Wolbachia screening in spiders and assessment of horizontal transmission between predator and prey

Recent studies have revealed that the prevalence of Wolbachia in arthropods is attributable not only to its vertical transmission, but also to its horizontal transfer. In order to assess the horizontal transmission of Wolbachia between predator and prey, arthropods belonging to 11 spider families and six insect families were collected in the same field of rice. The distribution of Wolbachia in these arthropods was detected by diagnostic PCR amplification of the wsp (Wolbachia outer surface protein gene) and 16S rDNA genes. Nurscia albofasciata Strand (Araneae: Titanoecidae), Propylea japonica Thunberg (Coleoptera: Coccinellidae), Paederus fuscipes Curtis (Coleoptera: Staphylinidae), and Nilaparvata lugens Stal (Homoptera: Delphacidae) were infected with Wolbachia. This is the first report of infection of N. albofasciata and P. fuscipes by Wolbachia. No direct evidence indicated the existence of horizontal transmission of Wolbachia between predator and prey.

Orf virus ORFV121 encodes a novel inhibitor of NF-kappaB that contributes to virus virulence

Orf virus (ORFV), the type member of the genus Parapoxvirus of the Poxviridae, has evolved novel strategies (proteins and/or mechanisms of action) to modulate host cell responses regulated by the nuclear factor-κB (NF-κB) signaling pathway. Here, we present data indicating that ORFV ORFV121, a gene unique to parapoxviruses, encodes a novel viral NF-κB inhibitor that binds to and inhibits the phosphorylation and nuclear translocation of NF-κB-p65. The infection of cells with an ORFV121 deletion mutant virus (OV-IA82Δ121) resulted in increased NF-κB-mediated gene transcription, and the expression of ORFV121 in cell cultures significantly suppressed NF-κB-regulated reporter gene expression. ORFV ORFV121 physically interacts with NF-κB-p65 in the cell cytoplasm, thus providing a mechanism for the inhibition of NF-κB-p65 phosphorylation and nuclear translocation. Notably, the deletion of ORFV121 from the viral genome markedly decreased ORFV virulence and disease pathogenesis in sheep, indicating that ORFV121 is a virulence determinant for ORFV in the natural host.

Spirobisnaphthalenes from fungi and their biological activities

Spirobisnaphthalenes have a unique structural feature involving two or three oxygen atoms acting as bridges connecting two original naphthalene subunits. Most of these metabolites isolated from fungi exhibit significant antifungal, antibacterial and cytotoxic properties to show great potential applications in medicine and agriculture. This review focuses on their structural characters and biological activities, as well as their structure-activity relationship, mechanism of action, synthesis and biosynthesis.

S-1 and intraperitoneal and intravenous paclitaxel as neoadjuvant chemotherapy for gastric cancer with positive peritoneal cytology

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Background: The prognosis of gastric cancer with positive peritoneal cytology is dismal. Standard treatments for these patients have not been established. The purpose of this study was to evaluate the safety and response of the regimen.

Methods: Patients who were diagnosed with advanced gastric cancer between 2007 and 2010 underwent staging laparoscopy and received intraperitoneal paclitaxel when peritoneal cytology were positive and sequential systemic chemotherapy, S-1 combined with intravenous paclitaxel within 14 days after staging laparoscopy. Paclitaxel was administered intraperitoneally at 80 mg/m2. S-1 was administered at 80 mg/m2/day for 14 consecutive days, followed by 7 days rest. Paclitaxel was administered intravenously at 50 mg/m2 on day 1 and day 8. After 2 courses of S-1 combined with paclitaxel were administered, clinical response was assessed by gastroendoscopy and computed tomography. Additional 2 or 3 courses were administered unless progression of disease was proved. Patients who achieved complete response (CR) or partial response (PR) and patients with stable disease (SD) underwent second-look laparoscopy following gastrectomy when peritoneal cytology turned negative.

