Reaching the Surveillance-Response Stage of Schistosomiasis Control in The People's Republic of China: A Modelling Approach

With the goal set to eliminate schistosomiasis nationwide by 2020, The People's Republic of China has initiated the surveillance-response stage to identify remaining sources of infection and potential pockets from where the disease could reemerge. Shifting the focus from classical monitoring and evaluation to rapid detection and immediate response, this approach requires modelling to bridge the surveillance and response components. We review here studies relevant to schistosomiasis modelling in a Chinese surveillance-response system with the expectation to achieve a practically useful understanding of the current situation and potential future study directions. We also present useful experience that could tentatively be applied in other endemic regions in the world. Modelling is discussed at length as it plays an essential role, both with regard to the intermediate snail host and in the definitive, mammal hosts. Research gaps with respect to snail infection, animal hosts and sectoral research cooperation are identified and examined against the prevailing background of ecosystem and socioeconomic changes with a focus on coexisting challenges and opportunities in a situation with increasing financial constraints.

Effects of potassium diformate on the gastric function of weaning piglets

Potassium diformate (KDF), as an acidifier, has been shown to improve growth performance in pigs, but it is not yet known whether KDF regulates gastric function. Thus, the objective of the present study was to investigate the effects of dietary KDF on gastric function in weaning piglets. One hundred and eighty Landrace × Large White piglets (bodyweight = 5.80 ± 0.15 kg) were weaned at 28 days old and randomly allocated into two groups, with six pens in each group and 15 piglets in each pen. Piglets in the control group were fed the basal diet, whereas the KDF-treated group was fed the basal diet supplemented with 10 g/kg KDF. After 35 days of feeding, the KDF treatment improved the bodyweight (P = 0.034) and reduced the relative weight of stomach (P = 0.050), decreased the hydrochloric acid concentration (P = 0.016) in the gastric digesta and the pepsin activity in the gastric oxyntic mucosa (P = 0.001) and increased the lactic acid concentration (P = 0.001) in the gastric digesta. Furthermore, KDF treatment increased the level of somatostatin (SS) (P = 0.009), but did not change the concentration of gastrin (P = 0.497) and the activity of H+-K+-ATPase (P = 0.575) in the gastric oxyntic mucosa. However, KDF treatment downregulated the expression of SS mRNA in the gastric oxyntic mucosa (P = 0.031) and upregulated the mRNA expression of gastrin (P < 0.001) and H+-K+-ATPase (P < 0.001) in the gastric oxyntic mucosa. These results suggest that the effects of KDF on weaning piglets may be related to the regulation of gastric function gene expression.

Supplemental lipoic acid relieves post-weaning diarrhoea by decreasing intestinal permeability in rats

Lipoic acid (LA) is a naturally existing substance which widely distributed in the cellular membranes and cytosol of animal cells. Its intracellular functions include quenching of free radicals and repairing oxidized proteins. The purpose of this study was to evaluate the effects of LA on post-weaning diarrhoea using a rat model. Sixty weaned rats were fed either a basal diet or a LA-supplemented diet, or a zinc oxide (ZnO)-supplemented diet as a positive control. Rats in the LA and ZnO groups had better performance and reduced incidence of diarrhoea (p < 0.05). Both LA and ZnO treatments enhanced intestinal homeostatic and architecture, significantly decreased urinary lactulose to mannitol ratios (p < 0.05) and increased the expression of the intestinal mucosal tight junction proteins occludin (OCLN) and zonula occludens protein-1 (ZO-1) (p < 0.05). LA significantly increased the activities of antioxidant enzymes, and reduced glutathione while decreasing the levels of oxidative glutathione and malondialdehyde in the intestinal mucosa (p < 0.05). Furthermore, an in vitro study indicated that supplementation with LA in IEC-6 intestinal epithelial cells significantly enhanced the expression of OCLN and ZO-1 under hydrogen peroxide-induced oxidative stress. Collectively, these results suggest that LA relieves post-weaning diarrhoea by reducing intestinal permeability and improving antioxidant indices.

