MEDI-573 as a novel approach to IGF-1R and IR-A signaling inhibition by blocking IGF ligands: Phase I PK/PD, safety data, and disease linkage studies in breast cancer

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Background: MEDI-573 is a dual-targeting human antibody that neutralizes IGF-I/-II ligands and inhibits IGF-1R and insulin receptor-A (IR-A) signaling pathways, which play a role in breast and other epithelial cancers. By sparing IR-B and its hybrid receptors, MEDI-573 is expected to achieve antitumor activity without perturbing glucose homeostasis.

Methods: In a 3 + 3 dose-escalation trial ( NCT00816361 ), patients with advanced solid tumors, KPS ≥ 60, received MEDI-573 as a weekly 1-hr IV infusion at 0.5, 1.5, 5, 10, or 15 mg/kg every 21 days. Objectives included determination of MTD, safety profile, pharmacokinetics (PK), pharmacodynamics, and tumor response. In a separate biomarker study, mRNA expression of IR-A and IR-B was compared in HR+/HER- breast cancers.

Results: Patients included 13M/12F (17 evaluable for efficacy at data cutoff); median age 59 yrs (range 37-78). No DLTs, drug-related SAEs, or significant toxicity patterns were reported. Forty-five AEs were considered treatment-related (% of patients): decreased appetite (28%), fatigue (24%), nausea (20%), diarrhea (16%), and anemia (12%). Hyperglycemia occurred in 2 patients, 1 with evidence of prestudy insulin resistance. No other significant changes in plasma glucose levels occurred. MEDI-573 had dose-proportionality, with AUC of 415 ± 165, 597 ± 298, and 1940 ± 904 d*μg/mL at 5, 10, and 15 mg/kg, respectively. Suppression of free IGF-1 and -2 was fully achieved at doses ≥ 5 mg/kg. Stable disease spanning ≥ 12 wks (range 12-36+) was seen in 6/17 patients. No antidrug antibodies were reported. In a study to identify breast cancer subsets that are dependent on IGF signaling, the IR-A:IR-B ratio was significantly higher in HR+/HER2- breast cancer than matched adjacent normal tissues and in proliferative luminal B than in luminal A breast cancer.

Conclusions: MEDI-573 showed acceptable safety and favorable PK profiles without significant changes in glucose levels. The IR-A:IR-B ratio supports a biomarker approach for MEDI-573 patient stratification. A biomarker-rich phase Ib/II study of MEDI-573 with an aromatase inhibitor in patients with advanced HR+/HER2- breast cancer opens in 2011.

Circulating obestatin concentration is lowered by insulin in rats

Circulating obestatin is lowered by food intake, but factors involved in obestatin regulation remain unclear. The aim of this study was to determine whether intravenous glucose or insulin infusion lowers obestatin. Rats were infused over 3 h with either A. saline (controls); B. dextrose to steady state blood glucose ~16.7 mM, or C. insulin 7.5 mU/kg.min, plus dextrose as needed to clamp to euglycemic basal concentrations. During 3 h of infusion, group B had significantly greater (P<0.01) glucose, 18.75±1.27 mM, than groups A (6.10±0.33 mM) or C (6.19±0.18 mM). Groups B and C had hyperinsulinemia at the end of the 3 h infusion (1.02±0.03 ng/ml, 1.07±0.02 ng/ml) compared with saline-infused (0.38±0.01 ng/ml, P<0.01). Obestatin concentrations were significantly reduced (P<0.01) in both hyperinsulinemic groups and (B=0.95±0.06 ng/ml; C=0.87±0.04 ng/ml) versus controls (1.56±0.13 ng/ml). These data suggest that insulin can decrease the plasma obestatin levels.

