Analysis of functional efficiency and risk of falls in patients with different types of dementia - preliminary observations

INTRODUCTION AND OBJECTIVE

Dementia is a multifactorial neurological disease that affects 50 million people worldwide. It is a disorder that impairs cognitive functions, functional efficiency, balance and gait. It contributes to an increased risk of falls, reduces independence in everyday activities and deepens disability. The aim of the study was to investigate the correlation between dementia and independence related to functional efficiency and risk of falls in the elderly.

MATERIAL AND METHODS

The eligibility criterion for participation in the study was age over 60, the presence of cognitive disorders, including dementia, and the ability to move with the use of orthopaedic equipment or independently. A total of 51 people participated in the study, including 13 people who underwent rehabilitation procedures. Each subject was evaluated once for cognitive abilities using two types of tests: the ADL scale, MMSE (Mini-Mental state Examination) and three physical fitness tests: SPPB (Short Physical Performance Battery), TUG (Timed Up & Go) and FRT (Functional Reach Test).

RESULTS

The average score of the MMSE test was 13.29±6.23 points, the average of the ADL scale was 4.20±1.23 points. A positive correlation was found between the level of dementia and the independence of the examined person, as well as a positive relationship between the MMSE test and the result of the Functional Reach Test, and the relationship between the ADL scale and the SPPB and 'Get-Up and Go' tests.

CONCLUSIONS

It has been demonstrated inter alia that static balance and functional efficiency depends on the patient's independence in everyday activities, and the level of dementia may suggest the patient's dynamic balance. In addition, the need for a broader analysis of targeted studies was recognized to confirm the conclusions obtained.

Evaluation of Knowledge and Self-Awareness of Polish Soldiers Regarding Exposure to Chemical and Physical Factors in Their Place of Service/Work

INTRODUCTION

Soldiers constitute a professional group carrying out their duties in variable, often challenging environmental conditions, including harmful and burdensome ones.

MATERIALS AND METHODS

This study was conducted on a nationwide sample of 1331 soldiers. The research tool was an anonymous questionnaire comprising 48 questions. Descriptive statistics were used to describe the characteristics of the studied group. The chi-square test was employed to examine the relationship between variables. A 95% confidence interval was adopted, with a significance level of p = 0.05.

RESULTS

One in four soldiers work with low and one in five with moderate exposure to harmful chemical factors. Almost 10% of respondents lack knowledge about the types of chemical factors present during their service. One in five soldiers work with low and one in eight with moderate exposure to ionizing radiation. Approximately 5% of survey participants lack knowledge about the types of physical factors. One in three soldiers are unaware of the carcinogenic and mutagenic effects of the aforementioned factors.

CONCLUSIONS

The systematic enhancement of knowledge and awareness among army members will help minimize the consequences of exposure to harmful conditions.

Evaluation of Antimicrobial Activities against Various E. coli Strains of a Novel Hybrid Peptide-LENART01

Finding the ideal antimicrobial drug with improved efficacy and a safety profile that eliminates antibiotic resistance caused by pathogens remains a difficult task. Indeed, there is an urgent need for innovation in the design and development of a microbial inhibitor. Given that many promising antimicrobial peptides with excellent broad-spectrum antibacterial properties are secreted by some frog species (e.g., bombesins, opioids, temporins, etc.), our goal was to identify the antimicrobial properties of amphibian-derived dermorphin and ranatensin peptides, which were combined to produce a hybrid compound. This new chimera (named LENART01) was tested for its antimicrobial activity against E. coli strains K12 and R1-R4, which are characterized by differences in lipopolysaccharide (LPS) core oligosaccharide structure. The results showed that LENART01 had superior activity against the R2 and R4 strains compared with the effects of the clinically available antibiotics ciprofloxacin or bleomycin (MIC values). Importantly, the inhibitory effect was not concentration dependent; however, LENART01 showed a time- and dose-dependent hemolytic effect in hemolytic assays.

Analysis of Non-Compulsory Influenza and COVID-19 Vaccination among Polish Soldiers

The COVID-19 pandemic posed many challenges in epidemiology, health care, and vaccinology. Pharmaceutical and biotechnology companies had to develop effective vaccines as soon as possible in order to halt the spread of infection outbreaks and enable the start of the National Vaccination Program. Firstly, medical services and security services (the army, fire brigade, and police), i.e., those most involved in the fight against the effects of the COVID-19 pandemic, were included in the aforementioned program. The presented publication analyzes the amount and type of vaccination against COVID-19 and influenza among Polish soldiers. Influenza, like COVID-19, is a viral disease that can vary in its course (from mild to acute and life-threatening). Both coronaviruses and influenza viruses are characterized by high genetic variability, resulting in the need for repeated vaccination during each autumn and winter season. Acquired data comes from the Central Register of Vaccination of Professional Soldiers. The collected material was statistically processed. The average level of the phenomenon was presented as a time series using a chronological average. In the analyzed period (December 2020-December 2021), the lowest vaccinations against COVID-19 were performed in December 2020, which is due to the schedule of the National Vaccination Program in Poland. In contrast, the highest number of vaccinations were administered between April and June 2021, or approximately 70.5% of all vaccines administered. In the case of influenza, there is a clear increase in the number of vaccinations during the autumn and winter seasons, which coincides with peaks in disease during these periods. Between August 2020 and January 2021, there is a noticeable increase in the number of flu injections given, nearly 50% compared to the previous period, which may be related to the simultaneous persistence of the COVID-19 pandemic and greater attention to one's own health. Non-mandatory vaccination is an important point in the vaccination schedule for soldiers. Numerous public campaigns combating misinformation and raising awareness of the need for immunization will help convince even more people, not only among soldiers but also the civilian population, to vaccinate.

