Ruxolitinib in corticosteroid-refractory graft-versus-host disease after allogeneic stem cell transplantation: a multicenter survey

Despite major improvements in allogeneic hematopoietic cell transplantation over the past decades, corticosteroid-refractory (SR) acute (a) and chronic (c) graft-versus-host disease (GVHD) cause high mortality. Preclinical evidence indicates the potent anti-inflammatory properties of the JAK1/2 inhibitor ruxolitinib. In this retrospective survey, 19 stem cell transplant centers in Europe and the United States reported outcome data from 95 patients who had received ruxolitinib as salvage therapy for SR-GVHD. Patients were classified as having SR-aGVHD (n=54, all grades III or IV) or SR-cGVHD (n=41, all moderate or severe). The median number of previous GVHD-therapies was 3 for both SR-aGVHD (1-7) and SR-cGVHD (1-10). The overall response rate was 81.5% (44/54) in SR-aGVHD including 25 complete responses (46.3%), while for SR-cGVHD the ORR was 85.4% (35/41). Of those patients responding to ruxolitinib, the rate of GVHD-relapse was 6.8% (3/44) and 5.7% (2/35) for SR-aGVHD and SR-cGVHD, respectively. The 6-month-survival was 79% (67.3-90.7%, 95% confidence interval (CI)) and 97.4% (92.3-100%, 95% CI) for SR-aGVHD and SR-cGVHD, respectively. Cytopenia and cytomegalovirus-reactivation were observed during ruxolitinib treatment in both SR-aGVHD (30/54, 55.6% and 18/54, 33.3%) and SR-cGVHD (7/41, 17.1% and 6/41, 14.6%) patients. Ruxolitinib may constitute a promising new treatment option for SR-aGVHD and SR-cGVHD that should be validated in a prospective trial.

Management of adults and children receiving CAR T-cell therapy: 2021 best practice recommendations of the European Society for Blood and Marrow Transplantation (EBMT) and the Joint Accreditation Committee of ISCT and EBMT (JACIE) and the European Haematology Association (EHA)

BACKGROUND

Several commercial and academic autologous chimeric antigen receptor T-cell (CAR-T) products targeting CD19 have been approved in Europe for relapsed/refractory B-cell acute lymphoblastic leukemia, high-grade B-cell lymphoma and mantle cell lymphoma. Products for other diseases such as multiple myeloma and follicular lymphoma are likely to be approved by the European Medicines Agency in the near future.

DESIGN

The European Society for Blood and Marrow Transplantation (EBMT)-Joint Accreditation Committee of ISCT and EBMT (JACIE) and the European Haematology Association collaborated to draft best practice recommendations based on the current literature to support health care professionals in delivering consistent, high-quality care in this rapidly moving field.

RESULTS

Thirty-six CAR-T experts (medical, nursing, pharmacy/laboratory) assembled to draft recommendations to cover all aspects of CAR-T patient care and supply chain management, from patient selection to long-term follow-up, post-authorisation safety surveillance and regulatory issues.

CONCLUSIONS

We provide practical, clinically relevant recommendations on the use of these high-cost, logistically complex therapies for haematologists/oncologists, nurses and other stakeholders including pharmacists and health sector administrators involved in the delivery of CAR-T in the clinic.

Rapid natural killer cell recovery determines outcome after T-cell-depleted HLA-identical stem cell transplantation in patients with myeloid leukemias but not with acute lymphoblastic leukemia

Natural killer (NK) cells are the first lymphocytes to recover after allogeneic stem cell transplantation (SCT) and can exert powerful graft-versus-leukemia (GVL) effects determining transplant outcome. Conditions governing NK cell alloreactivity and the role of NK recovery in sibling SCT are not well defined. NK cells on day 30 post-transplant (NK30) were measured in 54 SCT recipients with leukemia and donor and recipient killer immunoglobulin-like receptor (KIR) genotype determined. In univariate analysis, donor KIR genes 2DL5A, 2DS1, 3DS1 (positive in 46%) and higher numbers of inhibitory donor KIR correlated with higher NK30 counts and were associated with improved transplant outcome. NK30 counts also correlated directly with the transplant CD34 cell dose and inversely with the CD3+ cell dose. In multivariate analysis, the NK30 emerged as the single independent determinant of transplant outcome. Patients with NK30 >150/microl had less relapse (HR 18.3, P=0.039), acute graft-versus-host disease (HR 3.2, P=0.03), non-relapse mortality (HR 10.7, P=0.028) and improved survival (HR 11.4, P=0.03). Results suggest that T cell-depleted SCT might be improved and the GVL effect enhanced by selecting donors with favorable KIR genotype, and by optimizing CD34 and CD3 doses.

