[Statement of the Austrian Society of Pneumology (ASP)]

The COVID-19 pandemic is currently a challenge worldwide. In Austria, a crisis within the health care system has so far been avoided. The treatment of patients with community-acquired pneumonia (CAP), including SARS-CoV‑2 infections, should continue to be based on evidence-based CAP guidelines during the pandemic. However, COVID-19-specific adjustments are useful. The treatment of patients with chronic lung diseases must be adapted during the pandemic, but must still be guaranteed.

Impact Ionization Induced by Terahertz Radiation in HgTe Quantum Wells of Critical Thickness

We report on the observation of terahertz (THz) radiation induced band-to-band impact ionization in HgTe quantum well (QW) structures of critical thickness, which are characterized by a nearly linear energy dispersion. The THz electric field drives the carriers initializing electron-hole pair generation. The carrier multiplication is observed for photon energies less than the energy gap under the condition that the product of the radiation angular frequency ω and momentum relaxation time τ _l larger than unity. In this case, the charge carriers acquire high energies solely because of collisions in the presence of a high-frequency electric field. The developed microscopic theory shows that the probability of the light-induced impact ionization is proportional to exp ( - E 0 2 / E 2 ) , with the radiation electric field amplitude E and the characteristic field parameter E ₀. As observed in experiment, it exhibits a strong frequency dependence for ω τ ≫ 1 characterized by the characteristic field E ₀ linearly increasing with the radiation frequency ω.

Surface Potential Simulation for Robust Electrode Placement by MRI Based Human Phantom with FEM Based Quasi-Static Solver for Bioimpedance Measurement

Estimating cardiac output (CO) and thoracic fluid content (TFC) by non-invasive measurement of thoracic electrical bioimpedance (TEB) is on the rise of becoming clinically established. Dynamic fluid management and detecting and trending excess quasi-static thoracic fluids are of particular interest to benefit the critically ill patient. While the advantages such as easy application and non-invasive assessment are intriguing, there are some challenges. In addition to artifacts due to the patient's movement, instability of the electrode-skin interfaces, the accuracy of the applied current and varying cable capacity because of motion, exact placement of electrodes - or lack thereof - must be considered. In particular the robustness of the electrode placement, i.e., the insensitivity to inaccuracy of electrode placement (actual sensor from the nominal). We propose a new technique for evaluation of electrode placement by simulation with MRI based human phantoms with FEM based quasi-static solver for bioimpedance measurement. Results: We identified alternative electrode positions which lead to an increase in robustness of bioimpedance measurements of up to 9.5 times compared to the standard electrode placement. Simulations suggested an improvement in ECG signal quality which was confirmed by a subject measurement.

Synthesis and biological evaluation of triterpenoid thiazoles derived from betulonic acid, dihydrobetulonic acid, and ursonic acid

In this work, 35 new derivatives of betulonic, dihydrobetulonic and ursonic acid were prepared including 30 aminothiazoles and all of them were tested for their in vitro cytotoxic activity in eight cancer cell lines and two non-cancer fibroblasts. Compounds with the IC₅₀ below 5 μM in CCRF-CEM cells and low toxicity in non-cancer fibroblasts (4m, 5c, 5m, 6c, 6m, 7b, and 7c) were further subjected to tests of pharmacological parameters yielding the final set for advanced biological evaluation (4m, 5m, 6m, and 7b). It was proved by several methods, that all of them trigger apoptosis via the intrinsic pathway and derivatives 5m and 7b are the most effective (IC₅₀ 2.4 μM and 3.6 μM). They are the best candidates to become potentially new anticancer drugs and will be subjected to in vivo tests in mice. In addition, compounds 6b and 6c deserve more attention because their activity is not limited only to chemosensitive CCRF-CEM cell line. Specifically, compound 6b is highly active against K562 leukemic cell line (0.7 μM) and its IC₅₀ activity in colon cancer HCT116 cell line is 1.0 μM. Compound 6c is active in both normal K562 and resistant K562-TAX cell lines (IC₅₀ 3.4 μM and 5.4 μM) and both colon cancer cell lines (HCT116 and HCT116p53^-/-, IC₅₀ 3.5 μM and 3.4 μM).

