Does cross-linked polyethylene decrease the revision rate of total hip arthroplasty compared with conventional polyethylene? A meta-analysis

BACKGROUND

Although cross-linked polyethylene is resistant to wear in comparison to conventional polyethylene, it remains unknown whether it can decrease the wear-related revision rate of total hip arthroplasty.

OBJECTIVES

To determine whether cross-linked polyethylene decreases the wear-related revision rate of total hip arthroplasty compared with conventional polyethylene.

DATA SOURCES

Electronic databases, including PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials, were queried from inception to July 6, 2013.

STUDY SELECTION

Randomized controlled trials (RCTs) comparing cross-linked polyethylene with conventional polyethylene were included. In addition, the standard 28-mm femoral head was used, and follow-up was performed for a minimum of 5 years. The primary outcome assessed was wear-related revision. The secondary outcome measures evaluated were the incidence of osteolysis, the linear wear rate, and the linear head penetration.

DATA SYNTHESIS

The Cochrane Collaboration's tool for assessing the risk of bias was used for quality assessment. Data from eligible studies were pooled using a random effects model.

RESULTS

Eight studies involving 735 patients were included in this study. Meta-analysis showed there was no significant difference between cross-linked and conventional polyethylene group in terms of osteolysis or wear-related revision. The pooled mean differences were significantly less for the linear wear rate and linear head penetration for cross-linked polyethylene than for conventional polyethylene.

LIMITATIONS

The studies differed with respect to the cross-linked liner brands, manufacturing processes, and radiological evaluation methods. Moreover, the follow-up periods of the RCTs were not long enough.

CONCLUSIONS

The current limited evidence suggests that cross-linked polyethylene significantly reduced the radiological wear compared with conventional polyethylene at midterm follow-up periods. However, there is no evidence that cross-linked polyethylene had an advantage over conventional polyethylene in terms of reducing osteolysis or wear-related revision. Nevertheless, future long-term RCTs on this topic are needed.

KEY FINDINGS

Cross-linked polyethylene significantly reduced radiological wear but not osteolysis or wear-related revision in comparison to conventional polyethylene at midterm follow-up periods.

LEVEL OF EVIDENCE

Level I, systematic review of level I studies.

Obesity interventions in African American faith-based organizations: a systematic review

African Americans, especially women, have higher obesity rates than the general US population. Because of the importance of faith to many African Americans, faith-based organizations (FBOs) may be effective venues for delivering health messages and promoting adoption of healthy behaviours. This article systematically reviews interventions targeting weight and related behaviours in faith settings. We searched literature published through July 2012 for interventions in FBOs targeting weight loss, diet and/or physical activity (PA) in African Americans. Of 27 relevant articles identified, 12 were randomized controlled trials; seven of these reported a statistically significant change in an outcome. Four of the five quasi-experimental and single-group design studies reported a statistically significant outcome. All 10 pilot studies reported improvement in at least one outcome, but most did not have a comparison group. Overall, 70% of interventions reported success in reducing weight, 60% reported increased fruit and vegetable intake and 38% reported increased PA. These results suggest that interventions in African American FBOs can successfully improve weight and related behaviours. However, not all of the findings about the success of certain approaches were as expected. This review identifies gaps in knowledge and recommends more rigorous studies be conducted to strengthen the comparative methodology and evidence.

Myeloid dendritic cells are primed in allergic asthma for thymic stromal lymphopoietin-mediated induction of Th2 and Th9 responses

BACKGROUND

Type 1 myeloid dendritic cells (mDCs) contribute to inception of allergic asthma (AA) and are regulated by epithelial-derived cytokines.

OBJECTIVES

To evaluate whether mDCs from AA patients are primed for thymic stromal lymphopoietin (TSLP)-driven responses.

METHODS

mDCs from 18 AA patients and 15 controls were purified using immunomagnetic sorting. Cells were pulsed with TSLP or Dermatophagoides pteronyssinus (Der p) allergen, before FACS phenotyping and co-culture with allogeneic CD4+ T cells. Bronchial biopsies from 15 AA patients and four controls were immunostained for CD1c and TSLP receptor (TSLPR).

RESULTS

Allergic asthma patients had a higher proportion of TSLPR+ mDCs, in blood and bronchial mucosa. When compared to mDCs from controls, both TSLP- and Der p-pulsed blood mDCs from AA patients induced increased polarization of CD4+ T cells into Th2 cells (IL-5, IL-13, and GATA3+), while only TSLP-mDCs promoted Th9 cells (IL-9 and PU.1+ /IRF4+). In addition, OX40L was induced upon TSLP stimulation and was required for the induction of Th2, but not Th9, cells. In contrast, development of Th9 cells in this model depended on TGF-β1.

