Aqueous alteration processes in Jezero crater, Mars-implications for organic geochemistry

The Perseverance rover landed in Jezero crater, Mars, in February 2021. We used the Scanning Habitable Environments with Raman and Luminescence for Organics and Chemicals (SHERLOC) instrument to perform deep-ultraviolet Raman and fluorescence spectroscopy of three rocks within the crater. We identify evidence for two distinct ancient aqueous environments at different times. Reactions with liquid water formed carbonates in an olivine-rich igneous rock. A sulfate-perchlorate mixture is present in the rocks, which probably formed by later modifications of the rocks by brine. Fluorescence signatures consistent with aromatic organic compounds occur throughout these rocks and are preserved in minerals related to both aqueous environments.

Gas Migration Episodes Observed During Peridotite Alteration in the Samail Ophiolite, Oman

Serpentinization and carbonation of mantle rocks (peridotite alteration) are fundamentally important processes for a spectrum of geoscience topics, including arc volcanism, earthquake processes, chemosynthetic biological communities, and carbon sequestration. Data from a hydrophone array deployed in the Multi-Borehole Observatory (MBO) of the Oman Drilling Project demonstrates that free gas generated by peridotite alteration and/or microbial activity migrates through the formation in discrete bursts of activity. We detected several, minutes-long, swarms of gas discharge into Hole BA1B of the MBO over the course of a 9 month observation interval. The episodic nature of the migration events indicates that free gas accumulates in the permeable flow network, is pressurized, and discharges rapidly into the borehole when a critical pressure, likely associated with a capillary barrier at a flow constriction, is reached. Our observations reveal a dynamic mode of fluid migration during serpentinization, and highlight the important role that free gas can play in modulating pore pressure, fluid flow, and alteration kinetics during peridotite weathering.

Tracing Carbonate Formation, Serpentinization, and Biological Materials With Micro-/Meso-Scale Infrared Imaging Spectroscopy in a Mars Analog System, Samail Ophiolite, Oman

Visible-shortwave infrared (VSWIR) imaging spectrometers map composition remotely with spatial context, typically at many meters-scale from orbital and airborne data. Here, we evaluate VSWIR imaging spectroscopy capabilities at centimeters to sub-millimeter scale at the Samail Ophiolite, Oman, where mafic and ultramafic lithologies and their alteration products, including serpentine and carbonates, are exposed in a semi-arid environment, analogous to similar mineral associations observed from Mars orbit that will be explored by the Mars-2020 rover. At outcrop and hand specimen scales, VSWIR spectroscopy (a) identifies cross-cutting veins of calcite, dolomite, magnesite, serpentine, and chlorite that record pathways and time-order of multiple alteration events of changing fluid composition; (b) detects small-scale, partially altered remnant pyroxenes and localized epidote and prehnite that indicate protolith composition and temperatures and pressures of multiple generations of faulting and alteration, respectively; and (c) discriminates between spectrally similar carbonate and serpentine phases and carbonate solid solutions. In natural magnesite veins, minor amounts of ferrous iron can appear similar to olivine's strong 1-μm absorption, though no olivine is present. We also find that mineral identification for carbonate and serpentine in mixtures with each other is strongly scale- and texture-dependent; ∼40 area% dolomite in mm-scale veins at one serpentinite outcrop and ∼18 area% serpentine in a calcite-rich travertine outcrop are not discriminated until spatial scales of <∼1-2 cm/pixel. We found biological materials, for example bacterial mats versus vascular plants, are differentiated using wavelengths <1 μm while shortwave infrared wavelengths >1 μm are required to identify most organic materials and distinguish most mineral phases.

Tafasitamab combined with idelalisib or venetoclax in patients with CLL previously treated with a BTK inhibitor

Patients with relapsed/refractory chronic lymphocytic leukemia (R/R CLL) whose treatment failed with a Bruton's tyrosine kinase inhibitor have poor outcomes. We investigated tafasitamab plus idelalisib (cohort A) or venetoclax (cohort B) in this patient population in a phase II study (NCT02639910). In total, 24 patients were enrolled (cohort A: n = 11, median time on study, 7.4 months; cohort B: n = 13, median time on study, 15.6 months). The most common treatment-emergent adverse event (TEAE) in cohort A was anemia (63.6%) and in cohort B was infusion-related reaction (53.8%). The most common severe TEAE was neutropenia (cohort A: 45.5%; cohort B: 46.2%). The best overall response rate was 90.9% (cohort A) and 76.9% (cohort B). Undetectable minimal residual disease in peripheral blood was achieved in 2/8 patients (cohort A) and 6/7 patients (cohort B). Overall, these results suggest that anti-CD19 antibody-based combinations may be important in the treatment of patients with CLL.