Naphthalene Phthalimide Derivatives as Model Compounds for Electrochromic Materials

Electrochromism of organic compounds is a well-known phenomenon; however, nowadays, most research is focused on anodic coloring materials. Development of efficient, cathodic electrochromic materials is challenging due to the worse stability of electron accepting materials compared with electron donating ones. Nevertheless, designing stable cathodic coloring organic materials is highly desired-among other reasons-to increase the coloration performance. Hence, four phthalimide derivatives named 1,5-PhDI, 1,4-PhDI, 2,6-PhDI and 3,3'-PhDI were synthesized and analyzed in depth. In all cases, two imide groups were connected via naphthalene (1,5-PhDI, 1,4-PhDI, 2,6-PhDI) or 3,3'-dimethylnaphtidin (3,3'-PhDI) bridge. To observe the effect of chemical structure on physicochemical properties, various positions of imide bond were considered, namely, 1,5- 1,4- and 2,6-. Additionally, a compound with the pyromellitic diimide unit capped with two 1-naphtalene substituents was obtained. All compounds were studied in terms of their thermal behavior, using differential calorimetry (DSC) and thermogravimetric analysis (TGA). Moreover, electrochemical (CV, DPV) and spectroelectrochemical (UV-Vis and EPR) analyses were performed to evaluate the obtained materials in terms of their application as cathodic electrochromic materials. All obtained materials undergo reversible electrochemical reduction which leads to changes in their optical properties. In the case of imide derivatives, absorption bands related to both reduced and neutral forms are located in the UV region. However, importantly, the introduction of the 3,3'-dimethylnaphtidine bridge leads to a noticeable bathochromic shift of the reduced form absorption band of 3,3'-PhDI. This indicates that optimization of the phthalimide structure allows us to obtain stable, cathodic electrochromic materials.

Analysis of the Number and Type of Vaccinations Performed among Polish Soldiers in 2018-2021

Vaccination is a very common topic, but it is rarely raised or discussed with respect to military members. Soldiers are one of the main professional groups to be immunized on a regular basis. The military actively participates in research on new vaccine preparations. This paper presents data from 2018-2021 on vaccination among Polish soldiers. The material obtained from the Central Register of Vaccination for Professional Soldiers was analyzed using descriptive statistical methods. The number of injections performed in a given period depends on the location of the ongoing missions and the vaccination schedule specific to a given Polish Military Contingent. In Poland, soldiers undergo preventive vaccinations in accordance with the scheme developed by the Armed Forces Operational Command, taking into account the specific nature of the service, epidemiological risks and the calendar of current preventive vaccinations. Soldiers serving abroad are immunized against typhoid, hepatitis A, hepatitis B, rabies, measles, tick-borne encephalitis, Japanese encephalitis, polio, diphtheria, meningococcal disease, chickenpox, cholera and yellow fever. Regular vaccinations for soldiers are necessary to minimize the spread of infectious diseases, and they have a beneficial effect upon the effectiveness of military operations.

Heart rate control and its predictors in patients with heart failure and sinus rhythm. Data from the European Society of Cardiology Long-Term Registry

BACKGROUND

Higher resting heart rate (HR) in patients with heart failure (HF) and sinus rhythm (SR) is associated with increased mortality. In patients hospitalized for HF, the aim herein, was to assess the use and dosage of guideline-recommended HR lowering medications, HR control at discharge and predictors of HR control.

METHODS

In the present study, were Polish participants of the European Society of Cardiology HF Long-Term (ESC-HF-LT) Registry. Those selected were hospitalized for HF, with reduced ejection fraction (HFrEF) and SR at discharge (n = 236). The patients were divided in two groups ( < 70 and ≥ 70 bpm). Logistic regression was used to identify the predictors of HR ≥ 70 bpm.

RESULTS

Of patients with HFrEF and SR, 59% had HR ≥ 70 bpm at hospital discharge. At discharge, 96% and only 0.5% of the patients with HFrEF and SR received beta-blocker and ivabradine, respectively. In the HF groups < 70 and ≥ 70 bpm, only 11% and 4% of patients received beta-blocker target doses, respectively. There was no difference in the use of other guideline-recommended medications. Age, New York Heart Association class, HR on admission and lack of HR lowering medications were predictors of discharge HR ≥ 70 bpm.

CONCLUSIONS

Heart rate control after hospitalization for HFrEF is unsatisfactory, which may be attributed to suboptimal doses of beta-blockers, and negligence in use other HR lowering drugs (including ivabradine).

764 Characterization of RVU-27065 a novel small-molecule STING agonist suitable for systemic administration

Background

STimulator of INterferon Genes (STING) is a key signaling protein involved in activation of the immune system in response to self-DNA. In recent years, STING signaling has been demonstrated to play a major role in activating the antitumor immune response and therefore is considered an attractive drug target in immuno-oncology. The first wave of STING agonists, cyclic-dinucleotide analogues of the internal ligand cGAMP, were developed for local, intratumoral administration. Herein we present the most recent profiling results of our frontrunner molecule RVU-27065, a potent and selective systemic STING agonist with a favorable drug profile.

Methods

Binding to recombinant STING protein was examined using Fluorescence Thermal Shift and Fluorescence Polarisation. Primary activity screen was performed in THP-1 Dual reporter cells. Selectivity was confirmed in THP-1 reporter cells with knocked out STING or expressing STING variants. T cell viability and proliferation was assessed by flow cytometry using activated human T cells. PBMCs were isolated by density gradient from whole blood of healthy donors. Downstream STING pathway activation in cells treated with RVU-27065 was confirmed using Western blot analysis. BALB/c mice were inoculated with EMT6 tumor cells and the compound was administered intravenously followed by regular monitoring of tumor growth. Cured animals were rechallenged by repeated inoculation of EMT6 cells.

