Factors Associated with Nonsuppression of HIV Infection in the Spanish VACH Cohort

We aim to determine the prevalence of HIV nonsuppression and factors associated with it. This is a cross-sectional multicenter study carried out in January 2016 with data of the VACH Cohort, a registry participated by 23 hospitals from most regions of Spain. The prevalence of HIV nonsuppression, defined as HIV RNA ≥200 copies/mL, is documented. The possible association of HIV nonsuppression with sociodemographic and clinical variables is assessed with a logistic regression analysis. A total of 30,843 adult patients are included; 7,358 of them (23.86%) have nonsuppressed HIV. An association is found between nonsuppression of HIV and the following variables: lower body mass index, lower age of patients in their last registered visit, lower number of visits carried out during follow-up, lower last available CD4 cell count, higher age of patients at the time of their HIV infection diagnosis, higher lowest available CD4 cell count, higher highest available HIV RNA, enrolment in the Cohort in first years of the HIV epidemic, region of Spain where the patient is attended other than Andalusia, HIV risk factor other than sexual, occurrence of death during follow-up, hepatitis C coinfection, being a smoker, pertaining to groups A1 or A2 of the CDC groups classification, and not taking antiretroviral treatment, p < .001 in all cases. HIV nonsuppression is still common with the effective antiretroviral treatment nowadays available. HIV nonsuppression is associated with HIV risk factor other than sexual, hepatitis C coinfection, and being a smoker, among other factors.

Abstract D117: Differential reactivity and cell migration inhibitory functions of autoantibodies to Enolase 1 from African American and European American men with prostate cancer

Prostate cancer (PCa) is the second leading cause of cancer-related deaths in the U.S., with African American (AA) men showing a higher mortality than European American (EA) men. While biological determinants contributing to PCa health disparities remain to be clearly established, there is growing evidence of differences in immunobiology between AA and EA patients with PCa. We demonstrated previously, using immunoproteomic profiling of anti-tumor autoantibody responses in AA and EA patients with PCa, that the glycolytic enzyme enolase 1 (ENO1) is the target of an autoantibody response in subsets of these patients. AA patient sera showed immunoreactivity to ENO1 in a panel of PCa cell lines, as detected by immunoblotting, with lack of reactivity in docetaxel (DTX)-resistant PC3 and DU145 cells. By contrast, anti-ENO1 sera from EA patients and a monoclonal anti-ENO1 antibody (MoAB-ENO1) showed immunoreactivity across the same cell line panel, including DTX-resistant cells. We also noted differences in anti-ENO1 reactivity in ELISA and immunoblots of PCa cell lysates between AA-PCa and EA-PCa patients, suggesting a race-related generation of autoantibodies to different ENO1 variants. ENO1 is a surface protein in cancer cells with roles in plasminogen activation, cell migration, and metastasis. Thus, we explored if anti-ENO1 autoantibodies from AA and EA PCa patients exerted different anti-cancer effects against DTX-sensitive and DTX-resistant PCa cells. Using cell migration assays, we observed that anti-ENO1 sera from EA patients and MoAB-ENO1 reduced the migration of DTX-resistant PC3 and DU145 cells but not that of DTX-sensitive cells. This inhibitory effect was intrinsic to the autoantibodies since purified IgG fraction produced similar results. Further, these inhibitory effects were reversed by pre-absorption of anti-ENO1 sera and purified IgG with recombinant human ENO1. Intriguingly, anti-ENO1 sera from AA patients lacked the same inhibitory effects on the migration of DTX-resistant cells, consistent with their lack of immunoreactivity to ENO1 in these cells. In addition, we observed that MoAB-ENO1, which behaves similar to the anti-ENO1 EA sera, decreased viability without evident cell death, measured by MTT assays and imaging analysis, in both DTX-sensitive and DTX-resistant cells, with a more robust effect on the latter. Together, these results suggest that anti-ENO1 autoantibodies from EA-PCa patients may exert a protective effect by decreasing the migration and proliferation of chemoresistant PCa cells. By contrast, anti-ENO1 autoantibodies from AA PCa patients may lack these protective effects, which could contribute to increased cancer cell migration and metastasis. Further studies are needed to dissect the molecular basis for this race-related differential anti-ENO1 immunoreactivity in PCa patients, and exploit the immunotherapeutic potential of anti-ENO1 antibodies for the treatment of chemoresistant PCa.

Citation Format: Carlos Diaz-Osterman, Tino Sanchez, Carlos A Casiano. Differential reactivity and cell migration inhibitory functions of autoantibodies to Enolase 1 from African American and European American men with prostate cancer [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D117.

Inhibition of Human Immunodeficiency Virus-1 Integrase by β-Diketo Acid Coated Gold Nanoparticles

Gold nanoparticles (GNPs) have been proposed as carriers for drugs to improve their intrinsic therapeutic activities and to overcome pharmacokinetic problems. In this study, novel nanosystems constituted by a model β-diketo acid (DKA) grafted to the surface of GNPs were designed and synthesized following the "multivalent high-affinity" binding strategy. These first nanoscale DKA prototypes showed improved inhibition of HIV-1 integrase (HIV-1 IN) catalytic activities as compared with free DKA ligands.