CONCLUSIONS

Our data indicate overlapping but partially distinct effects of TSLP and Der p allergen pathways, showing that DCs are primed in human asthma for TSLP-driven induction of both Th2 and Th9 cells. This novel TSLP/mDC/Th9 axis operates through a distinct, OX40L-independent pathway. These data further highlight the TSLP pathway as a relevant target in human asthma.

A 3-D elasticity theory based model for acoustic radiation from multilayered anisotropic plates

A theoretical model built upon three-dimensional elasticity theory is developed to investigate the acoustic radiation from multilayered anisotropic plates subjected to a harmonic point force excitation. Fourier transform technique and stationary phase method are combined to predict the far-field radiated sound pressure of one-side water immersed plate. Compared to equivalent single-layer plate models, the present model based on elasticity theory can differentiate radiated sound pressure between dry-side and wet-side excited cases, as well as discrepancies induced by different layer sequences for multilayered anisotropic plates. These results highlight the superiority of the present theoretical model especially for handling multilayered anisotropic structures.

Comparison of flucytosine and fluconazole combined with amphotericin B for the treatment of HIV-associated cryptococcal meningitis: a systematic review and meta-analysis

Treatment guidelines recommend combination antifungal therapy with amphotericin B (AmB) as an induction therapy for cryptococcal meningitis. The objective of this study was to compare the survival benefit between 5-FC (flucytosine) and fluconazole as second-line drugs given in combination with AmB. We carried out a systematic review and meta-analysis of prospective controlled studies reporting early combination treatment for human immunodeficiency virus (HIV)-associated cryptococcal meningitis. We searched MEDLINE, EMBASE and the Cochrane Library up to October 2013. Randomised trials and prospective cohort studies were selected. The primary outcome was mortality in the first 14 and 70 days. The secondary outcome was early fungicidal activity (EFA) in the first 2 weeks. Four trials were included in our study. All included studies could be considered to be of fair quality in their methodology. The meta-analysis suggested that mortality was lower in patients who were given AmB and 5-FC at the 2 weeks point (Fig. 2); the overall reduction in mortality with the 5-FC combination group was 44% [risk ratio (RR) 0.56, 95% confidence interval (CI) 0.33-0.95, p = 0.03]. EFA was significantly shorter in patients receiving AmB plus 5-FC [mean difference (MD) -0.10 log10 colony-forming units (CFU) per day, 95 % CI -0.11-0.09, p < 0.00001]. Mortality was no different between the 5-FC and fluconazole groups at the 3 months time point (p = 0.15) (Fig. 4). Adverse events occurred with similar frequency between the two treatment groups. There was no statistically significant difference in the survival rate between AmB in combination with high-dose fluconazole and the current standard of AmB plus 5-FC therapy for HIV-associated cryptococcal meningitis.

Scalable implementation of boson sampling with trapped ions

Boson sampling solves a classically intractable problem by sampling from a probability distribution given by matrix permanents. We propose a scalable implementation of boson sampling using local transverse phonon modes of trapped ions to encode the bosons. The proposed scheme allows deterministic preparation and high-efficiency readout of the bosons in the Fock states and universal mode mixing. With the state-of-the-art trapped ion technology, it is feasible to realize boson sampling with tens of bosons by this scheme, which would outperform the most powerful classical computers and constitute an effective disproof of the famous extended Church-Turing thesis.

Effects of common polymorphisms rs2910164 in miR-146a and rs11614913 in miR-196a2 on susceptibility to colorectal cancer: a systematic review meta-analysis

PURPOSE

Emerging evidence has shown that single nucleotide polymorphisms occurred in microRNAs may contribute to the development of colorectal cancer (CRC). rs2910164 in miR-146a and rs11614913 in miR-196a2 are suggested to be associated with the susceptibility to CRC, but individually published studies revealed inconclusive results. To systematically summarize the possible correlationship between these polymorphisms and CRC risk, we performed this meta-analysis.

METHODS

We retrieved the relevant articles of the associations between these two microRNA polymorphisms and susceptibility to CRC for the period up to July 1, 2013. A total of seven articles were identified with 2,143 cases and 2,457 controls for miR-146a rs2910164, 1,594 cases and 2,252 controls for miR-196a2 rs11614913. Odds ratio and 95 % confidence interval were calculated to investigate the strength of the association.

RESULTS

The pooled analysis showed that miR-146a rs2910164 did not reveal any correlation with CRC susceptibility. However, a decreased risk was observed between miR-196a2 rs11614913 and CRC in all genetic models.