Ambient weathering of magnesium oxide for CO2 removal from air

To avoid dangerous climate change, new technologies must remove billions of tonnes of CO₂ from the atmosphere every year by mid-century. Here we detail a land-based enhanced weathering cycle utilizing magnesite (MgCO₃) feedstock to repeatedly capture CO₂ from the atmosphere. In this process, MgCO₃ is calcined, producing caustic magnesia (MgO) and high-purity CO₂. This MgO is spread over land to carbonate for a year by reacting with atmospheric CO₂. The carbonate minerals are then recollected and re-calcined. The reproduced MgO is spread over land to carbonate again. We show this process could cost approximately $46-159 tCO₂^-1 net removed from the atmosphere, considering grid and solar electricity without post-processing costs. This technology may achieve lower costs than projections for more extensively engineered Direct Air Capture methods. It has the scalable potential to remove at least 2-3 GtCO₂ year^-1, and may make a meaningful contribution to mitigating climate change.

CYP46A1 variants influence Alzheimer’s disease risk and brain cholesterol metabolism

Background

Cholesterol 24S-hydroxylase (CYP46) catalyzes the conversion of cholesterol to 24S-hydroxycholesterol, the primary cerebral cholesterol elimination product. Only few gene variations in CYP46 gene (CYP46A1) have been investigated for their relevance as genetic risk factors of Alzheimer’s disease (AD) and results are contradictory.

Methods

We performed a gene variability screening in CYP46A1 and investigated the effect of gene variants on the risk of AD and on CSF levels of cholesterol and 24S-hydroxycholesterol.

Results

Two of the identified 16 SNPs in CYP46A1 influenced AD risk in our study (rs7157609: p = 0.016; rs4900442: p = 0.019). The interaction term of both SNPs was also associated with an increased risk of AD (p = 0.006). Haplotypes including both SNPs were calculated and haplotype G–C was identified to influence the risk of AD (p = 0.005). AD patients and non-demented controls, who were carriers of the G–C haplotype, presented with reduced CSF levels of 24S-hydroxycholesterol (p = 0.001) and cholesterol (p < 0.001).

Conclusion

Our results suggest that CYP46A1 gene variations might act as risk factor for AD via an influence on brain cholesterol metabolism.

A multi-institutional analysis of intraoperative radiotherapy for early breast cancer: Does age matter?

BACKGROUND

Single-session intraoperative radiation therapy (IORT) minimizes treatment demands associated with traditional whole breast radiation therapy (WBRT) but outcomes on local disease control and morbidity among the elderly is limited.

METHODS

A multi-institutional retrospective registry was established from 19 centers utilizing IORT from 2007 to 2013. Patient, tumor, and treatment variables were analyzed for ages <70 and ≥70.

RESULTS

We evaluated 686 patients (<70 = 424; ≥70 = 262) who were margin and lymph node negative. Patients <70 were more likely to have longer operative time, oncoplastic closure, higher rates of IORT used as planned boost, and receive chemotherapy and post-operative WBRT. Wound complication rates were low and not significantly different between age groups. Median follow-up was 1.06 (range 0.51-1.9) years for < 70 and 1.01 (range 0.5-1.68) years for ≥ 70. There were 5 (0.73%) breast recurrences (4 in <70 and 1 ≥ 70, p = 0.65) and no axillary recurrences during follow-up.

CONCLUSIONS

IORT was associated with a low rate of wound complication and local recurrence on short-term follow-up in this cohort.

COSMOS: MOR208 plus idelalisib or venetoclax in patients with relapsed or refractory (R/R) chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) previously treated with a Bruton's tyrosine kinase inhibitor (BTKi)—A two-cohort phase II study

TPS7567

Background: Patients (pts) with R/R CLL who discontinue treatment with the BTKi ibrutinib due to progression have a particularly dismal prognosis. A phase I study showed that the Fc-enhanced, humanized, CD19 antibody MOR208 was well tolerated with encouraging single-agent activity in pts with R/R CLL/SLL. In preclinical models, MOR208 showed synergy with idelalisib (an inhibitor of PI3K delta) and venetoclax (an inhibitor of BCL-2), both approved for the treatment of CLL. Methods: This two-cohort, phase II study will investigate MOR208 combined with idelalisib (cohort A) or venetoclax (cohort B) in pts with R/R CLL or R/R SLL and includes a safety run-in phase for each cohort, to be evaluated by an Independent Data Monitoring Committee. Key inclusion criteria: aged ≥18 years, R/R CLL/SLL while receiving a BTKi therapy or intolerance of such therapy, BTKi administered as a single-agent or in combination for at least 1 month as the most recent prior anticancer therapy, ECOG performance status of 0–2, and adequate organ function. Key exclusion criteria: transformed CLL/SLL or Richter’s syndrome, BTKi treatment within 5 days prior to study drug dosing, prior treatment with a CD19-targeted therapy, a PI3K inhibitor (cohort A) or a BCL-2 inhibitor (cohort B). Pts will be treated for a maximum of 24 (28-day) cycles or until disease progression. Treatment will be MOR208 12 mg/kg IV (weekly for the first 3 months, every second week for the next 3 months, and monthly thereafter) in combination with oral idelalisib 150 mg twice-daily or venetoclax administered on a weekly ramp-up dosing schedule to the recommended daily dose of 400 mg. Primary endpoint: overall response rate based on independent review; secondary and exploratory endpoints include: progression-free and overall survival, duration of response, safety, pharmacokinetics, MOR208 immunogenicity, quality of life and minimal residual disease negativity. 120 pts per cohort are planned. Clinical trial information: 2015-002915-14.

