Ruscogenin glycoside (Lm-3) isolated from Liriope muscari improves liver injury by dysfunctioning liver-infiltrating lymphocytes

The effects of ruscogenin 1-O-[β-d-glucopyranosyl(1 → 2)] [β-d-xylopyranosyl(1 → 3)]-β-d-fucopyranoside (Lm-3) and its aglycone, ruscogenin, on liver injury induced in mice by delayed-type hypersensitivity to picryl chloride have been investigated. Lm-3 and ruscogenin significantly decreased liver injury when given during the effector phase of the delayed-type hypersensitivity reaction. The pretreatment of nonparenchymal cells, but not hepatocytes, with Lm-3 or ruscogenin in-vitro caused a concentration- and time-dependent inhibition against the damage. Lm-3 showed a stronger inhibition against the damage than ruscogenin (IC50: Lm-3 6.3 times 10−10  m, ruscogenin 3.9 times 10−7  m). However, neither Lm-3 nor ruscogenin blocked the hepatotoxic potential of CCl4, when used to pretreat hepatocytes. Moreover, Lm-3 and ruscogenin inhibited concanavalin A-induced lymphocyte proliferation only at high concentrations. These results suggested that Lm-3 and ruscogenin improved the immunological liver injury by selectively causing dysfunction of the liver-infiltrating cells rather than by protecting hepatocyte membranes. Such characteristics would be significant for treating immunologically related liver diseases as well as for developing new drugs.

Effects of supplemental 25-hydroxycholecalciferol on growth performance, small intestinal morphology, and immune response of broiler chickens

Three experiments were conducted to evaluate the effects of 25-hydroxycholecalciferol (25-OH-D(3)) on the growth performance, small intestinal morphology, and immune response of broiler chickens. In experiment 1, 25-OH-D(3) neither increased nor decreased weight gain and feed efficiency compared with the controls during the 39-d feeding period. Birds fed 25-OH-D(3) exhibited numerically higher phagocytosis (45%) than the controls (35%). In experiment 2, chicks were fed diets similar to those used in experiment 1 and were killed at 7, 14, 21, 28, and 35 d of age to determine the relative weight and histology of the small intestine. The relative weight of the small intestine from birds fed 25-OH-D(3) was numerically lower (P < 0.1) at 7 d of age. It was found that 25-OH-D(3) consistently resulted in longer (P < 0.05) villus length of the duodenum in 21- and 28-d-old birds and of the jejunum in 14- and 28-d-old birds. Shorter (P < 0.05) crypt depth was observed in the duodenum at 14 d of age and in the jejunum at 21 and 28 d of age. A higher (P < 0.05) ratio of villus length to crypt depth was also observed in the duodenum and jejunum at 14, 21, and 28 d of age of birds fed 25-OH-D(3). The thickness of muscle layer increased in the duodenum at 14, 28, and 35 d of age in birds fed 25-OH-D(3). In experiment 3, birds were orally challenged with either Luria-Bertani broth or Salmonella Typhimurium E29 at 7 and 14 d of age. Uninfected birds fed 25-OH-D(3) had lower total serum IgA at 14 d of age and lower total serum IgG at 21 d of age. However, infected birds fed 25-OH-D(3) produced higher (P < 0.1) total serum IgG at 21 d of age. The results of this study suggest that supplemental 25-OH-D(3) improves small intestinal morphology and protective humoral immunity to infection.

Functional magnetic resonance imaging study on dysphagia after unilateral hemispheric stroke: a preliminary study

BACKGROUND

Swallowing dysfunction is common and disabling after acute stroke; however, the mechanism of dysphagia or recovery of swallowing from dysphagia remains uncertain. The purpose of this study was to explore cerebral activation of swallowing in dysphagia using functional MRI (fMRI) to compare the functional anatomy of swallowing in unilateral hemispheric stroke patients and healthy adults.

METHODS

In total, five left hemispheric stroke patients with dysphagia, five right hemispheric stroke patients with dysphagia and 10 healthy controls were examined with event related fMRI while laryngeal swallow related movements were recorded. Data were processed using the general linear model.

RESULTS

A multifocal cerebral representation of swallowing was identified predominantly in the left hemisphere, in a bilateral and asymmetrical manner. Cerebral activation during swallowing tasks was localised to the precentral, postcentral and anterior cingulate gyri, insula and thalamus in all groups. Activation of volitional swallowing in dysphagic unilateral hemispheric stroke patients might require reorganisation of the dominant hemispheric motor cortex, or a compensatory shift in activation to unaffected areas of the hemisphere.

