Simvastatin modulates estrogen signaling in uterine leiomyoma via regulating receptor palmitoylation, trafficking and degradation

Uterine leiomyomas or fibroids are the most common tumors of the female reproductive tract. Estrogen (E2), a steroid-derived hormone, and its receptors (ERs), particularly ER-α, are important drivers for the development and growth of leiomyomas. We previously demonstrated that simvastatin, a drug used for hyperlipidemia, also possesses anti-leiomyoma properties. The aim of this work is to investigate the impact of simvastatin on ER-α signaling in leiomyoma cells, including its expression, downstream signaling, transcriptional activity, post-translational modification, trafficking and degradation. Primary and immortalized human uterine leiomyoma (HuLM) cells were used for in vitro experiments. Immunodeficient mice xenografted with human leiomyoma tissue explants were used for in vivo studies. Leiomyoma samples were obtained from patients enrolled in an ongoing double-blinded, phase II, randomized controlled trial. Here, we found that simvastatin significantly reduced E2-induced proliferation and PCNA expression. In addition, simvastatin reduced total ER-α expression in leiomyoma cells and altered its subcellular localization by inhibiting its trafficking to the plasma membrane and nucleus. Simvastatin also inhibited E2 downstream signaling, including ERK and AKT pathways, E2/ER transcriptional activity and E2-responsive genes. To explain simvastatin effects on ER-α level and trafficking, we examined its effects on ER-α post-translational processing. We noticed that simvastatin reduced ER-α palmitoylation; a required modification for its stability, trafficking to plasma membrane, and signaling. We also observed an increase in ubiquitin-mediated ER-α degradation. Importantly, we found that the effects of simvastatin on ER-α expression were recapitulated in the xenograft leiomyoma mouse model and human tissues. Thus, our data suggest that simvastatin modulates several E2/ER signaling targets with potential implications in leiomyoma therapy and beyond.

PERK in POMC neurons connects celastrol with metabolism

ER stress and activation of the unfolded protein response in the periphery as well as the central nervous system have been linked to various metabolic abnormalities. Chemically lowering protein kinase R–like ER kinase (PERK) activity within the hypothalamus leads to decreased food intake and body weight. However, the cell populations required in this response remain undefined. In the current study, we investigated the effects of proopiomelanocortin-specific (POMC-specific) PERK deficiency on energy balance and glucose metabolism. Male mice deficient for PERK in POMC neurons exhibited improvements in energy balance on a high-fat diet, showing decreased food intake and body weight, independent of changes in glucose and insulin tolerances. The plant-based inhibitor of PERK, celastrol, increases leptin sensitivity, resulting in decreased food intake and body weight in a murine model of diet-induced obesity (DIO). Our data extend these observations by demonstrating that celastrol-induced improvements in leptin sensitivity and energy balance were attenuated in mice with PERK deficiency in POMC neurons. Altogether, these data suggest that POMC-specific PERK deficiency in male mice confers protection against DIO, possibly providing a new therapeutic target for the treatment of diabetes and metabolic syndrome.

Quality Improvement of Cakes with Buckwheat Flour, and its Comparison with Local Branded Cakes

Buckwheat is one of the potential food ingredients for the functional food industry. A growing trend for consumer demand highlights the need for the development of composite flour-based bakery products like cookies and cakes. The aim of this study was to analysis the nutrient composition, and microbiological safety examination of buckwheat fortified cakes (BFC), as well as comparative evaluation with locally available branded cakes (LBC). BFC was prepared with the incorporation of 10, 20, 30, and 40% buckwheat flour in wheat flour to measure the quality and acceptability of cakes. As the concentration of buckwheat flour was increased up to 30%, BFC got the best quality, and high sensorial acceptability score evaluated by skilled panelists. BFC had the highest protein, fat, fiber, and micronutrients than all other LBC. No significant (P<0.05) changes were found in sensory tests of the tested cakes. On the basis of microbiological point of view, BFC was found acceptable up to 09 days. Therefore, cake prepared with the incorporation of 30% buckwheat in wheat flour is nutritionally more acceptable than other cakes available in Bangladesh.

