RNA sequencing and proteomic profiling reveal alterations by MPTP in chronic stomach mucosal injury in tree shrew Chinese (Tupaia belangeri chinensis)

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is a neurotoxin that can cause gastrointestinal ulcers by affecting dopamine levels. Therefore, MPTP has been considered a toxic substance that causes gastric ulcer disease in experimental animals. In this study, tree shrews were used as the animal model of gastric mucosa injury, and MPTP was intraperitoneally injected at a lower MPTP dosage 2 mg/kg/day for 13 weeks, while tree shrews were not injected as the control group. Under the light microscope, local congestion or diffuse bleeding points of gastric mucosa and multiple redness and swelling bleeding symptoms on the inner wall were observed in the treatment group, as well as immune cell infiltration was found in HE staining, but no such phenomenon was observed in the control group. In order to explore the molecular basis of changes in MPTP induced gastric mucosa injury, the transcriptome and proteome data of gastric mucosa were analyzed. We observed significant differences in mRNA and protein expression levels under the influence of MPTP. The changes in mRNA and proteins are related to increased immune infiltration, cellular processes and angiogenesis. More differentially expressed genes play a role in immune function, especially the candidate genes RPL4 and ANXA1 with significant signal and core role. There are also differentially expressed genes that play a role in mucosal injury and shedding, especially candidate genes GAST and DDC with certain signaling and corresponding functions. Understanding the factors and molecular basis that affect the expression of related genes is crucial for coping with Emotionality gastric mucosa injury disease and developing new treatment methods to establish the ability to resist disease.

[Selection and effects of flap/myocutaneous flap repair methods for the defect after perineum tumor resection]

Objective: To explore the selection and effects of flap/myocutaneous flap repair methods for the defect after perineum tumor resection. Methods: From January 2011 to February 2017, 31 patients with vulvar tumor who were admitted to Hunan Cancer Hospital underwent repair of wound after tumor resection with various flaps/myocutaneous flaps. The patients were composed of 5 males and 26 females, aged 39-76 years, with 27 vulvar cancer and 4 Paget's disease in primary diseases. The size of defects after vulvar tumor radical resection ranged from 8.0 cm×4.5 cm to 27.5 cm×24.0 cm. According to the theory of perforasome, the defects were repaired by the external pudendal artery perforator flap, deep inferior epigastric artery perforator flap, rectus abdominis myocutaneous flap, anterolateral thigh flap, internal pudendal artery perforator flap, gracilis myocutaneous flap, and profunda artery perforator flap based on the specific size and location of perineum and groin where the defect was located. According to the blood supply zone of flap, totally 17 local translocation flaps, 18 axial flaps/myocutaneous flaps, and 7 V-Y advancement flaps were resected, with an area of 7.0 cm×4.0 cm to 21.0 cm×13.0 cm. All the flaps/myocutaneous flaps were transferred in pedicled fashion, and the donor sites were closed without tension. The number of flaps/myocutaneous flaps, wound closure, flaps/myocutaneous flaps survival, and follow-up were observed and recorded. Results: Altogether 42 flaps/myocutaneous flaps were harvested in 31 patients. Two flaps/myocutaneous flaps were used in 11 cases for large circular defect repair. All the defects achieved tension-free primary closure. The blood supply of 32 flaps/myocutaneous flaps was good, while insufficient blood supply was noted in the other 10 flaps/myocutaneous flaps. Seventeen flaps/myocutaneous flaps survived smoothly. Wound dehiscence occurred in 5 flaps/myocutaneous flaps 8 to 14 days postoperatively, which was healed with dressing change. Temporary congestion was noted in 7 flaps/myocutaneous flaps 2 to 5 days postoperatively, which recovered without special treatment. Three flaps/myocutaneous flaps had infection 7 to 15 days postoperatively, two of which recovered after dressing change, while the other one had partial necrosis and received debridement and direct closure. Two flaps/myocutaneous flaps were totally necrotic 8 to 15 days postoperatively, which were repaired with pedicled rectus abdominis myocutaneous flap after debridement. Seven flaps/myocutaneous flaps had partial necrosis 7 to 20 days postoperatively and were healed after dressing change. Twenty-four patients were followed up for 9-38 months. The color of flaps/myocutaneous flaps was similar to that of the surrounding skin, the shape of vulva was natural, the movement of hip joint was not limited, the function of micturition and defecation was not affected, and tumor recurrence was noted in 3 patients. Conclusions: For the complicated large defect after perineum tumor resection, the flexible application of different forms of flaps/myocutaneous flaps to repair according to different areas regains the appearance and function. However, there are many complications, so it is necessary to further strengthen the postoperative care.

