[The selective anterior neck dissection for treating children's recurrent thyroglossal duct cysts]

Objective:To evaluate the therapeutic effect of selective anterior neck dissection on the treatment of children's recurrent thyroglossal duct cysts. Method: The clinical data of 28 patients with recurrent thyroglossal duct cysts were retrospectively analyzed. In accordance with the embryologic and anatomic features of thyroglossal duct cysts, different types of selective neck dissection were applied. Enbloc resection principles were applied to extirpate thyroglossal duct cysts,scarrings and inflammatory granuloma during the operation. Result:All the wounds of 28 patients healed primarily without significant complications including dysphagia, paragammacism, injury of hypoglossal nerve and superior laryngeal nerve. No recurrences were found in all 28 cases with a follow-up period of 24 to 72 months(average 46 months). Conclusion:Selective anterior neck dissection is a safe and effective surgical procedure for the radical treatment of children's recurrent thyroglossal duct cysts.

[The surgical strategy of microsurgical treatment for fulminant hemorrhagic dilation of the fourth ventricle]

Objective: To investigate the effectiveness and advantage of improved microsurgery for fulminant hemorrhagic dilation of the fourth ventricle. Methods: The clinical data of 21 patients with fulminant hemorrhagic dilation of the fourth ventricle were analyzed retrospectively.All patients underwent hemorrhage evacuation and improved atlantooccipital decompression via middle suboccipital trans-cerebellar vermis approach, with preceding external ventricular drain. Results: One patient died of brainstem failure postoperative, and 20 patients were followed up from 6 to 17 months.There were 8 patients whose KPS exceeded 90, 6 patients whose KPS were 60 to 90, 4 patients whose KPS were 30 to 60, and two patients whose KPS were lower than 30.There was no recurrence of hydrocephalus and posterior fossa fluid. Conclusions: The improved microsurgery for fulminant hemorrhagic dilation of the fourth ventricle not only could effectively raise the success rate of salvage, but also greatly reduce postoperative complications compared with traditional mode.

[Manifestation of first branchial anomaly:56 cases reportrhinitis]

Objective:To sum up and conclude manifestation of congenital first branchial anomaly(CFBCA).Method:The clinical data of 56 patients from 2005 to 2015 in our hospital were retrospective reviewed.Result:Manifestation:mass without pain(26.8%),repeated sore and discharge(71.4%),otological symptom(external auditory discharge､hearing loss,28.6%).Eleven cases bacterial sample showed positive result,and most of them show pseudomonas aeruginosa and staphylococcus aureus.Auricular endoscopy typically performed stricture of external auditory canal,cholesteatoma samples accumulated in ear canal,fistula at the conjunction of the bone and cartilage and tympanic membranous attachment.Typical performance of CT(MRI)was that there were cystic,lobulated or tubular abnormal shadow related with ear canal in Pochet's triangle area whose cyst wall or pipe wall could been enhanced in enhanced CT(MRI) scans,and part of that could be connected with skin.The statistical difference between type Oslen and Work and clinical characteristics(P<0.01),and the relationship between type Oslen and Work(P<0.01).Most of Work Ⅰ were cyst type,and these two type often had no infected symptom.Most of them were young patients.Most of Work Ⅱ were sinus and fistula type ,and these two type often had infected symptom.Most of them were teenagers.Part of patients of type Work Ⅱ showed tympanic membranous attachment.Conclusion:CFBCA was rare,and it is more common in young patients and often in left part.It always performed as mass without pain､repeated sore and discharge､external auditory discharge.Most of Work Ⅰ were cyst type,and these two type often had no infected symptom and most of them were young patients .Most of Work Ⅱ were sinus and fistula type,and these two type often had infected symptom and most of them were teenagers.Auricular endoscopy,CT,MRI could help make diagnose.Doctors clinical need to differentiate it with related diseases according to different manifestations.

Expression of transforming growth factor-β1 in neonatal rats with hyperoxia-induced bronchopulmonary dysplasia and its relationship with lung development

The aim of this study was to detect the expression of transforming growth factor-ß1 (TGF-ß1) in neonatal rats with hyperoxia-induced bronchopulmonary dysplasia (BPD) and to explore its relationship with lung development. Forty-eight rats (2-3 days old) were randomly divided into a hyperoxia group and a control group (N = 24) which were then fed in ≥95% oxygen atmosphere and air, respectively. On the 1st, 3rd and 7th days of hyperoxia exposure, morphological changes of lung tissues were observed under an optical microscope. TGF-ß1 mRNA and protein levels in lung tissues were detected by real-time quantitative polymerase chain reaction and western blot, respectively. With increasing time of hyperoxia exposure, the hyperoxia group gradually suffered from pathological changes such as poor development of lung tissues, alveolar simplification, decrease in the number of alveoli, and hindered pulmonary microvascular development. On the 7th day of hyperoxia exposure, TGF-ß1 mRNA and protein levels (relative to b-actin) of the hyperoxia group (0.34 ± 0.19 and 0.21 ± 0.09, respectively) were significantly lower than those of the control group (0.83 ± 0.45 and 0.57 ± 0.45, respectively; P < 0.05). TGF-ß1 participates in the pathogenesis of BPD as an important regulatory factor during pulmonary vascular development.

