EGFR Oncogenic Mutations in NSCLC Impair Macrophage Phagocytosis and Mediate Innate Immune Evasion Through Up-Regulation of CD47

INTRODUCTION

EGFR-mutated NSCLC is characterized by an immunosuppressive microenvironment that confers limited clinical effectiveness to anti-PD-1 or PD-L1 antibodies. Despite the discouraging outcomes of immunotherapy, novel immune checkpoints are constantly emerging, among which the specific vulnerability for therapeutic intervention in the context of EGFR-mutated NSCLC remains unresolved.

METHODS

Data sets of patient- and cell line-levels were used for screening and mutual validation of association between EGFR mutation and a panel of immune checkpoint-related genes. Regulatory mechanism was elucidated through in vitro manipulation of EGFR signaling pathway and evaluated by immunoblot analysis, quantitative polymerase chain reaction, flow cytometry, immunofluorescence staining, and chromatin immunoprecipitation. In vivo investigation of different therapeutic strategies were conducted using both immunocompetent and immunodeficient mouse models.

RESULTS

Among all screened immune checkpoints, CD47 emerged as the candidate most relevant to EGFR activation. Mechanistically, EGFR mutation constitutively activated downstream ERK and AKT pathways to respectively up-regulate the transcriptional factors c-Myc and NF-κB, both of which structurally bound to the promotor region of CD47 and actively transcribed this "don't eat me" signal. Impaired macrophage phagocytosis was observed on introduction of EGFR-sensitizing mutations in NSCLC cell line models, whereas CD47 blockade restored the phagocytic capacity and augmented tumor cell killing in both in vitro and in vivo models. Remarkably, the combination of anti-CD47 antibody with EGFR tyrosine kinase inhibitor revealed an additive antitumor activity compared with monotherapy of either antitumor agent in both immunocompetent and adaptive immunity-deficient mouse models.

CONCLUSIONS

EGFR-sensitizing mutation facilitates NSCLC's escape from innate immune attack through up-regulating CD47. Combination therapy incorporating CD47 blockade holds substantial promise for clinical translation in developing more effective therapeutic approaches against EGFR-mutant NSCLC.

Voriconazole-induced severe skin allergy and neurological adverse event in a liver failure patient: A case report

WHAT IS KNOWN AND OBJECTIVE

Triazole antifungal-associated severe skin allergy has received little attention. Here we report a case of an acute-on-chronic liver failure (ACLF) patient with diffused skin allergy pervading from the chest, abdomen, back, knees to perineum, with red colour and partially desquamation as well as a neurological adverse (insomnia) event after voriconazole treatment.

CASE SUMMARY

A 40-year-old man with liver failure in our hospital had received voriconazole for invasive fungal infection therapy, and while waiting for liver transplantation exhibited a severe diffuse rash and a neurological adverse event.

WHAT IS NEW AND CONCLUSION

To the best of our knowledge, this is the first report of a liver failure patient who suffered a severe allergy accompanied with a neurological adverse event after voriconazole administration.

Fluoride-bridged dinuclear dysprosium complex showing single-molecule magnetic behavior: supramolecular approach to isolate magnetic molecules

Using Na-encapsulated benzo[18]crown-6 (Na)(B18C6) as a counter cation, we successfully magnetically isolated a fluoride-bridging Dy dinuclear complex {[(PW₁₁O₃₉)Dy(H₂O)₂]₂F} (Dy₂POM) with lacunary Keggin ligands. (Na)(B18C6) formed two types of tetramers through C-H⋯O, π⋯π and C-H⋯π interactions, and each tetramer aligned in one dimension along the c-axis to form two types of channels. One channel was partially penetrated by a supramolecular cation from the ±a-axis direction, dividing the channel in the form of a "bamboo node". Dy₂POM was spatially divided by this "bamboo node," which magnetically isolated one portion from the other. The temperature dependence of the magnetic susceptibility indicated a weak ferromagnetic interaction between the Dy ions bridged by fluoride. Dy₂POM exhibited the magnetic relaxation characteristics of a single-molecule magnet, including the dependence of AC magnetic susceptibility on temperature and frequency. Magnetic relaxation can be described by the combination of thermally active Orbach and temperature-independent quantum tunneling processes. The application of a static magnetic field effectively suppressed the relaxation due to quantum tunneling.

Factors affecting transtemporal window quality in transcranial sonography

OBJECTIVE

To assess the influencing factors of transtemporal window quality and identify patients suitable for transcranial sonography (TCS) examination in two-dimensional imaging.

METHODS

In this cross-sectional study, TCS was performed in 161 consecutive patients through the temporal bone window (TBW) in the neurology or neurosurgery department. Each patient's sex, age, height, weight, and temporal bone thickness (TBT) were collected. After examination, the patients were divided into two groups: TBW success and TBW failure. The data were statistically compared between the two groups.

RESULTS

Among the studied population, the total TBW success rate was 80.1% (95% confidence interval [CI]: 74-86). The TBW success rate was 91.4% (95% CI: 85-98) in males and 70.9% (95% CI: 61-81) in females (p = .001). Sex (p = .001), age (p = .002), height (p = .047), and TBT (p < .001) showed significant differences between the TBW success and failure groups. In males, only TBT (p = .001) showed a significant difference; in females, age (p < .001) and TBT (p = .003) showed a significant difference. The area under the receiver operating characteristic curve (AUC) of sex, age, and TBT and their combination was 0.686, 0.659, 0.842, and 0.922 (p < .001), respectively. The AUC of the combination of parameters was significantly greater than that of age and sex alone (p = .007; p = .0002) but not greater than that of TBT (p = .090).