Variants in the SLCO1B3 Gene: Interethnic Distribution and Association with Paclitaxel Pharmacokinetics

To explore retrospectively the relationships between paclitaxel pharmacokinetics and three known, non-synonymous single-nucleotide polymorphisms (SNPs) in SLCO1B3, the gene encoding organic anion transporting polypeptide (OATP)1B3. Accumulation of [(3)H]paclitaxel was studied in Xenopus laevis oocytes injected with cRNA of Oatp1b2, OATP1A2, OATP1B1, OATP1B3, OAT1, OAT3, OCT1, and NTCP. The 334T>G (Ser112Ala), 699G>A (Met233Ile), and 1564G>T (Gly522Cys) loci of SLCO1B3 were screened in 475 individuals from five ethnic groups and 90 European Caucasian cancer patients treated with paclitaxel. Only OATP1B3 was capable of transporting paclitaxel to a significant extent (P=0.003). The 334T>G and 699G>A SNPs were less common in the African-American and Ghanaian populations (P<0.000001). Paclitaxel pharmacokinetics were not associated with the studied SNPs or haplotypes (P>0.3). The studied SNPs in SLCO1B3 appear to play a limited role in the disposition of paclitaxel, although their clinical significance in other ethnic populations remains to be investigated.

Selective depletion strategies in allogeneic stem cell transplantation

Despite improved prophylaxis and treatment, GvHD remains a major limitation to optimal allogeneic stem cell transplantation. Ex vivo selective depletion (SD) is a strategy to prevent GvHD, in which host-reactive donor lymphocytes are selectively eliminated from a PBSC allograft while useful donor immune function is preserved. The elimination of alloreactive and thereby GvHD-mediating T cells has been shown to be feasible in both pre-clinical and more recently clinical studies. However, SD techniques and the translational research needed for clinical application are still under development. Here we summarize and discuss the following aspects of the SD approach: selection of an appropriate allogeneic stimulator; the responder population; the alloresponse; methods for removal of alloreacting T cells; product testing; clinical considerations. Our review highlights the diversity of possible approaches and the need to develop different techniques for specific clinical applications.

Environmental persistence of foot-and-mouth disease virus applied to endemic regions

The consequences of foot-and-mouth disease impact regional economies and food security through animal mortality and morbidity, trade restrictions and burdens to veterinary infrastructure. Despite efforts to control the disease, some regions, mostly in warmer climates, persistently report disease outbreaks. Consequently, it is necessary to understand how environmental factors influence transmission, of this economically devastating disease. Extensive research covers basic aetiology and transmission potential of livestock and livestock products for foot-and-mouth disease virus (FMDV), with a subset evaluating environmental survival. However, this subset, completed in the early to mid-20th century in Northern Europe and the United States, is not easily generalized to today's endemic locations. This review uncovered 20 studies, to assess current knowledge and analyse the effects of environmental variables on FMDV survival, using a Cox proportional hazards (Coxph) model. However, the dataset is limited, for example pH was included in three studies and only five studies reported both relative humidity (RH) and temperature. After dropping pH from the analysis, our results suggest that temperature alone does not describe FMDV survival; instead, interactions between RH and temperature have broader impacts across various conditions. For instance, FMDV is expected to survive longer during the wet season (survival at day 50 is ~90% at 16°C and 86% RH) versus the dry season (survival at day 50 approaches 0% at 16°C and 37.5% RH) or comparatively in the UK versus the Southwestern United States. Additionally, survival on vegetation topped 70% on day 75 when conditions exceeded 20°C with high RH (86%), drastically higher than the survival on inanimate surfaces at the same temperature and RH (~0%). This is important in tropical regions, where high temperatures can persist throughout the year, but RH varies. Therefore, parameter estimates, for disease modelling and control in endemic areas, require environmental survival data from a wider range of conditions.

