Effects of glutamine-supplemented enteral or parenteral nutrition on apoptosis of intestinal mucosal cells in rats with severe acute pancreatitis

BACKGROUND

Hhigh mortality of the severe acute pancreatitis (SAP) is caused by the damage of intestinal mucosal barrier. Glutamine (Gln) has been used to protect the intestinal mucosal barrier in the treatments of many severe diseases.

AIM

To explore the impact of glutamine on the apoptosis of intestinal mucosa and Bax expression in rats with SAP.

MATERIALS AND METHODS

Eighty male SD rats were randomly divided into five groups: sham-operated group, SAP + parenteral nutrition (PN) group, SAP + enteral nutrition (EN) group, SAP + EN + Gln group, and SAP + PN + Gln group. Rats were sacrificed 4 days and 7 days after nutritional support. The intestinal epithelial apoptosis and the expression of Bax were examined by TUNEL assay and immunohistochemical staining, respectively.

RESULTS

The apoptotic index (AI) of SAP groups was higher than that of sham-operated group. After 7 days treatment, the AI of SAP + EN + Gln group was significantly lower than that of the SAP + EN or SAP + PN group. In addition, the AI of the SAP groups after 7 days treatment was significantly lower than that of the same groups at 4 days after treatment. Furthermore, the Bax expression of SAP + EN + Gln group was significantly lower than that in the SAP + EN or SAP + PN group. However, no significant differences were observed between SAP + EN + Gln group and SAP + PN + Gln group in AI and Bax expression.

CONCLUSIONS

Combination of Gln and parenteral nutrition or enteral nutrition inhibits the apoptosis of intestinal epithelial cells and maintains the integrity of the intestinal mucosal barrier.

The correlation between T helper type 17 cells and clinical characters in Chinese paediatric patients with chronic hepatitis B

Interleukin (IL)-17-mediated immune response has been shown to play a critical role in inflammation-associated disease. However, its role in the pathogenesis of chronic hepatitis B virus (HBV) in paediatric patients remains unknown. We investigated the frequency of T helper type 17 (Th17) cells and evaluated the association between the Th17 and clinical characters in paediatric patients with chronic hepatitis B (CHB). The frequency of Th17 cells was detected by flow cytometry analyses from 65 paediatric patients with CHB and nine healthy controls. The degree of hepatic inflammation was graded using the histological activity index (HAI). Compared with healthy controls, the frequency of Th17 cells in peripheral blood was significantly higher in paediatric patients with CHB. The proportion of Th17 cells was higher in the patients with higher HAI score (G2-G3) compared to those subjects with lower HAI score (G0-G1), but the frequency of Th17 cells had no correlation with serum HBV DNA loads or alanine aminotransferase levels. Compared with the younger age group (age 1-6 years), Th17 cell frequency was higher in the older age group (age 7-18 years). Peripheral Th17 cell frequency is associated closely with inflammation activity of liver tissues in paediatric patients with CHB.

Incubation period as part of the case definition of severe respiratory illness caused by a novel coronavirus

Non-specific symptoms of acute respiratory viral infections make it difficult for many countries without ongoing transmission of a novel coronavirus to rule out other possibilities including influenza before isolating imported febrile individuals with a possible exposure history. The incubation period helps differential diagnosis, and up to two days is suggestive of influenza. It is worth including the incubation period in the case definition of novel coronavirus infection.

Incubation period as part of the case definition of severe respiratory illness caused by a novel coronavirus

Non-specific symptoms of acute respiratory viral infections make it difficult for many countries without ongoing transmission of a novel coronavirus to rule out other possibilities including influenza before isolating imported febrile individuals with a possible exposure history. The incubation period helps differential diagnosis, and up to two days is suggestive of influenza. It is worth including the incubation period in the case definition of novel coronavirus infection.

