Predictors of corticosteroid tapering in SLE patients: the Hopkins Lupus Cohort

Purpose

Organ damage in systemic lupus erythematosus (SLE) patients is highly associated with the use of corticosteroids. Doses of prednisone below 6 mg daily are associated with reduced organ damage. We now report on the largest prospective cohort study of predictors of prednisone tapering in SLE patients.

Methods

A total of 866 SLE patients (91% female, 50% Caucasian, 43% African-American, mean age 43 years) who consented for the Hopkins Lupus Cohort from 1987 through 2009 were included. The analysis was based on patient visits in which the previously prescribed dose of prednisone was 5 mg/day. We then examined the proportion of times the patient’s dose was reduced to below 5 mg/day (“tapering”). Among those patients who tapered and were followed for at least one year thereafter, we examined the proportion whose prednisone dose remained below 5 mg/day for at least one year (“Successful tapering”). Rates of tapering and successful tapering were calculated for patient subsets based on demographic and clinical characteristics.

Result

The analyses showed that Caucasians, younger patients, patients with a higher level of education, lower disease activity, or absence of urine protein were more likely to have a prednisone taper. However, successful tapering was not dependent on age, ethnicity, or education. As expected, successful tapering was more frequent in those with lower disease activity. Successful tapering was achieved more often after the year 2000.

Conclusion

Our study suggests that successful tapering of prednisone below 5 mg has increased since the year 2000, which may reflect the greater knowledge of the long-term harm of even low-dose chronic corticosteroid use. Caucasians, younger age, higher level of education, and absence of proteinuria predicted tapering, but not successful tapering. Ongoing cutaneous or arthritis activity were associated with unsuccessful tapering. Lack of disease activity, as expected, was the only major clinical variable that significantly predicted successful tapering.

Radiofrequency ablation for liver metastasis from gastric cancer

AIMS

Several studies have reported the benefit of hepatic resection for metastatic tumor from gastric cancer. However, the value of treatment with radiofrequency ablation (RFA) has not been clearly defined.

METHODS

Between Jan 2002 and Dec 2007, 21 patients with primary gastric cancer were diagnosed with synchronous or metachronous liver metastases. All patients were treated with RFA, and the complication, survival, and recurrence rates were assessed.

RESULTS

The postoperative complication rate was 5% (1/21), with no mortality. The median actuarial survival time was 14 months. The 1-yr, 2-yr, 3-yr, and 5-yr survival rates after RFA were 70%, 11%, 5%, and 3%, respectively. With a median follow-up time of 19 months, local recurrence at the RFA site was 19% (4/21). Solitary metastasis had significantly longer survival than multiple lesions after RFA (22 vs 10 months, P = 0.004).

CONCLUSIONS

RFA provides a minimally invasive and safe modality of treatment patients with liver metastasis from gastric cancer. Patients with solitary liver lesion were considered appropriate candidates for RFA.

Radiofrequency ablation for liver metastasis from gastric cancer

AIMS

Several studies have reported the benefit of hepatic resection for metastatic tumor from gastric cancer. However, the value of treatment with radiofrequency ablation (RFA) has not been clearly defined.

METHODS

Between Jan 2002 and Dec 2007, 21 patients with primary gastric cancer were diagnosed with synchronous or metachronous liver metastases. All patients were treated with RFA, and the complication, survival, and recurrence rates were assessed.

RESULTS

The postoperative complication rate was 5% (1/21), with no mortality. The median actuarial survival time was 14 months. The 1-yr, 2-yr, 3-yr, and 5-yr survival rates after RFA were 70%, 11%, 5%, and 3%, respectively. With a median follow-up time of 19 months, local recurrence at the RFA site was 19% (4/21). Solitary metastasis had significantly longer survival than multiple lesions after RFA (22 vs 10 months, P = 0.004).