[Results of therapy after primary conservative management of distal radius fractures in patients over 65 years of age]

BACKGROUND

In the clinical routine of our City Hospital Triemli, Zürich, Switzerland, we prefer to treat old patients with fractures of the distal radius conservatively. It was our aim to examine the long-term effects of this treatment on anatomical position, mobility, strength, and patient satisfaction.

PATIENTS AND METHODS

We reviewed the data of 102 consecutive patients over 65 years of age. 95 were treated with a plaster cast and controlled weekly in our outpatient department, finally discharged after 50 days. After an average time of eight months, 79 patients could be controlled clinically and radiologically.

RESULTS

Although a significant (p < 0.001) reduction of joint mobility and grip strength was found in all cases, we documented no loss of independence in every-day life. Radiological malalignment of the distal radius with a dorsal or palmar angle of more than 20 degrees in the lateral view or a radio-ulnar angle of less than 15 degrees in the dorsopalmar view was associated with increased complaints and patients dissatisfaction.

CONCLUSION

In old-aged patients with distal radius fractures, the indication for surgical treatment should be made very carefully, since certain degrees of radiological malalignment are tolerated well.

Functional characterization of proton antiport regulation in the thylakoid membrane

During photosynthesis, energy is transiently stored as an electrochemical proton gradient across the thylakoid membrane. The resulting proton motive force (pmf) is composed of a membrane potential (ΔΨ) and a proton concentration gradient (ΔpH) and powers the synthesis of ATP. Light energy availability for photosynthesis can change very rapidly and frequently in nature. Thylakoid ion transport proteins buffer the effects that light fluctuations have on photosynthesis by adjusting pmf and its composition. Ion channel activities dissipate ΔΨ, thereby reducing charge recombinations within photosystem II. The dissipation of ΔΨ allows for increased accumulation of protons in the thylakoid lumen, generating the signal that activates feedback downregulation of photosynthesis. Proton export from the lumen via the thylakoid K+ exchange antiporter 3 (KEA3), instead, decreases the ΔpH fraction of the pmf and thereby reduces the regulatory feedback signal. Here, we reveal that the Arabidopsis (Arabidopsis thaliana) KEA3 protein homo-dimerizes via its C-terminal domain. This C-terminus has a regulatory function, which responds to light intensity transients. Plants carrying a C-terminus-less KEA3 variant show reduced feed-back downregulation of photosynthesis and suffer from increased photosystem damage under long-term high light stress. However, during photosynthetic induction in high light, KEA3 deregulation leads to an increase in carbon fixation rates. Together, the data reveal a trade-off between long-term photoprotection and a short-term boost in carbon fixation rates, which is under the control of the KEA3 C-terminus.

Comparison of 1-hour and 3-hours paclitaxel infusion pharmacokinetics: results from a randomized trial

PURPOSE

Aim of this study was to characterize the difference in pharmacokinetics (PK) of paclitaxel (PAC) after 1-h and 3-h infusion in humans and to define a pharmacodynamic relationship between PAC PK and myelotoxicity.

PATIENTS AND METHODS

PAC PK were studied during the first PAC application in the first treatment cycle (1 treatment cycle = 6 PAC applications) in 25 patients. This patient group represents a subgroup of a large clinical study with neurotoxicity as primary endpoint. These 25 patients were those patients who were willing to give additional blood samples. The group size was sufficient for a full description of the PK of PAC. PAC was administered at 100 mg/m(2) weekly by 1-h (n = 12) or 3-h (n = 13) infusion to patients with advanced cancer (lung, breast, ovarian, cervix, and head and neck). Total PAC was quantified by high-performance liquid chromatography (HPLC). Pharmacokinetic parameters were calculated by noncompartmental and model-dependent methods. The leukocyte and neutrophil decrease during a 6-week treatment period was calculated by the percentage in decrease of white blood cell count (WBC) and absolute neutrophil count (ANC) as well as the area over the curve (AOC) of WBC and ANC.

RESULTS

The area under the curve (AUC), the plasma clearance (Clp), the volume of distribution at steady state (V(ss)), the mean residence time (MRT) and the distribution half-life (t(1/2)) of PAC(tot) were not different in the two application modes. The elimination half-life (t1/2) and maximum plasma concentration C(max) were significantly different. No significant differences in the percentage of reduction of WBC and ANC were seen. Calculation of AOC of WBC showed a borderline significant difference (p = 0.0547) in case of WBC and no significant difference in case of ANC between the two PAC schedules. A considerable variance of AOC was observed.