CONCLUSION

Our current meta-analysis demonstrates that miR-196a2 rs11614913 most likely contributes to decreased risk of CRC, whereas miR-146a rs2910164 may not be associated with the susceptibility to CRC.

KL-6 regulated the expression of HGF, collagen and myofibroblast differentiation

OBJECTIVES

KL-6 is a pulmonary epithelial-derived mucin which is secreted mainly by type II alveolar epithelial cells. The level of KL-6 in serum is closely correlated to the clinical activity of various interstitial lung diseases (ILD) and acts as a prognostic factor for ILD patients. Previous studies have showed that KL-6 promoted chemotaxis, proliferation and inhibited the apoptosis of human lung fibroblasts. However, the underlying mechanism remains unknown. In this study, we investigated the function of KL-6 on the expression of hepatocyte growth factor (HGF), transforming growth factor-β1 (TGF-β1), collagen and α-smooth muscle actin(α-SMA) in human embryonic lung fibroblasts cell line MRC-5.

METHODS

Human embryonic lung fibroblasts were cultured in Eagle's minimum essential medium. The cells plated in 6-well plates was cultured in serum-free medium at 37°C in 5% CO2 and challenged with recombinant KL-6 at a final concentration of 0, 10, 20, 40 ng/mL. Five micrograms of total RNA template were transcripted to cDNA by using AMV (Avian Myeloblastosis Virus) reverse transcriptase and random 9 mers as the first-strand primer. Synthesized cDNA was used in PCR experiments. The expression of TGF-β1 and HGF in cell culture supernatants was measured using ELISA kit. Cells incubated with KL-6 for 72h were collected for flow-cytometry analysis. The analysis was done using a Beckman counter device.

RESULTS

It was found that KL-6 up-regulated the expression of collagen type I and III in a dose-dependent manner. However, the addition of KL-6 significantly inhibited the production of HGF. As regard to the biological function, KL-6 induced myofibroblast differentiation confirmed by the elevated expression of a-SMA.

CONCLUSIONS

KL-6 is one of the key molecules involved in epithelial-mesenchymal interactions and might contribute to the fibrosis in ILD.

Identification of epithelial stromal interaction 1 as a novel effector downstream of Krüppel-like factor 8 in breast cancer invasion and metastasis

Krüppel-like factor 8 (KLF8) is a transcriptional factor critical for metastatic progression of breast cancer. Epithelial stromal interaction 1 (EPSTI1), a recently identified stromal fibroblast-induced gene in non-invasive breast cancer cells is highly overexpressed in invasive breast carcinomas. The function and regulation of EPSTI1, however, remain largely unknown. In this paper, we report a novel KLF8 to EPSTI1 signaling pathway in breast cancer. Using various expression analyses, we revealed a high co-overexpression of KLF8 and EPSTI1 in invasive human breast cancer cells and patient tumors. Ectopic overexpression of KLF8 in the non-invasive, MCF-10A cells induced the EPSTI1 expression, whereas KLF8 knockdown from the invasive, MDA-MB-231 cells decreased the EPSTI1 expression. Promoter activation and binding analyses indicated that KLF8 promoted the EPSTI1 expression by directly acting on the EPSTI1 gene promoter. EPSTI1 knockdown dramatically reduced the KLF8-promoted MCF-10A cell invasion and ectopic expression of EPSTI1 in the non-invasive, MCF-7 cells is sufficient to induce the cell invasion. Experiments using nude mice demonstrated that the ectopic EPSTI1 granted the MCF-7 cells capability of both invasive growth in the breasts and metastasis to the lungs. Using co-immunoprecipitation coupled with mass spectrometry, we discovered that EPSTI1 interacts with the valosin containing protein (VCP), resulting in the degradation of IκBα and subsequent activation of NF-κB in the nucleus. These findings suggest a novel KLF8 to EPSTI1 to VCP to NF-κB signaling mechanism potentially critical for breast cancer invasion and metastasis.