CONCLUSIONS

The results indicate that unilateral stroke of either cerebral hemisphere can produce dysphagia. Effective recovery is associated with cerebral activation related to cortical swallowing representation in the compensating or recruited areas of the intact hemisphere. Functional MRI is a useful method for exploring the spatial localisation of changes in neuronal activity during tasks that may be related to recovery. Therefore, the subsequent information gleaned from changes in neural plasticity could be useful for assessing the prognosis of dysphagic stroke.

Clinical trial: prophylactic intravenous alanyl-glutamine reduces the severity of gastrointestinal toxicity induced by chemotherapy--a randomized crossover study

BACKGROUND

Glutamine has been shown in numerous studies to reduce intestinal permeability which can be increased by chemotherapy. However, there have been few reports that conduct on its clinical effect on gastrointestinal toxicity.

AIM

To examine whether prophylactic intravenous alanyl-glutamine dipeptide can ameliorate clinical manifestations of gastrointestinal toxicity induced by chemotherapy.

METHODS

Forty-four patients with gastric or colorectal cancer developing WHO side-effect grading system of grade 2 or higher were randomized to either control group (n = 22) or Gln group (n = 22) during next cycle of chemotherapy. Patients were crossed over to the alternate treatment during chemotherapy cycle 2. In the control group, the patients received the same chemotherapy regimens as screening cycle and in the Gln group, the patients received chemotherapy and alanyl-glutamine. Prophylactic intravenous 20 g of alanyl-glutamine dipeptide was given for 5 days.

RESULTS

Compared with the control group, the plasma glutamine level in the Gln group was significantly higher and the plasma endotoxin level was significantly lower. The scores of nausea/vomiting and diarrhoea decreased significantly.

CONCLUSION

Prophylactic intravenous alanyl-glutamine is effective in preventing intestinal permeability disruption induced by chemotherapy and clinical manifestations of gastrointestinal toxicity.

Basic ADL disability and functional limitation rates among older AMERICANS from 2000-2005: the end of the decline?

BACKGROUND

This study sought to determine whether the rates of basic activities of daily living (ADL) disabilities and functional limitations declined, remained the same, or increased between 2000 and 2005 when (a) only community-dwelling Americans aged 65 and older were examined and (b) when institutionalized older adults were included.

METHOD

Using data from the American Community Survey and the National Nursing Home Survey, we calculated annual prevalence rates of basic ADL disabilities and functional limitations and fitted regression lines to examine trends over time.

RESULTS

The rates of basic ADL disabilities among community-dwelling adults aged 65 and older increased 9% between 2000 and 2005. When institutionalized elders were included, basic ADL disability rates were stable among men but increased among women. Functional limitation rates did not significantly change between 2000 and 2005.

CONCLUSION

These findings suggest an end of the decline in disability rates among older Americans, which, if confirmed, could have important implications for health care.

Clinical value of tumour specific growth factor (TSGF) and carbohydrate antigen-125 (CA-125) in carcinoma of the endometrium

This study estimated the clinical value of tumour specific growth factor (TSGF) and carbohydrate antigen-125 (CA-125) in the diagnosis of endometrial carcinoma. Blood was collected from the peripheral and uterine veins of endometrial cancer patients, and serum TSGF and CA-125 levels were compared with those in uterine myoma patients (non-tumour controls) and normal women. Significantly higher levels of TSGF and TGSF-positive rates were observed in endometrial cancer patients versus non-tumour and normal controls. The sensitivity and specificity for detecting TGSF-positive rates in the endometrial carcinoma group were 64.9% and 62.5%, respectively. The TSGF levels in uterine blood were significantly higher than in peripheral blood and the TSGF-positive rate was also higher. The TSGF levels gradually increased with progression through the clinical stages and pathological grades of endometrial carcinoma. The sensitivity and specificity of combined TSGF and CA-125 for detecting endometrial cancer were 75.7% and 56.3%, respectively. It is concluded that there is an important correlation between serum levels of TSGF, CA-125 and endometrial cancer and that measurement of both TSGF and CA-125 combined would be of value in the diagnosis of endometrial carcinoma.

