Recent advances in the field of 16-membered macrolide antibiotics

The continuing emergence of bacterial resistance has provided an incentive for recent intensified research on macrolide antibiotics. Belonging to the macrolide family, 16-membered macrolides also experience a renewed interest in further exploration. The medicinal potential of 16-membered macrolides in search for new antibacterials stems from some advantages over 14-membered macrolides, such as gastrointestinal tolerability, structural flexibility, and lack of inducible resistance. Thus, compared with abundant articles on various 14-membered macrolide derivatives in the literature, this review will highlight some representative 16-membered macrolide antibiotics and their recently discovered analogs. Furthermore, the action and resistance mechanisms of 16-membered macrolide antibiotics will be elucidated as well to assist the drug design.

A comparison of the thermal adaptability of people accustomed to air-conditioned environments and naturally ventilated environments

It has been reported previously that people who are acclimated to naturally ventilated (NV) environments respond to hot and warm environments differently than people who are acclimated to air-conditioned (AC) environments. However, it is not clear whether physiological acclimatization contributes to this discrepancy. To study whether living and working in NV or AC environments for long periods of time can lead to different types of physiological acclimatization, and whether physiological acclimatization has an important influence on people's responses of thermal comfort, measurements of physiological reactions (including skin temperature, sweat rate, heart rate variability, and heat stress protein 70) and thermal comfort responses were conducted in a 'heat shock' environment (climate chamber) with 20 people (10 in the NV group and 10 in the AC group). The results showed that the NV group had a significantly stronger capacity for physiological regulation to the heat shock than the AC group. In other words, the NV group did not feel as hot and uncomfortable as the AC group did. These results strongly indicate that living and working in indoor thermal environments for long periods of time affects people's physiological acclimatization. Also, it appears that long-term exposure to stable AC environments may weaken people's thermal adaptability.

PRACTICAL IMPLICATIONS

This study examined the psychological and physiological differences of thermal adaptability of people used to air-conditioned environments and naturally ventilated environments. The results suggested that long-term exposure to stable air-conditioned environments may weaken people's thermal adaptability. Therefore, it might be advantageous for people to spend less time in static air-conditioned environments; this is not only because of its possible deleterious impact on people's physiological adaptability, but also because the air-conditioners' high-energy consumption will contribute to the effects of global warming.

Liver X receptor activation attenuates inflammatory response and protects cholinergic neurons in APP/PS1 transgenic mice

Alzheimer's disease (AD) is associated with beta-amyloid deposition, glial activation, and increased levels of the cytokines, as well as cholinergic dysfunction. Liver X receptor (LXR) has been found to inhibit the expression of pro-inflammatory genes. However, the effects of LXR activation on inflammatory response and on cholinergic system in AD are not yet clear. The present results revealed that LXR activation markedly attenuated several inflammatory markers and decreased microglial activation and reactive astrocytes in amyloid precursor protein (APP)/PS1 transgenic mice. Additionally, LXR activation significantly increased the number of cholinergic neurons in the medial septal regions and the basal nucleus of Meynert (NBM), and attenuated cognitive impairment. Furthermore, we observed that LXR activation inhibited the production of COX-2 and iNOS from Aβ(25-35)-induced microglia. LXR activation and nuclear factor kappa B (NF-κB) inhibitor PDTC both attenuated Aβ(25-35) induction of NF-κB activation. These results suggest that LXR agonists suppress the production of pro-inflammatory molecules, at least in part, by modulating NF-κB-signaling pathway. Collectively, these studies suggest that LXR agonists may have therapeutic significance in AD.

Immunological features in patients with pneumonitis due to influenza A H1N1 infection

BACKGROUND

Pneumonitis induced by pandemic influenza A H1N1 has a potential to cause respiratory failure, which is a risk factor for death. The underlying immunopathological mechanisms, however, have not yet been fully elucidated.