Caveolin-1-mediated negative signaling plays a critical role in the induction of regulatory dendritic cells by DNA and protein coimmunization

Induction of Ag-specific regulatory T cells (iTregs) by vaccination is a promising strategy for treating autoimmune diseases. We previously demonstrated that DNA and protein covaccination converted naive T cells to Ag-specific iTregs by inducing CD11c+CD40(low)IL-10+ regulatory dendritic cells (DCregs). However, it is unclear how coimmunization induces the DCregs. In this paper, we report that the event is initiated by coentry of sequence-matched DNA and protein immunogens into the same DC via caveolae-mediated endocytosis, which leads to inhibition of phosphorylation of caveolin-1 (Cav-1), the main component of caveolae, and upregulation of Tollip. This triggers downstream signaling that upregulates suppressor of cytokine signaling 1 and downregulates NF-κB and STAT-1α. Silencing either Cav-1 or Tollip blocks the negative signaling, leading to upregulated expression of CD40, downregulated production of IL-10, and loss of iTreg-inducing function. We further show that DCregs can be induced in culture from primary DCs and JAWS II DC lines by feeding them sequence-matched DNA and protein immunogens. The in vitro-generated DCregs are effective in ameliorating autoimmune and inflammatory diseases in several mouse models. Our study thus suggests that DNA and protein coimmunization induces DCregs through Cav-1- and Tollip-mediated negative signaling. It also describes a novel method for generating therapeutic DCregs in vitro.

SU-E-J-104: Evaluation of Atlas-Based Auto-Segmentation on Daily In-Room CT for Prostate Cancer

PURPOSE

Anatomy delineation is a major time consuming task to correct for inter-fractional changes in anatomy. Atlas-based auto-segmentation (ABAS) was developed to expedite this process. This study aims to evaluate the performance of ABAS applying to high quality verification CT-imaging acquired using a CT-on-rail system for prostate cancer.

METHODS

The prostate, rectum and bladder were manually contoured for seven prostate cancer patients. For each patient, three patient specific atlases were generated consisting of one, four and seven prior image and contour sets. ABAS was applied using these atlases for the last seven daily CT images of each patient. The auto- and manual-contours were compared both geometrically and dosimetrically. The reproducibility of the observation was validated by an experienced radiation oncologist performing the same procedure. The performance of ABAS with patient and non-patient specific atlases were also evaluated on 21 image sets. P<0.05 was considered statistical significant for two-tailed paired student t-test.

RESULTS

Contours obtained from ABAS agreed well with the manual ones. With 1-image set atlas, the OI and DSC for the bladder were greater than 96% and 91%, respectively. Both indices were above 81% for rectum and prostate. The consistencies significantly improved by including 4 image sets in the atlas, while a further increase of atlas size to 7 did not show obvious benefits. Dose coverage for the auto- and manual-contours was similar for all organs. Similar results were obtained by the second observer. Compared with non-patient specific atlas, patient specific atlas yielded more accurate contours. The time for ABAS and manual contouring was ∼2 min and ∼20 min per image set, respectively.

CONCLUSIONS

With diagnostic quality verification images, ABAS can provide fast and accurate delineations for prostate cancer on a daily basis. The inclusion of more than one CT set in atlas improves the contouring results.

Villous trophoblast apoptosis is elevated and restricted to cytotrophoblasts in pregnancies complicated by preeclampsia, IUGR, or preeclampsia with IUGR

Human placental villi are surfaced by an outer multinucleated syncytiotrophoblast and underlying mononucleated cytotrophoblasts. Conflicting data have attributed one, or the other, of these villous trophoblast phenotypes to undergo enhanced apoptosis in complicated pregnancies, compared to term, normotensive pregnancies. We use high-resolution confocal microscopy after co-staining for E-cadherin, as a trophoblast plasma membrane marker, and for the cleavage products of cytokeratin 18 and PARP1, as markers for caspase-mediated apoptosis, to distinguish between apoptotic cytotrophoblasts and apoptosis within the syncytiotrophoblast. We test the hypothesis that increased caspase-mediated apoptosis occurs in villi of placentas derived from pregnancies complicated by preeclampsia, intrauterine growth restriction (IUGR), or both. We find significantly elevated apoptosis in villous cytotrophoblasts from women with preeclampsia and/or IUGR, compared to term, normotensive pregnancies. Apoptosis of cytotrophoblasts in villi from complicated pregnancies appears to progress similarly to what we found previously for apoptotic cytotrophoblasts in villi from in term, normotensive pregnancies. Notably, caspase-mediated apoptosis was not detectable in regions with intact syncytiotrophoblast, suggesting strong repression of apoptosis in this trophoblast phenotype in vivo. We suggest that the elevated apoptosis in cytotrophoblasts in preeclampsia contributes to the placental dysfunction characteristic of this disorder. We also propose that repression of apoptosis in the syncytiotrophoblast is important to prevent apoptosis sweeping throughout the syncytium, which would result in widespread death of this essential interface for maternal-fetal exchange.

