface of the PSII dimer. The function of PsbM has been reported to be stabilization of the PSII dimer and maintenance of electron transfer efficiency of PSII based on previous X-ray crystal structure analysis at a resolution of 4.2 Å. In order to elucidate the structure–function relationships of PsbM in detail, we improved the quality of PSII crystals from a PsbM-deleted mutant (ΔPsbM-PSII) of Thermosynechococcus elongatus, and succeeded in improving the diffraction quality to a resolution of 2.2 Å. X-ray crystal structure analysis of ΔPsbM-PSII showed that electron densities for the PsbM subunit and neighboring carotenoid and detergent molecules were absent in the monomer–monomer interface. The overall structure of ΔPsbM-PSII was similar to wild-type PSII, but the arrangement of the hydrophobic transmembrane subunits was significantly changed by the deletion of PsbM, resulting in a slight widening of the lipid hole involving Q_B. The lipid hole-widening further induced structural changes of the bicarbonate ion coordinated to the non-heme Fe(ii) atom and destabilized the polypeptide chains around the Q_B binding site located far from the position of PsbM. The fluorescence decay measurement indicated that the electron transfer rate from Q_A to Q_B was decreased in ΔPsbM-PSII compared with wild-type PSII. The functional change in electron transfer efficiency was fully interpreted based on structural changes caused by the deletion of the PsbM subunit.

Pressure-induced nano-crystallization of silicate garnets from glass

Transparent ceramics are important for scientific and industrial applications because of the superior optical and mechanical properties. It has been suggested that optical transparency and mechanical strength are substantially enhanced if transparent ceramics with nano-crystals are available. However, synthesis of the highly transparent nano-crystalline ceramics has been difficult using conventional sintering techniques at relatively low pressures. Here we show direct conversion from bulk glass starting material in mutianvil high-pressure apparatus leads to pore-free nano-polycrystalline silicate garnet at pressures above ∼10 GPa in a limited temperature range around 1,400 °C. The synthesized nano-polycrystalline garnet is optically as transparent as the single crystal for almost the entire visible light range and harder than the single crystal by ∼30%. The ultrahigh-pressure conversion technique should provide novel functional ceramics having various crystal structures, including those of high-pressure phases, as well as ideal specimens for some mineral physics applications.

It is suggested that the optical and mechanical properties of transparent ceramics become very favourable if they can be synthesized as nanocrystals. Here, the authors report direct conversion of bulk glass starting material to pore-free nano-polycrystalline silicate garnet at high pressure and temperature.

Randomized phase III study of bevacizumab plus FOLFIRI and bevacizumab plus mFOLFOX6 as first-line treatment for patients with metastatic colorectal cancer (WJOG4407G)

BACKGROUND

FOLFIRI and FOLFOX have shown equivalent efficacy for metastatic colorectal cancer (mCRC), but their comparative effectiveness is unknown when combined with bevacizumab.

PATIENTS AND METHODS

WJOG4407G was a randomized, open-label, phase III trial conducted in Japan. Patients with previously untreated mCRC were randomized 1:1 to receive either FOLFIRI plus bevacizumab (FOLFIRI + Bev) or mFOLFOX6 plus bevacizumab (mFOLFOX6 + Bev), stratified by institution, adjuvant chemotherapy, and liver-limited disease. The primary end point was non-inferiority of FOLFIRI + Bev to mFOLFOX6 + Bev in progression-free survival (PFS), with an expected hazard ratio (HR) of 0.9 and non-inferiority margin of 1.25 (power 0.85, one-sided α-error 0.025). The secondary end points were response rate (RR), overall survival (OS), safety, and quality of life (QoL) during 18 months. This trial is registered to the University Hospital Medical Information Network, number UMIN000001396.

RESULTS

Among 402 patients enrolled from September 2008 to January 2012, 395 patients were eligible for efficacy analysis. The median PFS for FOLFIRI + Bev (n = 197) and mFOLFOX6 + Bev (n = 198) were 12.1 and 10.7 months, respectively [HR, 0.905; 95% confidence interval (CI) 0.723-1.133; P = 0.003 for non-inferiority]. The median OS for FOLFIRI + Bev and mFOLFOX6 + Bev were 31.4 and 30.1 months, respectively (HR, 0.990; 95% CI 0.785-1.249). The best overall RRs were 64% for FOLFIRI + Bev and 62% for mFOLFOX6 + Bev. The common grade 3 or higher adverse events were leukopenia (11% in FOLFIRI + Bev/5% in mFOLFOX6 + Bev), neutropenia (46%/35%), diarrhea (9%/5%), febrile neutropenia (5%/2%), peripheral neuropathy (0%/22%), and venous thromboembolism (6%/2%). The QoL assessed by FACT-C (TOI-PFC) and FACT/GOG-Ntx was favorable for FOLFIRI + Bev during 18 months.