Putative suppressing effect of IgG Fc-conjugated haemagglutinin (HA) stalk of influenza virus H7N9 on the neutralizing immunogenicity of Fc-conjugated HA head: implication for rational design of HA-based influenza vaccines

The emergence of influenza A H7N9 in infection has posed a great threat to public health globally. Poor immunogenicity of H7N9 haemagglutinin (HA) is a major obstacle to the development of an effective H7N9 vaccine. Here, we found that the vaccine containing the H7HA head conjugated with IgG Fc (Hd-Fc) induced strong neutralizing antibody responses and protection against H7N9 infection, whilst the Fc-conjugated H7HA stalk (St-Fc)-based vaccine could not induce neutralizing antibodies, although the St-Fc-immunized mice were partially protected. The vaccines containing the full-length extracellular domain of HA conjugated with Fc and the mixture of Hd-Fc plus St-Fc induced significantly lower neutralizing antibody and haemagglutination inhibition titres than the Hd-Fc-based vaccine. These results suggest that the St-Fc may have inhibitory effects on the neutralizing immunogenicity of Hd-Fc. Therefore, the neutralizing domain(s), such as the receptor-binding domain, in the HA head should be kept and the non-neutralizing domain(s) in the HA stalk with the ability to potentially suppress the neutralizing immunogenicity of HA head should be removed from Fc-conjugated HA-based influenza vaccines to increase the neutralizing antibody response.

Probable aerosol transmission of severe fever with thrombocytopenia syndrome virus in southeastern China

Some clusters of severe fever with thrombocytopenia syndrome virus (SFTSV) infection were reported in China as of 2010. However, to date, there has been no epidemiologic evidence of aerosol transmission of SFTSV. Epidemiologic investigations were conducted after a cluster of 13 cases of SFTSV in May 2014. A total of 13 cases, including 11 confirmed cases and one clinically diagnosed case, were identified besides the case of the index patient. The index patient experienced onset of SFTSV on 23 April and died on 1 May. The patients with secondary cases had onset from 10 to 16 May, peaking on 13 May. Moreover, eight secondary cases occurred in family members of the index patient, and the other five cases occurred in neighbors of the index patient. According to epidemiologic investigations, patients 1, 3, 4, 5, 6, 7, 9 and 12 contracted the disease through contact with blood of the index patient. Notably, patients 8 and 10 did not have a history of contact with the blood of the index patient, but they stayed in the mourning hall for hours. SFTSV could be transmitted from person to person by direct contact and/or aerosol transmission, and it is important to consider aerosol transmission as a possible transmission route.

Human infection with avian influenza A(H7N9) virus re-emerges in China in winter 2013

Through a national surveillance system for unexplained pneumonia, a severe case of influenza A(H7N9) in a man in his mid-30s was identified in Zhejiang Province, China on 14 October 2013. Epidemiological and clinical findings were consistent with the patterns reported during the outbreak in spring 2013, and laboratory findings showed that the virus had 99.6% identity with earlier H7N9 viruses identified in humans in the spring except for five mutations in the NA gene.

Blockage of Nrf2 suppresses the migration and invasion of esophageal squamous cell carcinoma cells in hypoxic microenvironment

Nuclear factor erythroid-2-related factor 2 (Nrf2) is a critical cell protector by inducing phase two detoxifying and anti-oxidant enzymes in normal cells. But recently, numerous evidence show Nrf2 may play the same beneficial roles toward the cancer cells. Nrf2 is found upexpressed in lots of cancers and promote the proliferation and drug resistance. But studies about the role of Nrf2 in the metastases are few. It has been testified that the tumor cells are under hypoxic conditions. As an important anti-oxidant element, the expression of Nrf2 may be upregulated, which in turn promotes the tumor invasion and metastases in the hypoxic microenvironment. Our team found the expression of Nrf2 correlated with the lymph node metastasis of esophageal squamous cell carcinoma by pathological sections of esophageal carcinoma patients. Further, the mechanism beneath it was studied in this paper. It was hypothesized that the hypoxia microenvironment transformed Nrf2 a friend to a foe. First, Eca-109 cells were treated with different concentration of CoCl2 . Western blot and quantitative reverse transcription-polymerase chain reaction showed that with the increase of the concentration of CoCl2 , the expression levels of Nrf2 and hypoxia-inducible factor-1 (HIF-1) alpha were upregulated simultaneously. By analyzing the data, a significant correlation between Nrf2 and HIF-1 alpha in the protein levels was found. Further, blockage of Nrf2 mediated by shRNA suppressed the expression of HIF-1 alpha, hemeoxygenase-1 (HO-1), and matrix metalloproteinase 2 but enhanced the expression of E-cadherin. In addition, the results of wound healing and invasion assay-verified blockage of Nrf2 suppressed the migration and invasion. So it was suggested that blockage of Nrf2 repressed the migration and invasion of esophageal squamous cell carcinoma cells in the hypoxic microenvironment. HIF-1 alpha might be one of the downstream genes of Nrf2 regulated through Nrf2/HO-1 axis in the CoCl2 model. Nrf2 inhibition suppressed matrix metalloproteinase 2 and enhanced E-cadherin partly through HIF-1 alpha way.