Extracellular matrix and Hippo signaling as therapeutic targets of antifibrotic compounds for uterine fibroids

BACKGROUND

Uterine fibroids are highly prevalent, collagen-rich, mechanically stiff, fibrotic tumors for which new therapeutic options are needed. Increased extracellular matrix (ECM) stiffness activates mechanical signaling and Hippo/YAP promoting fibroid growth, but no prior studies have tested either as a therapeutic target. We tested the hypothesis that injection of a purified form of collagenase Clostridium histolyticum (CCH) that selectively digests type I and type III collagens would alter ECM stiffness, Hippo signaling, and selectively reduce fibroid cell growth. We also used two FDA-approved drugs, verteporfin and nintedanib, to elucidate the role of Hippo/YAP signaling in uterine fibroid and myometrial cells.

METHODS

The clinical trial was registered (NCT02889848). Stiffness of samples was measured by rheometry. Protein expression in surgical samples was analyzed via immunofluorescence. Protein and gene expression in uterine fibroid or myometrial cell lines were measured by real time PCR and western blot, and immunofluorescence.

RESULTS

Injection of CCH at high doses (0.1-0.2 mg/cm3 ) into fibroids resulted in a 46% reduction in stiffness in injected fibroids compared to controls after 60 days. Levels of the cell proliferation marker proliferative cell nuclear antigen (PCNA) were decreased in fibroids 60 days after injection at high doses of CCH. Key Hippo signaling factors, specifically the transcriptionally inactive phosphorylated YAP (p-YAP), was increased at high CCH doses, supporting the role of YAP in fibroid growth. Furthermore, inhibition of YAP via verteporfin (YAP inhibitor) decreased cell proliferation, gene and protein expression of key factors promoting fibrosis and mechanotransduction in fibroid cells. Additionally, the anti-fibrotic drug, nintedanib, inhibited YAP and showed anti-fibrotic effects.

CONCLUSIONS

This is the first report that in vivo injection of collagenase into uterine fibroids led to a reduction in Hippo/YAP signaling and crucial genes and pathways involved in fibroid growth. These results indicate that targeting ECM stiffness and Hippo signaling might be an effective strategy for uterine fibroids.

Application and evaluation of a low-cost PM sensor and data fusion with CMAQ simulations to quantify the impacts of prescribed burning on air quality in Southwestern Georgia, USA

Prescribed burning (PB) is a prominent source of PM_2.5 in the southeastern US and exposure to PB smoke is a health risk. As demand for burning increases and stricter controls are implemented for other anthropogenic sources, PB emissions tend to be responsible for an increasing fraction of PM_2.5 concentrations. Here, to quantify the effect of PB on air quality, low-cost sensors are used to measure PM_2.5 concentrations in Southwestern Georgia. The feasibility of using low-cost sensors as a supplemental measurement tool is evaluated by comparing them with reference instruments. A chemical transport model, CMAQ, is also used to simulate the contribution of PB to PM_2.5 concentrations. Simulated PM_2.5 concentrations are compared to observations from both low-cost sensors and reference monitors. Finally, a data fusion method is applied to generate hourly spatiotemporal exposure fields by fusing PM_2.5 concentrations from the CMAQ model and all observations. The results show that the severe impact of PB on local air quality and public health may be missed due to the dearth of regulatory monitoring sites. In Southwestern Georgia PM_2.5 concentrations are highly non-homogeneous and the spatial variation is not captured even with a 4-km horizontal resolution in model simulations. Low-cost PM sensors can improve the detection of PB impacts and provide useful spatial and temporal information for integration with air quality models. R² of regression with observations increases from an average of 0.09 to 0.40 when data fusion is applied to model simulation withholding the observations at the evaluation site. Adding observations from low-cost sensors reduces the underestimation of nighttime PM_2.5 concentrations and reproduces the peaks that are missed by the simulations. In the future, observations from a dense network of low-cost sensors could be fused with the model simulated PM_2.5 fields to provide better estimates of hourly exposures to smoke from PB.Implications: Prescribed burning emissions are a major cause of elevated PM_2.5 concentrations, posing a risk to human health. However, their impact cannot be quantified properly due to a dearth of regulatory monitoring sites in certain regions of the United States such as Southwestern Georgia. Low-cost PM sensors can be used as a supplemental measurement tool and provide useful spatial and temporal information for integration with air quality model simulations. In the future, data from a dense network of low-cost sensors could be fused with model simulated PM_2.5 fields to provide improved estimates of hourly exposures to smoke from prescribed burning.