CONCLUSION

The pharmacokinetic study of total PAC of the two schedules investigated showed significant differences in the elimination half-life, which is longer in case of the 1-h infusion of PAC and in the maximum plasma concentration, which is higher in case of the 1-h infusion. The two schedules showed a similar myelotoxicity with a trend of less toxicity in the 1-h procedure.

Expression of the c-erbB-2-encoded oncoprotein p185 (HER-2/neu) in pregnancy as a model for oncogene-induced carcinogenesis

Although oncogenes are involved in tumor development and progression, their activation during human ontogenesis is inseparably associated with normal fetal development. The c-erbB-2-encoded oncoprotein p185 (HER-2/neu) is overexpressed on fetal epithelial cells, in the placenta, and in several human carcinomas. In patients with p185-overexpressing tumors and in pregnant women at term, increased serum levels of a 105 kDa proteolytic breakdown product corresponding to the extracellular domain of oncoprotein p185 are detectable. Estrogens have been described to be potent inhibitors of p185 expression in human breast cancer cells and to influence also p105 serum levels in females. Regarding the significantly poorer prognosis of patients with c-erbB-2-positive tumors, we discuss common features and differences between c-erbB-2 oncoprotein overexpression in pregnancy and in carcinogenesis.

Elevated serum levels of the c-erbB-2 encoded oncoprotein fragment in cases of pure preeclampsia and HELLP syndrome

OBJECTIVE

During normal human ontogenesis an overexpression of the c-erbB-2 encoded oncoprotein p185 (HER2/neu) occurs in the placenta and on fetal epithelial cells. It is accompanied by the increase of a 105 kD fragment (p105) in both maternal serum and cord blood. We examined whether p105 levels in maternal serum are influenced by destructions of placental tissue, fetal growth disturbances and placental circulation disorders.

METHODS

We analysed p105 serum concentrations in patients with abortion (n = 25), ectopic pregnancy (n = 5), intrauterine growth retardation (n = 9), pregnancy induced hypertension (n = 24) and compared them with normal pregnancies of a corresponding gestational age.

RESULTS

Patients with abortions showed normal p105 values. Intrauterine growth retardation was associated with lower p105 levels (p < 0.05) whereas patients with pure preeclampsia (p < 0.001) and HELLP syndrome (p < 0.05) had significantly higher levels.

CONCLUSION

The elevation of p105 in sera of preeclamptic women could be due to an increased fetomaternal transfer of p105.

Allogeneic donor split skin grafts for treatment of refractory ulcers in cutaneous chronic graft-versus-host disease after allogeneic hematopoietic stem cell transplantation-a retrospective analysis on seven patients

Refractory skin ulcers due to severe chronic graft-versus-host disease (cGVHD) remain to be associated with significant morbidity and mortality.We performed an allogeneic donor skin transplantation in seven adult patients after allogeneic hematopoietic stem cell transplantation for cGVHD-associated refractory skin ulcers. While four patients received a split skin graft (SSG), in one patient, a full thickness skin graft for two small refractory ulcers of the ankle was performed, and one patient received in vitro expanded donor keratinocyte grafts derived from hair roots of the original unrelated donor. In one additional patient, a large deep fascial defect of the lower leg was covered with an autologous greater omentum free graft before coverage with an allogeneic SSG. An additional patient was treated with an autologous scrotal skin graft for a refractory ulcer associated with deep sclerosis of cGVHD after unrelated donor transplantation.All skin grafts engrafted and resulted in permanent coverage of the grafted ulcers without any signs of immunological mediated damage. In the patient receiving in vitro expanded keratinocyte grafts, two localized ulcers were permanently covered by donor skin while this approach failed to cover extensive circular ulcers of the lower legs.Allogeneic donor skin grafts are a valuable treatment option in refractory ulcers due to cGVHD but are restricted mainly to related donors while keratinocyte grafts from unrelated donors remain experimental. In male patients lacking a related donor, autologous scrotal skin graft may be an alternative option.

