[Role of endoplasmic reticulum stress-mediated glycogen synthase kinase 3β activity in pathogenesis of acute liver failure in mice]

Objective: To study the role of endoplasmic reticulum (ER) stress-mediated glycogen synthase kinase 3β (GSK3β) activity in the pathological process of liver injury in acute liver failure (ALF) mice. Methods: ALF model was established by intraperitoneal injection of D-galactosamine/lipopolysaccharide (D-GalN/LPS) in C57BL/6 mice. The mice were divided into control group (n=10), ALF model group (n=18), 4-phenylbutyrate (4-PBA, an ER stress inhibitor) group (n=18) and SB216763 (a specific inhibitor of GSK3β) group (n=16). The serum alanine transaminase (ALT) and aspartate transaminase (AST) levels were measured to reflect the liver function, liver injury was assessed by observing pathological changes of liver tissue, the levels of proteins in liver tissue were analyzed by Western blotting, the activity of GSK3β in liver tissue was detected using GSK3β activity assay kit, and the survival rate of hepatocyte was measured by methyl thiazolyl tetrazolium (MTT) assay. Results: In in vivo experiment, the expression levels of ER stress markers, glucose-regulated protein 78 (GRP78) and CCAAT/enhancer-binding protein homologous protein (CHOP), were upregulated during the progression of D-GalN/LPS-induced ALF, indicating activation of severe ER stress and increased activity of GSK3β. Compared with the model group, inhibition of ER stress by 4-PBA improved liver function[ALT: (365.4±58.6) U/L vs (1 094.5±201.5) U/L, P<0.05; AST: (555.1±60.8) U/L vs (1 444.3±533.7) U/L, P<0.05)and pathological injury, also decreased the activity of GSK3β (2.6±0.3 vs 4.6±1.3, P<0.05). Inhibition of GSK3β activity was shown to alleviate liver injury in ALF by reducing the expression levels of GRP78 and CHOP. The in vitro experiment of tunicamycin-induced hepatocyte apoptosis showed that inhibition of GSK3β activity increased the cell survival rate. Conclusion: In ALF induced by D-GalN/LPS, severe ER stress may accelerate the development and progress of ALF by upregulating the activity of GSK3β.

[Association between the internal exposure levels of phthalates and executive function of preschool children]

Objective: To investigate the association between the internal exposure levels of phthalic acid esters (PAEs) and executive function (EF) of preschool children. Methods: Between October 2008 and October 2010, pregnant women who accepted pregnancy health care services in four municipal medical and health institutions in Ma'anshan city, Anhui Province, were recruited as study objects. A total of 5 084 pregnant women and 4 669 singleton live births were enrolled in this cohort. The follow-up study was conducted from April 2014 to April 2015. A total of 3 725 data-completed preschool children aged 3 to 6 years older entered in this study. The method of analysis seven metabolites of phthalates in urine was high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) and divided objects into low (P(0)-P(24)), medium (P(25)-P(74)) and high (P(75)-P(100)) groups according to their exposure concentrations. To investigate the executive function of preschool children, we used the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P). Univariate and multivariate statistical method was used to analyze the etiology association between the phthalate metabolites levels and preschool children's executive function. Results: In this study, 53.6% (1 997/3 725) of preschoolers were boys, children's age was (51.5±5.6) months. The detection rates of seven phthalate esters were: mono-n-methyl phthalate (MMP) was 99.89% (3 721/3 725); mono-ethyl phthalate (MEP) was 99.97% (3 724/3 725); mono-benzyl phthalate (MBzP) was 69.10% (2 574/3 725); mono-butyl phthalate (MBP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) and mono- (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) were 100.00% and mono-ethylhexyl phthalate (MEHP) was 99.95% (3 723/3 725). The median concentrations of the seven phthalate metabolites were: 17.71, 15.36, 0.07, 155.24, 10.73, 14.67, 3.59 µg/L, respectively. The median concentrations corrected by urinary creatinine were 29.65, 26.65, 0.12, 257.73, 17.94, 24.80, 6.27 µg/g Cr, respectively. The P(25) and P(7)5 concentration of the total PAEs metabolites corrected by urinary creatinine were 1.20 µmol/g Cr and 3.04 µmol/g Cr. After adjusted the relevant demographic information: children sex, children age in month, maternal age, parental education levels, household exposure to secondhand smoke and whether the child is the only child as confounds, multivariate logistic regression model showed that the risk of inhibitory self-control index (ISCI) dysplasia in MEHHP high concentration group and MEOHP high concentration group were 1.71 and 1.54 times (OR=1.71, 95% CI: 1.11-2.62; OR=1.54, 95% CI: 1.01-2.34) than in low concentration group. The risk of ISCI dysplasia in total PAEs metabolites high concentration group was 1.55 times (OR=1.55, 95% CI: 1.00-2.38) than in low concentration group. Conclusion: Phthalates exposure may damage the executive function of preschool children.

Abstract P2-02-04: Circulating protein biomarker profile for inflammatory breast cancer using a multiplexed proximity extension assay

Background: Expression of cancer related genes and proteins in clinical specimens are the mainstay of personalized targeted therapy; however, a diagnostic signature for inflammatory breast cancer (IBC) remains elusive. In this study, we employed a blood-based, non-invasive, sensitive technology to map biomarkers in patients with IBC at the protein level. Proximity Extension Assay consists of a harmonious blending of immunoassay and PCR to amplify protein expression signal, thereby enabling multiplexing with small sample input (1 μl). Other multi-platform assays require a large amount of clinical material, multi-step sample processing and complicated data analysis.

Materials and methods: Serum samples (n= 159) from patients with primary IBC (IBC, n= 30), metastatic IBC (MIBC, n= 54), locally advanced breast cancer (LABC, n= 24) and metastatic breast cancer (MBC, n= 27) were prospectively collected from subjects prior to starting a new therapy (treatment naive) or a new line of therapy between 2009 and 2012. Sera from 24 healthy normal donors (HD) were included in the analysis for comparison. The samples were analyzed using two panels: Proseek Multiplex Oncology II and Proseek Multiplex Inflammation I (Olink Proteomics, Uppsala, Sweden) for simultaneous detection of 92 human protein biomarkers in each panel. In the assay, each protein biomarker is detected by a matched pair of antibodies coupled to unique DNA-tags. Upon binding to the proteins, the correctly hybridized DNA-tags form an amplicon that can be measured by PCR.For initial analysis, sample populations were compared using the Mann-Whitney-U test.