Comparison of the safety and efficacy of conventional monopolar and 2-micron laser transurethral resection in the management of multiple nonmuscle-invasive bladder cancer

Objectives

To compare the safety and efficacy of conventional monopolar transurethral resection of bladder tumour (TURBT) and 2-micron continuous-wave laser resection (2-µm laser) techniques in the management of multiple nonmuscle-invasive bladder cancer (NMIBC), and to investigate long-term effects on tumour recurrence.

Methods

Patients with multiple NMIBC were randomized to receive TURBT or 2-µm laser in a nonblinded manner. All patients received intravesical chemotherapy with epirubicin (40 mg/40 ml) for 8 weeks, beginning 1 week after surgery, followed with monthly maintenance therapy for 12 months. Three-year follow-up data of preoperative, operative and postoperative management were recorded.

Results

In total, 120 patients were included: 56 in the TURBT group and 64 in the 2-µm laser group. Intra- and postoperative complications (including bladder perforation, bleeding and irritation) were less frequently observed in the 2-µm laser group compared with the TURBT group. There were no significant differences in first time to recurrence, overall recurrence or occurrence of urethral strictures.

Conclusions

The 2-µm laser resection method was more effective than TURBT in reducing rates of intra- and postoperative complications, but offered no additional benefit regarding tumour recurrence.

HMGB1 promotes the differentiation of Th17 via up-regulating TLR2 and IL-23 of CD14+ monocytes from patients with rheumatoid arthritis

High-mobility group box 1 (HMGB1) is a non-histone nuclear protein that is released extracellulary and has been implicated in autoimmune disease. Toll-like receptor 2 (TLR2) signalling is thought to be essential for the inflammatory response and for immune disorders. In recent studies, enhanced HMGB1 and TLR2 expressions have been found in rheumatoid arthritis (RA), respectively. The aim of this study is to explore whether HMGB1 stimulation can up-regulate the expression of TLR2 on CD14(+) monocytes from patients with RA and to clarify the subsequent events involving Th17 cells and Th17 cell-associated cytokine changes. Our results showed that the frequency of CD14(+) cells in peripheral blood mononuclear cell (PBMC) was obviously increased, and enhanced expression of TLR2 on CD14(+) monocytes was also found in patients with RA, compared with healthy controls with statistical significance (P < 0.001). In addition, the levels of IL-17, IL-23 and IL-6 in supernatants from cultured monocytes from patients and in patient's plasma were increased, and NF-κB, the downstream target of TLR2, also showed a marked elevation after monocytes were stimulated by HMGB1. This implies that the enhanced TLR2 pathway and Th17 cell polarization may be due to HMGB1 stimulation in rheumatoid arthritis.

Toughening and asymmetry in peeling of heterogeneous adhesives

The effective adhesive properties of heterogeneous thin films are characterized through a combined experimental and theoretical investigation. By bridging scales, we show how variations of elastic or adhesive properties at the microscale can significantly affect the effective peeling behavior of the adhesive at the macroscale. Our study reveals three elementary mechanisms in heterogeneous systems involving front propagation: (i) patterning the elastic bending stiffness of the film produces fluctuations of the driving force resulting in dramatically enhanced resistance to peeling; (ii) optimized arrangements of pinning sites with large adhesion energy are shown to control the effective system resistance, allowing the design of highly anisotropic and asymmetric adhesives; (iii) heterogeneities of both types result in front motion instabilities producing sudden energy releases that increase the overall adhesion energy. These findings open potentially new avenues for the design of thin films with improved adhesion properties, and motivate new investigations of other phenomena involving front propagation.

