Combining immunotherapy with an epidrug in squamous cell carcinomas of different locations: rationale and design of the PEVO basket trial

Squamous cell carcinomas (SCCs) are among the most frequent solid tumors in humans. SCCs, related or not to the human papillomavirus, share common molecular features. Immunotherapies, and specifically immune checkpoint inhibitors, have been shown to improve overall survival in multiple cancer types, including SCCs. However, only a minority of patients experience a durable response with immunotherapy. Epigenetic modulation plays a major role in escaping tumor immunosurveillance and confers resistance to immune checkpoint inhibitors. Preclinical evidence suggests that modulating the epigenome might improve the efficacy of immunotherapy. We herein review the preclinical and the clinical rationale for combining immunotherapy with an epidrug, and detail the design of PEVOsq, a basket clinical trial combining pembrolizumab with vorinostat, a histone deacetylase inhibitor, in patients with SCCs of different locations. Sequential blood and tumor sampling will be collected in order to identify predictive and pharmacodynamics biomarkers of efficacy of the combination. We also present how clinical and biological data will be managed with the aim to enable the development of a prospective integrative platform to allow secure and controlled access to the project data as well as further exploitations.

Green-light photocleavable meso-methyl BODIPY building blocks for macromolecular chemistry

We report the design of easily accessible, meso-methyl BODIPY monomers and their incorporation into photoclippable macromolecules.

Abdominal aortic aneurysm as an IgG4-related disease

The objectives of this study were to evaluate patients with aortic abdominal aneurysm (AAA) with regard to immunoglobulin (Ig)G4‐related disease (IgG4‐RD). IgG4‐RD represents a recently defined condition comprised of a collection of disorders characterized by IgG4 hypergammaglobulinemia, the presence of IgG4‐positive plasma cells in organs affected with fibrotic or sclerotizing changes and typical histopathological features. It was identified as a possible cause of vasculitis in large vessels. Studies have been published on a possible association between inflammatory aortic or cardiovascular disease and IgG4‐RD. We examined 114 patients with AAA requiring surgery in order to identify findings which are characteristic of IgG4‐RD. Aneurysm samples from seven patients showed histopathological features consistent with IgG4‐RD and the presence of IgG4⁺ plasma cells. Only two of these seven patients showed elevated IgG4 serum levels higher 1·35 g/l. In five of the patients, the concentration of serum IgG4 was lower than 1·20 g/l, with the number of IgG4⁺ plasma cells being higher than 50/high‐power field. These findings were consistent with AAA being a heterogeneous group of inflammatory diseases with different pathogenesis.

Clinical Evidence for Correlation of Insufficient Tissue Oxygen Supply (Hypoxia) and Tumor-Associated Proteolysis in Squamous Cell Carcinoma of the Head and Neck

Hypoxic tumors of patients with squamous cell carcinoma of the head and neck show a consistent trend towards poor treatment outcome. We now report that tumor hypoxia in these patients is correlated with elevated antigen content of the tumor-associated serine protease uPA (urokinase-type plasminogen activator), a marker of tumor cell invasion and metastasis.

Regenerative Therapie von Sehnen- und Banderkrankungen bei Pferden

Herkömmliche Therapieansätze führen bei Pferden zu einer unbefriedigenden Sehnenheilung mit einer relativ hohen Rezidivrate. Deshalb werden seit einigen Jahren unter anderem in vitro und an Labortieren so genannte regenerative Therapieformen wissenschaftlich untersucht. Darunter wird der Einsatz von Substanzen verstanden, die idealerweise die Bildung eines Ersatzgewebes bewirken, das vergleichbare funktionelle Eigenschaften hat wie das Ursprungsgewebe und sich somit von minderwertigerem Narbengewebe abhebt. Derzeit ist eine Fülle verschiedener Substrate entweder kommerziell verfügbar oder mithilfe von „Kits“ unter Praxisbedingungen herstellbar. Es werden die wesentlichen Erkenntnisse zur Herstellung und zum regenerativen Potenzial von kernhaltigen Zellen bzw. Stammzellen aus Knochenmark und Fettgewebe sowie der Blutprodukte PRP (thrombozytenreiches Plasma), ACP (autologes konditioniertes Plasma), ACS (autologes konditioniertes Serum) und der Gerüstsubstanz UBM (urinary bladder matrix) vorgestellt. Zuletzt wird das Potenzial einzelner Wachstumsfaktoren und der Gentherapie beleuchtet. Bisher wird angenommen, dass die Regeneration von Sehnengewebe durch ein komplexes Zusammenspiel aus Gerüstsubstanzen, Wachstumsfaktoren und Zellen begünstigt wird. Es sind bislang nur wenige Untersuchungen verfügbar, die einen Vergleich zwischen den genannten Substanzen erlauben. Untersuchungen zur Wirkung der Substrate an lebenden Pferden werden an anderer Stelle vorgestellt.