CONCLUSIONS

RFA provides a minimally invasive and safe modality of treatment patients with liver metastasis from gastric cancer. Patients with solitary liver lesion were considered appropriate candidates for RFA.

Exploiting online discussions to discover unrecognized drug side effects

BACKGROUND

Drugs can treat human diseases through chemical interactions between the ingredients and intended targets in the human body. However, the ingredients could unexpectedly interact with off-targets, which may cause adverse drug side effects. Notifying patients and physicians of potential drug effects is an important step in improving healthcare quality and delivery.

OBJECTIVE

With the increasing popularity of Web 2.0 applications, more and more patients start discussing drug side effects in many online sources. These online discussions form a valuable source for mining interesting knowledge about side effects. The main goal of this paper is to investigate the feasibility of exploiting these discussions to discover unrecognized drug side effects.

METHODS

We propose methods that can 1) build a knowledge base for drug side effects by automatically integrating the information related to drug side effects from different sources; and 2) monitor online discussions about drugs and discover potential unrecognized drug side effects.

RESULTS

Experiment results show that the online discussions indeed provide useful information discovering unrecognized drug side effects. We find that the integrated knowledge base contains more information than individual online sources. Moreover, both proposed detection methods can identify the side effects related to the four recently recalled drugs, and the information from online discussions makes it possible to make the detection much earlier than official announcements. Finally, the proposed generative modeling method is shown to be more effective than the discriminative method.

CONCLUSIONS

We find that it is possible to monitor online discussions to detect unrecognized drug side effects. The developed system is expected to serve as a complementary tool for drug companies and FDA to receive feedbacks from the patients, and it has the potentials to expedite the discovery process of unrecognized drug side effects and to improve the quality of healthcare.

Sidelobe-modulated optical vortices for free-space communication

We propose and experimentally demonstrate a new method for free-space optical (FSO) communication, where the transmitter encodes data into a composite computer-generated hologram and the receiver decodes through a retrieved array of sidelobe-modulated optical vortices (SMOVs). By employing the SMOV generation and detection technique, the usual stringent alignment and phase-matching requirement of the detection of optical vortices is released. In transmitting a gray-scale picture with 180×180 pixels, a bit error rate as low as 3.01×10(-3) has been achieved. Due to the orbital angular momentum multiplexing and spatial paralleling, this FSO communication method possesses the ability to greatly increase the capacity of data transmission.

Visualizing orbital angular momentum of plasmonic vortices

Plasmonic vortices (PVs) are generated by focusing a radially polarized optical vortex (OV) beam onto a metal surface. The intensity distribution of the PV is registered with a near-field scanning optical microscopy and agrees well with a theoretical prediction as well as numerical calculation. Beside the dark central spot, the numerical calculation also shows an azimuthal Poynting vector belonging to the PV, implying that the orbital angular momentum (OAM) was transferred from the radially polarized OV. To directly verify the OAM, plasmonic trapping experiments with gold micrometer particles are performed and the particle rotation is visualized. Further experiments by varying the topological charge of radially polarized OVs show the corresponding changes in rotation in terms of speed and radius.

P-selectin-dependent adhesion of human cancer-cells - requirement for coexpression of a psgl-1-like core protein and the glycosylation process for sialosyl-le(x) or sialosyl-le(a)

We studied the cell surface expression of sialosyl-Le(x) (SLe(x)) and sialosyl-Le(a) (SLe(a)) and its correlation with E-selectin- and P-selectin-dependent cell adhesion, employing 12 human cancer cell lines derived from solid tumors and 2 myelogenic leukemic cell lines, HL60 and U937. Among all the cell lines tested, there was a clear correlation between E-selectin-dependent adhesion and degree of SLe(x) and SLe(a) expression. None of the cell lines derived from solid tumors bound significantly to P-selectin, but leukemic cell lines HL60 and U937 bound strongly to P-selectin. The cDNA clone encoding P-selectin glycoprotein ligand-1 (PSGL-1) was transfected into colonic cancer HRT18 and lung cancer PC3 cells, which express SLe(x) and SLe(a) but normally do not bind to P-selectin, although they do bind to E-selectin. The resulting transfectants bound strongly to P-selectin and equally well to E-selectin. A crude mucin fraction extracted from pooled human colonic cancer tissue bound to E-selectin but not to P-selectin. We conclude that tumor cell adhesion to P-selectin is highly dependent on expression of a specific core protein which appropriately assembles a specific carbohydrate to present to P-selectin. In contrast, E-selectin binds promiscuously to various types of SLe(x) and SLe(a) epitopes presented at the cell surface through N-linked, O-linked, or lipid-linked structures.

