A phase I dose-escalation study of aflibercept administered in combination with pemetrexed and cisplatin in patients with advanced solid tumours

Background:

To evaluate the safety, pharmacokinetics (PKs), and pharmacodynamics of aflibercept, and to identify the recommended phase II dose (RP2D) of aflibercept in combination with pemetrexed and cisplatin.

Methods:

Aflibercept was administered at escalating doses of 2, 4, or 6 mg kg⁻¹ in combination with fixed doses of pemetrexed (500 mg m⁻²) plus cisplatin (75 mg m⁻²) every 3 weeks. Blood samples were collected for PK analyses. Serum antiaflibercept antibodies were quantified to assess their impact on systemic aflibercept concentrations.

Results:

Eighteen patients were enrolled. One patient dosed at 4 mg kg⁻¹ experienced grade 3 hypophosphatemia (dose-limiting toxicity; DLT), which prompted a cohort expansion. No further DLTs were observed in the 4 mg kg⁻¹ cohort or the 6 mg kg⁻¹ dose cohort. Most common adverse events (AEs) of all grades included (%): fatigue (89), anaemia (89), nausea (83), hyponatremia (78), and neutropenia (72). Grade ⩾3 AEs consistent with anti-vascular endothelial growth factor therapy included (%): hypertension (22), pulmonary embolism (11), and deep vein thrombosis (6). Five patients (28%) experienced mild neurocognitive disturbance. No episodes of reversible posterior leukoencephalopathy syndrome (RPLS) were noted.

Conclusion:

The results of this phase I study allowed further evaluation of the combination of aflibercept with pemetrexed and cisplatin in a phase II study. The RP2D of aflibercept was 6 mg kg⁻¹, to be administered intravenously every 3 weeks in combination with pemetrexed and cisplatin.

Wegener's granulomatosis with pulmonary fungal infection: a case report and brief review

Wegener's granulomatosis (WG) is an autoimmune, necrotizing granulomatous disease of unknown aetiology that affects small and medium blood vessels, and is usually recurrent. Infection is the most frequent cause of death in patients with WG. A case of WG with pulmonary fungal infection in a 50-year-old man is reported. The patient was hospitalized following a 2-month history of haemoptysis and a 1-month history of intermittent fever. Examination and pathology results confirmed a diagnosis of WG with associated pulmonary fungal infection. The patient's condition was complicated by a septic pneumothorax and sinus formation after lung biopsy, and preexisting diabetes and hypertension, which worsened rapidly due to his critical condition. He was treated with glucocorticoids and cyclophosphamide therapy with the goal of controlling these complications, and had no recurrence within the 4-year follow-up period. This case demonstrated the utility of combined glucocorticoid and cyclophosphamide therapy for the treatment of infection in WG.

Direct observation of the proliferation of ferroelectric loop domains and vortex-antivortex pairs

We discovered stripe patterns of trimerization-ferroelectric domains in hexagonal REMnO(3) (RE=Ho,···,Lu) crystals (grown below ferroelectric transition temperatures (T(c)), reaching up to 1435 °C), in contrast with the vortex patterns in YMnO(3). These stripe patterns roughen with the appearance of numerous loop domains through thermal annealing just below T(c), but the stripe domain patterns turn to vortex-antivortex domain patterns through a freezing process when crystals cross T(c) even though the phase transition appears to not be Kosterlitz-Thouless-type. The experimental systematics are compared with the results of our six-state clock model simulation and also the Kibble-Zurek mechanism for trapped topological defects.

Stent-assisted coiling of intracranial bifurcation aneurysms leads to immediate and delayed intracranial vascular angle remodeling

BACKGROUND AND PURPOSE

Wide-neck bifurcating aneurysms are increasingly treated with intracranial stent-assisted coiling by using shape-memory alloy microstents. We sought to investigate the short- and long-term effects of intracranial stent implantation on the geometry and angular conformation of the stent-coiled vascular bifurcation.