Amiloride enhances antigen specific CTL by faciliting HBV DNA vaccine entry into cells

The induction of relatively weak immunity by DNA vaccines in humans can be largely attributed to the low efficiency of transduction of somatic cells. Although formulation with liposomes has been shown to enhance DNA transduction of cultured cells, little, if any, effect is observed on the transduction of somatic tissues and cells. To improve the rate of transduction, DNA vaccine delivery by gene gun and the recently developed electroporation techniques have been employed. We report here that to circumvent requirement for such equipment, amiloride, a drug that is prescribed for hypertension treatment, can accelerate plasmid entry into antigen presenting cells (APCs) both in vitro and in vivo. The combination induced APCs more dramatically in both maturation and cytokine secretion. Amiloride enhanced development of full CD8 cytolytic function including induction of high levels of antigen specific CTL and expression of IFN-γ+perforin+granzymeB+ in CD8+ T cells. Thus, amiloride is a facilitator for DNA transduction into host cells which in turn enhances the efficiency of the immune responses.

Sam68 expression and cytoplasmic localization is correlated with lymph node metastasis as well as prognosis in patients with early-stage cervical cancer

BACKGROUND

This study was aimed at investigating the role and molecular mechanism of Sam68 in cervical cancer lymph node metastasis.

MATERIALS AND METHODS

Sam68 expression profile was detected by quantitative polymerase chain reaction, western blotting and immunohistochemical staining. Short hairpin RNA interfering approach was employed to suppress endogenous Sam68 expression in cervical cancer cells to determine its role in metastasis and the possible mechanism.

RESULTS

Sam68 expression in cervical cancer was significantly up-regulated at both messenger RNA and protein levels compared with that in normal cervical tissues. The high expression level of Sam68 and its cytoplasmic localization were significantly associated with risk factors including pelvic lymph node metastasis (P < 0.001), and served as independent prognostic factors for predicting shortening of the overall survival time and disease-free survival time in patients with early-stage cervical cancer. Moreover, down-regulation of Sam68 in cervical cancer cells remarkably inhibited cellular motility and invasion. In addition, down-regulation of Sam68 reversed epithelial-mesenchymal transition through inhibiting the Akt/ GSK-3β/Snail pathway.

CONCLUSION

This study demonstrated that Sam68 could induce cervical cancer lymph node metastasis through regulating epithelial-mesenchymal transition, and Sam68 expression profile possessed the potential to serve as predictors of pelvic lymph node metastasis in cervical cancer patients.

Signal transducer and activator of transcription 3 (STAT3) gene polymorphisms are associated with treatment outcomes in acute myeloid leukemia

INTRODUCTION

In the Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway, STAT3 is one of the most prominent prognosis factors for cancer and leukemia. STAT3 activation might promote cellular transformation and therefore have an important role in human tumors. This study aimed to investigate the relationship between STAT3 polymorphisms and treatment response of acute myeloid leukemia (AML) in the Chinese population.

METHODS

Three single-nucleotide polymorphisms (SNPs) were tested in 130 patients with AML. Genomic DNA was isolated from peripheral blood and assayed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS).

RESULTS

The results of response to chemotherapy showed that there were strong relationships between unfavorable cytogenetics, partial remission (and even no remission), and GG genotype frequency in rs9909659 (P = 0.01 and 0.03). Patients younger than 45 years were associated significantly with GA/AA genotype (P = 0.01).

CONCLUSIONS

The results of this study suggest that the GG genotype in rs9909659 might confer increased resistance to standard chemotherapy.

