Immune checkpoint inhibitors in the treatment of hepatocellular carcinoma

Despite advances in cancer treatment, hepatocellular carcinoma (HCC), the most common form of liver cancer, remains a major public health problem worldwide. The immune microenvironment plays a critical role in regulating tumor progression and resistance to therapy, and in HCC, the tumor microenvironment (TME) is characterized by an abundance of immunosuppressive cells and signals that facilitate immune evasion and metastasis. Recently, anti-cancer immunotherapies, therapeutic interventions designed to modulate the immune system to recognize and eliminate cancer, have become an important cornerstone of cancer therapy. Immunotherapy has demonstrated the ability to improve survival and provide durable cancer control in certain groups of HCC patients, while reducing adverse side effects. These findings represent a significant step toward improving cancer treatment outcomes. As demonstrated in clinical trials, the administration of immune checkpoint inhibitors (ICIs), particularly in combination with anti-angiogenic agents and tyrosine kinase inhibitors, has prolonged survival in a subset of patients with HCC, providing an alternative for patients who progress on first-line therapy. In this review, we aimed to provide an overview of HCC and the role of the immune system in its development, and to summarize the findings of clinical trials involving ICIs, either as monotherapies or in combination with other agents in the treatment of the disease. Challenges and considerations regarding the administration of ICIs in the treatment of HCC are also outlined.

Surface defects due to bacterial residue on shrimp shell

The changes in the surface chemistry and morphological structure of chitin forms obtained from shrimp shells (ShpS) with and without microorganisms were evaluated. Total mesophilic aerobic bacteria (TMAB), estimated Pseudomonas spp. and Enterococcus spp. were counted in Shp-S by classical cultural counting on agar medium, where the counts were 6.56 ± 0.09, 6.30 ± 0.12, and 3.15 ± 0.03 CFU/g, respectively. Fourier Transform Infrared (FTIR) Spectroscopy and Scanning Electron Microscopy (SEM)/Energy dispersed X-ray (EDX) were used to assess the surface chemistry/functional groups and morphological structure for ChTfree (non-microorganism), and ChTmo (with microorganisms). ChTfree FTIR spectra presented a detailed chitin structure by OH, NH, and CO stretching vibrations, whereas specific peaks of chitin could not be detected in ChTmo. Major differences were also found in SEM analysis for ChTfree and ChTmo. ChTfree had a flat, prominent micropore, partially homogeneous structure, while ChTmo had a layered, heterogeneous, complex dense fibrous, and lost pores form. The degree of deacetylation was calculated for ChTfree and ChTmo according to FTIR and EDX data. The results suggest that the degree of deacetylation decreases in the presence of microorganisms, affecting the production of beneficial components negatively. The findings were also supported by the molecular docking model.

Molecular and Technological Characterization of Saccharomyces cerevisiae from Sourdough

DNA markers help detect the intraspecific genetic diversity of yeast strains. Eight ISSR (Inter Simple Sequence Repeats) primers were used to assess the intraspecific diversity of Saccharomyces cerevisiae (n = 96) from different populations (n = 3), evaluate the technological characteristics, and investigate trait-loci associations. The primers amplified 154 reproducible and scorable bands, of which 79.87% were polymorphic. The UPGMA (unweighted pair group method with arithmetic mean) dendrogram clustered 96 isolates into two main clusters, supported by STRUCTURE HARVESTER results (ΔK = 2). Analysis of molecular variance (AMOVA) indicated significant genetic differences between (15%) and within the populations (85%) (p < 0.001). Twenty-nine genetically distinct strains were selected for the technological characterization. Principal component analysis (PCA) revealed that five strains with high fermentation capacity, leavening activity, high growth index at 37 °C, and harsh growth conditions were technologically relevant. Trait-loci association analyses indicated that the highest correlation (r = 0.60) was recorded for the fermentation capacity on the 8th and 113th loci, amplified by ISSR-1 and ISSR-6 primers, respectively (p < 0.05). The strains yielding high performances and the associated loci amplified by ISSR markers possess a high potential to generate locus-specific primers to target the strains with high fermentation capacity.

Determination of Acrylamide and 5-hydroxymethyl-2-furfural (HMF) Levels and Related Parameters in Turkish Pekmez (A Traditional Fruit Product)

Background: Pekmez is an important fruit-based food of Turkish culinary culture. The aim of this study is to determine the levels of acrylamide (AA), 5-hydroxymethyl-2-furfural (HMF) and other selected parameters in grape, mulberry and carob Pekmez. Methods: AA and HMF were analyzed by Liquid Chromatography and High Performance Liquid Chromatography, respectively. Also, glucose, fructose, pH, protein, total phenolic, and color (L*a*b*) were analyzed. The analyses were done by IBM SPSS Statistics 26 software. Results: The average AA, HMF, glucose, fructose, total reducing sugar, pH, protein, total phenolic, and colour (L*a*b*) values of Pekmez were 302 µg/kg, 25.7 mg/kg, 13.2%, 14.0%, 27.2%, 5.27, 1.16%, 4.64 mg GAE/g, and 4.83*5.60*1.52, respectively. AA indicates a moderate positive linear correlation with HMF, protein, total phenolic; whereas AA indicates a moderate negative linear correlation with glucose, fructose, total reducing sugar, pH, and L*a*b. Conclusion: It is presumed that heat treatment is a determinant in AA and HMF formulation.

