Recurrent activating mutations of CD28 in peripheral T-cell lymphomas

Peripheral T-cell lymphomas (PTCLs) comprise a heterogeneous group of mature T-cell neoplasms with a poor prognosis. Recently, mutations in TET2 and other epigenetic modifiers as well as RHOA have been identified in these diseases, particularly in angioimmunoblastic T-cell lymphoma (AITL). CD28 is the major co-stimulatory receptor in T cells which, upon binding ligand, induces sustained T-cell proliferation and cytokine production when combined with T-cell receptor stimulation. We have identified recurrent mutations in CD28 in PTCLs. Two residues-D124 and T195-were recurrently mutated in 11.3% of cases of AITL and in one case of PTCL, not otherwise specified (PTCL-NOS). Surface plasmon resonance analysis of mutations at these residues with predicted differential partner interactions showed increased affinity for ligand CD86 (residue D124) and increased affinity for intracellular adaptor proteins GRB2 and GADS/GRAP2 (residue T195). Molecular modeling studies on each of these mutations suggested how these mutants result in increased affinities. We found increased transcription of the CD28-responsive genes CD226 and TNFA in cells expressing the T195P mutant in response to CD3 and CD86 co-stimulation and increased downstream activation of NF-κB by both D124V and T195P mutants, suggesting a potential therapeutic target in CD28-mutated PTCLs.

Between-Scanner and Between-Visit Variation in Normal White Matter Apparent Diffusion Coefficient Values in the Setting of a Multi-Center Clinical Trial

PURPOSE

To study the between-scanner variation and the between-visit reproducibility of brain apparent diffusion coefficient (ADC) measurements in the setting of a multi-center chemotherapy clinical trial for glioblastoma multiforme.

METHODS AND MATERIALS

ADC maps of 52 patients at six sites were calculated in-house from diffusion-weighted images obtained by seven individual scanner models of two vendors. The median and coefficient of variation (CV) of normal brain white matter ADC values from a defined region of interest were used to evaluate the differences among scanner models, vendors, magnetic fields, as well as successive visits. All patients participating in this study signed institutional review board approved informed consent. Data acquisition was performed in compliance with all applicable Health Insurance Portability and Accountability Act regulations. The study spanned from August 1, 2006, to January 29, 2008.

RESULTS

For baseline median ADC, no difference was observed between the different scanner models, different vendors, and different magnetic field strength. For baseline ADC CV, a significant difference was found between different scanner models (p = 0.0002). No between-scanner difference was observed in ADC changes between two visits. For between-visit reproducibility, significant difference was seen between the ADC values measured at two successive visits for the whole patient group.

CONCLUSION

The CVs varied significantly between scanners, presumably due to image noise. Consistent scanner parameter setup can improve reproducibility of the ADC measurements between visits.

Fibroblastic rheumatism: the first case with infiltration of multinuclear giant cells and raised blood lead level

Fibroblastic rheumatism (FR) is a rare condition characterized by symmetrical polyarthritis and multiple cutaneous nodules. Approximately 30 cases have been reported worldwide to date. Laboratory tests are not particular useful to confirm the disease. Diagnosis is mainly dependent on the characteristic histopathological features: thickened collagen fibres with spindle-shaped cell proliferation in the skin lesion. We report a case of a 48-year-old Chinese man with typical clinical features of FR. In addition to the characteristic histopathological findings, multinuclear giant cell infiltration in skin lesions was detected, in this case. The evaluation of microelements revealed a raised blood lead level) of 129 μg/L (normal range 0-99 μg/L) These two features have never been described in the previous medical literature on FR. Thus, we propose that examining the infiltrated cells in detail in histopathological studies and inspecting the levels of lead and other microelements in the blood may increase our understanding of the pathogenesis of FR.

A novel frameshift mutation in the cylindromatosis (CYLD) gene in a Chinese family with multiple familial trichoepithelioma

Multiple familial trichoepithelioma (MFT) (OMIM: 601606) is an autosomal dominantly inherited disorder characterized by numerous, skin-colored papules and nodules with pilar differentiation. Recently, several mutations in the cylindromatosis (CYLD) gene have been reported in MFT. In this study, a mutation analysis of the CYLD was conducted in a Chinese pedigree of typical MFT. Affected individuals were identified through probands from Shanxi Province, China. Lesional skin biopsy of the proband revealed the typical histopathological characteristics of trichoepithelioma. Individuals belonging to five consecutive generations were similarly affected, which indicated an autosomal dominant inheritance pattern. Genomic DNA was extracted from peripheral blood lymphocytes using standard phenol/chloroform extraction method. All the coding exons (4-20) and exon-intron boundaries of the CYLD gene were amplified by polymerase chain reaction (PCR). Direct sequencing of all PCR products amplified from the complete coding regions of the CYLD gene was performed to identify mutations. Sequencing of the CYLD gene was performed in a further 100 unrelated, unaffected control individuals to exclude the possibility of polymorphism. A novel heterozygous frameshift mutation c.1169_1170delCA (p.Thr390Argfs) was identified in exon 10 of the CYLD gene in the affected family members. This mutation was also detected in unaffected family members, but not in the unrelated, healthy individuals who were also analyzed. Our study expands the database on the CYLD gene mutations in MFT and should be useful in providing genetic counseling and prenatal diagnosis for families affected by MFT.