Results: In comparison with HD sera, sera of breast cancer patients had 41 proteins from the oncology panel and 28 from the inflammation panel that were significantly higher, whereas 5 from the inflammation panel were significantly lower. From the inflammation panel, 11 proteins (PD-L1, IL-2, IL-7, IL-18, uPA, CCL4, CCL23, CXCL9, CXCL10, CXCL11 and TNF-alpha) showed significant differential expression between IBC and non-IBC derived samples (irrespective of metastatic status); for each marker, levels were higher in IBC than in non-IBC. In contrast, 9 proteins from the oncology panel (CRNN, CTSV, ERBB4, FR-gamma, ITGAV, MIA, PODXL, SCF and SEZ6L) were differentially expressed; however, each of these proteins was higher in non-IBC than in IBC. Among the aforementioned proteins, CCL4, IL-2, IL-7, PD-L1, TNF-alpha, uPA, CRNN, CTSV, FR-gamma, ITGAV, MIA, SCF and SEZ6L did not differentiate cancer and HD, but were uniquely characteristic of the IBC vs non-IBC comparison.

Conclusion: These preliminary data suggest that it is possible to distinguish between cancer patients and healthy normal donors, and also to delineate between IBC and non-IBC patients based on expression of serum proteins. Validation of this serum protein signature is planned in a larger patient cohort.

Citation Format: Cohen EN, Jayachandran G, Gao H, Tin S, Alvarez RH, Valero V, Lim B, Woodward WA, Ueno NT, Reuben JM. Circulating protein biomarker profile for inflammatory breast cancer using a multiplexed proximity extension assay [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-02-04.

Abstract OT1-02-02: A phase II study of pembrolizumab in combination with palliative radiotherapy for metastatic hormone receptor positive breast cancer

BACKGROUND: Despite recent advances in the treatment of patients with metastatic hormone receptor positive (HR+)/HER2- breast cancer (BC), it remains an incurable disease. The activity of immune checkpoint inhibitors (ICI) as monotherapy in patients with metastatic HR+/HER2- BC has been limited. Therefore, the addition of other strategies that elicit an immunogenic tumor microenvironment may be needed. We hypothesize that radiation therapy (RT) will potentiate the efficacy of the PD-1 inhibitor pembrolizumab in patients with metastatic HR+/HER2- BC. METHODS: Trial Design: This is a phase II single arm study assessing objective response rate (ORR) according to RECIST 1.1 in patients with metastatic HR+/HER2- BC who will receive pembrolizumab in combination with palliative RT. Pembrolizumab 200 mg intravenously will be administered 2-7 days before day 1 of RT, and will be given every 21 days until disease progression. Biopsies will be performed in the same lesion at baseline (mandatory if tumor tissue is accessible outside the field of RT) and during cycle 2 within 7-14 days before the day 1 of cycle 3 of pembrolizumab. Key Eligibility Criteria: Patients with metastatic HR+/HER2- BC, with measurable disease outside the field of radiation, for whom palliative RT to at least one bone, lymph node, or soft tissue lesion is indicated. Radiation of visceral lesions (such as lung or hepatic lesions) is not permitted. Although prior RT is allowed, patients must be at least 3 months free from RT; Re-irradiation of the same field is not allowed. There is no limit to the number of previous treatments, and systemic treatment naive patients for metastatic disease are also eligible. Specific Aims: The primary aim is to evaluate the efficacy of the combination, as defined by objective response rate (ORR) outside the field of RT according to RECIST 1.1. Secondary objectives include to determine the ORR according to immune-related criteria, the progression-free survival, the abscopal response rate, the clinical benefit rate, the safety and the tolerability of the combination. In addition, correlative studies will be performed to explore the correlation of immunosuppressive and/or immune-stimulating immune marker profiles at baseline and after cycle 2 to disease response to therapy. Statistical Methods: Using the Simons “optimal” method, in the first stage, 8 patients will be enrolled. If there is at least 1 response, accrual will continue to the second stage where up to 19 additional patients will be enrolled. If at least 3 of these 27 patients have an objective response (≥10%), the regimen will be considered worthy of further study. With this design, the probability of stopping the trial early is 78% if the true response rate is 3%. If the true response rate is 20% the chance that the regimen is declared worthy of further study is 80%. Patient accrual and target accrual: The trial opened in April/2017, and so far, has accrued 2 patients with a target accrual of 27 patients. Accrual should be complete in 14-25 months. Clinical trial information: NCT03051672.

Citation Format: Barroso-Sousa R, Gao H, Barry WT, Krop IE, Schoenfeld JD, Tolaney SM. A phase II study of pembrolizumab in combination with palliative radiotherapy for metastatic hormone receptor positive breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT1-02-02.

Safety and efficacy of sofosbuvir-based treatment of acute hepatitis C in end-stage renal disease patients undergoing haemodialysis

BACKGROUND

Hepatitis C virus (HCV) infection in patients undergoing haemodialysis is prevalent and aggressive. The treatment of chronic hepatitis C has been revolutionised by the advent of direct-acting antivirals (DAAs). However, the safety, efficacy, and tolerance of DAAs in the treatment of acute HCV infection in patients with end-stage renal disease who are on haemodialysis are unknown.

AIM

To evaluate the safety and efficacy of sofosbuvir plus daclatasvir in this specific, difficult-to-treat population.

METHODS

We conducted a prospective and observational study of end-stage renal disease patients who were undergoing haemodialysis and were acutely infected with HCV. Patients received a half dose of sofosbuvir (200 mg) and a full dose of daclatasvir (60 mg) daily. The primary endpoint was the proportion of patients with sustained virological responses (SVRs); the other primary outcomes were safety and tolerability.

RESULTS

Thirty-three patients were enrolled in the study. The median HCV RNA viral load at baseline was 6.8 log₁₀ IU/mL. Twenty-four patients were infected with HCV genotype 2a, seven patients with 1b, and two patients with 2a+1b. All patients achieved a SVR at 12 weeks after the end of treatment. The treatment was well tolerated, and there were no drug-related serious adverse events.