Genetic diversity and population structure of Saccharomyces cerevisiae isolated from Turkish sourdough by iPBS-retrotransposons markers

Molecular DNA markers are valuable tools for analyzing genetic variation among yeast from different populations to reveal the genetically different autochthonous strains. In this study, we employed inter-primer binding site (iPBS) retrotransposon polymorphism to assess the genetic variation and population structure of 96 Saccharomyces cerevisiae isolates from four different regions in Turkey. The nine selected iPBS primers amplified 102 reproducible and scorable bands, of which 95.10% were polymorphic with an average of 10.78 polymorphic fragments per primer. The average polymorphism information content and the resolving power were 0.26–3.58, respectively. Analysis of molecular variance (AMOVA) revealed significant (P < 0.001) genetic differences within populations (88%) and between populations (12%). The unweighted pair group mean with arithmetic (UPGMA) dendrogram grouped 96 S. cerevisiae strains into two main clusters, where the highest probability of the data elucidating the population structure was obtained at ΔK = 2. There was not an obvious genetic discrimination of the populations according to geographical regions on UPGMA, supported by principal coordinate analysis. However, the individuals of the closer provinces in each population were more likely to group together or closely. The results indicate that iPBS polymorphism is a useful tool to reveal the genetically diverse autochthonous S. cerevisiae strains that may be important for the production of sourdough or baked goods.

Effects of Preheating and Sonic Delivery Techniques on the Internal Adaptation of Bulk-fill Resin Composites

CLINICAL RELEVANCE

The internal adaptation of resin composites that are recommended to be placed with the conventional insertion technique could be improved when the resin composites are preheated prior to their placement. SonicFill 2 and VisCalor bulk show the best internal adaptation when they are inserted as per the manufacurer's recommended techniques.

SUMMARY

Objective: To compare the effects of conventional (hand-placed), sonic, or preheated insertion techniques on the internal adaptation of bulk-fill resin composites.Methods and Materials: A total of 150 freshly extracted human third molars were used to prepare standardized cylindrical occlusal cavities. Teeth were divided into five main groups according to the resin composites: 1 incremental (Clearfil Majesty Posterior [CMP]) and four paste-like bulk-fill (SonicFill 2 [SF2], VisCalor bulk [VCB], Filtek One bulk-fill restorative [FBR], and Tetric EvoCeram bulk-fill [TEB]). Each main group was divided into three subgroups according to the placement technique: conventional, preheating, and sonic delivery (n=10). In the conventional placement technique, cavities were filled manually. In the sonic insertion technique, a specific handpiece (SonicFill Handpiece; Kerr Corporation) was used. In the preheating technique, a heating device (Caps Warmer, Voco, Cuxhaven, Germany) was used to warm the resin composites before placement. Internal voids (%) of the completed restorations were calculated with microcomputed tomography. Data was analyzed with two-way analysis of variacne followed by Tukey's multiple comparisons test (α=0.05).Results: All resin composites showed fewer internal gaps with preheating compared with the conventional placement (p<0.05). For all resin composites other than SF2, preheating provided fewer internal gaps than that of the sonic placement (p<0.05). Sonic placement led to fewer internal gaps compared with the conventional placement, but only for SF2 and FBR (p<0.05). For the conventional placement, the lowest gap percentage was observed with the incremental resin composite (CMP, p<0.05). Among all groups, the lowest gap percentages were observed for preheated VCB followed by sonically inserted SF2 (p<0.05).Conclusion: The best internal adaptation was observed in sonically inserted SF2 and preheated VCB, which were the manufacturers' recommended insertion techniques. Preheating considerably improved the internal adaptation of all resin composites, except for that of SF2.