First Report of Stem Blight of Eleocharis dulcis Caused by Phoma bellidis in China

Eleocharis dulcis is a perennial herbaceous plant in the family Cyperaceae, which is native to China and India where it grows well in moist-to-wet soils. It is commonly used as a fruit or a vegetable. From August 2009 to December 2010, symptoms were observed on E. dulcis stems in Tuanfeng County, Hubei, China, with the crop area affected estimated to be more than 1,300 ha per year. Corm yield was reduced by 20% on average with as much as 60% yield losses in some fields. Lesions were initially small, red-brown, and oval or circular that enlarged to produce apical necrosis and extending until the stems withered, usually within 2 months. To obtain isolates, diseased tissue was disinfested for 1 min in 0.1% mercuric chloride solution, rinsed with sterilized water, and plated on potato dextrose agar. Isolates with similar morphological characteristics were consistently recovered. Three isolates, CTF-3, CTF-10, and CTF-11, were used to further evaluate characteristics of the pathogen. After 7 days, white colonies were 76 to 80 mm across on oatmeal agar (OA) with sparse aerial hyphae and a slight salmon color in the conidial masses. Pycnidia produced on OA were globose to subglobose, usually with one slightly ostiolar papilla, olivaceous to olivaceous black, and 93 to 245 μm in diameter. Conidia were hyaline, unicellular, ellipsoidal, mostly with two polar guttules, and 3.6 to 6.2 × 2.0 to 3.3 μm. Chlamydospores were absent. Growth of the isolates on malt extract agar (MEA) was slower than on OA, and the colony diameters at 7 days were 60 to 65 mm. The reactions with 1M NaOH were both positive on OA and MEA where the cultures initially changed to yellow green and gradually turned to red. The pathogen was identified as Phoma bellidis Neerg. based on descriptions in Boerema et al. (2). Pathogenicity tests were performed with the three isolates in the laboratory by spraying conidial suspensions (1 × 10⁶ conidia/ml) containing 0.1% Tween 20 until runoff (30 ml per plant) onto stem surfaces of 50-day-old, 60 cm tall plants. For each isolate, there were 50 stems from five replicate plants that had multiple stems per plant. Control plants were treated with sterilized water containing 0.1% Tween 20 only. Plants were incubated with a 16-h photoperiod at 28°C and 90% relative humidity in an artificial climate chamber. Five days after inoculation, typical red-brown spots were observed on all inoculated stems but no symptoms were seen on water-treated control plants. Koch's postulates were fulfilled by reisolation of P. bellidis from diseased stems. The pathogenicity tests were repeated twice more with the same results. P. bellidis has only been reported previously on Bellis spp. from England, Denmark, Italy, the Netherlands, and Switzerland (1,2). Furthermore, there are only a few fungal diseases known to be associated with E. dulcis, and none so far that involve species of Phoma (3,4). To our knowledge, this is the first report of P. bellidis infecting E. dulcis worldwide. References: (1) M. M. Aveskamp et al. Stud. Mycol. 65:27, 2010. (2) G. H. Boerema et al. Phoma Identification Manual: Differentiation of Specific and Infra-Specific Taxa in Culture. CABI Publishing, Wallingford, UK, 2004. (3) P. L. Lentz. Am. Midl. Nat. 67:184, 1962. (4) L. Pan et al. J. Changjiang Vegetables (in Chinese) 14:10, 2010.

Mutation screening of spastin, atlastin, and REEP1 in hereditary spastic paraplegia

Hereditary spastic paraplegia (HSP) comprises a group of clinically and genetically heterogeneous diseases that affect the upper motor neurons and their axonal projections. Over 40 chromosomal loci have been identified for autosomal dominant, recessive, and X-linked HSP. Mutations in the genes atlastin, spastin and REEP1 are estimated to account for up to 50% of autosomal-dominant HSP and currently guide the molecular diagnosis of HSP. Here, we report the mutation screening results of 120 HSP patients from North America for spastin, atlastin, and REEP1, with the latter one partially reported previously. We identified mutations in 36.7% of all tested HSP patients and describe 20 novel changes in spastin and atlastin. Our results add to a growing number of HSP disease-associated variants and confirm the high prevalence of atlastin, spastin, and REEP1 mutations in the HSP patient population.

