Impact of structured self-monitoring of blood glucose on the quality of life of insulin-treated Chinese patients with type 2 diabetes mellitus: Results from the COMPASS study

AIMS

To evaluate the effect of structured self-monitoring of blood glucose (SMBG) regimen on quality of life (QoL) in poorly controlled insulin-treated patients with type 2 diabetes.

METHODS

Phase II of the COMPASS trial was a 6-month, multicenter, prospective, single-arm, interventional study. This study recruited 820 outpatients from 19 clinical sites in China who met the following inclusion criteria: type 2 diabetes, insulin treatment for ≥ 3 months, and age 18-65 years, an HbA1c >8.0% (64 mmol/mol), and willingness to perform SMBG. Subjects were advised to follow a structured SMBG regimen specific to their insulin regimen, and were trained to respond to SMBG readings via lifestyle changes and insulin dose self-adjustment. QoL assessments (SF-36) were performed at baseline and 6 months.

RESULTS

Patients with a mean age of 55.13 ± 9.77 years had an average diabetes duration of 9.83 ± 7.05 years and had been receiving insulin therapy for a mean of 45.4 ± 46.79 months. All QoL parameters were significantly improved following structured SMBG after 6 months, most notably the physical role functioning (p<0.0001) and emotional role functioning (p<0.0001) component scores. Overall, 40.6% of patients rated their overall QoL as 'a bit' or a lot better' after structured SMBG compared with 16.5% prior to the intervention (p<0.0001). SMBG also improved overall feelings of wellbeing, with 39.13% of patients believing that their health was deteriorating prior to SMBG compared with only 14.4% of patients after the intervention (p<0.0001).

CONCLUSIONS

The structured SMBG program in insulin-treated Chinese outpatients with type 2 diabetes significantly improved QoL outcomes. Physical and emotional role functioning are the 2 QoL scales that demonstrate the largest improvement with SMBG.

Newer antifungal agents micafungin and voriconazole for fungal infection prevention during hematopoietic cell transplantation: a meta-analysis

OBJECTIVE

The new antifungal agents provide further opportunities for effective prophylaxis for fungal infections during stem cell transplantation for patients with hematologic malignancies; however, the efficacy of these antifungal prophylactic drugs has not yet been established. This study was to compare the newer antifungal agents micafungin and voriconazole for prophylaxis effects on the clinical outcomes.

MATERIALS AND METHODS

We electronically searched the database of Cochrane Central Register of Controlled Trials, Pubmed, EMbase, and relevant database articles (1996.01-2013.12). Comparative studies were carried out on proved fungal infections, mortality, and adverse effects. Meta-analysis was performed by Review Manager 5.1.6 software and the funnel plot regression was adopted to assess the publication bias.

RESULTS

We found 1508 records and 13 studies totaling 3767 patients included in analyses. Pooled comparisons of studies found that antifungal prophylaxis with the new agents does reduce the incidence of invasive fungal infections than fluconazole or itraconazole. The reduction in invasive fungal infections was achieved by using micafungin, voriconazole for antifungal prophylaxis. Using voriconazole prophylaxis can decrease the transplant mortality compared with fluconazole or itraconazole prophylaxis. Voriconazole had higher rates of liver dysfunction, lower gastrointestinal side effects over fluconazole, and lower rates of nephrotoxic effects than amphotericin B. Both micafungin and voriconazole had a significant decrease in adverse events requiring drug discontinuation compared with itraconazole.

CONCLUSIONS

This analysis indicated the 2 agents appear to be well tolerated with manageable side effects and beneficial in the prophylaxis of IFI. Further work is needed with a large scale of random controlled trials on the effect of these drugs.