Reliability and financial feasibility assessment of a community rainwater harvesting system considering precipitation variability due to climate change

This study proposes a community rainwater harvesting (RWH) system as an alternative water supply solution for Paikgacha, a water-scarce coastal urban area in Bangladesh. Although individual household-based RWH systems have been implemented in many areas in Bangladesh, to date, no study has been conducted designing a community RWH system and assessing its reliability and financial feasibility. This study employs historical observed and available climate model predicted future rainfall data into stormwater management model (SWMM) for rainfall-runoff simulation of the community RWH, and compares SWMM's performance with rational formula based estimation. We then calculate volumetric and time reliability of the proposed system and assess its financial viability. We observe good agreement in reliability curves generated by SWMM and rational formula-based model. Under the historical rainfall scenario, our proposed community RWH shows up to 99% reliability for 100 L per day household demand, given that proper community size and storage tank size are chosen. Predicted rainfall pattern of 2041-2070 period shows similar reliability-tank size relation to that of historical observed rainfall; however, predicted high precipitation intensity during 2021-2040 and 2071-2100 seem to assist the system in attaining higher reliability. Cost-benefit analysis indicates the financial viability of the proposed system. Finally, we develop a nomograph incorporating interactive factors of RWH, which would ease decision making by the policymakers regarding the implementation of community RWH.

Distribution of β-Thalassemia and Other Hemoglobinopathies in Bangladeshi University Students and Ready-Made Garment Workers

Background

The inheritable thalassemia and other structural hemoglobinopathies are prevalent globally. In Bangladesh, there is a scarcity of studies concerning thalassemia and other structural hemoglobinopathies. Hence, the present study investigated the prevalence and distribution of β-thalassemia and other hemoglobinopathies among the university students and ready-made garment (RMG) workers.

Methods

A cross-sectional study was conducted, whereas a total of 989 subjects were selected randomly from 10 garments industries (n=495) and five universities (n=494) for diagnosis and counseling from April 2018 to August 2018. Basic information related to the study and venous blood was collected and subjected to capillary Hb-electrophoresis for each participant.

Results

The present study identified thalassemia carriers and other hemoglobinopathies among 13.6% of the participants (14.1% university students and 13.2% RMG workers). The most common form of hemoglobin formation disorder was the Hb-E trait (10.5%), considering both participants’ groups. Other forms of hemoglobin formation disorders observed were a β-thalassemia trait, Hb-D trait, Hb-E disease, and β-thalassemia major. The hemoglobinopathies were significantly associated with the individuals who had a family history of thalassemia and were not vaccinated against hepatitis B in the total sample. Although not statistically suggestive, the most considerable portion (87.3%) of the carriers was unmarried in the present findings.

Conclusion

The present study findings are anticipated to help the public health authorities by providing novel data (of a neglected cohort, ie, RGM workers), facilitating the upcoming comprehensive national thalassemia prevention programs.

Characterization and profiling of bacteriocin-like substances produced by lactic acid bacteria from cheese samples

Bacteriocins have become biological weapons against harmful food pathogens and have attracted interest as tools for biopreservation. The aim of this study was to isolate, identify and characterize lactic acid bacterial (LAB) strains from cheese samples, partially purify potential bacteriocins and characterize their antimicrobial activity against pathogens. Bacteriocin-producing organisms were screened by Agar spot assay test. Initially, 25 LAB isolates were isolated from the cheese samples and identified as Lactobacillius spp., among them five strains were able to produce bacteriocin whose antimicrobial activates were analysed by agar-well-diffusion assay test against pathogenic organisms. Bacillus subtilis, Bacillus cereus, Staphylococcus aureus, Streptococcus thermophillus and Listeria monocytogens were inhibited, while Enterococcus faecalis, Salmonella typhi, Escherichia coli and Pseudomonas aeruginosa were resistant to the antimicrobial substances from LAB isolates. For optimal production of bacteriocin, LAB broth cultures were harvested at exponential phase. The molecular weights of the bacteriocins are between 7.0-15.0 kDa. The bacteriocins were characterized on the basis of their sensitivity to heat, pH, enzymes, NaCl and treatments with organic solvents. These results revealed that the bacteriocins from Lactobacillius spp. isolated from the cheese might have potential antimicrobial properties and give new insight in the development of bio-preservative agents to prevent and control pathogenic bacterial infection.