Effect of deposition parameters and post-deposition annealing on the morphology and cellular response of electrosprayed TiO2 films

Titania films (TiO(2)) were deposited on Ti alloy substrates by electrohydrodynamic atomization (EHDA), also called electrospraying, and the morphology and phase composition of the coatings were evaluated. A range of TiO(2) sols (2-8 wt%) were prepared via the hydrolysis of polymeric precursors using isopropanol (prOH) as a solvent carrier. Stable cone-jet formation during the EHDA process was greatly influenced by varying the liquid physical properties. Deposition parameters such as sol concentration, needle-to-substrate distance and spray time were found to affect film morphology. Dense and continuous films were obtained under optimized conditions whereby a 2 wt% TiO(2) sol was atomized at a flow rate of 5 µl min(-1) by a needle of 300 µm inner diameter, kept at a distance of 20 mm from the grounded substrate and operating at an applied voltage of 3.5-4.2 kV. The films were then crystallized by heating to 300-600 °C. Annealing increased the hydrophilicity of the films but did not significantly affect the surface roughness of the films. In vitro cellular response was determined by studying the interaction between MG63 cells and the films annealed at the various temperatures. MG63 cells were able to grow and proliferate on all the TiO(2) films, while the highest proliferation rate was found on the TiO(2) films annealed at 600 °C. Our results indicate that electrosprayed TiO(2) films possess great potential for biomedical applications.

Single spin asymmetries in charged pion production from semi-inclusive deep inelastic scattering on a transversely polarized 3He Target at Q2 = 1.4-2.7 GeV2

We report the first measurement of target single spin asymmetries in the semi-inclusive (3)He(e,e'π(±))X reaction on a transversely polarized target. The experiment, conducted at Jefferson Lab using a 5.9 GeV electron beam, covers a range of 0.16 < x < 0.35 with 1.4 < Q(2) < 2.7 GeV(2). The Collins and Sivers moments were extracted from the azimuthal angular dependence of the measured asymmetries. The π(±) Collins moments for (3)He are consistent with zero, except for the π(+) moment at x = 0.35, which deviates from zero by 2.3σ. While the π(-) Sivers moments are consistent with zero, the π(+) Sivers moments favor negative values. The neutron results were extracted using the nucleon effective polarization and measured cross section ratios of proton to (3)He, and are largely consistent with the predictions of phenomenological fits and quark model calculations.

Personality and bipolar disorder: dissecting state and trait associations between mood and personality

BACKGROUND

Some personality characteristics have previously been associated with an increased risk for psychiatric disorder. Longitudinal studies are required in order to tease apart temporary (state) and enduring (trait) differences in personality among individuals with bipolar disorder (BD). This study aimed to determine whether there is a characteristic personality profile in BD, and whether associations between BD and personality are best explained by state or trait effects.

METHOD

A total of 2247 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder study completed the NEO Five-Factor Inventory administered at study entry, and at 1 and 2 years.

RESULTS

Personality in BD was characterized by high neuroticism (N) and openness (O), and low agreeableness (A), conscientiousness (C) and extraversion (E). This profile was replicated in two independent samples, and openness was found to distinguish BD from major depressive disorder. Latent growth modeling demonstrated that manic symptoms were associated with increased E and decreased A, and depressed symptoms with higher N and lower E, A, C and O. During euthymic phases, high N and low E scores predicted a future depression-prone course.

CONCLUSIONS

While there are clear state effects of mood on self-reported personality, personality variables during euthymia predict future course of illness. Personality disturbances in extraversion, neuroticism and openness may be enduring characteristics of patients with BD.