Abstract 4395: The cMYC-associated transcription factor JPO2 is upregulated in taxane resistant prostate cancer cells and interacts with the stress oncoprotein LEDGF/p75

Prostate Cancer (PCa) progression leads to an advanced stage called metastatic castration PCa (mCRPC), for which currently there is no cure in spite of advances in treatment with new generation androgen deprivation drugs and chemotherapy with taxanes such as docetaxel (DTX). Our group demonstrated previously that the stress oncoprotein Lens Epithelium Derived Growth Factor of 75 kD (LEDGF/p75) is upregulated in clinical prostate tumors and contributes to DTX-resistance in mCRPC cells. However, little is known about the molecular mechanisms by which LEDGF/p75 promotes taxane resistance. The C-terminus of LEDGF/p75 contains a domain called the Integrase Binding Domain (IBD), which in T cells is responsible for tethering the HIV-integrase complex to transcriptionally active chromatin. In cancer cells, the LEDGF/p75 IBD interacts with oncogenic transcription complexes, such as Menin-MLL and the cMYC binding protein JPO2, to promote cell survival. However, the relevance of these protein-protein interactions (PPIs) in PCa and chemoresistance has never been explored. This study is designed to characterize the interaction between LEDGF/p75 and JPO2 in the DTX-resistant mCRPC cell lines PC3-DR and DU145-DR, and determine if this interaction contributes to drug resistance. Also, we want to target this interaction with repurposed HIV-based small molecule inhibitors (SMI’s) of LEDGF/p75, which target the IBD, to abrogate this resistance. We demonstrated by immunoblotting a significant 2-fold co-upregulation of JPO2 and LEDGF/p75 in the DTX-resistant PCa cells. We also observed the nuclear co-localization of these proteins by immunofluorescence microscopy. Using an immunoprecipitation approach, we confirmed that endogenous JPO2 and LEDGF/p75 co-immunoprecipitate in the DTX-resistant PCa cells. In addition, we initiated studies to evaluate SMIs originally designed to target the interaction between LEDGF/p75 and HIV-IN, for their efficacy in sensitizing resistant cells to DTX. After screening over 100 candidate inhibitors, we selected a set of SMIs which demonstrated a 20-30% decrease in viability in DTX-resistant cells when used alone, and 40-60% when used in combination with DTX. Studies are in progress to determine if these SMIs bind to LEDGF/p75 and inhibit its interaction with JPO2 and other oncoproteins. We predict that targeting LEDGF/p75 PPIs with HVI-based SMIs will disrupt transcriptional activity contributing to DTX resistance. Our goals are to establish the contribution of PPIs to LEDGF/p75-mediated transactivation of stress oncoproteins, and target these interactions to overcome PCa chemoresistance.

Citation Format: Greisha L. Ortiz Hernandez, Shannalee Martinez, Evelyn Sanchez-Hernandez, Leslimar Rios-Colon, Christina Cajigas-DuRoss, Tino Sanchez, Nouri Neamati, Carlos A. Casiano. The cMYC-associated transcription factor JPO2 is upregulated in taxane resistant prostate cancer cells and interacts with the stress oncoprotein LEDGF/p75 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4395.

Epidemiology and management of bacterial leaf spot on watermelon caused by Pseudomonas syringae

Bacterial leaf spot of watermelon caused by Pseudomonas syringae has been an emerging disease in the southeastern United States in recent years. Disease outbreaks in Florida were widespread from 2013 to 2014 and resulted in foliar blighting at the early stages of the crop and transplant losses. We conducted a series of field trials at two locations over the course of two years to examine the chemical control options that may be effective in management of this disease, and to investigate the environmental conditions conducive for bacterial leaf spot development. Weekly applications of acibenzolar-S-methyl (ASM) foliar, ASM drip, or copper hydroxide mixed with ethylene bis-dithiocarbamate were effective in reducing the standardized area under the disease progress curve (P < 0.05). Pearson's correlation test demonstrated a negative relationship between the average weekly temperature and disease severity (-0.77, P = 0.0002). When incorporated into a multiple regression model with the square root transformed average weekly rainfall, these two variables accounted for 71% of the variability observed in the weekly disease severity (P < 0.0001). This information should be considered when choosing the planting date for watermelon seedlings as the cool conditions often encountered early in the spring season are conducive for bacterial leaf spot development.

Sperm Release From the Oviductal Epithelium Depends on Ca(2+) Influx Upon Activation of CB1 and TRPV1 by Anandamide

The oviduct acts as a functional sperm reservoir in many mammalian species. Both binding and release of spermatozoa from the oviductal epithelium are mainly modulated by sperm capacitation. Several molecules from oviductal fluid are involved in the regulation of sperm function. Anandamide is a lipid mediator involved in reproductive physiology. Previously, we demonstrated that anandamide, through activation of the cannabinoid receptor type 1 (CB1), promotes sperm release from bovine oviductal epithelial cells, and through CB1 and the transient receptor potential vanilloid 1 (TRPV1), induces sperm capacitation. Herein we investigate co-activation between CB1 and TRPV1, and Ca(2+) influx as part of the mechanism of action of anandamide during sperm release from oviductal cells. Our results indicate that in the absence of Ca(2+) anandamide failed to release spermatozoa from oviductal epithelial cells. Additionally, sperm release promoted by cannabinoid and vanilloid agonists was abolished when the spermatozoa were preloaded with BAPTA-AM, a Ca(2+) chelator. We also determined Ca(2+) levels in spermatozoa preloaded with FURA2-AM co-cultured with oviductal cells and incubated with different cannabinoid and vanilloid agonists. The incubation with different agonists induced Ca(2+) influx, which was abolished by CB1 or TRPV1 antagonists. Our results also suggest that a phospholypase C (PLC) might mediate the activation of CB1 and TRPV1 in sperm release from the bovine oviduct. Therefore, our findings indicate that anandamide, through CB1 and TRPV1 activation, is involved in sperm release from the oviductal reservoir. An increase of sperm Ca(2+) levels and the PLC activation might be involved in anandamide signaling pathway.

