Neutralizing Antibody Correlates Analysis of Tetravalent Dengue Vaccine Efficacy Trials in Asia and Latin America

Background

In the CYD14 and CYD15 Phase 3 trials of the CYD-TDV dengue vaccine, estimated vaccine efficacy (VE) against symptomatic, virologically confirmed dengue (VCD) occurring between months 13 and 25 was 56.5% and 60.8%, respectively.

Methods

Neutralizing antibody titers to the 4 dengue serotypes in the CYD-TDV vaccine insert were measured at month 13 in a randomly sampled immunogenicity subcohort and in all VCD cases through month 25 (2848 vaccine, 1574 placebo) and studied for their association with VCD and with the level of VE to prevent VCD.

Results

For each trial and serotype, vaccinees with higher month 13 titer to the serotype had significantly lower risk of VCD with that serotype (hazard ratios, 0.19-0.43 per 10-fold increase). Moreover, for each trial, vaccinees with higher month 13 average titer to the 4 serotypes had significantly higher VE against VCD of any serotype (P < .001).

Conclusions

Neutralizing antibody titers postdose 3 correlate with CYD-TDV VE to prevent dengue. High titers associate with high VE for all serotypes, baseline serostatus groups, age groups, and both trials. However, lowest titers do not fully correspond to zero VE, indicating that other factors influence VE.

Assessment of serum Golgi protein 73 as a biomarker for the diagnosis of significant fibrosis in patients with chronic HBV infection

Transient elastography (TE) is accurate in staging fibrosis noninvasively. However, a reliable serum biomarker with comparable accuracy is also important, especially when TE is unreliable/unavailable. Therefore, we aimed to evaluate the diagnostic performance of serum Golgi protein 73 (GP73) for significant fibrosis in patients with chronic HBV infection. A total of 801 patients with chronic liver disease (CLD; 492 chronic HBV infection and 309 non-HBV liver disease) with liver biopsy performance were enrolled. Healthy controls (n = 180) and hepatocellular carcinoma (HCC) patients (n = 85) were included for comparisons. Liver biopsy was used as the reference method for fibrosis staging. Serum GP73 level was measured in duplicate in double-blind fashion. Serum GP73 was highest in HCC but also significantly higher in chronic hepatitis B than in healthy controls. The elevation of serum GP73 in non-HCC patients was significantly associated with the presence of significant fibrosis independently of ALT level, liver stiffness (LS) value, inflammation grade and other confounding factors. The diagnostic performance of serum GP73 was accurate in antiviral-naïve HBV patients (area under the receiver operating curve [AUROC], 0.76 95% CI: 0.72-0.81) but not in patients with ongoing antiviral treatment (AUROC, 0.60). The utility of serum GP73 was also confirmed in non-HBV CLD (AUROC, 0.80 95% CI: 0.75-0.85). Serum GP73 was comparable to LS (AUROC, 0.78 95% CI: 0.73-0.82) and significantly better than AST to platelet ratio index (APRI) (AUROC, 0.67 95% CI: 0.62-0.72) and FIB-4 (AUROC, 0.68 95% CI: 0.63-0.73). In conclusion, serum GP73 is an accurate serum marker for significant fibrosis in chronic HBV infection, with higher accuracy than APRI and FIB-4. Serum GP73 is potentially a complementary tool for TE when evaluating the necessity of antiviral treatment, particularly in patients without definite antiviral indication.

Photostability study of cis-configuration neonicotinoid insecticide cycloxaprid in water

Cycloxaprid (CYC) is a new cis-configuration neonicotinoid insecticide, which is currently under development in China for agricultural pest control. Considering the photodegradation of CYC is important for the application of CYC in the future, the photochemical behavior of CYC in aqueous solution was herein investigated in a "merry-go-round" reactor under a 300 W high-pressure mercury lamp. Twenty-five photodegradation products were identified via UPLC-TOF-ESI-MS/MS. The results suggested that NTN32692, the precursor of CYC was the predominant photodegradation product. CYC photodegrades via a more complex mechanism than imidacloprid and four potential photodegradation pathways were proposed.

