Exposure-Response Analysis of Necitumumab Efficacy in Squamous Non-Small Cell Lung Cancer Patients

We sought to describe the exposure-response relationship of necitumumab efficacy in squamous non-small cell lung cancer patients and evaluate intrinsic and extrinsic patient descriptors that may guide dosing. SQUIRE was a phase III study comparing necitumumab in combination with gemcitabine and cisplatin vs. gemcitabine and cisplatin alone in 1,014 patients. An integrated model for tumor size dynamics and overall survival was developed, where reduction in tumor size results in a decrease in survival hazard. The change in tumor size was characterized using linear growth and first-order shrinkage. Overall survival was described using a combination of a Weibull function and Gompertz function for the hazard, with dynamic tumor size being a predictor for the hazard. Although body weight resulted in higher clearance and lower exposure, simulations showed that an 800 mg flat dose provided optimal response regardless of body weight.

SEA-LEVEL RISE. Sea-level rise due to polar ice-sheet mass loss during past warm periods

Interdisciplinary studies of geologic archives have ushered in a new era of deciphering magnitudes, rates, and sources of sea-level rise from polar ice-sheet loss during past warm periods. Accounting for glacial isostatic processes helps to reconcile spatial variability in peak sea level during marine isotope stages 5e and 11, when the global mean reached 6 to 9 meters and 6 to 13 meters higher than present, respectively. Dynamic topography introduces large uncertainties on longer time scales, precluding robust sea-level estimates for intervals such as the Pliocene. Present climate is warming to a level associated with significant polar ice-sheet loss in the past. Here, we outline advances and challenges involved in constraining ice-sheet sensitivity to climate change with use of paleo-sea level records.

PD-L2 is a second ligand for PD-1 and inhibits T cell activation

Programmed death I (PD-I)-deficient mice develop a variety of autoimmune-like diseases, which suggests that this immunoinhibitory receptor plays an important role in tolerance. We identify here PD-1 ligand 2 (PD-L2) as a second ligand for PD-1 and compare the function and expression of PD-L1 and PD-L2. Engagement of PD-1 by PD-L2 dramatically inhibits T cell receptor (TCR)-mediated proliferation and cytokine production by CD4+ T cells. At low antigen concentrations, PD-L2-PD-1 interactions inhibit strong B7-CD28 signals. In contrast, at high antigen concentrations, PD-L2-PD-1 interactions reduce cytokine production but do not inhibit T cell proliferation. PD-L-PD-1 interactions lead to cell cycle arrest in G0/G1 but do not increase cell death. In addition, ligation of PD-1 + TCR leads to rapid phosphorylation of SHP-2, as compared to TCR ligation alone. PD-L expression was up-regulated on antigen-presenting cells by interferon gamma treatment and was also present on some normal tissues and tumor cell lines. Taken together, these studies show overlapping functions of PD-L1 and PD-L2 and indicate a key role for the PD-L-PD-1 pathway in regulatingT cell responses.

Engagement of the PD-1 immunoinhibitory receptor by a novel B7 family member leads to negative regulation of lymphocyte activation

PD-1 is an immunoinhibitory receptor expressed by activated T cells, B cells, and myeloid cells. Mice deficient in PD-1 exhibit a breakdown of peripheral tolerance and demonstrate multiple autoimmune features. We report here that the ligand of PD-1 (PD-L1) is a member of the B7 gene family. Engagement of PD-1 by PD-L1 leads to the inhibition of T cell receptor-mediated lymphocyte proliferation and cytokine secretion. In addition, PD-1 signaling can inhibit at least suboptimal levels of CD28-mediated costimulation. PD-L1 is expressed by antigen-presenting cells, including human peripheral blood monocytes stimulated with interferon gamma, and activated human and murine dendritic cells. In addition, PD-L1 is expressed in nonlymphoid tissues such as heart and lung. The relative levels of inhibitory PD-L1 and costimulatory B7-1/B7-2 signals on antigen-presenting cells may determine the extent of T cell activation and consequently the threshold between tolerance and autoimmunity. PD-L1 expression on nonlymphoid tissues and its potential interaction with PD-1 may subsequently determine the extent of immune responses at sites of inflammation.

