Synthesis, DPPH Radical Scavenging, Cytotoxic Activity, and Apoptosis Induction Efficacy of Novel Thiazoles and Bis-thiazoles

BACKGROUND

Heterocyclic materials-containing thiazoles exhibited incredible importance in pharmaceutical chemistry and drug design due to their extensive biological properties.

METHODS

Synthesis of thiazoles and bis-thiazoles from the reaction of 2-((6-Nitrobenzo[ d][1,3]dioxol-5-yl)methylene)hydrazine-1-carbothioamide with hydrazonoyl chlorides in dioxane and in the existence of triethylamine as basic catalyst. The antioxidant, invitro anti-proliferative, and cytotoxicity efficacy of thiazoles and bis-thiazoles were measured.

RESULTS

In this work, novel series of 5-methyl-2-(2-(-(6-nitrobenzo[d][1,3]dioxol-5-yl)methylene) hydrazinyl)-4-(aryldiazenyl)thiazoles (4a-f) were prepared via the reaction of hydrazonoyl chlorides 2a-f with 2-((6-nitrobenzo[d][1,3]dioxol-5-yl)methylene)hydrazine-1-carbothioamide (1) in dioxane and employing triethylamine as basic catalyst. Following the same procedure, bisthiazoles (6, 8, and 10) have been synthesized by utilizing bis-hydrazonoyl chlorides (5, 7, and 9) and carbothioamide 1 in a molar ratio (1:2), respectively. The distinctive features in the structure of isolated products were elucidated by spectroscopic tools and elemental analyses. The antioxidant, invitro anti-proliferative, cytotoxicity, and anti-cancer efficacy of thiazoles and bis-thiazoles were evaluated. Compounds 4d and 4f were the most potent antioxidant agents. Gene expression of apoptosis markers and fragmentation assay of DNA were assessed to explore the biochemical mechanism of synthesized products. Thiazoles significantly inhibited cell growth and proliferation more than bis-thiazoles. They induced apoptosis through induction of apoptotic gene expression P53 and downregulation of antiapoptotic gene expression Bcl-2. Moreover, they induced fragmentation of DNA in cancer cells, indicating that they could be employed as anticancer agents by inhibiting tumor growth and progression and can be considered effective compounds in the strategy of anti-cancer agents' discovery.

CONCLUSION

Synthesis, DPPH Radical Scavenging, Cytotoxic activity, and Apoptosis Induction Efficacy based on Novel Thiazoles and Bis-thiazoles.

A Comprehensive Pan-Cancer Analysis Identifies CEP55 as a Potential Oncogene and Novel Therapeutic Target

Emerging research findings have shown that a centrosomal protein (CEP55) is a potential oncogene in numerous human malignancies. Nevertheless, no pan-cancer analysis has been conducted to investigate the various aspects and behavior of this oncogene in different human cancerous tissues. Numerous databases were investigated to conduct a detailed analysis of CEP55. Initially, we evaluated the expression of CEP55 in several types of cancers and attempted to find the correlation between that and the stage of the examined malignancies. Then, we conducted a survival analysis to determine the relationship between CEP55 overexpression in malignancies and the patient's survival. Furthermore, we examined the genetic alteration forms and the methylation status of this oncogene. Additionally, the interference of CEP55 expression with immune cell infiltration, the response to various chemotherapeutic agents, and the putative molecular mechanism of CEP55 in tumorigenesis were investigated. The current study found that CEP55 was upregulated in cancerous tissues versus normal controls where this upregulation was correlated with a poor prognosis in multiple forms of human cancers. Additionally, it influenced the level of different immune cell infiltration and several chemokines levels in the tumor microenvironment in addition to the response to several antitumor drugs. Herein, we provide an in-depth understanding of the oncogenic activities of CEP55, identifying it as a possible predictive marker as well as a specific target for developing anticancer therapies.

Integration of Chemoinformatics and Multi-Omics Analysis Defines ECT2 as a Potential Target for Cancer Drug Therapy

Epithelial cell transforming 2 (ECT2) is a potential oncogene and a number of recent studies have correlated it with the progression of several human cancers. Despite this elevated attention for ECT2 in oncology-related reports, there is no collective study to combine and integrate the expression and oncogenic behavior of ECT2 in a panel of human cancers. The current study started with a differential expression analysis of ECT2 in cancerous versus normal tissue. Following that, the study asked for the correlation between ECT2 upregulation and tumor stage, grade, and metastasis, along with its effect on patient survival. Moreover, the methylation and phosphorylation status of ECT2 in tumor versus normal tissue was assessed, in addition to the investigation of the ECT2 effect on the immune cell infiltration in the tumor microenvironment. The current study revealed that ECT2 was upregulated as mRNA and protein levels in a list of human tumors, a feature that allowed for the increased filtration of myeloid-derived suppressor cells (MDSC) and decreased the level of natural killer T (NKT) cells, which ultimately led to a poor prognosis survival. Lastly, we screened for several drugs that could inhibit ECT2 and act as antitumor agents. Collectively, this study nominated ECT2 as a prognostic and immunological biomarker, with reported inhibitors that represent potential antitumor drugs.

AB0876 Can ultrasonographic peripheral enthesitis mirror spinal radiographic abnormalities and other disease parameters in patients radiographic axial SpA?

Background

Although enthesitis is the hallmark of spondyloarthritides, the association between peripheral enthesitis, radiographic spinal affection and disease assessment parameters is still underestimated.

Objectives

In this cross-sectional prospective study, we aimed to evaluate the relation of US pattern of peripheral enthesitis with the spinal radiographic changes and other disease parameters in patients with radiographic axial spondyloarthritis (SpA).

