Potency of CRISPR-Cas Antifungals Is Enhanced by Cotargeting DNA Repair and Growth Regulatory Machinery at the Genetic Level

The emergence of virulent, resistant, and rapidly evolving fungal pathogens poses a significant threat to public health, agriculture, and the environment. Targeting cellular processes with standard small-molecule intervention may be effective but requires long development times and is prone to antibiotic resistance. To overcome the current limitations of antibiotic development and treatment, this study harnesses CRISPR-Cas systems as antifungals by capitalizing on their adaptability, specificity, and efficiency in target design. The conventional design of CRISPR-Cas antimicrobials, based on induction of DNA double-strand breaks (DSBs), is potentially less effective in fungi due to robust eukaryotic DNA repair machinery. Here, we report a novel design principle to formulate more effective CRISPR-Cas antifungals by cotargeting essential genes with DNA repair defensive genes that remove the fungi's ability to repair the DSB sites of essential genes. By evaluating this design on the model fungus Saccharomyces cerevisiae, we demonstrated that essential and defensive gene cotargeting is more effective than either essential or defensive gene targeting alone. The top-performing CRISPR-Cas antifungals performed as effectively as the antibiotic Geneticin. A gene cotargeting interaction analysis revealed that cotargeting essential genes with RAD52 involved in homologous recombination (HR) was the most synergistic combination. Fast growth kinetics of S. cerevisiae induced resistance to CRISPR-Cas antifungals, where genetic mutations mostly occurred in defensive genes and guide RNA sequences.

Response to immune checkpoint blockade improved in pre-clinical model of breast cancer after bariatric surgery

Bariatric surgery is a sustainable weight loss approach, including vertical sleeve gastrectomy (VSG). Obesity exacerbates tumor growth, while diet-induced weight loss impairs progression. It remains unknown how bariatric surgery-induced weight loss impacts cancer progression or alters response to therapy. Using a pre-clinical model of obesity followed by VSG or diet-induced weight loss, breast cancer progression and immune checkpoint blockade therapy were investigated. Weight loss by VSG or weight-matched dietary intervention before tumor engraftment protected against obesity-exacerbated tumor progression. However, VSG was not as effective as diet in reducing tumor burden despite achieving similar weight and adiposity loss. Leptin did not associate with changes in tumor burden; however, circulating IL-6 was elevated in VSG mice. Uniquely, VSG tumors displayed elevated inflammation and immune checkpoint ligand PD-L1+ myeloid and non-immune cells. VSG tumors also had reduced T lymphocytes and markers of cytolysis, suggesting an ineffective anti-tumor microenvironment which prompted investigation of immune checkpoint blockade. While obese mice were resistant to immune checkpoint blockade, anti-PD-L1 potently impaired tumor progression after VSG through improved anti-tumor immunity. Thus, in formerly obese mice, surgical weight loss followed by immunotherapy reduced breast cancer burden. Finally, we compared transcriptomic changes in adipose tissue after bariatric surgery from patients and mouse models. A conserved bariatric surgery-associated weight loss signature (BSAS) was identified which significantly associated with decreased tumor volume. Findings demonstrate conserved impacts of obesity and bariatric surgery-induced weight loss pathways associated with breast cancer progression.

As the number of people classified as obese rises globally, so do obesity-related health risks. Studies show that people diagnosed with obesity have inflammation that contributes to tumor growth and their immune system is worse at detecting cancer cells. But weight loss is not currently used as a strategy for preventing or treating cancer.

Surgical procedures for weight loss, also known as ‘bariatric surgeries’, are becoming increasingly popular. Recent studies have shown that individuals who lose weight after these treatments have a reduced risk of developing tumors. But how bariatric surgery directly impacts cancer progression has not been well studied: does it slow tumor growth or boost the anti-tumor immune response?

To answer these questions, Sipe et al. compared breast tumor growth in groups of laboratory mice that were obese due to being fed a high fat diet. The first group of mice lost weight after undergoing a bariatric surgery in which part of their stomach was removed. The second lost the same amount of weight but after receiving a restricted diet, and the third underwent a fake surgery and did not lose any weight. The experiments found that surgical weight loss cuts breast cancer tumor growth in half compared with obese mice. But mice who lost the same amount of weight through dietary restrictions had even less tumor growth than surgically treated mice.