Galanin receptor 2 overexpressing mice display an antidepressive-like phenotype: possible involvement of the subiculum

The behavioral phenotype of a transgenic mouse overexpressing a galanin receptor 2 (GalR2)-enhanced, green fluorescent protein (EGFP)-construct under the platelet-derived growth factor-B promoter, and of controls, was assessed in various behavioral tests, such as the Porsolt forced swim test, as well as the open field, elevated plus maze and passive avoidance tests. In addition, the distribution of GalR2-EGFP expressing cell bodies and processes was studied in the brain of these mice using histochemical methods. Three age groups of the transgenic mice demonstrated decreased levels of immobility in the forced swim test, indicative of antidepressive-like behavior and/or increased stress resistance. Anxiety-like behaviors, measured in two different tests, did not differ between the GalR2-overexpressing and the wild-type mice, nor did motor activity levels, emotional learning or memory behaviors. High levels of GalR2 mRNA and protein expression were observed in the presubiculum, subiculum, cingulate cortex, retrosplenial granular and agranular cortices, subregions of prefrontal cortex, and the olfactory bulb, regions which are directly or indirectly implicated in depression-like behavior. These results may contribute to the understanding of the pathophysiology of major depressive disorder and the role of GalR2 in the regulation of mood, and suggest a potential therapeutic effect by targeting the GalR2 for treatment of depressive disorders.

Relationship between visual learning/memory ability and brain cAMP level in Drosophila

Using the flight simulator system, the operant conditioned visual flight orientation behavior in Drosophila was studied. It was demonstrated that the visual learning performance is associated with age; flies learn more reliably at 3-4 days than at 1-2 days of age; the cAMP level of brain is also increasing with age; the brain cAMP content of nonlearner flies of wild type is much higher than that of normal flies; the cAMP level of brain increased abnormally after being fed with caffeine, and the learning performance decreased. These results imply that a moderate range of cAMP level is necessary for the visual learning and memory process. Abnormally high or low level of cAMP causes defects of learning and memory ability.

Distribution of pathogenic Yersinia enterocolitica in China

Yersinia enterocolitica (1,295 strains) was isolated from diarrhea patients, livestock, poultry, wild animals, insect vectors, food, and the environment. They were studied for epidemiology distribution using bacterial biochemical metabolism tests, their virulence genes, and pulsed-field gel electrophoresis (PFGE) sub-typing. The data showed that 416 of the 1,295 strains were pathogenic, where the pathogenic Chinese isolates were of serotypes O:3 and O:9. These two serotypes were found in livestock and poultry, with swine serving as the major reservoir. The geographic distribution of pathogenic isolates was significantly different, where most of the strains were isolated from the cold northern areas, whereas some serotype O:3 strains were recovered from the warm southern areas. By the analysis of the data of the Ningxia Hui Autonomous Region, we find the phenomenon of 'concentric circle distribution' around animal reservoirs and human habitation. The clustering of PFGE showed that the patterns of the pathogenic strains isolated from diarrhea patients were identical compared to those from the animals in the same area, thus, suggesting that the human infection originated from the animals.

Bioavailability and therapeutic activity of alicaforsen (ISIS 2302) administered as a rectal retention enema to subjects with active ulcerative colitis

BACKGROUND

Alicaforsen is a phosphorothioate-modified antisense oligodeoxynucleotide designed to sequence-specifically reduce intercellular adhesion molecule 1 messenger RNA levels.

AIMS

To determine the systemic and local bioavailability of alicaforsen, and its activity when administered as a once daily enema in subjects with active ulcerative colitis. METHODS An open-label study was conducted to assess the relative absorption (local and systemic pharmacokinetics) and pharmacologic activity of alicaforsen enema in subjects with active ulcerative colitis. Fifteen subjects received nightly enemas of alicaforsen (240 mg) for a treatment period of 6 weeks. Alicaforsen concentrations in plasma and colonic tissue biopsies were determined. Disease activity index and multiple measurements including endoscopy were used to assess alicaforsen activity in these subjects.

RESULTS

Plasma concentrations of parent alicaforsen represented < 0.6% mean bioavailability when compared with historical intravenous area under the plasma concentration-time curves. Concentrations of the intact oligonucleotide in mucosal colonic tissue biopsies were orders of magnitude higher than those observed in plasma. A 46% reduction in mean Disease Activity Index and 33% rate of remission as defined by complete mucosal healing were observed at the end of treatment. Conclusion These data confirm that alicaforsen enema provides local treatment for a local disease with little meaningful systemic exposure.

A phase II dose ranging, double-blind, placebo-controlled study of alicaforsen enema in subjects with acute exacerbation of mild to moderate left-sided ulcerative colitis

BACKGROUND

Alicaforsen is an antisense oligonucleotide designed to inhibit expression of human intercellular adhesion molecule 1. Previous clinical studies have demonstrated activity of alicaforsen enema in ulcerative colitis and pouchitis.

AIM

To determine the minimally effective dosing regimen of alicaforsen enema in subjects with mild to moderate left-sided ulcerative colitis.