Results

RVU-27065 binds and strongly thermostabilizes recombinant STING proteins of all tested species. Binding to the protein results in activation of downstream signalling pathway, confirmed by western blot analysis. The agonist is characterized by selectivity and excellent potency in THP-1 dual reporter cells as well as in human PBMCs and dendritic cells. Short term incubation of RVU-27065 has no impact on T cell viability, activation or proliferation. Furthermore, STING activation with RVU-27065 leads to repolarization of immunosuppressive M2 macrophages into pro-inflammatory M1-like phenotype. In vivo efficacy of RVU-27065 was confirmed, leading to significant tumor growth inhibition and complete tumor regressions in an EMT6 mouse breast cancer syngeneic tumor model.

Conclusions

RVU-27065 is a novel representative of a 3rd generation of Ryvu STING agonists – small-molecule, non-macrocyclic molecules built around a unique chemotype. The compound is characterized by high in vitro potency which translates to efficacy in vivo in preclinical animal models. Drug-like properties, excellent selectivity and a good safety profile make RVU-27065 an attractive candidate for further development for standalone as well as targeted delivery, which holds high potential for improved immunotherapy in cancer patients.

[Exposure of military unit employees to carcinogenic factors in the work environment in 2018-2019]

BACKGROUND

The aim of the study was to analyze data on the exposure of military personnel to carcinogenic chemical substances, ionizing radiation and technological processes.

MATERIAL AND METHODS

Reports collected from the Military Centers of Preventive Medicine on carcinogens and exposure of workers in military units and institutions were subjected to a detailed analysis.

RESULTS

The number of workers exposed to carcinogenic factors increased in the period under analysis. In 2019, the total number of people exposed in the workplace to chemical carcinogens or mutagens was 4058, to ionizing radiation - 1015, and to technological processes with carcinogenic or mutagenic effects - 12, compared to 3224, 1289 and 8 people, respectively, in 2018. The most common chemical agents in military units which caused exposure, from the point of view of occupational health and safety, were mixtures of liquid hydrocarbons used as fuel for driving vehicles and devices with internal combustion engines. In military units dedicated to the provision of medical services, exposure to X-ray radiation (diagnostics imaging) and formaldehyde (pathomorphology) was the most common.

CONCLUSIONS

The collected data presents different approaches of individuals in terms of reporting and assessing occupational exposure. Understanding the long-term health effects requires more thorough research. Med Pr. 2021;72(5).

Abstract 1280: New generation of STING agonists: Development and characterization of a novel series of systemic immunomodulators with improved potency

Background. Stimulator of interferon genes, known as STING, is an intracellular sensor of nucleic acids and one of key regulators in activating the innate immune response. Employing synthetic STING agonists has been shown to promote immune-mediated antitumor response in preclinical animal models. Ryvu is developing small-molecule STING agonists suitable for systemic administration. Herein we present unpublished results from characterization of the new generation of our agonist series with significantly improved potency on human immune cells.

Methods. Binding to recombinant STING protein was examined using Fluorescence Thermal Shift and Fluorescence Polarisation and was confirmed by X-ray crystallography. Primary screen was performed in THP-1 Dual reporter cells and selectivity was confirmed in THP-1 reporter cells with knocked out STING or expressing varying STING variants. T cell viability and proliferation was assessed by flow cytometry using activated, human T cells exposed to STING agonists. STING pathway activation pattern in cells treated with Ryvu's molecules was confirmed using Western blot analysis. BALB/c mice were injected with compounds and the levels of cytokine release were measured in the plasma. Mice were inoculated with CT26 or EMT6 tumor cells and the compound was administered intravenously followed by the regular monitoring of tumor growth.

Results. New generation Ryvu STING agonists are strong binders of human STING protein. Ryvu's compounds show high cellular potency inducing cytokine production in human immune cells at low nM range. Moreover, high activity of developed agonists is maintained irrespective of the natural human STING variant as seen in THP-1 reporter cells as well as in human primary immune cells. High cellular potency of developed compounds also translates into efficacy observed in vivo, where systemic intravenous administration leads to significant tumor growth inhibition and complete tumor regressions in mouse syngeneic models.

Conclusion. Ryvu has developed a new generation of potent, direct and selective small-molecule STING agonists. The compounds are characterized by drug-like properties and high in vitro potency on par or outperforming known references. Ryvu agonists are suitable for systemic administration and allow to achieve excellent antitumor efficacy. Taken together, the promising results suggest that the developed series holds high potential for improving immunotherapy in cancer patients.

Citation Format: Maciej Krzysztof Rogacki, Stefan Chmielewski, Jolanta Mazurek, Magdalena Zawadzka, Katarzyna Wnuk-Lipińska, Kamil Kuś, Katarzyna Wójcik-Jaszczyńska, Aleksandra Poczkaj, Łukasz Dudek, Wojciech Schonemann, Urszula Głowniak-Kwitek, Marcin Leś, Marek Wronowski, Tushar Mahajan, Urszula Kulesza, Magdalena Zastawna, David Synak, Karol Zuchowicz, Karolina Gluza, Katarzyna Banaszak, Karolina Wiatrowska, Izabela Strojny, Mirosława Gładysz, Justyna Jabłońska, Ewelina Gabor-Worwa, Monika Dobrzańska, Raghuram Tangirala, Peter Littlewood, Krzysztof Brzózka. New generation of STING agonists: Development and characterization of a novel series of systemic immunomodulators with improved potency [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1280.

Characterization of changes in structural, physicochemical and mechanical properties of rigid polyurethane building insulation after thermal aging in air and seawater

The purpose of this study was the identification of qualitative and quantitative changes in the visual appearance, chemical structure, morphology and selected physicochemical and mechanical properties of the closed cell rigid PU foam while heated in air and seawater for predicting its performance and durability. Specimens were aged at constant temperatures of 40 and 80 °C for a period of 10 weeks. Aging caused a yellowing of the samples. Scanning electron microscopy (SEM) revealed that foam pores lost their regularity. Differential scanning calorimetry (DSC) showed that the glass transition temperature (Tg) increased on average by 15 and 80%, respectively for samples heated at 40 and 80 °C. Water absorption (WS) also increased over time, respectively, by a maximum of 15 and 25%. The flexural strength (σflex) and compressive (σcomp) strength showed a decreasing tendency, whereas for tensile strength (σtens), an increase was observed. The starting material was characterized by the σflex, σtens and σcomp of: 436, 413 and 284 kPa, respectively. The lowest determined σflex value was of 345 kPa, and σcomp value was of 158 kPa. The highest determined σtens equaled to 608 kPa, respectively. The changes in flexural modulus were statistically insignificant and its average value was of 4.0 MPa.