Geological and Geochemical Controls on Subsurface Microbial Life in the Samail Ophiolite, Oman

Microbial abundance and diversity in deep subsurface environments is dependent upon the availability of energy and carbon. However, supplies of oxidants and reductants capable of sustaining life within mafic and ultramafic continental aquifers undergoing low-temperature water-rock reaction are relatively unknown. We conducted an extensive analysis of the geochemistry and microbial communities recovered from fluids sampled from boreholes hosted in peridotite and gabbro in the Tayin block of the Samail Ophiolite in the Sultanate of Oman. The geochemical compositions of subsurface fluids in the ophiolite are highly variable, reflecting differences in host rock composition and the extent of fluid-rock interaction. Principal component analysis of fluid geochemistry and geologic context indicate the presence of at least four fluid types in the Samail Ophiolite (“gabbro,” “alkaline peridotite,” “hyperalkaline peridotite,” and “gabbro/peridotite contact”) that vary strongly in pH and the concentrations of H₂, CH₄, Ca²⁺, Mg²⁺, NO3-, SO42-, trace metals, and DIC. Geochemistry of fluids is strongly correlated with microbial community composition; similar microbial assemblages group according to fluid type. Hyperalkaline fluids exhibit low diversity and are dominated by taxa related to the Deinococcus-Thermus genus Meiothermus, candidate phyla OP1, and the family Thermodesulfovibrionaceae. Gabbro- and alkaline peridotite- aquifers harbor more diverse communities and contain abundant microbial taxa affiliated with Nitrospira, Nitrosospharaceae, OP3, Parvarcheota, and OP1 order Acetothermales. Wells that sit at the contact between gabbro and peridotite host microbial communities distinct from all other fluid types, with an enrichment in betaproteobacterial taxa. Together the taxonomic information and geochemical data suggest that several metabolisms may be operative in subsurface fluids, including methanogenesis, acetogenesis, and fermentation, as well as the oxidation of methane, hydrogen and small molecular weight organic acids utilizing nitrate and sulfate as electron acceptors. Dynamic nitrogen cycling may be especially prevalent in gabbro and alkaline peridotite fluids. These data suggest water-rock reaction, as controlled by lithology and hydrogeology, constrains the distribution of life in terrestrial ophiolites.

Objective decision making between conventional and oncoplastic breast-conserving surgery or mastectomy: An aesthetic and functional prospective cohort study

BACKGROUND

Breast-conserving surgery (BCS) is considered the standard treatment for early-stage breast cancer. However, fair to poor cosmetic outcomes following conventional BCS have been observed in as many as one-third of cases. The aim of this study was to determine the critical tumor-to-breast volume ratio for each quadrant of the breast beyond which conventional BCS would no longer offer acceptable cosmetic and functional results or satisfactory quality of life for the patient.

METHODS

A prospective cohort study was performed between December 2011 and December 2013 involving 350 patients younger than 70 years with early-stage unifocal (T ≤ 30 mm) breast cancer who underwent wide excision and axillary sentinel lymph node biopsy followed by whole-breast irradiation. Using validated panels and software (the Breast Cancer Treatment Outcome Scale [BCTOS], EORTC Cancer Quality of Life Questionnaire number C30-BR23, and Breast Cancer Conservative Treatment - cosmetic results [BCCT.core] software), quality of life and aesthetic and functional parameters and their changes in correlation to the percentage of breast volume excised were statistically analyzed.

RESULTS

The maximum percentages of breast volume that were resectable by conventional BCS without resulting in unacceptable aesthetic and functional outcomes or decreased quality of life were 18-19% in the upper-outer quadrant (p < 0.0001), 14-15% in the lower-outer quadrant (p < 0.0001), 8-9% in the upper-inner quadrant (p < 0.0001), and 9-10% in the lower-inner quadrant (p < 0.0001).