Traditional Herbal Medicines, Bioactive Metabolites, and Plant Products Against COVID-19: Update on Clinical Trials and Mechanism of Actions

SARS-CoV-2 is the latest worldwide pandemic declared by the World Health Organization and there is no established anti-COVID-19 drug to combat this notorious situation except some recently approved vaccines. By affecting the global public health sector, this viral infection has created a disastrous situation associated with high morbidity and mortality rates along with remarkable cases of hospitalization because of its tendency to be high infective. These challenges forced researchers and leading pharmaceutical companies to find and develop cures for this novel strain of coronavirus. Besides, plants have a proven history of being notable wellsprings of potential drugs, including antiviral, antibacterial, and anticancer therapies. As a continuation of this approach, plant-based preparations and bioactive metabolites along with a notable number of traditional medicines, bioactive phytochemicals, traditional Chinese medicines, nutraceuticals, Ayurvedic preparations, and other plant-based products are being explored as possible therapeutics against COVID-19. Moreover, the unavailability of effective medicines against COVID-19 has driven researchers and members of the pharmaceutical, herbal, and related industries to conduct extensive investigations of plant-based products, especially those that have already shown antiviral properties. Even the recent invention of several vaccines has not eliminated doubts about safety and efficacy. As a consequence, many limited, unregulated clinical trials involving conventional mono- and poly-herbal therapies are being conducted in various areas of the world. Of the many clinical trials to establish such agents as credentialed sources of anti-COVID-19 medications, only a few have reached the landmark of completion. In this review, we have highlighted and focused on plant-based anti-COVID-19 clinical trials found in several scientific and authenticated databases. The aim is to allow researchers and innovators to identify promising and prospective anti-COVID-19 agents in clinical trials (either completed or recruiting) to establish them as novel therapies to address this unwanted pandemic.

Radiosynthesis and Evaluation of Talazoparib and Its Derivatives as PARP-1-Targeting Agents

Poly (ADP-ribose) polymerase-1 (PARP-1) is a critical enzyme in the DNA repair process and the target of several FDA-approved inhibitors. Several of these inhibitors have been radiolabeled for non-invasive imaging of PARP-1 expression or targeted radiotherapy of PARP-1 expressing tumors. In particular, derivatives of olaparib and rucaparib, which have reduced trapping potency by PARP-1 compared to talazoparib, have been radiolabeled for these purposes. Here, we report the first radiosynthesis of [¹⁸F]talazoparib and its in vitro and in vivo evaluation. Talazoparib (3a″) and its bromo- or iodo-derivatives were synthesized as racemic mixtures (3a, 3b and 3c), and these compounds exhibit high affinity to PARP-1 (K_i for talazoparib (3a″): 0.65 ± 0.07 nM; 3a: 2.37 ± 0.56 nM; 3b: 1.92 ± 0.41 nM; 3c: 1.73 ± 0.43 nM; known PARP-1 inhibitor Olaparib: 1.87 ± 0.10 nM; non-PARP-1 compound Raclopride: >20,000 nM) in a competitive binding assay using a tritium-labeled PARP-1 radioligand [³H]WC-DZ for screening. [¹⁸F]Talazoparib (3a″) was radiosynthesized via a multiple-step procedure with good radiochemical and chiral purities (98%) and high molar activity (28 GBq/μmol). The preliminary biodistribution studies in the murine PC-3 tumor model showed that [¹⁸F]talazoparib had a good level of tumor uptake that persisted for over 8 h (3.78 ± 0.55 %ID/gram at 4 h and 4.52 ± 0.32 %ID/gram at 8 h). These studies show the potential for the bromo- and iodo- derivatives for PARP-1 targeted radiotherapy studies using therapeutic radionuclides.