Results: 8 (7 male, 1 female) patients were enrolled: median age was 64 years (range 40-75). Of 8 patients, 1 patient achieved CR, and 5 PR. 2 patients showed progressive disease (PD). Grade 3 neutropenia occurred in 1 patient. 6 patients underwent second-look laparoscopy and peritoneal cytology turned negative in all 6 patients. Total or distal gastrectomy with lymphnode dissection was performed consecutively in 3 or 3 patients, respectively. Median follow-up duration was 775 days (range 187-1,028). No recurrence has not been observed, while the 1-year and 2-year survival rates of 14 patients with peritoneal cytology positive gastric cancer who have not received neoadjuvant chemotherapy were 58.3% and 33.3%, respectively.

Conclusions: S-1, intraperitoneal and intravenous paclitaxel as neoadjuvant chemotherapy seems to be a effective strategy against gastric cancer with positive peritoneal cytology.

No significant financial relationships to disclose.

A nuclear inhibitor of NF-kappaB encoded by a poxvirus

Poxviruses have evolved various strategies to inhibit cytoplasmic events leading to activation of the nuclear factor κB (NF-κB) signaling pathway, with individual viruses often encoding multiple NF-κB inhibitors. Here, the novel orf virus (ORFV)-encoded protein ORFV002 was shown to inhibit nuclear events regulating NF-κB transcriptional activity. ORFV002 expression in cell cultures significantly decreased wild-type-virus-, tumor necrosis factor alpha (TNF-α)-, and lipopolysaccharide (LPS)-induced NF-κB-mediated gene expression. Expression of ORFV002 in cells, while not affecting phosphorylation or nuclear translocation of NF-κB-p65, markedly decreased TNF-α- and wild-type-virus-induced acetylation of NF-κB-p65, a p300-mediated nuclear modification of NF-κB-p65 that regulates its transactivating activity. ORFV002 was shown to colocalize and interact with NF-κB-p65, and expression of ORFV002 in cell cultures resulted in a reduced interaction of NF-κB-p65 with p300, suggesting that ORFV002 interferes with NF-κB-p65/p300 association. Deletion of ORFV002 from the OV-IA82 genome had no significant effect on ORFV pathogenesis in sheep, indicating that ORFV002 is nonessential for virus virulence in the natural host. This represents the first description of a nuclear inhibitor of NF-κB encoded by a poxvirus.

Melting of multilayer colloidal crystals confined between two walls

Video microscopy is employed to study the melting behaviors of multilayer colloidal crystals composed of diameter-tunable microgel spheres confined between two walls. We systematically explore film thickness effects on the melting process and on the phase behaviors of single crystal and polycrystalline films. Thick films (>4 layers) are observed to melt heterogeneously, while thin films (≤4 layers) melt homogeneously, even for polycrystalline films. Grain-boundary melting dominates other types of melting processes in polycrystalline films thicker than 12 layers. The heterogeneous melting from dislocations is found to coexist with grain-boundary melting in films between 5- and 12-layers. In dislocation melting, liquid nucleates at dislocations and forms lakelike domains embedded in the larger crystalline matrix; the "lakes" are observed to diffuse, interact, merge with each other, and eventually merge with large strips of liquid melted from grain boundaries. Thin film melting is qualitatively different: thin films homogeneously melt by generating many small defects which need not nucleate at grain boundaries or dislocations. For three- and four-layer thin films, different layers are observed to have the same melting point, but surface layers melt faster than bulk layers. Within our resolution, two- to four-layer films appear to melt in one step, while monolayers melt in two steps with an intermediate hexatic phase.

Abstract P4-08-07: Correlation of Oncotype Dx Recurrence Score and Luminal Subtypes of Breast Cancer

Background: Molecular subtypes of breast cancer have been characterized by gene expression analysis. Luminal subtypes are hormone receptor (HR) positive and Her2/neu negative. Immunohistochemistry (IHC) has been used as a surrogate test for gene expression. Ki67 is a proliferation marker that identifies high-risk subtype of luminal breast cancer. Recently, the proposed Ki67 index (KI) of 14% was suggested as a cut-off to distinguish between luminal A and luminal B tumors (JNCI. 2009;101:736-750). The oncotype dx (ODx) is a 21- gene test that provides prognostic and predictive information in early stage HR-positive breast cancer patients. The test is reported as low (<18), intermediate (18-30) and high (>30) risk recurrence scores (RS)

Design: We investigated the relationship between ODx RS and luminal subtypes of breast cancers using the KI of 14% as the cut-off for distinguishing luminal A and B tumors. Biomarker analysis (ER, PR, Her2/neu, Ki67 and p53) was performed as part of the diagnostic work-up using standard IHC procedures. Scoring was done by automated image analysis. Her2/neu FISH was performed on all IHC 2+ and 3 + results.