The expression significance of serum MiR-21 in patients with osteosarcoma and its relationship with chemosensitivity

OBJECTIVE

To investigate the expression level of serum microRNA-21 (miR-21) in 69 patients with osteosarcoma, to analyze the changes in miR-21 expression in the serum and tumor tissues before and after chemotherapy in patients with osteosarcoma, and to investigate the relationship between the expression of serum miR-21 in patients with osteosarcoma and chemosensitivity.

PATIENTS AND METHODS

Real-time polymerase chain reaction (RT-PCR) was used to detect the expression level of serum miR-21 in 69 patients with osteosarcoma before and after chemotherapy, and analyze the relationship between the expression of miR-21 with tumor necrosis grading and chemosensitivity. The expression level of programmed cell death protein 4 (PDCD4) in tumor tissues of patients with osteosarcoma before and after chemotherapy was detected by Western blot.

RESULTS

The expression level of serum miR-21 in patients with osteosarcoma was significantly higher than that in normal control subjects. The expression of serum miR-21 before and after chemotherapy was positively correlated with the expression of miR-21 in the corresponding tissues. In the group where chemotherapy was effective (the effective group), expression levels of miR-21 in patients with osteosarcoma before and after chemotherapy were significantly different. After chemotherapy, the expression level of target genes of miR-21 was increased, and the follow-up results showed that the 5-year survival rate was relatively higher after surgery.

CONCLUSIONS

The expression level of serum miR-21 in patients with osteosarcoma is closely related to the therapeutic effects of osteosarcoma, which can be used as one of the potential biomarkers and therapeutic targets for the diagnosis and prediction of osteosarcoma.

Lasso plate - An original implant for fixation of type I and II Regan-Morrey coronoid fractures

INTRODUCTION

Coronoid fractures are notoriously difficult to manage particularly when there is a small fragment. We report a retrospective analysis of our experience with consecutive type I and II Regan-Morrey coronoid fractures using a lasso plate.

HYPOTHESIS

Type I and II Regan-Morrey coronoid fractures can be effectively managed using a lasso plate.

METHODS

From October 2011 and December 2013, 25 patients (21 males and 4 females, mean age 40.0 years) with type I and II Regan-Morrey coronoid fractures were treated with the open reduction and internal fixation (ORIF) using the lasso plate. Postoperative measurements of the elbow range of motion were recorded. Elbow function was evaluated by the Mayo Elbow Performance Score (MEPS) and Disabilities of the Arm, Shoulder and Hand (DASH) score.

RESULTS

All patients were reexamined at a mean follow-up of 32.7 months (range: 24-49 months). The mean fractures healing time was 13.6 weeks (range: 6 to 18 weeks). The mean flexion range of the elbow was 121.8° (range: 90° to 135°) and the mean extension range of the elbow was 10.6° (range: 0° to 20°). The mean pronation of the forearm was 75.8° (range: 65° to 85°). The mean supination of the forearm was 80.4° (range: 70° to 90°). The mean DASH score was 10.2 (range: 0 to 28). The mean MEPS was 83.4 (range: 55 to 95), 8 patients (32%) were rated excellent, 14 patients (56%) were rated good, 2 (8%) patients were rated fair. One (4%) patient was rated poor. No patient was seriously infected but implant breakage was found in one case. Two cases of elbow heterotopic ossification (HO) were observed. Two cases of elbow medial instability were observed.

DISCUSSION

The type I and II Regan-Morrey coronoid fractures combined with the instability of the elbow should be operated. The lasso plate reduces the pressure between the wire and the insertion of capsule. A tight wire results in greater stability than ordinary suture fixation, thus enabling early functional exercise.

CONCLUSION

In the treatment of type I and II Regan-Morrey coronoid fractures, lasso plate can provide concentric fracture reduction of the elbow and stable fixation to allow for early rehabilitation. Good clinical outcomes can be anticipated.

LEVEL OF EVIDENCE

Level IV: retrospective study.