Patterns of foot-and-mouth disease virus detection in environmental samples in an endemic setting

Foot-and-Mouth Disease virus (FMDV) is endemic in several regions and is a virus that can persist in the environment dependent on pH, relative humidity (RH), temperature, and matrix (i.e., soil, water, or air). Our previously published analysis of available viral persistence data showed that persistence is likely affected by interactions between RH, temperature, and matrix. Understanding these relationships will aid efforts to eliminate FMD, which has significant impacts on economies and food security. In Cameroon, West Africa, the livestock system consists of mobile (transhumant), transboundary trade and sedentary herds. Studying this system can provide information about the patterns of environmental detection of FMDV RNA that may influence approaches to virus elimination on premises during an outbreak. To improve our understanding of these patterns, we collected samples from individuals, vehicles, and along cattle pathways at three sedentary herds beginning on day one of owner-reported outbreaks, ending by day 30, and tested for the presence of FMD viral RNA using rRT-PCR. Our analysis suggests that detection decreases in soil surface samples with increased distance from herd and time from the first report of disease. Whereas time but not distance decreases detection in air samples. Interaction of RH and temperature suggests increased detection at high temperatures (>24°C) and RH (>75%), providing us with new information about the patterns of FMD viral RNA detection in and around cattle herds that could help to inform targeted virus elimination strategies, such as location and application of disinfectants.

[Increased serum level of c-erbB-2-coded protein p105 in patients with pre-eclampsia]

OBJECTIVE

This study investigated p105 serum levels in normal pregnancies and in preeclamptic women.

PATIENTS AND METHODS

The p105 serum level was determined in 65 women with normal pregnancy and 25 preeclamptic women.

RESULTS

The mean p105 serum level for the control group was 102-333 fmol/ml (median 163 fmol/ml). Preeclamptic women had significant higher serum levels (97-368 fmol/ml, median 202 fmol/ml, p < 0,005).

CONCLUSION

Elevated serum levels of the c-erbB-2-encoded protein p105 in preeclamptic women could be the result of endothelial dysfunction in preeclampsia.

In vivo effects of estrogens on c-erbB-2 oncoprotein levels in chorionic villous tissue and maternal serum

The c-erbB-2-encoded oncoprotein p185 (HER2) is overexpressed in the fetal epithelium, the placenta and several carcinomas. Elevated serum levels of the released ectodomain (p105) were found in cancer patients and pregnant women at term. In cultured breast cancer cells estradiol inhibited p185 expression and induced growth arrest. These results prompted us to investigate the in vivo influence of serum estradiol and estriol on c-erbB-2 protein levels in pregnancy. We examined chorionic villous tissue extracts and maternal sera obtained from six legal abortions in the first trimester and 20 vaginal deliveries at term. For quantification of c-erbB-2 protein we employed an ELISA. In the first trimester maternal p105 serum levels were significantly (p < 0.0001) lower and p185 tissue levels significantly (p < 0.05) higher than in the third trimester. The highest p105 values were found in additionally examined cord blood. Interindividual regression analyses yielded inverse correlation between estradiol concentrations and placental p185 expression in the first (r = -0.58) and third trimester (r = -0.38) as well as p105 serum levels in the first trimester (r = -0.83). Estriol was correlated positively with p105 values in maternal and umbilical serum but not with placental p185 expression. We conclude that estradiol down-regulates p185 expression in pregnancy whereas the level of maternal p105 depends on the total amount of fetoplacental p185.

Remmenga M, R. Mielke S, Branan M, Daniel Mihalca A, Balmos OM, Adrian Balaban Oglan D, Supeanu A, Farkas A. Evaluation of Aggregate Oral Fluids for African Swine Fever Real-Time PCR Diagnostics Using Samples Collected on Romanian Farms with an Active Outbreak