Neoadjuvant chemoradiotherapy for locally advanced low-lying rectal cancer

e15095

Objective: The aim of this trial was to explore the possibility of further improvement of efficacy in neoadjuvant chemoradiation for the treatment of locally advanced low-lying rectal cancer and the management of patients with clinical complete regression. Methods: 192 cases with locally advanced low-lying rectal cancer (T3/T4 or N+) received preoperative radiotherapy comprising 40–46 Gy/20–23 fractions and concomitant oral capecitabine 625 mg/m2 bid for 10 weeks prior to surgery. Curative resection with TME was carried out 6 weeks after the end of radiation. Results: Patients (pts) were recruited from May 2001 through August 2007. Overall, 117 pts (60.9%) experienced adverse events but only 2 suffered from grade 3 hand-foot syndrome. 17 pts (8.9%) had clinical complete tumor regression without surgery, 175 pts underwent curative resection including of 134 pts with low anterior resection (LAR), 32 pts with ultra-low anterior resection with Parks’ coloanal anastomosis and among them 6 pts with diverting temporary colostomy and 9 pts with APR. Sphincter preservation was achieved in 95.3%. Pathologically, 24 pts (12.5%) showed CR together with 17 pts with clinical CR; the overall CR rate was 21.4%. According to the pathological staging: T0N0 41 cases, T2N0 43 cases, T3N0 77 cases, T4N0 5 cases, T2N1 11 cases, T3N1 13 cases, T4N0 5 cases, and T4N1 2 cases; in semiquantitative Dworak's tumor regression grade, TRG0 8 pts,TRG1 32, TRG2 28,TRG3 83 and TRG4 41 with an overall tumor downstaging of 79.2%. There were no operative deaths, 5 pts suffered from rectovaginal fistulas and 4 anastomotic leakages with an overall anastomotic leakage rate of 5.1% (9/175) and all recovered without further events. All patients have been followed up for a median of 46 months (range 12–87). During the time, 11 pts had lung metastases, 6 liver metastases and 7 had local recurrences. The 3-year disease-free survival was 86.6% and overall survival was 92.6%. Conclusions: Neoadjuvant chemoradiotherapy has high efficacy resulting in tumor down-staging, increased resectability and sphincter preservation, and a reduction in local recurrences. Meanwhile those patients with clinical complete response can be followed up closely and safely without surgery.

No significant financial relationships to disclose.

Phase II trial of extended dose anti-CTLA-4 antibody ipilimumab (formerly MDX-010) with a multipeptide vaccine for resected stages IIIC and IV melanoma

9023

Background: Ipilimumab is a human anti-CTLA-4 antibody shown to have clinical activity in melanoma that is associated with immune-related adverse events (IrAEs). Methods: 50 HLA A*0201 positive patients with resected stages IIIC/IV melanoma received MART-1/gp100/tyrosinase peptides with adjuvant Montanide ISA 51 12 times subcutaneously with Ipilimumab at 3 or 10 mg/kg intravenously every 8 weeks for 12 months, and 25 HLA A *0201 negative patients received Ipilimumab alone at 10 mg/kg. Primary endpoints were toxicity and the achievement of a 40% rate of tolerable IrAEs. Immune responses measured by ELISPOT and tetramer assays, and time to relapse were also assessed. 3 melanoma peptides were administered at 1000 mcg/dose each. Results: Median age was 58, with 44 men and 31 women. 46 patients had stage IV, and 29 had stage IIIC resected disease. 19/75 (25%) patients had grades 3–4 IrAEs that were dose-limiting. No patient with dose limiting toxicity required hospitalization and all returned to baseline status with the use of systemic steroids. Assays of induction of IL-17 secreting T cells showed a positive association with freedom from relapse (p=0.049). Change in slope of the increase in total lymphocyte count at four weeks was also associated with a trend toward freedom from relapse and development of an IrAE. 27 of 75 patients have relapsed with a median of 23 months of follow-up. 10 were again rendered NED surgically and are alive without disease. 68 patients are alive, 10 with disease. Only 1/19 patients with grade 3/4 IrAE has died of disease, compared to 6/56 without a dose limiting IBE. 23 of 27 relapses occurred without a grade 3/4 IrAE, compared with 15 IrAEs in 48 patients without a relapse. ELISPOT assays showed that patients at 10 mg/kg actually had decreased responsiveness in fresh PBMC to PHA and the CEF (CMV, EBV, FLU) pool of peptides. Conclusions: IrAEs are associated with clinical benefit in patients with resected high-risk melanoma receiving Ipilimumab with or without a peptide vaccine. Increases in IL-17 secreting CD4 T cells and the slope of increase in total lymphocytes over 4 weeks are associated with freedom from relapse. These data support testing the current regimen at 10 mg/kg in a larger randomized trial.

