Multifunctional Thio-Stabilized Gold Nanoparticles for Near-Infrared Fluorescence Detection and Imaging of Activated Caspase-3

Background

Gold nanoparticles (AuNPs) are commonly used in nanomedicine because of their unique spectral properties, chemical and biological stability, and ability to quench the fluorescence of organic dyes attached to their surfaces. However, the utility of spherical AuNPs for activatable fluorescence sensing of molecular processes have been confined to resonance-matched fluorophores in the 500 nm to 600 nm spectral range to maximize dye fluorescence quenching efficiency. Expanding the repertoire of fluorophore systems into the NIR fluorescence regimen with emission >800 nm will facilitate the analysis of multiple biological events with high detection sensitivity.

Objective

The primary goal of this study is to determine if spherical AuNP-induced radiative rate suppression of non-resonant near-infrared (NIR) fluorescent probes can serve as a versatile nanoconstruct for highly sensitive detection and imaging of activated caspase-3 in aqueous media and cancer cells. This required the development of activatable NIR fluorescence sensors of caspase-3 designed to overcome the nonspecific degradation and release of the surface coatings in aqueous media.

Method

We harnessed the fluorescence-quenching properties and multivalency of spherical AuNPs to develop AuNP-templated activatable NIR fluorescent probes to detect activated caspase-3, an intracellular reporter of early cell death. Freshly AuNPs were coated with a multifunctional NIR fluorescent dye-labeled peptide (LS422) consisting of an RGD peptide sequence that targets α_vβ₃-integrin protein (α_vβ₃) on the surface of cancer cells to mediate the uptake and internalization of the sensors in tumor cells; a DEVD peptide sequence for reporting the induction of cell death through caspase-3 mediated NIR fluorescence enhancement; and a multidentate hexacysteine sequence for enhancing self-assembly and stabilizing the multifunctional construct on AuNPs. The integrin binding affinity of LS422 and caspase-3 kinetics were determined by a radioligand competitive binding and fluorogenic peptide assays, respectively. Detection of intracellular caspase-3, cell viability, and the internalization of LS422 in cancer cells were determined by confocal NIR fluorescence spectroscopy and microscopy.

Results

Narrow size AuNPs (13 nm) were prepared and characterized by transmission electron microscopy and dynamic light scattering. When assembled on the AuNPs, the binding constant of LS422 for α_vβ₃ improved 11-fold from 13.2 nM to 1.2 nM. Whereas the catalytic turnover of caspase-3 by LS422-AuNPs was similar to the reference fluorogenic peptide, the binding affinity for the enzyme increased by a factor of 2. Unlike the α_vβ₃ positive, but caspase-3 negative breast cancer MCF-7 cells, treatment of the α_vβ₃ and caspase-3 positive lung cancer A549 cells with Paclitaxel showed significant fluorescence enhancement within 30 minutes, which correlated with caspase-3 specific activation of LS422-AuNPs fluorescence. Incorporation of a 3.5 mW NIR laser source into our spectrofluorometer increased the detection sensitivity by an order of magnitude (limit of detection ~0.1 nM of cypate) and significantly decreased the signal noise relative to a xenon lamp. This gain in sensitivity enabled the detection of substrate hydrolysis at a broad range of inhibitor concentrations without photobleaching the cypate dye.

Conclusion

The multifunctional AuNPs demonstrate the use of a non-resonant quenching strategy to design activatable NIR fluorescence molecular probes. The nanoconstruct offers a selective reporting method for detecting activated caspase-3, imaging of cell viability, identifying dying cells, and visualizing the functional status of intracellular enzymes. Performing these tasks with NIR fluorescent probes creates an opportunity to translate the in vitro and cellular analysis of enzymes into in vivo interrogation of their functional status using deep tissue penetrating NIR fluorescence analytical methods.

[Effect of platelet reactivity on clinical events in patients using bivalirudin in selective percutaneous coronary intervention]