Abstract 4532A: Development of selective small molecule STING agonists suitable for systemic administration

Background: Stimulator of Interferon Genes (STING) is a major player in the activation of robust innate immune response leading to initiation and enhancement of tumor-specific adaptive immunity. Several clinical and pre-clinical programs are developing cyclic dinucleotides - analogues of endogenous STING ligands. However their chemical nature and stability limit their use as systemic immuno-therapeutics. Herein, we present potent and selective non-nucleotide, non-macrocyclic, small molecule direct STING agonists, structurally unrelated to known chemotypes and suitable for systemic administration.

Methods: Binding to recombinant STING protein was examined using FTS, MST, FP and crystallography studies. Phenotypic screen was performed in THP-1 Dual reporter cells. Human macrophages (HMDM) and dendritic cells (HMDC) were differentiated from monocytes (obtained from PBMC) in the presence of M-CSF and GM-CSF/IL-4 for HMDM and HMDC, respectively. Mouse bone marrow-derived dendritic cells (BMDC) were obtained from C57BL/6 or STING KO mice and differentiated with mIL-4 and mGM-CSF. STING agonists were administered into BALB/c mice and cytokine release was measured in plasma. Additionally, mice were inoculated with CT26 murine colon carcinoma cells and the compound was administered, followed by the regular tumor growth monitoring. Finally, the compound was administered to C57BL/6 WT and STING KO mice in several escalating doses.

Results: Ryvu's agonists demonstrate a strong binding affinity to recombinant STING proteins across tested species. They trigger pro-inflammatory cytokine release from human PBMC and HMDC and induce dendritic cell maturation regardless of the STING haplotype. Systemic in vivo administration leads to dose-dependent upregulation of STING-dependent pro-inflammatory cytokines, suggesting immune activation which translates into efficacy in vivo in CT26 mouse colorectal cancer model and complete tumor remissions. Furthermore, cured animals develop lasting immunological response demonstrated by diminished tumor growth or lack of palpable tumors in re-challenged mice.

Conclusion: Ryvu's STING agonists selectively activate STING-dependent signaling in both mouse and human immune cells promoting anti-tumor immunity. Treatment with Ryvu's STING agonists leads to engagement of the immune system which results in complete tumor remission and development of immunological memory against cancer cells. The compounds show good selectivity and ADME properties enabling development for systemic administration as a single agent or in combinations with immunotherapies or targeted agents.

Citation Format: Stefan Chmielewski, Magdalena Zawadzka, Jolanta Mazurek, Maciej K. Rogacki, Karolina Gluza, Katarzyna Wójcik-Jaszczyńska, Aleksandra Poczkaj, Grzegorz Ćwiertnia, Grzegorz Topolnicki, Maciej Kujawa, Eliza Zimoląg, Urszula Głowniak-Kwitek, Magdalena Mroczkowska, Agnieszka Gibas, Marcin Leś, Sylwia Sudoł, Marek Wronowski, Kinga Michalik, Katarzyna Banaszak, Katarzyna Wiklik, Federico Malusa, Michał Combik, Karolina Wiatrowska, Łukasz Dudek, Jose Alvarez, Anna Rajda, Faustyna Gajdosz, Aniela Gołas, Katarzyna Wnuk-Lipińska, Kamil Kuś, Ewelina Gabor-Worwa, Charles Fabritius, Luigi Stasi, Peter Littlewood, Krzysztof Brzózka, Monika Dobrzańska. Development of selective small molecule STING agonists suitable for systemic administration [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4532A.

Abstract 4983: Discovery and characterization of next-generation small molecule direct STING agonists

Accumulating evidence highlights an important role of type I interferon response in the immune surveillance mechanisms. IFNβ release by antigen-presenting cells promotes spontaneous anti-tumor CD8+ T cell priming being largely dependent on activation of Stimulator of Interferon Genes (STING). STING agonists promote regression of established tumors and generation of long-term immunologic memory in preclinical animal models. Herein we report the discovery of potent and selective, first-in-class non-nucleotide, non-macrocyclic, small molecule direct STING agonists with molecular weight below 500, structurally unrelated to known cyclic dinucleotide chemotypes with potential for systemic administration. Activation of STING pathway was monitored in THP-1 Dual reporter monocytic cell line as well as peripheral blood mononuclear cells (PBMC) or antigen presenting cells from human and mouse origin. Surface expression of the antigen-presenting cell maturation markers i.e. CD80, CD86, CD83 and HLA-DR was assessed by flow cytometry. Binding affinity was confirmed by three independent assays. RNA sequencing was performed on total RNA isolated from THP-1 cells and PBMC isolated from 2 healthy human donors. Direct binding to both mouse and human STING protein of Selvita agonists have been confirmed in biophysical binding assays (FTS, MST and FP) and by crystallography studies. The compounds have fine-tunable ADME properties with good solubility, permeability and human plasma stability. They selectively activates STING-dependent signaling in both THP-1 reporter assays and in primary cells of human and mouse origin. In addition, RNA sequencing data confirmed selectivity of the Selvita compounds. In vitro functional assays demonstrated their ability to induce cytokine responses (IFNβ, TNFα) in a panel of human peripheral blood mononuclear cell (PBMC), human monocyte derived macrophage (HMDM) and human dendritic cells samples with various STING haplotypes including refractory alleles. Additionally, the compounds efficiently induced cytokine release in mouse bone marrow-derived macrophages and dendritic cells. Pro-inflammatory cytokine profile was accompanied by up-regulation of the maturation markers, i.e. CD80, CD86, CD83 and HLA-DR, on the surface of human antigen presenting cells. These data demonstrate potent, novel, next-generation small molecule STING agonists activating STING-dependent signaling in both mouse and human immune cells to promote potential antitumor immunity. The compounds show good selectivity and in vitro ADME properties enabling further development for systemic administration as a single agent or in combinatory immunotherapies for cancer treatment.