CONCLUSIONS

The TBW success rate varied with sex, age, height, and TBT. Males, younger patients, taller patients, and patients with a thinner temporal bone tended to be more suitable for the examination by TCS.

Hepatic paraoxonase 1 ameliorates dysfunctional high-density lipoprotein and atherosclerosis in scavenger receptor class B type I deficient mice

Background

High-density lipoprotein (HDL) plays an antiatherogenic role by mediating reverse cholesterol transport (RCT), antioxidation, anti-inflammation, and endothelial cell protection. Recently, series of evidence have shown that HDL can also convert to proatherogenic HDL under certain circumstances. Plasma paraoxonase 1 (PON1) as an HDL-bound esterase, is responsible for most of the antioxidant properties of HDL. However, whether PON1 can serve as a therapeutic target of dysfunctional HDL-related atherosclerosis remains unclear.

Methods

In this study, scavenger receptor class B type I deficient (Scarb1^−/−) mice were used as the animal model with dysfunctional HDL and increased atherosclerotic susceptibility. Hepatic PON1 overexpression and secretion into circulation were achieved by lentivirus injection through the tail vein. We monitored plasma lipids levels and lipoprotein profiles in Scarb1^−/− mice, and measured the levels and activities of proteins associated with HDL function. Meanwhile, lipid deposition in the liver and atherosclerotic lesions was quantified. Hepatic genes relevant to HDL metabolism and inflammation were analyzed.

Results

The results showed the relative levels of PON1 in liver and plasma were increased by 1.1-fold and 1.6-fold, respectively, and mean plasma PON1 activity was increased by 63%. High-level PON1 increased the antioxidative and anti-inflammatory properties, promoted HDL maturation and macrophage cholesterol efflux through increasing HDL functional proteins components apolipoprotein A1 (APOA1), apolipoprotein E (APOE), and lecithin-cholesterol acyltransferase (LCAT), while decreased inflammatory protein markers, such as serum amyloid A (SAA), apolipoprotein A4 (APOA4) and alpha 1 antitrypsin (A1AT). Furthermore, hepatic PON1 overexpression linked the effects of antioxidation and anti-inflammation with HDL metabolism regulation mainly through up-regulating liver X receptor alpha (LXRα) and its downstream genes. The pleiotropic effects involved promoting HDL biogenesis by raising the level of APOA1, increasing cholesterol uptake by the liver through the APOE-low density lipoprotein receptor (LDLR) pathway, and increasing cholesterol excretion into the bile, thereby reducing hepatic steatosis and aorta atherosclerosis in Western diet-fed mice.

Conclusions

Our study reveals that high-level PON1 improved dysfunctional HDL and alleviated the development of atherosclerosis in Scarb1^−/− mice. It is suggested that PON1 represents a promising target of HDL-based therapeutic strategy for HDL-related atherosclerotic cardiovascular disease.

A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province; and then named "2019 novel coronavirus (2019-nCoV)" by the World Health Organization (WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world's attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development; we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control (including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province; and then named "2019 novel coronavirus (2019-nCoV)" by the World Health Organization (WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world's attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development; we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control (including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province; and then named "2019 novel coronavirus (2019-nCoV)" by the World Health Organization (WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world's attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development; we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control (including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

The near-infrared luminescence and magnetism of dinuclear complexes with different local symmetries constructed from a β-diketonate co-ligand and bis-Schiff base ligand

A Dy^III-complex based on a β-diketonate co-ligand and bi-Schiff base ligand displays slow magnetic relaxation behavior.

Modulation of the properties of dinuclear lanthanide complexes through utilizing different β-diketonate co-ligands: near-infrared luminescence and magnetization dynamics

Four Dy₂ complexes based on the ligand H₂L display various slow magnetic relaxation behaviors through utilizing different β-diketonate co-ligands.

Near-infrared luminescence and magnetic properties of dinuclear rare earth complexes modulated by β-diketone co-ligands

The magnetic properties of complexes based on a Schiff base ligand H₂L can be modulated by subtle changes in the coordination environment resulting from changes in the co-ligand substituents.

A new family of dinuclear lanthanide complexes constructed from an 8-hydroxyquinoline Schiff base and β-diketone: magnetic properties and near-infrared luminescence

Six phenoxo-O bridged dinuclear lanthanide(iii) complexes have been assembled utilizing the 2-[(4-nitrophenyl)imino]methyl-8-hydroxyquinoline (HL) and dibenzoylmethane (Hdbm) ligands: [Ln2(dbm)4L2] (Ln = Nd (1), Eu (2), Gd (3), Tb (4), Dy (5) and Er (6)). Complexes 1 and 6 exhibit the characteristic emission peaks of the corresponding Nd3+ and Er3+ ions, respectively. Meanwhile, the excitation wavelength (470 nm) for complex 1 is located in the visible-light region, confirming a practical application value. The studies on magnetic properties reveal that complex 3 features a magnetocaloric effect with a magnetic entropy change of -ΔSm = 14.36 J kg-1 K-1 at 4 K for ΔH = 7 T. What's more, the dynamic magnetic studies for complex 5 show that it exhibits slow magnetic relaxation behavior, typical of SMM behavior, resulting in an energy barrier of ΔE/kB = 75 K with the pre-exponential factor τ0 = 2.2 × 10-7 s. Meanwhile, this research demonstrates that the magnetic properties can be modulated by regulating the electron-donating/withdrawing effects of the substituents on the ligands.