Very low level viraemia and risk of virological failure in treated HIV-1-infected patients

OBJECTIVES

The aim of the study was to investigate whether very low level viraemia (VLLV) (20-50 HIV-1 RNA copies/mL) was associated with increased risk of virological failure (VF) as compared with persistent full suppression (< 20 copies/mL).

METHODS

From the VACH Cohort database, we selected those patients who started antiretroviral therapy (ART) after January 1997 and who achieved effective viral suppression [two consecutive viral loads (VLs) < 50 copies/mL] followed by full suppression (at least one VL <20 copies/mL). We carried out survival analyses to investigate whether the occurrence of VLLV rather than maintaining full suppression at < 20 copies/mL was associated with virological failure (two consecutive VLs > 200 copies/mL or one VL > 200 copies/mL followed by a change of ART regimen, administrative censoring or loss to follow-up), adjusted for nadir CD4 cell count, sex, age, ethnicity, transmission group, type of ART and time on effective suppression at < 50 copies/mL.

RESULTS

Of 21 480 patients who started ART, 13 674 (63.7%) achieved effective suppression at < 50 copies/mL, of whom 4289 (31.4%) further achieved full suppression at < 20 copies/mL after May 2009. A total of 2623 patients (61.1%) remained fully suppressed thereafter, while 1666 had one or more episodes of VL detection > 20 copies/mL (excluding virological failure). A total of 824 patients had VLLV after suppression at < 20 copies/mL. VLLV was not associated with virological failure as compared with persistent full suppression [hazard ratio (HR) 0.67; 95% confidence interval (CI) 0.44-1.00], independently of the number of blips recorded (from one to 18).

CONCLUSIONS

In our population of HIV-infected patients on ART who achieved viral suppression at < 20 copies/mL, the risk of virological failure was no different for patients who remained fully suppressed compared with those who experienced subsequent episodes of VLLV.

Abstract B13: Differential expressions of stress proteins and miRNAs in circulating exosomes in prostate cancer health disparities

African American men are about 1.5 times more likely to develop prostate cancer and about 2.5 times more likely to die from prostate cancer. However, there's no known cause of increased rate of morbidity and mortality in these population. Stress is well known factor for the causation of health disparities. Stress is a known inducer of post-transcriptional modification in cellular levels. Survivin, a member of the inhibitor of apoptosis family can get alternatively spliced both transcriptionally and post-transcriptionally. We have shown that survivin and its splice variants are secreted from cells via exosomes, small membrane-bound vesicles used in cell-cell and cell-extracellular communication (1,2). MicroRNAs (miRNA) are small RNA, play regulatory role in tumor development and prognosis. Main objective of the present study is to find out differential expression patterns of stress proteins and miRNA from circulating exosomes deived from prostate cancer in African American (PCa-AA) and Caucasian (PCa-CC) patient populations. This is a novel way of establishing non-invasive early detection intervention that can be tailored to Americans of different ethnicities. In this study, exosomes are collected from sera of PCa-AA and PCa-CC using the commercially available ExoQuick kit. miRNAs are extracted from the exosomes using QIAGEN miRNA kit. Differential expressions of IAPs, wild type survivin and its splice variants are noted in the exosomes of AA-prostate cancer patients' sera compared to CC-prostate cancer sera. Differentially expressed miRNAs are identified by sequencing analysis. We find that this observation will ultimately pave the way for future studies focused on analyzing these biomarkers in larger cohorts of ethnically diverse cancer patients.

Citation Format: Salma Khan, TessaRae Stiff, Jennifer Simpson, James C. Lynch, Patrick Leaf, Amber Gonda, saeid mirshahidi, Tino Sanchez, Carlos A. Casiano, Nathan R. Wall. Differential expressions of stress proteins and miRNAs in circulating exosomes in prostate cancer health disparities. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B13.

Abstract 5411: Repositioning HIV-based small molecule inhibitors of the stress survival oncoprotein LEDGF/p75 to overcome taxane resistance in prostate cancer

Prostate cancer (PCa) is the second most commonly diagnosed cancer in men and the leading cause of cancer-related deaths in elderly males. Although early stage PCa is treatable, many patients eventually develop castration-resistant disease (mCRPC), characterized by metastasis and resistance to therapy. Furthermore, PCa also presents a major health disparity problem as evidenced by its disproportionately high incidence and mortality in African American men compared to other racial/ethnic groups. Reducing or eliminating these disparities in PCa mortality will require innovative therapeutic approaches to circumvent chemoresistance and increase patient survival. We have previously demonstrated that lens epithelium-derived growth factor of 75 kD (LEDGF/p75) is a stress survival protein that is overexpressed in PCa cells and clinical tumors, and promotes resistance to Docetaxel (DTX), the gold standard for mCRPC chemotherapy. LEDGF/p75 has also been extensively studied as a target to inhibit HIV-1 integration into host chromatin because of its role as a key cellular cofactor of HIV integrase (IN). A series of novel and potent small molecule inhibitors (SMI) of LEDGF/p75 were previously evaluated for their potential to disrupt its interaction with HIV-IN. We hypothesized that repositioning these SMI to target LEDGF/p75 in the context of PCa could be a promising strategy for overcoming taxane resistance. We observed that PC3 and DU145 mCRPC cells selected for DTX resistance expressed high levels of LEDGF/p75, and were also resistant to the taxanes Cabazitaxel (CTX) and Paclitaxel (PTX). This chemoresistance was selective since LEDGF/p75 did not protect cells against the classical apoptotic inducer TRAIL, which triggers caspase-mediated cleavage and inactivation of LEDGF/p75. RNAi-mediated knockdown of LEDGF/p75 in these cell lines sensitized them to taxane therapy. We then evaluated 130 LEDGF/p75 SMI for their cytotoxicity in DTX-resistant and sensitive PC3 and DU145 cells, in the presence and absence of DTX. These experiments yielded a number of inhibitors that induced cell death directly or re-sensitized resistant cells to taxanes only when combined with these drugs. Our results suggest that LEDGF/p75 is a druggable oncoprotein that could be targeted with repositioned HIV-based SMI to overcome PCa chemoresistance.