A new boronic acid-based fluorescent sensor for L-dihydroxyphenylalanine

Catecholamines, such as dopamine and L-dihydroxyphenylalanine (L-DOPA), are associated with different physiological functions and diseases. In our recent studies, a novel water-soluble boronic acid compound 3c was identified as a selective fluorescent sensor for L-DOPA. This compound not only has the ability to interact with dopamine and catechol, but also has no fluorescence intensity change for L-DOPA precursors in vivo, such as L-tyrosine.

Construction of a recombinant plasmid harbouring the glyceraldenyde-3-phosphate dehydrogenase gene of periodic Brugia malayi and observation on DNA immunity

PURPOSE

Controlling and eliminating lymphatic filariasis will require further research of preventative measures and implementation. Parasite is dependent on glycolysis for ATP production. The glycolytic enzyme glyceraldenyde-3-phosphate dehydrogenase (GAPDH) plays an important role in glycolysis and therefore is either a potential target for anti-parasite drug development or a vaccine candidate. Therefore, we tried to investigate the DNA vaccine-elicited immune responses in BALB/c mice.

MATERIALS AND METHODS

We cloned a gene encoding the glyceraldehyde-3-phosphate dehydrogenase (GAPDH) from periodic Brugia malayi into vector pcDNA3.1. Mice were injected at a dosage of 100 μg recombinant plasmid DNA with CpG intramuscular injection and immunized three times at 2-week intervals. pcDNA3.1 and normal saline were used as control. The tissue of muscles at the 4 weeks after the third injection was collected and target genes were detected using RT-PCR. The humoral responses elicited in mice by inoculation with the recombinant plasmid pcDNA3.1-BmGAPDH were detected using a standard ELISA. Two weeks after the third immunization, stimulation index (SI) was measured using the MTT method and the level of secreted IL-4 and INF-g were detected using ELISA.

RESULTS

Specific gene fragment coding GAPDH was amplified and the recombinant plasmid pcDNA3.1-BmGAPDH was constructed. Post-challenge sera from the mice immunized with the DNA vaccine had specific antibody titres of 1:1600 to 1:6400, and the highest titre was observed in the mice that were inoculated by pcDNA3.1-BmGAPDH/CpG at 6 weeks. At 4 weeks after immunization, the spleens of the mice were obviously enlarged. The proliferation of spleen T lymphocytes seen on the MTT assay was higher in the pcDNA3.1-BmGAPDH group than in the control group (P value <0.05). The levels of IL-4 and INF-γ in serums from the immunized mice were significantly higher than that of the control (P value <0.05).

CONCLUSIONS

We conclude that the recombinant eukaryotic plasmid pcDNA3.1-BmGAPDH could elicit humoral and cellular immune responses in mice.

The progress of selective fluorescent chemosensors by boronic acid

As a cutting-edge scientific research field, the detection of biological active substance is very important for the prevention, diagnosis and treatment of diseases. Boronic acid interacts with cis-1,2-or 1,3-diol to form five- or six-membered ring which could be used as the reporter of fluorescent sensors to probe carbohydrates and bioactive substance. This review summarizes the recent progress of boronic acid sensors for carbohydrates, L-dopamine, fluoride, copper ion, mercury ion and hydrogen peroxide. In this article, we will briefly introduce the chemistry of boronic acid, and then give a description of the fluorescence properties of each boronic acid sensor, such as fluorescence intensity change, excitation and emission wavelengths, quantum yields and water solubility. In addition, we summarize the mechanisms of fluorescent signal output for some representative sensors and discuss the strategies for developing new fluorescent probes.