Ground-State Cooling of a Mechanical Oscillator by Interference in Andreev Reflection

We study the ground-state cooling of a mechanical oscillator linearly coupled to the charge of a quantum dot inserted between a normal metal and a superconducting contact. Such a system can be realized, e.g., by a suspended carbon nanotube quantum dot with a capacitive coupling to a gate contact. Focusing on the subgap transport regime, we analyze the inelastic Andreev reflections which drive the resonator to a nonequilibrium state. For small coupling, we obtain that vibration-assisted reflections can occur through two distinct interference paths. The interference determines the ratio between the rates of absorption and emission of vibrational energy quanta. We show that ground-state cooling of the mechanical oscillator can be achieved for many of the oscillator's modes simultaneously or for single modes selectively, depending on the experimentally tunable coupling to the superconductor.

Ground-state cooling of a carbon nanomechanical resonator by spin-polarized current

We study the nonequilibrium steady state of a mechanical resonator in the quantum regime realized by a suspended carbon nanotube quantum dot in contact with two ferromagnets. Because of the spin-orbit interaction and/or an external magnetic field gradient, the spin on the dot couples directly to the flexural eigenmodes. Accordingly, the nanomechanical motion induces inelastic spin flips of the tunneling electrons. A spin-polarized current at finite bias voltage causes either heating or active cooling of the mechanical modes. We show that maximal cooling is achieved at resonant transport when the energy splitting between two dot levels of opposite spin equals the vibrational frequency. Even for weak electron-resonator coupling and moderate polarizations we can achieve ground-state cooling with a temperature of the leads, for instance, of T = 10 ω.

A sensitive and robust method for automated on-line monitoring of enzymatic activities in water and water resources

The realisation of a novel concept for automated on-line monitoring of enzymatic activities in water was successfully demonstrated by long-term field testing at two remote Austrian ground water resources. The β-D-glucuronidase (GLUC) activity was selected as a representative enzymatic model parameter for the on-line determination. But the device can be adapted for any enzymatic reaction with diagnostic relevance for microbial water quality monitoring, as demonstrated for the β-D-galactosidase activity. Automated filtration of volumes up to 5 litres supports sensitive quantification of enzymatic activities. Internet-based data transfer, using internal control parameters for verification and a dynamic determination of the limit of quantification, enabled robust enzymatic on-line monitoring during a 2-year period. A proportion of 5,313 out of 5,506 GLUC activity measurements (96.5%) could be positively verified. Hydrological (discharge, gauge, turbidity, temperature, pH, electric conductivity, spectral absorbance coefficient at 254 nm) as well as microbiological parameters (Escherichia coli, coliforms) were concurrently determined to characterise the investigated ground water resources. The enzymatic on-line measurements closely reflected the different hydrological conditions and contamination patterns of the test sites. Contrary to expectations, GLUC did not qualify as a proxy-parameter for the occurrence of cultivation-based E. coli contamination and warrants further detailed investigations on its indication capacity as a rapid means for microbial faecal pollution detection in such aquatic habitats. Microbial on-line monitoring is likely to become more important in the future, complementing existing surveillance strategies for water safety management. Further perspectives on the application of such analytical on-line technologies, such as their connection with event-triggered sampling and standardised diagnostics, are discussed.

[Comparison of different electrocardiographic techniques for the detection of arrhythmias in horses]

OBJECTIVE

The aim of the study was to extend the range of the electrocardiographic examination in horses, evaluating the practicability of special electrocardiographic techniques (exercise- and Holter-ECG) and comparing these with more common techniques (resting-ECG) in equine medicine.

MATERIAL AND METHODS

Electrocardiographic examination (resting-ECG for 1 minute, exercise-ECG and Holter-ECG) was performed in 20 horses without any clinical or echocardiographic findings and in 80 patients with abnormal findings (valvular regurgitation and/or atrial fibrillation).