HLA-B*1502 increases the risk of phenytoin or lamotrigine induced Stevens-Johnson Syndrome/toxic epidermal necrolysis: evidence from a meta-analysis of nine case-control studies

BACKGROUND AND STUDY AIMS

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are fatal adverse cutaneous drug reactions which may be induced by phenytoin (PHT) or lamotrigine (LTG). The objective of this study was to analyze the association of human leukocyte antigen (HLA)-B*1502 and PHT or LTG induced SJS/TEN.

PATIENTS AND METHODS

All the participants were epileptic patients and the SJS/TEN were induced by PHT or LTG. The presence or absence of the HLA-B*1502 allele of all the patients was determined. ISI Web of Knowledge, PubMed, ScienceDirect, EMBASE, and Cochrane Register of Controlled Trials (CENTRAL) data were searched for the literature published before April 2014. Meta-analysis was performed using Review Manager 5.2 software.

RESULTS

From 256 citations, 6 English studies were included that involved 480 epilepsy patients. Meta-analysis showed that odd ratio (OR) of PHT and LTG were 5.65 [95% CI: 2.76-11.57] and 4.51 [95% CI: 1.57-12.98], respectively. Funnel plot analysis showed symmetry, indicting less possible publication bias and the results were partly reliable.

CONCLUSION

There is a significant association between HLA-B*1502 and PHT or LTG-induced SJS/TEN.

A new strategy for identification of currant (Ribes nigrum L.) cultivars using RAPD markers

We developed a new approach using RAPD fingerprints to distinguish 37 currant cultivars from northeastern China based on optimization of RAPD by choosing 11 nucleotide primers and strict screening PCR annealing temperature. We found that the manual cultivar identification diagram (MCID) approach clearly developed fingerprints from 8 different primers that were useful for cultivar identification; a cultivar identification diagram (CID) was readily constructed. This CID allows efficient currant cultivar identification, providing information to separate all the currant cultivars from each other, based on the detail polymorphic bands from the corresponding primers, which were marked in the correct positions on the currant CID. According to the CID, 10 currant cultivars in 5 groups were randomly selected for the referable and workable identification of this strategy. The results proved the workability and efficiency of the MCID method, facilitating the identification of fruit cultivars with DNA markers. This MCID approach will be useful for early identification of seedlings in the nursery industry and protection of cultivar rights.

MiRNA s in oesophageal squamous cancer

Oesophageal cancer is a common cancer worldwide with a very poor prognosis. Oesophageal squamous cell carcinoma (OSCC) is the major subtype of oesophageal cancer but also one of the least studied cancers worldwide. Although the molecular genetics of OSCC have been widely studied, the molecular mechanism of OSCC carcinogenesis is not completely understood. MicroRNA (miRNA) is now essential to understanding the molecular mechanism of cancer progression. Recent findings include the following: 1) recent findings regarding the functions of miRNA; 2) some of the latest findings on expression profile of miRNA involved in OSCC; 3) miRNAs and their target genes and molecular mechanisms in OSCC; and 4) the therapeutic-clinical potential of miRNAs in OSCC. We can make full use of this knowledge to guide us to evaluate and improve the patient's condition and choose the most fitting medical treatment or explore new approaches to improve the survival ratio of OSCC patients.

Patterns of progression in patients with recurrent glioblastoma treated with bevacizumab

OBJECTIVE

We evaluated patterns of tumor progression in patients with recurrent glioblastoma who were treated with bevacizumab (BEV) alone or in combination with irinotecan (CPT-11) while participating in the BRAIN study.

METHODS

An independent neuroradiologist reviewed MRI scans at baseline and progression in patients who received BEV (n = 85) or BEV+CPT-11 (n = 82) while on BRAIN. Tumor patterns were scored as local, distant, diffuse, or multifocal. Median progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier methods. Hazard ratios for PFS and OS were estimated using a Cox regression model.