Induced pluripotent stem cells for spinal cord injury therapy: current status and perspective

Spinal cord injury (SCI) is induced by a variety of damages such as trauma, ischemia, and iatrogenic injury, resulting in sense and motion dysfunction. Despite the improvements in medical and surgical care, current treatment methods for SCI demonstrate poor and delayed efficiency, leading to different degree of permanent loss of neural function and disability in the patients. Rapid advances in stem-cells research suggest that stem cells may be applied in SCI therapy. Indeed, SCI is a major field in which stem-cell therapy has been proposed and practised, and most recently the clinical trials of stem-cell therapy were initiated, which aroused a number of clinical concerns. In this review, we summarize current status of SCI repair, then introduce the sources and biological characteristics of induced pluripotent stem cells (iPSCs), and discuss the differentiation potential of iPSCs and the perspective of the application of iPSCs in SCI therapy.

Development and validation of a quality of life instrument for Kashin-Beck disease: an endemic osteoarthritis in China

OBJECTIVES

To develop and validate a disease-specific Quality of Life (QOL) measure for a specialized osteoarthritis (OA)-Kashin-Beck disease (KBD).

METHODS

The standard methodology used for developing QOL instruments was employed. In phase 1, initially a group of health care professionals (HCPs) and KBD patient defined the overall concept of KBDQOL. It was followed by generation of an item pool through literature review, in-depth interview of 20 KBD patients and eight KBD HCPs and four focus group discussions. In phase 2, 368 KBD patients were interviewed and the reinterview of 95 participants, 10-14 days later assessed the reproducibility of the KBDQOL instrument.

RESULTS

A 37 items draft instrument was devised during phase 1. Principal Component Analysis (PCA) revealed six domains: physical function, activity limitation, social support, economics, mental health, and general health. Cronbach's alphas of six domains ranged from 0.77 to 0.90. The test-retest reliability (intraclass co-relation coefficient) of six domains was satisfactory, and ranged from 0.73 to 0.90. The smallest detectable change ranged from 13.2 to 30.2 points at the individual level and from 1.4 to 3.1 points at the group level for different domains. The construct validity was adequate when co-related with the EQ-5D (spearman co-relation coefficients: 0.49-0.61) and WHOQOL-BREF (spearman co-relation coefficients: 0.53-0.68). This resulted into the final version of KBDQOL instrument having 28 items and six domains.

CONCLUSIONS

The KBDQOL is a simple and easy to use 28-item six dimensional questionnaire. The measure has been developed as a true patient-based questionnaire and demonstrates good measurement properties.

A facile method for the synthesis of N-(α-aminoacyl) sulfonamides

N-Acylsulfonamide derivatives have important applications in organic synthesis and drug discovery. It was found that many problems occurred preparing amino acid derived N-acylsulfonamides with the commonly used coupling approach in our previous studies. In this paper, we report an efficient approach to synthesize various amino acids derived N-acylsulfonamides in high yields without any racemization.

Flow pattern analysis of a full-scale expanded granular sludge bed-type reactor under different organic loading rates

The hydraulic characteristics of a lab-scale and a full-scale (275 m(3)) expanded granular sludge bed (EGSB)-type reactor under different organic loading rates varying from 10 kg COD m(-3)d(-1) to 45 kg COD m(-3)d(-1) were investigated. A modified combined model composed of two completely mixing regions and a plug flow region was sufficient for simulating the flow pattern of a full-scale EGSB-type reactor. Moreover, the outputs fitted the measured tracer distribution results well. The simplified model structure was in very good agreement with the physical structure of a full-scale EGSB-type reactor. The upflow (liquid+gas) velocity, high concentration of granular sludge, and gas hold-up effect may contribute to the generation of dead spaces (maximum of 19.5%). The bed expansion characteristics indicated that the sludge bed of the EGSB-type reactor performed as a suspended bed, in which the bed expansion was controlled between 20% and 30%, rather than the usually considered expanded bed.