[Diffusion-weighted imaging characteristics of uterine leiomyomas with different pathological subtypes at 3.0 T]

OBJECTIVE

To investigate the imaging features of uterine leiomyomas with different pathological subtypes on DWI.

METHODS

Clinical records and MR images of pathologically confirmed uterine leiomyomas were retrospectively collected from the Second Affiliated Hospital of Wenzhou Medical University from June 2012 to April 2015. A total of 60 uterine leiomyomas were found and evaluated.All the patients were divided into three groups according to different pathological types, which included 17 cases of cellular leiomyomas, 10 cases of degenerated leiomyomas and 33 cases of ordinary leiomyomas.The DWI signal and ADC values in cellular portion of the lesions and adjacent normal myometrium (the control group) were measured.

RESULTS

(1) Most cellular leiomyomas showed hyperintensity on DWI (15/17), while degenerated leiomyomas manifested hypointensity, isointensity or hyperintensity signal on DWI, and most ordinary leiomyomas displayed isointensity signal on DWI (57.6%, 19/33). (2) The ADC values of cellular leiomyomas, degenerated leiomyomas and ordinary leiomyomas were (1.01±0.14)×10(-3) mm(2)/s, (1.73±0.49)×10(-3) mm(2)/s and (1.38±0.22)×10(-3) mm(2)/s respectively.The ADC values of adjacent normal myometrium (the control group) were (1.35±0.16)×10(-3) mm(2)/s.There were no significant statistical differences in the ADC values between ordinary leiomyomas and adjacent normal myometrium (P=0.623). There were significant statistical differences in the ADC values among other groups(all P<0.05). (3)The ROC curve showed that the diagnostic threshold for cellular leiomyomas was 1.11×10(-3) mm(2)/s, the sensitivity and specificity were 88.2%and 93.0% respectively.

CONCLUSION

The signal intensity on DWI and the ADC values are different in uterine leiomyomas with different pathological subtypes.Combination of these two parameters in clinical practice may be helpful to reflect the histopathological characteristics of uterine leiomyomas.

[Long term result of arytenoidectomy with CO₂ laser for dyspnoea in iatrogenic bilateral vocal fold paralysis patients]

Objective:To investigate the optimal time of tracheotomy/arytenoidectomy and the improvement of dyspnoea, dysphonia and dysphagia after arytenoidectomy with CO₂ laser in iatrogenic bilateral vocal folds paralysis patients. Method:Thirty patients [29 females, 56 (49-60) years, one male, 49 years] with bilateral vocal cords paralysis resulted from neck surgery were retrospectively analyzed by case archived information and following-up questionnaire. The data included patients' dysponea time, degree and duration from tracheotomy/arytenoidectomy to neck surgery. Twenty sixty patients required unilateral partial/total arytenoidectomy. The results of treatment were evaluated by questionnaire including dyspnoea, dysphonia and dysphagia. Result:All patients whose bilateral vocal paralysis were resulted from thyroid gland surgery. Dysponea occurred immediately after thyroidectomy surgery in 14 cases (46.7%), and 2 years later after thyroidectomy in 13 cases (43.3%), 8 years later in 3 cases (10.0%). There was one (3.3%) patient without tracheotomy. The duration of tracheotomy/arytenoidectomy to neck surgery was significantly correlated with duration of tracheotomy/arytenoidectomy to dyspnoea appearance (r=0.879, P<0.05), not correlated with duration of thyroid surgery to dyspnoea appearance. There is significantly negative correlation between degree of dyspnoea and duration of tracheotomy/arytenoidectomy to neck surgery (r=0.452, P<0.05). Twenty six patients appeared dyspnoea and underwent CO₂ laser arytenoidectomy after thyoidectomy 0.5-23 years. Five patients did unilateral total arytenoidectomy and 21 patients did unilateral partial arytenoidectomy. After 12-96 months following up, dyspnoea improved in 24 patients, no improved in 2 patients. Dysphonia improved and remained in 17 patients, being worse mildly in 8 patients and obviously in one patient. Dysphagia improved and remained in 24 patients, being worse in 2 patients. There was no difference between total and partial arytenoidectomy in dyspnoea, dysphonia and dysphagia. Conclusion:The morbidity of dyspnoea was correlated with time after neck surgery. It was rarely necessary to take tracheotomy immediately in bilateral vocal fords paralysis patients after neck surgery. The severer degree of dyspnoea led to shorter duration between neck surgery and tracheotomy/arytenoidectomy. There was obvious improvement after arytenoidectomy in dyspnoea, no significant change in dysphonia and dysphagia. The effect of total arytenoidectomy on bilateral vocal paralysis was similar to partial arytenoidectomy.