Effects of Dietary Supplementation of β-hydroxy-β-methylbutyrate on Sow Performance and mRNA Expression of Myogenic Markers in Skeletal Muscle of Neonatal Piglets

The effects of dietary β-hydroxy-β-methylbutyrate (HMB) supplementation during gestation on reproductive performance of sows and the mRNA expression of myogenic markers in skeletal muscle of neonatal pigs were determined. At day 35 of gestation, a total of 20 sows (Landrace × Yorkshire, at third parity) were randomly assigned to two groups, with each group receiving either a basal diet or the same diet supplemented with 4 g/day β-hydroxy-β-methylbutyrate calcium (HMB-Ca) until parturition. At parturition, the total and live litter size were not markedly different between treatments, however, the sows fed HMB diet had a decreased rate of stillborn piglets compared with the sows fed the control (CON) diets (p < 0.05). In addition, piglets from the sows fed HMB diet tended to have an increased birth weight (p = 0.08), and a reduced rate of low birth weight piglets (p = 0.05) compared with piglets from the CON sows. Nevertheless, lower feed intake during lactation was observed in the sows fed the HMB diet compared with those on the CON diet (p < 0.01). The relative weights of the longissimus dorsi (LD) and semitendinosus (ST) muscle were higher (p < 0.05) in neonatal pigs from the HMB than the CON sows. Furthermore, maternal HMB treatment increased the mRNA levels of the myogenic genes, including muscle regulatory factor-4 (MRF4, p < 0.05), myogenic differentiation factor (MyoD) and insulin-like growth factor-1 (IGF-1, p < 0.01). In conclusion, dietary HMB supplementation to sows at 4 g/day from day 35 of gestation to term significantly improves pregnancy outcomes and increases the expression of myogenic genes in skeletal muscle of neonatal piglets, but reduces feed intake of sows during lactation.

Particle emissions from microalgae biodiesel combustion and their relative oxidative potential

Microalgae are considered to be one of the most viable biodiesel feedstocks for the future due to their potential for providing economical, sustainable and cleaner alternatives to petroleum diesel. This study investigated the particle emissions from a commercially cultured microalgae and higher plant biodiesels at different blending ratios. With a high amount of long carbon chain lengths fatty acid methyl esters (C20 to C22), the microalgal biodiesel used had a vastly different average carbon chain length and level of unsaturation to conventional biodiesel, which significantly influenced particle emissions. Smaller blend percentages showed a larger reduction in particle emission than blend percentages of over 20%. This was due to the formation of a significant nucleation mode for the higher blends. In addition measurements of reactive oxygen species (ROS), showed that the oxidative potential of particles emitted from the microalgal biodiesel combustion were lower than that of regular diesel. Biodiesel oxygen content was less effective in suppressing particle emissions for biodiesels containing a high amount of polyunsaturated C20-C22 fatty acid methyl esters and generated significantly increased nucleation mode particle emissions. The observed increase in nucleation mode particle emission is postulated to be caused by very low volatility, high boiling point and high density, viscosity and surface tension of the microalgal biodiesel tested here. Therefore, in order to achieve similar PM (particulate matter) emission benefits for microalgal biodiesel likewise to conventional biodiesel, fatty acid methyl esters (FAMEs) with high amounts of polyunsaturated long-chain fatty acids (≥C20) may not be desirable in microalgal biodiesel composition.

Delocalized Surface State in Epitaxial Si(111) Film with Spontaneous √3 × √3 Superstructure

The “multilayer silicene” films were grown on Ag(111), with increasing thickness above 30 monolayers (ML). Scanning tunneling microscopy (STM) observations suggest that the “multilayer silicene” is indeed a bulk-like Si(111) film with a (√3 × √3)R30° honeycomb superstructure on surface. The possibility for formation of Si(111)(√3 × √3)R30°-Ag reconstruction on the surface can be distinctively ruled out by peeling off the surface layer with the STM tip. On this surface, delocalized surface state as well as linear energy-momentum dispersion was observed from quasiparticle interference patterns. Our results indicate that a bulklike silicon film with diamondlike structure can also host delocalized surface state, which is even more attractive for potential applications, such as new generation of nanodevices based on Si.

[Research progress on site-oriented and three-dimensional immobilization of proteins]

In today's post-genome era, the goals of research are geared toward understanding the meaning of information in sequenced DNA, namely, understanding the functional characteristics of proteins encoded by genomes of living beings. Protein array technologies, particularly miniaturized high-throughput platforms such as micro- or nano-fluidic chips that allow the parallel detection of thousands of proteins simultaneously, are playing increasing important roles as discovery tools in proteomics. These technologies are based on principles of molecular recognition and consist of a support surface, such as a glass slide, bead, or microtiter plate, to which an array of captured proteins is bound. However, immobilized proteins often lose their immunoactivity and suffer from low surface density, which results in inefficient signal response. In this review, we mainly provide an introduction about the research progress on site-oriented adsorption of protein at solid-liquid interfaces, especially the three-dimensional immobilization of protein, whose objective is to retain immobilized proteins in an active state at great density.