Objective: To investigate the effect of platelet reactivity and other clinical factors on the postoperative 1-year adverse clinical events in patients who underwent selective percutaneous coronary intervention (PCI) anticoagulated with bivalirudin. Methods: This is a multicenter, retrospective and observational study, enrolling 632 patients at high risk of bleeding adjudicated by operators who underwent selective PCI anticoagulated with bivalirudin and had preoperative thrombelastography (TEG) test results in Fuwai Hospital, Northern Theater General Hospital and Xinxiang Central Hospital between January 2017 and August 2018. Platelet reactivity was tested by TEG and adenosine-induced maximal amplitude (MAADP) was recorded. According to MAADP patients were divided into three groups: low on-treatment platelet reactivity (LTPR) group (MAADP<31 mm, n=229), normal on-treatment platelet reactivity (NTPR) group (31 mm≤MAADP≤47 mm, n=207) and high on-treatment platelet reactivity (HTPR) group (MAADP>47 mm, n=196). The endpoints consisted of major adverse cardiovascular and cerebrovascular events (MACCE) and bleeding events. The definition of MACCE was the composite of all-cause mortality, myocardial infarction, intrastent thrombosis, stroke and revascularization. Bleeding events were defined by bleeding academic research consortium (BARC) type 2, 3 and 5 bleeding. Using multivariate Cox regression to analyze the factors of MACCE and bleeding events in patients underwent selective PCI anticoagulated with bivalirudin. Results: A total of 632 patients were finally enrolled in the study with age of (68.3±10.0) years and there were 423 (66.9%) males. All of 632 patients finished one-year follow-up, and 48 (7.6%) patients occurred MACCE and 11 (1.7%) patients occurred bleeding events. There was not statistically significant difference in the incidence of MACCE (8.3% (19/229) vs. 6.3% (13/207) vs.8.2% (16/196), P=0.68) and bleeding events (1.8% (4/229) vs. 2.9% (6/207) vs. 0.5% (1/196), P=0.17) in LTPR, NTPR and HTPR group. Multivariate Cox regression showed that HTPR was not the independent factor of MACCE (HR=1.25, 95%CI 0.67-2.30, P=0.49), and the history of peripheral vessel disease was the independent risk factor of MACCE (HR=2.47, 95%CI 1.19-5.11, P=0.02). LTPR was not the independent factor of bleeding events (HR=1.35, 95%CI 0.39-4.66, P=0.64), and the independent factors of bleeding events were history of peripheral vessel disease (HR=3.95, 95%CI 1.03-15.22, P=0.05) and hemoglobin (HR=0.96, 95%CI 0.93-0.99, P=0.01). Conclusions: In patients undergoing selective PCI anticoagulated with bivalirudin, there is no significant association between platelet reactivity and postoperative 1-year MACCE or bleeding events. History of peripheral vessel disease is an independent risk factor of MACCE, and history of peripheral vessel disease and decreased hemoglobin are independent risk factors of bleeding events.

Imaging the Néel vector switching in the monolayer antiferromagnet MnPSe3 with strain-controlled Ising order

Antiferromagnets are interesting materials for spintronics because of their faster dynamics and robustness against perturbations from magnetic fields. Control of the antiferromagnetic order constitutes an important step towards applications, but has been limited to bulk materials so far. Here, using spatially resolved second-harmonic generation, we show direct evidence of long-range antiferromagnetic order and Ising-type Néel vector switching in monolayer MnPSe₃ with large XY anisotropy. In additional to thermally induced switching, uniaxial strain can rotate the Néel vector, aligning it to a general in-plane direction irrespective of the crystal axes. A change of the universality class of the phase transition in the XY model under uniaxial strain causes this emergence of strain-controlled Ising order in the XY magnet MnPSe₃. Our discovery is a further ingredient for compact antiferromagnetic spintronic devices in the two-dimensional limit.

Primary results from IMpassion131, a double-blind, placebo-controlled, randomised phase III trial of first-line paclitaxel with or without atezolizumab for unresectable locally advanced/metastatic triple-negative breast cancer

BACKGROUND

In the phase III IMpassion130 trial, combining atezolizumab with first-line nanoparticle albumin-bound-paclitaxel for advanced triple-negative breast cancer (aTNBC) showed a statistically significant progression-free survival (PFS) benefit in the intention-to-treat (ITT) and programmed death-ligand 1 (PD-L1)-positive populations, and a clinically meaningful overall survival (OS) effect in PD-L1-positive aTNBC. The phase III KEYNOTE-355 trial adding pembrolizumab to chemotherapy for aTNBC showed similar PFS effects. IMpassion131 evaluated first-line atezolizumab-paclitaxel in aTNBC.

PATIENTS AND METHODS

Eligible patients [no prior systemic therapy or ≥12 months since (neo)adjuvant chemotherapy] were randomised 2:1 to atezolizumab 840 mg or placebo (days 1, 15), both with paclitaxel 90 mg/m² (days 1, 8, 15), every 28 days until disease progression or unacceptable toxicity. Stratification factors were tumour PD-L1 status, prior taxane, liver metastases and geographical region. The primary endpoint was investigator-assessed PFS, tested hierarchically first in the PD-L1-positive [immune cell expression ≥1%, VENTANA PD-L1 (SP142) assay] population, and then in the ITT population. OS was a secondary endpoint.