Alpha-synuclein is highly prone to distribution in the hippocampus and midbrain in tree shrews, and its fibrils seed Lewy body-like pathology in primary neurons

The Chinese tree shrew (TS) has many unique advantages that make it suitable for use as an experimental animal model for human disease including moderate body size, low cost of feeding, short reproductive cycle and lifespan, and close phylogenetic relationship to primates. Our previous studies have shown that TS treated with the mitochondrial inhibitor MPTP displayed classic Parkinsonian symptoms. Additionally, the structure of TS alpha-synuclein (α-syn) is highly homologous to that found in humans. Previous studies have concluded that misfolded, fibrillar α-syn is a hallmark of α-synucleinopathies. In this study, we examined the distribution and expression levels of α-syn in different TS brain regions. We also obtained recombinant TS α-syn protein to study its aggregation and cytotoxic properties in primary neurons. Our results showed that α-syn was expressed in numerous different brain regions in TS but was most abundant in the hippocampus and midbrain. The recombinant α-syn of TS displayed straight fibrils when incubated for 72 h in vitro, which is very similar to human α-syn. When exposed to primary neurons, the TS and human α-syn fibrils led to cytotoxicity and Lewy-like pathology. Our findings indicated that TS could be a potential animal model to study the pathology of α-synucleinopathies.

Mixed cryoglobulinaemia in a rhesus macaque (Macaca mulatta)

We report cryoglobulinaemia (CG) in a rhesus macaque whose serum sample was gel-like at <37°C and resolubilised upon warming. Mixed CG was diagnosed using serum protein electrophoresis and serum immunofixation electrophoresis. Renal damage and arthrophyma were observed during necropsy. This is the first report of CG in a non-human primate.

Potassium oxonate induces acute hyperuricemia in the tree shrew (tupaia belangeri chinensis)

Potassium oxonate, a selectively competitive uricase inhibitor, produced hyperuricemia (HUA) in rodents in a previous study. In this study, we employed the tree shrew as an animal model to study potassium oxonate-induced HUA. The effect of allopurinol (ALLO), a uric acid reducer, was also examined in this model. Potassium oxonate at doses of 5, 20, 40, 60, 80, 100, and 1,000 mg/kg was given intraperitoneally to tree shrews. The results showed that potassium oxonate can effectively increase the levels of uric acid in tree shrews at doses ranging from 40 to 100 mg/kg. Semiquantitative RT-PCR showed that the xanthine dehydrogenase/oxidase (XDH/XO) mRNA expression level was significantly higher in the liver tissue of tree shrews with high levels of uric acid. There were no changes in serum urea nitrogen, or serum creatinine values. ALLO can significantly decrease serum uric acid levels (P<0.01) and raise XDH/XO mRNA expression levels in the liver tissue of tree shrews with HUA. XDH/XO mRNA expression levels did not change in untreated tree shrews. Studies on acute toxicity in the tree shrew did not show any significantly abnormal signs. There were no adverse effects at the macroscopic level up to doses ≤100 mg/kg. Potassium oxonate induced acute HUA in tree shrews at lower doses compared with other animal models. Potassium oxonate-treated tree shrews may be a potential animal model for studying pathogenic mechanism and evaluating a new therapeutic agent for treatment of HUA in humans.