[Table: see text]

Association of chromosome 2q36.1-36.3 and autosomal dominant transmission in ankylosing spondylitis: results of genetic studies across generations of Han Chinese families

Background:

Ankylosing spondylitis (AS) is a chronic, potentially crippling, spondyloarthropathy with strong genetic components affecting approximately 0.3% of the population. Its exact genetic mechanism and mode of transmission, however, remains obscure.

Methods and results:

The authors conducted a genome wide scan on 75 individuals across multiple generations of three Han Chinese families affected with AS. Segregation analysis and pedigree investigation suggested an autosomal dominant inheritance. Pairwise logarithm of odds (LOD) scores were calculated using LINKAGE package for the obtained genotypes. High resolution mapping was then performed based on markers with significant LOD scores. To minimise the number of crossovers in each family, haplotype were constructed and assigned. Two of the pedigrees shared one candidate region for AS on 2q36.1–2q36.3 spanning 6-cM (maximum heterogeneity LOD score of 12.41 at marker D2S2228), while the other showed strong linkage to the HLA-B region.

Conclusions:

This is the first report which proposes one of the new genetic models of autosomal dominant transmission in AS. The breakthrough in the identification of linkage to chromosome 2q36.1–2q36.3 and the HLA-B region highlights the future potential of more comprehensive genetic studies of determinants of disease risk.

Dietary factors in relation to daily activity energy expenditure and mortality among older adults

OBJECTIVES

To examine the association between dietary factors to daily activity energy expenditure (DAEE) and mortality among older adults.

DESIGN AND SETTING

A sub-study of Health, Aging, and Body Composition study.

PARTICIPANTS

298 older participants (aged 70-82 years) in the Health, Aging, and Body Composition Energy Expenditure sub-study.

MEASUREMENTS

Dietary factors, DAEE, and all-cause mortality were measured in 298 older participants. Dietary factors include dietary intake assessed by the Block Food Frequency Questionnaire (FFQ), Healthy Eating Index (HEI), and self-reported appetite and enjoyment of eating. DAEE was assessed using doubly labeled water. All-cause mortality was evaluated over a 9 year period.

RESULTS

Participants in the highest tertile of DAEE were more likely to be men and to report having a 'good' appetite; BMI among men, proportion married, IL-6 and CRP levels and energy intake were also higher. Fewer black participants were in the 'good' HEI category. Participants in the 'good' HEI category had higher cognitive scores and a higher education level. Participants who reported improvement in their appetite as well as participants who reported a 'good' appetite were at lower risk for mortality (HR (95% CI): 0.42 (0.24-0.74) and 0.50 (0.26-0.88), respectively) even after adjusting for DAEE, demographic, nutritional and health indices.

CONCLUSIONS

We showed an association between DAEE and appetite and mortality among well-functioning, community-dwelling older adults. These findings may have some practical use for the health providers. Inclusion of a question regarding appetite of an elderly patient may provide important information regarding risk for health deterioration and mortality.

Potentiometric monitoring DNA hybridization

The usual procedure to monitor the ion exchange of small ions utilizes a potentiometer with a selective membrane as part of the working electrode. As the next step, we have applied polyaniline electrodes to the monitoring the activity macromolecular ions during DNA hybridization. Single-strand oligonucleotide (ssODN) probes were immobilized using a nucleophilic substitution reaction of the thiolated ssODN molecules with polyaniline. The anionic phosphate groups of the probe molecules also interacted with the cationic-doped polyaniline surface. Three useful findings were observed with the potentiometric experiments. First, the binding of the complimentary target molecules with the immobilized probes revealed a substantial potential change. Further, potential change was observed neither with the non-complimentary targets nor with the samples with a mutation in the sequence. The last two experiments were important for the future evaluation of the impact of medium and potential interfering compounds: anionic groups and hydrogen bonding groups in the non-complimentary samples did not cause any interactions.

Predictive markers of chemotherapy-induced menopause in premenopausal women under the age of 40 with breast cancer