MATERIALS AND METHODS

Thirty patients underwent stent-mediated coiling for 31 bifurcation aneurysms by using 31 self-expanding Neuroform (n = 14) and Enterprise (n = 17) stents (17 women; mean age, 56 years). The angle (δ) between the stented mother and daughter vessels at the bifurcation was measured by using multiplanar imaging of reconstructed rotational conventional angiography volumes and was compared by using matched-pair statistics. Neuroform and Enterprise longitudinal stent stiffness was measured in vitro at an increasing bending angle θ (θ = 180°-δ).

RESULTS

Stent deployment increased the bifurcation angle δ from 101.5° to 119.8° postprocedurally and to 137.3° (P < .0001) at latest follow-up, resulting in effective straightening; the angular remodeling was greater in distal-versus-proximal arteries (anterior cerebral > MCA > BA > ICA), inversely proportional to mother-vessel diameter and proportional to pretreatment bending angle θ. At follow-up, angle δ continued to significantly expand, with remodeling being greater in the early period (1-6 versus >7 months) and more pronounced with the longitudinally stiffer closed-cell Enterprise compared with the open-cell Neuroform stent.

CONCLUSIONS

Stent placement across bifurcation aneurysms leads to a significant biphasic angular remodeling related to stent type and vessel caliber, altering morphology to mimic sidewall lesions, a phenomenon needing consideration during procedural planning. Future work is needed to uncover the hemodynamic implications of this structural change and any possible effect on aneurysm-recurrence rates.

High glucose-induced RhoA activation requires caveolae and PKCβ1-mediated ROS generation

Glomerular matrix accumulation is a hallmark of diabetic nephropathy. We previously showed that RhoA activation by high glucose in mesangial cells (MC) leads to matrix upregulation (Peng F, Wu D, Gao B, Ingram AJ, Zhang B, Chorneyko K, McKenzie R, Krepinsky JC. Diabetes 57: 1683-1692, 2008). Here, we study the mechanism whereby RhoA is activated. In primary rat MC, RhoA activation required glucose entry and metabolism. Broad PKC inhibitors (PMA, bisindolylmaleimide, Gö6976), as well as specific PKCβ blockade with an inhibitor and small interfering RNA (siRNA), prevented RhoA activation by glucose. PKCβ inhibition also abrogated reactive oxygen species (ROS) generation by glucose. The ROS scavenger N-acetylcysteine (NAC) or NADPH oxidase inhibitors apocynin and DPI prevented glucose-induced RhoA activation. RhoA and some PKC isoforms localize to caveolae. Chemical disruption of these microdomains prevented RhoA and PKCβ1 activation by glucose. In caveolin-1 knockout cells, glucose did not induce RhoA and PKCβ1 activation; these responses were rescued by caveolin-1 reexpression. Furthermore, glucose-induced ROS generation was significantly attenuated by chemical disruption of caveolae and in knockout cells. Downstream of RhoA signaling, activator protein-1 (AP-1) activation was also inhibited by disrupting caveolae, was absent in caveolin-1 knockout MC and rescued by caveolin-1 reexpression. Finally, transforming growth factor (TGF)-β1 upregulation, mediated by AP-1, was prevented by RhoA signaling inhibition and by disruption or absence of caveolae. In conclusion, RhoA activation by glucose is dependent on PKCβ1-induced ROS generation, most likely through NADPH oxidase. The activation of PKCβ1 and its downstream effects, including upregulation of TGF-β1, requires caveolae. These microdomains are thus important mediators of the profibrogenic process associated with diabetic nephropathy.

Laser-locked, continuously tunable high resolution cavity ring-down spectrometer

A continuous-wave cavity ring-down spectrometer with sub-MHz precision has been built using the sideband of a frequency stabilized laser as the tunable light source. The sideband is produced by passing the carrier laser beam through an electro-optic modulator (EOM) and then selected by a short etalon on resonance. The carrier laser frequency is locked to a longitude mode of a thermo-stabilized Fabry-Perot interferometer (FPI) with a long-term absolute frequency stability of 0.2 MHz (5 × 10(-10)). Broad and precise spectral scanning is accomplished, respectively, by selecting a different longitudinal mode of the FPI and by tuning the radio-frequency driving the EOM. The air broadened water absorption line at 12,321 cm(-1) was studied to test the performance of the spectrometer.