Abstract A149: Evaluating immune contexture in syngeneic mouse models of cancer

The explosion of research in the cancer immunotherapy field has led to a quest for better animal models to validate and develop various immunotherapies. Syngeneic mouse tumor models are one of the best options currently available to select cancers where clinical efficacy may be expected, to test mechanism of action hypotheses, in providing clues for possible biomarkers of immune pharmacodynamic (PD) activity and most successfully for predicting best partners for synergistic combinations. In order to select an appropriate model to evaluate a specific immunotherapy, it is essential to ensure sufficient understanding of the tumor model especially the immunogenicity and the characteristics of the immune infiltrates in the tumor microenvironment. It is also important to understand the dynamics of tumor growth and its effect on the immune landscape in the various peripheral tissues compartments during cancer progression.

We embarked on this study to systematically evaluate the dynamics and kinetics of phenotypic changes in immune cells in tumor, circulation and lymphoid organs with tumor progression in several syngeneic mouse tumor models. Pharmacodynamic evaluations of immune responses in all lymphoid compartments including the TME were made at various time points of tumor progression. Multicolor flow cytometry was performed on TILs, splenocytes and lysed whole blood to evaluate various T cells and the cell surface markers of activation, regulation and exhaustion. Additionally changes in cytokine levels in serum were also analyzed.

Our results show 1) significant changes in the tumor microenvironment (TME) with reference to the various types and functional status of immune cells in the various models and while tumor progression 2) Comparison between the different compartments within each model suggests significant changes in the co-stimulatory and co-inhibitory markers expressed on the TILs and their relative numbers and function in the periphery and other lymphoid compartments. 3) In addition, the dynamic changes observed with tumor progression in this study urge for a continuous assessment of these changes to obtain a complete kinetic picture rather than a snapshot when performing in-vivo biomarker studies in mice.

The information obtained from this study about the TIL and the expression of co-stimulatory/co-inhibitory molecules on these tumor models will enable us to employ a methodical approach when choosing a syngeneic model for efficacy and PD biomarker studies of immuno-modulatory agents under investigation.

All studies were conducted in accordance with the GSK Policy on the Care, Welfare and Treatment of Laboratory Animals and were reviewed the Institutional Animal Care and Use Committee either at GSK or by the ethical review process at the institution where the work was performed.

Citation Format: Sapna Yadavilli, Sabyasachi Bhattacharya, Ashleigh Hahn, Laura Seestaller-Wehr, David Kilian, Meixia Bi, Shu-Yun Zhang, Nicholas Vitali, Michael Adam, Yufeng Li, Niranjan Yanamandra, Roopa Srinivasan, Axel Hoos. Evaluating immune contexture in syngeneic mouse models of cancer. [abstract]. In: Proceedings of the CRI-CIMT-EATI-AACR Inaugural International Cancer Immunotherapy Conference: Translating Science into Survival; September 16-19, 2015; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2016;4(1 Suppl):Abstract nr A149.

Proteomic analysis of susceptibility in intestinal stromal tumors

We analyzed the susceptibility of intestinal stromal tumors using cell culture and proteomics. Human SGC7901 gastric cells were selected and divided into a blank control group (untransfected SGC7901 cells), a negative control group [SGC7901 cells transfected with negative interference control-small interfering RNA (siRNA)], and a COOH-terminus tensin-like molecule (CTEN)-siRNA-1 group (SGC7901 cells transfected with CTEN-siRNA-1). The cells were successfully transfected and subjected to analyses of cell proliferation, cell cycle, cell invasion, CTEN expression, and proteomics. The percentages of cells in the G0/G1, S, and G2/M phases were similar in the three groups (P > 0.05), and the OD values were also similar at 24, 48, and 72 h (P > 0.05). Compared with the levels in the blank and negative control groups, CTEN protein in the CTEN-siRNA-1 group decreased by 66 and 65%, respectively, and significantly fewer cells in the CTEN-siRNA-1 group were capable of invasion (P < 0.05). Proteomic analysis showed that in the CTEN-siRNA-1 group, 283 proteins were upregulated and 242 were downregulated; from these, the expression levels of E-cadherin and ERK proteins changed significantly. Silencing the expression of CTEN in intestinal stromal tumor cells reduces their invasion capability. Moreover, silencing CTEN at different stages can also regulate the expression levels of E-cadherin and ERK proteins.