The real-time ultrasonography for fusion image in glioma neurosugery

OBJECTIVES

The aim of study is to evaluate the general performance and efficiency of the using real time intraoperative ultrasound system with Volume Navigation system technology in glioma. Compare glioma intraoperative ultrasound and contrast agent ultrasound images to obtained preoperative MRI with fusion image in a real-time.

PATIENTS AND METHODS

Fifteen patients had been performed fusion imaging involved intraoperative real-time ultrasound and contrast agent ultrasound with preoperative MR imaging including preoperative gadolinium-enhanced MRI from March 2017 to December 2017. The number of tumor was counted online fusion imaging in real time ultrasound with and without preoperative MR. We analyzed ultrasound coplanar MR modalities in real time including tumor location, margin (obscure or defined). In addition, intraoperative ultrasound enhancement pattern was analyzed compare it to preoperative reconstruction gadolinium-enhanced T1-weighted MRI. Two radiologists who made planning ultrasound assessment for the focus lesion based on a 4 scoring system according to the degree of confidence.

RESULTS

Thirteen of fifteen patients whose automatically registration successful intraoperative neurosurgery accepted preoperative MR examination. Seven of fifteen fine-tuning registration phase were performed and satisfactory with fusion image substantially. Intraoperatively, 73.3% (11/15) glioma nodules were definite on conventional B-mode US by a radiologist who doesn't know the MR result before fusion US with MRI. However, 100% tumors were detected on fusion B-mode ultrasound imaging with MRI. Two radiologists evaluated the score between fusion B-mode ultrasound and CEUS with coplanar MRI and had a result that score was upgraded in 69.2% (9/13) and 84.6% (11/13) patients. Inter-observer agreement was significant (kappa value = 1.0, p < 0.001) in B-mode ultrasound fusion image with MRI. Inter-observer agreement was moderate (kappa value = 0. 0.618, p < 0.001) in CEUS fusion image with MRI.

CONCLUSION

Fusion imaging is very useful to detect poor sonographic visibility tumor on fusion B-mode US imaging with MR images. Fusion image may demonstrate multiplane images including same standard and nonstandard MRI and US images to help localize tumor. The additional real time fusion CEUS mode image with MR is a safe method for neurosurgery and the use of CEUS should be considered when fusion B-mode ultrasound imaging alone is not satisfactory for margin.

[Cochlear implantation and early outcomes in children with incompletely partition type Ⅲ malformation]

Objective:To analyze the early effect of the cochlear implantation (CI) in children with cochlear incompletely partition type Ⅲ malformation (IP-Ⅲ). Method:Ten children with IP-Ⅲ malformation who underwent CI were recruited in this study. The hearing characteristics, preoperative speech performance and surgery were analyzed retrospectively. The aided hearing threshold with CI, the categories of auditory performance (CAP) score, speech intelligibility rating (SIR) score and speech perception were designed to access the benefits of CI. Ten children with normal cochlea were also enrolled as the control group. Demographic information of children in the control group including hearing loss and speech level before implantation, age at implantation, hearing aids using history, duration with CI were matched with those in the IP-Ⅲ group. The hearing threshold, CAP score and SIR score in the IP-Ⅲ group were compared with the control group using the SPSS 20.0 software. Result:The computed tomography of temporal bones showed typical IP-Ⅲ malformation in all patients. The electrode arrays were properly and totally implanted in all children. Cerebrospinal fluid gusher occurred intra-operatively, and no other complications in all patients. The pure tone average (PTA) threshold at the 3rd, 6th, 9th and 12th month after implantation were (40.8±8.5) dB HL, (36.1±9.1) dB HL, (32.5±6.8) dB HL and (33.0±7.3) dB HL, respectively. The PTA thresholds in the IP-Ⅲ group were similar to those in the control group at all tested time points (P>0.05). At the 3rd, 6th, 9th and 12th month after implantation, the CAP scores in the IP-Ⅲ group were lower than those in the control group, but there was no significantly difference (P>0.05). Furthermore, the SIR scores were lower than those in the control group, and there were significantly difference at the 6 th, 9 th and 12 th month after implantation (P<0.05). Conclusion:CI was an effective treatment for children with IP-Ⅲ malformation. Surgery on IP-Ⅲ was challenging, however, seldom complication would occur with excellent surgical skills. Though the CI was benefit for IP-Ⅲ, the development of hearing and speech ability were slower than children with normal cochlea.

Modulating the magnetization dynamics of four phenoxo-O bridged Dy2 complexes based on a Schiff base derived from 8-hydroxyquinoline

The quantum tunneling process in Dy-SMMs is suppressed by the application of a dc field.