Fabrication of silver tips for scanning tunneling microscope induced luminescence

We describe a reliable fabrication procedure of silver tips for scanning tunneling microscope (STM) induced luminescence experiments. The tip was first etched electrochemically to yield a sharp cone shape using selected electrolyte solutions and then sputter cleaned in ultrahigh vacuum to remove surface oxidation. The tip status, in particular the tip induced plasmon mode and its emission intensity, can be further tuned through field emission and voltage pulse. The quality of silver tips thus fabricated not only offers atomically resolved STM imaging, but more importantly, also allows us to perform challenging "color" photon mapping with emission spectra taken at each pixel simultaneously during the STM scan under relatively small tunnel currents and relatively short exposure time.

In situ transmission electron microscopy imaging of grain growth in a platinum nanobridge induced by electric current annealing

We report an in situ transmission electron microscopy (TEM) imaging of grain growth in a Pt nanobridge induced by a high electric current density. The change in morphology at the nanoscale was recorded in real time together with the electrical characterization of the Pt nanobridge. We find a drop in the differential resistance as the voltage across the bridge is increased; TEM inspection shows that this coincides with thermally induced grain growth, indicating that a reduction of grain boundary scattering is the cause of the resistance decrease.

Prevention and treatment of diabetes with resveratrol in a non-obese mouse model of type 1 diabetes

AIMS/HYPOTHESIS

We recently found that activation of the type III histone deacetylase sirtuin 1 suppresses T cell immune responses. Here we sought to determine the therapeutic potential of the sirtuin 1 activator resveratrol in the treatment of diabetes in the NOD mouse model of type 1 diabetes and the mechanisms underlying such potential.

METHODS

NOD mice were fed or subcutaneously injected with resveratrol and evaluated for development of diabetes. Splenocytes from resveratrol-treated and control mice were analysed by gene array. The altered expression of inflammatory genes induced by resveratrol was validated and the role of changed gene expression in prevention of diabetes was determined.

RESULTS

Resveratrol administration potently prevented and treated type 1 diabetes in NOD mice. Gene array analysis indicated a dramatic decrease in expression of Ccr6, which encodes chemokine (C-C motif) receptor (CCR) 6, in the splenocytes from resveratrol-treated mice. CCR6 abundance on IL-17-producing cells and CD11b(+)F4/80(hi) macrophages was inhibited by resveratrol treatment. Interestingly, CCR6(+) IL-17-producing cells and CD11b(+)F4/80(hi) macrophages accumulated in the spleens and pancreatic lymph nodes, but their presence in the pancreas was reduced, suggesting that resveratrol blocks their migration from peripheral lymphoid organs to the pancreas. Indeed, the migration of splenocytes toward media containing chemokine (C-C motif) ligand 20 (CCL20) was impaired by resveratrol treatment. CCL20 peptides, which block CCR6 binding to CCL20, inhibited development of type 1 diabetes.

CONCLUSIONS/INTERPRETATION

Inhibition of CCR6-mediated migration of inflammatory cells by resveratrol may provide a powerful approach for treatment of type 1 diabetes and possibly of other inflammatory diseases.

Metformin in prostate cancer: two for the price of one

BACKGROUND

Androgen deprivation therapy (ADT) for prostate cancer treatment induces a metabolic syndrome, which may contribute to non-cancer-related morbidity and mortality. Metformin may abrogate these effects. Additionally, metformin has potential antineoplastic activity in various malignancies including prostate cancer.

MATERIALS AND METHODS

A literature review using PubMed with the keywords: AMPK, androgen deprivation therapy, insulin resistance, metabolic syndrome, metformin and prostate cancer was undertaken.

RESULTS

This overview will look at the current evidence linking ADT and metabolic syndrome while discussing ongoing clinical trials under way assessing the effectiveness of metformin in abrogating these effects. The potential antineoplastic activity of metformin, mediated by multiple proposed mechanisms based on evidence from preclinical and clinical studies, will also be elucidated in this review.

