[Research progress of mast cell activation syndrome]

Mast cells are the main effector cells in allergic diseases. Allergic diseases are mostly a direct result of mast cell mediator release effects, while allergen activation is only one of many triggers for mast cell mediator secretion. Increased mast cell number, high mast cell reactivity, or both can lead to abnormal mast cell activation. Mast cell activated syndrome (MCAS) refers to a group or a"spectrum"of mediator-related, symptomatically similar diseases in which mast cells are stimulated by multiple factors. The symptoms and signs of mast cell disease overlap with allergic diseases, but the etiology is different, which requires clinical attention. This article summarizes the research progress on mast cell activation syndrome in recent years thus increase awareness of the differential diagnosis.

Oridonin Enhances the Anti-Metastasis Effect of Oxaliplatinliplatin on Colorectal Cancer Liver Metastasis

The anti-metastasis effect of oridonin in combination with oxaliplatin on colorectal cancer liver metastasis was studied using a BALB/c nude mouse model. The liver condition, bloody ascites, cholestasis, and liver metastasis scores in the three groups receiving oxaliplatin combined with oridonin were significantly milder than in the control group and importantly the anti-migratory effect of oxaliplatin combined with oridonin was obviously the strongest (p<0.05). Oridonin possessed no hepatotoxicity; instead, it effectively alleviated liver injury caused by oxaliplatin. Oridonin alone or in combination with oxaliplatin significantly decreased serum levels of α-fetoprotein and carcinoembryonic antigen. Therefore, oridonin combined with oxaliplatin displays great potential to markedly increase the anti-metastasis effect of oxaliplatin in the treatment of liver metastases of colorectal cancer.

Effect of coronary disease characteristics on prognostic relevance of residual ischemia after stent implantation

Background

Although residual ischemia after revascularization is an important predictor of future cardiovascular events, its sensitivity and specificity to predict clinical events were relatively low, and data on which coronary disease characteristics affect prognostic implications of residual ischemia are limited.

Purpose

We aimed to investigate the influence of coronary disease characteristics on prognostic implications of residual ischemia after percutaneous coronary intervention (PCI).

Methods

This study included 1,476 patients with drug-eluting stent implantation and available pre- and post-PCI fractional flow reserve (FFR) measurements from the international post-PCI FFR registry (NCT04012281). Residual ischemia was defined as post-PCI FFR ≤0.80. Coronary disease characteristics with significant interaction hazard ratios (HRs) for clinical outcomes with residual ischemia were defined as interaction characteristics with residual ischemia (ICwRI). The primary outcome was target vessel failure (TVF)–a composite of cardiac death, target vessel myocardial infarction, and target vessel revascularization–at 2 years.

Results

The mean pre- and post-PCI FFR were 0.68±0.11 and 0.87±0.07, respectively. The 203 vessels (13.8%) with residual ischemia had higher risks of TVF compared to that for post-PCI FFR &gt;0.80 (HR 2.45, 95% confidence interval [CI] 1.50–4.00, P&lt;0.001). Among pre- and post-PCI angiographic characteristics, ICwRI with a significant interaction HR with residual ischemia (P&lt;0.10) included lesion length ≥40 mm, pre-PCI SYNTAX score &gt;17, and pre-PCI FFR ≤0.62 (Table). Each ICwRI had a direct prognostic effect not mediated by residual ischemia in mediation analysis. The association between an increased TVF risk and residual ischemia differed according to the number of ICwRI (p-for-interaction &lt;0.001). It was significant in patients with 0 or 1 ICwRI (HR 3.48, 95% CI 2.01–6.00, P&lt;0.001) but not in those with ≥2 ICwRI (HR 0.60, 95% CI 0.18–2.03, P=0.41) (Figure A). Compared to the residual ischemia group, patients without residual ischemia and those with 0 or 1 ICwRI showed a significantly lower risk of TVF (HR 0.32, 95% CI 0.19–0.54, P&lt;0.001), but those with ≥2 ICwRI had a similar risk of TVF as the residual ischemia group (HR 1.08, 95% CI 0.57–2.01, P=0.819) (Figure B). The prognostic impact of ≥2 ICwRI in patients without residual ischemia was consistent in all subgroups with different clinical characteristics.

Conclusions

Coronary disease characteristics including lesion length, SYNTAX score, and pre-PCI FFR affected the prognostic implications of residual ischemia. This prognostic relevance was attenuated in patients with multiple interacting characteristics. Therefore, comprehensive assessment of coronary disease characteristics with post-procedural coronary physiology can help better risk stratification and appropriate treatment planning after revascularization.