CONCLUSION

Aided by the calculated cut-off values for each breast quadrant, breast surgeons might render more objective decisions regarding performing conventional BCS, using oncoplastic techniques or choosing mastectomy with immediate reconstruction.

Does breast screening offer a survival benefit? A retrospective comparative study of oncological outcomes of screen-detected and symptomatic early stage breast cancer cases

INTRODUCTION

Mammography screening reduces breast cancer mortality by up to 32%. However, some recent studies have questioned the impact of non-palpable breast cancer detection on mortality reduction. The aim of this study was to analyse the clinicopathological and long-term follow-up data of early stage screened and symptomatic breast cancer patients.

PATIENTS AND METHOD

The institutional prospectively led database was systematically analysed for breast cancer cases diagnosed via the mammography screening program from 2002 to 2009. As a control group, symptomatic early stage breast cancer patients were collected randomly from the same database and matched for age and follow-up period. All medical records were reviewed retrospectively.

RESULTS

Data from 298 breast cancer patients were collected from 47,718 mammography screenings. In addition, 331 symptomatic breast cancer patients were randomly selected. The screened group presented a significantly lower median tumour size (P < 0.00001). The incidence of negative regional lymph nodes was significantly higher in the screened group (P < 0.0006). The incidence of chemotherapy was 17% higher in the symptomatic group (P = 4*10^-5). At the median follow-up of 65 and 80 months, the screened group did not exhibit better overall (P = 0.717) or disease-free survival (P = 0.081) compared to the symptomatic group.

CONCLUSION

Our results do not suggest that mammography screening does not reduce breast cancer mortality but the mammography screening did not bring any significant improvement in patient overall or disease-free survival for the early stage breast cancer patients compared to the symptomatic group. The drawback of symptomatic early stage tumours compared to non-palpable tumours could be equalized by modern multimodality oncology treatments.

Effect of octreotide LAR on quality of life of 93 Hungarian patients with neuroendocrine tumors

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Background: Studies have shown that health-related quality of life (HRQoL) of patients with neuroendocrine tumors (NET) is lower compared to the general population in the US and Norway. Secretory symptoms associated with functional NET (diarrhea/flushing) contribute to worsened HRQoL but may be controlled with the somatostatin analog octreotide long-acting repeatable (LAR). To date, there have been limited assessments of specific drug effects on HRQoL in patients with NET. The purpose of this study was to assess the effect of octreotide LAR treatment on HRQoL.

Methods: 93 Hungarian patients with gastroenteropancreatic NET who were treated with octreotide LAR participated in a multicenter observational study from 2005 to 2007. At study entry and 4 quarterly follow-up visits, patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) questionnaire. A mixed model was used to analyze the data and confirm significance.

Results: 91 patients (mean age = 61 years) were evaluable for QoL assessments. Overall, patients reported improvements in diarrhea, global health status, emotional functioning, and financial difficulties but worsening in role functioning, pain, and insomnia. There were some differences in trends, depending on the tumor site, but diarrhea still improved in all patient categories. Women reported lower global health status compared to men, including more fatigue, nausea/vomiting, pain, dyspnea, and constipation. Elderly patients >70 years did not report any lessening of overall global health status scores compared to younger patients; older patients did experience less nausea/vomiting and pain but more constipation and diarrhea. In addition, patients diagnosed <2 years had slightly lower global health status than patients diagnosed >2 years earlier.

Conclusions: Patients with NET who were treated with octreotide LAR had improvements in global health status and diarrhea. Interesting trends were noted in different patient populations, depending on tumor site, gender, or age. Additional analysis is planned to assess changes as measured by the GI NET disease-specific module of EORTC that was also applied to patients.

RXRA gene variations influence Alzheimer's disease risk and cholesterol metabolism