Citation Format: Leslimar Rios Colon, Catherine Elix, Ivana Alicea, Anamika Basu, Christina Du Ross, Tino Sanchez, Nouri Neamati, Carlos Casiano. Repositioning HIV-based small molecule inhibitors of the stress survival oncoprotein LEDGF/p75 to overcome taxane resistance in prostate cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 5411. doi:10.1158/1538-7445.AM2015-5411

[Results after distraction arthroplasty according to Bufalini and Perugia in early stages of trapeziometacarpal osteoarthritis]

BACKGOUND

A distraction arthroplasty of the trapeziometacarpal joint was introduced by Bufalini and Perugia for the treatment of the early stages of carpometacarpal osteoarthritis. Our retrospective study presents the results of this technique. Thereby, a tendon graft anchored to the distal second metacarpal is fixed at the base of the first metacarpal, keeping it in distraction.

MATERIAL AND METHODS

10 distraction arthroplasties were performed in 9 patients with carpometacarpal osteoarthritis stage I and II of the thumb after unsuccessful conservative therapy. In 2 cases, which were excluded from our study, trapeziectomy had to be performed because of persisting pain. Patient satisfaction, pain measurement, range of motion, and tip, key and grip strength were evaluated at a follow-up of 46.5 (29-63) months in the remaining 7 patients (8 operations overall). Strengh measurement was taken in an absolute value and compared to the opposite side. Thumb range of motion was measured with the combined flexion-opposition of the thumb with the Kapandij index and also the angle of abduction of the metacarpal I to metacarpal II. Assessment included a DASH score evaluation and an X-ray control.

RESULTS

All of the 7 evaluated patients were satisfied with the operation results. Compared to the opposite side, patients achieved 80.1% (5.9 kg±1.1 kg) of key pinch strength, 86.3% (4.8 kg±0.9 kg) of oppositional tip pinch strength, and 86.1% (23.1 kg±4.8 kg) of grip strength. In combined flexion and opposition a Kapandij index of 8.5 (94.4%) compared to 9 on the opposite side was achieved. Thumb radial abduction was 48.2°±2.8°, compared to 51.0°±2.9° on the contralateral hand. At follow-up, the mean DASH score was 17.8 (±10.0). Radiological control showed no progression of carpometacarpal osteoarthritis of the thumb.

CONCLUSIONS

The collected data after distraction arthroplasty according to Bufalini and Perugia confirm the efficacy of the technique in the early stage of carpometacarpal osteoarthritis of the thumb. Even though a failure rate of 20% occurred, in our opinion the operation is justified in the early stages of carpometacarpal osteoarthritis of the thumb as the patients benefit from a pain-free interval, leaving the option for future trapeziectomy.

[Corion Interposition Arthroplasty after Post-Traumatic Metacarpophalangeal Cartilage Defects - Two Case Reports]

We report on the long-term results of 2 patients after saw injury by restoration of metacarpophalangeal joint II with bone graft from the iliac crest and interposition arthroplasty of the corion. Clinical and radiological controls were performed in the 6(th) and 8(th) post-operative years, respectively. The DASH scores (11.6 and 18.3, respectively) and range of motion (60 and 70° respectively) were associated with no pain and satisfaction with the results of the operation for both patients. In summary, the reconstruction of selected cases of metacarpophalangeal joint defects with iliac crest and corium interposition arthroplasty is a good treatment option.

Formaldehyde chemistry in cometary ices: the case of HOCH2OH formation

Laboratory experiments devoted to simulate the chemistry occurring in interstellar and cometary ice analogues are of paramount importance to understand the formation of complex organic molecules that are detected throughout the universe.

Clinical evaluation of hip joint rotation range of motion in adults

INTRODUCTION

Data on hip joint rotation range of motion (ROM) are rare; the methods of measurement vary and reproducibility has not been evaluated, in particular in relation to the subject's position (prone or supine, seated).

HYPOTHESIS

Hip joint rotation ROM is symmetrical, and ROM is not modified by the patient's position when data is obtained.

PATIENTS AND METHODS

This series included 120 adults between 20 and 60 years old (71 women, 49 men), who had no hip, spine or lower extremity disorders. External (ER) and internal (IR) rotation ROM was obtained using a photographic method by two observers. Measurements were obtained with the patient in three positions: the dorsal decubitus (supine) (P1), and ventral decubitus (prone) (P2) with the hip in extension and seated with the hip in flexion (P3).

RESULTS

Hip rotation ROM was P1: 68.1° (ER=38.5°; IR=29.6°); P2: 77.1°(ER=41.8°; IR=35.2°); P3: 78.5° (ER=78.5°; IR=37.9°) with no significant difference among the three positions. Interobserver reproducibility was satisfactory (concordance correlation coefficient (ccc) 0.7) and was comparable in the three positions with a ccc of 0.7072 (P1), 0.7426 (P2) and 0.7332 (P3), respectively. Hip rotation ROM balance was ER predominant in 47.5%, neutral in 39.5% and IR predominant in 13%. Hip rotation ROM balance was symmetric in both hips in 73 subjects (61%). Hip rotation ROM was reduced with age (P<0.0001), and was 4.7° less in men (P=0.0078), and in overweight subjects (P<0.0006).

