Bevacizumab Exacerbates Paclitaxel-Induced Neuropathy: A Retrospective Cohort Study

Background

Bevacizumab (BEV), a humanized anti-vascular endothelial growth factor (VEGF) monoclonal antibody, enhances the antitumor effectiveness of paclitaxel (PTX)-based chemotherapy in many metastatic cancers. A recent study in mice showed that VEGF receptor inhibitors can interfere with the neuroprotective effects of endogenous VEGF, potentially triggering the exacerbation of PTX-induced neuropathy. In clinical trials, exacerbation of neuropathy in patients who received PTX combined with BEV (PTX+BEV) has generally been explained by increased exposure to PTX owing to the extended duration of chemotherapy. We investigated whether the concurrent use of BEV is associated with the exacerbation of PTX-induced neuropathy.

Methods

Female patients with breast cancer who had received weekly PTX or PTX+BEV from September 2011 through May 2016 were studied retrospectively. PTX-induced neuropathy was evaluated at the same time points (at the 6^th and 12^th courses of chemotherapy) in both cohorts. A multivariate Cox proportional-hazards model was used to assess the independent effect of BEV on the time to the onset of neuropathy.

Results

A total of 107 patients (median age, 55 years; range, 32–83) were studied. Sixty-one patients received PTX as adjuvant chemotherapy, 23 received PTX for metastatic disease, and 23 received PTX+BEV for metastatic disease. Peripheral sensory neuropathy was worse in patients who received PTX+BEV than in those who received PTX alone: at the 6^th course, Grade 0/1/2/3 = 4/13/4/0 vs. 25/42/6/0 (P = 0.095); at the 12^th course, 2/3/11/3 vs. 7/30/23/2 (P = 0.016). At the 12^th course, the incidence of Grade 2 or higher neuropathy was significantly higher in patients treated with PTX+BEV than in those treated with PTX alone (74% vs. 40%; P = 0.017). In multivariate analysis, BEV was significantly associated with an increased risk of neuropathy (HR 2.32, 95% CI 1.21–4.44, P = 0.012).

Conclusions

The concurrent use of BEV could worsen PTX-induced neuropathy in patients with breast cancer.

Efficacy of Whole Bowel Irrigation Using Solutions with or without Adsorbent in the Removal of Paraquat in Dogs

1 The efficacy of whole bowel irrigation with a solution containing either polyethylene glycol (PEG) with electrolyte or an adsorbent (Kayexalate™) with a cathartic (sorbitol) was investigated in 18 dogs who had been given 250 mg kg -1 paraquat dichloride via a jejunal tube to eliminate the influence of gastric absorption.

2 Plasma paraquat concentrations 2 and 3 h after the initiation of bowel irrigation and at the end of the study (5 h later) were significantly lower in the bowel irrigation groups than in the control (no bowel irrigation) group.

3 The total body clearances of paraquat in the bowel irrigation groups were significantly greater than in the control group.

4 There were no significant differences between the two different irrigation solution groups in plasma paraquat concentration, the area under the plasma concentration time curve and the total body clearance.

5 In the PEG with electrolyte group, about 70% of the administered dose of paraquat was removed by means of bowel irrigation (n=4).

6 The adjunction of the adsorbent had no beneficial effects.

7 Haemodynamic changes associated with whole bowel irrigation were unremarkable except that right atrial and pulmonary arterial pressures were elevated in the latter part of the study.

Activation of c-Jun N-terminal kinase by Akabane virus is required for apoptosis

Akabane virus (AKAV) belongs to the Simbu serogroup of the genus Orthobunyavirus in the family Bunyaviridae. It has been shown that AKAV induces apoptosis in mammalian cells. It is necessary to understand the signaling pathways involved in AKAV-induced apoptosis to further elucidate the molecular virology of AKAV. c-Jun N-terminal kinase (JNK) and p38 mitogen-activated protein kinase (MAPK) are mediators of apoptosis; therefore, we investigated the roles of JNK and p38 MAPK cascades in AKAV-infected cells. We found that JNK and p38 MAPK as well as their downstream substrates, c-Jun and heat shock protein 27 (HSP27), were phosphorylated in response to AKAV infection. A JNK inhibitor (SP600125) inhibited AKAV-mediated apoptosis whereas a p38 MAPK inhibitor (SB203580) did not. We conclude that AKAV infection activates the JNK and p38 MAPK signaling pathways, and the JNK cascade plays a crucial role in AKAV-induced apoptosis in vitro.

