Correlation of Neutrophil-Lymphocyte and Albumin-Globulin Ratios With Outcomes in Patients With Breast Cancer Undergoing Neoadjuvant Chemotherapy or Upfront Surgery

PURPOSE

Higher neutrophil-lymphocyte ratio (NLRs) indicate a pro-inflammatory state and are associated with poor survival. Conversely, higher albumin-globulin ratio (AGRs) may be associated with improved prognosis. We aimed to investigate the association between NLR and AGR and prognosis and survival in patients with breast cancer.

METHODS

This retrospective study included all patients with stage I-III breast cancer between 2011 and 2017 in Singapore General Hospital and National Cancer Center Singapore. Multivariate logistic regression analysis of NLR, AGR, age, stage, grade, and subtype was performed. Survival data between groups were compared using Cox regression analysis and log-rank tests.

RESULTS

A total of 1,188 patients were included, of whom 323 received neoadjuvant chemotherapy (NACT) and 865 underwent upfront surgery. In patients who underwent NACT, a higher AGR was significantly associated with a higher pCR rate (cut-off > 1.28; odds ratio [OR], 2.03; 95% confidence interval [CI], 1.13-3.74; p = 0.020), better DFS (cut off > 1.55; hazard ratio [HR], 0.37; 95% CI, 0.16-0.85; p = 0.019), and better CSS (cut off > 1.46; HR, 0.39; 95% CI, 0.17-0.92; p = 0.031). Higher NLR was significantly associated with worse DFS (cut off > 4.09; HR, 1.77; 95% CI, 1.07-2.91; p = 0.026) and worse CSS (cut off > 4.09; HR, 1.98; 95% CI, 1.11-3.53; p = 0.021). In patients who underwent upfront surgery, higher AGR correlated with significantly better OS (cut off > 1.17; HR, 0.54; 95% CI, 0.36-0.82; p = 0.004) and higher NLR correlated with worse OS (cut off > 2.38; HR, 1.63; 95% CI, 1.09-2.44; p = 0.018).

CONCLUSION

NLR and AGR are useful in predicting the response to NACT as well as prognosis of patients with breast cancer. Further studies are needed to explore their value in clinical decision making.

A comparative study of the digestion behavior and functionality of protein from chia (Salvia hispanica L.) ingredients and protein fractions

Protein derived from chia (Salvia hispanica L.), characterized by a balanced amino acid composition, represents a potentially healthier and environmentally friendly alternative poised for innovation within the plant-based food sector. It was hypothesized that the growing location of chia seeds and processing techniques used might influence protein digestion patterns, which in turn could affect the biological functions of the digestion products. To examine this hypothesis, we assessed the gastrointestinal fate of degummed-defatted flour (DDF), protein concentrate (PC), and isolated albumin (Alb) and globulin (Glo) fractions. Furthermore, we compared the antioxidant and anti-inflammatory activities of the resulting digesta by means of in vitro and cellular assays. Post-gastrointestinal digestion, the PC exhibited elevated levels of soluble protein (7.6 and 6.3 % for Mexican and British PC, respectively) and peptides (24.8 and 27.9 %, respectively) of larger molecular sizes compared to DDF, Alb, and Glo. This can be attributed to differences in the extraction/fractionation processes. Leucine was found to be the most prevalent amino acids in all chia digesta. Such variations in the digestive outcomes of chia protein components significantly influenced the bioactivity of the intestinal digestates. During gastrointestinal transit, British Glo exhibited the best reactive oxygen species (ROS) inhibition activity in oxidative-stressed RAW264.7 macrophages, while Mexican digesta outperformed British samples in terms of ROS inhibition within the oxidative-stressed Caco-2 cells. Additionally, both Mexican and British Alb showed effectively anti-inflammatory potential, with keratinocyte chemoattractant (KC) inhibition rate of 82 and 91 %, respectively. Additionally, Mexican PC and Alb generally demonstrated an enhanced capacity to mitigate oxidative stress and inflammatory conditions in vitro. These findings highlight the substantial potential of chia seeds as functional food ingredients, resonating with the shifting preferences of health-conscious consumers.