Color Doppler Ultrasound in Diagnosis and Assessment of Carotid Body Tumors: Comparison with Computed Tomography Angiography

A carotid body tumor (CBT) is a rare, non-chromaffin paraganglioma, and its diagnosis mainly depends on imaging modalities. The aim of this study was to investigate the ability of color Doppler ultrasound (CDU) in the diagnosis and assessment of CBT based on computed tomography (CT). We retrospectively reviewed the CDU and CT features of 49 consecutive CBTs and 23 schwannomas from 67 patients and compared these findings with surgical resection specimens. The mean size of CBT lesions on ultrasound scans and CT angiography (CTA) was 3.24 cm ± 0.82 cm (range, 1.6-5.2 cm) and 3.84 cm ± 1.08 cm (range, 1.8-6.8 cm), respectively, which had statistically significant difference (t = 9.815, p = 0.000). The vascularity of CBT lesions was richer than that of schwannoma lesions (p < 0.05). Intra-lesional vascularities feeding CBT mostly arose from the external carotid artery and had spectrum characteristics including low velocity and resistance. Peak systolic velocity (PSV) and resistance index (RI) of the vasa vasorum were 39.8 cm/s ± 19.8 cm/s and 0.54 ± 0.06, respectively. There was the correlation between CTA and CDU in identifying Shamblin type I CBT lesions, while CTA technique was superior for CDU, identifying Shamblin type II and III CBT lesions. Accuracy, specificity and sensitivity of CDU in diagnosing CBTs were 87.5% (63 of 72), 82.6% (19 of 23) and 89.8% (44 of 49), respectively. Both accuracy and sensitivity of CTA in diagnosing CBTs were 100%. CDU can be useful for assessment of Shamblin's type and intra-lesional blood flow of CBTs before its metastases, while CT imaging can reveal the relationship between lesions and adjacent arteries, as well as the involvement of the skull base. CDU combined with CT imaging can be used as an optimal detection modality for the assessment and management of CBT.

Allosteric modulation of metabotropic glutamate receptor 5 affects phosphorylation, internalization, and desensitization of the micro-opioid receptor

Recent evidence suggests that opioid analgesia and tolerance can be modulated by metabotropic glutamate receptors. Therefore, we studied the functional coupling and desensitization of the micro-opioid receptor (MOR) in human embryonic kidney (HEK) 293 cells which co-express metabotropic glutamate receptor 5 (mGluR5). As demonstrated by the D-Ala2,N-MePhe4,Gl-ol5-enkephalin (DAMGO)-induced inhibition of intracellular cAMP level and by binding studies, the co-expression of mGluR5 had no substantial effect on the agonist binding sites and functional coupling of the MOR. However, in MOR/ mGluR5 co-expressing cells, the non-competitive mGluR5 antagonist MPEP (2-methyl-6-(phenyl-ethynyl)-pyridine) decreases the DAMGO-induced MOR phosphorylation, internalization, and desensitization, whereas non-selective competitive mGluR antagonists or agonists had no effects. These findings indicate that an allosteric modulation of mGluR5 can affect the agonist-induced MOR signalling and regulation. As a mechanistic basis for the observed effects we suggested an interaction/heterodimerization of MOR and mGluR5, which is supported by the DAMGO-induced co-internalization of MOR and mGluR5 and by the increase of MPEP binding sites (Bmax) and a change of the binding affinity (K(D)) of mGluR5 receptors after the co-expression of MOR. In addition, co-immunoprecipitation experiments revealed evidence for an interaction between MOR and mGluR5 which is facilitated by MPEP treatment.

Prophylactic effect of glyceryl trinitrate on post-endoscopic retrograde cholangiopancreatography pancreatitis: A randomized placebo-controlled trial

AIM: To examine the prophylactic effect of glyceryl trinitrate on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis and hyperamylasemia.

METHODS: Patients scheduled for ERCP were randomly divided into study group and placebo group. Patients in study group and placebo group were treated with 5 mg glyceryl trinitrate and 100 mg vitamin C, respectively, 5 min before endoscopic maneuvers.

RESULTS: A total of 74 patients were enrolled in the final analysis. Post-ERCP pancreatitis occurred in 3 patients (7.9%) of the study group and 9 patients (25%) in the placebo group (P = 0.012). Hyperamylasemia occurred in 8 patients of the study group (21.1%) and 13 patients (36.1%) of the placebo group (P = 0.037).

CONCLUSION: Glyceryl trinitrate before ERCP can effectively prevent post-ERCP and hyperamylasemia.

Apolipoprotein E-deficient lipoproteins induce foam cell formation by downregulation of lysosomal hydrolases in macrophages

Apolipoprotein E (apoE) deficiency has been suggested to induce foam cell formation. Using lipoproteins obtained from wild-type mice and apoE-deficient mice expressing apoB-48 but not apoB-100, we studied apoE-deficient lipoprotein-induced changes in lipoprotein catabolism and protein expression in mouse peritoneal macrophages (MPMs). Our data demonstrate that incubation of MPMs with apoE-deficient lipoproteins induced intracellular lipoprotein, cholesteryl ester, and triglyceride accumulation, which was associated with a time-related decline in apoE-deficient lipoprotein degradation in MPMs. Confocal microscopy analysis indicated that the accumulated lipids were localized in lysosomes. ApoE-deficient lipoproteins reduced the protein levels of lysosomal acid lipase, cathepsin B, and cation-dependent mannose 6 phosphate receptor (MPR46). Exogenous apoE reduced apoE-deficient lipoprotein-induced lipid accumulation and attenuated the suppressive effect of apoE-deficient lipoproteins on lysosomal hydrolase and MPR46 expression. Although oxidized lipoproteins also increased lipid contents in MPMs, exogenous apoE could not attenuate oxidized lipoprotein-induced lipid accumulation. Our in vivo studies also showed that feeding apoE-deficient mice a high-fat diet resulted in cholesteryl ester and triglyceride accumulation and reduced lysosomal hydrolase expression in MPMs. These data suggest that apoE-deficient lipoproteins increase cellular lipid contents through pathways different from those activated by oxidized lipoproteins and that reducing lysosomal hydrolases in macrophages might be a mechanism by which apoE-deficient lipoproteins result in intralysosomal lipoprotein accumulation, thereby inducing foam cell formation.