RESULTS

Of 651 randomised patients, 45% had PD-L1-positive aTNBC. At the primary PFS analysis, adding atezolizumab to paclitaxel did not improve investigator-assessed PFS in the PD-L1-positive population [hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.60-1.12; P = 0.20; median PFS 6.0 months with atezolizumab-paclitaxel versus 5.7 months with placebo-paclitaxel]. In the PD-L1-positive population, atezolizumab-paclitaxel was associated with more favourable unconfirmed best overall response rate (63% versus 55% with placebo-paclitaxel) and median duration of response (7.2 versus 5.5 months, respectively). Final OS results showed no difference between arms (HR 1.11, 95% CI 0.76-1.64; median 22.1 months with atezolizumab-paclitaxel versus 28.3 months with placebo-paclitaxel in the PD-L1-positive population). Results in the ITT population were consistent with the PD-L1-positive population. The safety profile was consistent with known effects of each study drug.

CONCLUSION

Combining atezolizumab with paclitaxel did not improve PFS or OS versus paclitaxel alone. CLINICALTRIALS.GOV: NCT03125902.

Identification of a mitogen-activated protein kinase kinase (AccMKK4) from Apis cerana cerana and its involvement in various stress responses

The mitogen-activated protein kinase (MAPK) cascade pathway is a ubiquitous signal transduction pathway in eukaryotes that regulates a variety of immune responses. This study accomplished the first isolation of an AccMKK4 gene from Apis cerana cerana and explored its function. Yeast two-hybrid experiments proved that AccMKK4 can interact with Accp38b, and the silencing of AccMKK4 in honeybees downregulated the expression level of Accp38b, which suggests that AccMKK4 might participate in the oxidative stress response through the p38 MAPK pathway. Tissue-specific expression levels of AccMKK4 analysis showed that AccMKK4 in the thorax, particularly muscle tissue, was higher than that in other tissues. The qRT-PCR results from different conditions demonstrated that AccMKK4 responds to various environmental stresses. After AccMKK4 silencing, the transcription level of some antioxidant genes and the activity of antioxidant-related enzymes are reduced, which indicated that AccMKK4 plays an important role in resistance against oxidative stress caused by external stimuli. In summary, our findings indicate that AccMKK4 probably plays an indispensable role in the response of honeybees to environmental stress and might aid for further research on the role of the MAPK cascade pathway in the antioxidant defence mechanisms of insects.

Impact of ESC-endorsed high ischemic risk features and ARC-high bleeding risk criteria on clinical outcomes in all-comer patients undergoing PCI

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): Beijing Municipal Health Commission (Grant number: 2020-1-4032).

Background

Whether the underlying risk of high bleeding risk (HBR) influences the relationship of high ischemic risk (HIR) features with adverse events after drug-eluting stent implantation remains unclear. The purpose of this study was to evaluate (1) the prognostic effect of ESC guideline-endorsed HIR features on long-term clinical outcomes and (2) whether the outcomes of HIR versus non-HIR features vary by HBR status.

Methods

Ten thousand one hundred sixty-seven consecutive patients who underwent percutaneous coronary intervention between January 2013 and December 2013 were prospectively enrolled in Fuwai PCI Registry. Patients who are at HIR were defined as: diffuse multivessel disease in diabetic patients, chronic kidney disease, at least three stents implanted, at least three stents lesions treated, bifurcation with two stents implanted, total stent length &gt; 60 mm, or treatment of chronic total occlusion. The definition of HBR was based on the Academic Research Consortium (ARC) for HBR criteria. The primary ischemic outcome was major adverse cardiac event (MACE), a composite of cardiac death, myocardial infarction, target vessel revascularization and stent thrombosis. The primary bleeding outcome was clinically relevant bleeding, defined according to Bleeding Academic Research Consortium (BARC) type 2, 3 or 5 bleeding.

Results

With a 2.4-year median follow-up, 4430 patients (43.6%) having HIR experienced a significantly higher risk of MACE (hazard ratio [HR] adjust : 1.56, 95% confidence interval [CI]: 1.34–1.82; P &lt; 0.001) and device-oriented composite endpoint (composite of cardiac death, target-vessel MI, and target lesion revascularization) (HRadjust : 1.52 [1.27–1.83]; P &lt; 0.001), compared to those having non-HIR. The risk of clinically relevant bleeding did not differ between groups (HRadjust : 0.85 [0.66–1.08]; P = 0.174). Associations between HIR and adverse events were similar in HBR and non-HBR groups, without evidence of interaction (all P interaction &gt; 0.05); however, adverse event rates were highest among subjects with both HIR and HBR.