Effects of glycation method on the emulsifying performance and interfacial behavior of coconut globulins-fucoidan complexes

Coconut globulins (CG) possesses potential as an emulsifier but has not been utilized well. In this study, the emulsifying performance of glycated CG-fucoidan (CGF) complexes, and the relationship between emulsifying stability and interfacial behavior were investigated. The results showed that the grafting of fucoidan increased the molecular weight of CG, and decreased the zeta potential and fluorescence intensity. With the higher glycosylation degree, the fucoidan modified CG exhibited better emulsifying stability and higher viscosity. Moreover, the result of adsorption kinetics revealed that elasticity was the main property of the interface layer. Compared to CG, CGF complexes with high degree of glycosylation had thicker interfacial layer on the oil-water interface. A thicker elastic interfacial layer may be beneficial to the emulsion stability, owing to the strong interaction of electrostatic repulsion and steric hindrance between oil droplets. These findings may provide useful information for glycated CGF complexes as emulsifiers in functional food.

Surface tension of native and modified plant seed proteins

The present review, dedicated to Prof. Zbigniew Adamczyk on the occasion of his 70th anniversary, covers the literature data on surface tension and surface compression (dilational) rheology of the adsorbed layers of 21 plant seed proteins (10 leguminous and 11 non-leguminous plants). They are typically analyzed as protein concentrates or isolates, the latter usually obtained by isoelectric precipitation or diafiltration. Despite generally lower solubility, as compared to their animal counterparts (lactoglobulins, caseins, albumins, etc.), the plant seed proteins are also capable of lowering surface tension and forming viscoelastic adsorbed layers. Many seed proteins serve mostly as amino acids reservoirs for the future seedling (storage proteins), hence their instantaneous amphiphilicity is not always sufficient to induce strong adsorption at the aqueous-air interface. They can be, however, conveniently unfolded, hydrolyzed and/or chemically/enzymatically modified to expose more hydrophilic or hydrophobic patches. As shown in numerous contributions reviewed below, the resulting shift of the hydrophilic-lipophilic balance can boost their surface activity to the level comparable to that of many animal proteins or low molecular weight surfactants. An important advantage of the plant seed proteins over the animal ones is their much lower environmental cost and abundance in many plants (e.g. ~40% in sunflower or soybean seeds).

Serum Globulin Is Associated with Endoscopic Findings and Mucosal Healing in Japanese Patients with Ulcerative Colitis

BACKGROUND

Serum globulin is an inflammation marker. To date, no evidence regarding the association between serum globulin and disease activity in patients with ulcerative colitis has been reported.

AIMS

We evaluated the association between serum globulin and endoscopic activity in patients with ulcerative colitis.

METHODS

Serum globulin was divided into tertiles based on the distribution of study subjects (low globulin, ≤ 2.7 g/dl (reference); moderate globulin, 2.7-3.1 g/dl; and high globulin, > 3.1 g/dl). A single endoscopic specialist evaluated the endoscopic findings, and mucosal healing was based on Mayo endoscopic subscore.

RESULTS

A total of 277 patients with ulcerative colitis were included in the study. Serum globulin was independently positively associated with diminished or absent vascular markings [moderate: adjusted odds ratio (OR) 3.70 (95% confidence interval, CI: 1.82-7.88) and high: adjusted OR 2.40 (95%CI: 1.20-4.94), p for trend = 0.005]. A similar positive association between globulin and erosion was found [high: adjusted OR 2.00 (95%CI: 1.05-3.86)]. Serum globulin was independently inversely associated with mucosal healing [moderate: adjusted OR 0.37 (95%CI: 0.18-0.73) and high: adjusted OR 0.31 (95%CI: 0.14-0.64), p for trend = 0.001] and adjusted partial mucosal healing [moderate: OR 0.51 (95%CI: 0.26-0.98), p for trend = 0.048]. The inverse association between globulin and mucosal healing was significant in the low but not the high C-reactive protein group.

CONCLUSIONS

In patients with ulcerative colitis, serum globulin was significantly positively associated with endoscopic activity, and was significantly inversely associated with mucosal healing, especially in the low C-reactive protein group.