2-Deoxyglycoside Conjugates of Lupane Triterpenoids with High Cytotoxic Activity-Synthesis, Activity, and Pharmacokinetic Profile

A set of 41 glycosidic conjugates of pentacyclic triterpenes was synthesized in order to improve the solubility of highly cytotoxic parent compounds. Their in vitro cytotoxic activity was evaluated in 25 cancer cell lines and 2 noncancer fibroblasts. Fifteen compounds had high cytotoxicity on the T-lymphoblastic leukemia cell line CCRF-CEM and 6 of them were active in multiple cell lines of various histogenic origin and not toxic in fibroblasts. Compound 11a had IC₅₀ of 0.64 μM in CCRF-CEM cells, 0.60 μM in K-562 cells, and 0.37 μM in PC-3 cells; compound 12a had IC₅₀ of 0.64 μM in CCRF-CEM cells and 0.71 μM in SW620 cells; compound 17b had IC₅₀ of 0.86 μM in HCT116 cells and 0.92 μM in PC-3 cells. Compounds 11b and 12b were slightly less active than the previously mentioned derivatives; however, their solubility was significantly better, and therefore they were selected for the in vivo evaluation of the pharmacokinetic profile in mice. In both compounds, the maximum concentration in plasma was achieved very rapidly-the highest level in plasma was found 1 h after administration (22.2, respectively, 6.4 μM). For compound 12b, the resorption was followed with fast elimination, and 12 h after administration, the compound was not detected in plasma. In contrast, compound 11b was eliminated more slowly; it was still present in plasma after 12 h, but its concentration dropped below the detection limit after 24 h. The elimination half-time determined for compound 11b was 2.4 h and for compound 12b just about 1.4 h. These values are reasonable for further drug development.

Design and synthesis of pentacyclic triterpene conjugates and their use in medicinal research

Triterpenoids are natural products from plants and many other organisms that have various biological activities, such as antitumor, antiviral, antimicrobial, and protective activities. This review covers the synthesis and biological evaluation of pentacyclic triterpene (PT) conjugates with other molecules that have been found to increase the IC₅₀ or improve the pharmacological profile of the parent PT. Some of these molecules are designed to target specific proteins or cellular organelles, which has resulted in highly selective lead structures for drug development. Other PT conjugates are useful for investigating their mechanism of action. This concept has been very successful: 1) Many compounds, especially mitochondria-targeting PT conjugates, have reached a selective cytotoxicity at low nanomolar concentrations in cancer cells. 2) A number of PT conjugates have had high activity against HIV or the influenza virus. 3) Fluorescent PT conjugates have been able to visualize the PT in living cells, which has allowed quantification of the uptake and distribution of the PT within the cell. 4) Biotinylated PT conjugates have been used to identify target proteins, which may help to show their mechanism of action. 5) A large number of PT conjugates with polyethylene glycol (PEG), polyamines, etc. form nanometer-sized micelles that have a much better pharmacological profile than the PT alone. In summary, the connection of a PT to an appropriate modifying molecule has resulted in extremely useful semisynthetic compounds with a high potential to treat cancer or viral infections or compounds that are useful for the study of the mechanism of action of PTs at the molecular level.

Evaluation of Electrode Setups by MRI Based Human Phantom with FEM Based Quasi-Static Solver for Bioimpedance Measurement. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019;2019:3978-3982. [PMID: 31946743 DOI: 10.1109/embc.2019.8856693]

Transthoracic electrical bioimpedance (TEB) measurement for acquiring of hemodynamic parameters e.g. stroke volume (SV) and cardiac output (CO) becomes commonly used. For precise and reliable measurement, a good understanding of the measurement system is needed to provide robust electrode placement, reproducible results, and large signal amplitudes. We propose an evaluation by MRI based human phantom with FEM based quasi-static solver for electrode placement in bioimpedance measurement. Placements according to Osypka, Cheetah and Bernstein et al. were simulated and compared with measurements taken from a (real) human subject. As a parameter for evaluation of signal quality, the percentage of current passing through the descending aorta from the overall injected current is measured. The placement according to Osypka results in 1.46 % of current flow through the descending aorta (Cheetah placement 1.12 %, Bernstein et al. placement 0.877 %) for the male human phantom DUKE. The simulation was compared with a real human subject (with comparable age, height, weight) by calculating the baseline impedance (Z₀). The simulation seems to fit at best with Osypka placement, where the deviation between simulated baseline impedance and real human subject is 19.9 % (deviation for Cheetah 34.1 %, deviation for Bernstein 62.5 %). The simulation with MRI based human phantoms seems to be a very good basis for further investigations of current injection and bioimpedance measurement comprehension.

The enantioselective addition of 1-fluoro-1-nitro(phenylsulfonyl)methane to isatin-derived ketimines

An asymmetric organocatalytic addition of fluorinated phenylsulfonylnitromethane to isatin-derived ketimines was developed. The reaction was efficiently catalyzed by a chiral tertiary amine, cinchonine. This methodology provides a new type of optically active compound with two adjacent quaternary carbon stereocenters in good yield (up to 96%), with moderate diastereoselectivity (up to 5.7 : 1 dr) and excellent enantioselectivity (up to 98/96% ee).

A Synthetic Approach for the Rapid Preparation of BODIPY Conjugates and their use in Imaging of Cellular Drug Uptake and Distribution

A solid-phase synthetic (SPS) method was developed for the preparation of BODIPY-labeled bioactive compounds that allows for fast and simple synthesis of conjugates for use in fluorescent microscopy. The approach was used to visualize cellular uptake and distribution of cytotoxic triterpenes in cancer cells.