Pathologic parameters such as, tumor size, grade, and presence of LVI were evaluated. Ploidy was performed by the Autocyte system (Tripath) on Feulgen stained paraffin sections.

Results: We identified 106 patients with HR positive breast cancer who were tested for ODx from February 2006 to May 2010. 85/106 had Ki67 data available for analysis. 46/85 (54%) were luminal A and 39/85 (46%) luminal B tumors. The mean KI in luminal A was 6.93% versus 31.1% in luminal B (P<0.0001). The mean tumor size was 1.94 and 1.92 cm in luminal A and B respectively. Grade 1, 2 and 3 comprised 28/85 (32.9%), 49 (57.6%) and 8 (9.41%) of all tumors respectively. Of the grade1 tumors, 75% were luminal A, and grade 3 tumors were predominantly luminal B (p=0.013). LVI was present in 16 cases, 11 (68.8%) in luminal B and 5/16 (31.2%) in luminal A tumors (p=0.0416). Luminal A tumors were predominantly diploid 30/45 (66.6%) and luminal B were mostly aneuploid 21/32 (65.6%) (p=0.019). The overall mean RS in luminal A and B tumors was 14.67 and 20.15 respectively (P<0.0004). Luminal A tumors had low RS in 32/46 (66.6%). and luminal B tumors had predominantly intermediate/high RS in 23/39 (62.1%) (p=0.0082). ER Allred Scores were 7.1 and 7.3 and percent positivity was 88.1% and 91% respectively for luminal A and B subtypes. PR Allred scores were 5.6 and 5.8, and percent positivity was 62.1 and 52.9% for A and B tumors respectively. Information regarding treatment was available in 72 cases. 19 (26.3%) were treated by a combination of chemo and anti-hormonal therapy and 53 (73.6%) were treated by anti hormonal therapy alone, 8 of the 19 (42.1%) luminal A patients received combination therapy versus 11 (57.8%) in the luminal B category (p=0.277).

Conclusion: Ki67 is a useful marker that showed significant correlation with RS by ODx. Luminal A tumors are more likely to be low grade, diploid with low RS compared to luminal B tumors. Ki67 in conjunction with other pathologic parameters may serve as a surrogate marker for the ODx RS.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-08-07.

Abstract P4-08-10: Correlation of Oncotype Dx Recurrence Score with Histologic Parameters, Biomarker Expression and KI-67 Index

Background: Oncotype Dx (ODx) is a 21-gene RT-PCR based assay that provides prognostic and predictive information in patients with hormone receptor (HR) positive breast cancer. The test predicts the likelihood of disease recurrence in the form of a recurrence score (RS), which is categorized into low, intermediate and high-risk types. We examined the relationship between ODx RS and histologic parameters, DNA ploidy, tumor markers (ER, PR, Her2, Ki67, p53) expression by immunohistochemistry (IHC).

Design: We identified 106 patients with HR-positive invasive breast cancer who were tested for ODx from the department files. Pathologic variables such as, tumor size, grade, histologic type, lymphovascular invasion (LVI) were reviewed. Tumor markers ER, PR, Her2, p53 expression, Ki67 index (KI) and ploidy were performed as part of the patient's diagnostic work-up using standard procedures. Scoring was done by automated image analysis. Results of biomarker expression were compared to the ODx RS. All Her2neu 3+ and 2+ results by IHC were confirmed by FISH. Ploidy was performed by the Autocyte system (Tripath) on Feulgen stained sections. Oncotype RS was reported as low (<18), intermediate (18-30) and high risk (>30).