Citation Format: Monika Dobrzańska, Stefan Chmielewski, Magdalena Zawadzka, Jolanta Mazurek, Karolina Gluza, Katarzyna Wójcik-Jaszczyńska, Maciej Kujawa, Grzegorz Topolnicki, Grzegorz Ćwiertnia, Aleksandra Poczkaj, Izabela Dolata, Magdalena Mroczkowska, Agnieszka Gibas, Marcin Leś, Sylwia Sudoł, Adam Radzimierski, Kinga Michalik, Magdalena Sieprawska-Lupa, Katarzyna Banaszak, Katarzyna Wiklik, Federico Malusa, Michał Combik, Karolina Wiatrowska, Agnieszka Adamus, Lukasz Dudek, Jose Alvarez, Charles Fabritius, Anna Rajda, Maciej Rogacki, Faustyna Gajdosz, Peter Littlewood, Luigi Stasi, Krzysztof Brzózka. Discovery and characterization of next-generation small molecule direct STING agonists [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4983.

Smoking-related behaviours of pregnant women depending on their place of residence

OBJECTIVES

Smoking is a commonly recognized risk factor of civilization diseases. Despite many educational programmes concerning harmful effects of tobacco smoking, this habit is still very popular. Particularly alarming is a high percentage of pregnant women who smoke.

METHODS

The aim of the study was to analyse the prevalence of smoking among pregnant women depending on their place of residence. The research was conducted in randomly selected 30 outpatient clinics for women in Łodź and 16 outpatient clinics in rural communes of the Łodź province. The epidemiological analysis included 400 women. Collected data were processed statistically using the descriptive methods and statistical inference.

RESULTS

It has been demonstrated that smoking in the past was more popular among city residents than countryside residents (58.2% and 47.9%, respectively). Women living in the city smoked almost three times more frequently during the whole pregnancy than the respondents from the countryside (13.4% and 4.3%, respectively). Furthermore, every fifth respondent living in the urban area (f=0.21) smoked over 10 cigarettes a day, and every fourth respondent from rural communes (f=0.24) smoked from 5 to 10 cigarettes a day. However, in the month preceding the research, pregnant women from rural areas smoked slightly more frequently as compared to the subjects from the city. In the group of pregnant women who smoked in the past or who smoke at present, regardless from their place of residence, every other woman did not breastfeed her baby. 6.1% of city residents and 4.3% of countryside residents declared that they smoked during the breastfeeding period.

CONCLUSIONS

Within the analysed population the influence of place of residence on the prevalence of active smoking, number of smoked cigarettes and giving up smoking during pregnancy and breastfeeding period has been evidenced.

Movement Activity Among Patients Diagnosed with Alcohol Dependence Syndrome

Frequent consumption of large amounts of alcohol usually does not correspond to regular physical activity. However, regular physical activity can lead to an improved well-being and greater satisfaction with life. The aim of the study was to determine the level of physical activity in the group of patients diagnosed with alcohol dependence syndrome and examine the correlation between these variables. The study was conducted among a selected group of individuals of both sexes, aged 22-65 and undergoing treatment. Our study indicated an absence of a correlation between gender and the level of physical activity among people addicted to alcohol. Moreover, no statistically significant relationship was found between alcohol dependence and physical activity undertaken in the researched group.

Abstract 4087: Development of a potent, dual pan-PIM/FLT3 inhibitor for the treatment of heme malignancies

Despite huge effort spent on understanding the pathogenesis of acute myeloid leukemia (AML), current standards of care are still based on the same chemotherapy agents as two decades ago - combinational treatment of cytarabine with an anthracycline. Fms-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) is one of the most common genetic lesions in AML. Although FLT3 inhibitors initially exhibit clinical activity, resistance to treatment inevitably occurs within months. PIM kinases are thought to be major drivers of the resistance phenotype and their inhibition in relapsed samples restores cell sensitivity to FLT3 inhibitors. Thus, simultaneous PIM and FLT3 inhibition represents a promising strategy in AML therapy. Selvita has developed a potent and selective first-in-class, dual PIM/FLT3 kinase inhibitor, the SEL24-B489 compound, and profiled its activity for in vitro and in vivo AML models showing significantly broader anti-tumor activity of SEL24-B489 than selective FLT3-ITD or PIM inhibitors. We compared SEL24-B489 head-to-head with a selective PIM inhibitor (AZD1208) and a selective FLT3-ITD inhibitor (AC220) in a panel of AML cell lines with FLT3-ITD or unmutated kinase (FLT3-WT) as well as peripheral AML cells and CD34+ bone marrow blasts. SEL24-B489 exhibited a significantly broader activity, irrespective of FLT3 status, than either of the selective inhibitors. Since PIM kinases have emerged as important mediators of FLT3-inhibitor resistance, we hypothesized that the dual specificity of SEL24-B489 might overcome the phenotype of resistance. We utilized previously developed MOLM-14 cells transduced with either FLT3-WT or FLT3 alleles containing TKD point mutations to show that neither of the these mutations decreased the cellular sensitivity to SEL24-B489. Higher cellular activity and biomarker response of SEL24-B489 than competitive inhibitors was shown by inhibition of specific biomarkers such as S6 and STAT5 phosphorylation at nanomolar concentrations in both FLT3-ITD positive and FLT3-WT cell lines in vitro. We have also demonstrated SEL24-B489 superior potency of SEL24-B489 in xenograft models in vivo. Consistent with the experiments in vitro showing marked synergy between SEL24-B489 and AraC, a combination of these agents resulted in almost completely blocked tumor growth in vivo. Most importantly, SEL24-B489 has been selected as a clinical candidate and is currently in phase I clinical trials.