DISCUSSION

Our values are probably lower than those in the literature because of the difference in study population. In our series, age, BMI and gender seemed to be determining factors. Hip rotation ROM balance is usually ER predominant or neutral. Hip rotation ROM can be measured in the three positions with no significant difference, with satisfactory interobserver reproducibility for each.

TYPE OF STUDY

Diagnostic prospective study: level III.

Clinical research nursing: a critical resource in the national research enterprise

Translational clinical research has emerged as an important priority for the national research enterprise, with a clearly stated mandate to more quickly deliver prevention strategies, treatments and cures based on scientific innovations to the public. Within this national effort, a lack of consensus persists concerning the need for clinical nurses with expertise and specialized training in study implementation and the delivery of care to research participants. This paper reviews efforts to define and document the role of practicing nurses in implementing studies and coordinating clinical research in a variety of clinical settings, and differentiates this clinical role from the role of nurses as scientists and principal investigators. We propose an agenda for building evidence that having nurses provide and coordinate study treatments and procedures can potentially improve research efficiency, participant safety, and the quality of research data. We also provide recommendations for the development of the emerging specialty of clinical research nursing.

[Resection, interposition and suspension arthroplasty for treatment of Basal joint arthritis of the thumb: a randomized and prospective comparison of techniques using the abductor pollicis longus- and the flexor carpi radialis tendon]

The operative treatment of thumb carpometacarpal joint arthritis may include resection-suspension-interposition-arthroplasty. Although quite a technically demanding procedure, a suspension arthroplasty using a strip of the flexor carpi radialis tendon is quite a popular technique. Other techniques, which use the abductor pollicis longus (APL) tendon, is also widely accepted.The aim of this randomized, prospective study was to compare the results of these 2 procedures 8 months postoperatively.From May 2005 to December 2006 a total of 55 operations in 53 patients with symptomatic Grade III or IV 1st CMC joint arthritis were identified and recruited into the study. They were then randomized to one of the 2 groups (APL vs. FCR). Patients were assessed preoperatively, and then immediately and 8 months postoperatively. Both, subjective parameters (Visual Analog Scale and DASH-Score) and functional parameters (maximum radial abduction, opposition and pinch- and key grip strength) where recorded. Additionally, the trapezial space was assessed radiographically postoperatively.After 8 months both groups had comparable subjective results (APL-group: VAS 2.3 points, DASH 24 points; FCR-group: VAS 1.9 points, DASH 20 points) as well as functional results (APL-group: radial abduction 55.3°, key-grip strength 8.1 kg, pinch-grip strength 5.5 kg; FCR-group: radial abduction 55.8°, key-grip strength 7.2 kg, pinch-grip strength 4.7 kg). Radiologically both groups showed an approximate 50% reduction in the height of the trapezial space.In resection-suspension-interposition-arthroplasty of the 1st CMC joint, similar results can be obtained using the technically less demanding APL-procedure when compared with the FCR-technique 8 months postoperatively.

Circularization, photomechanical switching, and a supercoiling transition of actin filaments

We confine actin filaments onto a 2D surface using depletion interactions and show that this significantly increases the probability of intramolecular circularization. Quantitative analysis reveals that the resulting semiflexible rings fluctuate significantly less then their linear counterparts with equal stiffness-an effect induced by the constraint of circular geometry. When exposed to fluorescence excitation light, rhodamine-phalloidin-labeled filaments undergo a change in their natural twist. This photomechanical transition induces a localized small-wavelength supercoiling transition of absorbed actin rings. Upon completion of the photoinduced reaction, the twist of neighboring monomers in an actin filament changes by approximately 0.26 degrees .

Self-reported syphilis and gonorrhoea testing among men who have sex with men: national HIV behavioural surveillance system, 2003-5

OBJECTIVES

The Centers for Disease Control and Prevention provides guidance on sexually transmitted disease (STD) testing specifically for men who have sex with men (MSM) in STD treatment guidelines to address increasing rates of gonorrhoea and syphilis among MSM in the USA. The guidelines recommend at least annual syphilis, gonorrhoea and chlamydia testing for sexually active MSM. The implementation of these guidelines was evaluated.

METHODS

Data from the 2003-5 MSM cycle of the National HIV Behavioural Surveillance System were used. The proportion of sexually active HIV-negative MSM reporting syphilis and gonorrhoea testing during the previous year was determined and multivariate logistic regression was used to identify factors associated with testing.

RESULTS

Of 10 030 MSM, 39% and 36% reported having been tested for syphilis and gonorrhoea in the previous year, respectively. Four factors were associated with syphilis and gonorrhoea testing, respectively: age 18-24 years versus > or =45 years (odds ratio (OR) 2.2, 95% CI 1.8 to 2.5; OR 2.7, 95% CI 2.3 to 3.2), black versus white race (OR 1.3, 95% CI 1.1 to 1.4; OR 1.4, 95% CI 1.2 to 1.6), private insurance versus no insurance (OR 1.3, 95% CI 1.1 to 1.4; OR 1.3, 95% CI 1.1 to 1.4) and disclosing male-male sex to a healthcare provider (OR 2.2, 95% CI 2.0 to 2.5; OR 2.1, 95% CI 1.9 to 2.3).

CONCLUSIONS

Syphilis and gonorrhoea testing among MSM was low, despite specific testing recommendations in the STD treatment guidelines. To increase STD testing among MSM, healthcare providers should assess the risks of STD for male patients through routine enquiries about sexual activity.

Activation of kinin B receptor triggers differentiation of cultured human keratinocytes

BACKGROUND

Keratinocyte life span is modulated by receptors that control proliferation and differentiation, key processes during cutaneous tissue repair. The kinin B(1) receptor (B(1)R) has been reported in normal and pathological human skin, but so far there is no information about its role in keratinocyte biology.