Funding Acknowledgement

Type of funding sources: None.

A NIR-triggered multifunctional nanoplatform mediated by Hsp70 siRNA for chemo-hypothermal photothermal synergistic therapy

Recently, hypothermal photothermal therapy (HPTT) seemed essential for the future clinical transformation of cancer optical therapies. However, at a lower working temperature, heat shock proteins (HSPs) seriously affect the anti-tumor effect of HPTT. This work reports a reasonable design of a dual-responsive nanoplatform for the synergistic treatment of chemotherapy and HPTT. We adopted a one-step method to wrap indocyanine green (ICG) into imidazole skeleton-8 (ZIF-8) and further loaded it with the chemotherapy drug doxorubicin (DOX). Furthermore, we introduced Hsp-70 siRNA to block the affection of HSPs at an upstream node, thereby avoiding the side effects of traditional heat shock protein inhibitors. The prepared ZIF-8@ICG@DOX@siRNA nanoparticles (ZID-Si NPs) could significantly improve the stability of siRNA to effectively down-regulate the expression of HSP70 protein during the photothermal therapy, thus realizing the pH-controlled and NIR-triggered release of the chemotherapeutical drug DOX. Moreover, tumors were also imaged accurately by ICG wrapped in ZID-Si nanoparticles. After the evaluation of the in vitro and in vivo photothermal effect as well as the anti-tumor activity, we found that the added Hsp-70 siRNA enhanced the synergistic anti-cancer activity of HPTT and chemotherapy. In summary, this work holds great potential in cancer treatment, and suggests better efficacy of synergistic chemo/HPTT than the single-agent therapy.

A versatile nanoplatform based on multivariate porphyrinic metal-organic frameworks for catalytic cascade-enhanced photodynamic therapy

In recent years, the antitumor application of photodynamic therapy (PDT) has gained widespread interest in treating solid tumors. Due to the hypoxic environment in tumors, the major limit of PDT seems to be the source of oxygen. In this work, we attempted to relieve hypoxia and enhance photodynamic therapy, and therefore, designed and assembled a catalytic cascade-enhanced PDT multifunctional nanoplatform. The mentioned platform termed UIO@Ca-Pt is based on porphyrinic metal-organic framework (UIO) combination, which is simultaneously loaded by CaO2 NPs with polydopamine (PDA) and then the Pt raw material to further improve biocompatibility and efficiency. In a tumor microenvironment, CaO2 could react with water to generate calcium hydroxide and hydrogen peroxide, which was further decomposed by Pt nanoparticles to form oxygen, thereby facilitating the generation of cytotoxic singlet oxygen by photosensitizer TCPP under laser irradiation. Both in vitro and in vivo experiment results confirmed the excellent oxygen production capacity and enhanced PDT effect of UIO@Ca-Pt. With guaranteed safety in PDT, the oxygen-supplying strategy might stimulate considerable interest in the development of various metal-organic materials with multifunctionality for tumor diagnosis and therapy.

[Patterns of recurrence after neoadjuvant chemoradiotherapy compared with surgery alone in esophageal cancer]

Associated with improvement in survival, the neoadjuvant therapy had become the mainstay of therapy for patients with locally advanced esophageal cancer. Despite a significantly better survival, the recurrence risk after neoadjuvant therapy remains considerably high, with recurrence rate of>40%. Thus, it's important to gain a thorough understanding of the recurrence patterns for developing effective tertiary prevention and follow-up strategies. The aim of this review was to compare the patterns of recurrence in patients with esophageal cancer who received preoperative therapy followed by surgery or surgery alone. It is found that the most frequent recurrence pattern was distant metastasis in esophageal cancer regardless receipt of neoadjuvant therapy or not, and the major effect of neoadjuvant therapy appears to be an improvement in local regional disease control without a reduction in systemic. This frustrating fact may explain the poor survival of esophageal cancer patients receiving neoadjuvant therapy.