Absolute Bioavailability and Pharmacokinetic Comparability of Sirukumab Following Subcutaneous Administration by a Prefilled Syringe or an Autoinjector

This phase 1, randomized, open-label study assessed the absolute bioavailability and pharmacokinetic comparability of sirukumab, a human anti-interleukin-6 monoclonal antibody, following subcutaneous (SC) administration via Prefilled Syringe-UltraSafe Passive® Delivery System (PFS-U) or Prefilled Syringe-SmartJect® Autoinjector (PFS-AI; Janssen Research & Development, LLC, Spring House, Pennsylvania). A total of 144 healthy male subjects were randomized to 5 single-dose treatment groups: sirukumab 50 mg and 100 mg (each by PFS-U and PFS-AI) and sirukumab 100 mg intravenous (IV) infusion. Pharmacokinetic parameters were calculated using noncompartmental analysis. Following SC administration, maximum serum concentrations (C_max ) and area under the concentration-vs-time curve (AUC) increased in an approximately dose-proportional manner. Median time to reach C_max was 5 days, and mean half-life ranged from 16 to 19 days. Mean absolute bioavailability of sirukumab by PFS-AI and PFS-U, respectively, was estimated at 92.4% and 81.4% with 100 mg and 88.4% and 94.7% with 50 mg. Ratios of geometric means (90% confidence intervals) of C_max and AUC_0-77d for PFS-AI:PFS-U were 1.13 (1.03, 1.25) and 1.14 (1.05, 1.24), respectively, indicating comparable systemic exposures of sirukumab following a single 100-mg SC dose by PFS-U or PFS-AI. The incidence of antibodies to sirukumab was low (1.4%). No new safety concerns associated with sirukumab were identified at either dose.

Correlation between TRAIL and caspase-8 expression and their relationship with cell proliferation and apoptosis in human osteosarcoma

Osteosarcoma is a common malignant bone tumor that mainly affects children and adolescents. Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is a member of the tumor necrosis factor superfamily. Caspase-8 appears in the upstream of apoptosis signaling pathway among caspases. We investigated TRAIL and caspase-8 levels in osteosarcoma patients to determine their correlation with cell proliferation and apoptosis. Osteosarcoma and osteochondroma patients receiving surgery in our hospital were selected. TRAIL and caspase-8 expression levels in tissue were determined by immunohistochemistry, and protein levels in cells were evaluated by western blotting. Human osteosarcoma cell viability was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The osteosarcoma and osteochondroma cell cycles and apoptosis were investigated by flow cytometry. Correlation analysis was applied to TRAIL and caspase-8 levels during cell apoptosis. Positive TRAIL and caspase-8 expression rates in osteosarcoma tissue were significantly lower than in the controls (P < 0.05). TRAIL (0.114 ± 0.002) and caspase-8 (0.352 ± 0.124) levels in experimental cells were obviously lower than in the controls (P < 0.05). Osteosarcoma cells in the experimental group demonstrated higher proliferation and lower apoptosis at 24, 48, and 72 h (P < 0.05). The experimental cell number increased in the G1 stage and decreased in the S stage (P < 0.05). TRAIL and caspase-8 proteins showed positive correlation with apoptosis in osteosarcoma (P < 0.05). Human osteosarcoma presented reduced TRAIL and caspase-8 levels with enhanced cell proliferation and reduced apoptosis. TRAIL and caspase-8 expression levels were positively correlated with apoptosis in osteosarcoma.

[Clinical value of contrast-enhanced ultrasound in evaluating portal hypertension in patients with decompensated liver cirrhosis]

OBJECTIVE

To investigate the correlation between contrast-enhanced ultrasound parameters and hepatic venous pressure gradient (HVPG), and to develop a new noninvasive method for the evaluation of portal hypertension in patients with decompensated liver cirrhosis.

METHODS

One-hundred patients with decompensated liver cirrhosis were examined by contrast-enhanced ultrasound, and the dynamic images were collected for offline analysis. The contrast arrival time was obtained in the hepatic artery (HA), portal vein (PV), and hepatic vein (HV), and HA-HV transit time (HA-HVTT) and PV-HV transit time (PV-HVTT) were calculated. At the same time, HVPG was measured within 24 hours after contrast-enhanced ultrasound, Pearson correlation analysis was performed between each parameter and HVPG, and the receiver operating characteristic (ROC) curve was also used for analysis.

