The efficacy of moxifloxacin-based triple therapy in treatment of Helicobacter pylori infection: a systematic review and meta-analysis of randomized clinical trials

Recent evidence shows that moxifloxacin could exert an antimicrobial effect against Helicobacter pylori in both in vitro and in vivo models. To systematically evaluate whether moxifloxacin-containing triple therapy could improve eradication rates and reduce side effects in first-line or second-line anti-H. pylori treatment, eligible articles were identified by searches of electronic databases. We included all randomized trials comparing moxifloxacin-based triple therapy with standard triple or quadruple therapy during H. pylori eradication treatment. Statistical analysis was performed with Review Manager 5.0.10. Subanalysis/sensitivity analysis was also performed. We identified seven randomized trials (n=1263). Pooled H. pylori eradication rates were 79.03% (95%CI: 75.73-82.07) and 68.33% (95%CI: 64.44-72.04) for patients with moxifloxacin-based triple therapy or with standard triple or quadruple therapy, respectively (intention-to-treat analysis). The odds ratio (OR) was 1.82 (95%CI: 1.17-2.81), the occurrence of total side effects was 15.23% (95%CI: 12.58-18.20) and 27.17% (95%CI: 23.64-30.92) for groups with or without moxifloxacin, and the summary OR was 0.45 (95%CI: 0.26-0.77). In subgroup analyses, we noted that the second-line eradication rate in the moxifloxacin group was significantly higher than that in the quadruple therapy group (73.33 vs 60.17%, OR: 1.78, 95%CI: 1.16-2.73, P<0.001). However, there was no difference in first-line eradication treatment. Findings from this meta-analysis suggest that moxifloxacin-based triple therapy is more effective and better tolerated than standard triple or quadruple therapy. Therefore, a moxifloxacin-based triple regimen should be used in the second-line treatment of H. pylori infection.

Neuregulin-1 protects against doxorubicin-induced apoptosis in cardiomyocytes through an Akt-dependent pathway

In previous studies, it has been shown that recombinant human neuregulin-1(rhNRG-1) is capable of improving the survival rate in animal models of doxorubicin (DOX)-induced cardiomyopathy; however, the underlying mechanism of this phenomenon remains unknown. In this study, the role of rhNRG-1 in attenuating doxorubicin-induce apoptosis is confirmed. Neonatal rat ventricular myocytes (NRVMs) were subjected to various treatments, in order to both induce apoptosis and determine the effects of rhNRG-1 on the process. Activation of apoptosis was determined by observing increases in the protein levels of classic apoptosis markers (including cleaved caspase-3, cytochrome c, Bcl-2, BAX and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL) staining). The activation of Akt was detected by means of western blot analysis. The study results showed that doxorubicin increased the number of TUNEL positive cells, as well as the protein levels of cleaved caspase-3 and cytochrome c, and reduced the ratio of Bcl-2/Bax. However, all of these effects were markedly antagonized by pretreament with rhNRG-1. It was then further demonstrated that the effects of rhNRG-1 could be blocked by the phosphoinositole-3-kinase inhibitor LY294002, indicating the involvement of the Akt process in mediating the process. RhNRG-1 is a potent inhibitor of doxorubicin-induced apoptosis, which acts through the PI3K-Akt pathway. RhNRG-1 is a novel therapeutic drug which may be effective in preventing further damage from occurring in DOX-induced damaged myocardium.

Leukemia-related chromosomal loss detected in hematopoietic progenitor cells of benzene-exposed workers

Benzene exposure causes acute myeloid leukemia and hematotoxicity, shown as suppression of mature blood and myeloid progenitor cell numbers. As the leukemia-related aneuploidies monosomy 7 and trisomy 8 previously had been detected in the mature peripheral blood cells of exposed workers, we hypothesized that benzene could cause leukemia through the induction of these aneuploidies in hematopoietic stem and progenitor cells. We measured loss and gain of chromosomes 7 and 8 by fluorescence in situ hybridization in interphase colony-forming unit-granulocyte-macrophage (CFU-GM) cells cultured from otherwise healthy benzene-exposed (n=28) and unexposed (n=14) workers. CFU-GM monosomy 7 and 8 levels (but not trisomy) were significantly increased in subjects exposed to benzene overall, compared with levels in the control subjects (P=0.0055 and P=0.0034, respectively). Levels of monosomy 7 and 8 were significantly increased in subjects exposed to <10 p.p.m. (20%, P=0.0419 and 28%, P=0.0056, respectively) and ≥ 10 p.p.m. (48%, P=0.0045 and 32%, 0.0354) benzene, compared with controls, and significant exposure-response trends were detected (P(trend)=0.0033 and 0.0057). These data show that monosomies 7 and 8 are produced in a dose-dependent manner in the blood progenitor cells of workers exposed to benzene, and may be mechanistically relevant biomarkers of early effect for benzene and other leukemogens.

