Graphic Mining of High-Order Drug Interactions and Their Directional Effects on Myopathy Using Electronic Medical Records

We propose to study a novel pharmacovigilance problem for mining directional effects of high-order drug interactions on an adverse drug event (ADE). Our goal is to estimate each individual risk of adding a new drug to an existing drug combination. In this proof-of-concept study, we analyzed a large electronic medical records database and extracted myopathy-relevant case control drug co-occurrence data. We applied frequent itemset mining to discover frequent drug combinations within the extracted data, evaluated directional drug interactions related to these combinations, and identified directional drug interactions with large effect sizes. Furthermore, we developed a novel visualization method to organize multiple directional drug interaction effects depicted as a tree, to generate an intuitive graphical and visual representation of our data-mining results. This translational bioinformatics approach yields promising results, adds valuable and complementary information to the existing pharmacovigilance literature, and has the potential to impact clinical practice.

A Mixture Dose-Response Model for Identifying High-Dimensional Drug Interaction Effects on Myopathy Using Electronic Medical Record Databases

Interactions between multiple drugs may yield excessive risk of adverse effects. This increased risk is not uniform for all combinations, although some combinations may have constant adverse effect risks. We developed a statistical model using medical record data to identify drug combinations that induce myopathy risk. Such combinations are revealed using a novel mixture model, comprised of a constant risk model and a dose–response risk model. The dose represents the number of drug combinations. Using an empirical Bayes estimation method, we successfully identified high-dimensional (two to six) drug combinations that are associated with excessive myopathy risk at significantly low local false-discovery rates. From the curve of a dose–response model and high-dimensional drug interaction data, we observed that myopathy risk increases as the drug interaction dimension increases. This is the first time that such a dose–response relationship for high-dimensional drug interactions was observed and extracted from the medical record database.

Gut carbohydrate metabolism instead of fat metabolism regulated by gut microbes mediates high-fat diet-induced obesity

The aim of this study was to investigate the mechanisms underlying the involvement of gut microbes in body weight gain of high-fat diet-fed obesity-prone (obese) and obesity-resistant (lean) mice. C57BL/6 mice were grouped into an obese group, a lean group and a normal control group. Both obese and lean mice were fed a high-fat diet while normal control mice were fed a normal diet; they were observed for six weeks. The results showed that lean mice had lower serum lipid levels, body fat and weight gain than obese mice. The ATPase, succinate dehydrogenase and malate dehydrogenase activities in liver as well as oxygen expenditure and rectal temperature of lean mice were significantly lower than in obese mice. As compared with obese mice, the absorption of intestinal carbohydrates but not of fats or proteins was significantly attenuated in lean mice. Furthermore, 16S rRNA abundances of faecal Firmicutes and Bacteroidetes were significantly reduced in lean mice. In addition, faecal β-D-galactosidase activity and short chain fatty acid levels were significantly decreased in lean mice. Expressions of peroxisome proliferator-activated receptor gamma 2 and CCAAT/enhancer binding protein-β in visceral adipose tissues were significantly downregulated in lean mice as compared with obese mice. Resistance to dyslipidaemia and high-fat diet-induced obesity was mediated by ineffective absorption of intestinal carbohydrates but not of fats or proteins, probably through reducing gut Bacteroidetes and Firmicutes contents and lowering of gut carbohydrate metabolism. The regulation of intestinal carbohydrates instead of fat absorption by gut microbes might be a potential treatment strategy for high-fat diet-induced obesity.

Histone deacetylase inhibitors prevent activation-induced cell death and promote anti-tumor immunity

The poor efficacy of the in vivo anti-tumor immune response has been partially attributed to ineffective T-cell responses mounted against the tumor. Fas-FasL-dependent activation-induced cell death (AICD) of T cells is believed to be a major contributor to compromised anti-tumor immunity. The molecular mechanisms of AICD are well-investigated, yet the possibility of regulating AICD for cancer therapy remains to be explored. In this study, we show that histone deacetylase inhibitors (HDACIs) can inhibit apoptosis of CD4⁺ T cells within the tumor, thereby enhancing anti-tumor immune responses and suppressing melanoma growth. This inhibitory effect is specific for AICD through suppressing NFAT1-regulated FasL expression on activated CD4⁺ T cells. In gld/gld mice with mutation in FasL, the beneficial effect of HDACIs on AICD of infiltrating CD4⁺ T cells is not seen, confirming the critical role of FasL regulation in the anti-tumor effect of HDACIs. Importantly, we found that the co-administration of HDACIs and anti-CTLA4 could further enhance the infiltration of CD4⁺ T cells and achieve a synergistic therapeutic effect on tumor. Therefore, our study demonstrates that the modulation of AICD of tumor-infiltrating CD4⁺ T cells using HDACIs can enhance anti-tumor immune responses, uncovering a novel mechanism underlying the anti-tumor effect of HDACIs.