Results: Mean tumor size was 1.96 cm. Of the 106 cases, 87 (82%), 14 (13.2%) and 2(1.8%) were ductal, lobular and mixed types respectively. Grade 1, 2 and 3 comprised 35 (33.0%), 62 (58.4%) and 9 (8.5%) respectively. Twenty-one (19.8%) had LVI. Oncotype RS was low in 56 (52.8%), intermediate in 45 (42.4%) and high in 5 (4.7%). Mean tumor size in low RS group was 2.2 cm versus 1.6 cm in the intermediate/high RS group (p <0.05). There was no significant association of grade and LVI with RS. ER Allred score was 7.2, 7.2 and 8.0 and percent positivity was 88.0%, 91.1% and 96.3% in low, intermediate and high RS respectively (p=0.6325). The PR Allred score was 6.0, 5.3 and 3.5 and percent positivity was 64.7%, 51.8% and 16.6% in low, intermediate and high RS respectively (p=0.0432). There was 100% concordance between ER by IHC and ODx. Concordance for PR was 71/75 (94.6%). The four discordant PR results by ODx had mean score of 20% by IHC. The mean KI was 14.4%, 21.8% and 25.6% in low, intermediate and high RS respectively (p=0.0248). Low KI (<14%) and high KI (>14%) showed significant correlation with RS (p=0.0055). Her2neu IHC was negative in 43/49 (87.7%) and borderline in 6/49 (12.2%) and all were negative by FISH. Her2 FISH showed 100% (44/44) concordance with Her2 results by ODx. There was no association between DNA ploidy and RS (p=0.7143). P53 expression showed no significant correlation with RS (p=0.2602). Patients in the intermediate/high RS group were more likely to be treated with a combination of chemo plus anti-hormonal therapy (P<0.0001) and radiation (P<0.05) compared to the low RS group.

Conclusions: This study shows a complete concordance between ER IHC and Her2 FISH with RT-PCR by ODx. Low PR scores and high KI predict

high RS by ODx. There is a significant association between KI and ODx RS. Ki67 index identifies low and high RS groups, which correspond to the luminal A, and B subtypes of breast cancer respectively.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-08-10.

A randomized prospective study of rehabilitation therapy in the treatment of radiation-induced dysphagia and trismus

PURPOSE

To evaluate the therapeutic effect of rehabilitation therapy on radiation-induced dysphagia and trismus in nasopharyngeal carcinoma (NPC) patients after radiotherapy.

PATIENTS AND METHODS

43 NPC patients after radiotherapy were included. Patients were randomly assigned to either the rehabilitation group or a control group. Both groups were subjected to routine treatment, while the rehabilitation group also received rehabilitation therapy for 3 months. The severity of dysphagia was assessed using the water swallow test, while trismus was evaluated with the LENT/SOMA score and the interincisor distance (IID). The water swallow test, the LENT/SOMA score, as well as IID for both groups before and after treatment were analyzed and compared.

RESULTS

After treatment, the rehabilitation group displayed a significant improvement in swallowing function, while the control group did not. The efficacy rate (percentage of patients with excellent or effective results) of rehabilitation group was higher than that of control group (77% vs. 43%), and the difference was statistically significant (ϰ(2) = 5.32, p = 0.02). IID pretreatment and posttreatment did not show much difference in the rehabilitation group, while in the control group IID significantly decreased posttreatment (1.1 ± 0.36 cm vs.1.8 ± 0.56 cm, p = 0.001). Although the mean IID in patients of both groups decreased after the 3 month follow-up, the decrease in the rehabilitation group was less than that of the control group (0.19 ± 0.5 cm vs. 0.69 ± 0.56 cm, p = 0.004 ). The efficacy rate of trismus in the rehabilitation group was significantly higher than that of the control group (64% vs. 28%, ϰ(2) = 5.31, p = 0.02).

CONCLUSIONS

Rehabilitation training can improve swallow function and slow down the progress of trismus in NPC patients following radiotherapy.

Limitations of metformin use in patients with kidney disease: are they warranted?