[Correlation between preoperative inflammatory biomarkers and postoperative pneumonia or long-term prognosis in patients with esophageal cancer after neoadjuvant therapy]

Objective: To examine the correlation between neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR) and neutrophil-monocyte ratio (NMR) for postoperative pneumonia or long-term overall survival in patients with esophageal cancer after neoadjuvant therapy. Methods: The clinical data of 137 patients, including 111 males and 26 females, with the age of (M(QR))61(10) years (range: 45 to 75 years), undergoing radical resection of esophageal cancer after neoadjuvant therapy admitted at Department of Thoracic Surgery, West China Hospital from January 2016 to May 2019 were analyzed retrospectively. The blood routine one or two days before surgery and the occurrence of pneumonia after surgery were collected via hospital information system. The absolute count of neutrophils, lymphocytes and monocytes was recorded, to calculate NLR, LMR and NMR. The survival of patients was recorded systematically via follow-up. In the first part, the influencing factors of postoperative inflammation were analyzed, to group the patients into two groups according to the occurrence of postoperative pneumonia. χ2 test, t-test or rank-sum test were conducted for inter-group comparison. In the second part, cutoff values of inflammatory biomarkers were obtained with the receiver operating characteristic (ROC) curve and grouped, with postoperative pneumonia as endpoint criteria. Independent factors correlated with postoperative pneumonia were determined through univariate and multivariate Logistic regression analysis. In the third part, the analysis on prognosis factors was carried on, with the survival as endpoint criteria. Cutoff values of inflammatory biomarkers were obtained with X-Tile software and grouped. The survival analysis was carried on with univariate and multivariate Cox proportional hazards regression model, and the Kaplan-Meier curve was drawn finally. The results of survival analysis were verified by Log-rank test. Results: Median follow-up time was 614 (299) days (range: 382 to 1 612 days). Cutoff values of NLR, LMR, and NMR obtained via the ROC curve were 3.0, 3.9, and 6.2, respectively. According to the multivariate Logistic regression analysis, NLR>3.0 (OR=2.740, 95% CI: 1.221 to 6.152, P=0.015) and LMR>3.9 (OR=0.140, 95% CI: 0.022 to 0.890, P=0.037) were independent prognosis factors for postoperative pneumonia in patients with esophageal cancer after neoadjuvant therapy. Cutoff values of NLR, LMR, and NMR obtained with X-Tile software were 3.3, 4.2, and 7.2, respectively. Through multivariate Cox proportional risk regression analysis, late tumor ypTNM staging (8th AJCC) (HR=2.087, 95% CI:1.079 to 4.038, P=0.029), poor pathologic response (HR=2.251, 95% CI: 1.117 to 4.538, P=0.023), and LMR>4.2 (HR=0.347, 95% CI: 0.127 to 0.946, P=0.039) could be independent prognosis factors for overall survival. Kaplan-Meier survival analysis indicated that the overall survival of patients with LMR ≤4.2 was worse (P=0.002), with the 1-year overall survival rate of 82.9%, and the 1-year overall survival rate of patients with LMR>4.2 was 94.6%. Conclusion: Preoperative LMR ≤3.9 and NLR>3.0 can be considered as independent prognosis factors for postoperative pneumonia, while LMR≤4.2 as one of independent prognosis factors for overall survival.

A Novel Fluorescent Probe for Selective Detection of Hydrazine and Its Application in Imaging

In this work, a novel fluorescent probe with first-time-selected thiazepine backbone, TZPzine-1, was developed for selective detection of hydrazine in water samples and living cells. Chosen from our recent anti-cancer agents, TZPzine-1 inferred structurally based advantages of the optical adjustability and the hydrazine-trapping approach. It also showed applicable properties including high sensitivity (LOD = 50 nM), wide linear range (0–15 equiv.), high selectivity (especially from competing species), rapid response (within 20 min), and practical steadiness in various pH (6.0–11.0) and temperature (15–50 °C) conditions. To satisfy the interdisciplinary requirements in environmental toxicology, TZPzine-1 was successfully applied in water samples and living cells. We hope that the information in this work, as well as the concept of monitoring the nitrogen cycle, may be referable for future research on systematic management.

Recent Progress in the Development of Quinoline Derivatives for the Exploitation of Anti-Cancer Agents

BACKGROUND

Along with the progress in medicine and therapies, the exploitation of anti-cancer agents focused more on the vital signaling pathways and key biological macromolecules. With rational design and advanced synthesis, quinoline derivatives have been utilized frequently in medicinal chemistry, especially in developing anti-cancer drugs or candidates.

METHODS

Using DOI searching, articles published before 2020 all over the world have been reviewed as comprehensively as possible.

RESULTS

In this review, we selected the representative quinoline derivate drugs in market or clinical trials, classified them into five major categories with detailed targets according to their main mechanisms, discussed the relationship within the same mechanism, and generated a summative discussion with prospective expectations. For each mechanism, the introduction of the target was presented, with the typical examples of quinoline derivate drugs.