Ossifying fibroma in the temporomandibular joint: report of an unusual case and treatment perspectives

An unusual case of ossifying fibroma involving the right temporomandibular joint (TMJ) in a 7-year-old girl is presented. The treatment protocol comprised TMJ reconstruction with a costochondral graft following radical tumour resection, with the use of both pedicled and free fat grafts to improve the surgical outcome. Pathological examination confirmed the diagnosis. Aspects of the treatment are discussed.

Pyrene is a Novel Constitutive Androstane Receptor (CAR) Activator and Causes Hepatotoxicity by CAR

Polycyclic aromatic hydrocarbons (PAHs) are a class of ubiquitous persistent environmental pollutants which are primarily formed from the incomplete combustion of organic materials. Many potential sources of human exposure to PAHs exist, including daily exposures from the ambient environment or occupational settings. PAHs have been found to cause harmful effects on human health. Here, we evaluated the adverse effects of pyrene, a common PAH, on the liver. The present study demonstrates that pyrene is able to activate mouse constitutive androstane receptor (CAR). CAR protein, as measured by Western blot analysis, was observed to translocate into the nucleus from the cytoplasm in mouse liver after exposure to pyrene. Utilizing CAR null mice, we identified that CAR mediates pyrene-induced hepatotoxicity. Increased relative liver weight, hepatocellular hypertrophy, and elevated serum alanine aminotransferase levels were found in wild-type but not CAR null mice after orally administered pyrene. We further show that pyrene induced the expression of mouse liver metabolism enzymes including CYP2B10, CYP3A11, GSTm1, GSTm3, and SULT1A1, and caused hepatic glutathione depletion in wild-type but not CAR null mice. Moreover, by luciferase reporter assay and quantitative real-time PCR analysis, pyrene was found to be a potential inducer of CYP2B6 expression via activation of human CAR in HepG2 cells and human primary hepatocytes. Our observations suggest that pyrene is a novel CAR activator and that CAR is essential for mediating pyrene-induced liver injury.

Impact of the free-vaccine policy on timely initiation and completion of hepatitis B vaccination in Fujian, China

The extent to which the free-vaccine policy impacts the initiation and completion of a hepatitis B vaccine series is poorly understood. The aim of this study was to evaluate the impact of the free-vaccine policy on hepatitis B vaccination. A provincial survey was conducted in 2006 in Fujian Province, south-east of China, where the free-vaccine policy for hepatitis B was announced in 2002 and implemented in 2003. A total of 1628 children were investigated, and 1443 (88.6%) were included in this analysis. Among the children studied, 55.2% were vaccinated within 24 h of birth, and 76.1% completed the hepatitis B vaccine series on time. The rate of hepatitis B surface antibody positivity increased from 29.9% among children born in 1992 to 90.5% among children born in 2005, while the corresponding HBV infection rate decreased from 30.4% to 1.72%. Logistic regression indicated that, compared to children born between 1996 and 2001, the odds ratios (ORs) for timely initiation were 2.57 (95% confidence interval [CI], 1.71-3.84), 5.24 (95% CI, 3.26-8.43) and 9.06 (95% CI, 4.48-18.34) among children born in 2003, 2004 and 2005, respectively; the corresponding ORs for completing the vaccine series were 4.23 (95% CI, 1.97-9.10), 3.76 (95% CI, 1.81-7.82) and 4.94 (95% CI, 1.74-14.00) among children born in 2003, 2004 and 2005, respectively. Children with delayed vaccine initiation (>24 h after birth) were less likely to complete the vaccine series than those who received a timely first dose (OR = 0.02, 95% CI, 0.005-0.09). The impact of the free-vaccine policy on vaccine initiation and vaccine series completion did not differ by children's residence area (rural vs urban). As hypothesized, the odds of completing the vaccine series increased after the free-vaccine policy was announced in 2002 among children with delayed initiation (>24 h after birth) but not among those with timely initiation (≤ 24 h after birth). In conclusion, the free-vaccine policy significantly improved the timely initiation and completion of the vaccine series. The impact of this policy on completion of the vaccine series was larger among children with delayed vaccine initiation.