Stratigraphic architecture, relative sea-level, and models of estuary development in southern England: new data from Southampton Water

This paper presents the results of an investigation into the Holocene depositional history of Southampton Water, southern England. A three phase history of estuary development is proposed. Between c. 7500 and 5000 bp (8200 to 5700 cal. a bp), mean sea-level rose rapidly from c. −9m to −4 m od. During this interval thin basal peats which developed in present outer estuary locations were inundated and the area of intertidal and subtidal environments within the estuary expanded. Relative sea-level (RSL) rise began to slow between 5000 and 3000 bp (5700 and 3200 cal. a bp) and a phase of saltmarsh and freshwater peat accumulation occurred. In this interval freshwater peat-forming communities extended outwards and seawards across former saltmarsh and mudflat environments and caused a reduction in the extent of the intertidal area within the estuary. During the late Holocene there was a switch to renewed minerogenic sedimentation as most of the freshwater coastal wetlands of Southampton Water were inundated. This tripartite model is broadly applicable to the Thames and the Severn estuaries, suggesting that regional processes have controlled their macroscale evolution. RSL change and variations in sediment supply emerge as key controls during the first two phases of estuary development. The late Holocene demise of the estuary wetlands probably reflects a propensity for increased sediment reworking and unfavourable conditions for the accumulation and preservation of organogenic deposits due to reduced rates of long-term RSL and watertable rise.

Anaerobic crystallisation of an isopenicillin N synthase.Fe(II).substrate complex demonstrated by X-ray studies

Isopenicillin N synthase (IPNS) was cocrystallised with ferrous sulphate and its substrate, delta-(L-alpha-aminoadipoyl)-L-cysteinyl-D-valine (Aad-Cys-Val). Vital to the successful procedure was the maintenance of a rigorously anaerobic environment. Hanging-drop vapour-diffusion crystallisation experiments, using lithium sulphate as the precipitant produced three crystal forms. Form I crystals, with a plate habit, diffracted X-rays to at least 0.11-nm resolution at the European Synchrotron Radiation Facility and belong to the space group P2(1)2(1)2(1), with unit-cell dimensions a = 4.68, b = 7.15, c = 10.10 nm. Their asymmetric unit contains a single IPNS.Fe(II).Aad-Cys-Val complex with a solvent content of 38.5%. Form II crystals, with a hexagonal habit, diffract X-rays to at least 0.21 nm resolution at the European Synchrotron Radiation Facility and belong to the space group P3(1)21, with unit-cell dimensions a = 10.10, b = 10.10, c = 11.567 nm. Their asymmetric unit also contains a single IPNS.Fe(II).Aad-Cys-Val complex with a solvent content of 69.5%. Form III crystals, needles, do not show well-ordered diffraction. Although all three forms were initially produced in crystallisation experiments under identical conditions, appropriate micro and streak seeding allows selective crystallisation of form I or form II crystals. Extended X-ray-absorption fine-structure studies on a crystalline slurry of the form I crystals demonstrate the presence of an Fe-S(Aad-Cys-Val) bond length of 0.234 +/- 0.003 nm.

Quantifying the kinematics of natural and prosthetic knee flexion

A new method has been developed for quantifying knee kinematics during flexion. This method was used to measure knee kinematics from lateral radiographs taken at different angles of flexion with the two femoral condyles superimposed in each image, thus standardizing the plane of flexion-extension. When applied to the radiogaphs of five healthy male volunteers (age range 21-26 years), it showed that flexion was accompanied by translation between the articular surfaces. Knee kinematics were also measured in five patients after total knee replacement (TKR) surgery with a Kinemax Modular Total Knee prosthesis (Howmedica, Warsaw, Indiana). In the TKR patients, a translation was detected in three out of the five patients. This indicates that the prosthesis is capable of restoring normal kinematics, but does not always do so.

A method for the kinematic evaluation of the knee following anterior cruciate ligament injury and reconstruction

A quantitative method for assessing the kinematics of the knee in the sagittal plane has been developed in order to evaluate the role of the anterior cruciate ligament following injury and reconstruction. Measurements were made on a series of lateral radiographs obtained at different angles of flexion with the limb weight-bearing and the foot and ankle rotated so that the condyles of the femur overlapped. The kinematics of the joint were then defined by recording the path of the tip of the medial tibial spine as flexion proceeded, using a coordinate system based on the femur. This method overcomes the problems inherent in quantifying knee kinematics by using the pathway of the centre of rotation. In an amputated knee, tibial positions could be specified to within approximately 1.2 mm. There were no significant differences between results obtained at the beginning and end of a six month period for the normal knees of two patients; the standard deviation of the measured tibial positions was approximately 1.6 mm.