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JNK and p38 MAPK were phosphorylated in response to Akabane virus infection.

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Downstream substrates, c-Jun and heat shock protein 27, were also phosphorylated by viral infection.

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JNK inhibitor (SP600125) inhibited AKAV-mediated apoptosis whereas a p38 MAPK inhibitor (SB203580) did not.

Stiff substrates increase YAP-signaling-mediated matrix metalloproteinase-7 expression

Abnormally stiff substrates have been shown to trigger cancer progression. However, the detailed molecular mechanisms underlying this trigger are not clear. In this study, we cultured T84 human colorectal cancer cells on plastic dishes to create a stiff substrate or on collagen-I gel to create a soft substrate. The stiff substrate enhanced the expression of matrix metalloproteinase-7 (MMP-7), an indicator of poor prognosis. In addition, we used polyacrylamide gels (2, 67 and 126 kPa) so that the MMP-7 expression on the 126-kPa gel was higher compared with that on the 2-kPa gel. Next, we investigated whether yes-associated protein (YAP) affected the MMP-7 expression. YAP knockdown decreased MMP-7 expression. Treatment with inhibitors of epidermal growth factor receptor (EGFR) and myosin regulatory light chain (MRLC) and integrin-α2 or integrin-β1 knockdown downregulated MMP-7 expression. Finally, we demonstrated that YAP, EGFR, integrin-α2β1 and MRLC produced a positive feedback loop that enhanced MMP-7 expression. These findings suggest that stiff substrates enhanced colorectal cancer cell viability by upregulating MMP-7 expression through a positive feedback loop.

Nongenomic effects of fluticasone propionate and budesonide on human airway anion secretion

This study investigated the physiological effects of inhaled corticosteroids, which are used widely to treat asthma. The application of fluticasone propionate (FP, 100 μM) induced sustained increases in the short-circuit current (I(SC)) in human airway Calu-3 epithelial cells. The FP-induced I(SC) was prevented by the presence of H89 (10 μM, a protein kinase A inhibitor) and SQ22536 (100 μM, an adenylate cyclase inhibitor). The FP-induced responses involved bumetanide (a Na(+)-K(+)-2Cl(-) cotransporter inhibitor)-sensitive and 4,4'-dinitrostilbene-2,2'-disulfonic acid (an inhibitor of HCO(3)(-)-dependent anion transporters)-sensitive components, both of which reflect basolateral anion transport. Further, FP augmented apical membrane Cl(-) current (I(Cl)), reflecting cystic fibrosis transmembrane conductance regulator (CFTR)-mediated conductance, in the nystatin-permeabilized monolayer. In I(SC) and I(Cl) responses, FP failed to enhance the responses to forskolin (10 μM, an adenylate cyclase activator). Nevertheless, we found that FP synergistically increased cytosolic cAMP concentrations in combination with forskolin. All these effects of FP were reproduced with the use of budesonide. Collectively, inhaled corticosteroids such as FP and budesonide stimulate CFTR-mediated anion transport through adenylate cyclase-mediated mechanisms in a nongenomic fashion, thus sharing elements of a common pathway with forskolin. However, the corticosteroids cooperate with forskolin for synergistic cAMP production, suggesting that the corticosteroids and forskolin do not compete with each other to exert their effects on adenylate cyclase. Considering that such synergism was also observed in the FP/salmeterol combination, these nongenomic aspects may play therapeutic roles in mucus congestive airway diseases, in addition to genomic aspects that are generally recognized.