The surgically treated mice who lost weight had more inflammation than mice in the two other groups, and had increased amounts of proteins and cells that block the immune response to tumors. Giving the surgically treated mice a drug that enhances the immune system’s ability to detect and destroy cancer cells reduced inflammation and helped shrink the mice’s tumors. Finally, Sipe et al. identified 54 genes which were turned on or off after bariatric surgery in both mice and humans, 11 of which were linked with tumor size.

These findings provide crucial new information about how bariatric surgery can impact cancer progression. Future studies could potentially use the conserved genes identified by Sipe et al. to develop new ways to stimulate the anti-cancer benefits of weight loss without surgery.

Abstract PS17-29: Surgically induced weight loss corrects obesity associated tumor progression and improves responsiveness to immunotherapy

Background: Obesity leads to a higher risk of cancer invasion, metastases, recurrence, mortality, and impaired therapeutic response through various mechanisms. One of these mechanisms is microenvironment dysfunction, where changes in immune cells, microbes, metabolites, and growth factors contribute to tumor aggressiveness. We study obesity-induced changes to the tumor microenvironment in Triple Negative Breast Cancer (TNBC), an aggressive subtype associated with obesity. The goal to compare tumor progression in lean vs. obese vs. weight loss manipulations to identify causal and targetable pathways associated with reprogramming the tumor microenvironment. Clinically, bariatric surgery induced weight loss reduced the risk of BC, with the greatest benefit detected in pre-menopausal patients with ER- tumors, like TNBC. We hypothesize surgically-induced weight loss will diminish obesity-associated tumor progression. Methods: To study weight gain and loss that best mimics human adiposity, we utilized obesogenic C57BL/6 females with a syngeneic orthotopic transplant of TNBC cells. Female mice placed on a high fat diet (HFD) at weaning became obese compared to mice on a low fat diet (LFD). After 16 weeks on an HFD diet, mice underwent the bariatric surgery Vertical Sleeve Gastrectomy (VSG). The VSG resulted in reduced body weight, adiposity, and correction of metabolic profiles compared to obese mice. Two weeks post-surgery, TNBC cells were OT into the mammary fat. Results: As expected, tumor growth was increased in obese mice compared to lean. Importantly, surgical weight loss rescued obese tumor progression. We identified key changes in tumor infiltrating of immune cells that could be responsible for the beneficial effects of bariatric surgery on tumor progression. We then exploited these changes with immunotherapy, which was uniquely effective in mice that underwent bariatric surgery. Conclusions: In conclusion obesity promotes a pro-tumor microenvironment, that can be corrected through surgically induced weight loss.

Citation Format: Laura Sipe, Mehdi Chaib, Emily B Korba, Mary C Lovely, Jared C Clements, Neena A John, Ajeeth K Pingili, Joseph F Pierre, Liza Makowski. Surgically induced weight loss corrects obesity associated tumor progression and improves responsiveness to immunotherapy [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS17-29.

Extreme ocean acidification reduces the susceptibility of eastern oyster shells to a polydorid parasite

Ocean acidification poses a threat to marine organisms. While the physiological and behavioural effects of ocean acidification have received much attention, the effects of acidification on the susceptibility of farmed shellfish to parasitic infections are poorly understood. Here we describe the effects of moderate (pH 7.5) and extreme (pH 7.0) ocean acidification on the susceptibility of Crassostrea virginica shells to infection by a parasitic polydorid, Polydora websteri. Under laboratory conditions, shells were exposed to three pH treatments (7.0, 7.5 and 8.0) for 3- and 5-week periods. Treated shells were subsequently transferred to an oyster aquaculture site (which had recently reported an outbreak of P. websteri) for 50 days to test for effects of pH and exposure time on P. websteri recruitment to oyster shells. Results indicated that pH and exposure time did not affect the length, width or weight of the shells. Interestingly, P. websteri counts were significantly lower under extreme (pH 7.0; ~50% reduction), but not moderate (pH 7.5; ~20% reduction) acidification levels; exposure time had no effect. This study suggests that extreme levels - but not current and projected near-future levels - of acidification (∆pH ~1 unit) can reduce the susceptibility of eastern oyster shells to P. websteri infections.