Cholesterol metabolism is altered in Alzheimer's disease (AD). The nuclear hormone receptor Retinoic X Receptor a (RXRa) is a member of the nuclear ligand-activated transcription factor family. RXRs are key regulators of cholesterol synthesis and thus cholesterol metabolism. We performed a systematic screen for gene variants in the RXRA gene. The effect of these gene variants on the risk of AD was investigated in 405 AD patients (mean age: 74.27 +/- 9.37 years; female 78.6%) and 347 controls (mean age: 73.26 +/- 8.37 years; female 57.2%). Furthermore, the influence of RXRA gene variants on CSF and plasma levels of cholesterol, lathosterol and 24S-hydroxycholesterol were evaluated. One of the identified seven SNPs in RXRA influenced AD risk in our single marker analysis (rs3132293: P= 0.006). Haplotype analysis identified a three-marker haplotype (TGC) consisting of rs3118570, rs1536475 and rs3132293, which decreased the risk of AD (P= 0.009). The single marker rs3132293 (P= 0.026) and the TGC haplotype (P= 0.026) influenced CSF lathosterol levels in non-demented controls, and cholesterol levels in the combined sample comprising AD patients and controls (Rs3132293: P= 0.050; TGC haplotype: P= 0.035). 24S-Hydroxycholesterol CSF and plasma levels were also influenced by rs3132293 (CSF: P= 0.004; plasma: P= 0.001) and the TGC haplotype (CSF: P= 0.004; plasma: P= 0.002); this effect was most pronounced in AD patients (rs3132293: CSF: P= 0.009, plasma: P= 0.002; TGC haplotype: CSF: P= 0.019, plasma: P= 0.005). Our results suggest that RXRA gene variants might act as risk factor for AD via an influence on cerebral cholesterol metabolism.

Association of CETP polymorphisms with the risk of vascular dementia and white matter lesions

Cholesteryl ester transfer protein (CETP), a component of the high density lipoprotein (HDL), plays a central role in reverse cholesterol transport. We investigated the association of two putative functional CETP polymorphisms (C-629A and I405V) with the risk of vascular dementia (VD) and tested if this association is influenced by the presence of APOE4 allele. Our study included 163 VD patients (mean age: 74.25 +/- 7.9 years) and 452 cognitively healthy probands (mean age: 70.81 +/- 7.9 years). As a biological correlate, the association of CETP gene variants with white matter lesion (WML) load was investigated. Neither the C-629A (P = 0.169) nor the I405V (P = 0.840) polymorphism was associated with VD risk in the whole sample. However, in non-carriers of the APOE4 allele, homozygote carriers of the CETP C-629A A allele presented with an increased risk of VD (P = 0.01). Whereas in APOE4 carriers, no association of CETP polymorphisms with VD risk was detected. In addition, carriers of the CETP C-629A AA genotype presented with decreased WML load in the frontal brain (P = 0.009). Our results suggest that CETP gene polymorphisms might influence WML load and the risk of VD, the latter in non-carriers of the APOE4 allele.

Gene variations in GSTM3 are a risk factor for Alzheimer's disease

Oxidative stress is a relevant pathomechanism in Alzheimer's disease (AD) and gene variations in the glutathione S-transferase M3 gene (GSTM3), involved in the detoxification of oxygen radicals, might influence the risk of AD. We investigated the effect of three polymorphisms in GSTM3: rs1332018 (C/A); rs1799735 (del/AGG); rs7483 (G/A), on the risk of AD in 363 AD patients and 358 healthy controls. Single marker association analyses revealed that the AGG/AGG genotype of the GSTM3 rs1799735 (del/AGG) polymorphism was associated with an increased risk of AD (p=0.05), especially in the group of APOE4-allele non-carriers (p=0.004; OR=2.07). Examination of the haplotypes identified a two-marker haplotype (C/AGG) consisting of rs1332018 (C/A) and rs1799735 (del/AGG) to increase the risk of AD (p=0.029), this effect was also most prevalent in APOE4-allele non-carriers (p=0.009; OR=1.95). The population attributable risk of this haplotype in APOE4-allele non-carriers was 32.2%. Our results suggest that there is a group of AD patients in which variations in metabolism of oxidative stress play an important role.

Cowden Syndrome as an indication for bilateral prophyllactic mastectomy: A series of two cases

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Background: Multiple hamartoma syndrome, or Cowden Syndrome, is an autosomal dominant disorder which predisposes toward neoplasms in the thyroid, colon, and breast. Chemoprevention in women with a genetic predisposition toward breast cancer has not yet been shown to be beneficial in prospective data. Bilateral prophylactic mastectomy (BMP) has emerged as a viable option for women with suspected genetic predispositions toward breast cancer, with an estimated risk reduction of around 90 percent. Our search of the literature has not detected any case series of BMP in the Cowden Syndrome patients. Methods: We present two women presenting with historical and physical evidence for this Cowden Syndrome with desire to undergoing PBM. Results: Both women successfully underwent subcutaneous bilateral mastectomy with immediate reconstruction. (See table ) They are both alive without evidence of breast cancer to date. Conclusions: Cowden Syndrome can be added to other genetic syndromes with clear predispositions toward breast cancer, and presents an option for prophylactic bilateral mastectomy in women who desire a risk reduction for breast cancer.

[Table: see text]

No significant financial relationships to disclose.