Preoperative Insertion of an Intra-Aortic Balloon Pump Improved the Prognosis of High-Risk Patients Undergoing Off-Pump Coronary Artery Bypass Grafting

This study investigated the efficacy and safety of preoperative insertion of an intra-aortic balloon pump (IABP) in high-risk coronary atherosclerotic disease patients undergoing off-pump coronary artery bypass grafting (OPCAB). A total of 232 patients were recruited to the study, of whom 107 underwent percutaneous insertion of an IABP prior to OPCAB. The remaining 125 patients underwent OPCAB alone. Pre-, peri- and postoperative parameters were compared between the two groups. Preoperative insertion of an IABP was associated with a shorter stay in intensive care, decreased incidence of postoperative dialysis and acute heart failure, and a reduction in postoperative mortality compared with OPCAB alone. There were no between-group differences in terms of haematocrit level, number of distal anastomoses, volume of postoperative drainage or incidence of reoperation for bleeding and postoperative stroke/cerebrovascular accident. In conclusion, preoperative insertion of an IABP improved the prognosis of high-risk CAD patients undergoing OPCAB.

Cyclin-dependent kinase inhibitor 3 (CDKN3) novel cell cycle computational network between human non-malignancy associated hepatitis/cirrhosis and hepatocellular carcinoma (HCC) transformation

The relationship of cyclin-dependent kinase inhibitor 3 (CDKN3) with tumours has previously been presented in a number of publications. However, the molecular network and interpretation of CDKN3 through the cell cycle between non-malignancy associated hepatitis/cirrhosis and hepatocellular carcinoma (HCC) have remained to be elucidated. Here, we have constructed and analysed significant high expression gene CDKN3 activated and inhibited cell cycle networks from 25 HCC versus 25 non-malignancy associated hepatitis/cirrhosis patients (viral infection HCV or HBV) in GEO Dataset GSE10140-10141, by combination of a gene regulatory network inference method based on linear programming, and decomposition procedure using CapitalBio MAS 3.0 software, based on integration of public databases including Gene Ontology, KEGG, BioCarta, GenMapp, Intact, UniGene, OMIM, and others. Comparing the same and differently activated and inhibited CDKN3 networks with GO analysis, between non-malignancy associated hepatitis/cirrhosis and HCC, our results suggest a CDKN3 cell cycle network (i) with stronger DNA replication and with weaker ubiquitin-dependent protein catabolism as common characteristics in both non-malignancy associated hepatitis/cirrhosis and HCC; (ii) with more cell division and weaker mitotic G2 checkpoint in non-malignancy associated hepatitis/cirrhosis; (iii) with stronger cell cycle and weaker cytokinesis, as a result forming multinucleate cells in HCC. Thus, it is useful to identify CDKN3 cell cycle networks for comprehension of molecular mechanism between non-malignancy associated hepatitis/cirrhosis and HCC transformation.

Clinical features of axial undifferentiated spondyloarthritis (USpA) in China: HLA-B27 is more useful for classification than MRI of the sacroiliac joint

OBJECTIVES

To analyse the clinical features of Chinese undifferentiated spondyloarthritis (USpA) patients with predominantly axial involvement, and in particular the influence of human leucocyte antigen (HLA)-B27 and magnetic resonance imaging (MRI) of the sacroiliac joint (SIJ) on the classification of axial USpA.

METHODS

Patients with low back pain for ≥ 3 months and no definite radiographic sacroiliitis were enrolled in this study. They were diagnosed as USpA based on rheumatologists' findings. Correlations between clinical features and HLA-B27 status or MRI manifestations were analysed.

RESULTS

A total of 197 USpA patients were recruited, of whom 135 (70.3%) were positive for HLA-B27. Acute inflammation, structural damage lesions, and normal findings on SIJ MRI were recorded in 64.5, 13.2 and 22.3% of patients, respectively. Classification criteria for axial SpA according to the European Spondylarthropathy Study Group (ESSG), Amor, and the Assessment of SpondyloArthritis International Society (ASAS) were fulfilled by 63.5, 64.5 and 83.2% patients, respectively. Cross-validation showed significant correlation among these three criteria. Patients positive for HLA-B27 included more males, with earlier onset age, better response to non-steroidal anti-inflammatory drugs (NSAIDs), and higher erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP) levels. In addition, more HLA-B27-positive than HLA-B27-negative patients fulfilled the ESSG, Amor, and ASAS criteria. Patients with acute inflammation on SIJ MRI had a higher level of ESR/CRP, and a greater proportion of them fulfilled the Amor and ASAS criteria. However, the proportion of those fulfilling the ESSG criteria did not differ with different MRI manifestations.