CONCLUSION

A half dose of sofosbuvir (200 mg once daily) plus a full dose of daclatasvir (60 mg once daily) were suitable for the treatment of acute HCV-infected patients who were undergoing end-stage renal disease and were on haemodialysis.

A peculiar low-luminosity short gamma-ray burst from a double neutron star merger progenitor

Double neutron star (DNS) merger events are promising candidates of short gamma-ray burst (sGRB) progenitors as well as high-frequency gravitational wave (GW) emitters. On August 17, 2017, such a coinciding event was detected by both the LIGO-Virgo gravitational wave detector network as GW170817 and Gamma-Ray Monitor on board NASA’s Fermi Space Telescope as GRB 170817A. Here, we show that the fluence and spectral peak energy of this sGRB fall into the lower portion of the distributions of known sGRBs. Its peak isotropic luminosity is abnormally low. The estimated event rate density above this luminosity is at least \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$190_{ - 160}^{ + 440}$$\end{document}190-160+440 Gpc⁻³ yr⁻¹, which is close to but still below the DNS merger event rate density. This event likely originates from a structured jet viewed from a large viewing angle. There are similar faint soft GRBs in the Fermi archival data, a small fraction of which might belong to this new population of nearby, low-luminosity sGRBs.

A short-duration gamma-ray burst was detected along with a double neutron start merger gravitational wave by LIGO-Virgo on August 17th 2017. Here, the authors show that the fluence and spectral peak energy of this event fall into the lower portion of the distribution of known short-duration gamma-ray bursts.

Genomic prediction for growth and reproduction traits in pig using an admixed reference population

This study investigated the efficiency of genomic prediction using an admixed reference population comprising 3 Yorkshire populations with different genetic backgrounds. In total, 2,084 and 1,388 individuals with growth and reproduction records, respectively, were genotyped with a PorcineSNP80 marker panel. The corrected phenotypic values derived from conventional EBV of each population were taken as response variables. Three approaches, that is, a linear genomic BLUP (GBLUP) model, a Bayesian mixture model (BayesR), and single-step GBLUP (ssGBLUP), were implemented to predict genomic breeding values. Our results indicated that the accuracy of genomic prediction was increased by enlarging the reference population by admixing different populations. However, the improvement was lower than expected, because the relationships among individuals of different populations were not strong enough. Among the 3 approaches, for reproduction and growth traits, ssGBLUP produced 30 to approximately 38% and 23 to 31%, respectively, higher accuracy than GBLUP. And the ssGBLUP produced 28 to approximately 38% and 18 to approximately 31% higher accuracy than BayesR. In addition, ssGBLUP also yielded lower bias. In most situations, BayesR performed comparably to GBLUP for most traits. Our results indicated ssGBLUP using an admixed reference population is also meaningful for national joint genetic evaluation of Chinese pig breeding.

[Association between elective cesarean section and infants' developmental behaviors: a cohort study]

Objective: To investigate the effect of elective cesarean section (ECS) on infants' developmental behaviors. Methods: A total of 3 474 pregnant women living in Ma'anshan more than 6 months and accepting obstetric examination in Ma'anshan Maternal and Child Care Center were recruited from May 2013 to September 2014. Excluding participants with pregnancy termination (162), twin pregnancy (39), assisted delivery (14), emergency cesarean section (76) and unclear delivery mode (141), 3 042 pair of mother and infant entered the final analysis. Information of maternal basic demographic characteristics, pregnancy histories, pregnancy life style and pregnancy-related diseases were collected by using self-complied Maternal and Child Health Questionnaire. Information of infants' general condition and delivery modes were acquired from obstetric record. The Ages and Stages Questionnaires-third edition was used to assess infants' communication, gross motor, fine motor, problem solving and person-social function, which was completed at age of 6 months old and 18 months old, respectively. And multi-factor non-conditional logistic regression model was used to analyze the association between ECS and infants' developmental behaviors. Results: The prevalence of ECS was 47.5% (1 443/3 042), among which ECS without medical indication and ECS with medical indication were 27.2% (826/3 042) and 20.3% (617/3 042), respectively. After maternal demographic characteristics, pregnant exposure and infants' basic information adjusted, compared to women with vaginal delivery, both ECS with medical indication and without medical indication increased the risk of a delay in gross motor on infants at 6 months old (RR (95%CI: 1.72 (1.08-2.77) and 1.87 (1.11-3.15), respectively.) ECS without indication decreased the risk of a delay in fine motor on infants at 6 months old (RR (95%CI):0.48 (0.28-0.82)), both ECS without medical indication and with medical indication had no statistically significant effect on 18 months infants' communication, gross motor, fine motor, problem solving and person-social function, the RR (95%CI) for ECS without medical indication were 0.86 (0.43-1.74), 1.55 (0.86-2.78), 0.74 (0.49-1.15), 1.10 (0.68-1.78) and 1.17 (0.66-2.08), respectively; and the RR (95%CI) for ECS with medical indication were 0.33 (0.12-1.02), 1.10 (0.55-2.21), 0.79 (0.48-1.29), 0.58 (0.29-1.13) and 1.48 (0.78-2.81), respectively. Conclusion: ECS affected motor development in infants at the age of 6 months old, and no influence was found in infants at the age of 18 months old.

Measurement of the Vector and Tensor Asymmetries at Large Missing Momentum in Quasielastic (e[over →],e^{'}p) Electron Scattering from Deuterium

We report the measurement of the beam-vector and tensor asymmetries A_{ed}^{V} and A_{d}^{T} in quasielastic (e[over →],e^{'}p) electrodisintegration of the deuteron at the MIT-Bates Linear Accelerator Center up to missing momentum of 500  MeV/c. Data were collected simultaneously over a momentum transfer range 0.1<Q^{2}<0.5  (GeV/c)^{2} with the Bates Large Acceptance Spectrometer Toroid using an internal deuterium gas target polarized sequentially in both vector and tensor states. The data are compared with calculations. The beam-vector asymmetry A_{ed}^{V} is found to be directly sensitive to the D-wave component of the deuteron and has a zero crossing at a missing momentum of about 320  MeV/c, as predicted. The tensor asymmetry A_{d}^{T} at large missing momentum is found to be dominated by the influence of the tensor force in the neutron-proton final-state interaction. The new data provide a strong constraint on theoretical models.