A case of bone marrow infection by Staphylococcus saccharolyticus

We report a case of fatal bone marrow infection caused by Staphylococcus saccharolyticus in a 26 year old female. The causative organism was isolated by anaerobic culture on blood agar, and was identified by PCR amplification of the gap gene and genotyping of the resultant sequence.

Evidence for hydrophobic catalysis of DNA strand exchange

DNA strand exchange is catalysed by a hydrophobic environment which destabilises base stacking and promotes DNA breathing.

Ginkgo biloba extract for essential hypertension: a systemic review

BACKGROUND

Ginkgo biloba extract (GBE), a traditional natural herbal product, is often used in the treatment of essential hypertension (EH) as complementary therapy in China and European countries.

AIM

To critically assess the current clinical evidence of efficacy and safety of GBE for EH.

METHODS

7 electronic databases (Cochrane Library, PubMed, EMBASE, VIP, CBM, Wanfang data, and CNKI) were searched to identify randomized controlled trials (RCTs) of GBE for EH. Methodological quality was assessed independently using the Cochrane Handbook for Systematic Reviews of Interventions.

RESULTS

A total of 9 RCTs with 1012 hypertensive patients were identified and reviewed. Most RCTs were of high risk of bias with flawed study design and poor methodological quality. 6 trials demonstrated potential positive effect of GBE as complementary therapy on BP reduction when compared with antihypertensive drug therapy; however, it was not associated with a statistically significant effect on both SBP and DBP reduction in 3 other trials. Despite the positive findings, there were so many methodological limitations and significant clinical heterogeneity. Most of the trials did not report adverse effects, and the safety of GBE is still uncertain.

CONCLUSION

No confirmative conclusions on the efficacy and safety of GBE for EH could be drawn. More rigorous trials are warranted to support their clinical use.

Abnormalities in whole-brain functional connectivity observed in treatment-naive post-traumatic stress disorder patients following an earthquake

BACKGROUND

Convergent studies have highlighted the dysfunction of the amygdala, prefrontal cortex and hippocampus in post-traumatic stress disorder (PTSD). However, only a few studies have investigated the functional connectivity between brain regions in PTSD patients during the resting state, which may improve our understanding of the neuropathophysiology of PTSD. The aim of this study was to investigate patterns of whole-brain functional connectivity in treatment-naive PTSD patients without co-morbid conditions who experienced the 8.0-magnitude earthquake in the Sichuan province of China.

METHOD

A total of 72 PTSD patients and 86 trauma-exposed non-PTSD controls participated in the resting-state functional magnetic resonance imaging study. All these subjects were recruited from the disaster zone of the 2008 Sichuan earthquake. Functional connectivities between 90 paired brain regions in PTSD patients were compared with those in trauma-exposed non-PTSD controls. Furthermore, Pearson correlation analysis was performed between significantly abnormal connectivities in PTSD patients and their clinician-administered PTSD scale (CAPS) scores.

RESULTS

Compared with non-PTSD controls, PTSD patients showed weaker positive connectivities between the middle prefrontal cortex (mPFC) and the amygdala, hippocampus, parahippocampal gyrus and rectus, as well as between the inferior orbitofrontal cortex and the hippocampus. In addition, PTSD patients showed stronger negative connectivity between the posterior cingulate cortex (PCC) and the insula. The CAPS scores in PTSD patients correlated negatively with the connectivity between the amygdala and the mPFC.

CONCLUSIONS

PTSD patients showed abnormalities in whole-brain functional connectivity, primarily affecting the connectivities between the mPFC and limbic system, and connectivity between the PCC and insula.

Observation of Dirac cone warping and chirality effects in silicene

We performed low temperature scanning tunneling microscopy (STM) and spectroscopy (STS) studies on the electronic properties of (√3 × √3)R30° phase of silicene on Ag(111) surface. We found the existence of Dirac Fermion chirality through the observation of -1.5 and -1.0 power law decay of quasiparticle interference (QPI) patterns. Moreover, in contrast to the trigonal warping of Dirac cone in graphene, we found that the Dirac cone of silicene is hexagonally warped, which is further confirmed by density functional calculations and explained by the unique superstructure of silicene. Our results demonstrate that the (√3 × √3)R30° phase is an ideal system to investigate the unique Dirac Fermion properties of silicene.