KLF8 and FAK cooperatively enrich the active MMP14 on the cell surface required for the metastatic progression of breast cancer

Krüppel-like factor 8 (KLF8) regulates critical gene transcription associated with cancer. The underlying mechanisms, however, remain largely unidentified. We have recently demonstrated that KLF8 expression enhances the activity but not expression of matrix metalloproteinase-2 (MMP2), the target substrate of MMP14. Here, we report a novel KLF8 to MMP14 signaling that promotes human breast cancer invasion and metastasis. Using cell lines for inducible expression and knockdown of KLF8, we demonstrate that KLF8 promotes MMP14 expression at the transcriptional level. Knocking down KLF8 expression inhibited the breast cancer cell invasion both in vitro and in vivo as well as the lung metastasis in mice, which could be rescued by ectopic expression of MMP14. Promoter reporter assays and oligonucleotide and chromatin immunoprecipitations determined that KLF8 activates the human MMP14 gene promoter by both directly acting on the promoter and indirectly via promoting the nuclear translocation of β-catenin, the expression of T-cell factor-1 (TCF1) and subsequent activation of the promoter by the β-catenin/TCF1 complex. Inhibition of focal adhesion kinase (FAK) using pharmacological inhibitor, RNA interference or knockout showed that the cell surface presentation of active MMP14 downstream of KLF8 depends on FAK expression and activity. Taken together, this work identified novel signaling mechanisms by which KLF8 and FAK work together to promote the extracellular activity of MMP14 critical for breast cancer metastasis.

Integration microarray and regulation datasets for Chronic Obstructive Pulmonary Disease

BACKGROUND

Pulmonary disease has become one of the major health problems.

AIM

To investigate the regulation mechanism of Chronic Obstructive Pulmonary Disease (COPD) on gene expression and pathway level.

MATERIALS AND METHODS

We mapped the differentially expressed genes to a regulation network and pathways, using transcriptome profiles and regulation data. We constructed a TF-target gene regulation network, TF-pathway regulation network, and pathway crosstalk network.

RESULTS

STAT1, NFKB1, SMAD4, and STAT3 played an important role in COPD through participating in a number of pathways. Although these related pathways all have been demonstrated associated with COPD in previous reports, the detail mechanism may be not very clear.

CONCLUSIONS

Our results may help to further understanding the mechanism of COPD. And Identified multiple pathways will also provide novel avenues in the treatment of COPD.

Model and Numerical Simulation for the Second Penetration in Water-assisted Injection Molding

Unlike gas-assisted injection molding, subsequent penetration occurs on the radial direction after water displacing polymer melt in cavity due to the incompressibility and fast cooling of water in water-assisted injection molding. To simulate this second penetration, a dimensionless method was employed to simplify the governing equations for melt flow. Based on the reduced model, a formula was derived via mathematical inference to calculate the second penetration velocity and distance. In order to catch the huge temperature gradient at water-polymer interface, both polymer and water thermal conduct problems were founded and coupled at the interface. The finite element method was employed to solve the melt flow problem, and the finite difference method was used to discretize the energy equation. To verify the validity of the proposed model and algorithm, experiments were performed to measure the displacement of the water–melt interface for various melt temperatures and water pressures. The experimental results indicate that the primary penetration theory is not accurately on predicting residual wall thickness, whereas the combined primary and second penetration method significantly improve the accuracy.

Study of Shrinkage and Warpage in Microcellular Co-Injection Molding

This study investigated the effects of processing conditions on the shrinkage and warpage behavior of a box-shaped, polypropylene part created using a special microcellular co-injection molding process. Results were compared to the shrinkage and warpage of conventional and microcellular injection molded parts. A preliminary study was performed to determine processing condition limits and the steady state conditions for each combination of molding parameters. A 26-1 fractional factorial design of experiments (DOE) was performed utilizing the previously determined processing conditions. The molded parts were measured using an optical coordinate measuring machine (OCMM), which had previously been examined with a repeatability and reproducibility (R&R) study. These measurements were analyzed to determine the processing parameters that had the greatest effect on the shrinkage and warpage (S&W). The results of this analysis indicated that the supercritical fluid content and core-to-skin volume ratio had the greatest effect on the shrinkage and warpage of microcellular co-injection molded parts. The results of the experiment were that a considerable reduction in shrinkage and warpage could be achieved by utilizing microcellular co-injection molding.

Home-based HIV counselling and testing in western Kenya

BACKGROUND

The World Health Organisation (WHO) estimates that only 12% of men and 10% of women in sub-Saharan Africa have been tested for HIV and know their test results. Home-based counselling and testing (HBCT) offers a novel approach to complement facility-based provider initiated testing and counselling (PITC) and voluntary counselling and testing (VCT) and could greatly increase HIV prevention opportunities. However, there is almost no evidence that large-scale, door-to-door testing is even feasible in settings with both limited resources and significant stigma around HIV and AIDS.

OBJECTIVE

To describe our experience with the feasibility and acceptance of home-based HIV counselling and testing (HBCT) in two large, rural, administrative divisions of western Kenya.