Suitability of polymers as screw post materials in primary teeth: an in vitro study

AIM

Primary teeth undergo physiological root resorption during the transition to permanent dentition. The aim of this study was to assess the potential use of screw posts in core build-up for primary teeth while adequately retaining the crown restoration and allowing smooth physiological root resorption.

METHODS

To determine whether biodegradable polymers such as polyglycolic acid (PGA) and poly-L-lactic acid (PLLA) were appropriate as post materials, bending strength test and bending elastic modulus test were performed according to ISO standards. The prepared screw posts were immersed in 0.01 mol/L phosphate-buffered saline at 37 degrees Celsius, and changes due to hydrolysis were observed. Results In the bending strength test and bending elastic modulus test, PGA and PLLA showed similar values to composite resins used for core build-up. Although both showed adequate hydrolysis, the hydrolysis rate of PGA was higher than that of PLLA.

CONCLUSION

PGA and PLLA may be suitable as biodegradable screw posts for primary teeth because they have appropriate strength and hydrolysis ability.

First Report of Tomato leaf curl New Delhi virus Infecting Cucumber in Central Java, Indonesia

Cucumber (Cucumis sativus L.) is an important vegetable in Indonesia. Cucumber plants showing yellowy green mosaic symptoms on leaves were observed in Klaten, Central Java, Indonesia in August 2008. Total DNAs were extracted from symptomatic leaves, and the putative viral genomes were amplified by PCR with the Deng A and B primers (2). The PCR-amplified viral genomic DNA was sequenced. The remaining part of DNA-A was amplified with two primers sets (ToLCNDV-A1F 5'-ACCAACAGGCCGATGAACA-3' and ToLCNDV-A1R 5'-TTCCCACTATCTTCCTGTGCA-3'; ToLCNDV-A2F 5'-TCGAGTGTGATRAAGAYTGCA-3' and ToLCNDV-A2R 5'-ACTAACTAAGCATTGCAGCGTC-3' [R = A and G, Y = C and T]) and sequenced. The remaining part of DNA-B was amplified with two primers sets (ToLCNDV-B1F 5'-ARGAGTTYMCRYYTGTGGA-3' and ToLCNDV-B1R 5'-TKCWGTYGGTCATGTCGT-3'; ToLCNDV-B2F 5'-TCYGTCAATCKCATGTCGYGT-3' and ToLCNDV-B2R 5'-CCTTACGCGTATAYTGTYTRGA-3' [K = G and T, M = A and C, W = A and T]) and sequenced. Full-length DNA-A (2,739 nt; GenBank Accession No. AB613825) and DNA-B (2,690 nt; GenBank Accession No. AB613826) sequences of a bipartite Tomato leaf curl New Delhi virus (ToLCNDV) from Central Java were obtained and they were most similar to the corresponding sequences of both DNA-A and DNA-B of ToLCNDV-[cucumber:Thailand] (DNA-A, GenBank Accession No. AB330079; DNA-B, GenBank Accession No. AB330080) at 95.5 and 91.0% nucleotide identities, respectively. On the basis of high nucleotide sequence identity with ToLCNDV-[cucumber:Thailand] and the demarcation criteria in species identification (3), the virus isolate from the diseased cucumber in Central Java is considered as a variant of ToLCNDV and was accordingly named ToLCNDV-Indonesia[Indonesia:Java:Cucumber:2008] (ToLCNDV-ID[ID:Jav:Cuc:08]). Although the importance of begomovirus diseases on chili pepper (Solanaceae) is currently highly noticed in Indonesia (1), ToLCNDV was newly isolated from cucumber (Cucurbitaceae) in this study. Therefore, farmers in Indonesia should pay more attention to controlling begomovirus vectors, white flies, on Cucurbitaceae. To our knowledge, this is the first report of the natural occurrence of ToLCNDV in Indonesia. References: (1) P. J. D. Barro et al. Biol. Invas.10:411, 2008. (2) D. Deng et al. Ann. Appl. Biol. 125:327, 1994. (3) C. M. Fauquet et al. Arch. Virol. 153:783, 2008.