Polymorphisms in different EST-SSR types derived from the Chinese bayberry Myrica rubra, Myricaceae) transcriptome

Most plant expressed sequence tag-simple sequence repeats (EST-SSRs) are not polymorphic, and it is important to learn the characteristics of highly polymorphic EST-SSRs. In this study, 357 compound and 5557 non-compound EST-SSRs, identified from the transcriptome of the Chinese bayberry (Myrica rubra 'Biqi'), were divided into 11 types based on their characteristics. Polymorphisms in all 11 EST-SSR types were investigated in 10 cultivars. The percentages of polymorphic loci ranged from 12.9 to 87.5%, with 2-ntL having the highest, followed by 3-ntL, Compound B, and Compound A. The number of alleles and the polymorphic information content of 2-ntL and Compound B were the highest, followed by 2-ntM and Compound A. Therefore, we recommend that 2-ntL, Compound B, and Compound A EST-SSRs should be preferentially selected for the screening of polymorphic EST-SSRs in the Chinese bayberry. Our results should facilitate genetic and breeding studies of this species, and provide a reference for similar study in other plant species.

Eukaryotic elongation factor-2 kinase (eEF2K): a potential therapeutic target in cancer

Eukaryotic elongation factor-2 kinase (eEF2K), encoded by the EEF2K gene, is well-known to be a Ca(2+)/calmodulin (CaM)-dependent kinase which can negatively modulate protein synthesis. It is highly conserved among eukaryotes from mammals to invertebrates, of which human and mouse may have 99 % overall amino acid identity. This kinase can phosphorylate eukaryotic elongation factor-2 (eEF2) or undergo the process of autophosphorylation at multiple sites to inhibit its function in translation elongation. Due to the fact that regulation of eEF2 by eEF2K is an evolutionarily conserved mechanism, eEF2K activity may confer tumor cell adaption to metabolic stress under acute nutrient depletion, and the high expressed level of eEF2K has been found in several types of malignancies. eEF2K may modulate the expression of some apoptotic proteins such as XIAP, c-FLIPL, Bcl-XL, PI3KCI and p70(S6K) to inhibit apoptotic process in cancer. On the other hand, it plays a regulatory role in autophagy involved in mTORC1, AMPK and Atg8, thereby promoting cancer cell survival. Additionally, eEF2K may play a crucial role in the crosstalk between apoptosis and autophagy in cancer. Collectively, these findings have led to the conclusions that eEF2K may contribute to carcinogenesis, and thus being utilized as a potential target for future cancer therapy.

The BRAF and MEK Inhibitors Dabrafenib and Trametinib: Effects on Immune Function and in Combination with Immunomodulatory Antibodies Targeting PD-1, PD-L1, and CTLA-4

PURPOSE

To assess the immunologic effects of dabrafenib and trametinib in vitro and to test whether trametinib potentiates or antagonizes the activity of immunomodulatory antibodies in vivo.

EXPERIMENTAL DESIGN

Immune effects of dabrafenib and trametinib were evaluated in human CD4(+) and CD8(+) T cells from healthy volunteers, a panel of human tumor cell lines, and in vivo using a CT26 mouse model.

RESULTS

Dabrafenib enhanced pERK expression levels and did not suppress human CD4(+) or CD8(+) T-cell function. Trametinib reduced pERK levels, and resulted in partial/transient inhibition of T-cell proliferation/expression of a cytokine and immunomodulatory gene subset, which is context dependent. Trametinib effects were partially offset by adding dabrafenib. Dabrafenib and trametinib in BRAF V600E/K, and trametinib in BRAF wild-type tumor cells induced apoptosis markers, upregulated HLA molecule expression, and downregulated certain immunosuppressive factors such as PD-L1, IL1, IL8, NT5E, and VEGFA. PD-L1 expression in tumor cells was upregulated after acquiring resistance to BRAF inhibition in vitro. Combinations of trametinib with immunomodulators targeting PD-1, PD-L1, or CTLA-4 in a CT26 model were more efficacious than any single agent. The combination of trametinib with anti-PD-1 increased tumor-infiltrating CD8(+) T cells in CT26 tumors. Concurrent or phased sequential treatment, defined as trametinib lead-in followed by trametinib plus anti-PD-1 antibody, demonstrated superior efficacy compared with anti-PD-1 antibody followed by anti-PD-1 plus trametinib.

CONCLUSION

These findings support the potential for synergy between targeted therapies dabrafenib and trametinib and immunomodulatory antibodies. Clinical exploration of such combination regimens is under way.

Correlation between the disc status in MRI and the different types of traumatic temporomandibular joint ankylosis

OBJECTIVES

We aimed to investigate the correlation between the disc status in MRI and the different types of traumatic temporomandibular joint (TMJ) ankylosis.

METHODS

51 consecutive patients (69 joints), diagnosed with traumatic TMJ ankylosis with a residual condyle (Types A2 and A3), were included in this study. All patients had pre-operative MRI, which was reviewed to determine the disc shape, length and position. The results were compared using the Mann-Whitney test.