OBJECTIVES

To determine the consequence of kinin B(1)R stimulation on tyrosine phosphorylation, a key signalling mechanism involved in keratinocyte proliferation and differentiation.

METHODS

Subconfluent primary cultures of human keratinocytes were used to investigate tyrosine phosphorylation, epidermal growth factor receptor (EGFR) transactivation, cell proliferation and keratinocyte differentiation. Cell proliferation was assessed by measuring bromodeoxyuridine incorporation whereas assessment of cell differentiation was based on the expression of filaggrin, cytokeratin 10 (CK10) and involucrin.

RESULTS

The major proteins phosphorylated, after B(1)R stimulation, were of molecular mass 170, 125, 89 and 70 kDa. The 170- and 125-kDa proteins were identified as EGFR and p125(FAK), respectively. Phosphorylation was greatly reduced by GF109203X and by overexposure of keratinocytes to phorbol 12-myristate 13-acetate, indicating the participation of protein kinase C. B(1)R stimulation did not increase [Ca(2+)]i, but triggered EGFR transactivation, an event that involved phosphorylation of Tyr(845), Tyr(992) and Tyr(1068) of EGFR. B(1)R stimulation did not elicit keratinocyte proliferation, but triggered cell differentiation, visualized as an increase of filaggrin, CK10 and involucrin. Blockade of EGFR tyrosine kinase by AG1478, before B(1)R stimulation, produced an additional increase in filaggrin expression.

CONCLUSIONS

The kinin B(1)R may contribute to keratinocyte differentiation and migration by triggering specific tyrosine signalling pathways or by interacting with the ErbB receptor family.

Novel dimeric aryldiketo containing inhibitors of HIV-1 integrase: effects of the phenyl substituent and the linker orientation

Aryl diketoacids (ADK) and their bioisosteres are among the most promising HIV-1 integrase (IN) inhibitors. Previously, we designed a series of ADK dimers as a new class of IN inhibitors that were hypothesized to target two divalent metal ions on the active site of IN. Herein we present a further structure-activity relationship (SAR) study with respect to the substituent effect of the ADK and the dimerization with conformationally constrained linkers such as piperazine, 4-amino-piperidine, piperidin-4-ol, and trans-cyclohexan-1,4-diamine. The substituents on the phenyl ring as well as the spatial orientation of the two diketo units were observed to play important roles in the IN inhibitory potency. The hydrophobic group was an optimal substitution at the 3-position of the aryl ring. The piperazine and 4-amino-piperidine linkers brought about the most potent analogs among the hydrophobic group or halogen substituted ADK dimers. The docking studies suggested that the bulky hydrophobic substitution at 3-phenyl ring and the linker of 4-amino-piperidine were beneficial for adopting an active conformation to achieve strong interactions with the active site Mg(2+) and the key residue E152 within the catalytic core domain. This study is a significant extension of our previous report on the dimeric ADK-containing IN inhibitors, providing a new promising template for further lead optimization.

Synthesis and anti-HIV-1 integrase activities of 3-aroyl-2,3-dihydro-1,1-dioxo-1,4,2-benzodithiazines

A series of novel 3-aroyl-2,3-dihydro-1,1-dioxo-1,4,2-benzodithiazines 15-28 as potential HIV-1 integrase (IN) inhibitors have been synthesized by the reduction of 3-aroyl-1,1-dioxo-1,4,2-benzodithiazines 1-14 with benzenesulfonyl hydrazide. All the compounds 15-28 inhibited IN mediated strand transfer reaction with IC(50) values ranging from 3 to 30 microM. The 3-(4-bromobenzoyl)-6-chloro-7-methyl-2,3-dihydro-1,1-dioxo-1,4,2-benzodithiazine 17 with the IC(50) values of 4+/-1 and 3+/-1 microM for 3'-processing and strand transfer, respectively, was the most potent. Compound 17 as well its analogues were 5-20-fold less potent in Y99S and H114A mutants, implicating these residues as potential drug-binding site. This is a first report implicating Y99S and H114A of IN core domain in drug-binding interactions.

Discovery of structurally diverse HIV-1 integrase inhibitors based on a chalcone pharmacophore

Recently, we reported small-molecule chalcones as a novel class of HIV-1 integrase (IN) inhibitors. The most potent compound showed an IC50 value of 2 microM for both IN-mediated 3'-processing and strand transfer reactions. To further utilize the chalcones, we developed pharmacophore models to identify chemical signatures important for biological activity. The derived models were validated with a collection of published inhibitors, and then were applied to screen a subset of our small molecule database. We tested 71 compounds in an in vitro assay specific for IN enzymatic activity. Forty-four compounds showed inhibitory potency<100 microM, and four of them exhibited IC50 values<10 microM. One compound, 62, with an IC50 value of 0.6 microM, displayed better potency than the original chalcone 2 against the strand transfer process. This study demonstrates the systematic use of pharmacophore technologies to discover novel structurally diverse inhibitors based on lead molecules that would exhibit poor characteristics in vivo. The identified compounds have the potential to exhibit favorable pharmacokinetic and pharmacodynamic profiles.