The inverse problem of electrocardiography: a solution in terms of single- and double-layer sources of the epicardial surface

An approach to the inverse problem of electrocardiography that involves an estimation of the electric potentials (double-layer equivalent sources) on the heart's epicardial surface from the electrocardiographic potentials that are measurable on the body surface has received considerable attention. This report deals with a heretofore unexplored extension of this approach, one that yields, in addition to the electric potentials on the epicardial surface, the normal components of their gradients (single-layer equivalent sources). We show that this formulation has at least three advantages over the formulation in term of epicardial potentials alone: (1) single-layer equivalent sources, which reflect the flow of current across the epicardial surface, are well suited for the imaging of regional ischemia and infarction; (2) the transfer matrix linking the epicardial and body-surface potentials for this formulation is less ill conditioned than that for the formulation in terms of potentials alone; (3) the input vector for inverse calculations consists of spatially filtered (rather that directly measured and therefore noise) body-surface potentials. To establish the feasibility of this new formulation of the inverse problem and to compare it with the formulation in terms of potentials alone, we used a realistically shaped boundary-element model of human torso. By calculating singular values less ill conditioned. We then directly calculated epicardial and body-surface potentials for a single dipole located centrally and for three simultaneously active dipoles located eccentrically in the torso's heart region and used these results to test three methods that are prerequisites of a successful inverse solution: Tikhonov regularization, linearly constrained least squares, and an L-curve method. The feasibility of the new formulation was demonstrated by the fact that the method based on the linearly constrained least squares improved on overregularized Tikhonov solutions over a wide range of regularization parameters, and it yielded solutions that were more accurate than the best-possible Tikhonov solutions. Moreover, the L-curve solution procedure, which requires no a priori information about the solution, yielded slightly underregularized, but accurate, estimates for the optimal regularization parameter and the corresponding best-possible Tikhonov solution. Our results also showed that replacing--in the interest computational economy--quadrature formulas for the planar triangles with various approximate formulas for the nodes of the model reduces the accuracy of the inverse solution.

Transperineal ultrasound-guided radioactive seed implantation for organ-confined carcinoma of the prostate

PURPOSE

This retrospective study was undertaken to: (a) determine the prognostic significance of pretreatment and 1-year nadir serum prostate specific antigen (PSA) levels in organ-confined carcinoma of the prostate treated with ultrasound-guided radioactive 125I seed implantation; (b) determine the factors associated with postimplant morbidity and whether modification of the technique would reduce morbidity; (c) evaluate the local control rate and disease-free survival of patients undergoing seed implantation.

METHODS AND MATERIALS

From October 1988 through December 1992, 142 patients with organ-confined adenocarcinoma of the prostate and a Gleason score < or = 7 underwent ultrasound-guided radioactive 125I seed implantation as an alternative to radical prostatectomy. Patients were considered to have persistent or progressive disease if there was evidence of local progression on digital exam, or if there were two consecutive increases in the PSA level. Patients suspected of persistent or progressive disease underwent restaging to include CT scan of the pelvis, bone scan, and ultrasound-guided prostate biopsy. Patients with increasing PSA levels in which active disease could not be confirmed were considered biochemical failures with occult systemic disease and were offered hormone ablation.

RESULTS

With 1-6-year follow-up, median 30 months, the relapse patterns were prostate 4 (2.8%), bone 4 (2.8%), rising PSA 16 (11%). Pretreatment PSA level correlated with subsequent recurrence; pretreatment PSA < or = 4 (0), 4.1 to 10 (14%), 10.1 to 20 (21%), 20.1 to 50 (58%). Disease free survival at 2 years was 90% and at 5 years 76%. Nadir PSA (nPSA) at 1 year also correlated with recurrence: nPSA < or = 1 (3%), nPSA 1 < or = 4 (50%), and nPSA > or = 4 (100%). Seed implantation was well tolerated with 31% of patients experiencing RTOG morbidity > or = Grade 2, which typically consisted of transient radiation urethritis, which resolved with conservative measures. Eleven (8%) experienced RTOG morbidity > or = Grade 3. There was no correlation between number of seeds or total millicuries implanted and subsequent morbidity. However, reduction in the periurethral seed intensity reduced > or = Grade 3 morbidity from 11 to 4%.