RESULTS

There were 37 joints of Type A2 ankylosis and 32 joints of Type A3. All joints of Type A2 and 27 joints of Type A3 (84.4%) definitely had a discernible disc, while 5 joints of Type A3 had no discernible discs. Among the discernible discs, the lateral disc of Type A2 and the whole disc of Type A3 had severe deformity, while the medial disc of Type A2 had mild deformity. The mean (standard deviation) disc length was 10.88 (1.19) mm in Type A2, but 7.50 (0.82) mm in Type A3. There was a significant difference between Types A2 and A3 (p < 0.05). As for the disc position, the intermediate position was found in all joints.

CONCLUSIONS

There is a correlation between the disc status and the different types of traumatic TMJ ankylosis. Therefore, MRI examination is needed to help treatment planning and predict post-operative TMJ function.

In silico analysis and experimental validation of active compounds from fructus Schisandrae chinensis in protection from hepatic injury

OBJECTIVES

The aim of this study was to explore mechanisms by which fructus Schisandrae chinensis (Wuweizi) is able to reveal its protective capacity against hepatocyte injury.

MATERIALS AND METHODS

Identification of candidate small molecular compounds was performed by text-mining, extraction and isolation, reverse-docking, network construction, molecular docking and molecular dynamics (MD) simulation. In vitro cytological examination and western blotting were used to validate efficacy of selected compounds.

RESULTS

We analyzed chemical composition of fructus Schisandrae chinensis and constructed protein-protein networks of key targets. Networks of miRNA-protein were constructed. Molecular docking and MD simulation results supported good interaction between selected compound 11/12 and GBA3/SHBG. Further in vitro examination divulged molecular mechanisms involved.

CONCLUSIONS

In silico analysis and experimental validation together demonstrated that compound 11/12 of fructus Schisandrae chinensis targetted GBA3/SHBG in hepatocytes. Hopefully this will shed light on exploration of its complex molecular mechanisms.

Abstract 5031: Effects of BRAF and MEK inhibitors, dabrafenib and trametinib, on the immune system and in combination with immunomodulatory antibodies targeting PD1, PD-L1 and CTLA-4

The immunological effects of dabrafenib and trametinib and whether they potentiate or antagonize the activity of immunomodulatory antibodies are not well understood. We assessed the immunological effects of dabrafenib and trametinib at clinically relevant exposure concentrations on both immune and tumor cells in vitro and in vivo, and tested their anti-tumor efficacy in combination with immunomodulatory antibodies in immune-competent syngeneic mouse models. Human CD4+ and CD8+ T cells isolated from healthy volunteers were treated with trametinib and dabrafenib either alone or in combination, and with or without anti-CD3/anti-CD28 bead activation (concurrently or sequentially). Dabrafenib alone enhanced pERK expression levels with no changes of pAKT and pS6 proteins, and had no suppressive impact on human CD4+ or CD8+ T cell proliferation, apoptosis and cytokine production in response to T cell activation. Trametinib alone reduced the pERK levels with no changes in pAKT and apoptosis. However trametinib resulted in partial inhibitory effects on T cell proliferation, pS6 proteins and cytokine expression. These inhibitory effects were transient and only observed if cells were treated with trametinib prior to or simultaneously with T cell activation, while trametinib had little or no suppressive effects on activated T cells. Adding dabrafenib partially offset the transient inhibitory effects caused by trametinib alone. Similarly, gene expression profiling showed that trametinib partially decreased the expression levels of a subset of cytokines and chemokines (e.g. IL1, IL2, IL8, IL10, TNFa, CCL2) and activation/regulation markers (e.g. CD69, CD25, PD1, CTLA4) when trametinib was added prior to or simultaneously with T cell activators. Multi-color flow cytometry confirmed cell surface changes in the expression of CD69, CD25, PD1, OX40 and CTLA4. However, the expression levels of CD69 and OX40 were still well above non-activated T cells. On tumor cells, dabrafenib and trametinib up-regulated HLA molecules and melanoma antigen MART1 expression, and down regulated immune-suppressive factors such as PD-L1, VEGF and IL8 etc in BRAFV600E melanoma cells. Combinations of trametinib with immunomodulators targeting PD1, PD-L1 or CTLA4 in murine syngeneic tumor models are underway and will be presented at the meeting. These findings to date support clinical exploration of dabrafenib and/or trametinib in combination with specific immunomodulatory antibodies.