Effect of domperidone (leisguard®) on antibody titers, inflammatory markers and creatinine in dogs with leishmaniosis and chronic kidney disease

Background

Immunotherapeutic drugs, such as domperidone, have been shown to be promising treatments against canine leishmaniosis (CanL), but limited data are available. The aim of this pilot study (therapeutic, prospective and non-controlled) was to evaluate the effect of domperidone on serum antibody titers of Leishmania infantum, globulins, gamma globulins, acute-phase proteins (e.g. C-reactive protein [CRP]), big endothelin-1 (big ET-1), serum creatinine (SC) and proteinuria in dogs with leishmaniosis affected by chronic kidney disease (CKD).

Methods

Dogs were recruited if “exposed” to or “infected” with L. infantum and affected by CKD (IRIS stage 1 [proteinuric] or IRIS stage 2–3a [SC < 3.5 mg/dl; proteinuric or non-proteinuric]). After inclusion, an oral suspension of domperidone was administered, and the dogs were followed up for 180 days, with checks at 30, 60, 90 and 180 days after initial treatment.

Results

Of the 14 recruited dogs, nine showed a statistically significant reduction in SC (χ² = 9.1, df = 3, P = 0.028), but not in the urine protein/creatinine ratio (χ² = 6.43, df = 3, P = 0.092). All dogs showed a significant reduction in antibody titers for L. infantum (χ² = 9.56, df = 2, P = 0.008), globulins (χ² = 11.08, df = 3, P = 0.011) and gamma globulins (χ² = 12.38, df = 3, P = 0.006) during the study period. There was also a statistically significant reduction in CRP (χ² = 16.7, df = 3, P = 0.001), but not in big ET-1 (χ² = 2.04, df = 3, P = 0.563).

Conclusions

This study provides preliminary results on the ability of domperidone to improve SC and reduce anti-L. infantum antibody titers, globulins, gamma globulins and CRP in dogs with leishmaniosis and CKD.

Graphical abstract

Prognostic role of preoperative albumin to globulin ratio in predicting survival of clear cell renal cell carcinoma

Purpose:

To investigate the prognostic role of preoperative albumin/globulin ratio (AGR) in predicting disease-free survival (DFS) and overall survival (OS) in localized and locally advanced clear cell renal cell carcinoma (RCC) patients.

Patients and Methods:

162 patients who met the criteria specified were included in the study. The DFS and OS ratios were determined using the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were performed to determine the prognostic factors affecting DFS and OS.

Results:

Median follow-up period was 27.5 (6-89) months. There was a statistically significant relationship between low AGR and high pathological tumor (pT) stage, presence of collecting system invasion, presence of tumor necrosis, and a high platelet count (p = 0.012, p = 0.01, p = 0.001, and p = 0.004, respectively). According to the Kaplan-Meier survival analysis, both OS and DFS were found to be significantly lower in the low AGR group (p = 0.006 and p = 0.012). In the multivariate Cox regression analysis, collecting system invasion and tumor necrosis were found to be independent prognostic factors in predicting OS and pT stage was found to be an independent prognostic factor in predicting DFS (HR: 4.08, p = 0.043; HR: 8.64, p = 0.003 and HR: 7.78, p = 0.041, respectively).

Conclusion:

In our study, low AGR was found to be associated with increased mortality and disease recurrence in localized and locally advanced RCC.

[Analysis of haematological phenotype and mutation spectrum of δ-globin gene from Guangdong area in Chinese Han prenatal population]

Objective: To analyze the genotype-phenotype correlations among southern Chinese Han prenatal population in Guangdong area with δ-globin gene mutation, so as to enrich the delta-thalassemia gene mutations data. Methods: A total of 33 cases were selected in 7 580 patients during prenatal thalassemia trait screening, from January 2012 to May 2015(including 10 males and 23 females, aged 22-48 years old). Complete blood cell count was performed on a XE 4000i automatic hemocyte analyzer. Hb, HbF and HbA2 were tested by high performance liquid chromatography (HPLC). Genomic DNA was extracted from whole blood samples using a whole blood genomic DNA extraction kit. Polymerase chain reaction (PCR) was used to amplify three different fragments corresponding to the exons and the regulatory sequences using three different couples of primers for the δ-globin gene. Results: Twenty one of the 33 samples were positive for the δ-globin gene defects. Four previously known mutations were detected: including 12 cases for -77(T>C)[HBD c. -127 (T>C)](57.14%), 4 cases for -30 (T>C)[HBD c. -80 (T>C)](19.05%), 1 case for codon 10 (-G) (HBD c. 31delG)(4.76%), and 1 case for HBD c. 244 C>T(4.76%). Three new δ-globin gene defects which had not yet been reported in database were detected, including 1 case for HBD c. 22_24delGAG(4.76%), 1 case for HBD c. 347 C>T(4.76%), and one case for HBD c. 349 C>G(4.76%). Conclusions: -77 (T>C) is the most common mutation in Chinese southern prenatal population. Three new HBD gene mutations are referred in this report, which provide the valuable information for genetic counseling and prenatal diagnosis in Guangdong area.