Citation Format: Wojciech Czardybon, Renata Windak, Aniela Gołas, Michał Gałęzowski, Aleksandra Sabiniarz, Izabela Dolata, Magdalena Salwińska, Paweł Guzik, Magdalena Zawadzka, Ewelina Gabor-Worwa, Bożena Winnik, Małgorzata Żurawska, Ewa Kolasińska, Ewelina Wincza, Marta Bugaj, Monika Danielewicz, Grzegorz Dubin, Ewa Jabłońska, Maciej Szydłowski, Tomasz Sewastianik, Bartosz Puła, Anna Szumera-Ciećkiewicz, Monika Prochorec-Sobieszek, Elżbieta Mądro, Ewa Lech-Marańda, Krzysztof Warzocha, Jerome Tamburini, Przemysław Juszczyński, Krzysztof Brzózka. Development of a potent, dual pan-PIM/FLT3 inhibitor for the treatment of heme malignancies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4087. doi:10.1158/1538-7445.AM2017-4087

The Assessment of Knowledge of Organisational - Administrative Procedures in the Case of a Bioterrorist Threat in Selected Environmental Populations

In the past we have seen numerous cases of the purposeful utilisation of micro-organisms and toxins. This situation forced us to undertake actions aimed at a limitation of the production and storage of biological weapons. Unfortunately, despite the signing of the Convention on Biological and Chemical Weapons, many countries are still involved in research into the use of biological agents as a military resource.

The objective of the work was to perform an assessment of the knowledge of threats connected with bioterrorism as well as of the procedures in the case of a bioterrorist attack in two different urban populations - i.e. of below 50 thousand and above 500 thousand inhabitants.

The study was conducted in two towns, Nysa and Łódź. A self-designed questionnaire included 100 persons from each town, both men and women aged between 18 and 65 years. Despite the small differences between the researched populations, the knowledge of respondents concerning bioterrorist threats and procedures during an attack is insufficient.

On the basis of the obtained results we may conclude that there is a need to educate the entire society, irrespective of the place of residence, in order to raise an awareness with regard to the potential threat and procedures in the event of a bioterrorist attack.

Abstract C26: Development of selective MELK kinase inhibitors for breast cancer treatment

Breast cancer is the second most common cancer in the world and the most frequent cancer among women. Despite the progress in developing breast cancer therapies, approximately, 15% of all breast cancers are diagnosed as triple negative breast cancer (TNBC) and due to the lack of estrogen and progesterone receptors this subgroup of patients remains difficult to treat with hormonal therapies. Additionally, therapies targeting HER2, such as Herceptin, are also inefficient against TNBC. In recent years, maternal embryonic leucine zipper kinase (MELK) has been identified as a novel oncogenic target that is highly expressed in several types of solid cancers: breast (especially triple negative breast cancer), colon, ovary, lung, and brain and present at low levels in normal tissues. MELK overexpression in patient tumors strongly correlates with poor prognosis in glioblastoma and breast cancer. siRNA mediated knockdown of MELK kinase significantly inhibits growth of tumor cell lines both in vitro and in vivo. Therefore, MELK kinase is emerging as a novel and interesting target with significant potential for therapeutic intervention in cancer.

MELK is an atypical member of the AMPK family of serine-threonine kinases that been implicated has been implicated in stem cell renewal, cell cycle progression, cytokinesis, mRNA splicing and apoptosis. Its activity is correlated with its phosphorylation level, is cell cycle dependent, and maximal during mitosis although direct upstream regulators of MELK kinase activity are unknown. Despite the fact that the exact function is currently under investigation, selective targeting of MELK may be an effective cancer treatment strategy in a wide range of solid tumors. In this study, we are reporting development of a series of selective MELK kinase inhibitors. Synthesized compounds exert excellent selectivity and potency in MELK inhibition in a low nanomolar range. Therapeutic effect of the compounds was investigated in the panel of breast cancer cell lines with different genetic background as well as with different MELK kinase levels; it was shown that for some cell lines compounds induced cell death with nanomolar ED50 values. The compound's effect on the proliferation and in the colony formation assay was also investigated. Taken altogether, the presented data supports our rationale of using MELK kinase inhibitors as a novel approach for the cancer therapy.

Citation Format: Piotr Kowalczyk, Paulina Węgrzyn, Monika Prokopowicz, Martyna Knop, Karolina Mazur, Katarzyna Dziedzic, Karolina Gluza, Martyna Knop, Katarzyna Dziedzic, Karolina Mazur, Adam Radzimierski, Claude Commandeur, Magdalena Zawadzka, Kristjan Bloudoff, Fred Vaillancourt, Nick Larsen, John Wang, Dom Reynolds, Daisuke Ito, Jian Zou, Michelle Aicher, Pete Smith, Ping Zhu, Krzysztof Brzózka. Development of selective MELK kinase inhibitors for breast cancer treatment. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2015 Nov 5-9; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2015;14(12 Suppl 2):Abstract nr C26.