DESIGN

The USAID-AMPATH Partnership conducted population-based, house-to-house HIV counselling and testing in western Kenya between June 2007 and June 2009. All individuals aged > or = 13 years and all eligible children were offered HBCT. Children were eligible if they were above 13 years of age, and their mother was either HIV-positive or had unknown HIV serostatus, or if their mother was deceased or whose vital status was unknown.

SETTING

Kosirai and Turbo Divisions, Rift Valley Province, Kenya.

RESULTS

There were 47,066 households approached in 294 villages: 97% of households allowed entry. Of the 138,026 individuals captured, 101,167 individuals were eligible for testing: 89% of adults and 58% of children consented to HIV testing. The prevalence of HIVin these communities was 3.0%: 2.7% in adults and 3.7% among children. Prevalence was highest in the 36-45 year age group and was almost always higher among women and girls. All persons testing HIV-positive were referred to Academic Model Providing Access to Healthcare (AMPATH) for further assessment and care; all consenting persons were counselled on HIV risk-lowering behaviours.

CONCLUSION

Home-based HIV counselling and testing was feasible among this rural population in western Kenya, with a majority of the population accepting to get tested. These data suggest that scaling-up of HBCT is possible and may enable large numbers of individuals to know their HIV serostatus in sub-Saharan Africa. More research is needed to describe the cost-effectiveness and clinical impact of this approach.

Suppression of the high-p(T) charged-hadron R(AA) at the LHC

We present a parameter-free postdiction of the high-p(T) charged-hadron nuclear modification factor (R(AA)) in two centralities, measured by the CMS Collaboration in Pb-Pb collisions at the LHC. The evolution of the bulk medium is modeled using viscous fluid dynamics, with parameters adjusted to describe the soft hadron yields and elliptic flow. Assuming the dominance of radiative energy loss, we compute the medium modification of the R(AA) using a perturbative QCD-based formalism, the higher twist scheme. The transverse momentum diffusion coefficient q[over ^] is assumed to scale with the entropy density and is normalized by fitting the R(AA) in the most central Au-Au collisions at the Relativistic Heavy-Ion Collider. This setup is validated in noncentral Au-Au collisions at the Relativistic Heavy-Ion Collider and then extrapolated to Pb-Pb collisions at the LHC, keeping the relation between q[over ^] and entropy density unchanged. We obtain a satisfactory description of the CMS R(AA) over the p(T) range from 10 to 100 GeV.

CCL2−2518 (A/G) polymorphisms and tuberculosis susceptibility: a meta-analysis

BACKGROUND

It has been found that the -2518 C-C motif ligand (CCL)-2 promoter variant increases the risk of developing active tuberculosis (TB).

OBJECTIVE

To study the association between -2518 variants and susceptibility to TB.

DESIGN

We searched Medline, PubMed and the Wan Fang databases for human genetic studies on whether the -2518 CCL2 polymorphism influences the expression of active TB. Articles published from January 1998 to November 2010 were included. A random effects model was conducted in the meta-analysis.

RESULTS

The CCL2-2518G allele (OR 1.51, 95%CI 1.11-2.04, P = 0.008) showed significant association with susceptibility to TB. In genotype analysis, the recessive model (CCL2 genotype GG, OR 1.66, 95%CI 1.19-2.33, P = 0.003) was slightly superior to the dominant model (G carrier genotypes OR 1.53, 95%CI 1.07-2.17, P = 0.018). These observations were prominent among Asians and Latin-Americans of Hispanic ancestry, but not in Africans from Ghana and South Africa. The presence of epistatic genes in one population but not in the other, environmental differences and pathogen virulence may account for this.

CONCLUSION

The CCL2-2518G allele increases the risk of developing TB in Asians and Hispanics.

Size control and catalytic activity of highly dispersed Pd nanoparticles supported on porous glass beads

This paper presents a novel in situ method to prepare monodispersed palladium nanoparticles supported on porous glass beads with an egg-shell structure at room temperature. This method integrates two processes of ion exchange and reduction in one step just by changing the solvent from water to alcohol. The monodispersed Pd nanoparticles around 3.75 nm in diameter with a face-centered cubic structure have been successfully prepared. The adsorption capacity for palladium reached 55.00 ± 0.55 mg/g in ethanol, which was 26 times larger than that in water. These Pd nanoparticles supported on porous glass beads showed an excellent catalytic performance through the hydrogenation of cyclohexene. In addition, this in situ method was also successfully applied to prepare monodispersed silver and gold nanoparticles supported on porous glass beads. Overall, this facile method provided an alternative for preparing a supported nanoparticle catalyst in a green way.