Association of Janus kinase 2 (JAK2) polymorphisms with acute leukemia susceptibility

INTRODUCTION

Aberrant activation of Janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway leads to deregulated proliferation, differentiation, or apoptosis of normal cells. One of the members of this family, JAK2, plays a very important role in metabolizing carcinogens and medications. This study aimed to detect whether any association exists between genetic polymorphisms in JAK2 gene and individual susceptibility to acute leukemia.

METHODS

A case-control study in a Chinese population with 260 acute leukemia cases and 280 healthy controls matched by age, gender, and ethnicity. Genomic DNA was assayed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) with five genetic polymorphisms in JAK2 gene.

RESULTS

The distributions of rs56118985 GA genotype in the acute leukemia and acute myeloid leukemia (AML) groups were both slightly different when compared with the control group (P = 0.049 and P = 0.045). The frequencies of rs2230724 AA and GA genotypes in the acute leukemia and its subtypes were all significantly higher than that in the control group (P < 0.001). This suggested that subjects with A allele of rs2230724 were susceptible to acute leukemia and its subtypes. In addition, A allele of rs2230724 should be an important genetic determinant for acute leukemia and AML.

CONCLUSION

The results indicate that the risk of acute leukemia might be associated with JAK2 polymorphisms.

Preclinical pharmacology of TP1, a novel potent triple reuptake inhibitor with antidepressant properties

Triple reuptake inhibitors (TRIs) that block the dopamine transporter (DAT), norepinephrine transporter (NET), and serotonin transporter (SERT) are being developed as a new class of antidepressant that may have better efficacy and fewer side effects compared with traditional antidepressants. The purpose of this study was to characterize a new chemical entity, 4-[2-(dimethylamino)-1-(1-hydroxycyclohexyl)ethyl] phenyl 4-methoxybenzoate hydrochloride (TP1). TP1 was designed as a prodrug of desvenlafaxine. Competitive radioligand binding assays were performed using cells expressing the human dopamine (DA) transporter (hDAT), the human serotonin (5-HT) transporter (hSERT), and the human norepinephrine (NE) transporter (hNET) with K(i) values for TP1 of 190 nM, 2076 nM, and 1023 nM, respectively. Uptake assays were performed with IC(50) values for TP1 of 712 nM, 521 nM, and 628 nM, respectively. TP1 (0.06 mmol/kg, orally) rapidly penetrated rat brain and hypothalamus, translated into desvenlafaxine within 1 h, and demonstrated higher bioavailability and better pharmacokinetic properties than desvenlafaxine succinate (DVS). TP1 (0.06 mmol/kg, orally) significantly increased extracellular levels of DA, NE, and 5-HT compared with baseline in the rat hypothalamus by microdialysis assay. In dose-response assays, oral administration of TP1 reduced the time of immobility in a dose-dependent manner during tail suspension test and forced swimming test (FST). This antidepressant-like effect manifests in the absence of significant increases in motor activity even at doses of up to 32 mg/kg. The ability of TP1 to inhibit the reuptake of three biogenic amines closely linked to the etiology of depression may result in a therapeutic profile different from antidepressants that inhibit the reuptake of serotonin and/or NE.

First-trimester placental protein 13, PAPP-A, uterine artery Doppler and maternal characteristics in the prediction of pre-eclampsia

OBJECTIVE

To test the hypothesis that a combination of PP13, PAPP-A and first-trimester uterine artery Doppler would improve the prediction of pre-eclampsia.

METHODS

This is a prospective cohort study of pregnant women followed from the first-trimester to delivery. PP13 and PAPP-A were determined by immunoassay of maternal serum at 11-14 weeks', when uterine artery Doppler measurements were assessed. Cases identified with any form of pre-eclampsia were compared with a control group without pre-eclampsia. The sensitivity of each marker or their combinations in predicting pre-eclampsia for different fixed false positive rates was calculated from the ROC curves.