Wnt/β-catenin signaling pathway in uterine leiomyoma: role in tumor biology and targeting opportunities

Uterine leiomyoma is the most common tumor of the female reproductive system and originates from a single transformed myometrial smooth muscle cell. Despite the immense medical, psychosocial, and financial impact, the exact underlying mechanisms of leiomyoma pathobiology are poorly understood. Alterations of signaling pathways are thought to be instrumental in leiomyoma biology. Wnt/β-catenin pathway appears to be involved in several aspects of the genesis of leiomyomas. For example, Wnt5b is overexpressed in leiomyoma, and the Wnt/β-catenin pathway appears to mediate the role of MED12 mutations, the most common mutations in leiomyoma, in tumorigenesis. Moreover, Wnt/β-catenin pathway plays a paracrine role where estrogen/progesterone treatment of mature myometrial or leiomyoma cells leads to increased expression of Wnt11 and Wnt16, which induces proliferation of leiomyoma stem cells and tumor growth. Constitutive activation of β-catenin leads to myometrial hyperplasia and leiomyoma-like lesions in animal models. Wnt/β-catenin signaling is also closely involved in mechanotransduction and extracellular matrix regulation and relevant alterations in leiomyoma, and crosstalk is noted between Wnt/β-catenin signaling and other pathways known to regulate leiomyoma development and growth such as estrogen, progesterone, TGFβ, PI3K/Akt/mTOR, Ras/Raf/MEK/ERK, IGF, Hippo, and Notch signaling. Finally, evidence suggests that inhibition of the canonical Wnt pathway using β-catenin inhibitors inhibits leiomyoma cell proliferation. Understanding the molecular mechanisms of leiomyoma development is essential for effective treatment. The specific Wnt/β-catenin pathway molecules discussed in this review constitute compelling candidates for therapeutic targeting.

Comparative effects of ascobin and glutathione on copper homeostasis and oxidative stress metabolism in mitigation of copper toxicity in rice

Copper (Cu) pollution of agricultural land is a major threat to crop production. Exogenous chemical treatment is an easily accessible and rapid approach to remediate metal toxicity, including Cu toxicity in plants. We compared the effects of ascobin (ASC; ascorbic acid:citric acid at 2:1) and glutathione (GSH) in mitigation of Cu toxicity in rice. Plants subjected to Cu stress displayed growth inhibition and biomass reduction, which were connected to reduced levels of chlorophylls, RWC, total phenolic compounds, carotenoids and Mg²⁺ . Increased accumulation of ROS and malondialdehyde indicated oxidative stress in Cu-stressed plants. However, application of ASC or GSH minimized the inhibitory effects of Cu stress on rice plants by restricting Cu²⁺ uptake and improving mineral balance, chlorophyll content and RWC. Both ASC and GSH pretreatments reduced levels of ROS and malondialdehyde and improved activities of antioxidant enzymes, suggesting their roles in alleviating oxidative damage. A comparison on the effects of ASC and GSH under Cu stress revealed that ASC was more effective in restricting Cu²⁺ accumulation (69.5% by ASC and 57.1% by GSH), Ca²⁺ and Mg²⁺ homeostasis, protection of photosynthetic pigments and activation of antioxidant defence mechanisms [catalase (110.4%), ascorbate peroxidase (76.5%) and guaiacol peroxidase (39.0%) by ASC, and catalase (58.9%) and ascorbate peroxidase (59.9%) by GSH] in rice than GSH, eventually resulting in better protection of ASC-pretreated plants against Cu stress. In conclusion, although ASC and GSH differed in induction of stress protective mechanisms, both were effective in improving rice performance in response to Cu phytotoxicity.