RESULTS

In comparison with the resting-ECG, the exercise-ECG demonstrated more atrial and ventricular premature beats, while the Holter-ECG had a higher detection rate of 2nd degree atrioventricular or sinuatrial blocks, and of ventricular and atrial premature depolarisations (p < 0.001). In comparison to the exercise-ECG, the Holter-ECG registered more 2nd degree atrioventricular blocks (p < 0.001) and ventricular (p < 0.001) or atrial premature contractions (p < 0.01). Atrial fibrillation was detected in every recorded ECG-type, but Holter-ECG provided additional information. Three of 16 horses with atrial fibrillation had R-on-T-episodes during Holter-monitoring. In addition to more common findings in the ECG, Holter-monitoring detected a 2nd degree atrioventricular block associated with an adjacent ventricular escape beat in a horse without any clinical or echocardiographic findings. An accelerated idioventricular rhythm was identified in a horse without any clinical or echocardiographic findings and in a horse with mitral valve insufficiency.

CONCLUSION AND CLINICAL RELEVANCE

The Holter-ECG is a useful tool in the evaluation of heart disease and could supply additional information when compared to the usual diagnostic electrocardiographic procedures used in horses. Exercise-ECG should not be replaced by Holter-ECG, however, Holter-EGC can provide additional diagnostic value.

Vergleichende Untersuchung von elektrokardiographischen Techniken zur Diagnostik von Herzrhythmusstörungen beim Pferd

Das Ziel dieser Studie war, die Befunde des Langzeit-EKGs beim Pferd mit denen des Belastungs- und des Ruhe-EKGs zu vergleichen. Material und Methode: Zwanzig klinisch und echokardiographisch unauffällige Kontrolltiere und 80 Patienten mit Klappeninsuffizienzen und/oder Vorhofflimmern wurden elektrokardiographisch untersucht. Die elektrokardiographischen Aufzeichnungen umfassten ein einminütiges Ruhe-EKG, ein Belastungs-EKG an der Longe und ein Langzeit-EKG über 24 Stunden. Ergebnisse: Im Vergleich zum Ruhe-EKG wurden Vorhof- und ventrikuläre Extrasystolen mithilfe des Belastungs-EKGs signifikant (p < 0,001) häufiger erkannt. Anhand des Langzeit-EKGs konnten signifikant mehr AV-Blöcke 2. Grades, sinuatriale Blöcke sowie Vorhof- und ventrikuläre Extrasystolen festgestellt werden als mithilfe des Ruhe-EKGs (p < 0,001). Beim Vergleich zwischen Belastungs-EKG und Langzeit-EKG zeigten sich im Langzeit-EKG signifikant häufiger AV-Blöcke 2. Grades (p < 0,001) sowie Extrasystolen atrialen (p < 0,001) und ventrikulären Ursprungs (p < 0,01). Vorhofflimmern wurde mit allen drei EKG-Techniken erfasst. Mittels Langzeit-EKG ließen sich allerdings neben dem Vorhofflimmern weitere elektrokardiographische Befunde erheben. Drei Tiere mit Vorhofflimmern zeigten zusätzlich das R-auf-T-Phänomen. Bei einem Pferd ohne klinische und echokardiographische Befunde traten im Langzeit-EKG Phasen mit je einem ventrikulären Ersatzschlag direkt nach einem AV-Block 2. Grades auf. Außerdem zeigten ein Kontrolltier und ein Pferd mit Mitralklappeninsuffizienz einen akzelerierten idioventrikulären Rhythmus. Schlussfolgerung und klinische Relevanz: Insgesamt erscheint es sinnvoll, das Langzeit-EKG wegen seines zusätzlichen Informationsgehalts in der Diagnostik von Herzerkrankungen häufiger anzuwenden als bisher üblich. Dabei sollte jedoch das Belastungs-EKG nicht ersetzt, sondern durch die Informationen des Langzeit-EKGs ergänzt werden.