P3-18-05: Triple-Negative Breast Cancer: Stem Cells, Cancer and New Treatment Strategy

Background: Women with triple negative breast cancer (TNBC) have a worse prognosis compared with other breast cancer subtypes. Hormonal or Herceptin-based therapies were found to be ineffective because of the loss of target receptors such as ER, PR and HER-2 amplification. TNBC has increased recurrence and poor survival, despite initial response to neoadjuvant chemotherapy. The aim of this study was to determine whether current drug treatment(s) eliminates bulk of tumor cells, but it has a minimal effect on cancer stem cells (CSCs) leading to tumor recurrence.

Materials and Methods: Cancer stem cells were identified by ALDH-positive population by fluorescence-activated cell sorting. CSCs ability to form mammospheres, are generated in nonadherent and nondifferentiated conditions. Apoptosis was assessed using the Cell Death Detection ELISAPLUS kit. Xenograft tumor formation was evaluated using Nod/Scid mice. Cancer stem cell levels in human TNBC and ER+, PR+ and HER2− tumors were obtained by CD44+/ CD24low/− immunohistochemistry.

Results: TNBC tumors express relatively higher levels of cancer stem cells compared to ER-positive, PR-positive and HER2−negative breast tumors. We studied the effects of PARP inhibitors (AZD2281 and BSI-201), paclitaxel, docetaxel, cisplatin and cisplatin plus TRAIL on CSCs derived from CRL-2335 and MDA-MB-468 TNBC cells in vitro. The in vitro data indicates that cisplatin plus TRIAL treatment was most effective in eliminating CSCs compared to PARP inhibitors, cisplatin, paclitaxel and docetaxel. Treatment with cisplatin plus TRAIL also inhibits Wnt-1 signaling and its downstream target, β-catenin, phospho β-catenin, cyclin D1, increased apoptosis, reduced proliferation and mammosphere formation. Inhibition of Wnt-1 by siRNA significantly reduced the ability of CSCs to form mammospheres compared to control. However, maximum effect was seen in cisplatin plus TRAIL treated cells. The combination of cisplatin/TRAIL also inhibited the growth of CRL-2335 Xenografts. Discussion: We demonstrate for the first time that cisplatin plus TRAIL is highly effective in reducing CSCs compared to PARP inhibitors, docetaxel or paclitaxel in TNBC cells in vitro. Inhibition of Wnt-1 signaling pathways by siRNA or cisplatin plus TRAIL reduces cell proliferation and increases apoptosis in CSCs. Taken together the data suggests that cisplatin plus TRAIL treatment has the potential of providing a new strategy for improving the therapeutic outcome in TNBC patients.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-18-05.

Immediate Repair Compared with Delayed Repair of Congenital Omphalocele: Short-Term Neonatal Outcomes in China

This prospective study evaluated the short-term outcomes of 16 neonates undergoing single congenital omphalocele repair. Parents made informed choices for their baby to receive either immediate repair (IR group, n = 8) or repair ≥ 3 h after delivery (control group, n = 8). All babies were delivered by elective caesarian section. Babies in the two groups were matched one-to-one according to their birth weight, bulging volume and gestational age. Short-term outcomes included the incidence of infection and the lengths of stay in the neonatal intensive care unit (NICU) and in the hospital. Compared with the control group, the IR group showed a significantly lower incidence of infection, shorter surgical duration, shorter NICU stay, less time on total parenteral nutrition, less time to total enteral nutrition and shorter length of hospital stay. Immediate repair significantly improved the short-term neonatal outcomes of congenital omphalocele in China.

Efficient cochlear gene transfection in guinea-pigs with adeno-associated viral vectors by partial digestion of round window membrane

The auditory portion of the inner ear, the cochlea, is an ideal organ for local gene transfection owing to its relative isolation. Various carriers have been tested for cochlear gene transfection. To date, viral vectors appear to have much higher transfection efficacy than non-viral mechanisms. Among these vectors, recombinant adeno-associated virus (rAAV) vectors have several advantages such as being non-pathogenic and the ability to produce prolonged gene expression in various cell types. However, rAAV vectors cannot pass through the intact round window membrane (RWM), otherwise a very attractive approach to access the human inner ear. In this study, performed in guinea-pigs, we describe a method to increase the permeability of RWM to rAAV vectors by partial digestion with collagenase solution. Elevated delivery of rAAV across the partially digested RWM increased transfection efficacy to a satisfactory level, even though it was still lower than that achieved by direct cochleostomy injection. Functional tests (auditory brainstem responses) showed that this enzymatic manipulation did not cause permanent hearing loss if applied appropriately. Morphological observations suggested that the damage to RWM caused by partial digestion healed within four weeks. Taken together, these findings suggest that partial digestion of the RWM is a safe and effective method for increasing the transfection of cochlear sensory cells with rAAV.