Carnosol inhibits Hedgehog signaling pathway in both LNCaP and DU145 prostate cancer cell lines

To investigate the effect of carnosol on the Hedgehog (HH) signaling pathway in human hormone-dependent prostate cancer cell line LNCaP and hormone-independent prostate cancer cell line DU145. The expression levels of glioma-associated oncogene homolog 1 (Gli1) and Sonic hedgehog (Shh) in human prostate cancer tissues were detected by immunohistochemistry. After treated with carnosol (0.25-16 μmol/L), the cell survival of LNCaP and DU145 cells were detected by MTT assay. The expression levels of Gli1 and Shh mRNA and protein in the two cells were detected by qRT-PCR and western blot, respectively. The apoptosis was determined by the caspase-3 activity assay. Results showed that Shh and Gli1 were upregulated in cancer tissues. The inhibitory effect of carnosol on cell survival was enhanced with concentration, suggesting both LNCaP and DU145 cells were sensitive to carnosol. The inhibitory effects of carnosol on Gli1 and Shh mRNAs in the hormone-dependent LNCaP prostate cancer cell was stronger than that in the hormone-independent DU145 prostate cancer cells. Carnosol downregulated the expression of Gli1 in nucleus, and Shh in cells. Greater carnosol concentration resulted in lower levels of Gli1 and Shh. Carnosol increased caspase-3 activity in a dose-dependent manner, suggesting that carnosol promotes cell apoptosis. Thus, carnosol can inhibit the proliferation and induce the apoptosis of prostate cancer cells in vitro, and its mechanism might be associated with the inhibiting of HH signaling pathway. Although the inhibitory effect of carnosol on hormone-dependent LNCaP prostate cancer cells is stronger than hormone-independent DU145 prostate cancer cells, carnosol might be a potential drug for hormone-independent prostate cancer.

Preliminary study on the changes of ovarian reserve, menstruation, and lymphocyte subpopulation in systemic lupus erythematosus (SLE) patients of childbearing age

Objective

The main aim of this study was to investigate the ovarian reserve, menstruation, and lymphocyte subpopulation in systemic lupus erythematosus (SLE) patients of childbearing age.

Methods

We enrolled 40 SLE patients of childbearing age and 40 age-matched healthy controls. Anti-Müllerian hormone (AMH) was tested by electrochemiluminescence, and lymphocyte subsets were tested by flow cytometry. Menstruation situation was obtained by interview.

Results

The AMH level of the SLE group was significantly lower than that of the control group ( p < 0.001), which was negatively correlated with erythrocyte sedimentation rate (ESR ( r = −0.316, p = 0.047)) and disease activity (SLEDAI ( r = −0.338, p = 0.033)). The AMH concentration of SLE patients with normal menstruation was higher than those with abnormal menstruation ( p < 0.001). The percentages of CD4+ T lymphocytes and NK (natural killer) cells in the SLE group were significantly lower than those in the control group ( p < 0.001). However, the percentages of B cells and CD8+ T lymphocytes in the SLE group were higher than those in the control group ( p < 0.05).

Conclusion

Decreased AMH and high incidence of abnormal menstruation indicated that autoimmunity activities of SLE can impair the ovarian reserve of female patients. Lymphocytes in SLE patients were in a state of disorder.

High hepatitis E virus antibody positive rates in dogs and humans exposed to dogs in the south-west of China

Hepatitis E (HE) is a zoonotic viral disease caused by hepatitis E virus (HEV). The objective of this study was to investigate the prevalence of HEV infection among dogs and humans exposed to dogs in the south-west region of China. A total of 4,490 dog serum samples and 2,206 relative practitioner serum samples were collected from 18 pet hospitals and dog farms in Yunnan, Sichuan and Guizhou province, and the anti-HEV IgG antibodies were detected by ELISA. The results showed that the total positive rate of anti-HEV antibodies was 36.55% with the highest rate in city stray dogs, and the differences in distinct species and growth phases were significant. The positive rate of anti-HEV antibody in veterinarian and farm staff-related practitioners was significantly higher than the general population. The finding of the present survey suggested that high HEV seroprevalence in dogs and humans exposed to dogs in the south-west area of China poses a significant public health concern. It is urgent to improve integrated strategies to detect, prevent and control HEV infection in dogs and humans exposed to dogs in this area.

Proinflammatory effects and mechanisms of calprotectin on human gingival fibroblasts

BACKGROUND AND OBJECTIVE

Calprotectin (S100A8/A9) is a heterodimer of S100A8 and S100A9 and is associated with multiple inflammatory diseases, including Crohn's disease, rheumatoid arthritis and periodontitis. Levels of calprotectin are elevated in the gingival crevicular fluid of patients with periodontitis; however, the effects of calprotectin on human gingival fibroblasts (HGFs) remain unknown. This study investigated the proinflammatory activity of calprotectin on HGFs and the functional receptors and signaling pathways engaged by calprotectin.

MATERIAL AND METHODS

HGFs were stimulated by equimolar concentrations of S100A8 and/or S100A9, and the expression levels of interleukin (IL)-6 and IL-8 were detected using real-time quantitative polymerase chain reaction and enzyme-linked immunosorbent assays. The calprotectin receptors were identified by pre-incubating HGFs with the toll-like receptor (TLR) 4 inhibitor or the antibody targeting the advanced glycation end product receptor (RAGE). The involvement of reactive oxygen species (ROS) and signaling pathways were also investigated by treating HGFs with ROS inhibitor or specific pathway inhibitors, respectively.

RESULTS

S100A9 and S100A8/A9 significantly upregulated IL-6 and IL-8 expression, which was inhibited upon treatment with the TLR4 inhibitor TAK242. Pretreatment with RAGE-blocking antibodies did not affect cytokine expression. Additionally, S100A9 promoted the production of IL-6 and IL-8 from HGFs via different signaling pathways. IL-6 expression was upregulated via the NF-κB, c-Jun amino-terminal kinase (JNK) 1/2 and p38 mitogen-activated protein kinase (MAPK) pathways, and IL-8 expression was upregulated via NF-κB, p38, JNK1/2 and extracellular-regulated kinase 1/2 MAPK pathways. The release of both cytokines was dependent upon the production of ROS.