Current trends in the diagnosis of vascular prosthesis infection

Early diagnosis of an infected vascular prosthesis, a potentially life-threatening disease, is a precondition of adequate treatment. The most frequently used diagnostic imaging method is computer tomography. Non-acute infections caused by low grade agents may pose a challenge with ambiguous CT-images and other ancillary imaging methods are used for these cases, each offering different levels of diagnostic sensitivity. These methods come from the fields of radiology (magnetic resonance imaging - MRI) and nuclear medicine studies using labelled leukocytes (111In or 99mTc HMPAO), 99mTc labelled antigranulocyte antibodies, 67Ga-citrate or labelled antibiotics (99mTc-ciprofloxacin) or avidin in combination with 111In-biotin. Positron emission tomography (PET) or hybrid PET/CT using 18F-FDG are becoming increasingly popular. The authors of this review article point out the diagnostic potential of the different methods and current trends, including the possibilities of microbiological demonstration of the agent, as well as their potential position in the diagnostic algorithm.

High mobility, low voltage operating C(60) based n-type organic field effect transistors

We report on C(60) based organic field effect transistors (OFETs) that are well optimized for low voltage operation. By replacing commonly used dielectric layers by thin parylene films or by utilizing different organic materials like divinyltetramethyldisiloxane-bis(benzocyclo-butene) (BCB), low density polyethylene (PE) or adenine in combination with aluminum oxide (AlOx) to form a bilayer gate dielectric, it was possible to significantly increase the capacitance per unit area (up to two orders of magnitude). The assembly of metal-oxide and organic passivation layer combines the properties of the high dielectric constant of the metal oxide and the good organic-organic interface between semiconductor and insulator provided by a thin capping layer on top of the AlOx film. This results in OFETs that operate with voltages lower than 500 mV, while exhibiting field effect mobilities exceeding 3 cm(2) V(-1) s(-1).

Electric field and grain size dependence of Meyer-Neldel energy in C(60) films

Meyer-Neldel rule for charge carrier mobility measured in C(60)-based organic field-effect transistors (OFETs) at different applied source drain voltages and at different morphologies of semiconducting fullerene films was systematically studied. A decrease in the Meyer-Neldel energy E(MN) from 36 meV to 32 meV was observed with changing electric field in the channel. Concomitantly a decrease from 34 meV to 21 meV was observed too by increasing the grain size and the crystallinity of the active C(60) layer in the device. These empiric findings are in agreement with the hopping-transport model for the temperature dependent charge carrier mobility in organic semiconductors with a Gaussian density of states (DOS). Experimental results along with theoretical descriptions are presented.

[Regenerative therapy for tendon and ligament disorders in horses. Terminology, production, biologic potential and in vitro effects]

Conventional treatments of equine tendon injuries lead to an unsatisfactory healing process that usually results in a relatively high recurrence rate. Therefore, in recent years so-called regenerative therapeutics were studied scientifically in vitro and in laboratory animals. These include substances that ideally lead to the formation of replacement tissue, which in contrast to the low quality scar, has similar functional properties as the original intact tendon. Currently, a plethora of different substrates is either commercially available or can be produced in practice with the help of kits. The current knowledge on the production and the regenerative potential of nucleated cells like stem cells from bone marrow and fat tissue, of the blood products PRP (platelet rich plasma), ACP (autologous conditioned plasma), ACS (autologous conditioned serum) and of the scaffold substance UBM (urinary bladder matrix) are presented. Finally, the potential of some growth factors and of gene therapy is considered. Currently, it is assumed that the regeneration of tendon tissue is promoted by a complex interaction of scaffolds, growth factors and cells. At present, only very few studies are available which allow a comparison between these substances. Studies on the effect of regenerative substrates on tendons in live horses are presented elsewhere.

Contribution to FDG-PET/CT diagnostics and post-operative monitoring of patients with mycotic aneurysm of the thoracic aorta

Bacterial infection of the aorta is a life threatening condition calling for timely diagnostics and therapy. In the short communication presented here, the authors offer a case report on a patient of 70 years of age with aneurysm of the descending aorta caused by salmonella. The advantages of a new diagnostic hybrid modality are demonstrated and also the possibility of using it in the course of long-term monitoring of patients.

Diagnostics of "non-acute" vascular prosthesis infection using 18F-FDG PET/CT: our experience with 96 prostheses

INTRODUCTION

Vascular prosthesis infection (VPI) is a life-threatening complication that occurs in 0.5-5% of prostheses. Low-grade infections in non-acute patients are a diagnostic challenge requiring a new method with good diagnostic accuracy. The aim of this work was to define the accuracy of (18)F-FDG PET/CT in these settings and to identify essential parameters of the evaluation.