Guided bone regeneration using acellular bovine pericardium in a rabbit mandibular model: in-vitro and in-vivo studies

BACKGROUND AND OBJECTIVE

To investigate the feasibility of acellular bovine pericardium (BP) for guided bone regeneration (GBR) in vitro and in vivo. The success of GBR relies on the fact that various cellular components possess different migration rates into the defect site and that a barrier membrane plays a significant role in these processes.

MATERIAL AND METHODS

BP membrane was isolated and decellularized using an enzymatic method. The microarchitecture, mechanical properties, cytotoxicity and cell chemotaxis properties of the acellular BP were evaluated in vitro, and the in-vivo efficacy of the acellular BP was also investigated in a rabbit mandibular model.

RESULTS

The acellular BP membrane possessed an interconnected fibrous structure. Glutaraldehyde (GA) treatment was efficient for enhancement of the mechanical properties of the acellular BP bur and resulted in negligible cytotoxicity. After 16 wk, standardized osseous defects created in the rabbit mandible, and covered with acellular BP, were associated with an enhanced deposition of mineralized tissue when compared with defects left to spontaneous healing.

CONCLUSION

GA-treated acellular BP is promising as a barrier membrane for GBR for further in-vivo and clinical studies.

Transporter studies in drug development: experience to date and follow-up on decision trees from the International Transporter Consortium

The International Transporter Consortium (ITC) organized a second workshop in March 2012 to expand on the themes developed during the inaugural ITC workshop held in 2008. The final session of the workshop provided perspectives from regulatory and industry-based scientists, with input from academic scientists, and focused primarily on the decision trees published from the first workshop. These decision trees have become a central part of subsequent regulatory drug-drug interaction (DDI) guidances issued over the past few years.

Multiple statistical methods for assessing differential gene expression in microarray data of diabetic model rats to predict the molecular mechanism of atorvastatin on anti-atherogenesis

BACKGROUND

Many evidences indicate that statins have pleiotropic effects that are lipid-lowering independent. These effects could suggest attenuation of many of the stages critical to atherosclerosis. However, the specific molecular mechanisms of statins on atherogenesis are still unknown. The goal is to detect and analyze the altered gene expression of the artery after atorvastatin treatment in streptozocin (STZ)-induced diabetic rats, and to predict the possible cholesterol-independent effects of atorvastatin on anti-atherogenesis.

METHODS

A total of 33 Sprague Dawley (SD) rats were randomly divided into 3 groups: control group, diabetic group, and diabetic group with atorvastatin treatment (receiving 50 mg/kg qd atorvastatin). Rats were sacrificed at the end of 4 weeks, and the aortas were obtained. The pathological changes were observed by Hematoxylin and eosin (HE) staining. A cDNA microarray analysis was carried out, and the results were analyzed by the random variance model (RVM) t-test, Stc analysis, Stc-Gene Ontology (GO) analysis, Stc-pathway analysis, and GeneFunNet analysis. Then reverse transcription polymerase chain reaction (RT-PCR) was used to evaluate the mRNA expression of Cathepsin S (Cat S),Which was one of the significant genes obtained by statistical analysis, in the aortas of rats in control group (Wistar rats), DM group (Goto Kakisaki rats) and atorvastatin treated DM group (Goto Kakisaki rats with 50 mg/kg qd atorvastatin) for 12 weeks.

RESULTS

A total of 1 073 differential expression genes were found in the 3 groups. 2 tendency profiles of gene expression, which represented the medicine effect, were picked out by Stc analysis of gene expression. The main functions of genes and the significant pathways in the 2 profiles were figured out by Stc-go analysis and Stc-pathway analysis. The core regulatory factors in the co-expression network were shown by GeneFunNet analysis. Among these significant genes, Cat S was chosen to be further evaluated as a target gene. Expression of Cat S was upregulated in the aortas of the diabetic rats and downregulated with statistical significance by atorvastatin treatment.