Overexpression of X-linked inhibitor of apoptosis protein protects against noise-induced hearing loss in mice

Apoptosis is responsible for cochlear cell death induced by noise. Here, we show that transgenic (TG) mice that overexpress X-linked inhibitor of apoptosis protein (XIAP) under control of the ubiquitin promoter display reduced hearing loss and cochlear damage induced by acoustic overstimulation (125 dB sound pressure level, 6 h) compared with wild-type (WT) littermates. Hearing status was evaluated using the auditory brainstem response (ABR), whereas cochlear damage was assessed by counts of surviving hair cells (HCs) and spiral ganglion neurons (SGNs) as well as their fibers to HCs. Significantly smaller threshold shifts were found for TG mice than WT littermates. Correspondingly, the TG mice also showed a reduced loss of HCs, SGNs and their fibers to HCs. HC loss was limited to the basal end of the cochlea that detects high frequency sound. In contrast, the ABRs demonstrated a loss of hearing sensitivity across the entire frequency range tested (2-32 kHz) indicating that the hearing loss could not be fully attributed to HC loss alone. The TG mice displayed superior hearing sensitivity over this whole range, suggesting that XIAP overexpression reduces noise-induced hearing loss not only by protecting HCs but also other components of the cochlea.

Batch effects in the BRLMM genotype calling algorithm influence GWAS results for the Affymetrix 500K array

The Affymetrix GeneChip Human Mapping 500K array is common for genome-wide association studies (GWASs). Recent findings highlight the importance of accurate genotype calling algorithms to reduce the inflation in Type I and Type II error rates. Differential results due to genotype calling errors can introduce severe bias in case-control association study results. Using data from the Wellcome Trust Case Control Consortium, 1991 individuals with coronary artery disease (CAD) and 1500 controls from the UK Blood Services (NBS) were genotyped on the Affymetrix 500K array. Different batch sizes and compositions were used in the Bayesian Robust Linear Model with Mahalanobis distance classifier (BRLMM) genotype calling algorithm to assess the batch effect on downstream association analysis. Results show that composition (cases and controls genotyped simultaneously or separate) and size (number of individuals processed by BRLMM at a time) can create 2-3% discordance in the results for quality control and statistical analysis and may contribute to the lack of reproducibility between GWASs. The changes in batch size are largely responsible for differential single-nucleotide polymorphism results, yet we observe evidence of an interactive effect of batch size and composition that contributes to discordant results in the list of significantly associated loci.

Assessment of variability in GWAS with CRLMM genotyping algorithm on WTCCC coronary artery disease

The robustness of genome-wide association study (GWAS) results depends on the genotyping algorithms used to establish the association. This paper initiated the assessment of the impact of the Corrected Robust Linear Model with Maximum Likelihood Classification (CRLMM) genotyping quality on identifying real significant genes in a GWAS with large sample sizes. With microarray image data from the Wellcome Trust Case-Control Consortium (WTCCC), 1991 individuals with coronary artery disease (CAD) and 1500 controls, genetic associations were evaluated under various batch sizes and compositions. Experimental designs included different batch sizes of 250, 350, 500, 2000 samples with different distributions of cases and controls in each batch with either randomized or simply combined (4:3 case-control ratios) or separate case-control samples as well as whole 3491 samples. The separate composition could create 2-3% discordance in the single nucleotide polymorphism (SNP) results for quality control/statistical analysis and might contribute to the lack of reproducibility between GWAS. CRLMM shows high genotyping accuracy and stability to batch effects. According to the genotypic and allelic tests (P<5.0 x 10(-7)), nine significant signals on chromosome 9 were found consistently in all batch sizes with combined design. Our findings are critical to optimize the reproducibility of GWAS and confirm the genetic role in the pathophysiology of CAD.