RESULTS

HV arrival time (HVAT), HA-HVTT, and PV-HVTT were negatively correlated with HVPG (r = -0.385, -0.409, and -0.572, respectively). The area under the ROC curve (AUROC) was 0.903 for PV-HVTT < 2.5 s in judging HVPG≥ l0 mmHg in patients with decompensated liver cirrhosis, and the sensitivity and specificity were 74.4% and 89.5%, respectively. The AUROC was 0.861 for PV-HVTT < 1.5 s in judging HVPG≥l6 mmHg in these patients, and the sensitivity and specificity were 80.4% and 81.5%, respectively.

CONCLUSIONS

HVAT and intrahepatic transit time demonstrate negative linear correlations with HVPG in patients with decompensated liver cirrhosis, and among all parameters, PV-HVTT shows the strongest correlation with HVPG and can be used to determine and predict the severity of portal hypertension.

[Measuring facial paralysis using the three-dimensional dynamic quantitative analysis system of facial motion: correlation with subjective grading systems]

OBJECTIVE

The aim of this study was to measure the facial motion of patients with facial paralysis using a three-dimensional dynamic quantitative analysis system of facial motion (3D ASFM) and analyze its correlation with subjective grading systems.

METHODS

We included 30 healthy volunteers and 50 patients with unilateral facial paralysis. After placing landmarks on the faces, the facial motions of the patients were measured using the 3D ASFM. The regional symmetry ratios(SRs) and gross scores of different parameters were calculated. Then a comparison with four subjective grading systems(House-Brackmann, Sunnybrook, Facial Nerve Grading System 2.0, Fisch) was performed.

RESULTS

The entire test could be completed within five minutes. The normal range of healthy volunteers were obtained, the gross score of which was 91.9±1.5. The SRs of the maximal moving distance(MMD) were most strongly correlated with regional subjective grading systems, followed by the SRs of the maximal moving velocity (MMV). The SRs of the maximal moving acceleration (MMA) were either poorly correlated or uncorrelated with the subjective grading systems. Moreover, the Spearman coefficients with four subjective grading systems were -0.630(House-Brackmann), -0.728(Facial Nerve Grading System 2.0), 0.697(Sunnybrook), and 0.617(Fisch)respectively(P<0.05).

CONCLUSIONS

The 3D ASFM is a convenient method to rapidly assess facial paralysis. It not only overcomes the shortcomings of conventional subjective grading systems, but also correlates well with them.

MicroRNA-141 inhibits tumor growth and metastasis in gastric cancer by directly targeting transcriptional co-activator with PDZ-binding motif, TAZ

Gastric cancer (GC) is a biologically heterogeneous disease accompanying various genetic and epigenetic alterations, and the molecular mechanisms underlying this disease are complex and not completely understood. Increasing evidence shows that abnormal microRNA (miRNA) expression is involved in GC tumorigenesis, but the role of specific miRNAs involved in this disease remains elusive. MiR-141 was previously reported to act as tumor suppressors or oncogenes in diverse cancers. However, their accurate expression, function and mechanism in GC are largely unclear. Here we found that the expression of miR-141 was significantly reduced in GC compared with paired adjacent normal tissues and was significantly correlated with a more aggressive phenotype of GC in patients. Ectopic expression of miR-141 mimics in GC cell lines resulted in reduced proliferation, invasion and migration, and inhibition of miR-141 in GC cell lines promoted cell proliferation, invasion and migration in vitro. We further demonstrated that miR-141 acted as tumor suppressors through targeting transcriptional co-activator with PDZ-binding motif (TAZ) in GC. Moreover, the inverse relationship between miR-141 and its target was verified in patients and xenograft mice. Finally, overexpression of miR-141 suppressed tumor growth and pulmonary metastasis in nude mice. Take together, we identified that miR-141 is a potent tumor suppressor in the stomach, and its growth inhibitory effects are, in part, mediated through its downstream target gene, TAZ. These findings implied that miR-141 might be employed as novel prognostic markers and therapeutic targets of GC.