Application of acoustic radiation force impulse imaging (ARFI) in quantitative evaluation of neonatal brain development

OBJECTIVE

This study aims to quantitatively evaluate the effect of acoustic radiation force impulse imaging (ARFI) in neonatal brain development.

MATERIALS AND METHODS

The authors observed 41 neonatal brain different tissues by using traditional two-dimensional gray scale ultrasound and color Doppler flow imaging and frequency spectrum ultrasound. After that they used ARFI to quantitative evaluate white and gray matter of neonatal different tissues in brain with different gestational ages. They also used new technical index: virtual touch tissue quantification (VTQ) to evaluate elastic changes of brain tissues.

RESULTS

Different tissues in brain had different elastic numerical values. Neonatal with different gestational ages had different elastic numerical values. The more gestational ages were, the more the elastic numerical values. Elastic numerical values between preterm and full-term infants were different. Elastic numerical values of full-term infants were higher than preterm infants.

CONCLUSION

ARFI provides a new quantitative index to evaluate neonatal brain development. It increases objectivity and reliability of clinical analysis. Ultrasound was a noninvasive examination method, safe, simple, and convenient, and it has more usefulness of ARFI in quantitative evaluation of neonatal brain development.

Cardiovascular Z-scores in fetuses with tetralogy of Fallot

OBJECTIVE

To establish formulae for the calculation of fetal cardiovascular Z-scores based on femur length (FL), and to compare cardiovascular parameters between fetuses with tetralogy of Fallot (TOF) and normal fetuses in order to assess their value for the prenatal diagnosis of TOF.

METHODS

A total of 329 normal fetuses and 43 fetuses with TOF were included in this study. Eleven cardiovascular dimensions were measured offline after cardiac spatiotemporal image correlation volume acquisition. Normal cardiovascular Z-score formulae were constructed for these measurements based on FL by performing a standard regression analysis followed by weighted regression of absolute residual values. The following ratios were calculated: right ventricular internal diameter (RVID) to left ventricular internal diameter (LVID) and pulmonary artery diameter (PA) to aorta diameter (Ao). Subsequently, all parameters were compared between the normal and TOF groups.

RESULTS

Formulae for calculating Z-scores for the 11 cardiovascular dimensions were constructed. FL was significantly correlated with all cardiovascular dimensions assessed (r = 0.816-0.944, P < 0.001 for all). RVID, Ao, PA, aortic arch isthmus, and ductus arteriosus mean Z-scores and PA/Ao ratio were statistically significantly different between normal fetuses and those with TOF. In the TOF group, all Ao Z-scores (43/43) were > + 2 and all PA/Ao ratios (43/43) were below the normal 95% range. However, only 48.8% (21/43) of the PA Z-scores were < -2.

CONCLUSIONS

The cardiovascular Z-score formulae developed can provide a quantitative basis for the prenatal diagnosis of TOF. Aortic dilatation and abnormal PA/Ao ratio may be markers for the antenatal diagnosis of TOF.

Serum microRNA panel as biomarkers for early diagnosis of colorectal adenocarcinoma

Background:

Currently, none of the available colorectal adenocarcinoma (CAC) testing has been established as a well-accepted diagnosis tool, particularly for the early stage of CAC. The recent discovery of serum microRNA (miRNA) profile has provided a new auxiliary approach for tumour diagnosis. Our study is involved in the global analysis of serum miRNAs during the normal–colorectal adenoma (CA)–CAC sequence.

Methods:

Serum samples were collected from 307 CAC patients, 164 CA patients and 226 healthy controls. Differentially expressed serum miRNAs were screened with Miseq sequencing followed by the reverse transcription PCR (RT–qPCR) validation. The miRNA panel was developed with a logistic regression model and validated using an independent cohort. The miRNA levels in CAC patients of different clinical stages and CA patients of different grades were compared. Receiver operating characteristic curves were constructed to evaluate the diagnostic accuracy of the panel.