Abstract C257: Preclinical development of a potent dual PIM/FLT3 mutant kinase inhibitor for the treatment of AML and other hematological malignancies

Despite an evolving understanding of acute myeloid leukemia (AML), a group of heterogeneous diseases with a common feature of abnormal levels of myeloblasts in bone marrow and in circulation, the current standard of care including chemotherapy and allogeneic hematopoietic stem cell transplantation results in less than 40 % cure rate with little progress over the last decades. One of the most extensively investigated approaches in targeted therapy of AML are FLT3 inhibitors that address the population of patients harboring FLT3 mutations that result in high relapse rate and decreased overall survival when compared to patients lacking such mutations. Therefore inhibition of the constitutively active mutants of FLT3 is a promising therapeutic approach. Unfortunately, the clinical development of selective or multitargeted FLT3 inhibitors turned out to result in rapid, but very transient responses followed by disease progression. One of the main reasons for development of resistance was selection of clones harboring both ITD and tyrosine kinase mutations (TKD). In parallel, the role of PIM kinases, especially PIM1 in FLT3 mediated leukemogenesis attracted attention of the pharmaceutical industry with currently two phase I programs targeting PIM kinases in hematological malignancies. PIM kinases are important downstream effectors of FLT3 signaling and play a crucial role in cell survival and inhibition of apoptosis upon expression. For that reason, PIM kinases represent an emerging therapeutic target class in AML with promising preliminary data from clinical trials. Due to the heterogeneous nature of AML, dual inhibition of FLT3 mutant kinase and PIM kinases could lead to improved efficacy and constitute a promising approach to overcome rapid resistance development to targeted therapies. Selvita has developed a potent and selective dual PIM/FLT3 mutant kinase inhibitor - SEL24-B489 which is highly active in in vitro and in vivo AML models. The compound shows high inhibitory activity against mutated FLT3 (FLT3-ITD and TKD mutations such as D835H, D835Y, N841I) and all three PIM kinase isoforms, comparable to activity of selective inhibitors of FLT3 (A220) and PIM (AZD1208). A head to head comparison of SEL24-B489 in cellular models reveals high activity across tested cellular AML models and biomarker inhibition in line with the expected kinase activity profile. Most importantly, SEL24-B489 showed strong synergistic effect in combination with the current standard of care in AML - cytarabine, and with other targeted inhibitors in advanced clinical development. The activity of B489 in vivo in xenograft models of AML and lymphomas after oral administration was higher than compared to selective PIM inhibitor and led to remissions in certain models. SEL24-B489 is a successful example of rational drug design and is currently in preclinical development. It represents a promising therapeutic approach which addresses alternative survival pathways downstream of FLT3 in addition to the activity on resistant FLT3 mutant kinases, which hopefully will translate into improved survival of AML patients in clinical trials.

Citation Information: Mol Cancer Ther 2013;12(11 Suppl):C257.

Citation Format: Wojciech Czardybon, Michal Galezowski, Pawel Guzik, Magdalena Zawadzka, Renata Windak, Izabela Dolata, Magdalena Salwińska, Radoslaw Obuchowicz, Krzysztof D. Brzózka. Preclinical development of a potent dual PIM/FLT3 mutant kinase inhibitor for the treatment of AML and other hematological malignancies. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr C257.

Abstract 3245: Identification of potent, dual PIM/FLT3 kinase inhibitors for AML treatment

Acute myeloid leukemia (AML) is a highly heterogeneous disease with numerous signaling pathways that contribute to its pathogenesis. Advances in our understanding of molecular mechanisms of AML pathogenesis and prognosis so far did not translate into significant clinical improvements. AML is still the highest unmet medical need within hematological malignancies area, particularly in case of the elderly patients. FLT3 inhibitors were investigated in the recent years as possible therapeutic agents, however to date the clinical trials of FLT3 inhibitors have yielded disappointing results. On the other hand, PIM kinases have been identified in the last years as critical downstream components of FLT3 signaling, especially in the case of oncogenic FLT3 mutants. PIM kinases are being overexpressed in a range of hematopoietic malignancies and solid cancers and the overexpression of PIMs is associated with a poor prognosis and decreased survival of patients suffering from cancer. In many cases also, PIM overexpression was associated with development of drug resistance. As dual and simultaneous inhibition of various pathway components is an emerging therapeutic idea, exemplified by several compounds in development for cancer treatment, we have developed a series of dual PIM/FLT3 small molecule inhibitors to investigate this concept. Similarly to examples of small molecule inhibitors from the JAK/STAT or PI3K/AKT pathways, where compounds are being developed as a way to improve efficacy, resistance development and overcoming the negative feedback loops, often seen after single target inhibition, we have observed increased potency of compounds developed in this series of dual PIM/FLT3 inhibitors. Synthesized inhibitors showed higher activity towards mutated FLT3 (FLT3-ITD and other FLT3 mutants) than wild type kinase and the selectivity profile on a panel of 450 kinases was comparable to best clinical examples of kinase inhibitors. In contrast to selective PIM inhibitors, the treatment with dual PIM/FLT3 inhibitors showed potent apoptosis induction as a results of Erk and S6 phosphorylation inhibition. The in vitro activity in FTL3-ITD positive cells was also confirmed in vivo in a PK/PD xenograft experiment, where sustained biomarker inhibition was observed already after single compounds administration. Oral administration of dual PIM/FLT3 inhibitors led to potent effect in vivo and in certain cases also to remissions in subcutaneous xenograft models. Observed activity profile and synergistic effects observed with other targeted therapies and standard of care compounds, makes dual PIM/FLT3 inhibitors an exciting approach for treatment of FLT3-mutant positive AML patients with high chances of clinical success.

Citation Format: Wojciech Czardybon, Michal Galezowski, Renata Windak, Magdalena Salwińska, Izabela Dolata, Ewa Trebacz, Radosław Obuchowicz, Pawel Guzik, Magdalena Zawadzka, Ewelina Wincza, Katarzyna Wiklik, Mariusz Milik, Malgorzata Zurawska, Karolina Krawczynska, Krzysztof Brzózka. Identification of potent, dual PIM/FLT3 kinase inhibitors for AML treatment. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3245. doi:10.1158/1538-7445.AM2013-3245

[Promoting remyelination in multiple sclerosis by endogenous adult neural stem/precursor cells]

Although the treatment of multiple sclerosis has made significant strides in the last decade, successful translation from laboratory to clinical medicine of neuronal repair remains a therapeutic challenge. Nevertheless, advances in the biology of stem and precursor cells, particularly in relation to myelin damage, make this a realistic proposition during the next decade. Replacing lost myelin (remyelination) is currently thought to be an important clinical objective because of the role it might play in slowing or preventing axonal degeneration. Stem/precursor cell-based strategies for enhancing remyelination can be divided into those in which cell are transplanted into a patients (exogenous or cell therapies) and those in which the patients own stem/precursor cells are mobilised to more efficiently engage in healing areas of demyelination (endogenous or pharmacological therapies). While the two approaches tend to be regarded separately they are not mutually exclusive. This article focuses on the endogenous approach and reviews the nature and nomenclature of the stem and precursor cells present within the adult CNS that engage in remyelination and that are therefore potential targets for pharmacological manipulation.