CONCLUSION

FOLFIRI plus bevacizumab was non-inferior for PFS, compared with mFOLFOX6 plus bevacizumab, as the first-line systemic treatment for mCRC.

CLINICAL TRIALS NUMBER

UMIN000001396.

Triclosan (TCS) exposure impairs lipid metabolism in zebrafish embryos

Triclosan (TCS) is an active antimicrobial ingredient used in many household products, such as skin creams and toothpaste. It is produced in high volumes, and humans are directly exposed to it and dispose it on a daily basis. TCS has been found to contaminate water worldwide. This study aimed to understand the potential developmental and metabolic abnormalities caused by TCS exposure by using zebrafish as the experimental model. Four developmental stages (70-85% epiboly, 10-12 somite, prim-5, and 5dpf) were selected to perform in situ hybridization staining to investigate the effects of TCS on dorsal ventral patterning, segmentation, brain development, and organ formation. Results showed, in terms of developmental toxicology, that neither phenotypic nor molecular changes were found after 5 days of 250μg/L TCS exposure. However, such dosage of TCS exposure resulted in lipid droplet accumulation in the yolk sac, which might due to the deregulated mRNA expression level of beta-oxidation transcripts. This study showed that 250μg/L TCS exposure does not affect normal embryogenesis or organogenesis; however, there are concerns regarding possible impairment of lipid metabolism.

Comparison of the multidetector-row computed tomography findings of IgG4-related sclerosing cholangitis and extrahepatic cholangiocarcinoma

AIM

To compare the multidetector-row computed tomography (MDCT) findings of IgG4-related sclerosing cholangitis (IgG4-SC) and extrahepatic cholangiocarcinoma (EH-CCA).

MATERIALS AND METHODS

Two radiologists who had no knowledge of the patients' clinical information retrospectively evaluated the CT findings of patients with IgG4-SC (n=33) and EH-CCA (n=39) on a consensus basis. Another radiologist measured the biliary lesions. IgG4-SC was diagnosed using the Japan Biliary Association criteria (2012) or the Mayo Clinic's HISORt criteria. EH-CCA was diagnosed based on surgical findings.

RESULTS

Compared with EH-CCA, IgG4-SC exhibited the following findings significantly more frequently: (a) wall thickening alone, (b) concentric wall thickening, (c) smooth inner margins, (d) homogeneous attenuation in the arterial phase, (e) a lesion involving the intrapancreatic bile duct, (f) smooth outer margins, (g) fully visible lumen, (h) a funnel-shaped proximal bile duct, (i) skip lesions, and (j) abnormal pancreatic findings. Conversely, (k) dual-layered attenuation in all phases was significantly more common in EH-CCA. The specificity values of parameters (e-k) were >80%. Regarding dimensions, (l) the biliary lesions were longer in IgG4-SC than in EH-CCA. (m) The diameters of the dilated proximal common bile duct and (n) the dilated proximal intrahepatic bile duct were smaller in IgG4-SC than in EH-CCA.

CONCLUSION

A number of CT findings are useful for differentiating between IgG4-SC and EH-CCA. CT findings (e-k) are particularly useful for this purpose.

The Effects of Spinal Fusion on Lumbar Disc Degeneration in Patients with Adolescent Idiopathic Scoliosis: A Minimum 10-Year Follow-Up

STUDY DESIGN

Retrospective study.

OBJECTIVES

This study focused on patients with adolescent idiopathic scoliosis (AIS) who were followed up for more than 10 years, and assessed the influence of spinal balance on lumbar degenerative changes at distal unfused segments (DUS).

SUMMARY OF BACKGROUND DATA

Previous studies suggested that longer fusion segments may result in higher rates of occurrence of disc degeneration (DD) at unfused segments adjacent to the distal fused area. However, there are no existing studies that correlate the degree of DD to the location of lower instrumented vertebra (LIV) and the amount of the residual lumbar curve during the follow-up period.