PATIENTS AND METHODS

We investigated changes in plasma cytokines, T cell subsets, and C-reactive protein (CRP) in 16 hospitalized patients with pneumonia caused by 2009 H1N1 influenza infection. The patients were classified into a severe disease group and a mild disease group according to PaO2.

RESULTS

Cytokine profiles showed no changes in interferon gamma (IFN-gamma), interleukin 6 (IL-6), IL-8, or transforming necrosis factor alpha (TNF-alpha) levels throughout the observation period. Transforming growth factor beta (TGF-beta1) was overproduced in the severe group but not in the mild group. Accordingly, we also found some signs of pulmonary fibrosis during the recovery period. Elevated CRP levels and lymphopenia were common in both the severe and the mild group. After treatment, there was a significant elevation in lymphocytes in both groups, but a significant decrease in CRP in the mild group. Lymphocyte counts and CRP levels rapidly recovered to normal levels in all survivors posttreatment; otherwise it seemed to be related to poor prognosis.

CONCLUSIONS

Serial measurements of cytokines showed that only TGF-beta1 was overproduced, possibly in relation to the early use of corticosteroids, which may have downregulated immune responses to H1N1 infection. Pretreatment TGF-beta1 plasma concentrations and absolute lymphocyte counts were independent predictors of severity. However, the role of elevated TGF-beta1 in H1N1 infection-associated pulmonary fibrosis requires further investigation.

Increased levels of soluble vascular endothelial cadherin are associated with poor outcome in severe sepsis

Endothelial cells are thought to play a key role in sepsis pathogenesis: vascular endothelial damage occurs in severe sepsis and multiple organ dysfunction. Soluble vascular endothelial cadherin (VE-cadherin) levels were investigated in a prospective study involving 28 consecutive critically ill patients with or without severe sepsis who were admitted to surgical intensive care; 13 healthy age-matched volunteers were included as controls. Soluble VE-cadherin levels increased significantly in patients with severe sepsis compared with ill patients without severe sepsis and healthy controls. There was a significant linear correlation between soluble VE-cadherin levels and illness severity scores. Soluble VE-cadherin levels were significantly higher in patients who died compared with survivors. In vitro cell culture showed that serum from patients with severe sepsis greatly decreased VE-cadherin staining at intercellular junctions and total VE-cadherin expression in human umbilical cord vein endothelial cells. These findings suggest that endothelial cells play an important role in the poor outcome of patients with severe sepsis.

Multimodality imaging of hypoxia in preclinical settings

Hypoxia has long been recognized to influence solid tumor response to therapy. Increasingly, hypoxia has also been implicated in tumor aggressiveness, including growth, development and metastatic potential. Thus, there is a fundamental, as well as a clinical interest, in assessing in situ tumor hypoxia. This review will examine diverse approaches focusing on the preclinical setting, particularly, in rodents. The strategies are inevitably a compromise in terms of sensitivity, precision, temporal and spatial resolution, as well as cost, feasibility, ease and robustness of implementation. We will review capabilities of multiple modalities and examine what makes them particularly suitable for investigating specific aspects of tumor pathophysiology. Current approaches range from nuclear imaging to magnetic resonance and optical, with varying degrees of invasiveness and ability to examine spatial heterogeneity, as well as dynamic response to interventions. Ideally, measurements would be non-invasive, exploiting endogenous reporters to reveal quantitatively local oxygen tension dynamics. A primary focus of this review is magnetic resonance imaging (MRI) based techniques, such as ¹⁹F MRI oximetry, which reveals not only hypoxia in vivo, but more significantly, spatial distribution of pO₂ quantitatively, with a precision relevant to radiobiology. It should be noted that preclinical methods may have very different criteria for acceptance, as compared with potential investigations for prognostic radiology or predictive biomarkers suitable for use in patients.