Capsaicinoids regulate airway anion transporters through Rho kinase- and cyclic AMP-dependent mechanisms

To investigate the effects of capsaicinoids on airway anion transporters, we recorded and analyzed transepithelial currents in human airway epithelial Calu-3 cells. Application of capsaicin (100 μM) attenuated vectorial anion transport, estimated as short-circuit currents (I(SC)), before and after stimulation by forskolin (10 μM) with concomitant reduction of cytosolic cyclic AMP (cAMP) levels. The capsaicin-induced inhibition of I(SC) was also observed in the response to 8-bromo-cAMP (1 mM, a cell-permeable cAMP analog) and 3-isobutyl-1-methylxanthine (1 mM, an inhibitor of phosphodiesterases). The capsaicin-induced inhibition of I(SC) was attributed to suppression of bumetanide (an inhibitor of the basolateral Na(+)-K(+)-2 Cl(-) cotransporter 1)- and 4,4'-dinitrostilbene-2,2'-disulfonic acid (an inhibitor of basolateral HCO(3)(-)-dependent anion transporters)-sensitive components, which reflect anion uptake via basolateral cAMP-dependent anion transporters. In contrast, capsaicin potentiated apical Cl(-) conductance, which reflects conductivity through the cystic fibrosis transmembrane conductance regulator, a cAMP-regulated Cl(-) channel. All these paradoxical effects of capsaicin were mimicked by capsazepine. Forskolin application also increased phosphorylated myosin phosphatase target subunit 1, and the phosphorylation was prevented by capsaicin and capsazepine, suggesting that these capsaicinoids assume aspects of Rho kinase inhibitors. We also found that the increments in apical Cl(-) conductance were caused by conventional Rho kinase inhibitors, Y-27632 (20 μM) and HA-1077 (20 μM), with selective inhibition of basolateral Na(+)-K(+)-2 Cl(-) cotransporter 1. Collectively, capsaicinoids inhibit cAMP-mediated anion transport through down-regulation of basolateral anion uptake, paradoxically accompanied by up-regulation of apical cystic fibrosis transmembrane conductance regulator-mediated anion conductance. The latter is mediated by inhibition of Rho-kinase, which is believed to interact with actin cytoskeleton.

Radiologic and neuropathologic findings in patients in a family with dentatorubral-pallidoluysian atrophy

We describe the cases of 2 patients, a father and his son, with DRPLA who underwent MR examinations prior to death and in whom postmortem examinations of the brain were obtained. MR imaging findings had the following features: 1) atrophy of the cerebellum and brain stem were the common findings, 2) high-signal-intensity lesions in the cerebral white matter and brain stem were observed on T2-weighted images in the patient with adult-onset DRPLA, 3) signal-intensity changes in the cerebral white matter were restricted to the periventricular white matter in the patient with juvenile-onset DRPLA, but these changes appear in the advanced stage, and 4) progressive cerebral atrophy was more marked in the patient with juvenile-onset DRPLA. In the patients with DRPLA, the abnormal high signal intensity of the cerebral white matter or brain stem on MR images reflect the loss of myelinated fibers. Cerebral atrophy mainly reflects atrophy of the neuropile.

Change in carrier type in high-k gate carbon nanotube field-effect transistors by interface fixed charges

We study the phenomenon of change in carrier type in carbon nanotube field-effect transistors (CNFETs) caused by the atomic layer deposition (ALD) of a HfO(2) gate insulator. When a HfO(2) layer is deposited on a CNFET, the type of carrier changes from p-type to n-type. The so-obtained n-type device has good performance and stability in air. The conductivity of such a device with a channel length of 0.7 microm is 11% of the quantum conductance 4e(2)/h. The contact resistance for electron current is estimated to be 14 kOmega. The n-type conduction of this CNFET is maintained for more than 100 days. The change in carrier type is attributed to positive fixed charges introduced at the interface between the HfO(2) and SiO(2) layers. We also propose a novel technique to control the type of conduction by utilizing interface fixed charges; this technique is compatible with Si CMOS process technology.