CONCLUSIONS

Overall available data support the potential dual benefit of metformin on ADT-induced metabolic syndrome and in its antineoplastic activity in prostate cancer, justifying the need for ongoing clinical trials to confirm these effects as the evidence currently available for standard practice is lacking.

HB-EGF release mediates glucose-induced activation of the epidermal growth factor receptor in mesangial cells

Glomerular matrix accumulation is a hallmark of diabetic nephropathy. We showed that transactivation of the epidermal growth factor receptor (EGFR) is an important mediator of matrix upregulation in mesangial cells (MC) in response to high glucose (HG). Here, we study the mechanism of EGFR transactivation. In primary MC, EGFR transactivation by 1 h of HG (30 mM) was unaffected by inhibitors of protein kinase C, reactive oxygen species, or the angiotensin II AT1 receptor. However, general metalloprotease inhibition, as well as specific inhibitors of heparin-binding EGF-like growth factor (HB-EGF), prevented both EGFR and downstream Akt activation. HB-EGF was released into the medium by 30 min of HG, and this depended on metalloprotease activity. One of the metalloproteases shown to cleave proHB-EGF is ADAM17 (TACE). HG, but not an osmotic control, activated ADAM17, and its inhibition prevented EGFR and Akt activation and HB-EGF release into the medium. siRNA to either ADAM17 or HB-EGF prevented HG-induced EGFR transactivation. We previously showed that EGFR/Akt signaling increases transforming growth factor (TGF)-β1 transcription through the transcription factor activator protein (AP)-1. HG-induced AP-1 activation, as assessed by EMSA, was abrogated by inhibitors of metalloproteases, HB-EGF and ADAM17. HB-EGF and ADAM17 siRNA also prevented AP-1 activation. Finally, these inhibitors and siRNA prevented TGF-β1 upregulation by HG. Thus, HG-induced EGFR transactivation in MC is mediated by the release of HB-EGF, which requires activity of the metalloprotease ADAM17. The mechanism of ADAM17 activation awaits identification. Targeting upstream mediators of EGFR transactivation including HB-EGF or ADAM17 provides novel therapeutic targets for the treatment of diabetic nephropathy.

Hierarchically structured carbon-based composites: Design, synthesis and their application in electrochemical capacitors

This feature article provides an overview of the recent research progress on the hierarchically structured carbon-based composites for electrochemical capacitors. The basic principles of electrochemical capacitors, and the design, construction and performance of hierarchically structured carbon-based composites electrode materials with good ions and electron transportation and large specific surface area are discussed. The trend of future development of high-power and large-energy electrochemical capacitors is proposed.

Directional differentiation of chicken primordial germ cells into adipocytes, neuron-like cells, and osteoblasts

Primordial germ cells (PGCs) are useful for producing transgenic chickens and preserving genetic material in avian species. In this study, we investigated the in vitro differentiation potential of chicken PGCs into different cell types. For differentiation into adipocytes, chicken PGCs were cultured for 21 days in induction media containing dexamethasone, insulin and/or 3-isobutyl-1-methylxanthine (IBMX), and differentiation rates ranging from 74% to 91% were identified by oil red-O and alkaline phosphatase (ALP) staining. For differentiation into neuron-like cells, chicken PGCs were cultured for 3 or 7 days in the induction media containing retinoic acid (RA) and IBMX, and differentiation rates ranging from 71% to 87% were identified by toluidine blue staining and immunohistochemical staining. For differentiation into osteoblasts, chicken PGCs were cultured for 15 or 21 days in the induction media containing desamethasone, beta-glycerol phosphate and/or vitamin C, and differentiation rates ranging from 47% to 79% were confirmed by Von Kossa, cytochemical and immunohistochemical staining. These data suggest that, like mammalian PGCs, chicken PGCs can differentiate into different cell types in vitro.