Effects of haptoglobin polymorphisms and deficiency on susceptibility to inflammatory bowel disease and on severity of murine colitis

BACKGROUND

Haptoglobin (Hp) is a haemoglobin-binding protein with immunomodulatory properties. Its gene (16q22) harbours a common polymorphism with two different alleles: Hp1 and Hp2. Genotype Hp22 has been shown to be over-represented in different immune diseases. Results in Crohn's disease (CD) are contradictory.

AIMS

To determine whether Hp plays a role in inflammatory bowel disease, both genetically and functionally.

METHODS

1061 patients with CD, 755 with ulcerative colitis (UC) and 152 with primary sclerosing cholangitis, as well as 452 healthy controls, were genotyped using touch-down PCR. To confirm association results, 464 CD trios and 151 UC trios were genotyped. Serum Hp concentrations were determined in 62 individuals of different genotype. Colitis was induced in mice with dextran sulphate sodium (DSS) and oxazolone (Oxa). Cytokine production was evaluated by mRNA quantification in colonic tissue and ELISA on supernatants of mesenteric lymph node cells.

RESULTS

Prevalence of Hp2 was higher in CD and UC than in controls. In the confirmatory cohorts, Hp2 was over-transmitted to the affected offspring. Serum Hp concentrations were higher in individuals with genotypes Hp11 and Hp21 than in those with Hp22 (1.38 vs 0.89 g/l). DSS- and Oxa-induced colitis were more severe in Hp-deficient mice than in control mice and accompanied by higher concentrations (although not statistically significantly different) of tissue mRNA for cytokines. Interleukin-17 production was significantly higher in the presence of Hp-deficient serum compared with wild-type serum.

CONCLUSIONS

The Hp gene may play a role in susceptibility to inflammatory bowel disease. Its implication in other immune diseases underscores the common pathways between these diseases. Experimental models of colitis showed that Hp has a protective role in inflammatory colitis, most likely by inhibiting the production of Th1 and Th17 cytokines.

Solitary intracranial Rosai-Dorfman disease: case report and literature review

Rosai-Dorfman disease is a well-established autoimmune histioproliferative disorder, and solitary central nervous system involvement is rare. A 35-year-old man presented with headache and transient blurred vision of 4 months' duration and weakness of the left extremities for 1 month. He had left temporal hemianopsia, a right nasal visual field defect of the upper medial quadrant and decreased muscle strength of the left extremities. Magnetic resonance imaging (MRI) showed a contrastenhancing tentorium-based lesion in the right trigone, intruding into the right lateral ventricle. The lesion was totally resected. Rosai-Dorfman disease was confirmed pathologically by an inflammatory infiltrate in the absence of an infectious agent, emperipolesis and positive S100 staining. From a review of the literature on Rosai-Dorfman disease in the central nervous system it is concluded that follow-up MRI should be performed in order to detect possible recurrence and that this rare entity should be considered in the differential diagnosis of intracranial lesions.

P5-06-01: Gene Expression Analysis of Resistance to Bevacizumab in a VEGF-Reinforced Xenograft Model of ER-Positive Breast Cancer

Background: Bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor (VEGF), had promising therapeutic efficacy in breast cancer. However, intrinsic or acquired resistance is common in the clinic. To improve our understanding of the underlying mechanisms of resistance to bevacizumab (BEV), we report the gene expression analysis of resistance to bevacizumab in a VEGF-overexpressing xenograft model of ER-positive breast cancer.

Methods: We developed a nude mouse xenograft model of resistance to anti-VEGF therapy with BEV in which MCF-7 control (ML20) or MCF-7 VEGF (MV165) transfectants were implanted in mammary fat pads, allowed to grow, then treated with BEV, with collection of tumor at early or late time points (while responding (R) to or progressing (NR) on anti-VEGF therapy). To elucidate differentially expressed gene profiling associated with tumor resistance to BEV, we performed whole-genome gene expression analysis (Human WG-6v2 Expression Beadchips, Illumina) and miRNA profiling (TaqMan ***ArrayHuman MicroRNAA+B Cards Set v3.0, Applied Biosystems). Validation of the chosen genes was performed using quantitative real-time RT-PCR (qRT-PCR).