Citation Format: Li Liu, Patrick Mayes, Stephen Eastman, Hong Shi, Sapna Yadavilli, Xiaoyu Pan, Jingsong Yang, Laura Seestaller-Wehr, Shu-Yun Zhang, Chris Hopson, Lyuben Tsvetkov, Junping Jing, James Smothers, Drew M. Pardoll, Axel Hoos. Effects of BRAF and MEK inhibitors, dabrafenib and trametinib, on the immune system and in combination with immunomodulatory antibodies targeting PD1, PD-L1 and CTLA-4. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5031. doi:10.1158/1538-7445.AM2014-5031

First Report of Tomato yellow leaf curl China virus with Betasatellite Infecting Panax notoginseng

Panax notoginseng, an important medicinal herb commonly known as notoginseng, san qi, or tian qi, is in the family Araliaceae. The herb is mainly cultivated in Guangxi and Yunnan provinces of southern China for its root, which is used in Chinese herbal medicine to treat various blood disorders. In December 2012, Panax yellowing was observed in several notoginseng farms with prevalence of 5 to 10% in Wenshan, Yunnan Province. Foliar symptoms included yellowing, shrinking, curling, and blistering. Leaf samples collected from 15 symptomatic plants were initially tested by negative staining electron microscopy, and no distinct virions were observed. Total nucleic acids were extracted from these samples by a CTAB method and used as templates in RT-PCR for presence of criniviruses, tobamoviruses, and tospoviruses, but results were negative. Infestation of whiteflies (Bemisia tabaci) has been a problem on these farms in recent years, suggesting a whitefly-transmitted begomovirus as potential causal agent. To explore this possibility, the samples were tested by PCR using degenerate primers BegoAFor1 and BegoARev1 described by Ha et al. (3). Amplicons of ~1.2 kbp were obtained from 12 out of 15 samples, indicating the presence of a putative begomovirus. These amplicons were cloned and sequenced in both directions. BLAST search showed that they had high sequence identities (94 to 95%) to the genome of Tomato yellow leaf curl China virus (TYLCCNV). A pair of virus-specific primers, TYLCCNVFa (5'-TGRTAGGWACYTGAGTAGAGTGG-3') and TYLCCNVRa (5'-TCRTCCATCCATATCTTCCCAA-3'), was then designed and used to amplify the remaining genomic sequence. The full-length genomic sequence of one isolate, YWSh03, was determined to be 2,733 nt (KJ477327). Sequence comparison showed that the genome of YWSh03 shared 96.2% nucleotide sequence identity with that of TYLCCNV-[G102] (AM050555). PCR using primers Beta01 and Beta02 (1) was also tested for the association of betasatellite with this virus. A DNA fragment was obtained from isolate YWSh03, and its sequence was determined to be 1,336 bp (KJ477326). This sequence has 99.9% nucleotide sequence identity to Tomato yellow leaf curl China betasatellite (TYLCCNB) [Y10] (AJ421621). The results show that TYLCCNV, a virus infecting tomato, tobacco, kidney bean, and several weeds (2), is also associated with the yellowing disease in P. notoginseng. To determine whether TYLCCNV and TYLCCNB might cause disease on P. notoginseng, infectious clones of TYLCCNV and TYLCCNB provided by Dr. Xueping Zhou (Zhejiang University, China) were used to inoculate to 44 healthy P. notoginseng plants by an Agrobacterium-mediated method. Thirty-four inoculated plants showed typical symptoms of yellowing, curling, and stunting, confirming TYLCCNV and TYLCCNB are the causal agents of the disease. To further investigate the distribution and incidence of the virus, 258 symptomatic P. notoginseng samples were collected from 18 fields in Wenshan, Honghe, Qujing, and Kunming of Yunnan Province and tested by PCR with TYLCCNV-specific primers of TYLCCNVdF (5'-CCTGTATATGCGACTTTGAAAGT-3') and TYLCCNVdR (5'-CCCAATTCCAGCTATAAAGAGTA-3'). The virus was detected in 149 samples (57.8%), indicating that TYLCCNV infection of P. notoginseng is common. However, the agent causing the disease in the 109 symptomatic plants lacking TYLCCNV remains under investigation. To our knowledge, this is the first report of TYLCCNV with TYLCCNB infecting P. notoginseng and the family Araliaceae. References: (1) R. W. Briddon et al. Mol Biotechnol. 20:315, 2002. (2) J. H. Dong et al. Plant Pathol. 56:342, 2007. (3) C. Ha et al. J. Gen. Virol. 87:997, 2006.