CONCLUSION

Both HLA-B27 status and SIJ MRI findings influence the classification of Chinese axial USpA patients, but HLA-B27 seems of more value.

Anion secretion by a model epithelium: more lessons from Calu-3

Anion transport drives fluid into the airways and is essential for humidifying inspired air and supplying surface liquid for mucociliary transport. Despite the importance of airway secretion in diseases such as cystic fibrosis, the cellular mechanisms remain poorly understood, in part due to the small size and complicated structure of the submucosal glands that produce most of the fluid. The Calu-3 human lung adenocarcinoma cell line has become a popular model for studying airway secretion because it can be cultured as a flat sheet, expresses the cystic fibrosis transmembrane conductance regulator and several acinar cell markers, forms polarized monolayers with tight junctions, has robust cAMP-stimulated anion transport, and responds to secretagogues that regulate the glands in vivo. However, some properties of Calu-3 cells are less consistent with those of native tissue. In particular, Calu-3 monolayers do not secrete chloride when stimulated by forskolin under short-circuit conditions. Bicarbonate ions are thought to carry the short-circuit current (I(sc)) and the drive secretion of alkaline fluid, in contrast to the neutral pH secretions that are produced by submucosal glands. Calu-3 cells also have abnormal chromosomes and characteristics of both serous and mucus cells. In this article, we discuss Calu-3 as a model in light of our ongoing studies, which suggest that Calu-3 monolayers resemble submucosal glands more closely than was previously thought. For example, we find that net HCO(3)(-) flux fully accounts for I(sc) as previously suggested but Cl(-) is the main anion transported under physiological conditions. A novel, HCO(3)(-) -dependent mechanism of Cl(-) transport is emerging which may explain secretion by Calu-3 and perhaps other epithelial cells.

Sequential Diagnosis by Abstraction

When a system behaves abnormally, sequential diagnosis takes a sequence of measurements of the system until the faults causing the abnormality are identified, and the goal is to reduce the diagnostic cost, defined here as the number of measurements. To propose measurement points, previous work employs a heuristic based on reducing the entropy over a computed set of diagnoses. This approach generally has good performance in terms of diagnostic cost, but can fail to diagnose large systems when the set of diagnoses is too large. Focusing on a smaller set of probable diagnoses scales the approach but generally leads to increased average diagnostic costs. In this paper, we propose a new diagnostic framework employing four new techniques, which scales to much larger systems with good performance in terms of diagnostic cost. First, we propose a new heuristic for measurement point selection that can be computed efficiently, without requiring the set of diagnoses, once the system is modeled as a Bayesian network and compiled into a logical form known as d-DNNF. Second, we extend hierarchical diagnosis, a technique based on system abstraction from our previous work, to handle probabilities so that it can be applied to sequential diagnosis to allow larger systems to be diagnosed. Third, for the largest systems where even hierarchical diagnosis fails, we propose a novel method that converts the system into one that has a smaller abstraction and whose diagnoses form a superset of those of the original system; the new system can then be diagnosed and the result mapped back to the original system. Finally, we propose a novel cost estimation function which can be used to choose an abstraction of the system that is more likely to provide optimal average cost. Experiments with ISCAS-85 benchmark circuits indicate that our approach scales to all circuits in the suite except one that has a flat structure not susceptible to useful abstraction.