Results: Gene expression analysis revealed differentially regulated genes in the MV165-NR group compared with the MV165-R group. Among the significant genes, Follistatin (FST) and HEY2 were the top genes upregulated in NR compared to R by ANOVA. Expression of HEY2 is induced by the Notch signaling pathway. Using qRT-PCR, we validated the expression of FST and Notch in our system. FST was significantly decreased (Fold change= −3.2; P=0.03) in the R group compared with vehicle in MV165 xenografts. In contrast to R group, FST was upregulated significantly (Fold change= 9.3; P=0.05) in the NR group. Notch4 displayed increased levels of expression in NR group, but it did not reach significance (P=0.23). In addition, correlation of mRNA and miRNA profiles showed that miRNAs targeting FST and Notch4 were differentially regulated in NR group compared to R group in MV165 xenograft tumors. Among the miRNAs, TGF-β-induced oncomiR miR-181a is up-regulated in NR and targets both FST and Notch4. Other miRNAs that target both Notch4 and FST include miR-1, miR-133a, miR-133b, and mir-449b. Conclusion: Our data serve as a potential mechanistic explanation for acquired resistance to bevacizumab. These data may shed light on the transitory effect of BEV observed in the E2100 firstline metastatic breast cancer trial, where VEGF-targeted therapy prolongs progression-free survival in metastatic breast cancer without improving overall survival.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-06-01.

Antileukaemia immunity: effect of exosomes against NB4 acute promyelocytic leukaemia cells

Exosomes are a family of bioactive vesicles and play important roles in antigen presentation. A recent phase I clinical trial with an exosome vaccine derived from colorectal cancer has shown minor clinical benefit. Exosomes derived from leukaemia cell lines have been little studied so, in the present study, the immunoprotective effect of exosomes secreted by NB4 cells, a human acute promyelocytic leukaemia cell line, was investigated. NB4-derived exosomes expressed the proteins retinoic acid receptor α and interstitial cell adhesion molecule 1 and contained heat shock protein 70, as demonstrated by transmission electron microscopy and Western blotting. Cytotoxicity assay demonstrated that cytotoxic T lymphocytes (CTLs) induced by dendritic cells (DCs) pulsed with exosomes were significantly more effective in killing target NB4 cells than CTLs induced by DCs alone. Exosome-based vaccines may be a promising means of prolonging disease-free survival in acute promyelocytic leukaemia patients after induction therapy.

UCP2 -866G/A and Ala55Val, and UCP3 -55C/T polymorphisms in association with type 2 diabetes susceptibility: a meta-analysis study

AIMS/HYPOTHESIS

A meta-analysis was performed to assess the association between the UCP2 -866G/A, UCP2 Ala55Val and UCP3 -55C/T polymorphisms and type 2 diabetes susceptibility.

METHODS

A literature-based search was conducted to identify all relevant studies. The fixed or random effect pooled measure was calculated mainly at the allele level to determine heterogeneity bias among studies. Further analyses were performed that stratified for ethnicity.

RESULTS

We examined 17 publications. Stratified analysis for ethnicity and sensitivity analysis revealed that there was no heterogeneity between studies for these variants. Using an additive model, no significant association of the UCP2 -866G/A polymorphism with type 2 diabetes risk was observed, either in participants of Asian (OR 1.05, 95% CI 0.96, 1.16) or of European (OR 1.03, 95% CI 0.99, 1.07) descent. Neither the UCP2 Ala55Val nor the UCP3 -55C/T polymorphism showed any significant association with type 2 diabetes risk in Europeans (OR 1.04, 95% CI 0.98, 1.09 for Ala55Val; OR 1.04, 95% CI 1.00, 1.09 for -55C/T). In contrast, a statistically significant association was observed for both polymorphisms in participants of Asian descent (OR 1.23, 95% CI 1.12, 1.36 for Ala55Val; OR 1.15, 95% CI 1.03, 1.28 for -55C/T).

CONCLUSIONS/INTERPRETATION

Our meta-analysis suggests that the UCP2 -866G/A polymorphism is unlikely to be associated with increased type 2 diabetes risk in the populations investigated. In contrast, our results indicate that the UCP2 Ala55Val and UCP3 -55C/T polymorphisms may indeed be risk factors for susceptibility to type 2 diabetes in individuals of Asian descent, but not in individuals of European descent. This conclusion warrants confirmation by further studies.

DNA tracking within a nanochannel: device fabrication and experiments

Fabrication of nanochannels is drawing considerable interest due to its broad applications in nanobiotechnology (e.g. biomolecular sensing and single DNA manipulation). Nanochannels offer distinct advantages in allowing a slower translocation and multiple sensing spots along the channel, both of which improve the read-out resolution. However, implementing electrodes inside the nanochannel has rarely been demonstrated to our knowledge. The device described in this work is a Si-Glass anodically bonded Lab-on-a-Chip (LOC) device of a few millimetres in size capable of performing DNA manipulation. The LOC device structure is based on two mainstream microchannels interconnected by nanochannels. DNA, once trapped within the nanochannel, has been tracked throughout the length of the channel and the data have been recorded and analysed.