Results:

The Miseq sequencing results revealed 15 differentially expressed miRNAs in the intersection of CAC vs CA and CA vs healthy controls according to our criteria. After the selection and validation process via RT–qPCR, we identified a four-miRNA panel (miR-19a-3p, miR-223-3p, miR-92a-3p and miR-422a) with a high diagnostic accuracy of CAC. Even in the low-carcinoembryonic antigen level group, the diagnostic accuracy of this miRNA panel was still acceptable (AUC=0.810). Surprisingly, our results indicated that the miRNA panel could differentiate stage I/II CAC from controls. In addition, this panel could also differentiate CA from CAC (AUC=0.886) and healthy controls (AUC=0.765).

Conclusions:

We established a serum four-miRNA panel with considerable clinical value in the early-stage diagnosis of CAC.

IgA subclass switch recombination in human mucosal and systemic immune compartments

Human immunoglobulin A (IgA) comprises two IgA subclasses, IgA1 and IgA2, whose distribution has been shown by immunohistochemistry to be different in various body compartments. In comparison with systemic immune compartments, we investigated the IgA switch profiles at the molecular level in salivary and lacrimal glands, nasal mucosa, and proximal and distal gut mucosa. Direct switching from IgM to IgA1 or IgA2 predominated in all immune compartments analyzed. Similar composition of the Sμ-Sα1 and Sμ-Sα2 junctions was observed, including microhomology usage, which suggested that there is no major difference in the actual recombination mechanism utilized during IgA subclass switching. The proportion of IgA1/IgA2 switch recombination events largely paralleled the previously published immunohistochemical representation of IgA1(+) and IgA2(+) plasma cells, implying that the local subclass distribution generally reflects precommitted memory/effector B cells that have undergone IgA subclass switching before extravasation at the effector site. The extremely low or undetectable levels of activation-induced cytidine deaminase (AID) and Iα-Cμ circle transcripts in intestinal lamina propria samples as compared with Peyer's patches suggest that the cellular IgA subclass distribution outside of organized gut-associated lymphoid tissue is only to a minor extent, if at all, influenced by in situ switching.

Synthesis and Properties of a Novel Intumescent Flame Retardant and its Application in LLDPE

In this study, a novel phosphorus-containing flame retardant (IFR) of spirocyclic pentaerythritol diphosphonate dinitroguanidine (SPDD) was successfully synthesized, which was characterized by 1H NMR, 31P NMR and FTIR spectra. At the same time, the SPDD was used in LLDPE to prepare flame-retardant materials whose flammability and thermal behavior were studied by thermogravimetric analysis (TGA), limiting oxygen index (LOI) and scanning electron microscopy (SEM). The TGA data showed that SPDD could effectively enhance the thermal stability and char residue of LLDPE/IFR composite. And with the increase of SPDD, the LOI value of LLDPE/IFR increases obviously. When SPDD reached 30 wt%, the LOI value of LLDPE/IFR reaches 31 %. The SEM also shows the surface of intumescent chars of LLDPE/IFR (30 %) has many sphere-like swollen bubbles.

Cerebrovascular collaterals correlate with disease severity in adult North American patients with Moyamoya disease

BACKGROUND AND PURPOSE

Cerebrovascular collaterals have been increasingly recognized as predictive of clinical outcomes in Moyamoya disease in Asia. The aim of this study was to characterize collaterals in North American adult patients with Moyamoya disease and to assess whether similar correlations are valid.

MATERIALS AND METHODS

Patients with Moyamoya disease (n = 39; mean age, 43.5 ±10.6 years) and age- and sex-matched control subjects (n = 33; mean age, 44.3 ± 12.0 years) were graded via angiography. Clinical symptoms of stroke or hemorrhage were graded separately by imaging. Correlations between collateralization and disease severity, measured by the modified Suzuki score, were evaluated in patients with Moyamoya disease by fitting a regression model with clustered ordinal multinomial responses.

RESULTS

The presence of leptomeningeal collaterals (P = .008), dilation of the anterior choroidal artery (P = .01), and the posterior communicating artery/ICA ratio (P = .004) all correlated significantly with disease severity. The presence of infarct or hemorrhage and posterior steno-occlusive disease did not correlate significantly with the modified Suzuki score (P = .1). Anterior choroidal artery changes were not specific for hemorrhage. Patients with Moyamoya disease were statistically more likely than controls to have higher posterior communicating artery/ICA ratios and a greater incidence of leptomeningeal collaterals.