Abstract P4-22-19: Time on treatment of everolimus versus endocrine monotherapy or chemotherapy for early-line treatment of HR+/HER2- metastatic breast cancer: A retrospective chart review study in the US

Background:

Among postmenopausal women with hormone receptor-positive, human epidermal growth factor receptor-2-negative (HR+/HER2-) metastatic breast cancer (mBC) whose disease progressed on a non-steroidal aromatase inhibitor (NSAI), everolimus-based therapy (EVE), different endocrine monotherapies (ET mono), and chemotherapies (CT) are commonly used. Time on treatment is an outcome primarily determined by a therapy's combined efficacy and safety profile. This study assessed the real-world time on treatment (TOT) among patients receiving these treatments in early-line (i.e., 1st and 2nd) settings.

Methods:

A nationwide sample of postmenopausal HR+/HER2- mBC patients treated by community oncologists in the US was included in this retrospective chart review. Eligible patients for this study were required to fail NSAI and then receive EVE, ET mono or CT (index therapy) as an early-line therapy for mBC between July 1, 2012 and April 15, 2013. TOT was measured from index therapy initiation to physician-reported treatment discontinuation and compared among treatment groups using Kaplan-Meier analyses with log-rank tests and Cox proportional hazards models adjusting for the line of therapy and baseline characteristics including recurrent or de novo disease status, age, race, insurance type, Charlson comorbidity index, sites of metastases (e.g., bone, any other visceral site), ECOG performance status, previous CT treatment in the mBC setting, and duration from the initiation of the last adjuvant ET to mBC diagnosis.

Results:

A total of 145 patients treated with EVE, 217 patients treated with ET mono, and 102 patients treated with CT were included in the analysis. Baseline characteristics among the three treatment groups were similar, although EVE-treated patients had higher burden of metastases relative to ET mono-treated patients, but lower burden relative to CT-treated patients. TOT was longer among EVE-treated patients than ET mono- and CT- treated patients (log-rank tests: p=0.01 and p&lt;0.01). For patients who completed their index treatment, the median TOT among EVE, ET mono, and CT treatment groups were 8.9, 5.7, and 6.1 months, respectively. After adjusting for baseline characteristics, EVE was associated with significantly longer TOT compared with ET mono [hazard ratio (HR) = 0.62, 95% confidence interval (CI): 0.45 – 0.85] and with CT (HR = 0.32, 95% CI: 0.22 – 0.46).

Conclusions:

This real-world US chart review study of postmenopausal women with HR+/HER2- mBC showed that patients receiving EVE in line 1 or 2 experienced significantly longer TOT than those receiving ET mono or CT.

Citation Format: Li N, Ohashi E, Koo V, Xie J, Hao Y, Tang DH. Time on treatment of everolimus versus endocrine monotherapy or chemotherapy for early-line treatment of HR+/HER2- metastatic breast cancer: A retrospective chart review study in the US [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-22-19.

Dopaminergic neuron-like cells derived from bone marrow mesenchymal stem cells by Lmx1α and neurturin overexpression for autologous cytotherapy in hemiparkinsonian rhesus monkeys

Bone marrow-derived mesenchymal stem cells hold great potential for cytotherapeutics of neurodegenerative disorders, including Parkinson's disease. The neurotrophic factor neurturin can rescue dopaminergic neurons damaged during the disease process. Lmx1α can promote mesencephalic dopaminergic differentiation during embryogenesis. In this study, we tested a cytotherapeutic strategy combining NTN/Lmx1α gene therapy and cell transplantation to ameliorate disease progression in hemiparkinsonian rhesus. Rhesus BMSCs were prepared for autologous grafting by transfection with recombinant adenoviral vectors expressing secreted NTN and Lmx1α,and cultured in the presence of induce factors, particularly the Lmx1α regulatory factor sonic hedgehog, to guide dopaminergic differentiation. These induced rh-BMSCs exhibited gene/protein expression phenotypes resembling nigral dopaminergic neurons. They survived and retained dopaminergic function following stereotaxic injection into the MPTP-lesioned right-side substantia nigra as indicated by SPECT measurement of DAT activity. Injected cells preserved and supplemented the remaining endogenous population of dopamine neurons (TH-positive cell ipsilateral/contralateral ratio was 56.81% ± 7.28% vs. 3.86%±1.22% in vehicle-injected controls; p<0.05). Cell injection also partially restored motor function and reduce apomorphine-evoked rotation (p<0.05). Moreover, function recovery occurred earlier than in previous studies on injected BMSCs. Our findings demonstrate a promising strategy for restoration of PD-associated motor dysfunction by transplantation of autologous BMSCs overexpressing NTN/Lmx1α.