CONCLUSION

This review has highlighted the quinoline drugs or candidates, suited them into corresponding targets in their pathways, summarized and discussed. We hope that this review may help the researchers who are interested in discovering quinoline derivate anti-cancer agents obtain considerable understanding of this specific topic. Through the flourishing period and the vigorous strategies in clinical trials, quinoline drugs would be potential but facing new challenges in the future.

Covalently immobilize crude d-amino acid transaminase onto UiO-66-NH2 surface for d-Ala biosynthesis

Enzyme reaction has been accepted widely in numerous applications owing to the high efficiency and stereo-selectivity, as well as simple preparation by gene engineering. However, the fragility and complex purification process of the enzyme are long-standing problems which limit the large-scale application. One possible solution may be the enzyme immobilization. As one type of porous material with high loading capacity and designable functionality, Metal-Organic Frameworks (MOFs) are ideal choices for the immobilization of enzyme with a considerable interest in recent years. In this study, d-amino acid transaminase (DAT), an important enzyme for industrial synthesis of d-Ala, was covalently immobilized on the surface of a star MOFs material, UiO-66-NH_2. Interestingly, we found that the nanoscale hybrid enzyme UiO-66-NH₂-Gd-DAT not only maintained the high catalytic efficiency but also got rid of the interference of polluting enzymes, which meant that we could obtain efficient and stereo-selective immobilized enzyme without complex purification process. In general, our findings demonstrated that using UiO-66-NH₂ might be a promising strategy to immobilize enzyme and produce effective biocatalyst with high activity and stereo-selectivity.

Design and synthesis of a novel "turn-on" long range measuring fluorescent probe for monitoring endogenous cysteine in living cells and Caenorhabditis elegans

Cysteine (Cys) is an indispensable small organic molecule containing sulfhydryl groups, which has essential regulatory effects on the physiological process of human body. In this work, a red emission fluorescent probe TCFQ-Cys was designed and exploited based on 2-(3-cyano-4,5,5-trimethylfuran-2(5H)-ylidene) malononitrile-derivatives. The probe could effectively monitor Cys through the typical acrylate cleavage. The detecting system showed a red emission at 633 nm and the fluorescence was stable within the pH range of 6-9. The detection could be completed in 30 min. TCFQ-Cys presented high sensitivity with a detection limit of 0.133 μM and high selectivity towards Cys from other biological mercaptans. The most important feature was that the system had a wide linear range of 0-300 μM, which covered the physiological requirements of Cys detection. Subsequently, we conducted the biological imaging of Cys in MCF-7 cells and Caenorhabditis elegans (C. elegans). Therefore, TCFQ-Cys had a practical application prospect for further investigating the physiological function of Cys.

Recent Progress in Small Molecular Inhibitors of DNA Gyrase

BACKGROUND

In the past a few decades, with the abuse of antibiotics, bacterial resistance has enhanced constantly. More and more super species of bacteria, which are seriously threatening human health, have been discovered. Developing novel antibacterial agents to overcome the drug-resistance is an urgent duty. We all know that blocking the information-transfer of bacterial DNA and RNA is one of the effective ways to inhibit bacterial growth. Therefore, as the indispensable enzyme for DNA replication and transcription, DNA gyrase is one of the important targets for bacterial inhibitors. Accordingly, many inhibitors of DNA gyrase have also been developed.

METHODS

In this review, to highlight the recent progress in DNA gyrase inhibitors, the study in this field over the past three years (2017-2019) were summarized and organized based on their backbones or core moieties. Both of the subunits of DNA gyrase were taken into consideration.

RESULTS

These DNA gyrasee inhibitors have been classified based on their backbones or core moieties. After the comparison of the divided 14 categories, we could achieve some clues for future modification. In particular, we found that benzodiazepines and naphthalene heterocycles were the most common structures in the drug design. On the other hand, isopropyl and cyclopropyl have also been used in the drug design, which provides more inspiration for the investigations. Except for GSK2140944, which has entered the phase III clinical trial stage, other compounds here were not fully promulgate with their optimal pharmacokinetic activity.

CONCLUSION

We briefly summed up the current situation and future challenges on this topic. Through the discussion of the design strategies and drug effect, we hope that this review can provide focused direction for future researches.