RESULTS

Forty two women were diagnosed with pre-eclampsia and 410 women with pregnancies not complicated by pre-eclampsia were used as controls. For a fixed false positive rate (FPR) of 20%, PP13, PAPP-A and mean uterine artery pulsatility index identified 49%, 58% and 62% respectively, of women who developed any form of pre-eclampsia. PP13 was best in predicting early onset pre-eclampsia with a sensitivity of 79% at a 20% FPR. Combinations of the three first-trimester assessments did not improve the prediction of pre-eclampsia in later pregnancy.

CONCLUSION

First-trimester PP13, PAPP-A and uterine artery PI are reasonable, individual predictors of women at risk to develop pre-eclampsia. Combinations of these assessments do not further improve the prediction of pre-eclampsia.

Abstract 2410: Characterization of Notch as an oncogenic driver in liver

INTRODUCTION: Notch is an evolutionary conserved pathway essential for embryonic development and tissue renewal in metazoan. It plays a key role in liver development by regulating hepatic progenitor cell differentiation. Dysregulation of Notch pathway is found in several cancers, while there are few data regarding its role in hepatocarcinogenesis.

AIMS: (1) To study Notch dysregulation in human hepatocellular carcinoma (HCC), and (2) to determine the oncogenic capacity of constitutive Notch activation in transgenic mice.

METHODS: Eighteen key Notch pathway genes were evaluated in human samples covering the whole spectrum of human hepatocarcinogenesis (normal liver, cirrhosis, dysplasia and HCC) for DNA copy number changes (Affymetrix 238K, 132 samples) and mRNA levels (Affymetrix U133, 132 samples – Illumina DASL, 164 samples). Notch1 mutation analysis was performed in 50 human HCC samples using Sanger sequencing (GENEWIZ, Inc.). A knock in mouse line carrying the mouse Notch1 intracellular domain (NICD) inserted in the Rosa26 locus downstream of a floxed Neo/STOP codon was crossed with an AFP/albumin-Cre transgenic mouse line. To generate a Notch activation gene signature, we compared the transcriptome of control and transgenic liver samples. The presence of the Notch activation signature was evaluated in human HCC (225 samples) and intrahepatic cholangiocarcinoma (ICC) (149 samples) using the nearest template prediction method. CK19 staining and histopathological features were evaluated by a pathologist in paraffin embedded liver samples from control and transgenic mice.

RESULTS: Several Notch genes were significantly up-regulated (corrected p-value&lt;0.05) in human HCC when compared to normal liver, including ligands (JAG1, JAG2), putative targets/modifiers (DTX2, HEY1, SOX9, SPP1), and effectors (MAML1). Among them, HEY locus exhibited DNA gains that correlated with gene expression (p&lt;0.009). Up-regulation of HEY1 (median 2.3 fold-increase), a Notch target, was significantly enriched in the “Proliferation” class of HCC molecular classification (Chiang et al. Cancer Res 2008). Notch1 was mutated in 4% of the human HCC samples (2/50) comprising exons 27 and 34. Notch activation signature significantly captured 15% of human HCCs and ICCs. In vivo activation of Notch in transgenic mice induced liver tumors with high frequency, reaching 100% at &gt;10 months (11/11). Predominant tumor type was HCC, although 30% showed a mixed pattern with progenitor-like cells and CK19 positive staining (3/10).

CONCLUSIONS: Notch pathway is significantly dysregulated in human HCC. Genetically engineered mice with constitutive activation of Notch1 undergo liver oncogenesis, suggesting that Notch behaves as an oncogene in liver cancer.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2410. doi:10.1158/1538-7445.AM2011-2410

Genotypic resistance profile of hepatitis B virus (HBV) in a large cohort of nucleos(t)ide analogue-experienced Chinese patients with chronic HBV infection