CONCLUSION

Ultrasound-guided radioactive seed implantation provides excellent local control of 97%, with a median 30 month follow-up. Morbidity is comparable to other curative modalities and by modifying Blasko's technique to reduce radioactive seed strength in the periurethral area, significant morbidity is rare. Pretreatment PSA and the nadir PSA at 1 year are important predictors of subsequent disease outcome. With a liberal definition of systemic recurrence as two consecutive increases in PSA levels, the 5-year disease-free survival is 76%.

The root morphology of Lupinus angustifolius in relation to other Lupinus species

Commercial L. angustifolius cultivation is restricted to acid to neutral coarse-textured soils in Australia. An unsuitable root system may be part of the reason for the poor performance on fine-textured or alkaline soils. As a first step to examine this question plants of 12 annual Lupinus species were grown in a coarse soil with the aim of describing the range of root morphologies within the genus and to compare these to commercial L. angustifolius. A wide range of rooting patterns were observed. The differences in the dominance of the taproot was pronounced between species. The commercial genotype of L. angustifolius occupied an extreme within the range of root morphologies of the species. Roots of L. angustifolius consisted of a dominant taproot and a relatively high number of primary lateral roots but few secondary roots. In contrast, the primary, secondary and tertiary lateral roots of L. pilosus, L. mutabilis, L. atlanticus, L. palaestinus and L. micranthus were more dominant than the taproot. The length and distribution of primary lateral roots along the taproot also varied between species. The number of primary lateral roots fell rapidly with depth in L. angustifolius and L. mutabilis, while the other species had a more even distribution. L. angustifolius had a less extensive root system and relatively thick roots when compared to species such as L. albus and L. mutabilis. L. luteus also had relatively thick roots. The relatively thick roots and less extensive lateral root system in commercial L. angustifolius may partially explain its poor growth on fine-textured soils, where a greater proliferation of finer, lateral roots may be necessary. Proteoid root formation was observed for L. albus, L. cosentinii, L. pilosus, L. palaestinus, L. micranthus, L. digitatus, L. princei and L. atlanticus. They were particularly numerous in L. micranthus and L. albus. The structure of proteoid root clusters varied between species.

Association between collection site soil pH and chlorosis in Lupinus angustifolius induced by a fine-textured, alkaline soil

Collection site soil pH may be a useful predictor of tolerance in Lupznus angustifolzus to chlorosis induced by alkaline soils. We examined a range of genotypes from the Mediterranean region for their tolerance of an alkaline sandy clay loam (pH 8.8) from Merredin, Western Australia. Fifteen wild L. angustifolius lines, collected on a variety of soils that ranged in pH from 4.2 to 9.0, were compared with cultivars of L. angustifolzus and known alkaline-tolerant (L. cosentinii) and alkaline-sensitive (L. luteus) lupin species. Five-week-old seedlings varied greatly in chlorosis on the alkaline soil, from almost no chlorosis (as in L. cosentinzi cv Erregulla) to severely chlorotic (L. angustifolius line MJS176 from Spain). No lines were chlorotic after acid amelioration of the soil. Chlorosis score in wild L. angustifolius was not significantly correlated with soil pH at the collection site and was not associated with a particular soil texture, but there was a significant correlation between altitude of collection sites and chlorosis scores. Chlorosis-sensitive lines were from higher altitudes, had lower root and shoot fresh weight, were lower in Fe, Mn and K and were higher in Zn, P, and S in new growth than resistant lines. Chlorosis-sensitive lines also had the largest increases in fresh weight of roots and shoots in response to soil acidification. Genotypes with better root growth and therefore lower chlorosis symptoms on alkaline soil did not necessarily have the strongest root growth on acid ameliorated soil. Soil pH at the collection site in the Mediterranean region was not a reliable predictor of chlorosis in L. angustifolius induced by an alkaline fine-textured soil in Western Australia, although significant variation in tolerance to this soil was found within the species.

A brief correction procedure for the management of high rate spitting in a profoundly retarded girl

This study demonstrates the effectiveness of a brief correction procedure in decelerating a high rate anti-social behaviour (spitting) in a profoundly retarded girl. A simple correction procedure seemed as effective as a more elaborate procedure incorporating positive practice elements, and gains were sustained with some variability over an extended period of time. No reliable increases in collateral behaviours were noted to result from the deceleration in spitting.

