Novel prediction models for hyperketonemia using bovine milk Fourier-transform infrared spectroscopy

Metabolic diseases driven by negative energy balance in dairy cattle contribute to reduced milk production, increased disease incidence, culling, and death. Cow side tests for negative energy balance markers are available but are labor-intensive. Milk sample analysis using Fourier transform infrared spectroscopy (FTIR) allows for sampling numerous cows simultaneously. FTIR prediction models have moderate accuracy for hyperketonemia diagnosis (beta-hydroxybutyrate (BHB) ≥ 1.2 mmol/L). Most research using FTIR has focused on homogenous datasets and conventional prediction models, including partial least squares, linear discriminant analysis, and ElasticNet. Our objective was to evaluate more diverse modeling options, such as deep learning, gradient boosting machine models, and model ensembles for hyperketonemia classification. We compiled a sizable, heterogeneous dataset including milk FTIR and concurrent blood samples. Blood samples were tested for blood BHB, and wavenumber data was obtained from milk FTIR analysis. Using this dataset, we trained conventional prediction models and other options listed above. We demonstrate prediction model performance is similar for convolutional neural networks and ensemble models to simpler algorithm options. Results obtained from this study indicate that deep learning and model ensembles are potential algorithm options for predicting hyperketonemia in dairy cattle. Additionally, our results indicate hyperketonemia prediction models can be developed using heterogeneous datasets.

Brain/blood ratios of methadone and ABCB1 polymorphisms in methadone-related deaths

Methadone is an opioid that often leads to fatalities. Interpretation of toxicological findings can be challenging if no further information about the case history is available. The aims of this study were (1) to determine whether brain/blood ratios can assist in the interpretation of methadone findings in fatalities; (2) to examine whether polymorphisms in the gene encoding the P-glycoprotein (also known as multidrug resistance protein 1 (MDR1) or ATP-binding cassette sub-family B member 1 (ABCB1)), which functions as a multispecific efflux pump in the blood–brain barrier, affect brain/blood ratios of methadone. Femoral venous blood and brain tissue (medulla oblongata and cerebellum) from 107 methadone-related deaths were analysed for methadone by gas chromatography-mass spectrometry. In addition, all the samples were genotyped for three common ABCB1 single nucleotide polymorphisms (SNPs rs1045642, rs1128503, and rs2032582) using ion-pair reversed-phase high-performance liquid chromatography-electrospray ionization mass spectrometry (ICEMS). In nearly all cases, methadone concentrations were higher in the brain than in the blood. Inter-individual brain/blood ratios varied (0.6–11.6); the mean ratio was 2.85 (standard deviation 1.83, median 2.35). Moreover, significant differences in mean brain/blood ratios were detected among the synonymous genotypes of rs1045642 in ABCB1 (p = 0.001). Cases with the T/T genotype had significantly higher brain/blood ratios than cases with the other genotypes (T/T vs. T/C difference (d) = 1.54, 95% CI [1.14, 2.05], p = 0.002; T/T vs. C/C d = 1.60, 95% CI [1.13, 2.29], p = 0.004). Our results suggest that the rs1045642 polymorphisms in ABCB1 may affect methadone concentrations in the brain and its site of action and may be an additional factor influencing methadone toxicity.

Exopolysaccharide from Bifidobacterium longum subsp. longum 35624™ modulates murine allergic airway responses

Interactions between the host and the microbiota are thought to significantly influence immunological tolerance mechanisms at mucosal sites. We recently described that the loss of an exopolysaccharide (EPS) from Bifidobacterium longum 35624™ eliminated its protective effects in colitis and respiratory allergy murine models. Our goal was to investigate the immune response to purified EPS from B. longum 35624, determine if it has protective effects within the lung and identify the protective mechanisms. Isolated EPS from B. longum 35624 cultures was used for in vitro, ex vivo and in vivo studies. Human monocyte-derived dendritic cells (MDDCs) were used to investigate in vitro immunological responses to EPS. Cytokine secretion, expression of surface markers and signalling pathways were examined. The ovalbumin (OVA) respiratory allergy murine model was used to evaluate the in vivo immunomodulatory potential of EPS. In addition, interleukin (IL)-10 knockout (KO) mice and anti-Toll-like receptor (TLR)-2 blocking antibody were used to examine the underlying protective mechanisms of intranasal EPS administration. Stimulation of human MDDCs with EPS resulted in IL-10 secretion, but not proinflammatory cytokines. IL-10 secretion was TLR-2-dependent. Eosinophil recruitment to the lungs was significantly decreased by EPS intranasal exposure, which was associated with decreased expression of the Th2-associated markers C-C motif chemokine 11 (CCL11), C-C chemokine receptor type 3 (CCR3), IL-4 and IL-13. TLR-2-mediated IL-10 secretion was shown to be required for the reduction in eosinophils and Th2 cytokines. EPS-treatment reduced eosinophil recruitment within the lung in a respiratory inflammation mouse model, which is both TLR-2 and IL-10 mediated. EPS can be considered as a novel molecule potentially reducing the severity of chronic eosinophil-related airway disorders.