Protective effects of Angelica sinensis polysaccharides on acetic acid-induced rat colitis

AIM: To study the protective effects of Angelica sinensis polysaccharides (ASP) on colon injury in acetic acid-induced rat colitis and its mechanism.

METHODS: The colitis model of rats was produced by intracolon enema with acetic acid. The experimental animals were divided into 6 groups: normal, model, 5-ASA (100 mg/kg), and ASP (250, 500, 1 000 mg/kg), and treated intracolonically with saline, 5-ASA, and ASP respectively once a day for 7 days. The colon mucosa damage index(CMDI) and occult blood test (OBT) were evaluated. The activities of MPO and SOD, the contents of MDA and NO, the expression levels of TGF-β and EGF in the colon tissue were detected. H-E stained section was also observed.

RESULTS: Intracolon enema with ASP decreased the significanctly elevated extents of CMDI, OBT and levels of MPO, MDA, and NO in the model group (CMDI: 2.1±0.8, 1.8±0.6, 1.4±0.7 vs 2.9±0.6; OBT: 3.1±1.3, 2.7±1.1, 2.2±1.2 vs 3.8±0.8; MPO: 77.2±23.6 , 72.5±16.8, 61.3±19.2 vs 98.1±26.9; MDA: 44.26±10.25, 38.72±14.84, 31.59±12.68 vs 31.59±12.68; NO: 0.252±0.041, 0.223±0.037, 0.217±0.032 vs 0.331±0.092, P < 0.05 or P < 0.01), increased the significantly reduced level of expression of TGF-β and the activity of SOD in the model group (SOD: 30.16±2.88, 31.27±2.73, 33.52±2.81 vs 28.33±1.17; TGF-β: 0.136±0.031, 0.153±0.036, 0.169±0.029 vs 0.105±0.021, P < 0.05 or P < 0.01), and also increased significantly the expression of EGF (EGF: 0.178±0.021, 0.195±0.031, 0.191±0.022 vs 0.151±0.026, P < 0.05 or P < 0.01). The histological changes were also alleviated with ASP treatment.

CONCLUSION: Enteroclysis with ASP markedly relieve the colon injury in acetic acid-induced rats colitis, which is related with promoting growth factors, decreasing oxygen free radicals and some anti-inflammation effects.

Protective effect of angelica sinensis polysaccharide on experimental immunological colon injury in rats

AIM: To study the effect of angelica sinensis polysaccharide (ASP) on immunological colon injury and its mechanisms in rats.

METHODS: Immunological colitis model of rats was induced by intracolon enema with 2, 4, 6-trinitrobenzene sulfonic acid (TNBS) and ethanol. The experimental animals were randomly divided into normal control, model control, 5-aminosalicylic acid therapy groups and three doses of ASP therapy groups. The 6 groups were treated intracolonically with normal saline, normal saline, 5-aminosalicylic acid (100 mg·kg^-1), and ASP daily (8: 00 am) at the doses of 200, 400 and 800 mg·kg^-1 respectively for 21 days 7 d following induction of colitis. The rat colon mucosa damage index (CMDI), the histopathological score (HS), the score of occult blood test (OBT), and the colonic MPO activity were evaluated. The levels of SOD, MDA, NO, TNF-α, IL-2 and IL-10 in colonic tissues were detected biochemically and immunoradiometrically. The expressions of TGF-β and EGF in colonic tissues were also determined immunochemically.

RESULTS: Enhanced colonic mucosal injury, inflammatory response and oxidative stress were observed in colitis rats, which manifested as significant increases of CMDI, HS, OBT, MPO activity, MDA and NO contents, as well as the levels of TNF-α and IL-2 in colonic tissues, although colonic TGF-β protein expression, SOD activity and IL-10 content were significantly decreased compared with the normal control (P < 0.01). However, these parameters were found to be significantly ameliorated in colitis rats treated intracolicly with ASP at the doses of 400 and 800 mg·kg^-1 (P < 0.05-0.01). Meantime, colonic EGF protein expression in colitis rats was remarkably up-regulated.

CONCLUSION: ASP has a protective effect on immunological colon injury induced by TNBS and ethanol enema in rats, which was propably due to the mechanism of antioxidation, immunomodulation and promotion of wound repair.

Ameliorative effects of sodium ferulate on experimental colitis and their mechanisms in rats

AIM: To investigate the ameliorative effects of sodium ferulate (SF) on acetic acid-induced colitis and their mechanisms in rats.