[Should sinus rhythm be restored in patients with chronic atrial fibrillation? Preliminary results from the Polish "Hot Cafe" study]

Atrial fibrillation (AF) is the most common arrhythmia occurring in clinical practice. It is the most frequent cause of hospitalization in cardiac rhythm disturbance. Despite comprehensive progress in the research into electrophysiological mechanisms leading to this loss of normal rhythm and new procedures dealing with it, the main problem being the conversion to and maintaining the normal sinus rhythm (SR) has not been solved. The polish study "Hot Cafe" is trying to evaluate the advantages and risks of the two procedures widely used in clinical practice in patients (pts) with chronic AF, i.e. conversion and maintaining SR vs leaving pts with the arrhythmia. Pts with non-valvular chronic AF fulfilling the criteria for including them into the sample are randomly assigned to two procedures: conversion to SR by means of direct current cardioversion and maintaining it or leaving pts with AF. Pts left with AF are treated by rate control and antithrombotic treatment. The project is of prospective kind and it will be carried out by many medical institutions. It is planned to include 200 pts. The observation period will last at least 12 months. Preliminary results after inclusion of the first 121 pts are shown.

Egg shells of mallophagans and anoplurans (Insecta: Phthiraptera): morphogenesis of specialized regions and the relation to F-actin cytoskeleton of follicular cells

The egg shells of investigated phthirapterans consist of three basic elements: an anterior operculum, a main egg shell and a posterior hydropyle. In some species these elements show further regional specializations: bristles and projections that facilitate attachment to feathers of the host, micropyles and aeropylar openings. All of the egg shell specializations are formed by distinct subpopulations of follicular cells. Staining with rhodamine-conjugated phalloidin has revealed that these subpopulations significantly differ in the distribution of microfilaments (F-actin). In this respect four morphological categories of the follicular cells have been distinguished: (1) cells devoid of processes and microvilli, with basal arrays of microfilaments, responsible for the secretion of a flat chorion; (2) cells devoid of processes and microvilli, separated by intercellular spaces, with basal arrays of microfilaments, responsible for the secretion of attachment structures; (3) cells equipped with actin-containing processes, responsible for the formation of micropyles or aeropyles, and (4) cells equipped with bundles of microvilli, responsible for the formation of hydropyles.

[Effect of low-dose recombinant humane erythropoietin therapy on the quality of life in patients with anemia in the course of end-stage renal failure treated with dialysis]

The aim of the study was to assess the efficacy of low-dose subcutaneous recombinant human erythropoietin (rHuEpo) therapy in hemodialysis patients with particular emphasis on their quality of life. Twenty five anemic (Ht25%) patients (14 males and 11 females, age 39-13 years) with end-stage renal disease were given rHuEpo (initial dose: 52.5 +/- 2.5 IU/kg/week; maintenance dose: 67.0-10.5 IU/kg/week) once or twice weekly for 12 months. Quality of life, assessed by self-administered questionnaire (1-3 scale), was measured every month. Additionally, sexual functions (-1 up to 3 scale, basal level 0), including libido and sexual satisfaction, and serum sex hormones (testosterone, LH, FSH, prolactin) were evaluated every 6 months. During first 4 months of the therapy there was a significant increase of Ht (21.1 +/- 0.5% vs 28.5 +/- 0.6%; p < 0.0001), which was maintained for the whole study period. From the 3rd month in majority of patients a marked (p < 0.01) improvement in their physical fitness, mood and cold tolerance was noted. Despite a substantial increase in sexual satisfaction (p < 0.01) and libido (p < 0.001), no significant changes in serum sex hormones profile, except transient rise in serum prolactin level, were observed. It is concluded that low-dose rHuEpo therapy for the renal anemia of hemodialysis patients is associated with a sustained significant improvement in their quality of life and sexual functions, despite no significant changes in sex hormones serum levels.

[Evaluation of treating anemia in patients undergoing chronic dialysis with small doses of human recombinant erythropoietin]

The aim of the study was to assess the efficacy of low dose subcutaneous (sc) recombinant human erythropoietin (rHuEpo) therapy in hemodialysis (hd) patients, with particular emphasis on their quality of life. 25 anemic (Ht < 25%) hd patients with end-stage renal disease were given small sc doses of rHuEpo once or twice weekly for 12 months. During first 4 months of the therapy there was a significant increase of Ht (21.1 +/- 0.5 vs 28.5 +/- 0.6%; p < 0.0001) and serum hb (6.68 +/- 0.12 vs 8.51 +/- 0.18 g/dl; p < 0.0001) at mean induction dose of 52.5 +/- 2.5 IU/kg/week and this was maintained with a mean dose 67.0 +/- 10.5 IU/kg/week. RHuEpo was effective in 24 patients; all of them required no blood transfusions after starting the therapy. In majority of patients an substantial (p < 0.01) improvements in exercise tolerance, well-being, cold tolerance, sexual satisfaction and libido were observed, although sexual hormones profile revealed no significant changes during the treatment. Within first 6 months of the study cardiac index decreased substantially (p < 0.01), mainly because of stroke volume reduction, but after one year this hemodynamic improvement was noted only in patients who maintained a stable blood pressure. Hypertension worsened in 31% of patients. Low-dose s.c. rHuEpo: (1) is effective and safe treatment for anemia in hds patients, sufficient to abolish blood transfusion requirements; (2) produces significant improvements in quality of life; and (3) allows for 50% costs reduction.