A curcumin-analogous fluorescent sensor for cysteine detection with a bilateral-response click-like mechanism

A novel curcumin-analogous fluorescent sensor, DNP, was developed for cysteine detection with a bilateral-response click-like mechanism. DNP indicated high selectivity and practical sensitivity. It could recognize Cys from other biologically relevant molecules, especially, from GSH and Hcy. The most interesting point was that, with typical azide groups for sensing, DNP indicated a covalent binding procedure with Cys instead of a presupposed simple reduction for reductive sulfide. Moreover, the recognition occurred at both sides of the sensor. DNP could be utilized into the detection of endogenous and exogenous Cys in living cells. Though the specific optical performances of DNP still need optimization, this work supplied novel information for broadening the vision on fluorophores and mechanisms, for the monitoring of Cys and even other sulfur-containing species.

A novel series of benzothiazepine derivatives as tubulin polymerization inhibitors with anti-tumor potency

In this work, a series of diaryl benzo[b][1,4]thiazepine derivatives D1-D36 were synthesized and screened as tubulin polymerization inhibitors with anti-tumor potency. They were designed by introducing the seven-member ring benzothiazepine as the linker for CA-4 modification for the first time. Among them, the hit compound D8 showed potential on inhibiting the growth of several cancer cell lines (IC₅₀ values: 1.48 μM for HeLa, 1.47 μM for MCF-7, 1.52 μM for HT29 and 1.94 μM for A549), being comparable with the positive controls Colchicine and CA-4P. The calculated IC₅₀ value of D8 as an tubulin polymerization inhibitor was 1.20 μM. The results of the flow cytometry assay revealed that D8 could induce the mitotic catastrophe and the death of living cancer cells. D8 also indicated the anti-vascular activity. The possible binding pattern was implied by docking simulation, inferring the possibility of introducing interactions with the nearby tubulin chain. Since the novel structural trial has been conducted with preliminary discussion, this work might stimulate new ideas in further modification of tubulin-related anti-cancer agents and therapeutic approaches.

A fluorescent sensor for selective detection of hypochlorite and its application in Arabidopsis thaliana

Hypochlorite, as one of reactive oxygen species, has drawn much attention due to its essential roles in special biological events and disorders. The exogenous hypochlorite remains a risk for human, animals and plants. In this work, a novel water soluble quinolin-containing nitrone derivative T has been developed for fluorometric sensing hypochlorite. The response mechanism of T towards ClO^- was reported for the first time. In comparison with the reported sensors for ClO^-, the sensor T in this work exhibited advantages including high selectivity (80 fold over other analytes), rapid response (within 5 s) and lipid-water distribution transformation (LogP from 2.979 to 6.131). Further biological applications suggested that T was capable of monitoring both exogenous and endogenous ClO^- in living cells. The imaging in Arabidopsis thaliana indicated that the absorption and transmission of ClO^- in plant could be monitored by this sensor through the chlorine-related mechanism. This work might raise referable information for further investigations in the physiological and pathological events in both tumor and plants.

Two birds with one stone: a NIR fluorescent probe for mitochondrial protein imaging and its application in photodynamic therapy

Mitochondrial proteins, most of which are encoded in the nucleus and the rest of which are regulated by the mitochondrial genome, play pivotal roles in essential cellular functions. However, fluorescent probes that can be used for monitoring mitochondrial proteins have not yet been widely developed, thereby severely limiting the exploration of the functions of proteins in mitochondria. Towards this end, here we propose a near-infrared (NIR) fluorescence probe MPP to effectively illuminate the dynamic changes in mitochondrial proteins in live cells under oxidative stress, with excellent temporal and spatial resolution. Of particular importance, MPP extends the study of the pharmacology involved in apoptosis induced by anti-cancer drugs (hydroxycamptothecin (HCPT), epirubicin (Epi) and cyclophosphamide (CPA)) for the first time. Furthermore, employing a protein-activatable strategy, this probe could serve as an excellent phototherapeutic agent in photodynamic therapy (PDT). Finally, in vivo experiments suggest that this versatile probe can be used to image tumors in HeLa tumor-bearing mice for 24 h, which demonstrates that our probe could play a dual role as a robust phototherapeutic and imaging agent.

[The progress in management of esophagogastric variceal bleeding in cirrhotic portal hypertension]

Esophagogastric variceal bleeding (EVB) is the most dangerous complication of cirrhotic portal hypertension.With the continuous emergence of research findings on EVB, multiple disciplinary team, including internal medicine department, surgery department, intervention therapy department, radiology department, has become a new mode for the prevention and treatment of EVB. This article first reviewed the classification of esophageal varices and gastric varices, and then reviewed the recent research findings of EVB from three aspects: primary prophylaxis, active variceal bleeding treatment, and secondary prophylaxis.The aim was to provide new ideas for the individualized prevention and treatment of EVB.