Tumor necrosis factor alpha increases epithelial barrier permeability by disrupting tight junctions in Caco-2 cells

The objectives of this study were to determine the effect of tumor necrosis factor alpha (TNF-alpha) on intestinal epithelial cell permeability and the expression of tight junction proteins. Caco-2 cells were plated onto Transwell microporous filters and treated with TNF-alpha (10 or 100 ng/mL) for 0, 4, 8, 16, or 24 h. The transepithelial electrical resistance and the mucosal-to-serosal flux rates of the established paracellular marker Lucifer yellow were measured in filter-grown monolayers of Caco-2 intestinal cells. The localization and expression of the tight junction protein occludin were detected by immunofluorescence and Western blot analysis, respectively. SYBR-Green-based real-time PCR was used to measure the expression of occludin mRNA. TNF-alpha treatment produced concentration- and time-dependent decreases in Caco-2 transepithelial resistance and increases in transepithelial permeability to the paracellular marker Lucifer yellow. Western blot results indicated that TNF-alpha decreased the expression of phosphorylated occludin in detergent-insoluble fractions but did not affect the expression of non-phosphorylated occludin protein. Real-time RT-PCR data showed that TNF-alpha did not affect the expression of occludin mRNA. Taken together, our data demonstrate that TNF-alpha increases Caco-2 monolayer permeability, decreases occludin protein expression and disturbs intercellular junctions.

Mechanism of the transforming growth factor-beta induction of fibronectin expression in hepatic stem-like cells

Transforming growth factor-beta1 (TGF-beta1) plays an important role in the fibrogenic process in the liver. The aim of the present study was to explore the action of TGF-beta1 on fibronectin expression in rat hepatic stem-like cells and the underlying mechanisms. The level of fibronectin expression was determined in hepatic stem-like cells (WB cells) before and after TGF-beta1 stimulation by RT-PCR and Western blot methods. Using immunogold transmission electron microscopy and the Western blot method, we observed the result of the expression and the distribution of cAMP, phosphorylated Smad3 and Smad7 before and after TGF-beta1 treatment. The levels of fibronectin expression in both mRNA and protein increased 4- to 5-fold after TGF-beta1 stimulation, reaching an optimum level after 8 h and then gradually falling back. Similarly, TGF-beta1 stimulation resulted in an increase of cAMP in WB cells, peaking at 8 h. After treatment with TGF-beta1 for 24 h, the expression of cAMP gradually decreased. In addition, we found that TGF-beta1 treatment also contributed to the increased expression and to changes in cellular distribution of phosphorylated Smad3 (translocation from the cytoplasm to the nucleus) and Smad7 (translocation from the nucleus to the cytoplasm) in WB cells. The present study demonstrates that TGF-beta is involved in the fibrogenic process in hepatic stem cells through up-regulation of fibronectin expression, and the mechanisms underlying this process may be associated with the activation of cAMP and Smad pathways.

Thrombomodulin improves early outcomes after intraportal islet transplantation

Primary islet nonfunction due to an instant blood mediated inflammatory reaction (IBMIR) leads to an increase in donor islet mass required to achieve euglycemia. In the presence of thrombin, thrombomodulin generates activated protein C (APC), which limits procoagulant and proinflammatory responses. In this study, we postulated that liposomal formulations of thrombomodulin (lipo-TM), due to its propensity for preferential uptake in the liver, would enhance intraportal engraftment of allogeneic islets by inhibiting the IBMIR. Diabetic C57BL/6J mice underwent intraportal transplantation with B10.BR murine islets. In the absence of treatment, conversion to euglycemia was observed among 29% of mice receiving 250 allo-islets. In contrast, a single infusion of lipo-TM led to euglycemia in 83% of recipients (p = 0.0019). Fibrin deposition (p < 0.0001), neutrophil infiltration (p < 0.0001), as well as expression TNF-alpha and IL-beta (p < 0.03) were significantly reduced. Significantly, thrombotic responses mediated by human islets in contact with human blood were also reduced by this approach. Lipo-TM improves the engraftment of allogeneic islets through a reduction in local thrombotic and inflammatory processes. As an enzyme-based pharmacotherapeutic, this strategy offers the potential for local generation of APC at the site of islet infusion, during the initial period of elevated thrombin production.