Conclusions

ESC guideline-endorsed HIR was associated with significantly increased risk of MACE without any significant differences in clinically relevant bleeding. The presence of ARC-HBR does not emerge as a modifier of cardiovascular risk for patients at HIR, suggesting more potent and longer antiplatelet therapy may be beneficial for this patient population.

[Clinical study of dienogest in the treatment of refractory endometriosis-associated pain]

Objective: To evaluate the efficacy and safety of dienogest (DNG) in the treatment of refractory endometriosis-associated pain (REAP). Methods: In this study, REAP was defined according to the following criteria: (1) the pain duration was ≥12 months and visual analogue scale (VAS)≥60 mm; (2) the previous treatments with over two medicines like oral contraceptives and levonorgestrel-releasing intrauterine system failed to achieve satisfactory relief of pain, with VAS reduction less than 50%; with gonadotropin-releasing hormone agonist or mifepristone, the pain could be controlled temporarily, but it recurred after discontinuation of medicines; (3) the pain could not be relieved by surgery or even repeated surgeries. In the present study, 48 patients with REAP were treated with DNG 2 mg/day orally and the clinical outcomes were retrospectively analyzed. The VAS scores, levels of CA₁₂₅, estradiol, FSH, LH and changes in the size of endometriotic lesions before and after treatment were compared respectively. The side effects were also analyzed. Results: The average duration of DNG treatment was (20.1±12.8) months. After 3 months of medication, the VAS score was significantly reduced from (77.9±15.8) mm to (20.8±10.7) mm (P<0.01), and CA₁₂₅ level was significantly reduced from (95±139) kU/L to (38±45) kU/L (P<0.05). The effects were maintained with continuation of DNG treatment. Endometriotic lesions tended to shrink, after 12 months of DNG treatment, the size of ovarian endometriomas was reduced significantly from (3.1±1.0) cm to (1.9±1.2) cm (P<0.05). The mean level of estradiol was maintained at 124.82-221.04 pmol/L and levels of FSH and LH did not change significantly during the treatment. The major side effect was irregular bleeding (75%, 36/48). Conclusions: DNG could effectively relieve REAP and is a well-tolerated therapy. It may supply an alternative option for patients with REAP.

[The Autism Spectrum Disorder Cohort-the sub-cohort of China National Birth Cohort]

Autism spectrum disorder (ASD), a representative disease of children's neurodevelopmental disorders, brings huge pressure and financial burden to families and society. It is of great significance to explore its etiology and pathogenesis. Therefore, we established an ASD Cohort based on the existing China National Birth Cohort (CNBC), which applied parallel design to recruit and follow up families who achieved pregnancy after receiving assisted reproductive technologies (ART) and families with spontaneous conception. The main aims of this study are to compare the incidence of ASD among children born after ART with those born under spontaneous pregnancy, and to evaluate the impact of ART on the neurobehavioral development of offspring. Additionally, with a variety of clinical and behavioral related information collected during pregnancy and at early life of offspring, we are able to investigate the risk factors associated with ASD comprehensively. This article briefly introduces the objectives, contents, preliminary progress, strength and limitations, as well as further prospects of the ASD cohort study, mainly focusing on the overall design and current progress.

Multilevel Risk Factors for Weight Change after Breast Cancer Diagnosis Among Black Women

Background: Weight gain after breast cancer diagnosis increases the risk of mortality. African American/Black breast cancer survivors are more likely to have excess body weight than their White counterparts, which may contribute to their higher mortality rate. Emerging evidence suggests that post-diagnosis weight gain may result from multilevel determinants. However, no study has investigated the multilevel characteristics among Black breast cancer survivors. Objective: To evaluate associations between individual-level factors and neighborhood social and built environment factors with weight change after breast cancer diagnosis among Black women. Methods: We evaluated associations of interest among 785 women enrolled in the Women's Circle of Health Follow-Up Study (WCHFS), a longitudinal study of Black breast cancer survivors in New Jersey. Weight change was primarily based on measurements at baseline and follow-up visits (Median: 10.3 and 23.2 mo. since diagnosis, respectively). Participants were grouped into categories of stable weight (52.4%), ≥3% weight loss (20.0%), and ≥3% weight gain (27.6%). Using multivariate- adjusted multinomial logistic regression and multilevel multinomial logistic regression, we evaluated relative risk ratios (RRRs) for associations between multilevel factors and post-diagnosis weight change category. Results: Black breast cancer survivors who were older at diagnosis, had higher household income, post-menopausal status, and higher baseline BMI were less likely to gain weight compared to women with stable weight. Former smoking, higher tumor stage, and chemotherapy were associated with increased relative risk of weight gain (e.g. RRR-chemo: 1.45, 95% CI: 1.01, 2.08). Black women residing in neighborhoods in the highest tertile for density of walkable destinations had a decreased relative risk of post- diagnosis weight gain (e.g. RRR-T3 highest density vs. T1 lowest: 0.39, 95% CI: 0.20, 0.75), while those residing in neighborhoods with higher density of fast food restaurants had increased relative risk of weight gain (RRR-T3 highest density vs. T1 lowest: 1.94, 95% CI: 1.23, 3.05). Conclusion: Both individual and neighborhood factors may influence the risk of weight gain among Black women after breast cancer diagnosis.