CONCLUSIONS

As with Moyamoya disease in Asian patients, the presence of cerebrovascular collaterals correlated with the modified Suzuki score for disease severity in North American patients with Moyamoya disease. However, anterior choroidal artery changes, which correlated with increased rates of hemorrhage in Asian studies, were not specific to hemorrhage in North Americans.

Leptin-mediated regulation of ICAM-1 is Rho/ROCK dependent and enhances gastric cancer cell migration

Background:

Our previous study indicates that leptin enhances gastric cancer (GC) invasion. However, the exact effect of leptin on GC metastasis and its underlying mechanism remain unclear. Intercellular adhesion molecule-1 (ICAM-1), a major molecule in stabilising cell–cell and cell–extracellular matrix interactions, is overexpressed and has crucial roles in tumour metastasis.

Methods:

Here, we investigated leptin and ICAM-1 expression in GC tissues. Furthermore, we characterised the influence of leptin on ICAM-1 expression in GC cells and elucidated the underlying mechanism.

Results:

Leptin and ICAM-1 were overexpressed in GC tissues, and a strong positive correlation was observed. They were also related with clinical stage or lymph node metastasis. Furthermore, leptin induced GC cell (AGS and MKN-45) migration by upregulating ICAM-1, and knockdown of ICAM-1 by small interference RNA (siRNA) blocked this process. Cell surface ICAM-1, as well as soluble ICAM-1 (sICAM-1), was also enhanced by leptin. Moreover, leptin increased ICAM-1 expression through Rho/ROCK pathway, which was attenuated by pharmacological inhibition of Rho (C3 transferase) or its downstream effector kinase Rho-associated protein kinase (ROCK) (Y-27632).

Conclusions:

Our findings indicate that leptin enhances GC cell migration by increasing ICAM-1 through Rho/ROCK pathway, which might provide new insight into the significance of leptin in GC.

Long-term behavioral effects of neonatal blockade of gastrin-releasing peptide receptors in rats: similarities to autism spectrum disorders

Gastrin releasing peptide, the mammalian counterpart of the amphibian peptide, bombesin, has been increasingly implicated in regulating normal brain function as well as in the pathogenesis of psychiatric and/or neurodevelopmental disorders. We have previously shown that the neonatal blockade of the gastrin-releasing peptide receptor (GRPr) in rats produces long-lasting consequences during central nervous system development that are commonly observed in neurodevelopmental disorders such as autism spectrum disorders. The present investigation assessed in further detail, long-term behavioral effects of neonatal GRPr blockade. During postnatal days 1-10, male Wistar rat pups (n=5-10/litter) were injected (subcutaneously) with the GRPr antagonist, RC-3095 (1 mg/kg), or a vehicle (control), twice daily. Following the drug treatment regimen, several behaviors were assessed (starting on postnatal day 14) including specific social behaviors (namely, group huddling characteristics, social interaction, and social approach), restrictive/repetitive and stereotyped behaviors (y-maze, repetitive novel object contact task, observation for stereotypies) and anxiety/fear-related responses (open field, elevated plus maze and contextual fear conditioning). Rats treated neonatally with RC-3095 showed reduced sociability, restrictive interests, motor stereotypies and enhanced learned fear response compared to the controls (vehicle-treated rats). These behavioral abnormalities are consistent with those observed in autism spectrum disorders and provide further evidence that neonatal blockade of GRPr could potentially serve as a useful model to gain a better understanding of the underlying neurodevelopmental disruptions contributing to the expression of autism-relevant phenotypes.

Physicochemical and functional properties of gelatins extracted from turkey and chicken heads

Gelatins were prepared from chicken and turkey heads in a series of batch extractions at 2 different temperatures (50 and 60°C), and their composition and functional properties were evaluated. Gelatin yield from chicken and turkey heads was 52.29 and 62.76%, respectively, on a dry weight basis relative to the total collagen content in the raw materials. The gel strength of turkey gelatins varied from 332.7 to 368.4 g, which was significantly (P < 0.05) higher than that of chicken gelatins. Both chicken and turkey head gelatins had high solubility at acidic and alkaline pH values. However, turkey head gelatins showed better emulsifying and foaming properties compared with chicken gelatins.