Modified tensor fascia lata musculofasciocutaneous flap for the coverage of trochanteric pressure sores

The method most frequently used for the coverage of trochanteric pressure sores is the tensor fascia lata (TFL) flap. The authors introduce a new, hatchet-shaped incision strategy for the TFL flap, which preserves the safe blood supply of the flap and keeps the flap mobile enough. The part of the flap including the muscle is adapted to the greater trochanter. This provides a good aesthetic result without dog-ear formation at the rotation point of the flap. The donor site is closed in a V-Y fashion, and the closure does not require any skin grafting or designing a local flap. The TFL hatchet flap was used nine times on eight patients to cover trochanteric pressure sores. With one exception all patients healed. No recurrence was observed during the follow-up period, and no contour difference developed on the lateral aspect of the thigh.

Reversible Binding of Multivalent Ions by Surfactant Self-Assembly

High molecular weight nonionic surfactants have been chemically modified to bind multivalent ions reversibly by using a moderate temperature stimulus as an on/off mechanism. Only above the critical micellization temperature (CMT) does binding of multivalent ions take place, whereas below the CMT, no binding occurs to the free surfactant molecules. Different calorimetric techniques have been used to prove the reversible binding of multivalent ions. This tunable binding of multivalent metal ions allows for the improvement of many ion-exchange processes and offers attractive opportunities in the biomedical field.

Hyporesponsiveness in alloreactive T-cells by NF-kappaB inhibitor-treated dendritic cells: resistance to calcineurin inhibition

Dendritic cells (DC) are the most potent antigen-presenting cells (APC) initiating primary T-cell responses. Beyond this immunostimulatory function, certain DC subsets have been shown to induce T-cell tolerance in vitro and in vivo. In this study, immature monocyte-derived DC were activated in the presence of the NF-kappaB inhibitor pyrrolidine dithiocarbamate (PDTC) and characterized with regard to phenotype, cytokine production and allostimulatory potential. Furthermore, the functional consequences of calcineurin inhibition were studied in T cells exposed to PDTC-modulated DC. We demonstrate that PDTC treatment of DC leads to an arrest in maturation as reflected by down-regulated major histocompatibility complex (MHC) antigens and costimulatory molecules, suppressed immunostimulatory cytokines and an impaired capability to support allogeneic T-cell activation. Allogeneic T cells challenged with PDTC-treated DC are refractory upon restimulation with alloantigens but not to polyclonal stimuli. Interestingly, the successful establishment of alloantigenic hyporesponsiveness is not prevented by concomitant calcineurin inhibition in vitro as well as in T cells from patients under cyclosporine A (CsA)-based immunosuppression ex vivo. These data may have important implications for the design of clinical regimens for the establishment of antidonor hyporeactivity in organ transplantation using in vitro-modulated DC.

Prevention of CD40-triggered dendritic cell maturation and induction of T-cell hyporeactivity by targeting of Janus kinase 3

Pharmacological targeting of Janus kinase 3 (JAK3) has been employed successfully to control allograft rejection and graft-vs.-host disease (GVHD). Recent evidence suggests that in addition to its involvement in common-gamma chain (cgamma) signaling of cytokine receptors, JAK3 is also engaged in the CD40 signaling pathway of peripheral blood monocytes. In this study, we assessed the consequences of JAK3 inhibition during CD40-induced maturation of myeloid dendritic cells (DCs), and tested the impact thereof on the induction of T-cell alloreactivity. Dendritic cells triggering through CD40 induced JAK3 activity, the expression of costimulatory molecules, production of IL-12, and potent allogeneic stimulatory capacity. In contrast, JAK3 inhibition with the rationally designed JAK3 inhibitor WHI-P-154 prevented these effects arresting the DCs at an immature level. Interestingly, DCs exposed to the JAK3-inhibitor during CD40-ligation induced a state of hyporeactivity in alloreactive T cells that was reversible upon exogenous IL-2 supplementation to secondary cultures. These results suggest that immunosuppressive therapies targeting the tyrosine kinase JAK3 may also affect the function of myeloid cells. This property of JAK3 inhibitors therefore represents a further level of interference, which together with the well-established suppression of cgamma signaling could be responsible for their clinical efficacy.

15N NMR spectroscopy of labeled alkoxyamines. 15N-labeled model compounds for nitroxide-trapping studies in free-radical (Co)polymerization

Eight (15)N-labeled derivatives of 1-ethoxy-2,2,6,6-tetramethylpiperidine were synthesized in order to investigate the effects of their structural units on (15)N NMR spectra. A single peak is found for each alkoxyamine. The chemical shift depends extensively on the nature of the alpha carbon atom of the alkoxy group. The remote functional group attached to position 4 of the piperidine ring has a smaller but still significant effect. The results of the (15)N NMR measurements are supported by the detection of the N-H and N-C spin-spin coupling from the (1)H and (13)C NMR. The investigated alkoxyamines are model compounds for the radical-trapping products of styryl, methyl methacryloyl, alpha-methylstyryl, and methyl acryloyl radicals by (15)N-labeled nitroxides. The potential of (15)N NMR spectroscopy to analyze such products is discussed. In addition, it is shown that the (13)C chemical shifts of the alpha carbon atom of the alkoxy group fall in an empty part of the (13)C NMR spectrum, which allows the identification of trapped (macro)radicals via natural abundance (13)C NMR.