CONCLUSIONS

Atorvastatin can influence the expression of many genes and signal pathways, some may be significant and produce their marked effects on all of the processes of atherogenesis. Cat S is one of them. These data thus predict the possible molecular mechanism of pleiotropic effects of atorvastatin, which is useful for further experimental design.

Spontaneous symmetry breaking and dynamic phase transition in monolayer silicene

The (sqrt[3]×sqrt[3])R30° honeycomb of silicene monolayer on Ag(111) was found to undergo a phase transition to two types of mirror-symmetric boundary-separated rhombic phases at temperatures below 40 K by scanning tunneling microscopy. The first-principles calculations reveal that weak interactions between silicene and Ag(111) drive the spontaneous unusual buckling in the monolayer silicene, forming two energy-degenerate and mirror-symmetric (sqrt[3]×sqrt[3])R30° rhombic phases, in which the linear band dispersion near the Dirac point and a significant gap opening (150 meV) at the Dirac point were induced. The low transition barrier between these two phases enables them to be interchangeable through dynamic flip-flop motion, resulting in the (sqrt[3]×sqrt[3])R30° honeycomb structure observed at high temperature.

Evidence for Dirac fermions in a honeycomb lattice based on silicon

Silicene, a sheet of silicon atoms in a honeycomb lattice, was proposed to be a new Dirac-type electron system similar to graphene. We performed scanning tunneling microscopy and spectroscopy studies on the atomic and electronic properties of silicene on Ag(111). An unexpected √3 × √3 reconstruction was found, which is explained by an extra-buckling model. Pronounced quasiparticle interferences (QPI) patterns, originating from both the intervalley and intravalley scatter, were observed. From the QPI patterns we derived a linear energy-momentum dispersion and a large Fermi velocity, which prove the existence of Dirac fermions in silicene.

Evidence of silicene in honeycomb structures of silicon on Ag(111)

In the search for evidence of silicene, a two-dimensional honeycomb lattice of silicon, it is important to obtain a complete picture for the evolution of Si structures on Ag(111), which is believed to be the most suitable substrate for growth of silicene so far. In this work we report the finding and evolution of several monolayer superstructures of silicon on Ag(111), depending on the coverage and temperature. Combined with first-principles calculations, the detailed structures of these phases have been illuminated. These structures were found to share common building blocks of silicon rings, and they evolve from a fragment of silicene to a complete monolayer silicene and multilayer silicene. Our results elucidate how silicene forms on Ag(111) surface and provides methods to synthesize high-quality and large-scale silicene.

Increased signal transducer and activator of transcription 3 (STAT3) and decreased cyclin D1 in recurrent astrocytic tumours compared with paired primary astrocytic tumours

This study compared the levels of signal transducer and activator of transcription 3 (STAT3) and cyclin D1 protein in paired primary and recurrent astrocytic tumours, and analysed their correlation with clinicopathological and treatment factors. A total of 48 samples from 24 patients who had undergone surgical removal of primary and recurrent astrocytic tumours were analysed. Levels of STAT3 and cyclin D1 protein were detected using immunohistochemistry. Increased STAT3 and decreased cyclin D1 levels were observed in recurrent astrocytic tumours compared with their paired primary tumours. There was a significant correlation between higher levels of STAT3 protein and shorter progression-free survival in primary tumours after surgery (r = 0.417), and a significant correlation between decreased cyclin D1 protein levels and radiotherapy in recurrent tumours (r = 0.468). It was concluded that increased STAT3 and decreased cyclin D1 protein levels may contribute to the recurrence of astrocytic tumours. Detection of STAT3 may be useful in predicting progressionfree survival in primary astrocytic tumours after surgery. In addition, radiotherapy may decrease cyclin D1 levels in astrocytic tumours, but the nature of this association requires further investigation.

Glucose metabolism among residents in Shanghai: natural outcome of a 5-year follow-up study

BACKGROUND

Previous studies have shown that Type 2 diabetes mellitus (T2DM) is usually preceded by a condition known as pre-diabetes. However, few studies evaluate the rate of each status of impaired glucose regulation progressed to T2DM and its related metabolic disorders impacting the development.