AIM

To show that metformin, one of the most widely used agents, is contraindicated in patients with diabetes having chronic kidney disease (CKD) (i.e. serum creatinine >1.5 mg/dl) secondary to fear of lactic acidosis. The overall incidence of lactic acidosis is estimated at an upper limit of eight cases per 100 000 patient-years. We evaluated metformin use in two cohorts, one from the University of Chicago Diabetes Center and the other from National Health and Nutrition Examination Survey (NHANES) 1999-2006.

METHODS

Estimated glomerular filtration rate (eGFR) was calculated using the re-expressed Modification of Diet in Renal Disease (MDRD) Study equation and compared to serum creatinine. We hypothesized that metformin is used in patients with undetected advanced CKD (i.e. serum creatinine is ≥1.5 mg/dl). A chi-squared test was used to compare per cent differences of metformin use across demographic variables and eGFR in the NHANES cohort.

RESULTS

At the University of Chicago Diabetes Center, 36 of 234 (15.3%) patients with an eGFR of <60 ml/min/1.73 m(2) were receiving metformin. Data from NHANES, age >18 years and eGFR <60 ml/min/1.73 m(2) showed that Blacks with advanced nephropathy were three times more likely to receive metformin.

CONCLUSIONS

We conclude that metformin utilization occurs with a higher frequency than predicted by serum creatinine in people with eGFR <60 ml/min/1.73 m(2) . Given the very low incidence of lactic acidosis, the recommendation should be changed to reflect eGFR cut-off values rather than serum creatinine.

The efficacy and safety of abatacept in patients with non-life-threatening manifestations of systemic lupus erythematosus: results of a twelve-month, multicenter, exploratory, phase IIb, randomized, double-blind, placebo-controlled trial

OBJECTIVE

To evaluate abatacept therapy in patients with non-life-threatening systemic lupus erythematosus (SLE) and polyarthritis, discoid lesions, or pleuritis and/or pericarditis.

METHODS

In a 12-month, multicenter, exploratory, phase IIb randomized, double-blind, placebo-controlled trial, SLE patients with polyarthritis, discoid lesions, or pleuritis and/or pericarditis were randomized at a ratio of 2:1 to receive abatacept (∼10 mg/kg of body weight) or placebo. Prednisone (30 mg/day or equivalent) was given for 1 month, and then the dosage was tapered. The primary end point was the proportion of patients with new flare (adjudicated) according to a score of A/B on the British Isles Lupus Assessment Group (BILAG) index after the start of the steroid taper.

RESULTS

A total of 118 patients were randomized to receive abatacept and 57 to receive placebo. The baseline characteristics were similar in the 2 groups. The proportion of new BILAG A/B flares over 12 months was 79.7% (95% confidence interval [95% CI] 72.4, 86.9) in the abatacept group and 82.5% (95% CI 72.6, 92.3) in the placebo group (treatment difference -3.5 [95% CI -15.3, 8.3]). Other prespecified flare end points were not met. In post hoc analyses, the proportions of abatacept-treated and placebo-treated patients with a BILAG A flare were 40.7% (95% CI 31.8, 49.5) versus 54.4% (95% CI 41.5, 67.3), and the proportions with physician-assessed flare were 63.6% (95% CI 54.9, 72.2) and 82.5% (95% CI 72.6, 92.3), respectively; treatment differences were greatest in the polyarthritis group. Prespecified exploratory patient-reported outcomes (Short Form 36 health survey, sleep problems, fatigue) demonstrated a treatment effect with abatacept. The frequency of adverse events (AEs) was comparable in the abatacept and placebo groups (90.9% versus 91.5%), but serious AEs (SAEs) were higher in the abatacept group (19.8 versus 6.8%). Most SAEs were single, disease-related events occurring during the first 6 months of the study (including the steroid taper period).

CONCLUSION

Although the primary/secondary end points were not met in this study, improvements in certain exploratory measures suggest some abatacept efficacy in patients with non-life-threatening manifestations of SLE. The increased rate of SAEs requires further assessment.

Suppression of nuclear factor-kappaB activity in Kupffer cells protects rat liver graft from ischemia-reperfusion injury

OBJECTIVE

The objective of this study was to investigate the protective effect and mechanisms of nuclear factor (NF)-kappaB decoy oligodeoxynucleotides (ODN) on rat liver grafts following ischemia-reperfusion injury (IRI).