CONCLUSION

Our findings suggest that calprotectin exerts proinflammatory effects on HGFs via the S100A9 subunit and TLR4-mediated NF-κB and MAPK signaling pathways.

Ab initio molecular dynamics simulation of low energy radiation responses of α-Al2O3

In this study, an ab initio molecular dynamics method is employed to investigate the response behavior of α-Al2O3 to low energy irradiation. Different from the previous experiments, our calculations reveal that the displacements of oxygen dominate under electron irradiation and the created defects are mainly oxygen vacancy and interstitial. The experimental observation of the absorption peaks appearing at 203, 233 and 256 nm for α-Al2O3 under electron irradiations should be contributed by the oxygen defects and these defects will reduce the transmittance of α-Al2O3, which agrees well with the very recent experiment. This study demonstrates the necessity to reinvestigate the threshold displacement energies of α-Al2O3, and to introduce recombination center for oxygen defects to improve its optical properties and performance under radiation environment.

Higher RABEX-5 mRNA predicts unfavourable survival in patients with colorectal cancer

OBJECTIVE

The aim of the present study was to clarify the expression pattern and prognostic role of RABEX-5 mRNA in colorectal cancer (CRC) patients.

PATIENTS AND METHODS

RABEX-5 mRNA levels in 187 CRC were examined by Real-time polymerase chain reaction. Then, the association of RABEX-5 mRNA levels with clinicopathological features was analyzed. Survival curves were plotted using the Kaplan-Meier method and differences in survival rates were analyzed using the log-rank test. The influence of each variable on survival was examined by the Cox multivariate regression analysis.

RESULTS

RABEX-5 mRNA expression was significantly upregulated in CRC tissues compared with the adjacent noncancerous tissues (p < 0.01). By statistical analyses, high RABEX-5 mRNA expression was observed to be closely correlated with histology/differentiation (p = 0.010), N classification (p = 0.004), and TNM stage (p = 0.004). Kaplan-Meier curves showed that patients with high RABEX-5 mRNA expression showed unfavorable overall survival (OS) than the low RABEX-5 mRNA expression group (p < 0.001). Finally, univariate and multivariate analyses showed that RABEX-5 mRNA expression was an independent predictor of overall survival (p < 0.05).

CONCLUSIONS

RABEX-5 mRNA may be a promising biomarker for the detection and prognosis evaluation of CRC.

[The observation of tacrolimus eye drops preventing the early immunological rejection after penetrating keratoplasty for fungal keratitis]

Objective: To observe the early immunological rejection prevention effect of tacrolimus eye drops combined with glucocorticoids on fungal keratitis patients who received penetrating keratoplasty (PKP). Methods: In a retrospective case series study, medical records of fungal keratitis patients who received PKP in Shandong Eye Institute from March 2013 to December 2015 were reviewed. Twenty-six patients (26 eyes) were given tacrolimus eye drops, and 24 patients (24 eyes) were given 1% cyclosporine A eye drops immediately after PKP. Two weeks after PKP, these patients were given low concentration of glucocorticoids if no fungal recurrence was found. Immune rejection, fungal recurrence, intraocular pressure, and drug irritation symptoms were monitored. Data were analyzed by chi-square test and independent t-test. Results: The average follow-up was 7 months (range, 3 to 12 months) postoperatively. The rejection rate was 15.3% in the tacrolimus group and 47.8% in the cyclosporine A group (χ(2)=5.510, P<0.05). One patient in the tacrolimus group and two patients in the cyclosporine A group suffered fungal recurrence. Two patients in the tacrolimus group and four patients in the cyclosporine A group had secondary glaucoma. The intraocular pressure was controlled. Three patients receiving tacrolimus eye drops and 13 patients receiving cyclosporine A eye drops had mild irritation symptoms. Conclusions: Tacrolimus eye drops combined with low concentration of glucocorticoids can prevent the early immunological rejection after PKP for fungalkeratitis effectively and safely. (Chin J Ophthalmol, 2017, 53:305-310).

Harm and Benefits of Salvage Transplantation for Hepatocellular Carcinoma: An Updated Meta-analysis

OBJECTIVE

The aim of this work was to compare salvage liver transplantation (SLT) and primary liver transplantation (PLT) in terms of the harm and benefits.

METHODS

The authors searched Pubmed, Embase, and the Cochrane Library from their dates of establishment to December 2015. Based on selection and exclusion criteria, 2 researchers screened the literature independently. The meta-analysis was performed with the use of the Review Manager software. Meta-analysis of the pooled standard mean difference (SMD) and odds ratio (OR) with 95% confidence interval (CI) were calculated based on either a fixed-effects or a random-effects model. In addition, risk of bias was assessed with the use of the Newcastle-Ottawa scale.

RESULTS

Sixteen studies were selected, involving almost 8,707 patients. According to the pooled estimates, compared with PLT, SLT was associated with a longer operative time (SMD, 0.28; 95% CI, 0.11-0.46;), higher intraoperative blood loss (SMD, 0.41; 95% CI, 0.08-0.75;), more postoperative bleeding (OR, 1.95; 95% CI, 1.10-3.45), an increased risk of recurrence (OR, 2.08; 95% CI, 1.24-3.50), and poorer 3-year (OR, 0.86; 95% CI, 0.76-0.98) and 5-year (OR, 0.86; 95% CI, 0.76-0.98) overall survival rates. However, no difference was detected between case and control groups in either rates of postoperative complications or such aspects as perioperative mortality, length of intensive care unit stay, length of hospital stay, and 1-year overall survival rate.

CONCLUSIONS

The 3-year and 5-year overall survival rates were inferior in SLT, which shows that PLT is a better treatment strategy for transplantable hepatocellular carcinoma (HCC). However, considering the severe organ limitation and the feasibility and safety of SLT, it provides a better option for patients with HCC recurrence after curative resection.