The Prospects of Lactobacillus oris as a Potential Probiotic With Cholesterol-Reducing Property From Mother's Milk

This experiment was conducted to characterize potential Lactobacillus spp. isolated from mother's milk and infant feces to obtain new and specific probiotic strains. In this study, seven ascendant strains were identified as Lactobacillus spp. based on their morphological characteristics and biochemical properties. Among them, only one (C-1) isolate was identified as Lactobacillus oris through BioLog^TM identification. The study further investigated the isolate through probiotic potentiality tests such as pH and bile tolerance, NaCl tolerance test, gastric juice tolerance, antioxidant activity, resistance to hydrogen, reduction of sodium nitrate, antimicrobial activity, and antibiotic susceptibility test. The result showed that the strain is a potential probiotic based on probiotic capability. The identified strain was most acid-tolerant and retained around 80% viability for up to 4 h at pH 1.0 and 2.0. The isolate showed tolerance against up to 1.50% bile concentration and gastric juice and was able to grow 1-6% NaCl concentrations. Lactobacillus oris showed resistance to most antibiotics as well as antagonistic activity against the tested pathogen, good antioxidant properties, reduction of sodium nitrate and H₂O₂. The isolate exhibited good intestinal epithelial adhesion properties, and SDS page was performed for secreted protein analysis. Moreover, the strain showed promising cholesterol-lowering properties based on the cholesterol level. This present result indicates that L. oris has superior probiotic properties and can be regarded as a potential probiotic candidate.

Mechanical stiffness augments ligand-dependent progesterone receptor B activation via MEK 1/2 and Rho/ROCK-dependent signaling pathways in uterine fibroid cells

OBJECTIVE

To test whether mechanical substrate stiffness would influence progesterone receptor B (PRB) signaling in fibroid cells. Uterine fibroids feature an excessive extracellular matrix, increased stiffness, and altered mechanical signaling. Fibroid growth is stimulated by progestins and opposed by anti-progestins, but a functional interaction between progesterone action and mechanical signaling has not been evaluated.

DESIGN

Laboratory studies.

SETTING

Translational science laboratory.

PATIENT(S)/ANIMAL(S)

Human fibroid cell lines and patient-matched fibroid and myometrial cell lines.

INTERVENTION(S)

Progesterone receptor B-dependent reporter assays and messenger RNA quantitation in cells cultured on stiff polystyrene plates (3GPa) or soft silicone plates (930KPa). Pharmacologic inhibitors of extracellular signal-related protein kinase (ERK) kinase 1/2 (MEK 1/2; PD98059), p38 mitogen-activated protein kinase (SB202190), receptor tyrosine kinases (RTKs; nintedanib), RhoA (A13), and Rho-associated coiled-coil kinase (ROCK; Y27632).

MAIN OUTCOME MEASURE(S)

Progesterone-responsive reporter activation.

RESULT(S)

Fibroid cells exhibited higher PRB-dependent reporter activity with progesterone (P4) in cells cultured on stiff vs. soft plates. Mechanically induced PRB activation with P4 was decreased 62% by PD98059, 78% by nintedanib, 38% by A13, and 50% by Y27632. Overexpression of the Rho-guanine nucleotide exchange factor (Rho-GEF), AKAP13, significantly increased PRB-dependent reporter activity. Collagen 1 messenger RNA levels were higher in fibroid cells grown on stiff vs. soft plates with P4.

CONCLUSION(S)

Cells cultured on mechanically stiff substrates had enhanced PRB activation via a mechanism that required MEK 1/2 and AKAP13/RhoA/ROCK signaling pathways. These studies provide a framework to explore the mechanisms by which mechanical stiffness affects progesterone receptor activation.

Microplastics contamination in the soil from Urban Landfill site, Dhaka, Bangladesh

Microplastics (MP) pollution has become a matter of global concern because of its several deleterious effects on environmental health, especially on the terrestrial environment. The evidence of MP contamination in terrestrial environment is less explored compared to aquatic bodies. However, in Bangladesh despite having high possibility of MP contamination, there is lacking of available research-based evidence. Urban areas soil is subjected to act as a major environmental reservoir for MPs. Thus, this study was carried out to investigate the presence of MP contamination in constructed landfill sites near Dhaka city, Bangladesh. Ten unmixed soil samples were collected from the Aminbazar Sanitary landfill sites, from that thirty replicated samples were investigated via Fourier Transform Infrared Spectroscopy (FT-IR) analysis and Stereomicroscope. The range of physicochemical parameters were found in the soil samples as follows: moisture content; 15.84%-56.54%; soil pH; 5.76-6.02, electric conductivity; 0.1 μs/cm - 2.43 μs/cm, alkalinity; 6.7 ± 1.528-14.33 ± 0.577, TOC; 0.18% ± 0.02-1.09 ± 0.03. Among the ten samples, 3 samples were identified to have the presence of MP in the form of Low density polyethylene (LDPE), High density polyethylene (HDPE), and Cellulose acetate (CA) respectively. The detection limit ranged from 1 - 2000 μm. Hence, the results show that the procurement and discharge of MPs in the landfills is an overlong process. The results of this study provide an initial evidence and affirm that landfill can be a potential source of MPs. This study indicates that MPs are comparatively overlong outcome of human induced activities which can significantly cause changes in terrestrial ecosystems.