Spatial and temporal expression of spermadhesin genes in reproductive tracts of male and female pigs and ejaculated sperm

Spermadhesins, a novel protein family identified in the reproductive tract of ungulates, have important roles in reproduction. In this study, the expression of pig (Sus domesticus) spermadhesion genes in seminal vesicles, prostate, and bulbourethral glands from birth to sexual maturity and the spatial expression in adult male and female genital tracts and ejaculated sperm of Meishan pigs were evaluated by reverse transcription-polymerase chain reaction (RT-PCR). In general, all spermadhesin genes increased from Days 1 to 150 in the seminal vesicle and bulbourethral gland. However, their expression in the prostate was variable; it increased from Days 1 to 60 and then declined until Day 150. In adult boars, all genes had a very high level of expression in the seminal vesicle and somewhat lower (but still relatively high) in the prostate, caput and caudal epididymides, and bulbourethral gland. Expression of AQN1 and AQN3 was not detectable in the corpus epididymis. In the testis, AQN3 gene expression was not detectable, and gene expressions were weak for AQN1, PSP-I, and PSP-II, but strong for AWN. In female pigs, most spermadhesins had low expression in the cervix, uterine horn, oviduct, and ovary. Expression of AQN1 and AQN3 was very weak in the cervix and uterine horn. Signals for AQN1 in oviduct and ovary and AQN3 in ovary were not detectable, whereas AWN had high expression in the cervix and uterine horn. In ejaculated sperm, a strong mRNA signal of spermadhesins was detected. We concluded that transcripts of spermadhesins were not only distributed extensively in male and female reproductive tissues but also in ejaculated sperm. Furthermore, their dynamic changes of expression paralleled reproductive development. Seminal vesicles were the main source of spermadhesins; when the boar reached puberty, expression of spermadhesins reached very high levels.

Three-terminal electric transport measurements on gold nano-particles combined with ex situ TEM inspection

We have fabricated nanometer-spaced electrodes on electron-transparent silicon nitride membranes. A thin Cr/Au layer is evaporated on the backside of the membrane which serves as a gate electrode. Using these devices, we have performed three-terminal electron transport measurements on gold nano-particles at liquid helium temperature. Coulomb Blockade features have been observed and the capacitance to the gate has been extracted. After transport measurements, the Cr/Au back gate is removed and the devices are inspected with a transmission-electron microscope (TEM). TEM inspection reveals the presence of a few nano-particles in the nanogap, which is in agreement with the transport measurements. In addition, the nano-particle size as observed by TEM coincides with the one estimated from the gate capacitance value.

EGFR-PLCgamma1 signaling mediates high glucose-induced PKCbeta1-Akt activation and collagen I upregulation in mesangial cells

Glomerular matrix accumulation is a hallmark of diabetic nephropathy. We have recently shown that epidermal growth factor receptor (EGFR) transactivation mediates high glucose (HG)-induced collagen I upregulation through PI3K-PKCbeta1-Akt signaling in mesangial cells (MC). Phospholipase Cgamma1 (PLCgamma1) interacts with activated growth factor receptors and activates classic PKC isoforms. We thus studied its role in HG-induced collagen I upregulation in MC. Primary rat MC were treated with HG (30 mM) or mannitol as osmotic control. Protein kinase activation was assessed by Western blotting and collagen I upregulation by Northern blotting. Diabetes was induced in rats by streptozotocin. HG treatment for 1 h led to PLCgamma1 membrane translocation and Y783 phosphorylation, both indicative of its activation. Mannitol was without effect. PLCgamma1 Y783 phosphorylation was also seen in cortex and glomeruli of diabetic rats. HG induced a physical association between EGFR and PLCgamma1 as identified by coimmunoprecipitation. PLCgamma1 activation required EGFR kinase activity since it was prevented by the EGFR inhibitor AG1478 or overexpression of kinase-inactive EGFR (K721A). Phosphoinositide-3-OH kinase inhibition also prevented PLCgamma1 activation. HG-induced Akt S473 phosphorylation, effected by PKCbeta1, was inhibited by the PLCgamma inhibitor U73122. PLCgamma1 inhibition or downregulation by small interference RNA also prevented HG-induced collagen I upregulation. Our results indicate that EGFR-PLCgamma1 signaling mediates HG-induced PKCbeta1-Akt activation and subsequent collagen I upregulation in MC. Inhibition of EGFR or PLCgamma1 may provide attractive therapeutic targets for the treatment of diabetic nephropathy.