LncRNA MEG3 inhibits proliferation and promotes apoptosis of synovial cells in rats with knee osteoarthritis by regulating PTEN

OBJECTIVE

To study the influences of long non-coding ribonucleic acid (lncRNA) maternally expressed gene 3 (MEG3) on the proliferation and apoptosis of synovial cells in rats with knee osteoarthritis by regulating phosphate and tension homology deleted on chromosome ten (PTEN).

MATERIALS AND METHODS

In this experiment, rat synovial cell (RSC)-364 cells were cultured in vitro. Then, they were treated with PBS or lncRNA MEG3 overexpression lentiviruses and divided into normal control (NC) group and lncRNA MGE3 overexpression group (LncRNA MEG3 group). The messenger RNA (mRNA) expression levels of lncRNA MEG3 and PTEN in rat synovial cells were measured via qRT-PCR in each group, and Western blotting (WB) was performed to determine the protein levels of PTEN, cyclin D1, P21, B-cell lymphoma 2 (Bcl-2) and tubulin in rat synovial cells in both groups. The proliferation of rat synovial cells was detected via MTT assay, and the apoptosis was evaluated using FITC/PI double staining and flow cytometer.

RESULTS

Compared with NC group, LncRNA MEG3 group had notably overexpressed lncRNA MEG3 in RSC-364 cells (p<0.01), and an extremely substantially elevated mRNA level of PTEN (p<0.05). Besides, it was found through WB that the protein expression level of PTEN had a consistent trend with that of the mRNA level. The proliferation ability of cells was weakened (p<0.05), and the number of apoptotic cells was increased (p<0.05) in LncRNA MEG3 group compared with those in NC group. Finally, LncRNA MEG3 group had remarkably lower protein levels of cyclin D1 and Bcl-2, but a markedly higher protein level of P21 than NC group (p<0.05).

CONCLUSIONS

LncRNA MEG3 can raise the level of PTEN to weaken the proliferation ability but elevate the apoptosis level of RSC-364 cells.

[Survival benefit of primary site surgery acquired by stage Ⅳ non-small cell lung cancer: a retrospective study based on seer database]

Objective: To investigate the value of primary site surgery in stage Ⅳ non-small cell lung cancer (NSCLC) and associated prognostic factors. Methods: The data of stage Ⅳ primary non-small cell lung cancer initially diagnosed from 2010 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database and retrospective analyzed. Propensity-matched analysis was performed to decrease the selection bias between surgery and non-surgery groups. Overall survival (OS) and cancer-specific survival (CSS) were calculated by Kaplan-Meier curves. Log rank test and Cox regression analyses were applied to evaluate the prognostic factors. Results: A total of 4 657 patients were recruited. In the matched population, the median OS of surgery and non-surgery groups were 7 and 3 months. The 3-years OS were 14.6% and 5.0%, respectively. The 3-years CSS were 17.3% and 6.5%, respectively. Univariate and multivariate analyses indicated primary lesion surgery was an independent prognostic factor for OS and CSS (P<0.001). Subgroup analysis showed that patients with stage Ⅳ NSCLC who <80 years old, White and Black, gender, tumor located in the upper lobe and crossover, moderately and poorly differentiated, adenocarcinoma, T1-2 or T4 stage, N0 or N2, without regional lymph node dissection, without metastatic sites operation, and the number of metastatic organs<3, obtained a better 3-years OS and CSS from primary site surgery (P<0.05). Conclusion: Primary site surgery can significantly improve the OS and CSS of patients with stage Ⅳ NSCLC carefully selected.