Simvastatin ameliorates altered mechanotransduction in uterine leiomyoma cells

BACKGROUND

Uterine leiomyomas, the most common tumors of the female reproductive system, are characterized by excessive deposition of disordered stiff extracellular matrix and fundamental alteration in the mechanical signaling pathways. Specifically, these alterations affect the normal dynamic state of responsiveness to mechanical cues in the extracellular environment. These mechanical cues are converted through integrins, cell membrane receptors, to biochemical signals including cytoskeletal signaling pathways to maintain mechanical homeostasis. Leiomyoma cells overexpress β1 integrin and other downstream mechanical signaling proteins. We previously reported that simvastatin, an antihyperlipidemic drug, has antileiomyoma effects through cellular, animal model, and epidemiologic studies.

OBJECTIVE

This study aimed to examine the hypothesis that simvastatin might influence altered mechanotransduction in leiomyoma cells.

STUDY DESIGN

This is a laboratory-based experimental study. Primary leiomyoma cells were isolated from 5 patients who underwent hysterectomy at the Department of Gynecology and Obstetrics of the Johns Hopkins University Hospital. Primary and immortalized human uterine leiomyoma cells were treated with simvastatin at increasing concentrations (0.001, 0.01, 0.1, and 1 μM, or control) for 48 hours. Protein and mRNA levels of β1 integrin and extracellular matrix components involved in mechanical signaling were quantified by quantitative real-time polymerase chain reaction, western blotting, and immunofluorescence. In addition, we examined the effect of simvastatin on the activity of Ras homolog family member A using pull-down assay and gel contraction.

RESULTS

We found that simvastatin significantly reduced the protein expression of β1 integrin by 44% and type I collagen by 60% compared with untreated leiomyoma cells. Simvastatin-treated cells reduced phosphorylation of focal adhesion kinase down to 26%-60% of control, whereas it increased total focal adhesion kinase protein expression. Using a Ras homolog family member A pull-down activation assay, we observed reduced levels of active Ras homolog family member A in simvastatin-treated cells by 45%-85% compared with control. Consistent with impaired Ras homolog family member A activation, simvastatin treatment reduced tumor gel contraction where gel area was 122%-153% larger than control. Furthermore, simvastatin treatment led to reduced levels of mechanical signaling proteins involved in β1 integrin downstream signaling, such as A-kinase anchor protein 13, Rho-associated protein kinase 1, myosin light-chain kinase, and cyclin D1.

CONCLUSION

The results of this study suggest a possible therapeutic role of simvastatin in restoring the altered state of mechanotransduction signaling in leiomyoma. Collectively, these findings are aligned with previous epidemiologic studies and other reports and support the need for clinical trials.

Leprosy patients with deformities at post‐elimination stage: The Bangladesh experience

Background

Disability assessment in leprosy patients is a very important factor in the evaluation of the effectiveness of a leprosy elimination program. Little information exists on deformities in leprosy patients in Bangladesh.

Objectives

To describe the pattern and prevalence of deformities in leprosy patients after leprosy has been declared eliminated from Bangladesh in 1998.

Methods

A descriptive retrospective cross‐sectional study was carried out in Chittagong Medical College Hospital using the registered records of patients for the period 2004–2013.