A new diphenyl ether from Phoma sp. strain, SHZK-2

A new diphenyl ether methyl 2-(2-formyl-3-hydroxy-5-methylphenoxy)-5-hydroxy-3-methoxybenzoate (3), together with four known compounds, asterric acid (1), methyl asterrate (2), 9(Z),12(Z)-nonadecadienoic acid (4) and orsellinic acid (5), were isolated from the Phoma sp. strain SHZK-2, which was isolated from a polluted environment in southern China. The structures of these compounds were determined by spectroscopic methods. Cytotoxicities of compounds against HEPG2 cell and Raji cell lines were preliminarily evaluated by the MTT method.

Expression, purification, and S-nitrosylation of recombinant histone deacetylase 8 in Escherichia coli

Histone deacetylase (HDAC) 8 is a zinc ion dependent enzyme involved in removing the acetyl group from the core histones and other proteins which belong to Class I HDACs. It was reported that nitric oxide (NO) is a key regulator of HDAC function and S-nitrosylation of HDAC2 induces chromatin remodelling in neurons. This work reports the successful recombinant expression of human HDAC8 in Escherichia coli with two plasmids and the purification and S-nitrosylation in vitro. It was found that HDAC8 can be S-nitrosylated by the NO donor S-nitrosoglutathione (GSNO) in vitro, and the activity of HDAC8 was significantly inhibited when incubated with GSNO and S-nitrosocysteine in a time- and dosage-dependent manner, but sodium nitroprusside (SNP), and dithiothreitol cannot reverse this inhibition. These observations support and extend the concept that NO may regulate HDAC8 function by S-nitrosylation.

Clinical development of histone deacetylase inhibitor romidepsin

Histone deactylase inhibitors have emerged as a promising epigenetic therapy for neoplasic indications. The US Food and Drug Administration granted approval to romidepsin for treatment of cutaneous T cell lymphoma (CTCL) in 2009. Phase I/II trials of romidepsin as monotherapy or hybird therapy have demonstrated substantial efficacy profoundly in CTCL and peripheral T-cell lymphoma and marginally in other hematogological malignancies and solid tumors, with a tolerable safety and toxicity profile. The current status of the clinical evaluation of romidepsin is detailed in the present contribution.

Genomic indicators in the blood predict drug-induced liver injury

Genomic biomarkers for the detection of drug-induced liver injury (DILI) from blood are urgently needed for monitoring drug safety. We used a unique data set as part of the Food and Drug Administration led MicroArray Quality Control Phase-II (MAQC-II) project consisting of gene expression data from the two tissues (blood and liver) to test cross-tissue predictability of genomic indicators to a form of chemically induced liver injury. We then use the genomic indicators from the blood as biomarkers for prediction of acetaminophen-induced liver injury and show that the cross-tissue predictability of a response to the pharmaceutical agent (accuracy as high as 92.1%) is better than, or at least comparable to, that of non-therapeutic compounds. We provide a database of gene expression for the highly informative predictors, which brings biological context to the possible mechanisms involved in DILI. Pathway-based predictors were associated with inflammation, angiogenesis, Toll-like receptor signaling, apoptosis, and mitochondrial damage. The results show for the first time and support the hypothesis that genomic indicators in the blood can serve as potential diagnostic biomarkers predictive of DILI.