RESULTS

Twenty-eight percent of patients who participated in BRAIN had nonlocal disease at baseline (72% local disease). Sixty-seven (79%) patients treated with single-agent BEV and 57 (70%) patients treated with BEV+CPT-11 experienced disease progression while on BRAIN. Most patients in each treatment group did not have a change in the radiographic pattern of their tumor (i.e., "no shift") at the time of progression. The proportion of BEV patients with no shift (82%) was greater than that of BEV+CPT-11 patients (53%, χ(2) p = 0.0004), and a greater proportion of BEV+CPT-11 patients (39%) compared with BEV patients (16%) experienced local-to-diffuse tumor pattern at progression (χ(2) p = 0.002). Patients treated with BEV or BEV+CPT-11 who had local-to-local or local-to-diffuse progression patterns had similar efficacy outcomes, including objective response, PFS, and OS.

CONCLUSIONS

Most patients treated with BEV or BEV+CPT-11 on BRAIN did not experience a change from baseline in radiographic characteristics of disease at the time of progression.

Genetic deletion of faim reveals its role in modulating c-FLIP expression during CD95-mediated apoptosis of lymphocytes and hepatocytes

Fas-apoptosis inhibitory molecule (FAIM) is inducibly expressed in B lymphocytes and had been shown to antagonize Fas-mediated killing of B-cell lines in vitro. However, its mechanism and role in vivo are unknown. We have generated faim(-/-) mice and found these mutants to be viable. In contrast to fas(-/-) mice, faim(-/-) mice have normal B- and T-cell populations. However, faim(-/-) B cells and thymocytes show increased sensitivity to Fas-triggered apoptosis in vitro, and faim(-/-) mice suffer greater mortality and exhibit exacerbated liver damage in response to Fas (CD95) engagement in vivo. The lack of FAIM results in greater activation of caspase-8 and -3 in Fas-stimulated thymocytes. Detailed biochemical analyses further reveal the decreased expression of c-FLIP(L) and c-FLIP(R) in faim(-/-) thymocytes and increased association of caspase-8 with Fas in Fas-activated mutant cells. Decreased levels of c-FLIP(L) and c-FLIP(R) are also evident in faim(-/-) liver. Thus, FAIM plays a novel role in modulating Fas-mediated apoptosis and acts through influencing the expression of c-FLIP and regulating the physical binding of caspase-8 to Fas.

Transsphenoidal surgery utilizing computer-assisted stereotactic guidance

Computer-assisted guidance technology represents the next step in the application of stereotactic techniques to skull base surgery. Use of this 3-D technique reduces operative time and complications as the technique allows a more direct approach with precise real-time anatomical guidance. We present seven cases of transsphenoidal parasellar surgery where this technique has been employed. The pathology included lesions of the sella turcica, parasellar region and the petrous apex.

[Study on the gene polymorphismand the levels of α₁-antitrypsin (α1-AT) in patients with lung cancer in Harbin]

BACKGROUND

To study the gene polymorphism and the dynamic changes of the level of α₁-antitrypsin(α₁-AT) in patients with lung cancer of Chinese Han race in Harbin and its clinical significance.

METHODS

The phenotypes of α₁-AT from 99 patients with lung cancer and 749 normal persons were determined by polyacrylamide gel isoelectricfocusing electrophoresis. The levels of α₁-AT in serum were determined by monophonic immunodiffusion.

RESULTS

The common subtypes, such as M₁M₁ , M₁M₂ , M₂M₃, etc, were positive and the deficiency subtype was negative in both of the two groups. There was no significant difference in phenotypes and gene frequencies between the two groups ( P > 0. 05) . The level of α₁-AT in patients with lung cancer were remarkably higher than that in normal group ( P < 0. 05) , and significantly increased after anti-inflammatory or/and chemical treatment ( P < 0. 05) .

CONCLUSIONS

There is no significant difference in gene polymorphism of α₁-AT between the patients with lung cancer and normal persons, but the dynamic changes of α₁-AT are valuable to differentiate inflammation from cancer, estimate the efficacy of chemotherapy, and formulate and adjust the treatment scheme.

[Effect of NaFeEDTA fortified soy sauce on iron deficiency anemia in students]

NaFeEDTA fortified soy sauce was given to 300 students with iron deficiency anemia (IDA) for 3 months. The subjects were divided into three groups: control group, low iron supplemented group (Fe 5 mg/d) and high iron supplemented group (Fe 20 mg/d). Hemoglobin (Hb), serum iron, serum ferrtin, erythrocyte protoporphyrin, total iron binding capacity and serum transferrin were evaluated before and after the study. The results showed that Hb, serum iron, ferrtin and transferrin of the intervention groups had improved and erythrocyte protoporphyrin, total iron binding capacity decreased. There were no differences between the two intervention groups after the trial. The parameters of both intervention groups were much better than those of the control group. The results suggested that NaFeEDTA fortified soy sauce had positive influence on IDA.