Abstract #1118

Background: Premenopausal women undergoing adjuvant chemotherapy are at risk for chemotherapy induced menopause (CIM). To date, age &gt;40 has been the strongest predictor of ovarian failure. For women &lt;40, identifying patients early who are at greatest risk may alter treatment decisions, therefore early predictors of CIM are needed. Our objective was to assess a marker of ovarian reserve, Mullarian Inhibitory Substance (MIS), as well as estradiol (E2), Follicle Stimulating Hormone (FSH) and menstrual status, in young women undergoing adjuvant chemotherapy for breast cancer.&#x2028; Patients and Methods: We conducted a prospective cohort study in women aged less than 40 years undergoing chemotherapy for early stage breast cancer (n=26). Patients were treated with chemotherapy (adriamycin, cyclophosphamide and paclitaxel) following surgery. Serum MIS, FSH, and E2 were measured before chemotherapy, at weeks 6, 12 , 36 and 52. Controls were 134 age-matched women with known fertility. Hormone levels were compared in the 2 groups at baseline. Trends during chemotherapy were assessed based on age and correlated with menstrual status in the breast cancer patients only.&#x2028; Results: Compared with age-matched controls, patients with breast cancer had similar baseline MIS levels (median 0.94 vs. 0.86 ng/ml, p&gt;0.05). However, 29% of cancer patients had baseline MIS levels below the lower normal range (0.2 ng/ml). Serum MIS decreased significantly at 6 weeks and remained suppressed for 52 weeks (median 0.08 ng/ml at week 6, 0.05 ng/ml at week 12, 0.07 ng/ml at week 52, p&lt;0.05 compared to baseline). At 6 weeks after treatment, 96% of the patients had MIS levels below 0.2 ng/ml. E2 levels decreased during chemotherapy, however, at 52 weeks, the levels returned to baseline levels. The percentage of women with E2 &lt;30 pg/ml increased during chemotherapy and following chemotherapy. FSH levels increased 6 weeks after chemotherapy and returned to premenopausal levels by week 52, although only 33% of FSH levels were within premenopausal range (&lt;10 IU/L) at week 52. At 52 weeks, 11 of 26 cancer patients (42%) remained amenorrheic. In women &lt;35 years old, only 25% of women remained amenorrheic, whereas in women over 35 years, 50% were amenorrheic. Compared to women who regained menses, amenorrheic women had similar MIS values pre-chemotherapy and at 52 weeks post-chemotherapy.&#x2028; Conclusions: In women &lt;40, chemotherapy decreases MIS rapidly and dramatically, and therefore early changes in MIS can not be used as a predictor of CIM. Although E2 levels generally recover, with 58% of young women regaining some menstrual function by 52 weeks, MIS levels remain abnormal, with all values remaining below the normal range of age-matched fertile women. Age continues to be an important factor for the recovery of ovarian function, specifically endocrine function, after chemotherapy.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1118.

Lithium chloride preconditioning optimizes skeletal myoblast functions for cellular cardiomyoplasty in vitro via glycogen synthase kinase-3beta/beta-catenin signaling

The benefits of skeletal myoblast (SkM) transplantation for cardiomyoplasty are limited due to their decreased functional integration with host cardiomyocytes and the poor survival of implanted cells in ischemic hearts. However, little success has been achieved with respect to the strategies aiming to improve the efficiency of SkM transplantation. In this study, we demonstrated that LiCl-preconditioned SkMs resulted in significantly increased connexin 43 (Cx43) expression and gap-junctional communication with cardiomyocytes. Vascular endothelial growth factor (VEGF) expression of SkMs was significantly upregulated in response to LiCl. Furthermore, hydrogen peroxide induced SkM apoptosis and increased caspase-3 expression, whereas LiCl inhibited SkM apoptosis, resulted in the decrease of caspase-3 expression and promoted SkM proliferation. These effects of LiCl were mediated by inactivating glycogen synthase kinase-3beta (GSK-3beta), stabilizing the effector protein beta-catenin and translocating it into the nucleus of SkMs, confirming that LiCl mimics canonical Wnt signaling. These findings suggest that LiCl preconditioning may be a novel strategy to optimize SkM function for cellular cardiomyoplasty in vitro.

Regenerative cell therapy and pharmacotherapeutic intervention in heart failure: Part 2: Pharmacological targets, agents and intervention perspectives

Regenerative medicine represents a promising perspective on therapeutic angiogenesis in patients with cardiovascular disease, including heart failure. However, previous or ongoing clinical trials show ambiguous outcomes with respect to the benefit of regenerative therapy by means of bone marrow stem cell infusion in myocardial infarction patients. Therefore, it is necessary to set up a rational therapeutic strategy in the treatment of congestive heart failure. Chemokines, cytokines and growth factors, as well as pharmaceutical agents, may have an impact on endothelial progenitor cell (EPC) physiology and thus can provide targets for pharmacological intervention. Indeed, EPCs and stem cell niches both in bone marrow and myocardial tissue can be treated as an integral target for recruitment of EPCs from the bone marrow to the cardiac ischaemic niche. In this article, we individually place the signalling factors in their specified context, and explain their roles in the various phases of neovascularisation (see Part 1). (Neth Heart J 2008;16:337-43.).