Discovery of novel AKT inhibitors with enhanced anti-tumor effects in combination with the MEK inhibitor

Tumor cells upregulate many cell signaling pathways, with AKT being one of the key kinases to be activated in a variety of malignancies. GSK2110183 and GSK2141795 are orally bioavailable, potent inhibitors of the AKT kinases that have progressed to human clinical studies. Both compounds are selective, ATP-competitive inhibitors of AKT 1, 2 and 3. Cells treated with either compound show decreased phosphorylation of several substrates downstream of AKT. Both compounds have desirable pharmaceutical properties and daily oral dosing results in a sustained inhibition of AKT activity as well as inhibition of tumor growth in several mouse tumor models of various histologic origins. Improved kinase selectivity was associated with reduced effects on glucose homeostasis as compared to previously reported ATP-competitive AKT kinase inhibitors. In a diverse cell line proliferation screen, AKT inhibitors showed increased potency in cell lines with an activated AKT pathway (via PI3K/PTEN mutation or loss) while cell lines with activating mutations in the MAPK pathway (KRAS/BRAF) were less sensitive to AKT inhibition. Further investigation in mouse models of KRAS driven pancreatic cancer confirmed that combining the AKT inhibitor, GSK2141795 with a MEK inhibitor (GSK2110212; trametinib) resulted in an enhanced anti-tumor effect accompanied with greater reduction in phospho-S6 levels. Taken together these results support clinical evaluation of the AKT inhibitors in cancer, especially in combination with MEK inhibitor.

Med25 is required for estrogen receptor alpha (ERα)-mediated regulation of human CYP2C9 expression

The CYP2C subfamily of cytochrome P450 enzymes is an important class of drug metabolizing enzymes in human liver. CYP2C9 is the most abundant member of the human CYP2C subfamily in liver and metabolizes ~15% of the therapeutic drugs as well as other xenobiotics and endogenous compounds. A number of nuclear receptors including xenobiotic-sensing receptors such as the constitutive androstane receptor (CAR), pregnane X receptor (PXR), and glucocorticoid receptor (GR) as well as liver enriched receptors hepatic nuclear factor 4α (HNF4α) and the estrogen receptor α (ERα) regulate CYP2C9 expression. Here, we show that Med25, a variable component of Mediator complex, enhanced ligand dependent ERα-mediated transcriptional activation of CYP2C9 promoter and interacts with activated ERα by 17β-estradiol through its C-terminal LXXLL motif. In conclusion, Med25 is identified as a new coactivator of ERα that is required for ERα-mediated regulation of CYP2C9 expression.

High-precision distribution of highly stable optical pulse trains with 8.8 × 10⁻¹⁹ instability

The high-precision distribution of optical pulse trains via fibre links has had a considerable impact in many fields. In most published work, the accuracy is still fundamentally limited by unavoidable noise sources, such as thermal and shot noise from conventional photodiodes and thermal noise from mixers. Here, we demonstrate a new high-precision timing distribution system that uses a highly precise phase detector to obviously reduce the effect of these limitations. Instead of using photodiodes and microwave mixers, we use several fibre Sagnac-loop-based optical-microwave phase detectors (OM-PDs) to achieve optical-electrical conversion and phase measurements, thereby suppressing the sources of noise and achieving ultra-high accuracy. The results of a distribution experiment using a 10-km fibre link indicate that our system exhibits a residual instability of 2.0 × 10⁻¹⁵ at1 s and8.8 × 10⁻¹⁹ at 40,000 s and an integrated timing jitter as low as 3.8 fs in a bandwidth of 1 Hz to 100 kHz. This low instability and timing jitter make it possible for our system to be used in the distribution of optical-clock signals or in applications that require extremely accurate frequency/time synchronisation.

Quercetin induces HepG2 cell apoptosis by inhibiting fatty acid biosynthesis

Quercetin can inhibit the growth of cancer cells with the ability to act as a 'chemopreventer'. Its cancer-preventive effect has been attributed to various mechanisms, including the induction of cell-cycle arrest and/or apoptosis, as well as its antioxidant functions. Quercetin can also reduce adipogenesis. Previous studies have shown that quercetin has potent inhibitory effects on animal fatty acid synthase (FASN). In the present study, activity of quercetin was evaluated in human liver cancer HepG2 cells. Intracellular FASN activity was calculated by measuring the absorption of NADPH via a spectrophotometer. MTT assay was used to test the cell viability, immunoblot analysis was performed to detect FASN expression levels and the apoptotic effect was detected by Hoechst 33258 staining. In the present study, it was found that quercetin could induce apoptosis in human liver cancer HepG2 cells with overexpression of FASN. This apoptosis was accompanied by the reduction of intracellular FASN activity and could be rescued by 25 or 50 μM exogenous palmitic acids, the final product of FASN-catalyzed synthesis. These results suggested that the apoptosis induced by quercetin was via the inhibition of FASN. These findings suggested that quercetin may be useful for preventing human liver cancer.