Discovery and hit-to-lead evaluation of piperazine amides as selective, state-dependent NaV1.7 inhibitors

NaV1.7 is a particularly compelling target for the treatment of pain. Herein, we report the discovery and evaluation of a series of piperazine amides that exhibit state-dependent inhibition of NaV1.7. After demonstrating significant pharmacodynamic activity with early lead compound 14 in a NaV1.7-dependent behavioural mouse model, we systematically established SAR trends throughout each sector of the scaffold. The information gleaned from this modular analysis was then applied additively to quickly access analogues that encompass an optimal balance of properties, including NaV1.7 potency, selectivity over NaV1.5, aqueous solubility, and microsomal stability.

[Noteworthy and controversial problems of deep anterior lamellar keratoplasty]

Corneal transplant is the main treatment for blindness caused by corneal diseases. The common methods of corneal transplant include penetrating keratoplasty and lamellar keratoplasty. With the advances of microsurgical instruments and technology in recent years, deep anterior lamellar keratoplasty (DALK) has gradually increased. Compared with conventional penetrating keratoplasty, the optical effects of DALK are not much different, but DALK has fewer complications. So DALK is expected to become the mainstream of corneal transplantation. Clinical surgeons try to promote DALK in China. However, there are certain learning curves and some controversies. Therefore, we discuss the controversial issues about DALK in this article.(Chin J Ophthalmol, 2017, 53: 164-166).

[A cohort study on association between the first trimester phthalates exposure and fasting blood glucose level in the third trimester]

Objective: To examine the association between the phthalate exposure in the first trimester and fasting blood glucose level or gestational diabetes mellitus (GDM) in the third trimester in pregnant women. Methods: A total of 3 474 pregnant women, receiving their prenatal examination in Ma' anshan Maternal and Child Health-Care Hospital of Anhui province, were selected from May 2013 to September 2014. Questionnaires were used to collect the information about their socio-demographic characteristics, clinical characteristics and GDM diagnostic results in the first, second and third trimesters. Urine samples and fasting venous blood samples were collected. Concentrations of 7 kinds of phthalate metabolites in urine samples were detected by solid phase extraction-high performance liquid chromatography-tandem mass spectrometry (SPE-HPLC-MS/MS), and multiple linear regression model was used for statistical analyses. Logistic regression analysis on the risk of the first trimester phthalate exposure for GDM in the third trimester was conducted. Results: The prevalence of GDM in this study was 12.8%, monomethyl phthalate (MMP), monoethyl phthalate (MEP), mono-n-butyl phthalate (MBP), monobenzyl phthalate (MBzP) and mono-(2-ethyl-5-oxohexyl) phthalate (MEHHP) exposure levels were positively correlated with the fasting blood glucose level in the third trimester (P<0.05), but mono-(2-ethylhexyl) phthalate (MEHP) and mono-(2-ethyl-5-hydroxylhexyl) phthalate (MEOHP) exposure levels were negatively correlated with the fasting blood glucose level in the third trimester (P<0.05). Stratified analysis showed a positive correlation between MEHHP exposure and the third trimester fasting blood glucose level in both normal group and GDM group. However, MMP, MEP, MBP, MBzP, MEHP and MEOHP exposure levels had influences on the third trimester fasting blood glucose level in normal group but not in GDM group. MMP and MBP exposure might increase the risk of GDM, but MEOHP exposure might reduce the risk of GDM. Conclusion: The phthalate exposure in the first trimester might be associated with the fasting blood glucose level in the third trimester, MMP, MEP, MBP, MBzP and MEHHP concentrations were positively associated with the third trimester blood glucose level, MEHP and MEOHP concentrations were negatively associated with the third trimester blood glucose level. Moreover, the effects of different kinds of phthalates might be different.

Abstract P1-01-19: Circulating tumor cells in triple-negative breast cancer patients express prostate related genes and show different genetic profiles in US and German patient cohorts

Background: Triple negative breast cancer (TNBC) is known for its aggressive behavior and poor prognosis since treatment options are limited. Specific biomarkers are urgently needed to treat patients (pts) accordingly. In this regard, circulating tumor cells (CTCs) are discussed to be an ideal surrogate marker for individualized treatment options. Using a multi-marker gene panel for the characterization of CTCs, we recently demonstrated that CTCs in TNBC pts and non-TNBC pts showed different genetic profiles including the expression of the androgen receptor (AR). We here compared CTCs of TNBC pts in two different national Institutions in the US (mainly Afro-American women) and Germany (Caucasian women) to identify potentially ethnical differences and to further explore AR expression related similarities of prostate cancer to TNBC.

Methods: 2x5 ml blood of TNBC pts before therapy (n=18 from the Dep. of Gynecol. and Obstetrics, Essen, GER; n=31 from the MDA Cancer Center Houston, US) were analyzed for CTCs applying positive immunomagnetic selection targeting EpCAM, EGFR and HER2 using the AdnaTest EMT-2/Stem Cell Select (QIAGEN Hannover GmbH, Germany). Subsequently, cDNA was pre-amplified for specific genes using TaqMan PreAmp Master Mix according to in house designed assays. Establishment of a 19 gene qPCR panel was performed for the markers PI3K, AKT2, ERCC1, AURKA, HER2, HER3, EGFR, ALK, AR, BRCA1, c-KIT, c-MET, KRT5, mTOR, NOTCH1, PARP1, SRC1, CD45 (leucocyte control) and GAPDH (housekeeping gene) as well as an internal reference. The cutoff was calculated, taking the false positive rate in healthy donors into account, and defined as Ct (cutoff) - Ct (sample) - [Ct (CD45cutoff) – Ct (CD45sample)]. Using the AdnaPanel Prostate Cancer (QIAGEN Hannover GmbH, Germany), cDNA obtained from a subset of 14 pts was further analyzed for the expression profile of AR, prostate specific antigen (PSA) as well as prostate specific membrane antigen (PSMA).

Results: The overall CTC-positivity rate (at least one of the markers expressed) was comparable between both sites (GER: 78%; US: 65%). Similar overexpression frequencies were found for AKT2, AR, AURKA, c-KIT, NOTCH1 and SRC at both sites. However, ALK, BRCA1, HER3 and KRT5 were predominantly found in CTCs of German pts while these genes were not or only weakly expressed in CTCs of the US group. In contrast, c-MET, ERCC1, HER2 and PARP were mainly expressed in CTCs of the US group and rarely in the German group. Interestingly, EGFR was not detected in both groups. Analyzing the overexpression of prostate related genes in a subgroup of 14 TNBC pts resulted in the expression of AR in 21%, PSA in 14%, and PSMA in 36% of cases, respectively.