The utility of iPBS retrotransposons markers to analyze genetic variation in yeast

Yeasts are one of the main organisms in the food industry and effective components of many ecosystems. The method for identifying and detecting certain yeast species or strains is a crucial step for the food industry and should be simple, reliable, fast, and inexpensive. In our study, inter-priming binding sites (iPBS) retrotransposon marker system was employed to elucidate the genetic variability at intraspecies and interspecies levels among 112 yeast strains belonging to eight species previously obtained from fermented foods. The molecular identification of yeast strains was firstly confirmed by sequencing the D1/D2 domain of the 26S rRNA. The eight selected retrotransposon-based primers produced 278 bands, all of which were polymorphic with an average of 34.75 polymorphic fragments per primer. The averages of polymorphism information contents and the resolving power values for the iPBS marker system were 0.23 and 10.11, respectively. The genetic parameters within each yeast species obtained from iPBS markers were observed as; the percentage of polymorphic loci for each species ranging from 19.23% to 71.21%, Nei's gene diversity from 0.085 to 0.228, while Shannon's information index values ranging from 0.125 to 0.349. The value of gene flow (0.09) and genetic variation among the populations (0.85) showed higher genetic variation among the species. UPGMA analyses demonstrated considerable genetic variability in the yeast strains, clustered them according to their species, and revealed the intraspecific variation. Each of the selected iPBS primer provided enough species-discrimination. Present evaluations suggest the utility of iPBS marker system to estimate the genetic variation of yeast strains. This study is a preliminary point for further studies on the identification methodology, and population genetics of yeast species having importance in the food industry with iPBS markers.

Renal Autotransplantation in a Patient with Bilateral Renal Artery Stenosis Secondary to Takayasu Arteritis

Involvement of the renal artery is common in Takayasu arteritis. We, herein, present on a patient with Takayasu arteritis causing severe renal failure and a successful auto-transplantation. This case shows that early diagnosis and immediate appropriate interventions are life-saving in patients with Takayasu arteritis. Renal auto-transplantation performed in selected cases increases dialysis-free survival.

Urinary CXCL9 and CXCL10 Levels and Acute Renal Graft Rejection

BACKGROUND

Monitoring of chemokines, CXCL9 and CXCL10, in serum may present a non-invasive detection method for rejection.

OBJECTIVE

To investigate the relationship between urinary levels of CXCL9 and CXCL10 and graft function following renal transplantation.

METHODS

75 living-related donor renal transplant recipients were studied. Urinary levels of chemokines were collected pre-operatively, on post-operative 1^st day, 7^th day, 1^st month, 3^rd month, and at the time of rejection. Chemokines levels were assayed using and enzyme-linked immunosorbent assay.

RESULTS

Clinical variables were monitored. 10 (15%) patients had biopsy-proven rejection during the follow-up period. The urinary CXCL9 level in those with rejection was significantly higher than that in those with non-rejection group at the 1^st day (p<0.001), 7^th day (p<0.001), and at the time of rejection (p=0.002). The urinary CXCL10 level was also significantly higher in those with rejection compared with non-rejection group at 1^st day (p<0.001), 7^th day (p<0.001), and at the time of rejection (p=0.001). Serum creatinine level was strongly correlated with the urinary CXCL9 and CXCL10 levels at the time of rejection (r=0.615, p=0.002; and r=0.519, p=0.022, respectively). Among those with T cell-mediated rejections the mean urinary CXCL10 level increased to as high as 258.12 ng/mL.

CONCLUSION

Urinary CXCL9 and CXCL10 levels might have a predictive value for T cell-mediated rejection in early post-transplantation period. Measurement of urinary CXCL9 and CXCL10 levels could provide an additional tool for the diagnosis of rejection.

Serum galectin-3 levels in patients with Behçet's disease: association with disease activity over a long-term follow-up

BACKGROUND

There is a need for a laboratory marker that correlates with the clinical activity of Behçet's disease (BD).

OBJECTIVE

We aimed to investigate whether serum galectin-3 (Gal-3) levels were affected during the course of the disease with regard to disease activity.

METHODS

A total of 131 subjects were involved in the study as follows: Group 1: BD active (n = 39); Group 2: BD inactive (n = 31); Group 3: Disease controls with leucocytoclastic vasculitis confirmed with a skin biopsy (n = 22); and Group 4: Healthy control subjects (n = 39). The BD patients were followed regularly and samples were taken in their active and inactive periods of the disease over a 2-year period.

RESULTS

Serum Gal-3 levels were significantly higher in active BD patients (mean 2.38) than inactive BD patients (mean 0.63; P < 0.0001) and the healthy control subjects (mean 0.75; P < 0.0001). There was no significant difference between the leucocytoclastic vasculitis and active BD patients (P = 0.093). Serum Gal-3 levels were positively correlated with clinical activity scores of active BD patients (r = 0.66, P < 0.0001). In addition, the Gal-3 levels were significantly higher in the active disease period when compared with the inactive period during the follow-up. There were no significant differences between the two inactive periods of the disease among the same patients. Further analyses revealed that patients with vascular involvement had significantly higher Gal-3 levels than the other active BD patients (mean 7.57; P = 0.007).

LIMITATIONS

The limitation of the study is the small number of patients with vascular involvement in the active BD patient group.

CONCLUSION

Gal-3 levels are correlated with the activity of Behçet's disease especially with the vascular involvement.