Extended magnetic reconnection across the dayside magnetopause

The extent of where magnetic reconnection (MR), the dominant process responsible for energy and plasma transport into the magnetosphere, operates across Earth's dayside magnetopause has previously been only indirectly shown by observations. We report the first direct evidence of X-line structure resulting from the operation of MR at each of two widely separated locations along the tilted, subsolar line of maximum current on Earth's magnetopause, confirming the operation of MR at two or more sites across the extended region where MR is expected to occur. The evidence results from in-situ observations of the associated ion and electron plasma distributions, present within each magnetic X-line structure, taken by two spacecraft passing through the active MR regions simultaneously.

CBF-dependent signaling pathway: a key responder to low temperature stress in plants

Plants under low temperature (LT) stress exhibit a C-repeat binding factor (CBF)-dependent responsive pathway. The transcription factors in the CBF family, existing in multiple plant species, are the key regulators of the cold-responsive (COR) genes. CBF1 and CBF3 are regulated in a different way from CBF2, and CBF4 is the only known CBF gene definitely involved in abscisic acid (ABA)-dependent signaling pathways. RAP2.1 and RAP2.6 are the downstream regulators under CBFs. The upstream regulators of the CBF named inducer of CBF expression (ICE) acts as a positive regulator of CBFs. Meanwhile, these CBF signaling pathway components could associate with many other transcription activators and repressors in regulating gene expression when plants are under LT stress. HOS1 negatively regulates ICE1, which down regulates MYB15, an upstream repressor of CBFs. ZAT12 participates in the repression of CBFs, while ZAT10 and FRY2 negatively regulate the CBF-target genes. ADF5 was recently also found to repress CBFs. LOS2 works against ZAT10, and LOS4 positively regulates CBFs. SFR6 is involved in the modification of CBFs to activate the COR genes, and SIZ1-dependent sumoylation plays a positive role in the regulation of ICE1. The utilization of CBF-dependent signaling components has a broad perspective in the field of plant breeding for enhancing crop LT tolerance.

Invasive pulmonary aspergillosis in patients with HBV-related liver failure

Invasive pulmonary aspergillosis (IPA) has been increasingly frequent in severe liver disease. We aim to investigate the clinical presentation, predisposing factors, and treatment of IPA in patients with liver failure caused by hepatitis B virus (HBV) infection. Medical records from 798 patients with HBV-related liver failure were reviewed. A total of 43 patients with probable IPA were selected as the case group, another 43 patients with bacterial infection and 43 patients without any infections were selected, for whose age, sex, date of admission, and the disease onset were matched with the case group. We evaluated the risk factors, clinical manifestations, treatment, and subsequent outcome of IPA in patients with HBV-related liver failure. Multivariate logistic regression models were used to demonstrate risk factors associated with IPA. Compared with patients with bacterial infection and those without any infection, patients with probable IPA used more antibiotics and steroids, and had poorer conditions and the highest mortality (P < 0.0001). Multiple antibiotics use and frequent invasive procedures were independent factors associated with the occurrence of IPA in patients with HBV-related liver failure. Patients with HBV-related liver failure are predisposed to IPA and may have a more severe condition and poorer prognosis.

Expression of the nonclassical HLA class I and MICA/B molecules in human hepatocellular carcinoma

HLA-G and HLA-E are nonclassical human MHC class I molecules, which promote tolerance to NK cytotoxicity. MICA and MICB are known to enhance the functions of NK and T cells. However, the expression of these molecules has never been investigated in liver cancer. Using RT-PCR and western blot, we aimed to identify the expression of HLA-G, HLA-E, MICA and MICB in a panel of 41 tissues dissecting from liver cancer patients in China. HLA-G mRNA was expressed in 8 of 41 Human Hepatocellular Carcinoma (HCC) specimens and in 1 adjacent normal hepatocellular tissue. The expression of HLA-G protein was found in 7 of the 8 HLA-G mRNA-positive HCC tissues. HLA-E mRNA was up-regulated in 56% HCC specimens but the expression of HLA-E protein was only upregulated in 29% HCC tissues in comparison with their adjacent normal counterpart. MICA and MICB mRNA was decreased in 5% and 8% HCC specimens, while the expression of their proteins decreased in 21% and 24% HCC tissues. These results suggested that the expressions of HLA-G, HLA-E, MICA and MICB were differently up-regulated in HCC tissues. Furthermore, HLA-E and MICA/B genes showed obviously distinctive expression pattern at transcription and translation level.