METHODS

Animals were randomly divided into 3 groups (n = 8): control ischemia-reperfusion (IR) and decoy ODN groups; in the last cohort donor grafts were transfected with 120 microg NF-kappaB decoy ODN before procurement. Following 2 hours of reperfusion, NF-kappaB binding activity was detected in isolated Kupffer cells (KCs) using electrophoretic mobility shift assays (EMSA). Tumor necrosis factor (TNF)-alpha and interleukin (IL)-6 messenger RNA (mRNA) expressions were analyzed using reverse transcriptase polymerase chain reaction (RT-PCR) methods. Liver tissue and blood serum were collected for histopathologic examination and liver function test, respectively.

RESULTS

The NF-kappaB binding activity, TNF-alpha and IL-6 mRNA expression as well as serum ALT and total bilirubin levels were significantly increased compared with the control group following reperfusion (P < .01). A large number of hepatocytes showed degeneration and necrosis. However, these indices were significantly ameliorated among the decoy ODN group (P < .01) with preserved hepatic lobule architecture.

CONCLUSION

KCs NF-kappaB activation following reperfusion plays an important role in IRI after liver transplantation. The decoy strategy showed an apparent effect to suppress NF-kappaB activation and inhibit production of downstream cytokines, thereby protecting liver grafts from IRI.

Establishment and evaluation of a model of a community health service in an underdeveloped area of China

OBJECTIVES

To develop and evaluate an applicable model for a community health service (CHS) in an underdeveloped area of China that ensures efficient, convenient and affordable primary healthcare access for all residents.

STUDY DESIGN

The current study was carried out in Puyang, a typical medium-sized city in central-eastern China. Based on the healthcare requirements of the residents in Puyang, a CHS network was set up and its operation was evaluated from 1999 to 2006. The system is characterized by its focus on community health education (CHE).

METHODS

Firstly, 8231 residents, selected at random, were surveyed to investigate the healthcare requirements of the local residents. Meanwhile, the operation of the pre-existing healthcare resources was investigated in Puyang. Based on the information gained, a network-based CHS system was proposed and established, with CHE as the major focus. This study compared CHS operation prior to and after establishment of the network. Finally, an analytic hierarchy process based evaluation model was applied to evaluate the operation of the CHS network.

RESULTS

There was a high prevalence (86.98 per thousand) of chronic diseases among the residents who participated in this investigation. The majority (84.39%) of the residents who had healthcare requirements resorted to professional health care; the other residents did not have access to health services. Among those residents who sought professional treatment, 71.3% visited primary healthcare institutions. This information reflects the enormous requirement for a CHS in primary health care but the lack of accessibility among the residents; this motivated the authors to establish a system to solve the problem. The improvement in CHS operation after the network was established suggests the importance of a network for optimizing the primary healthcare system. The improvement was indicated by better understanding of the residents regarding the CHS, and enhanced capability of self-monitoring for chronic diseases such as hypertension after the network was established. Moreover, the residents' knowledge of health care was significantly increased and, accordingly, the incidence of health risk behaviour was reduced after the network was established. Furthermore, the CHE index between 1999 and 2006 showed good correlation (r=0.988, p<0.005) with the CHS index, suggesting the important role of CHE in CHS development.

CONCLUSIONS

A network-characterized CHS system was established in Puyang, and improved the primary healthcare situation. This study provides a feasible model for the development of a CHS in medium and small cities in underdeveloped parts of China.

Melting of colloidal crystal films

We study melting mechanisms in single and polycrystalline colloidal films composed of diameter-tunable microgel spheres with short-ranged repulsive interactions and confined between two glass walls. Thick films (>4 layers), thin-films (≤4 layers), and monolayers exhibit different melting behaviors. Thick films melt from grain boundaries in polycrystalline solid films and from film-wall interfaces in single-crystal films; a liquid-solid coexistence regime is observed in thick films but vanishes at a critical thickness of 4 layers. Thin solid films (2 to 4 layers) melt into the liquid phase in one step from both grain boundaries and from within crystalline domains. Monolayers melt in two steps with a middle hexatic phase.