Synthesis and antiproliferative properties of new hydrophilic esters of triterpenic acids

To improve the properties of cytotoxic triterpenoid acids 1-5, a large set of hydrophilic esters was synthesized. We choose betulinic acid (1), dihydrobetulinic acid (2), 21-oxoacid 3 along with highly active des-E lupane acids 4 and 5 as a model set of compounds for esterification of which the properties needed to be improved. As ester moieties were used - methoxyethanol and 2-(2-methoxyethoxy)ethanol and glycolic unit (type a-d), pyrrolidinoethanol, piperidinoethanol and morpholinoethanol (type f-h), and monosaccharide groups (type i-l). As a result, 56 triterpenic esters (49 new compounds) were obtained and their cytotoxicity on four cancer cell lines and normal human fibroblasts was tested. All new compounds were fully soluble at all tested concentrations, which used to be a problem of the parent compounds 1 and 2. 16 compounds had IC₅₀ < 10 μM on at least one cancer cell line, 12 compounds had cytotoxicity of <10 μM against at least three of four tested cancer cell lines. The highest activity was found for compound 3c (1.8 μM on MCF7, 2.8 μM on HeLa, and 1.6 μM on G-361 cells) which also had no toxicity on non-cancerous BJ fibroblasts at the highest tested concentration (50 μM). High selective cytotoxicity was also found in compounds 1k, 2k, 3c, and 3i that are ideal candidates for drug development. Therefore, more studies to identify the mechanism of action were performed in case of 1k, 3c, and 3g such as effects on cell cycle and apoptosis. It was found that compounds 3c and 3g can induce apoptosis via caspase-3 activation and modulation of protein Bcl-2 in G-361 cells. In conclusion, compounds 1k, 3c, and 3g show high and selective cytotoxicity, therefore they are significantly better candidates for anti-cancer drug development than the parent acids 1-5.

Cytotoxic conjugates of betulinic acid and substituted triazoles prepared by Huisgen Cycloaddition from 30-azidoderivatives

In this work, we describe synthesis of conjugates of betulinic acid with substituted triazoles prepared via Huisgen 1,3-cycloaddition. All compounds contain free 28-COOH group. Allylic bromination of protected betulinic acid by NBS gave corresponding 30-bromoderivatives, their substitution with sodium azides produced 30-azidoderivatives and these azides were subjected to CuI catalysed Huisgen 1,3-cycloaddition to give the final conjugates. Reactions had moderate to high yields. All new compounds were tested for their in vitro cytotoxic activities on eight cancer and two non-cancer cell lines. The most active compounds were conjugates of 3β-O-acetylbetulinic acid and among them, conjugate with triazole substituted by benzaldehyde 9b was the best with IC50 of 3.3 μM and therapeutic index of 9.1. Five compounds in this study had IC50 below 10 μM and inhibited DNA and RNA synthesis and caused block in G0/G1 cell cycle phase which is highly similar to actinomycin D. It is unusual that here prepared 3β-O-acetates were more active than compounds with the free 3-OH group and this suggests that this set may have common mechanism of action that is different from the mechanism of action of previously known 3β-O-acetoxybetulinic acid derivatives. Benzaldehyde type conjugate 9b is the best candidate for further drug development.

Synthesis and Cytotoxic Activity of Triterpenoid Thiazoles Derived from Allobetulin, Methyl Betulonate, Methyl Oleanonate, and Oleanonic Acid

A total of 41 new triterpenoids were prepared from allobetulone, methyl betulonate, methyl oleanonate, and oleanonic acid to study their influence on cancer cells. Each 3-oxotriterpene was brominated at C2 and substituted with thiocyanate; subsequent cyclization with the appropriate ammonium salts gave N-substituted thiazoles. All compounds were tested for their in vitro cytotoxic activity on eight cancer cell lines and two non-cancer fibroblasts. 2-Bromoallobetulone (2 b) methyl 2-bromobetulonate (3 b), 2-bromooleanonic acid (5 b), and 2-thiocyanooleanonic acid (5 c) were best, with IC₅₀ values less than 10 μm against CCRF-CEM cells (e.g., 3 b: IC₅₀ =2.9 μm) as well as 2'-(diethylamino)olean-12(13)-eno[2,3-d]thiazole-28-oic acid (5 f, IC₅₀ =9.7 μm) and 2'-(N-methylpiperazino)olean-12(13)-eno[2,3-d]thiazole-28-oic acid (5 k, IC₅₀ =11.4 μm). Compound 5 c leads to the accumulation of cells in the G₂ phase of the cell cycle and inhibits RNA and DNA synthesis significantly at 1×IC₅₀ . The G₂ /M cell-cycle arrest probably corresponds to the inhibition of DNA/RNA synthesis, similar to the mechanism of action of actinomycin D. Compound 5 c is new, active, and nontoxic; it is therefore the most promising compound in this series for future drug development. Methyl 2-bromobetulonate (3 b) and methyl 2-thiocyanometulonate (3 c) were found to inhibit nucleic acid synthesis only at 5×IC₅₀ . We assume that in 3 b and 3 c (unlike in 5 c), DNA/RNA inhibition is a nonspecific event, and an unknown primary cytotoxic target is activated at 1×IC₅₀ or lower concentration.