A comparison of batch effect removal methods for enhancement of prediction performance using MAQC-II microarray gene expression data

Batch effects are the systematic non-biological differences between batches (groups) of samples in microarray experiments due to various causes such as differences in sample preparation and hybridization protocols. Previous work focused mainly on the development of methods for effective batch effects removal. However, their impact on cross-batch prediction performance, which is one of the most important goals in microarray-based applications, has not been addressed. This paper uses a broad selection of data sets from the Microarray Quality Control Phase II (MAQC-II) effort, generated on three microarray platforms with different causes of batch effects to assess the efficacy of their removal. Two data sets from cross-tissue and cross-platform experiments are also included. Of the 120 cases studied using Support vector machines (SVM) and K nearest neighbors (KNN) as classifiers and Matthews correlation coefficient (MCC) as performance metric, we find that Ratio-G, Ratio-A, EJLR, mean-centering and standardization methods perform better or equivalent to no batch effect removal in 89, 85, 83, 79 and 75% of the cases, respectively, suggesting that the application of these methods is generally advisable and ratio-based methods are preferred.

Genetic diagnosis of Hailey-Hailey disease in two Chinese families: novel mutations in the ATP2C1 gene

Hailey-Hailey disease (HHD; OMIM 169600), is an autosomal dominantly inherited disorder characterized by suprabasal cell separation of the epidermis. Mutations in ATP2C1, which encodes the human secretory pathway Ca(2+)/ Mn(2) +/- ATPase protein 1 (hSPCA1), have been identified as the pathogenic gene of HHD without evidence of genetic heterogeneity. In this study, the ATP2C1 gene was screened in two typical Chinese pedigrees with HHD, and two specific novel mutations of the ATP2CL gene were identified. Family 1 had a 16-base deletion mutation c.1068-1083del16 and family 2 had a substitution mutation c.1982T>G (p.Met661Arg). DNA sequencing of the three descendants of the probands revealed that they all had the normal genotype, indicating that there had been no transmission of the mutation.

Assessing sources of inconsistencies in genotypes and their effects on genome-wide association studies with HapMap samples

The discordance in results of independent genome-wide association studies (GWAS) indicates the potential for Type I and Type II errors. We assessed the repeatibility of current Affymetrix technologies that support GWAS. Reasonable reproducibility was observed for both raw intensity and the genotypes/copy number variants. We also assessed consistencies between different SNP arrays and between genotype calling algorithms. We observed that the inconsistency in genotypes was generally small at the specimen level. To further examine whether the differences from genotyping and genotype calling are possible sources of variation in GWAS results, an association analysis was applied to compare the associated SNPs. We observed that the inconsistency in genotypes not only propagated to the association analysis, but was amplified in the associated SNPs. Our studies show that inconsistencies between SNP arrays and between genotype calling algorithms are potential sources for the lack of reproducibility in GWAS results.

Design, synthesis, and primary activity evaluation of pyrrolidine derivatives as matrix metalloproteinase inhibitors

A series of novel pyrrolidine derivatives was designed, synthesized, and assayed to determine the derivatives' activity against matrix metalloproteinase-2 (MMP-2) and aminopeptidase N (APN)/CD13. Preliminary biological tests showed that most compounds inhibit MMP-2 in a highly selective manner compared to APN. Compounds 9d, 9e, and 9g had better inhibitory activity than LY52 and could be used as lead compounds in the future.

Engineered Saccharomyces cerevisiae that produces 1,3-propanediol from D-glucose

AIMS

Saccharomyces cerevisiae is a safe micro-organism used in fermentation industry. 1,3-Propanediol is an important chemical widely used in polymer production, but its availability is being restricted owing to its expensively chemical synthesis. The aim of this study is to engineer a S. cerevisiae strain that can produce 1,3-propanediol at low cost.

METHODS AND RESULTS

By using D-glucose as a feedstock, S. cerevisiae could produce glycerol, but not 1,3-propanediol. In this study, we have cloned two genes yqhD and dhaB required for the production of 1,3-propanediol from glycerol, and integrated them into the chromosome of S. cerevisiae W303-1A by Agrobacterium tumefaciens-mediated transformation. Both genes yqhD and dhaB functioned in the engineered S. cerevisiae and led to the production of 1,3-propanediol from D-glucose.