METHODS: The colitis model of Sprague-Dawley rats was induced by intracolon enema with 8% (V/V) of acetic acid. The experimental animals were randomly divided into model control, 5-aminosalicylic acid therapy group and three dose of SF therapy groups. The 5 groups were treated intracolonically with normal saline, 5-aminosalicylic acid (100 mg•kg^-1), and SF at the doses of 200, 400 and 800 mg·kg^-1 respectively and daily (8: 00 am) for 7 d 24 h following the induction of colitis. A normal control group of rats clystered with normal saline instead of acetic acid was also included in the study. Pathological changes of the colonic mucosa were evaluated by the colon mucosa damage index (CMDI) and the histopathological score (HS). The insulted colonic mucosa was sampled for a variety of determinations at the end of experiment when the animals were sacrificed by decapitation. Colonic activities of myeloperoxidase (MPO) and superoxide dismutase (SOD), and levels of malondialdehyde (MDA) and nitric oxide (NO) were assayed with ultraviolet spectrophotometry. Colonic contents of prostaglandin E2 (PGE2) and thromboxane B2 (TXB2) were determined by radioimmunoassay. The expressions of inducible nitric oxide synthase (iNOS), cyclo-oxygenase-2 (COX-2) and nuclear factor kappa B (NF-κB) p65 proteins in the colonic tissue were detected with immunohistochemistry.

RESULTS: Enhanced colonic mucosal injury, inflammatory response and oxidative stress were observed in the animals clystered with acetic acid, which manifested as the significant increase of CMDI, HS, MPO activities, MDA and NO levels, PGE₂ and TXB₂ contents, as well as the expressions of iNOS, COX-2 and NF-κB p65 proteins in the colonic mucosa, although the colonic SOD activity was significantly decreased compared with the normal control (CMDI: 2.9 ± 0.6 vs 0.0 ± 0.0; HS: 4.3 ± 0.9 vs 0.7 ± 1.1; MPO: 98.1 ± 26.9 vs 24.8 ± 11.5; MDA: 57.53 ± 12.36 vs 9.21 ± 3.85; NO: 0.331 ± 0.092 vs 0.176 ± 0.045; PGE₂: 186.2 ± 96.2 vs 42.8 ± 32.8; TXB₂: 34.26 ± 13.51 vs 8.83 ± 3.75; iNOS: 0.365 ± 0.026 vs 0.053 ± 0.015; COX-2: 0.296 ± 0.028 vs 0.034 ± 0.013; NF-κB p65: 0.314 ± 0.026 vs 0.039 ± 0.012; SOD: 28.33 ± 1.17 vs 36.14 ± 1.91; P < 0.01). However, these parameters were found to be significantly ameliorated in rats treated locally with SF at the given dose protocols, especially at 400 mg·kg^-1 and 800 mg·kg^-1 doses (CMDI: 1.8 ± 0.8, 1.6 ± 0.9; HS: 3.3 ± 0.9, 3.1 ± 1.0; MPO: 63.8 ± 30.5, 36.2 ± 14.2; MDA: 41.84 ± 10.62, 37.34 ± 8.58; NO: 0.247 ± 0.042; 0.216 ± 0.033; PGE₂: 77.2 ± 26.9, 58.4 ± 23.9; TXB₂: 18.07 ± 14.83; 15.52 ± 8.62; iNOS:0.175 ± 0.018, 0.106 ± 0.019; COX-2: 0.064 ± 0.018, 0.056 ± 0.014; NF-κBp65: 0.215 ± 0.019, 0.189 ± 0.016; SOD: 32.15 ± 4.26, 33.24 ± 3.69; P < 0.05-0.01). Moreover, a therapeutic dose protocol of 800 mg·kg^-1 SF was observed as effective as 100 mg·kg^-1 of 5-ASA in the amelioration of colonic mucosal injury as evaluated by CMDI and HS.

CONCLUSION: Administration of SF intracolonically may have significant therapeutic effects on the rat model of colitis induced by acetic acid enema, which was probably due to the mechanism of antioxidation, inhibition of arachidonic acid metabolism and NF-κB expression.

[Sodium ferulate alleviates prednisolone induced liver toxicity in mice]

Prednisolone (Pred) 20 mg.kg-1 sc caused an increase in serum glutamicpyruvic transaminase (sGPT) and serum glutathione S-transferase (sGST) activities and an elevation of MDA content in mouse liver homogenate. An increase of membrane fluidity of liver microsomes and mitochondria was also observed. The results indicate that the elevations of sGPT and sGST levels were related to enhancement of lipid peroxidation and membrane fluidity in Pred-treated mice. Pretreatment with sodium ferulate (SF) 100 mg.kg-1 partially alleviated the liver lesions as observed by electron microscope observation. The sGPT and sGST levels and liver homogenate MDA content were reduced, and the membrane fluidity of liver microsomes was recovered. But, the membrane fluidity of liver mitochondria was further elevated. The results demonstrate partial inhibitory effect of sodium ferulate on prednisolone-induced liver toxicity.

Measurement of urinary clusterin as an index of nephrotoxicity

Measurements of tissue immunoassayable clusterin, a protein associated with programmed cell death and tissue reorganization, were performed in rats treated with nephrotoxic doses of gentamicin sulfate. Adult Lewis rats were treated with 100 mg/kg/day of gentamicin sulfate for 12 days. Urine, serum, and tissue levels of clusterin protein were measured, as were urinary N-acetyl beta-glucosaminidase (NAG) and serum creatinine levels. Induction of renal injury by gentamicin was detectable within 4 days by increased levels of urinary N-acetyl beta-glucosaminidase (from 280 +/- 66 (mean +/- SD) to 910 +/- 210 nmol/mg creatinine), and within 9 days of initiating gentamicin treatment by increased serum creatinine (from 0.5 +/- 0.1 to 1.2 +/- 0.4 mg/dl). Paralleling these changes, renal, urinary, and serum levels of clusterin increased 10-, 116-, and 3-fold (P less than 0.05). Treatment with gentamicin sulfate did not increase clusterin levels in the seminal vesicle, ventral prostate, testis, or epididymis. The measurement of urinary or serum clusterin may play a role in the early detection of renal injury.