Testing Hadronic Interactions at Ultrahigh Energies with Air Showers Measured by the Pierre Auger Observatory

Ultrahigh energy cosmic ray air showers probe particle physics at energies beyond the reach of accelerators. Here we introduce a new method to test hadronic interaction models without relying on the absolute energy calibration, and apply it to events with primary energy 6-16 EeV (E_{CM}=110-170  TeV), whose longitudinal development and lateral distribution were simultaneously measured by the Pierre Auger Observatory. The average hadronic shower is 1.33±0.16 (1.61±0.21) times larger than predicted using the leading LHC-tuned models EPOS-LHC (QGSJetII-04), with a corresponding excess of muons.

Abstract 2077: Carbonate prodrugs derived from triterpenoids with high cytotoxic activity

Number of active anticancer compounds failed in the drug development due to unfavorable pharmacological properties. Design of pro-drugs is plausible approach to improve drug-like properties of biologically active compounds. Betulinic acid is a well-known representative of triterpenes, which possess a moderate cytotoxic activity and high selectivity towards the tumor cells. However, its pharmacological properties, particularly solubility and bioavailability, are poor. In order to improve pharmacology of betulinic acid derivatives, we have synthesized and tested activities of above 40 carbonate based prodrugs. We have developed methods for activation of “pro-drug” derivatives of betulinic acid by primary rat hepatocytes. Cytotoxicity of pro-drugs and activated metabolites was measured on the sensitive tumor cell line CCRF-CEM (human T-lymphoblastic leukemia). We have identified 21 prodrugs &gt;10 times more cytotoxic to CCRF-CEM cells after pre-incubation with rat hepatocytes. The best candidate pro-drug showed &gt;100 fold increase of cytotoxicity due to metabolic activation and it was cytotoxic to cancer cells in sub-micromolar concentrations. Our concept and predicted mechanisms of pro-drug activation were verified by HPLC-MS/MS where the pro-drugs and corresponding active compounds were identified and quantified. For the most active derivatives we have tested ADME characteristics and in vivo pharmacokinetics which showed significantly improved drug-like properties. Analysis of anti-cancer activities of the pro-drugs is currently being performed. This work was supported by grants LF_2015_031 and by the National Sustainability Program (LO1304).

Citation Format: Petr Dzubak, Renata Burianova, Martina Michalova, Barbora Liskova, Milan Urban, Jan Sarek, Adela Galandakova, Jitka Ulrichova, Marian Hajduch. Carbonate prodrugs derived from triterpenoids with high cytotoxic activity. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 2077.

Determination of two mercapturic acids related to crotonaldehyde in human urine: influence of smoking

Crotonaldehyde, an αβ-unsaturated aldehyde, and a potent alkylating agent, is present in many foods and beverages, ambient air and tobacco smoke. A previous study indicated that two metabolites, 3-hydroxy-1- methylpropylmercapturic acid (HMPMA) and 2-carboxy1-1-methylethylmercapturic acid (CMEMA), were excreted in rat urine after subcutaneous injection of crotonaldehyde. Herein, we report the development of a method based on liquid chromatography with tandem mass spectrometry (LC-MS/MS) and deuterated analytes as internal standards, for the determination of HMPMA and CMEMA in human urine. The limits of quantification of the method were 92 and 104 ng/mL for HMPMA and CMEMA, respectively. The calibration curves for both compounds were linear up to 7500 ng/mL with R2 >0.99. It was found that cigarette smokers excreted about three to five-fold more HMPMA, and only slightly elevated amounts of CMEMA, in their urine compared to non-smokers. In smokers, we also found significant correlations between the urinary excretion levels of HMPMA (but not CMEMA) and several markers of exposure for smoking, including the daily cigarette consumption, carbon monoxide in exhaled breath, salivary cotinine, and nicotine plus five of its major metabolites in urine. Smoking cessation or switching from smoking conventional cigarettes to experimental cigarettes with lower crotonaldehyde delivery led to significant reductions of urinary HMPMA excretion, but not CMEMA excretion. Alcohol consumption did not influence either urinary HMPMA or CMEMA excretion. We conclude that HMPMA is a potentially useful biomarker for smoking-related exposure to crotonaldehyde.