A preliminary investigation on the use of the Portage system in day nursery settings

The paper describes the impact of a training programme for local authority day nursery staff on the use of the Portage system with handicapped children. The results suggest that the staff mastered the techniques and were able to continue using them, though some modification to the system seems indicated for these settings. These findings were discussed in the light of more general issues about the support needed for day nursery staff.

Radiation therapy for nonseminomatous germ cell tumors of the testis: a reappraisal

We analyzed the efficacy of radiation therapy and retroperitoneal lymphadenectomy preceded and followed by radiation therapy as curative treatment in 113 patients with clinical stages I and II nonseminomatous germ cell tumors of the testis. Radiation therapy alone was curative in 86 and 82 per cent of the patients with clinical stages I and II disease, respectively, and radiation therapy before and after retroperitoneal lymphadenectomy was curative in 89 and 73 per cent of patients with clinical stages I and II disease, respectively. Of 26 patients with clinical stage II disease in the group receiving radiation therapy before and after retroperitoneal lymphadenectomy only 13 (50 per cent) had pathologic documentation of retroperitoneal metastasis or histologic evidence of nodal metastases that had been destroyed by radiation therapy alone. When analyzed by pathologic stage radiation therapy before and after retroperitoneal lymphadenectomy was curative in 91 and 51 per cent of patients with stage I and II disease, respectively. In our series clinical overstaging may have been responsible for the favorable results of radiation therapy alone, and radiation before and after retroperitoneal lymphadenectomy in the treatment of clinical stage II nonseminomatous germ cell tumors.

Prostatic trauma and release of acid phosphatase. Radioimmunochemical and enzymatic comparison

Radioimmunoassay for prostatic acid phosphatase and a conventional enzymatic method using alpha-naphthyl phosphate were employed to document the changes in serum levels of this enzyme following transurethral prostatectomy and prostatic massage. Thirty-four patients with histologically proved benign prostatic hyperplasia and 120 controls were studied. Consistent parallel elevations were noted after surgical trauma. A rapid clearance was observed with normal levels returning at twenty-four hours. Prostatic massage did not elicit a change by either method.

A home advisory service for pre-school children with developmental delays

This paper describes the development of a home advisory service for families of children with developmental difficulties. It demonstrates the transition from a research phase to routine service provision, and indicates that the expansion in numbers of families receiving the service has been achieved whilst maintaining or improving the actual quality of the service. Information is provided on the placement of children who have left the service, and on the plans for future research within the service.

Anaplastic seminoma: an analysis of 77 patients

Over a 28 year period, 77 patients with early stage anaplastic seminoma of the testis were treated by orchiectomy and lymphatic irradiation at three Army medical centers. With a median follow-up of 97 months, the 10 year actuarial survival is 96% of Stage I patients and 87% for Stage II patients. For patients with Stage I anaplastic seminoma no survival advantage can be demonstrated for adding mediastinal and supraclavicular irradiation versus para-aortic and pelvic irradiation alone. The addition of retroperitoneal lymphadenectomy to lymphatic irradiation increased the frequency of major gastrointestinal complications without significantly improving survival. Patients with anaplastic seminoma and elevated serum beta-subunit human chorionic gonadotrophin levels have a poor prognosis and should be considered for adjuvant combination chemotherapy. Anaplastic seminoma of the testis has a similar clinical presentation, response to therapy and prognosis compared to typical seminoma and should be managed in the same way.

Clinical evaluation of the Technico Stat/Ion system

1. We describe our evaluation of the Technicon Stat/Ion, an instrument which performs sodium, chloride and bicarbonate analysis simultaneously. 2. All four of the assays resulted in linear response over the entire clinical range with insignificant carryover between specimens. 3. Precision studies for within-run variation were: sodium 0.3 percent, potassium 0.7 percent, chloride 0.5 percent and bicarbonate 1.6 percent. Day-to-day precision was similar to the within-run precision. 4. Comparison methods for sodium, potassium, chloride and bicarbonate utilizing flame photometry, chloridometry and titration of released carbon dioxide respectively showed the following linear regression and correlation coefficients: sodium y=0.96+5.5 (a=0.988) potassium y=1.01x+0.0 (a=.996) chloride y=0.99x+1.0 (a=.993)bicarbonate y=1.0x+1.2 (alpha=.969).