Abstract P4-02-17: Polymerase Chain Reaction-Liquid Chromatography-Mass Spectrometry — A Convenient and Cost-Effective Strategy for CYP2D6 Genotyping

Background: Genetic polymorphisms in the drug metabolizing enzyme Cyotchrome P450 2D6 (CYP2D6) gene can significantly influence a person's ability to mediate CYP2D6 dependent metabolism. For example, a notable influence of the CYP2D6 genotype has been described regarding the conversion of tamoxifen to its pharmacologically active metabolites. Thus, the genetic determination of the CYP2D6 metabolizer status has the potential to represent a valuable therapeutic supplement in breast cancer therapy. However, the clinical relevance of the CYP2D6 genotype regarding the treatment of breast cancer with tamoxifen still remains to be elucidated. Due to the high number of relevant polymorphisms to be screened, pharmacogenetic CYP2D6 testing is considered to be time-consuming and laborious and is therefore limited to a few clinical studies only. To enable a more widespread use, we present polymerase chain reaction (PCR) - ion-pair reversed-phase high-performance liquid chromatography — electrospray ionization time of flight mass spectrometry (ICEMS) as fast, convenient and cost-effective strategy for CYP2D6 genotyping.

Material and Methods: After DNA extraction from saliva swabs, the CYP2D6 gene was amplified by a long range PCR. Subsequently, polymorphism-specific short amplicons were generated in a multiplexed PCR. The amplicons were directly analysed by ICEMS. The information necessary to determine the allelic state of a PCR-amplified polymorphic locus were obtained from the measured molecular masses. Gene duplications or deletions were analysed by a long range PCR protocol and subsequent agarose gel detection.

Results: The developed CYP2D6 genotyping approach enables the reliable determination of the most frequent CYP2D6 alleles in Europe (*1, *2, *3, *4, *6, *7, *8, *9, *10, *11, *12, *17, *41) including whole gene duplications and deletions (*5). The assay involves the following steps: (1) collecting biological material in form of non-invasive saliva swabs; (2) DNA extraction; (3) long range PCR for a specific CYP2D6 amplification; (3) multiplexed PCR for the generation of polymorphism-specific short amplicons; (4) direct analysis of the reaction mixture with ICEMS; (4) determination of the allelic state with the measured molecular masses; (5) analysis of gene duplications or deletions by a long range PCR protocol and subsequent agarose gel detection. Genotyping of a single sample costs about 5-10 USD and can be accomplished within 2-3 days. Parallelization increases the sample throughput and reduces costs. For proof of principle, we have applied the developed method in the context of the PRO-BETh study to determine the CYP2D6 status of 106 breast cancer patients treated with tamoxifen. According to the classification of Gaedik A. et al [1], 19% of the typed breast cancer patients turned out to be “Poor Metabolizers", 51% were “Intermediate Metabolizers", 29% were “Extensive Metabolizers” and 7% turned out to be “Ultrarapid Metabolizers”.

Conclusion: PCR-ICEMS represents a cost-effective and convenient tool for pharmacogenetic testing, which enables the determination of the CYP2D6 status using DNA obtained from a non-invasive saliva swab as template.

[1] Gaedigk A. et al, J. Clin Pharmacol Ther. 2007 Jun;81(6):817-20.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-02-17.

Sarcomatoid renal tumors. Clinicopathologic correlation of three cases

The clinical, light and ultrastructural features of three renal neoplasms demonstrating a sarcomatous appearance on light microscopic examination are reported. At the time of radical nephrectomy, all three tumors displayed aggressive features with capsular invasion and either metastases or invasion of adjacent organs. Ultrastructural examination revealed epithelial features in a pure spindle cell tumor and in a malignant fibrous histiocytoma-like tumor (sarcomatoid renal carcinoma) and smooth muscle differentiation (leiomyosarcoma) in a lesion showing features of malignant fibrous histiocytoma. All three patients died from 1 to 9 months after nephrectomy. Renal tumors with a sarcomatous histologic appearance are aggressive neoplasms that cannot be classified accurately solely by employing light microscopic criteria.

The treatment of rheumatoid arthritis with OM-8930, a bacterial immunostimulating agent

OM 8930, a bacterial product with immunostimulatory capacities, was studied for its efficacy in the long-term treatment of rheumatoid arthritis (RA). Ten (10) patients with active seropositive rheumatoid arthritis were treated intermittently for six months with the agent and were evaluated according to clinical, laboratory and immunological parameters. OM-8930 has been demonstrated to be an effective drug in reducing arthritic activity in rheumatoid arthritis. It is slow acting without any anti-inflammatory capacities and resembles other slow acting agents like Levamisol, Penicillamin, etc. OM-8930 provoked a long lasting immunological stimulation allowing a normalization of lymphocytes counts, increasing the number of active T-cells and enhancing lymphocyte mitogenic response. No adverse clinical-laboratory reactions were recorded throughout the study, which indicates that the agent is suitable for long-term use in humans.