METHODS

Radiologic measurements were recorded at the time of surgery, immediately after surgery, and 10 years after surgery. The Pfirrmann grading scale was used to rate the MR images of these patients. The presence of vertebral DD was also used to classify patients into DD+ and DD- groups.

RESULTS

93 patients with AIS participated in this study. The average age at the time of surgery was 15.2 years; the average follow-up time was 154 months. DD was found in 45 patients (48%) and L5/S1 was the most common (40%) location in those patients. The L1 group experienced DD at a frequency of 34%, whereas the frequency increased with lower LIV placement. There was a significant difference between DD+ and DD- in age at the time of operation, the L4 tilt (pre Op. and post. 10 years), and the number of mobile segments.

CONCLUSIONS

Disc degeneration occurred in 48% of the patients at the time of postop. 10 years. Disc degeneration had a tendency to occur in patients with greater preoperative and postoperative 10 years L4 tilt angle and fewer mobile segments in the lower lumbar spine.

LEVEL OF EVIDENCE

Level III.

Abstract P4-04-08: EphA4-deleted microenvironment regulates cancer development of isografted 4T1 murine breast cancer cells via reduction of an IGF1 signal

Background:

EphA4 (the erythropoietin-producing hepatocellular receptor A4) belongs to a large family of receptor tyrosine kinases that play critical roles in cancer progression. We have previously reported that the absence of EphA4 expression decreases the amount of IGF1 in the circulation and locally in tissues, which contributes to the short stature (Cell Reports 2012). It is known that 4T1 murine breast cancer is a good model of human metastatic breast cancer. 4T1 cells are also known to produce a large amount of granulocyte colony-stimulating factor which can cause extramedullary hematopoiesis associated with a poor recipient prognosis.

Aim:

To investigate whether EphA4-deleted microenvironment affects growth of primary tumors, tumor metastasis, and extramedullary hematopoiesis via a novel EphA4-mediated IGF1 synthesis pathway.

Methods:

We isografted 105 mouse breast cancer cells (4T1) into the left inguinal mammary fatpad of both EphA4-knockout (KO) and control wild type (WT) female littermate mice. The parameters evaluated in vivo were growth of the primary tumors, distribution of metastatic foci, number of peripheral blood leukocytes (PBL), and splenomegaly. To examine the effect of IGF1 treatment on these parameters, recombinant human IGF1 (5 mg/kg body weight (BW)/day) was subcutaneously injected into the EphA4-KO mice for 9 weeks starting 4 weeks before grafting 4T1 cells. And the corresponding WT control mice were treated with saline alone for the same period. We evaluated the extent of metastasis by counting the number of metastatic foci larger than 1 mm in diameter in the lung, heart, liver, kidney, adrenal glands, lymph nodes, peritoneum, pleura and ovary.

Results:

In the absence of IGF1 injection, both the weight of primary tumors and the number of metastatic tumor foci were significantly reduced in EphA4-KO mice as compared with those in control WT littermate mice (n=6 of each genotype, t-test P<0.005). Splenomegaly (n=6 of each genotype, t-test P<0.001) and the number of PBL (n=6 of each genotype, t-test P<0.005) were also markedly decreased in EphA4-KO mice. When treated with IGF1, EphA4-KO mice showed significant weight gain of the primary tumors to almost the level of WT mice, had a greatly increased number of metastatic tumors, and showed an enhanced PBL number to the level of WT mice. However, IGF1 treatment could not enhance splenomegaly.

Conclusions:

EphA4 expression in the tumor microenvironment plays an important role in tumor growth, metastasis, leukemoid reaction and splenomegaly. Deletion of EphA4 in the microenvironment delays primary tumor growth and metastasis and reduces leukemoid reaction mainly by regulating the amount of IGF1 in the circulation and tissues. However, splenomegaly might not solely be mediated by an IGF1 signal. Our findings may prove a new therapeutic target for breast cancer.

Citation Format: Xuefeng Jing, Takashi Sonoki, Masayasu Miyajima, Takahiro Sawada, Nanako Terada, Kenryo Furushima, Daiki Arai, Kazuki Kawakami, Kazushige Sakaguchi. EphA4-deleted microenvironment regulates cancer development of isografted 4T1 murine breast cancer cells via reduction of an IGF1 signal [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P4-04-08.