Suppression of early T-cell-receptor-triggered cellular activation by the Janus kinase 3 inhibitor WHI-P-154

BACKGROUND

Therapeutic targeting of Janus kinase 3 (JAK3) has received particular attention, because it is associated with the common gamma signaling of cytokine receptors and thus vitally influences T-cell growth and survival. Recent evidence, however, indicates a critical role for JAK3 in signaling linked to the T-cell antigen receptor.

METHODS

In this study we investigated whether targeting JAK3 with a rationally designed inhibitor affects early T-cell activation events. T cells were stimulated by CD3 and CD28 cross-linking, and interleukin (IL)-2 production, activation marker expression, increase of free intracellular Ca2+ concentration, activation of the extracellular-related kinase, and nuclear translocation of transcription factors were evaluated.

RESULTS

We found that JAK3 inhibitor treatment dramatically impaired T-cell-receptor (TCR)-induced IL-2 production, surface activation marker expression (CD69, CD154), and homotypic T-cell aggregation. Accordingly, mRNA production of IL-2, interferon-gamma, and IL-10 was profoundly inhibited. Molecular analysis revealed that TCR-triggered phosphorylation of phospholipase C-gamma1, increase in cytoplasmic Ca2+ concentration, and activation of extracellular-related kinase were markedly reduced by the JAK3 inhibitor, resulting in substantially decreased DNA binding of nuclear factor of activated T cells and alkaline phosphatase-1 and subsequent IL-2 promoter activation. Remarkably, on TCR-independent stimulation, IL-2 production, CD69 expression, and blast formation were completely insensitive to JAK3 inhibitor treatment.

CONCLUSION

These data indicate that pharmacologic targeting of JAK3 uncouples early TCR-triggered signaling from essential downstream events, which may have important implications for the use of such compounds in T-cell-mediated disorders such as allograft rejection or graft-versus-host disease.

Art v 1, the major allergen of mugwort pollen, is a modular glycoprotein with a defensin-like and a hydroxyproline-rich domain

In late summer, pollen grains originating from Compositae weeds (e.g., mugwort, ragweed) are a major source of allergens worldwide. Here, we report the isolation of a cDNA clone coding for Art v 1, the major allergen of mugwort pollen. Sequence analysis showed that Art v 1 is a secreted allergen with an N-terminal cysteine-rich domain homologous to plant defensins and a C-terminal proline-rich region containing several (Ser/Ala)(Pro)2-4 repeats. Structural analysis showed that some of the proline residues in the C-terminal domain of Art v 1 are posttranslationally modified by hydroxylation and O-glycosylation. The O-glycans are composed of 3 galactoses and 9-16 arabinoses linked to a hydroxyproline and represent a new type of plant O-glycan. A 3-D structural model of Art v 1 was generated showing a characteristic "head and tail" structure. Evaluation of the antibody binding properties of natural and recombinant Art v 1 produced in Escherichia coli revealed the involvement of the defensin fold and posttranslational modifications in the formation of epitopes recognized by IgE antibodies from allergic patients. However, posttranslational modifications did not influence T-cell recognition. Thus, recombinant nonglycosylated Art v 1 is a good starting template for engineering hypoallergenic vaccines for weed-pollen therapy.

The T cell response to Art v 1, the major mugwort pollen allergen, is dominated by one epitope

Mugwort (Artemisia vulgaris) pollen allergens represent the main cause of pollinosis in late summer in Europe. At least 95% of sera from mugwort pollen-allergic patients contain IgE against a highly glycosylated 24- to 28-kDa glycoprotein. Recently, this major allergen, termed Art v 1, was characterized, cloned in Escherichia coli, and produced in recombinant form. In the present study we characterized and compared the T cell responses to natural (nArt v 1) and recombinant Art v 1 (rArt v 1). In vitro T cell responses to nArt v 1 and rArt v 1 were studied in PBMC, T cell lines (TCL), and T cell clones (TCC) established from PBMC of mugwort-allergic patients. Stimulation of PBMC or allergen-specific TCL with either nArt v 1 or rArt v 1 resulted in comparable proliferative T cell responses. Eighty-five percent of the TCC reactive with rArt v 1 cross-reacted with the natural protein. The majority of the CD4(+)CD8(-)TCR alphabeta(+) Art v 1-specific TCC, obtained from 10 different donors, belonged to the Th2 phenotype. Epitope mapping of TCL and TCC using overlapping peptides revealed a single immunodominant T cell epitope recognized by 81% of the patients. Inhibition experiments demonstrated that the presentation of this peptide is restricted by HLA-DR molecules. In conclusion, the T cell response to Art v 1 is characterized by one strong immunodominant epitope and evidently differs from the T cell responses to other common pollen allergens known to contain multiple T cell epitopes. Therefore, mugwort allergy may be an ideal candidate for a peptide-based immunotherapy approach.