CONCLUSION

Saccharomyces cerevisiae can be engineered to produce 1,3-propanediol from low-cost feedstock D-glucose.

SIGNIFICANCE AND IMPACT OF THE STUDY

To our knowledge, this is the first report on developing S. cerevisiae to produce 1,3-propanediol by using A. tumefaciens-mediated transformation. This study might lead to a safe and cost-efficient method for industrial production of 1,3-propanediol.

Distinct ribotypes and rates of antimicrobial drug resistance in Clostridium difficile from Shanghai and Stockholm

Seventy-five clinical isolates of Clostridium difficile from Shanghai and 80 from Stockholm were investigated. The prevalence of toxin A-negative, toxin B-positive isolates of C. difficile among isolates from Shanghai (33.3%) was significantly higher than among isolates from Stockholm (0%). Both sets of isolates were fully susceptible to metronidazole and vancomycin. However, the MICs of fluoroquinolones, erythromycin-clindamycin, tetracycline, rifampin and fusidic acid were significantly higher for the Shanghai isolates than for the Stockholm isolates. Thirty-three PCR ribotypes were identified; a dominant clone, 017, accounted for 18.7% of Shanghai isolates, whereas clone 005 dominated among Stockholm isolates, accounting for 11.3%. Strains 027 and 078 were not detected. No outbreak occurred during the study period.

A survey of U.S. and Canadian oncologists’ attitudes toward the cost, cost-effectiveness (CE), and reimbursement of cancer drugs

9502

Background: Drug costs and reimbursement issues offer significant challenges to U.S. and Canadian oncologists even though they practice in substantially different health care systems. However, little is known about the attitudes of American and Canadian oncologists towards these issues. Methods: We surveyed 1,379 U.S. and 356 Cdn oncologists to assess their attitudes to cancer drug costs, CE and reimbursement policies. Results: Response rate was 57% in the U.S. and 48% in Canada. Oncologists in both countries stated that patients' “out-of-pocket” drug costs influenced their treatment recommendations (84% U.S., 80% Cdn respondents). Most respondents felt that every patient should have access to effective cancer treatments regardless of cost (66% US; 54% Cdn), while 59% of U.S. and 72% of Cdn and respondents believed that patients should only have access to effective cancer treatments that provided “good value for money.” 70% of U.S. and 64% Cdn respondents felt that <$100,000 per life year gained was a reasonable definition of “good value for money” but less than half of respondents (42% US, 49% Cdn) felt well prepared to interpret and use CE information in their treatment decisions. A majority of respondents (57% US, 69% Cdn) felt government price controls for cancer drugs are needed while a minority felt that more cost-sharing by patients was needed (29% US, 37% Cdn). Most oncologists felt that evaluating whether a drug provides “good value” should be overseen by an independent non-profit agency (57% US, 71% Cdn) or physicians (61% US and Cdn); in contrast, few believed that government (21% US, 33% Cdn), patients (36% US, 37% Cdn) or insurance companies (6% US, 10% Cdn) should determine “good value”. 79% of U.S. and 69% of Cdn respondents felt more use of CE data in coverage and reimbursement decisions is needed. Conclusions: Oncologists in the U.S. and Canada share many similar attitudes to cancer drug costs, CE, and reimbursement policies despite differences in their health care systems. In both countries, oncologists favor more use of CE information.

No significant financial relationships to disclose.