Rapid decrease of cytochrome P-450IIE1 in primary hepatocyte culture and its maintenance by added 4-methylpyrazole

Studies were conducted to evaluate the possible induction or the maintenance of cytochrome P-450IIE1 in primary hepatocyte cultures by the inducing agent 4-methylpyrazole. Hepatocytes were isolated from control (noninduced) rats and from rats treated in vivo with either pyrazole or 4-methylpyrazole to induce P-450IIE1. The content of P-450IIE1 was determined by Western blots with antipyrazole P-450 IgG, and catalytic activity was assessed by assays of dimethylnitrosamine demethylase activity. The treatment with 4-methylpyrazole in vivo increased the content of P-450IIE1 and dimethylnitrosamine demethylase activity sevenfold and fourfold, respectively. In cultures prepared from noninduced hepatocytes, P-450IIE1 levels fell to values of 76%, 65%, 31% and 1% of freshly isolated hepatocytes after 1, 3, 6 and 9 days in culture. A similar decrease in dimethylnitrosamine demethylase was observed during this time. In cultures prepared from induced hepatocytes, the decline in P-450IIE1 was more rapid as levels fell to 77%, 31%, 3% and 3% of initial values after 1, 3, 6 and 9 days in culture. Again, the fall in dimethylnitrosamine demethylase activity paralleled the decline in content of P-450IIE1 and was more rapid with the induced hepatocytes. With cultures prepared from noninduced or induced hepatocytes, the addition of 4-methylpyrazole in vitro did not increase the content of P-450IIE1 or the activity of dimethylnitrosamine demethylase over the initial values. However, 4-methylpyrazole appeared to stabilize the P-450IIE1 and to decrease its rate of decline in culture. In noninduced cultures, the percent remaining content of P-450IIE1 after 6 days was 31% in the absence of and 52% in the presence of 5 mol/L 4-methylpyrazole. In cultures from 4-methylpyrazole-induced hepatocytes, the percent remaining P-450IIE1 after 3 days was 31% in the absence of inducer and 59% with 4-methylpyrazole added in vitro. Similarly 4-methylpyrazole helped to prevent the rapid decline of dimethylnitrosamine demethylase activity in induced and noninduced cultures. Viability of the induced and noninduced cultures in the absence or presence of added 4-methylpyrazole was similar. Levels of mRNA for P-450IIE1 were similar for livers from control rats and from rats treated in vivo with 4-methylpyrazole. The mRNA levels rapidly declined in induced and noninduced cultures, and this decline, unlike the fall in P-450IIE1 or dimethylnitrosamine demethylase activity, could not be prevented by the addition of 4-methylpyrazole in vitro to the cultures.(ABSTRACT TRUNCATED AT 400 WORDS)

Stereoselective interaction between gossypol and rat plasma

Gossypol, a potential male oral contraceptive, is chiral and chemically reactive. The present study was done to learn more about the stereoselective activity of this drug. The isomers were equipotent in hemolyzing erythrocytes in protein-free buffer while (+) gossypol was a more potent hemolysin than (-) in plasma. Both isomers disappeared from buffer at the same rate while (-) disappeared from plasma much faster than (+). Treating plasma with aspirin or DNFB to react with the free amino groups on the protein, slowed the disappearance of (-) gossypol. We conclude that (-) gossypol binds to free amino groups on protein and this stereoselective protein binding may account for some of the pharmacokinetic or pharmacodynamic difference between the two isomers of gossypol.

Lack of effect of glutathione depletion by L-buthionine-S,R-sulfoximine on gentamicin nephrotoxicity in rats

The mechanism of gentamicin-induced renal proximal tubular cell injury is not known, but generation of reactive oxygen species with subsequent lipid peroxidation has been proposed. In this study, male adult rats were given gentamicin and L-buthionine-S,R-sulfoximine (BSO), a selective glutathione (GSH)-depleting agent, to determine the effects of GSH depletion on acute gentamicin-induced nephrotoxicity. Urinary N-acetyl-beta-glucosaminidase (NAG) excretion increased equally in the groups given gentamicin alone compared to the groups given gentamicin and BSO. BSO treatment alone did not increase NAG excretion. GSH depletion by BSO did not enhance either gentamicin-induced azotemia or the degree of cell necrosis seen by light microscopy. In conclusion, BSO-induced GSH deficiency does not enhance acute gentamicin nephrotoxicity, suggesting that reactive oxygen species are not the major initiating cause of gentamicin-induced acute kidney injury.

[DNA repair capacity, chromosome aberration rate and chromosome fragile sites among members of 7 cancer families]

A nucleoid sedimentation technique was developed and used for analysis of DNA repair capacity in 40 members from 7 cancer families. Chromosome aberration rate (CAR) and chromosome fragile sites (CFS) were assayed simultaneously for comparison. It was shown that 32 members (80%) had a decreased DNA repair capacity and 34 (85%) had increased CAR as well as an apparent increase of CFS. 28 members (70%) showed both decreases of DNA repair capacity and increases of CAR. The importance of these criteria in heritable susceptibility to cancer is discussed.