African swine fever (ASF), caused by African swine fever virus (ASFv), is a highly contagious disease of domestic and wild pigs with a mortality rate that can reach 100%. Continuous spread of the virus into ASF-free regions, including the Caribbean island of Hispaniola in 2021, is causing socioeconomic burdens and presents a threat to food security. Pork-producing countries, including the United States and Canada, are urgently looking for efficient tools for early detection to reduce spread of the virus in the event of an outbreak. Previous experimental infection studies evaluated the utility of aggregate porcine oral fluids (OFs) as a sample type with a highly sensitive ASFv real-time PCR for individual blood and tissue-based diagnosis. In this study, real-time PCR with porcine OFs was further evaluated to better understand diagnostic performance using samples from three Romanian farms with an ongoing ASF outbreak. In this limited dataset using a Bayesian latent class model, no statistical difference in diagnostic sensitivity was found between the real-time PCR using aggregate OFs and the process of determining pen disease status by testing individual blood samples collected from a subset of pigs from the same pen. Known negative aggregate OF samples from pigs in the United States had no occurrences of false positives, suggesting reliable diagnostic specificity of the sample matrix used for this study. Until results are produced from further studies with sufficient sample size, aggregate OF testing using real-time PCR could cautiously be used as a supplementary sample type for ASF diagnosis alongside currently approved sample types, including blood and lymphoid tissues.

Serum levels of the c-erbB-2 (HER2/neu) encoded oncoprotein fragment p105 in normal pregnancies

The c-erbB-2 encoded oncoprotein p185 is overexpressed in fetal epithelial cells, in the placenta, and in several human carcinomas. Elevated serum levels of the 105 kD extracellular part are found in cancer patients and in pregnancy. Our purpose was to examine whether there is a characteristic development of p105 serum levels in the course of normal pregnancy. Using ELISA, we measured the p105 serum concentrations in nonpregnant women, women with normal pregnancy in the 1st, 2nd, and 3rd trimester and pueperas. Compared to nonpregnant women, we found a significant decrease in p105 in the 1st and 2nd trimester, followed by a significant increase in the 3rd trimester. Post partum serum values returned to the levels found in nonpregnant women. The clinical judgment of female p105 serum values requires comparison with the normal range of random samples, and the consideration of pregnancy and the age of gestation as in vivo influencing factors.

Optimizing Swine Oral Fluid Sampling Procedures for Growing Pigs in Commercial Settings

Pen-based oral fluids are used extensively for surveillance and disease detection in swine, but there is sparse information on the sampling process itself. To address this shortcoming, we documented the pen-based oral fluid sampling process with the aim of optimizing the number of pigs in a pen that contributed to the sample. We quantified the effects of (1) previous experience with rope sampling (training), (2) the number of ropes suspended in the pen, and (3) sampling time on pig participation and pig-rope contact. A subset of pigs was clearly marked for individual identification and their interactions with ropes video recorded. Thereafter, pig-rope contacts were counted from the recordings, with "contact" defined as an individually identified pig clearly taking the rope into its mouth. Data were analyzed using appropriate models (R version 4.4.1 R core team 2024). Training, provision of additional ropes, and extended sampling time all increased pig participation across pen sizes. However, for routine oral fluid collection in the field, we recommend training pigs prior to hanging ropes for sample collection and increasing sampling time to maximize the pigs' contribution to the oral fluid sample. Importantly, these studies focused on pig behavior and not detection; thus, future studies should evaluate the impact of these same factors on the probability of detection.

[Ophthalmic oncology in a warmer world: climate-related increase in the prevalence of eyelid cancer]

BACKGROUND

Damage induced by ultraviolet (UV) radiation plays a decisive role in the carcinogenesis of malignant tumors of the eyelids.

METHODS

A selective literature search was performed in PubMed and Google Scholar.

RESULTS

Large epidemiological studies show an increase in the prevalence of eyelid tumors in recent decades. The incidence of malignant eyelid tumors has increased especially in the white population over the last 70 years. A UV-induced damage to tumor suppressor genes and oncogenes which play a key role in the carcinogenesis of malignant eyelid tumors has been demonstrated. Strong intermittent UV exposure and sunburn have been identified as risk factors for basal cell carcinoma and malignant melanoma. For squamous cell carcinoma, cumulative UV exposure over a longer period of time is considered a risk factor.

CONCLUSION

In order to counteract the UV-related increase in malignant eyelid tumors, preventive protective measures, early detection and increased public awareness are essential. On the one hand, changes in behavior, appropriate clothing, wearing hats and sunglasses or contact lenses with UV filters are effective measures for UV protection. On the other hand, the underlying mechanisms of carcinogenesis should be investigated further in order to be able to carry out effective prevention and further develop treatment.