Structural, Functional and Evolutionary Aspects of Seed Globulins

Globulins are a major class of seed storage proteins which were thought to be enzymatically inactive. These proteins belong to the most ancient cupin superfamily. They can be graded into 11S legumin type and 7S vicilin type based on their sedimentation coefficients. Members from both classes share structural homology are thought to have evolved from either one-domain germin predecessor by duplication or by horizontal gene transfer of two-domain gene from bacteria to eukaryotes. Globulins are known to define the nutritional quality of the seeds, however, they are also involved in sucrose binding, desiccation, defense against microbes, hormone binding and oxidative stress etc. Major drawback with globulins is their tendency to bind to IgE. Studying structural-functional behavior of such protein can help in modifying proteins for enhanced functionality in food processing industries.

Effect of thermal processing on protein solubility of green gram (Phaseolus aureus) legume cultivars

Green gram legume cultivars were analyzed for their protein solubility profile by fractionation in the raw form and also after heat processing. The results indicated that globulin fractions, which are present in major amounts that ranged from 79.5 to 85.4 % significantly decreased after the heat treatment. This decrease was accompanied by a significant increase in the glutelin-3 fractions. The prolamine contents did not vary considerably after processing. The protein and non-protein nitrogen contents ranged from 22.6 to 26.2 % and 2.3 to 2.7 % in the legume cultivars, respectively. The antinutritional factors like total polyphenol and phytic phosphorous were also determined. The accumulation of polyphenols was in the seed coat portion of the legume where as that of phytic phosphorus was in the cotyledons. SDS - PAGE profiles of all the three green gram cultivars had five major polypeptides (molecular weight 15, 18, 20, 45 and 60 kDa) in the total protein composition. Wide variation in electrophoresis pattern was observed after heat processing. Thermal treatment increased the insoluble protein fractions and eliminated the minor polypeptide bands below 14.3 kDa in the green gram cultivars.

Initiation of immunoglobulin therapy by subcutaneous administration in immunodeficiency patients naive to replacement therapy

Background

Patients with immunodeficiency diseases require lifelong treatment with immunoglobulin (Ig), yet few studies have vetted dosing strategies and effectiveness of Ig in older patient populations. Patients requiring subcutaneous (SC) Ig (SCIG) typically start with intravenous dosing before transitioning to SCIG weekly maintenance. In this retrospective review, we investigated an alternate strategy with higher initial SC doses among an older patient population with antibody deficiency syndromes.

Findings

Records of 13 patients (mean age, 70 years) with antibody deficiencies who were naive to treatment with Ig were assessed. SCIG (Vivaglobin® [Immune Globulin Subcutaneous (Human), 16% Liquid] or Hizentra® [Immune Globulin Subcutaneous (Human), 20% Liquid]) was given twice weekly (100 mg/kg) for 2 weeks, followed by weekly (100 mg/kg) administration The mean pretreatment IgG level was 460 mg/dL; at 1, 3, and 6 months after SCIG initiation, mean IgG serum levels were 852, 907, and 943 mg/dL, respectively. Maintenance doses were unchanged during 6 months of follow-up. All patients remain on SCIG (median, 44 months). One patient developed sepsis/cholangitis unrelated to treatment 3 months after starting SCIG; no other serious bacterial infections were reported.

Conclusions

Initiation of SCIG by doubling the maintenance dose over 2 weeks may be a well-tolerated and effective option for patients with antibody deficiencies requiring Ig replacement, especially among older patients.