AIM

To investigate the natural outcome of glucose metabolism among Shanghai adult residents during a 5-yr period, and estimate the metabolic characteristics related with the conversion of glucose tolerance.

SUBJECTS AND METHODS

A cross-sectional survey with multiple- stage and random sampling was conducted among 1869 adult residents from Shanghai Pudong New District in 2002. In 2007, 1042 non-diabetic subjects were successfully followed up. All the participants completed a questionnaire and underwent anthropometric measurements and a 75-g oral glucose tolerance test.

RESULTS

The incidence of diabetes was higher in isolated impaired glucose tolerance (i- IGT), isolated impaired fasting glucose (i-IFG), and combined fasting and post-prandial hyperglycemia (IFG/IGT) group when compared to that in normal glucose tolerance group, as relative ratios with 95% confidence intervals of 9.2 (5.5- 15.2), 7.5 (3.6-15.7), and 13.2 (5.8-30.2), respectively. Subjects who had 2 or more metabolic disorders had a 2-3-fold higher incidence than those with less than 1 metabolic disorder (all p<0.001).

CONCLUSIONS

People with pre-diabetes are at increased risk of diabetes, suggesting the need for frequent screening in theloe people with several metabolic disorders.

Renal, retinal and cardiac changes in type 2 diabetes are attenuated by macitentan, a dual endothelin receptor antagonist

AIMS

Diabetes is known to cause alteration of the endothelin (ET) system. We have previously demonstrated that ETs regulate augmented production of extracellular matrix proteins causing structural alterations in type 1 diabetes. Here we investigated the effects of macitentan, an orally-active, tissue-targeting dual ET receptor antagonist on chronic complications in type 2 diabetes.

MAIN METHODS

db/db mice and their age- and sex-matched controls were examined after 2 and 4 months of diabetes. Groups of diabetic animals were treated with oral macitentan (25mg/kg/day). The animals were monitored with respect to body weight and blood glucose. Urine analyses were performed for albumin. Cardiac hemodynamic studies were carried out. Renal, cardiac and retinal tissues were analyzed for ET-1, transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor (VEGF), fibronectin (FN), extradomain B containing FN (EDB(+)FN) and collagen α-I (IV) mRNA. Cardiac atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) were measured. Protein expressions were measured by ELISA and Western blot. Microscopic analyses were performed in the kidneys.

KEY FINDINGS

Diabetic animals showed hyperglycemia, increased urinary albumin and augmented serum creatinine levels. Diabetes caused increased renal, cardiac and retinal ET-1, TGF-β1, VEGF, FN, EDB(+)FN, collagen α-I(IV) mRNA expression along with increased FN and collagen protein and NF-κB activation. Diabetic mice also demonstrated mesangial expansion, cardiac dysfunction and increased expression of ANP and BNP. Treatment with macitentan attenuated such abnormalities.

SIGNIFICANCE

These experiments confirmed that ET system plays a significant role in the pathogenesis of chronic complications in type 2 diabetes. Such diabetes induced changes can be reduced macitentan therapy.

Statins for primary prevention of cardiovascular and cerebrovascular events in diabetic patients without established cardiovascular diseases: a meta-analysis

AIMS

Lipid-lowering medications could lead to a significant reduction in major cardiovascular events in patients with diabetes. However, there was still controversy regarding the use of statins in patients with diabetes for primary prevention. The meta-analysis was performed to evaluate the outcomes of statin-therapy in diabetic patients without established cardiovascular diseases.

METHODS

7 randomized controlled trials of statin- vs. control-therapy in patients with diabetes were included. A total number of 12,711 patients were involved. The outcomes of interest were major adverse cardiovascular and cerebrovascular events (MACCE), including myocardial infarction, stroke, all-cause mortality and coronary revascularization.

RESULTS

A total of 1,376 MACCE occurred during follow-up, with 9.54% (605 patients) in the statin therapy group and 12.10% (771 patients) in control group. Statin therapy was associated with a significant reduction in the incidence of MACCE (0.79, 95%CI 0.66-0.95; P=0.01). Meanwhile, the risk of stroke and coronary revascularization were reduced 29 and 26% in statin therapy group. However, there was no statistical difference of all-cause mortality between statin- and control-therapy group (3.73 vs. 4.65%, P=0.13).