Glyceraldehyde-3-phosphate dehydrogenase: activity inhibition and protein overexpression in rotenone models for Parkinson's disease

Rotenone, a widely used pesticide and an environmental risk factor for Parkinson's disease (PD), induces nigrostriatal injury, Lewy body-like inclusions, and Parkinsonian symptoms in rat models for PD. Our previous data indicated that glyceraldehyde-3-phosphate dehydrogenase (GAPDH) overexpression and glycolytic inhibition were co-current in rotenone-induced PC12 (rat adrenal pheochromocytoma cells) cell death. However, whether GAPDH overexpression plays any role in dopaminergic neurodegeneration in vivo remains unknown. In this study, we have found that GAPDH overexpression and GAPDH-positive Lewy body-like aggregates in nigral dopaminergic neurons while nigral GAPDH glycolytic activity decreases in rotenone-based PD animal models. Furthermore, GAPDH knockdown reduces rotenone toxicity significantly in PC12. These in vitro and in vivo data suggest that GAPDH contributes to the pathogenesis of Parkinson's disease, possibly representing a new molecular target for neuroprotective strategies and alternative therapies for PD.

Simvastatin exerts favourable effects on neointimal formation in a mouse model of vein graft

BACKGROUND

Simvastatin inhibits human saphenous vein neointima formation in human saphenous vein organ cultures. However, it is not known if simvastatin actually inhibits vein graft intima hyperplasia in vivo, and the underlying mechanisms behind that. In this study, we used a murine vein graft model to address these issues.

METHODS AND RESULTS

Vein grafting was performed among C57BL/6 J mice treated with low-dose (2 mg kg(-1)) or high-dose (20 mg kg(-1)) simvastatin or vehicle subcutaneously 72 h before and then daily after surgery. As compared to the vehicle, simvastatin dose-dependently significantly inhibited vein graft intima hyperplasia 4 weeks after surgeries. Immunohistochemistry studies suggested that vein graft neointima was mainly composed of vascular smooth muscle cells (VSMCs), and the rate of proliferating cell nuclear antigen (PCNA)-positive cells in the intima of vein grafts was significantly lower in simvastatin-treated groups than in control group. We isolated VSMC from mouse vena cava, simvastatin significantly reduced VSMC proliferation, and platelet-derived growth factor (PDGF)-induced VSMC migration in a dose-dependent manner.

CONCLUSION

Simvastatin inhibits neointima formation of mouse vein graft under normocholesterolaemic condition in vivo, the mechanisms might be associated with inhibitory effects of simvastatin on VSMC proliferation and migration.

Quantitative determination of lysophosphatidic acids (LPAs) in human saliva and gingival crevicular fluid (GCF) by LC-MS/MS

Lysophosphatidic acid (LPA) is a phospholipid mediator that plays multiple cellular functions by acting through G protein-coupled LPA receptors. LPAs are known to be key mediators in inflammation, and several lines of evidence suggest a role for LPAs in inflammatory periodontal diseases. A simple and sensitive liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) method has been developed and validated to quantify LPA species (LPA 18:0, LPA 16:0, LPA 18:1 and LPA 20:4) in human saliva and gingival crevicular fluid (GCF). LPA 17:0 was used as an internal standard and the LPA species were extracted from saliva by liquid-liquid extraction using butanol. Chromatography was performed using a Macherey-Nagel NUCLEODUR® C8 Gravity Column (125 mm × 2.0 mm ID) with a mixture of methanol/water: 75/25 (v/v) containing 0.5% formic acid and 5 mM ammonium formate (mobile phase A) and methanol/water: 99/0.5 (v/v) containing 0.5% formic acid and 5mM ammonium formate (mobile phase B) at a flow rate of 0.5 mL/min. LPAs were detected by a linear ion trap-triple quadrupole mass spectrometer with a total run time of 8.5 min. The limit of quantification (LOQ) in saliva was 1 ng/mL for all LPA species and the method was validated over the range of 1-200 ng/mL. The method was validated in GCF over the ranges of 10-500 ng/mL for LPA 18:0 and LPA 16:0, and 5-500 ng/mL for LPA 18:1 and LPA 20:4. This sensitive LC-MS/MS assay was successfully applied to obtain quantitative data of individual LPA levels from control subjects and patients with various periodontal diseases. All four LPA species were consistently elevated in samples obtained from periodontal diseases, which supports a role of LPAs in the pathogenesis of periodontal diseases.