Conclusion: Although we observed similar gene expression profiles in both patient cohorts, clear differences in some gene expression frequencies were detected at both sites. Whether these findings can be related to ethnic differences will be subject of further investigations. Furthermore, we were able to demonstrate that prostate related genes were frequently detectable which so far have not been discussed in the context of breast cancer.

Citation Format: Kasimir-Bauer S, Gao H, Bittner A-K, Plappert L, Feniuk N, Ueno NT, Cohen L, Valero V, Woodward WA, Alvarez RH, Hoffmann O, Kimmig R, Reuben JM. Circulating tumor cells in triple-negative breast cancer patients express prostate related genes and show different genetic profiles in US and German patient cohorts [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-01-19.

Abstract P1-04-07: Environmental influence on epigenetic markers in the development of breast cancer

Aberrant DNA methylation plays an important role in breast cancer initiation and progression. We hypothesize that environmental risk factors contribute to causal alterations in DNA methylation and that such causal changes have already occurred prospectively in normal breast tissue before tumor occurrence. In order to test this hypothesis, normal breast tissue from healthy women must be used. We therefore conducted an integrative molecular epidemiological study that combined the environmental regulation of DNA methylation in normal breast tissue and the differential DNA methylation profiling in tumor and normal breast tissue. We examined for the first time the environmental impact on DNA methylation in normal breast tissue from healthy women and determine the association of these epigenetic changes with breast cancer development. Potentially causal DNA methylation markers identified from our study has the potential to make a major scientific and clinical impact in understanding breast cancer etiology as well as developing novel, more effective prevention and treatment strategies.

Citation Format: He C, Wu W, Gao H, Nephew K, Li L, Schneider B, Han J, Liu Y. Environmental influence on epigenetic markers in the development of breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-04-07.

[Let-7 miRNA silencing promotes Kaposi's sarcoma-associated herpesvirus lytic replication via activating mitogen-activated protein kinase kinase kinase kinase 4 and its downstream factors]

OBJECTIVE

To explore the effect of let-7 miRNA silencing on Kaposi's sarcoma-associated herpesvirus (KSHV) lytic replication and the underling mechanism.

METHODS

The pEGFP-C2-let-7 sponge vector was transfected into BCBL-1 and 293T cells with Lipofectamine 2000 to silence the expression of let-7 miRNAs. Quantitative real-time PCR (qRT-PCR) was used to quantify the expression of let-7 miRNAs, the transcriptional levels of mitogen-activated protein kinase kinase kinase kinase 4 (MAP4K4), cyclooxygenase-2 (COX-2) and matrix metalloproteinase 13 (MMP-13), and the DNA copy numbers of KSHV open reading frame 50 (ORF50) and open reading frame 72 (ORF72). Western blot was used to detect the total and phosphorylated protein levels of MAP4K4, COX-2, extracellular regulated protein kinases (ERK1/2), c-Jun N-terminal kinase (JNK) and p38 MAPK.

RESULTS

The expression of let-7 miRNAs was dramatically decreased in the let-7 sponge transfected BCBL-1 and 293T cells compared with that in the vector-transfected cells (P<0.05 for all). The gene copy number and mRNA transcriptional level of KSHV ORF50 were significantly increased in the let-7 sponge transfected BCBL-1 cells compared with that in the vector-transfected cells (1.00±0.10 vs. 2.33±0.18 and 1.08±0.48 vs 3.22±0.27, respectively,P<0.001 for both). The gene copy number and mRNA transcriptional level of KSHV ORF72 were also significantly increased in let-7 sponge transfected BCBL-1 cells compared with those in the vector-transfected cells(1.07±0.49 vs 1.67±0.45 and 1.01±0.19 vs 1.54±0.11, respectively,P<0.05 for both). Furthermore, the mRNA transcriptional levels of MAP4K4, COX-2 and MMP-13 were significantly increased in the let-7 sponge transfected BCBL-1 cells compared with those in the vector-transfected cells (1.00±0.05 vs 5.73±0.96, 1.00±0.05 vs 2.68±0.19, 1.00±0.02 vs 2.69±0.25, respectively,P<0.001 for all). Let-7 miRNAs silencing also increased the protein expression levels of MAP4K4, COX-2 and phospho-ERK1/2, while the phospho-JNK and phospho-p38 were not changed in the BCBL-1 and 293T cells.

CONCLUSIONS

Let-7 silencing may activate the replication of KSHV, possibly through up-regulating MAP4K4 and its downstream molecules COX-2, MMP-13, and phosphorylation of ERK1/2, finally results in the progression of Kaposi sarcoma.

Clinical analysis of Krukenberg tumours in patients with colorectal cancer-a review of 57 cases

BACKGROUND

A Krukenberg tumour (KT) is defined as an ovarian metastasis from a gastrointestinal adenocarcinoma and suggests a terminal condition. This study aimed to identify the prognostic factors affecting the survival of patients with KTs of colorectal origin who receive cytoreductive surgery.

METHODS

Medical records of patients who had received cytoreductive surgery and had been pathologically diagnosed with KT of colorectal origin in two centres were reviewed. Information about the patients' clinicopathological features and follow-up visit were collected. Factors influencing patient survival were analysed.

RESULTS

Fifty-seven patients were included in this study. The median survival time was 35 months. Five-year overall survival was 25%. Patients who had recurrence 2 years after resection of the primary tumour, achieved complete cytoreduction, had metastases confined to the pelvis, had no lymph node involvement, and received systemic chemotherapy had a significantly longer median survival than those who had recurrence at the same time as resection of the primary tumour (P = 0.027), received incomplete cytoreduction (P < 0.001), had metastases beyond the pelvis (P < 0.001), had lymph node involvement (P = 0.011), and did not receive systemic chemotherapy (P = 0.006) on log-rank test. Less extensive metastatic disease, achievement of complete cytoreduction, and use of systemic chemotherapy were significantly associated with improved prognosis on multivariate analysis.