Synthesis and biological evaluation of novel 5(H)-phenanthridin-6-ones, 5(H)-phenanthridin-6-one diketo acid, and polycyclic aromatic diketo acid analogs as new HIV-1 integrase inhibitors

A new series of phenanthridinone derivatives, and diketo acid analogs, as well as related phenanthrene and anthracene diketo acids have been synthesized and evaluated as HIV integrase (IN) inhibitors. Several new beta-diketo acid analogs with the phenanthridinone scaffold replaced by phenanthrene, anthracene or pyrene exhibited the highest IN inhibitory potency. There is a general selectivity against the integrase strand transfer step. The most potent IN was 2,4-dioxo-4-phenanthren-9-yl-butyric acid (27f) with an IC(50) of 0.38microM against integrase strand transfer. The phenanthrene diketo acids 27d-f were more potent (IC(50)=2.7-0.38microM) than the corresponding phenanthridinone diketo acid 16 (IC(50)=65microM), suggesting that the polar amide bridge in the phenanthridinone system decreases inhibitory activity relative to the more lipophilic phenanthrene system. This might have to do with the possible binding of the aryl group of the compounds binding to a lipophilic pocket at the integrase active site as suggested by the docking simulations. Molecular modeling also suggested that effectiveness of chelation of the active site Mg(2+) contributes to IN inhibitory potency. Finally, some of the potent compounds inhibited HIV-1 replication in human peripheral blood mononuclear cells (PBMC) with EC(50) down to 8microM for phenanthrene-3-(2,4-dioxo)butyric acid (27d), with a selectivity index of 10 against PBMCs.

Discovery and structure-activity relationship studies of a unique class of HIV-1 integrase inhibitors

HIV-1 integrase (IN) is an essential enzyme for viral replication and a validated target for the development of drugs against AIDS. Currently there are no approved drugs that target IN. However, new IN inhibitors are under clinical investigation. As more IN inhibitors enter human drug trials, there is a growing need for the design of novel lead compounds with diverse structural scaffolds and promising pharmacokinetic properties to counteract the difficulties observed with first-generation IN inhibitors. We have identified a novel class of IN inhibitors through the systematic exploration of structure-activity relationships in a series of linomide analogues. The predicted bound conformation of the most active analogues inside the IN active site also supports the observed structure-activity correlation in this new compound class.

Ring substituent effects on biological activity of vinyl sulfones as inhibitors of HIV-1

In a previous study, we prepared a small library of chicoric acid analogs that possessed both potent anti-integrase and antiviral activity. It was also shown that active compounds fell into one of two groups: those that inhibited an early stage in viral replication and those that inhibited at a later stage. In this study, a series of vinyl geminal disulfone-containing compounds possessing a range of ring substituents has been synthesized to probe the impact of structure on inhibitory mechanisms. Four active compounds were identified using HIV drug susceptibility assays. Three of the inhibitors possessing either no substituents or electron-withdrawing substituents on the aromatic rings led to high levels of cytotoxicity and antiviral activity. Intrigued by the potential implications of electronic effects on activity, we probed whether the active compounds could be nonspecifically reacting via 1,4-addition. To investigate this hypothesis, the compounds were incubated with glutathione and upon LC/MS analysis, molecular ion peaks corresponding to both mono and double addition adducts were identified. Second, we synthesized analogs lacking the ability to participate in 1,4-addition and tested them for antiviral activity and cytotoxicity, and found the compounds inactive for both activities. Taken together, the studies reported herein suggest that compounds lacking electron-donating substituents on the aromatic ring are promiscuous acceptors of biological nucleophiles, whereas compounds possessing electron-donating substituents seem to resist addition or at least be more selective and significantly less toxic.

Dynamic Pharmacophore Model Optimization: Identification of Novel HIV-1 Integrase Inhibitors

We extended the previously described dynamic pharmacophore model studies of HIV-1 integrase (IN) by considering more key residues in the active site, including Mg2+. First, we applied a Monte Carlo sampling method to map the complementary features of the IN binding surface. Two types of dynamic pharmacophore models were generated. One considers Mg2+ as part of the IN and therefore as an excluded volume, and the other treats Mg2+ as a positively charged feature, representing a new type of pharmacophore model aimed to identify compounds potentially preventing Mg2+ binding. Second, we validated the models with 385 known active (IC50 < 20 microM) and 235 (IC50 > 100 microM) inactive IN inhibitors. Third, we used the derived models to screen our small molecule database. Twenty-two structurally novel compounds were tested in an in vitro assay specific for IN, and two of them showed IC50 < or = 10 microM for strand transfer reaction.

Diketo acid pharmacophore. 2. Discovery of structurally diverse inhibitors of HIV-1 integrase

Because of its unique role in the viral replication process, HIV-1 integrase (IN) is an important antiretroviral drug target. The beta-diketo acid class of IN inhibitors has played a major role in validating IN as a legitimate target for antiretroviral drug design. S-1360 (1) and L-870,810 (2) are examples of beta-diketo acid related compounds to enter clinical trials. With an aim to discover novel lead compounds with diverse structural scaffolds, we employed common feature pharmacophore models using four known beta-diketo acid analogues including S-1360 (J. Med. Chem. 2005, 1, 111-120). The best-ranked pharmacophore model (Hypo1) contained a hydrophobic (HYA), an H-bond acceptor (HBA), and two H-bond donor (HBD) features. A search of a 3D database containing approximately 150,000 small molecules using Hypo1 found 1700 compounds that satisfied all the features of the pharmacophore query. Of the 1700 compounds, 110 were selected for in vitro screening studies on the basis of their docking scores, predicted binding location inside the active site of IN, and their druglike properties. Forty-eight compounds inhibited IN catalytic activities with an IC50 value less than 100 microM. Twenty-seven structurally diverse inhibitors are reported here. Out of the 27 compounds, 13 compounds inhibited strand transfer activity of IN with an IC50 value less than 30 microM. These compounds are novel, druglike, and readily amenable for synthetic optimization.