Bacterial metabolite interference with maturation of human monocyte-derived dendritic cells

Dendritic cells (DC), the most potent APC, are central to antimicrobial immunity. Because of evolutionary pressure, it is reasonable that pathogens have evolved strategies to also subvert this host-defense mechanism. In the present study, we describe a novel way of bacterial interference with DC maturation. The bacterial metabolite n-butyrate, which occurs physiologically in high concentrations in the gastrointestinal tract and has well-known anti-inflammatory effects, is able to prevent LPS-induced maturation of DC resulting in a reduced capability to stimulate T cells. In particular, n-butyrate prevents homotypic DC clustering, inhibits IL-12 while sparing IL-10 production, and at the molecular level, blocks NF-kappa B translocation. These results demonstrate efficient targeting of DC function by a bacterial metabolite, which might explain the particular type of immune responsiveness in the presence of this bacterial agent as exemplified in the gastrointestinal tract.

[The Hungarian translation of the "Dental Fear Survey" based on the Hungarian population]

Authors translated the "Dental Fear Survey" (DFS) into Hungarian. 196 persons have been investigated and the DFS values have been compared to DAS, STAI-S, STAI-T values. Mean values were: DFS: 46.27; DAS: 12.24; STAI-S: 41.58; STAI-T: 42.68. Authors found all values higher in the case of women comparing to men. Positive correlation has been found between DAS and DFS, but STAI-S and STAI-T increased only moderately comparing to the DAS and DFS values.

Universal application of intraoperative lymphatic mapping and sentinel lymphadenectomy in solid neoplasms

PURPOSE

Regional lymph node involvement is the most important prognostic indicator in patients with solid tumors. Conventional lymph node dissection has not been shown to affect survival and is often associated with considerable morbidity. Intraoperative lymphatic mapping and sentinel lymph node dissection were therefore designed as a minimally invasive alternative to routine elective lymph node dissection in patients with primary cutaneous melanoma. This study examined whether introperative lymphatic mapping and sentinel lymph node dissection were accurate in staging patients with other solid malignancies.

PATIENTS AND METHODS

Between 1985 and 1998, 107 patients with breast cancer, 17 with thyroid tumors, 14 with gastrointestinal/gynecologic cancers, six with Merkel cell cancers, and five with squamous cell carcinomas of the head and neck have undergone mapping and sentinel lymph node dissection at the John Wayne Cancer Institute.

RESULTS

The sentinel node was identified in 96% of patients (98% melanoma). In 36% of patients the sentinel node was the only tumor-positive node (71% melanoma). Eighteen percent of sentinel nodes were negative by hematoxylin and eosin staining but were positive by immunohistochemical staining (15% melanoma).

CONCLUSION

These data suggest that many solid neoplasms have a primary lymphatic channel and lymph node to which it drains. Although sentinel lymph node dissection has been popularized in melanoma therapy, we have found it feasible for treatment of other solid malignancies. This technique may ultimately replace conventional dissection with more accurate staging.

[Introduction of the concept of Dental Anxiety Scale in Hungary. Epidemiologic studies on the Hungarian population]

Authors translated the Corah's "Dental Anxiety Scale" (DAS) into Hungarian. 143 dental patients, and 74 dental student's, were investigated and the DAS values were compared to the State-Trait Anxiety Invertory (STAI-S and STAI-T) values. Mean values were: DAS: 9.92, STAI-S: 39.17, STAI-T: 41.34. Authors found lower scores in the case of dental students comparing to patients (p < 0.001), and women comparing to men (p < 0.001). DAS values increased slowly with age, and decreased at 60 years old, or older patients. Married patients had higher DAS and STAI-S scores, but lower STAI-T scores comparing to the unmarried and divorced patients.

[The use of hypnosis in stomatology]

It follows from the fore going that hypnosis itself can not cure, but it is a great possibility to use it as a supplementary method and a curing means in our practice. The treatment is applicable for stomatological interventions, and somatic diseases of psychic origin which have connections on our field. Thus hypnosis can effect out therapeutic-work very favourable.