MATERIAL AND METHODS

PET/CT was performed prospectively in 76 consecutive patients with a total of 96 vascular prosthetic grafts in which infection was suspected. PET/CT scans were analysed in terms of the presence and intensity of focal and diffuse FDG uptake, the presence of an anastomotic pseudoaneurysm, the presence of an irregular boundary of infiltration, a combination of these, and the uptake ratio between the graft and blood background. The gold standard was based on operative/histopathological finding or a clinical follow up of >6 months.

RESULTS

Among the various assessed parameters only focal FDG uptake and an irregular graft boundary were significant predictors of VPI. Focal intense FDG uptake together with an irregular boundary of the lesion on CT scan predicted VPI with 97% probability, while smooth lesion boundaries and no focal FDG uptake predicted a probability of VPI of less than 5%. Even in lesions with nondiagnostic inhomogeneous focal FDG uptake (18/96) an irregular boundary effectively helped in decision-making with a probability of 28% (smooth) or 77% (irregular) for VPI.

CONCLUSION

PET/CT gave reliable results with an accuracy >95% in 75% of prostheses. PET/CT can identify those prostheses (25% of prosthesis) for which its diagnostic accuracy is diminished to 70-75%. In our series PET/CT was an excellent diagnostic modality for suspected VPI.

Pulmonary dysfunction and skeletal muscle changes in horses with RAO

BACKGROUND

Chronic pulmonary diseases (recurrent airway obstruction [RAO]) have been reported to alter skeletal muscle cells in humans. The purpose of this study was to evaluate a potential relationship between pulmonary and muscle variables in horses with a clinical diagnosis of RAO. Muscle biopsies from healthy horses and from horses with RAO were investigated and the relationship between the severity of lung disease and the degree of muscular changes was determined.

HYPOTHESIS

We hypothesized that chronic pulmonary disease can lead to changes of the skeletal muscle in horses.

ANIMALS

Fifteen healthy horses (control) and 50 horses with RAO were examined.

METHODS

In a prospective clinical trial, a complete lung examination was performed in all horses. In all horses, muscle enzyme activity at rest and after exercise and muscle biopsies from the M. gluteus medius were examined.

RESULTS

None of the horses had clinical or histologic signs of primary or neurogenic myopathies. According to the clinical, endoscopic, and radiographic findings and with a scoring system, the horses with RAO were grouped according to the severity of pulmonary findings (15 horses mild, 24 horses moderate, 11 horses severe RAO). Pathologic changes of the skeletal muscle (fiber atrophy or fiber hypertrophy, myofibrillar degeneration, hyperplasia of mitochondria, and ragged-red-like fibers) were identified in most horses with RAO but in only a few individual control horses. In addition, a marked depletion of muscle glycogen storage was evident in the RAO horses but not in the control group. Other pathologic changes of skeletal muscle such as centralized nuclei and regenerating fibers were rare, but were more frequent in horses with lung diseases than in the control group. The degree of muscle cell changes was also graded with a scoring system and correlated with the severity of pulmonary disease (r= 0.55).

CONCLUSION

Chronic pulmonary disease in horses is associated with structural changes in skeletal muscle.

CLINICAL IMPORTANCE

Because chronic pulmonary disease may affect muscles, early and effective therapy may prevent these changes. This finding could be of clinical importance but requires further studies.

[Reference values for echocardiographic parameters of trained and untrained Icelandic horses]

The aim of this study was to establish echocardiographic reference values for healthy Icelandic horses. For this purpose cardiologic examinations were performed on 44 healthy trained and untrained Icelandic horses without known cardiologic or pulmonary disease. The atrial diameter of the trained horses were significantly greater than in the untrained horses and the left ventricular free wall diameter was also higher in the trained than in the untrained horses. These findings confirm that the changes of the heart caused by training which have previously been described by other authors in warmbloods, thoroughbreds, dogs and humans are present in Icelandic horses as well. However, in contrast to the findings in race horses, no enlargement of the left ventricle was found in trained Icelandic horses, which may indicate that training conditions of Icelandic horses are not comparable to those of race- or jumping-horses in high level training. The reference values established in this study will serve as basis for the current interpretation of the results of echocardiographic examinations in Icelandic horses. This should enable cardiologists to perform a more detailed and precise examination similar to cardiological examinations in warmbloods and race horses.