Hormonal treatment with sex steroids in women is associated with lower p105 serum concentrations

BACKGROUND

In breast and ovarian cancer patients elevated serum levels of the oncoprotein p105 were detected. We examined the influence of endocrine factors on the p105 serum concentration.

MATERIALS AND METHODS

The sera of 115 and non-pregnant women were analysed. Of the premenopausal women (n = 77) hormonal contraception was used by 30 women, and of the postmenopausal women (n = 33) there were 15 women using hormonal replacement therapy (HRT). The serum specimens were analysed by ELISA.

RESULTS

Women with hormonal contraception had significantly lower serum levels than premenospausal controls (82-138 fmol/ml, median 109 fmol/ml vs. 103-183 fmol/ml, median 130 fmol/ml; P < 0.001). In postmenopausal women with HRT serum levels were significantly lower than in postmenopausal controls (88-136 fmol/ml, median 117 fmol/ml vs. 99-261 fmol/ml, median 148 fmol/ml; P < 0.001).

CONCLUSIONS

Sex steroids seem to modulate c-erbB-2 activity. These results are important with regard to clinical studies on p105 oncoprotein in cancer patients.

Effects of interfering and influencing factors on the analyses of p105 (c-erbB-2/HER-2) oncoprotein fragment in serum

BACKGROUND

The 105 kDa extracellular domain of c-erbB-2 encoded protein p185 is detectable in serum. Elevated p105 serum levels were found in patients with breast and ovarian cancer and in pregnancy. The effects of interfering and influencing factors on the measurement are still unclear.

MATERIAL AND METHODS

We used an ELISA based on the monoclonal capture antibody OD-3 and investigated possible interfering factors, like changing transporting and storing conditions of blood and serum samples. In order to evaluate a normal range of p105 serum values we examined 71 healthy women.

RESULTS

In our tests we found no influence on the reproducibility of results by changing transporting and storing conditions. We could not find any dependency of p105 serum values on the menstrual cycle or the age of controls. Postmenopausal women showed significantly higher serum values than premenopausal women (p = 0.0127).

CONCLUSIONS

Clinical interpretation of female p105 serum values requires comparison with normal ranges when considering the menopause as an influencing factor.

Assessment of a reconfiguration of the InterSpread Plus US national FMD model as a potential tool to analyze a foot-and-mouth disease outbreak on a single large cattle feedlot in the United States

Introduction

An incursion of foot-and-mouth disease (FMD) into the United States remains a concern of high importance and would have devastating socioeconomic impacts to the livestock and associated industries. This highly transmissible and infectious disease poses continual risk for introduction into the United States (US), due to the legal and illegal global movement of people, animals, and animal products. While stamping out has been shown to effectively control FMD, depopulation of large cattle feedlots (>50,000 head) presents a number of challenges for responders due to the resources required to depopulate and dispose of large numbers of animals in a timely and effective manner.

Methods

However, evaluating alternative strategies for FMD control on large feedlots requires a detailed within-farm modeling approach, which can account for the unique structure of these operations. To address this, we developed a single feedlot, within-farm spread model using a novel configuration within the InterSpread Plus (ISP) framework. As proof of concept we designed six scenarios: (i) depopulation - the complete depopulation of the feedlot, (ii) burn-through - a managed "burn-through" where the virus is allowed to spread through the feedlot and only movement restriction and biosecurity are implemented, (iii) firebreak-NV - targeted depopulation of infected pens and adjacent pens without vaccination; (iv) firebreak - targeted depopulation of infected pens and adjacent pens with vaccination of remaining pens; (v) harvest-NV - selective harvest of pens where a 100% movement restriction is applied for 28-30 days, then pens are set for selection to be sent to slaughter, while allowing a controlled "burn-through" without vaccination; and (vi) harvest - selective harvest of pens with vaccination.

Results

Overall, the burn-through scenario (ii) had the shortest epidemic duration (31d (30, 33)) median (25th, 75th percentiles), while the firebreak scenario (iv) had the longest (47d (38,55)). Additionally, we found that scenarios implementing depopulation delayed the peak day of infection and reduced the total number of pens infected compared to non-depopulation scenarios.

Discussion

This novel configuration of ISP provides proof of concept for further development of this new tool to enhance response planning for an incursion of FMD in the US and provides the capability to investigate response strategies that are designed to address specific outbreak response objectives.