Results

Out of 670 leprosy patients, 213 (31.79%) had deformities. The prevalence of deformity was for grade 1: 92 (43.20%), for grade 2: 121 (56.80%). Among the patients with deformity, males 144 (67.60%) outnumbered females 69 (32.40%). Four age groups were considered. The calculated age‐specific cumulative detection rates showed the highest case detection in >40 years group at 81 (38.02%). The rate of children (<14 years) was less at 7 (3.29%). Of the 213 patients with deformity, the borderline tuberculoid patients were totalled 79 (37.08%), which was higher than other forms of leprosy. Among the 121 patients with limb deformity, 57 (8.50%) had claw hand followed by wrist drop 31 (4.63%), foot drop 30 (4.48%). Three (0.45%) had a nerve abscess, 27 (4.02%) had a trophic ulcer and 7 (1.05%) patients had ocular complications.

Conclusion

The grade 2 deformities among newly detected leprosy patients were still high. Claw hand was the most common deformity in the upper limbs, whereas foot drop and trophic ulcer were the most common deformities in the lower limbs. Although leprosy according to the World Health Organization has been eliminated globally, the disease continues to be a significant cause of peripheral neuropathy, deformity, disability and disfigurement in some developing countries like Bangladesh.

Selective Progesterone Receptor Modulators-Mechanisms and Therapeutic Utility

Selective progesterone receptor modulators (SPRMs) are a new class of compounds developed to target the progesterone receptor (PR) with a mix of agonist and antagonist properties. These compounds have been introduced for the treatment of several gynecological conditions based on the critical role of progesterone in reproduction and reproductive tissues. In patients with uterine fibroids, mifepristone and ulipristal acetate have consistently demonstrated efficacy, and vilaprisan is currently under investigation, while studies of asoprisnil and telapristone were halted for safety concerns. Mifepristone demonstrated utility for the management of endometriosis, while data are limited regarding the efficacy of asoprisnil, ulipristal acetate, telapristone, and vilaprisan for this condition. Currently, none of the SPRMs have shown therapeutic success in treating endometrial cancer. Multiple SPRMs have been assessed for efficacy in treating PR-positive recurrent breast cancer, with in vivo studies suggesting a benefit of mifepristone, and multiple in vitro models suggesting the efficacy of ulipristal acetate and telapristone. Mifepristone, ulipristal acetate, vilaprisan, and asoprisnil effectively treated heavy menstrual bleeding (HBM) in patients with uterine fibroids, but limited data exist regarding the efficacy of SPRMs for HMB outside this context. A notable class effect of SPRMs are benign, PR modulator-associated endometrial changes (PAECs) due to the actions of the compounds on the endometrium. Both mifepristone and ulipristal acetate are effective for emergency contraception, and mifepristone was approved by the US Food and Drug Administration (FDA) in 2012 for the treatment of Cushing's syndrome due to its additional antiglucocorticoid effect. Based on current evidence, SPRMs show considerable promise for treatment of several gynecologic conditions.

Identification and Growth Characterization of a Novel Strain of Saccharomyces boulardii Isolated From Soya Paste

The nonpathogenic yeast Saccharomyces boulardii (Sb) has beneficial effects on the human intestine, and thus has been prescribed as probiotics for the treatment of diarrhea and gastrointestinal diseases. This is the only commercialized yeast with the purpose of being used as human medicine. Currently, little is known about their multiple mechanisms of actions. The S. boulardii yeast strain is isolated and identified by using the BIOLOG^TM microarray identification system and morphologically. To understand its functional roles, the present study investigates the ability of this yeast to tolerate different concentrations of bile salt up to 2.5%, cell hydrophobicity, antioxidants, autoaggregation activity, and simulated gastrointestinal digestion. The effect of temperatures (up to 50°C), pH (up to 8.0), and salinity (at best 7%) was also monitored on the growth and survival of the yeast cell. The physicochemical analyses revealed that S. boulardii could survive in stomach conditions at pH 2.5, temperature 37°C, and 2% bile salt. Antibiotic susceptibility of S. boulardii was carried out using commercial antibiotic discs. The antimicrobial activity of the isolated S. boulardii against bacterial pathogens related to diarrhea diseases was in-vitro determined by the Well Diffusion method. The biosafety assay findings also claimed S. boulardii could be a potential probiotic. The experimental findings suggest that the isolated S. boulardii possesses excellent probiotic capacities as a biotherapeutic agent for antidiarrheal and gastrointestinal disorders.