CONCLUSIONS

For primary prevention in patients with diabetes without established cardiovascular disease, statin therapy could reduce the cardiovascular and cerebrovascular events, but not all-cause mortality.

Modulation of visceral hypersensitivity by glial cell line-derived neurotrophic factor family receptor &alpha;-3 in colorectal afferents

Irritable bowel syndrome is characterized by colorectal hypersensitivity and contributed to by sensitized mechanosensitive primary afferents and recruitment of mechanoinsensitive (silent) afferents. Neurotrophic factors are well known to orchestrate dynamic changes in the properties of sensory neurons. Although pain modulation by proteins in the glial cell line-derived neurotrophic factor (GDNF) family has been documented in various pathophysiological states, their role in colorectal hypersensitivity remains unexplored. Therefore, we investigated the involvement of the GDNF family receptor α-3 (GFRα3) signaling in visceral hypersensitivity by quantifying visceromotor responses (VMR) to colorectal distension before and after intracolonic treatment with 2,4,6-trinitrobenzene sulfonic acid (TNBS). Baseline responses to colorectal distension did not differ between C57BL/6 and GFRα3 knockout (KO) mice. Relative to intracolonic saline treatment, TNBS significantly enhanced the VMR to colorectal distension in C57BL/6 mice 2, 7, 10, and 14 days posttreatment, whereas TNBS-induced visceral hypersensitivity was significantly suppressed in GFRα3 KO mice. The proportion of GFRα3 immunopositive thoracolumbar and lumbosacral colorectal dorsal root ganglion neurons was significantly elevated 2 days after TNBS treatment. In single fiber recordings, responses to circumferential stretch of colorectal afferent endings in C57BL/6 mice were significantly increased (sensitized) after exposure to an inflammatory soup, whereas responses to stretch did not sensitize in GFRα3 KO mice. These findings suggest that enhanced GFRα3 signaling in visceral afferents may contribute to development of colorectal hypersensitivity.

Surface Structure of A Liquid Perfluoropolyether Examined by Reactive Ion/Surface Scattering

This study shows that reactive ion/surface collisions can provide information on the surface structure of molecular systems. The microscopic structures of perfluorinated polyether (PFPE) liquid surfaces are characterized by ion/surface collision experiments in a mass spectrometer and the results are compared to those obtained with a fluorinated self-assembled monolayer (F-SAM) surface. Low energy (< 100 eV) beams of W+ and W(CO)6+ ions are used for surface-induced dissociation (SID) and ion/surface reactive scattering, while Xe+ and Kr+ beams are used for chemical sputtering experiments. Both the PFPE and F-SAM surfaces show similar SID fragments while reactions with W+ and W(CO)6+ lead to the scattered metal ion with multiple fluorine atoms attached. The main peaks in chemical sputtering spectra are similar for both surfaces as well. Both hydrogen probe beams and chemical sputtering confirm that the liquid PFPE surface is nearly free of impurities. Our results on both surfaces also suggest that the CF3 group of the monomer units is most likely projected outward from the bulk of the liquid surface.

Abstract P1-03-06: Population Based In Vivo Biomarker Discovery Using Engineered Human Tumors

Background:

Tumors from patients exhibit significant inter-tumor variation, where each tumor harbors a unique set of genetic alterations that impact prognosis and response to treatment. Unfortunately, this variation contributes to low response rates in the clinic and creates significant challenges for treating patients with appropriate drugs. Cancer cell line based xenografts have traditionally been the preclinical model of choice to assess the efficacy of clinical compounds; however, such in vitro models exhibit inherent artifacts, and are unable to adequately capture natural variation seen in human tumor populations. It has therefore become a priority in oncology and personalized medicine to match patients to drugs that will result in a favorable treatment outcome. In this report, we describe a population based approach for response prediction featuring naturally occurring variation in tumors derived from genetically defined human-in-mouse models of cancer. Materials and Methods:

A population of De novo human breast tumors were generated by genetically engineering normal primary human breast epithelial cells with HER2 and SV40 early region (HER2/SV40er) or KRAS and SV40 early region (KRAS/SV40er) in an in vivo Human-In-Mouse (HIM) tissue transgenic model (Wu et al, Proc Natl Acad Sci U S A 2009, 106: 7022-2027). Each tumor of the population has been comprehensively characterized histopathologically, and at the RNA and DNA level. Furthermore, the population has been adapted to conduct quantitative efficacy studies of anti-cancer agents and combinations. Results:

The HER2/SV40er and the KRAS/SV40er HIM tumors develop as invasive human breast adenocarcinoma that are histologically similar to those observed in patients. Microarray and CGH profiling demonstrated significant inter-tumor variation among the established tumors, as has been reported for patient tumors. Moreover, the KRAS/SV40er tumors clustered with basal type breast cancers from patients, a poor prognosis human breast cancer subtype. Both HER2/SV40er and KRAS/SV40er tumors exhibited variable responses to treatments with the potent selective triple VEGFR inhibitor, tivozanib. Further characterization of those tumors, both pre-and post-treatment, identified potential biomarkers for tumor response to tivozanib. Discussion:

The genetically defined human-in-mouse tumors exhibited natural variations similar to that occurs in human cancer. This population-based HIM system enables us to identify and validate biomarkers of therapeutic response in an in vivo human tumor model. Figure available in online version.

Preparation and mechanical property of poly(ε-caprolactone)-matrix composites containing nano-apatite fillers modified by silane coupling agents

This study aims to improve the tensile strength and elastic modulus of nano-apatite/poly(ε-caprolactone) composites by silane-modification of the nano-apatite fillers. Three silane coupling agents were used to modify the surfaces of nano-apatite particles and composites of silanized apatite and PCL were prepared by a technique incorporating solvent dispersion, melting-blend and hot-pressing. The results showed that the silane coupling agents successfully modified the surfaces of nano-apatite fillers, and the crystallization temperatures of the silanized apatite/PCL composites were the higher than that of the non-silanized control material, although the melting temperature of the composites remained almost unaffected by silanization. The ultimate tensile strength and elastic modulus of the silanized composites reached 22.60 MPa and 1.76 GPa, as a result of the improved interfacial bonding and uniform dispersion of nano-apatite fillers. This study shows that the processing technique and silanization of nano-apatite particles can effectively improve the tensile strength and elastic modulus of nano-apatite/PCL composites.

The endothelin receptor antagonist avosentan ameliorates nephropathy and atherosclerosis in diabetic apolipoprotein E knockout mice

AIMS/HYPOTHESIS

There is convincing evidence that the endothelin system contributes to diabetic nephropathy and cardiovascular disease. This study aimed to assess the effects of the non-peptidergic endothelin receptor A (ETA) antagonist avosentan in a mouse model of accelerated diabetic nephropathy and atherosclerosis in comparison with the ACE inhibitor, quinapril.

METHODS

Apolipoprotein E (Apoe) knockout (KO) mice (n = 20 per group, five groups) were randomised to the following groups: non-diabetic controls and streptozotocin-induced diabetic animals gavaged daily for 20 weeks with placebo, avosentan (high dose: 30 mg/kg, or low dose: 10 mg/kg) or quinapril (given in drinking water, 30 mg/kg).

RESULTS

BP was unchanged by avosentan treatment but decreased with quinapril treatment. Diabetes-associated albuminuria was significantly attenuated by high-dose avosentan after 10 and 20 weeks of treatment. Diabetic animals showed a decreased creatinine clearance, which was normalised by avosentan treatment. In diabetic mice, high-dose avosentan treatment significantly attenuated the glomerulosclerosis index, mesangial matrix accumulation, glomerular accumulation of the matrix proteins collagen IV, and renal expression of genes encoding connective tissue growth factor, vascular endothelial growth factor, transforming growth factor beta and nuclear factor kappaB (p65 subunit). Furthermore, high-dose avosentan treatment was also associated with reduced expression of the genes for ETA, ETB and angiotensin receptor 1. The renoprotective effects of avosentan were comparable or superior to those observed with quinapril. High-dose avosentan also significantly attenuated diabetes-associated aortic atherosclerosis in Apoe KO mice and reduced macrophage infiltration and aortic nitrotyrosine expression.

CONCLUSIONS/INTERPRETATION

This study demonstrates that ETA blockade with avosentan may provide an alternate therapeutic strategy for the treatment of diabetic micro- and macrovascular complications.