Risk-benefit assessment of oral phosphodiesterase type 5 inhibitors for treatment of erectile dysfunction: a multiple criteria decision analysis

BACKGROUND

Erectile dysfunction (ED) is a common male sexual disorder worldwide. Three oral phosphodiesterase type 5 inhibitors (PDE5Is) - sildenafil, tadalafil and vardenafil - are available for treatment of ED. This study quantitatively evaluated the therapeutic efficacy and safety of these medications to assist treatment decision making.

METHODS

We used multiple criteria decision analysis (MCDA) to assess the totality of risk-benefit of PDE5Is. We created two models: (i) the overall model included 'overall improvement in erections' and 'any adverse events' and (ii) the detailed model included 'erectile function domain', 'ability for sexual intercourse', 'duration of erection last', 'serious adverse events', 'headache', 'flushing' and 'dyspepsia'. We calculated a synthetic utility for each drug accounting for all of its benefits and risks.

RESULTS

Considering the overall risk-benefit, vardenafil had the highest synthetic utility among three medications; in the order of synthetic utilities: vardenafil (0.568), tadalafil (0.478) and sildenafil (0.437). However, when specific risk and benefit criteria were assessed, tadalafil had the highest synthetic utility (0.602) according to the conjoint evaluation (synthetic utility for vardenafil is 0.491 and sildenafil is 0.442, respectively). The sensitivity analysis based on the uncertainties of weight on risks of any adverse events (including serious adverse events and headache) suggested our results were robust.

CONCLUSIONS

This study provides a useful approach that comprehensively and systematically assesses and compares the risk-benefit of several treatment alternatives. Our study not only rank treatment alternatives by synthetic utilities based on the risk-benefit balance but also compare specific risk and benefit criteria between these medicines. Our results provide valuable evidence that can guide clinicians and patients in making treatment decisions.

Outcomes in breast reduction surgery

Previous studies have established that patients with macromastia rate their physical and emotional health as substantially poorer than a control population. The aim of the current study was to confirm this discrepancy, and to evaluate the hypothesis that patients with macromastia who undergo bilateral reduction mammaplasty experience a marked improvement of their general health, both physical and emotional, when compared with their preoperative state and age-matched control population. Sixty-nine consecutive patients were enrolled and evaluated preoperatively and 9 months postoperatively. The methods used for patient evaluation were the Short Form SF-36, a health-related quality-of-life questionnaire, and the Brief Symptom Inventory (BSI), a self-reporting instrument used to assess psychological symptoms. Preoperatively, all patients reported physical health poorer than the age-matched control group. At 9 months postoperatively, patients reported substantial improvement in all areas measured by SF-36 and in the variables this study measured with BSI. Postoperative groups reported their health to be similar to the nonpatient control groups. These findings confirm the therapeutic role of bilateral reduction mammaplasty in alleviation of symptoms associated with macromastia and in restoration of normal physical and emotional functioning.

Temperature effect on bilirubin adsorption with the anion exchange resin BR-601

Plasma perfusion with the anion exchange resin BR-601 is an effective method to treat patients with hepatic failure and hyperbilirubinemia. To assess the temperature dependency of bilirubin sorption in vitro, isotherm studies with human pathologic plasmas and an albumin-bilirubin solution were carried out. Results showed that BR-601 was more effective at 37 degrees C and 42 degrees C than at 4 degrees C and 25 degrees C for sorbing bilirubin. Therefore, plasma sorption at near physiologic temperature would be expected to be more efficient for plasma treatment than sorption at ambient temperature.