METHODS

Randomized, placebo-controlled, double-blind, two-dose ranging multicentre study. One hundred and twelve subjects were equally randomized to receive one of four alicaforsen enema regimens or placebo daily for 6 weeks. Primary end point was Disease Activity Index at week 6. Secondary end points included evaluation of clinical improvement, relapse rates and durability of response. Analysis of data were performed on the intent-to-treat population.

RESULTS

No significant difference was observed between treatment arms and placebo in the primary end point. A prolonged reduction in mean% Disease Activity Index relative to baseline was observed in the daily 240 mg alicaforsen enema treatment arm in comparison with placebo from week 18 (51% vs. 18%, P=0.04) to week 30 (50% vs. 11%, P=0.03).

CONCLUSIONS

Alicaforsen enema was safe and well tolerated at all doses studied. The durability of the response to alicaforsen enema treatment may suggests a disease-modifying effect.

Safety and efficacy of two dose formulations of alicaforsen enema compared with mesalazine enema for treatment of mild to moderate left-sided ulcerative colitis: a randomized, double-blind, active-controlled trial

BACKGROUND

Alicaforsen is an antisense oligonucleotide inhibitor of intercellular adhesion molecule 1 protein expression with activity in subjects with ulcerative colitis and pouchitis.

AIM

To compare the effects of alicaforsen enema to standard of care mesalazine (mesalamine) enema in subjects with mild to moderate active left-sided ulcerative colitis.

METHOD

A randomized, double-blind, active-controlled multicentre clinical trial. Subjects received a nightly enema of 120 mg alicaforsen (n=55), 240 mg alicaforsen (n=50), or 4 g mesalazine (n=54) for 6 weeks, followed by a 24-week monitoring period. The primary end point was Disease Activity Index at week 6. Clinical improvement, remission and relapse were secondary end points.

RESULTS

No significant difference was observed between treatment arms in the primary end point. However, the median duration of response to alicaforsen enema treatment was two- to threefold longer (128 and 146 days) in comparison with mesalazine (54 days). Complete mucosal healing occurred in 24% of the 240 mg alicaforsen group, when compared with 17% in the mesalazine.

CONCLUSIONS

Alicaforsen enema demonstrated an acute response and safety profile similar to mesalazine enema, but was differentiated by a more durable response. The extended length of remission suggests that alicaforsen enema treatment may have a disease modifying effect.

Erk pathway inhibitor U0126 induces gamma-globin expression in erythroid cells

Fetal hemoglobin (HbF) induction is an effective approach to improve clinical symptoms in sickle cell disease. Understanding molecular mechanisms for gamma-gene re-activation will aid efforts to design lead compounds. A potential inhibitory role for the extracellular signal-regulated kinase (ERK) mitogen-activated protein kinase (MAPK) pathway in gamma-gene expression has been suggested recently. Therefore, we determined the ability of U0126, a selective inhibitor of MEK1/2 the upstream activators of ERK, to re-activate gamma-globin expression. K562 stable lines over-expressing constitutively active MEK1 were established. A significant increase in ERK phosphorylation was observed and gamma-gene expression was silenced concomitantly, however U0126 attenuated this effect. Studies in human erythroid progenitors confirmed the ability of U0126 to induce HbF. Cellular mechanisms for the inhibitory role of ERK signaling in drug-mediated HbF induction will be discussed.

[Androgen receptor isoforms expression and its novel cDNA cloning in human prostate]

OBJECTIVE

To investigate the androgen receptor isoforms expression and its novel eDNA cloning in prostate tissue.

METHODS

The tissue from a case of benign prostatic hyperplasia (BPH) was analyzed by high resolution isoelectric focusing (IEF) technique and molecular biological technique of cDNA cloning was used to determine its AR isoforms expression and genes of AR isoforms.

RESULTS

From the prostatic specimen, three types of AR isoforms were detected with pI values of 6.5, 6.0 and 5.3 respectively. A novel AR subtype cDNA cloning, named as PHAR-1 and including 1 913 nucleotides was isolated from the same BPH tissue. The GenBank accession number for the nucleotide sequence of this AR cDNA was BankIT372205 AF324243. The comparison between PHAR-1 and AR nucleotide sequence registered in GenBank showed that 961 nucleotides in three part of nucleotide sequence were the same, while the other 952 nucleotides were different.

CONCLUSION

These three AR isoforms may originate from the same gene. The results may be important for the study of BPH, or prostatic growth. It is also valuable in the field of pharmacotherapy for treatment of BPH and prostatic cancer.