Determination of gossypol enantiomers in plasma after administration of racemate using high-performance liquid chromatography with precolumn chemical derivatisation

A high-performance liquid chromatographic assay with precolumn chemical derivatisation was developed for the determination of gossypol enantiomers in plasma, after administration of the racemate. Racemic gossypol acetic acid in plasma was extracted into acetonitrile and analysed using a reversed-phase column and a coulometric detector in the redox mode. To separate the enantiomers, 30 microliters of the chiral derivatising reagent, (R)-(-)-2-amino-1-propanol (50 mg/ml) and 15 microliters of 20% (v/v) acetic acid were added to the acetonitrile layer which was then heated at 60 degrees C for 100 min. The mobile phase used to resolve the derivatised enantiomers was 0.2 M phosphate buffer (pH 3.5)-acetonitrile (38:62, v/v). At a flow-rate of 1.5 ml/min, the retention times for derivatised (+)-gossypol and (-)-gossypol were 4.0 and 7.8 min, respectively. Two cancer patients received 10 mg racemic gossypol acetic acid three times a day. In one patient, the racemic, (+)- and (-)-gossypol acetic acid plasma concentrations after 65 days of therapy were 317, 213 and 104 ng/ml, respectively. In the other patient, these values were 362, 210 and 152 ng/ml, respectively, after a week of therapy. This represents, to our knowledge, the first determination of the individual enantiomer levels of gossypol after administration of the racemate.

Pharmacokinetics of (+/-)-, (+)-, and (-)-gossypol in humans and dogs

Pharmacokinetic parameters of (+/-)-, (+)-, and (-)-gossypol were determined in humans and dogs after a single oral or intravenous dose. Mean (+/- SD) oral bioavailability of (+/-)-gossypol in dogs was 30.9% +/- 16.2%. Studies in dogs who received single intravenous injections revealed that the elimination t1/2 and volume of distribution of (+)-gossypol were five and six times those of (-)-gossypol, respectively, whereas total body clearance and the AUC of the two enantiomers were similar. Data from men receiving the compounds orally show that the average peak plasma concentration and the AUC of (+)-gossypol are significantly greater than those of the (-)-isomer. The rate constants of alpha, beta, ka, k21, and k10 for (-)-gossypol are significantly greater than those for (+)-gossypol, indicating higher rates of mass transfer of the (-)-species. In humans the elimination t1/2 of (+)-gossypol was 29 times as that of (-)-gossypol, a difference that is more striking than that found in dogs. The elimination t1/2 of (+/-)-gossypol in humans averages 286 +/- 179 hours.

[Mixed function oxidase isolated from human gastric epithelium in Fujian Province, a high incidence area of stomach cancer, and its role in the metabolism of diethylnitrosamine]

Mixed function oxidase (MFO) was isolated from the mucosa of human stomach in Fujian Province, a high incidence area of stomach cancer. Its activity was analyzed using a modified micromethod. In the non-cancer group, the activity of MFO in high incidence area of stomach cancer was significantly higher than that in low incidence area (P less than 0.001). A significant difference was also observed between stomach cancer and non-cancer groups. But the MFO concentrations between the high and low incidence areas were not different. These results suggest that the high MFO activity in gastric mucosal epithelial cells may cause higher incidence of stomach cancer. MFO isolated from human gastric epithelium is capable of metabolizing directly diethylnitrosamine in vitro.

High-performance liquid chromatography with electrochemical detection of gossypol in human plasma

A sensitive and selective high-performance liquid chromatographic method with electrochemical detection for the determination of gossypol in human plasma is described. Glutathione is used as a protective agent and gossypol dimethyl ether as an internal standard. Acetonitrile-treated protein-free plasma sample is first introduced on to a C18 pre-column for enrichment and clean-up. By using a column-switching technique, gossypol and the internal standard are subjected to further separation on a C8 analytical column, while the major interfering components are eliminated before entering the column. Methanol-0.1 M citrate buffer (pH 3.2) (80:20) is used as the mobile phase. The detector potential on the glassy carbon electrode is maintained at +0.6 V vs. an Ag-AgCl reference electrode. The linearity with human plasma ranged from 5 to 250 ng/ml. The absolute recoveries of gossypol and gossypol dimethyl ether were 91.3 and 97.5%, respectively, with a within-day precision of 2.5% and a day-to-day precision of 3.8%. The limit of detection is 5 ng/ml (signal-to-noise ratio = 3:1). The method is considered to be suitable for the clinical pharmacokinetic studies of gossypol.

Malignant transformation of baby hamster lung fibroblasts induced in vitro by a new nitrosamine compound

A new nitrosamine compound, N-1-methylacetonyl-N-3-methylbutyl-nitrosamine (MAMB-NA), isolated from corn bread inoculated with moulds commonly occurring in Linxian County, a high incidence area for esophageal cancer in North China was tested for its potential carcinogenicity in vitro. Baby hamster lung fibroblasts (BHL) were treated with MAMBNA in tissue culture medium containing liver microsome preparation of Aroclor 1254 treated rat. Cell transformation was assessed by morphological changes, loss of density-dependent inhibition and unlimited growth in vitro, chromosome changes, colony formation on soft agar, growth at low serum concentration, Con A agglutinability and tumor formation after heterotransplantation into immunosuppressed newborn rats. Like the known carcinogens N-methyl-N'-nitro-N-nitroso-guanidine and diethylnitrosamine, MAMBNA was able to cause malignant transformation of cells cultured in vitro.