Solvothermal synthesis and characterization of ceria-zirconia mixed oxides for catalytic applications

Solvothermal synthesis under supercritical conditions (400 degrees C) and high autogenous pressure (about 40 MPa), has been carried out for the direct preparation of nanocrystalline powders of CeO2, Ce(0.85)Zr(0.15)O2, Ce(0.75)Zr(0.25)O2, Ce(0.65)Zr(0.35)O2 and Ce(0.5)Zr(0.5)O2 which are characterized for applications as catalysts for oxygen storage in automotive catalysis. The synthesis was carried out in the presence of polyethylene glycol and water. For the characterization, x-ray diffraction (XRD), transmission electron microscopy (TEM), dynamic light scattering (DLS) and the Brunauer-Emmet-Teller (BET) technique were employed. The oxygen storage capacity (OSC) of as-prepared and calcined samples without loading of noble metals was measured using thermogravimetric-differential thermal analysis (TG-DTA) at 600 degrees C with a continuous flow of CO-N2 gas and air alternately. Ce(0.5)Zr(0.5)O2 nanoparticles with a BET surface area of 102 m(2) g(-1) exhibited the highest OSC of 0.073 50 mol-O2/mol-CeO2. The OSC values obtained increased with increasing the amount of ZrO2 doping in the samples.

Association between genetic variants in VEGF, ERCC3 and occupational benzene haematotoxicity

INTRODUCTION

Benzene is an established human haematotoxin, with substantial interindividual variation in benzene-induced toxicity.

METHODS

To further examine if genetic variation contributes to benzene haematotoxicity, we analysed 1023 tagSNPs in 121 gene regions important for benzene metabolism, haematopoiesis, leukaemia and lymphoma among 250 workers exposed to benzene and 140 unexposed controls in a cross-sectional study carried out in China. Linear regression was used to analyse the relationship between genetic polymorphisms and total white blood cell (WBC) count and its subtypes, adjusting for potential confounders and occupational exposure to benzene and toluene among exposed workers. The minp test assessed the association on the gene region level. The false discovery rate method was used to control for multiple comparisons.

RESULTS

VEGF (minp = 0.0030) and ERCC3 (minp = 0.0042) were the most significantly associated gene regions with altered WBC counts among benzene-exposed workers, after accounting for multiple comparisons. Highly significant changes were also found for WBC subtype counts, including granulocytes, CD4+ T cells and lymphocytes for VEGF and granulocytes and NK cells for ERCC3. Further, in workers exposed to <1 ppm, a SNP in VEGF was associated with changes in WBC and granulocyte counts, and SNPs in ERCC3 were associated with changes in WBC, NK cell and granulocyte counts.

DISCUSSION

Our findings suggest that genetic variation in VEGF, which plays an important role in blood vessel growth, and ERCC3, which is a member of the DNA repair pathway and is responsible for repairing bulky DNA adducts formed by chemicals, may contribute to individual susceptibility to benzene-induced haematotoxicity at relatively low levels of benzene exposure.

A rapid hydrothermal synthesis of rare earth oxide activated Y (OH)3 and Y2O3 nanotubes

One-dimensional single crystalline rare earth ion (Tm(3+), Tb(+3), and Eu(3+)) doped Y (OH)(3) nanotubes with inner diameters of 20-110 nm, outer diameters of 50-140 nm, and 1-5 microm in length were prepared for the first time by a rapid hydrothermal method within a short reaction period (5 min) at subcritical temperature (320 degrees C) and high pressure (about 40 MPa). A temperature dependent nanostructure evolution study was performed under rapid hydrothermal conditions and the effects of other processing parameters such as concentration of KOH and reaction time were found to be key parameters for the formation of highly anisotropic crystal structures of rare earth hydroxide nanotubes. Rare earth ion (Tm(3+), Tb(+3), and Eu(3+)) doped Y(2)O(3) nanotubes can be obtained after calcinations above 450 degrees C. The luminescent property of rare earth doped Y(2)O(3) nanotubes was also explored and compared with reference samples prepared via a conventional co-precipitation method.

Trichostatin A and nuclear reprogramming of cloned rabbit embryos

To investigate the influence of histone deacetylases on nuclear reprogramming after nuclear transfer, we treated the cloned embryos with a histone deacetylase inhibitor, Trichostatin A (TSA). In the present study, global changes in acetylation of histone H3-lysine 14, histone H4-lysine 12, and histone H4-lysine 5 were studied in rabbit in vivo fertilized embryos, somatic cell nuclear transfer (SCNT) embryos, and TSA-treated SCNT embryos. From the pronuclear to the morula stage, the deacetylation-reacetylation changes in acetylation of histone H3-lysine 14 and histone H4-lysine 12 occurred in both fertilized embryos and TSA-treated cloned embryos; however, the distribution pattern in untreated cloned embryos failed to display such changes. More interesting, the signal of acetylation of histone H4-lysine 12 in cloned embryos was detected in both the inner cell mass and the trophectoderm, whereas TSA-treated cloned embryos showed the same staining pattern as fertilized embryos and the staining was limited to the inner cell mass. The histone acetylation pattern of TSA-treated SCNT embryos appeared to be more similar to that of normal embryos, indicating that TSA could improve nuclear reprogramming after nuclear transfer.