CONCLUSIONS

Cytoreductive surgery may confer survival benefits in patients with KTs of colorectal origin who attain complete cytoreduction and whose metastases are confined to the pelvis and when combined with active systemic chemotherapy.

Template-free 3D titanium carbide (Ti3C2Tx) MXene particles crumpled by capillary forces

The shape of Ti₃C₂T_xMXenes can be altered using spray drying, providing a new route for controlling MXene nanosheet morphology.

Androgen and AR contribute to breast cancer development and metastasis: an insight of mechanisms

The role of androgen and androgen receptor (AR) in breast carcinogenesis has long been a disputed issue. This report provides a mechanistic insight into how androgen and AR contributes to invasion and metastasis of breast cancer. We find that dihydrotestosterone (DHT) is able to induce the epithelial-to-mesenchymal transition in breast cancer cells in an AR-dependent/estrogen receptor-independent manner. This process is dependent on the demethylation activity of lysine-specific demethylase 1A (LSD1) by epigenetically regulating the target genes E-cadherin and vimentin. In vivo, DHT promotes metastasis in a nude mouse model, and AR and LSD1 are indispensable in this process. We establish that higher expression of nucleus AR to cytoplasm AR associated with worse prognostic outcomes in breast cancer patient samples. This study maps an 'androgen-AR/LSD1-target genes' pathway in breast carcinogenesis, implicating the importance of hormonal balance in women, and the potential clinical significance of serum androgen and AR in prediction of breast cancer and selection of breast cancer therapy.

Effects of Dietary Selenium Against Lead Toxicity on mRNA Levels of 25 Selenoprotein Genes in the Cartilage Tissue of Broiler Chicken

The interactions between the essential element selenium (Se) and the toxic element lead (Pb) have been reported extensively; however, little is known about the effect of Se on Pb toxicity and the expression pattern of selenoproteins in the cartilage of chicken. To investigate the effects of Se on Pb toxicity and the messenger RNA (mRNA) expressions of selenoproteins in cartilage tissue, an in vitro study was performed on 1-day-old broiler chickens (randomly allocated into four groups) with diet of different concentration of Se and Pb. After 90 days, the meniscus cartilage and sword cartilage tissue were examined for the mRNA levels of 25 selenoprotein genes. The results showed that Se and Pb influenced the expression of selenoprotein genes in the chicken cartilage tissue. In detail, Se could alleviate the downtrend of the expression of Gpx1, Gpx2, Gpx4, Txnrd2, Txnrd3, Dio1, Dio2, Seli, Selu, Sepx1, Selk, Selw, Selo, Selm, Sep15, Sepnn1, Sels, and Selt induced by Pb exposure in the meniscus cartilage. In the sword cartilage, Se alleviated the downtrend of the expression of Gpx2, Gpx3, Gpx4, Txnrd1, Txnrd2, Dio2, Dio3, Seli, Selh, SPS2, Sepx1, Selk, Selw, Selo, Selm, Sep15, Selpb, Sepn1, and Selt induced by Pb exposure. The present study provided some compensated data about the roles of Se against Pb toxicity in the regulation of selenoprotein expression.

A single nucleotide polymorphism in GABAA receptor isoforms is potentially responsible for isoflurane sensitivity in mice

GABAA receptors are chloride channels in the brain that are activated by binding with g-aminobutyric acid (GABA). The cDNA sequences of GABAA receptor subunits from two strains of mice with different sensitivities to isoflurane were compared to identify nucleotide mutations. Included 80 mice from two strains with different sensitivities to isoflurane on C57BL/6 background. Forty mice were from an isoflurane-sensitive strain (S group) and 40 mice were from a resistant strain (R group). RNA was extracted from brains of the mice, and cDNA were reverse transcribed using AMV reverse transcriptase. The amplified products were processed, sequenced, and analyzed for differences between the two strains. Chi-square analysis was performed to compare differences in nucleotide mutation frequencies between the two strains. No differences were identified in the α1-6, β2, β3, or γ1-3 nucleotide sequences and no single nucleotide polymorphisms were found in the comparison with the GenBank sequence for the GABAA receptor subunit. A single nucleotide polymorphism (SNP) at the nucleotide position 462 (C/G) in the β1 sequence was found. This SNP was observed in 5 mice from the sensitive strain and in 36 mice from the resistant strain. The Fischer exact test (P < 0.01) was used to compare two strains of mice for SNP in the cDNA sequence of the β1 subunit. Additional studies are required to understand whether the GABAA receptor is a specific target of inhaled anesthetic action or whether the identified SNP affects the action of the volatile anesthetic.

Circulating Tumor Cells (CTC) Are Associated with Defects in Adaptive Immunity in Patients with Inflammatory Breast Cancer

Background: Circulating tumor cells (CTCs) play a crucial role in tumor dissemination and are prognostic in primary and metastatic breast cancer. Peripheral blood (PB) immune cells contribute to an unfavorable microenvironment for CTC survival. This study aimed to correlate CTCs with the PB T-cell immunophenotypes and functions of patients with inflammatory breast cancer (IBC).

Methods: This study included 65 IBC patients treated at the MD Anderson Cancer Center. PB was obtained from patients prior to starting a new line of chemotherapy for CTCs enumeration by CellSearch^®, and T cell phenotype and function by flow cytometry; the results were correlated with CTCs and clinical outcome.

Results: At least 1 CTC (≥1) or ≥5 CTCs was detected in 61.5% or 32.3% of patients, respectively. CTC count did not correlate with total lymphocytes; however, patients with ≥1 CTC or ≥5 CTCs had lower percentages (%) of CD3+ and CD4+ T cells compared with patients with no CTCs or <5 CTCs, respectively. Patients with ≥1 CTC had a lower percentage of T-cell receptor (TCR)-activated CD8+ T cells synthesizing TNF-α and IFN-γ and a higher percentage of T-regulatory lymphocytes compared to patients without CTCs. In multivariate analysis, tumor grade and % CD3+ T-cells were associated with ≥1 CTC, whereas ≥5 CTC was associated with tumor grade, stage, % CD3+ and % CD4+ T cells, and % TCR-activated CD8 T-cells synthesizing IL-17.

Conclusions: IBC patients with CTCs in PB had abnormalities in adaptive immunity that could potentially impact tumor cell dissemination and initiation of the metastatic cascade.