Mining the NCI antiviral compounds for HIV-1 integrase inhibitors

HIV-1 integrase (IN) is an essential enzyme for effective viral replication and is a validated target for the development of antiretroviral drugs. Currently, there are no approved drugs targeting this enzyme. In this study, we have identified 11 structurally diverse small-molecule inhibitors of IN. These compounds have been selected by mining the moderately active antiviral molecules from a collection of 90,000 compounds screened by the National Cancer Institute (NCI) Antiviral Program. These compounds, which were screened at the NCI during the past 20 years, resulted in approximately 4000 compounds labeled as 'moderately active.' In our study, chalcone 11 shows the most potent activity with an IC(50) of 2+/-1 microM against purified IN in the presence of both Mn(2+) and Mg(2+) as cofactors. Docking simulations using the 11 identified inhibitors as a training set have elucidated two unique binding areas within the active site: the first encompasses the conserved D64-D116-E152 motif, while the other involves the flexible loop region formed by amino acid residues 140-149. The tested inhibitors exhibit favorable interactions with important amino acid residues through van der Waals and H-bonding contacts.

Dynamic receptor-based pharmacophore model development and its application in designing novel HIV-1 integrase inhibitors

We present here a dynamic receptor-based pharmacophore model representing the complementary features of the active site region of HIV-1 integrase (IN), which was developed from a series of representative conformations of IN. Conformations of IN were sampled through a molecular dynamics study of the catalytic domain of an IN monomer, and an ensemble of representative IN structures were collected via a probability-based representative conformer sampling method that considers both the potential energy and the structural similarity of the protein conformations. The dynamic pharmacophore model was validated by a set of 128 known inhibitors, and the results showed that over 72% of the active inhibitors (IC(50) lower than 20 microM) could be successfully identified by the dynamic model. Therefore, we screened our in-house database of commercially available compounds against this model and successfully identified a set of structurally novel IN inhibitors. Compounds 7 and 18 with IC(50)s of 8 microM and 15 microM, respectively, against the strand transfer reaction were the most potent. Moreover, 7, 8 and 20 showed a 5-fold selectivity for the strand transfer reaction over 3'-processing.

β-Diketo Acid Pharmacophore Hypothesis. 1. Discovery of a Novel Class of HIV-1 Integrase Inhibitors

HIV-1 Integrase (IN) is an essential enzyme for viral replication. The discovery of beta-diketo acids was crucial in the validation of IN as a legitimate target in drug discovery against HIV infection. In this study, we discovered a novel class of IN inhibitors using a 3D pharmacophore guided database search. We used S-1360 (1), the first IN inhibitor to undergo clinical trials, and three other analogues to develop a common feature pharmacophore hypothesis. Testing this four-featured pharmacophore against a multiconformational database of 150,000 structurally diverse small molecules yielded 1,700 compounds that satisfied the 3D query. Subsequently, all 1,700 compounds were docked into the active site of IN. On the basis of docking scores, Lipinski's rule-of-five, and structural novelty, 110 compounds were selected for biological screening. We found that compounds that contain both salicylic acid and a 2-thioxo-4-thiazolidinone (rhodanine) group (e.g. 5-13) showed significant inhibitory potency against IN, while the presence of either salicylic acid or a rhodanine group alone did not. Although some of the compounds containing only a salicylic acid showed inhibitory potency against IN, none of the compounds containing only rhodanine exhibited considerable potency. Of the 52 compounds reported in this study, 11 compounds (5, 6, 8, 10-13, 32-33, 51, and 53) inhibited 3'-processing or strand transfer activities of IN with IC(50) < or = 25 microM. This is the first reported use of S-1360 and its analogues as leads in developing a pharmacophore hypothesis for IN inhibition and for identification of new compounds with potent inhibition of this enzyme.

Design and synthesis of novel dihydroxyindole-2-carboxylic acids as HIV-1 integrase inhibitors

In a search for new HIV-1 integrase (IN) inhibitors, we synthesized and evaluated the biological activity of 5,6-dihydroxyindole-2-carboxylic acid (DHICA) and a series of its derivatives. These compounds were designed as conformationally constrained analogues of the acrylate moiety of caffeic acid phenethyl ester (CAPE). DHICA, an intermediate in the biosynthesis of melanins, was prepared as a monomeric unit by a novel synthetic route. In order to perform coherent SAR studies, two series of DHICA amides were synthesized. First, to validate the utility of a previously identified three-point pharmacophore based on CAPE in inhibitor design, we prepared a series of benzyl- or phenylethylamine substituted derivatives lacking and containing hydroxyl groups. Second, dimers of DHICA containing various aminoalkylamine linkers were also prepared with a goal to increase potency. All compounds were tested against purified IN and the C65S mutant in enzyme-based assays. They were also tested for cytotoxicity in an ovarian carcinoma cell line and antiviral activity in HIV-1-infected CEM cells. Seven compounds inhibited catalytic activities of purified IN with IC50 values below 10 microM. Further computational docking studies were performed to determine the title compounds' mode of interaction with the IN active site. The residues K156, K159 and D64 were the most important for potency against purified IN.

Synthesis, antiviral, and anti-HIV-1 integrase activities of 3-aroyl-1,1-dioxo-1,4,2-benzodithiazines

HIV-1 integrase (IN) is an essential enzyme for effective viral replication and is an attractive target for selective blockade of viral infection. Previously, we identified a series of sulfones, sulfonamides, and mercaptosalicylhydrazides (MBSAs) as IN inhibitors with antiviral activities in cell-based assays. In an effort to optimize a series of our active site directed lead compounds, we designed and synthesized novel benzodithiazines starting from MBSAs. In contrast to all reported IN inhibitors benzodithiazines are essentially nontoxic. Significant antiviral potency was only observed at concentration exceedingly higher than that required to inhibit purified IN.