The study investigated the hepatitis B virus (HBV) genotypic resistance profile in 1803 nucleos(t)ide analogue (NA)-experienced Chinese patients with chronic HBV infection. Serum HBV DNA was extracted, and the reverse transcriptase region was analysed by a high-sensitive direct PCR sequencing and verified by clonal sequencing if necessary. Drug-resistant mutations were detected in 560 of the 1803 patients, including 214 of 490 patients who received lamivudine (LAM), 35 of 428 patients who received adefovir (ADV), five of 18 patients who received telbivudine and 306 of 794 patients who received various sequential/combined NA therapies. ADV-resistant mutations were detected in 36 of 381 patients who received LAM and then switched-to ADV in contrast to one of 82 patients who received ADV add-on LAM. Entecavir (ETV)-resistant mutations were detected not only in LAM- and ETV-treated patients but also in LAM-treated ETV-naïve patients. Double mutations rtM204I and rtL180M were detected more frequently in genotype C than in genotype B virus, and patients infected with this mutant had higher alanine transaminase levels than those infected with mutant containing the rtM204I substitution alone. Multidrug-resistant HBV strains were identified in eight patients, including two novel strains with mutational patterns rtL180M + A181V + S202G + M204V + N236T and rtL180M + S202G + M204V + N236T. The results provide new information on HBV genotypic resistance profiles in a large cohort of Chinese patients with chronic HBV infection and may have important clinical implication for HBV drug resistance management in China.

Selective Rapid Thermal Cvd of Germanium

Selective depositions of germanium thin films have been investigated in a cold-wall, lamp heated rapid thermal processor. Films were deposited at low pressures (1 Torr-8 Torr) using the thermal decomposition of germane. Selectivity was maintained throughout the temperature range investigated, 350°C-600°C. Growth rates as high as 800 Å/min were obtained at 425°C where deposition is controlled by the surface reactions, making germanium compatible with the throughput requirements of single wafer manufacturing. Three dimensional growth was seen at temperatures above 450°C resulting in a rough surface morphology. Smooth films were deposited below 450°C with the films characterized by two dimensional growth. In this work, germanium is considered as a potential material to fabricate MOS transistors with raised source and drain junctions (UPMOS). Kelvin structures were fabricated to study the effect of the intermediate germanium layer between aluminum and silicon on contact resistance. It is shown that contact resistivity is improved by approximately 17% using an Al/p-Ge/p+-Si structure. In this work, it is also shown that titanium germanide formation can be used as a means of reducing the resistivity of the Ge buffer layer.

First-trimester serum analytes, biophysical tests and the association with pathological morphometry in the placenta of pregnancies with preeclampsia and fetal growth restriction

OBJECTIVE

We test the hypothesis that first-trimester serum analytes, 4-D power Doppler placental vascular indices and uterine artery Doppler (UAD) predicts abnormal placental morphometry in pregnancies with preeclampsia (PE) and fetal growth restriction (FGR).

STUDY DESIGN

Maternal serum analytes (PAPP-A, hCG, ADAM12s, and PP13), bilateral UADs, and placental vascular indices were measured at 11-14 weeks in a nested-case control study within a prospective cohort of women followed from the first-trimester to delivery. Vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were obtained from 4-D power Doppler histograms. Serum analytes were measured using immunofluorometric assays and values converted to multiples of the median (MoM) for gestational age. Morphometric analysis was performed on placentas from pregnancies complicated by PE (n = 13), gestational hypertension (HBP, n = 7) and FGR (defined as fetal weight <10th percentile with abnormal umbilical artery Doppler: n = 7); and 20 uncomplicated pregnancies. Two pregnancies had both FGR and PE. Each placenta was weighed and random samples taken, and fixed in formalin within 1 h of delivery. Hematoxylin & Eosin stained slides were analyzed by design-based stereology to quantify linear dimensions, surface areas and volumes of placental components. Paired t-test and ANOVA with adjustments for multiple comparisons were used.

RESULTS

The surface areas of terminal and intermediate villi as well as the volume of terminal villi were significantly smaller in placentas from pregnancies complicated by FGR and PE. Compared with the control group the mean PAPP-A (MoM) was lower in the pregnancies with abnormal placenta morphometry (1.1 ± 0.5 versus 0.7 ± 0.5, P = 0.03). The morphometric indices were lower in those pregnancies with low PAPP-A and IUGR compared with preeclampsia.

CONCLUSION

First-trimester PAPP-A levels are associated with abnormal placental morphometry at delivery in pregnancies with PE and IUGR. These findings may explain the association between adverse pregnancy outcomes and first-trimester PAPP-A.