QSAR studies of histone deacetylase (HDAC) inhibitors by CoMFA, CoMSIA, and molecular docking

In order to develop highly potent antitumor agents, three-dimensional quantitative structure-activity relationship (3-D QSAR) studies were conducted using a series of thienyl-based hydroxamic acids. Comparative molecular field analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA) methods were applied to provide the structural information for further chemical modification and optimization. ClogP was applied as an additional descriptor in the CoMFA analysis to study the effects of lipophilic parameters on the activity of these compounds, and it did improve the statistical significance of the model. Two molecules were designed based on the 3-D QSAR analysis, their activity values were predicted by the generated model, and their binding mode was elucidated by a docking approach compared to molecules in the dataset.

The main functions and structural modifications of tripeptide N-formyl-methionyl-leucyl-phenylalanine (fMLP) as a chemotactic factor

Gram negative bacteria-derived and synthetic N-formyl peptides play a key role in host defense as chemotactic factors for phagocytic leukocytes. The first compound to be identified was N-formylmethionyl-leucyl-phenylalanine (fMLP) which contains highly potent leukocyte chemoattractant. Natural fMLP was subsequently purified and identified in supernatants of gram negative bacteria. Recently, much more attention has been focused on the human formyl peptide receptor (FPR) and its variant formyl peptide receptor-like 1 (FPRL1) and formyl peptide receptor-like 2 (FPRL2). Chemotactic factors such as fMLP interact with their specific cell surface receptors, which results in multiple biological responses through a G protein-coupled signal pathway. In this review, the functions and structural modifications of fMLP are discussed in view of future drug development.

Effects of repeated applications of chlorpyrifos on its persistence and soil microbial functional diversity and development of its degradation capability

Effects of repeated applications of chlorpyrifos on its persistence and soil microbial functional diversity were studied under laboratory conditions. The results showed that the degradation rate of chlorpyrifos increased whereas its inhibitory effect on soil microbial communities gradually decreased with application frequency of chlorpyrifos. A bacterial strain DSP capable of utilizing chlorpyrifos as a sole source of carbon and energy was isolated 21 days after the third chlorpyrifos application, which indicated that the capability of soil microorganism for degrading chlorpyrifos was formed during the experiment. It could be concluded that repeated applications of chlorpyrifos had no lasting impact on soil health.

Novel N-hydroxybenzamide histone deacetylase inhibitors as potential anti-cancer agents

Histone deacetylases (HDACs) are a class of Zn(2+) dependent metalloproteases that play an important role in tumorigenesis. Inhibition of HDACs may be a potential strategy for cancer therapy. This study designed and synthesized a series of novel N-hydroxybenzamide histone deacetylase inhibitors based on the structural features of suberoylanilide hydroxamic acid (SAHA), the first HDAC inhibitor that came to market. Preliminary biological evaluation in vitro found that most of the inhibitors had satisfactory inhibitory activity (IC(50) =1-17 μM) against HDACs and HCT116 tumor cells.

3D-QSAR study with pharmacophore-based molecular alignment of hydroxamic acid-related phosphinates that are aminopeptidase N inhibitors

3D-QSAR models for a series of aminopeptidase N inhibitors were developed based on comparative molecular field analysis (CoMFA) and comparative molecular similarity analysis (CoMSIA).GALAHAD, a pharmacophore generation module involving a genetic algorithm, was used to generate the pharmacophore model of the series of inhibitors. Molecules both in the training set and test set were aligned to the pharmacophore model. Values for the CoMFA model were r(2) = 0.992, q(2) = 0.586, SEE = 0.111, and F (8, 10) = 191.263. Values for the CoMSIA model were r(2) = 0.990, q(2) = 0.776, SEE = 0.123, and F (7, 11) = 156.68. This model can help not only in improving current understanding of enzyme-ligand interactions but also in predicting the activity of derivatives and designing new compounds with better potency.

Hermaphroditism in a Sprague-Dawley rat

A spontaneous case of unilateral true hermaphroditism was observed during the routine necropsy of a 9-week-old presumed female Sprague-Dawley rat on a repeat-dose toxicity study. There were no drug-related effects observed. True hermaphroditism is rare in rats, and despite the large numbers of rats examined annually, few cases are reported in the literature.