Methods

Fifty-eight patients with radiographic axial SpA (ASAS criteria) were studied for the presence and pattern of peripheral lower limb enthesitis according to the Outcome Measures in Rheumatology (OMERACT) US definitions: Achilles tendon, plantar fascia, proximal and distal patellar ligaments, and quadriceps tendon insertions. The findings then were correlated with the radiographic spinal abnormalities, Bath AS radiographic index (BASRI), Bath AS disease activity index (BASDAI), Bath AS functional index (BASFI), and Bath AS metrology index (BASMI) together with the HLA-B27 status and inflammatory markers using Spearmann rho correlation co-efficient.

Results

The mean age was 37.96 (±13.1) years, 75.86% were males. Thirty-six patients (62%) had US enthesitis (USE) with a mean age of 39.2 (±12.8). HLA-B27 was positive in 61% of patients with USE and 54.5% in those without. There was no difference between patients with and without USE regarding the disease duration, age at onset but those with USE showed less diagnostic delay (p = 0.03). Clinical enthesitis and peripheral arthritis were more frequent in those with USE (50% vs 22.7% and 25% vs 13.6% respectively). No statistical significant difference has been found between the inflammatory, structural and total scores of USE and BASRI, BASFI and BASDAI (p > 0.05). No correlation could be detected between BASRI and USE scores (rs= 0.12, p =0.45 for inflammatory, rs=0.25, p=0.11 for structural and rs=0.18, p=0.28 for total score). There was a positive correlation between BASMI and both inflammatory and total scores of USE (rs= 0.485, p=0.003). No significant association between BASDAI, CRP or ESR and USE scores.

Conclusion

Ultrasonographic peripheral entheseal abnormalities couldn’t reflect the spinal radiographic changes or disease assessment parameters in patients with radiographic axial SpA. However, these results can be considered preliminary and more studies on wider scales are needed to support our findings.

Disclosure of Interests

Abdelhfeez Moshrif Speakers bureau: Amgen, Jansen, Novartis, Mohamed Ismail Abdelkareem Speakers bureau: Abbvie, Jansen, Novartis and Organon, Sonya Rashad: None declared, Ahmed Negm: None declared, Ahmed Mosallam Speakers bureau: Amgen, Pfizer and Novartis, Hassan Bassiouni Speakers bureau: Abbvie, Jansen, Novartis, and MSD

Carboxymethyl Cellulose/Zn-Organic Framework Down-Regulates Proliferation and Up-Regulates Apoptosis and DNA Damage in Colon and Lung Cancer Cell Lines

A solvothermal technique was used to prepare a Zn–benzenetricarboxylic acid (Zn@BTC) organic framework covered with a carboxymethyl cellulose (CMC/Zn@BTC). Fourier transform infrared spectroscopy (FTIR), field emission scanning electron microscope (FESEM), and Brunauer, Emmett, and Teller (BET) surface area were applied to characterize CMC/Zn@BTC. Moreover, the anticancer, anti-migrative, anti-invasive, and anti-proliferative action of CMC/Zn@BTC nanoparticles were assessed on cancer cell lines. Apoptotic markers and DNA damage were assessed to explore the cellular and biological changes induced by CMC/Zn@BTC nanoparticles. The microscopic observation revealed that CMC controls the surface morphology and surface characteristics of the Zn@BTC. The obtained BET data revealed that the Zn@BTC nanocomposite surface area lowers from 1061 m²/g to 740 m²/g, and the pore volume decreases from 0.50 cm³/g to 0.37 cm³/g when CMC is applied to Zn@BTC nanocomposites. The cellular growth of DLD1 and A549 was suppressed by CMC/Zn@BTC, with IC50 values of 19.1 and 23.1 μg/mL, respectively. P53 expression was upregulated, and Bcl-2 expression was downregulated by CMC/Zn@BTC, which promoted the apoptotic process. Furthermore, CMC/Zn@BTC caused DNA damage in both cancer cell lines with diverse impact, 66 percent (A549) and 20 percent (DLD1) compared to cisplatin’s 52 percent reduction. CMC/Zn@BTC has anti-invasive properties and significantly reduced cellular migration. Moreover, CMC/Zn@BTC aims key proteins associated with metastasis, proliferation and programmed cellular death.

Chitosan Containing Nano Zn-Organic Framework: Synthesis, Characterization and Biological Activity

A biologically active agent based on a Zn-1,3,5-benzen tricarboxylic acid (Zn-BTC) framework incorporated into a chitosan (CS) biopolymer (Zn-BTC@CS) was successfully synthesized using a microwave irradiation technique. The synthesized Zn-BTC@CS was characterized using a scanning electron microscope (SEM) and the obtained data indicated a highly smooth surface morphology of the synthesized Zn-BTC and no morphological changes when the Zn-BTC covered the CS. In addition, the particle size diameter varied from 20 to 40 nm. XRD displayed a well-maintained Zn-BTC structure, and the crystal structure of Zn-BTC was not distorted by the composition of Zn-BTC and chitosan in the nanocomposite. Data from BET analysis revealed that the specific surface area of the Zn-BTC was reduced from 995.15 m²/g to 15.16 m²/g after coating with chitosan. The pore size distribution and pore volume of the Zn-BTC, Zn-BTC@CS were centered at 37.26 nm and at 22.5 nm, respectively. Zn-BTC@CS exhibited anticancer efficacy against lung and colon cancer cell lines. Zn-BTC@CS inhibited the proliferation of A549 and DLD-1 cancer cell lines in a dose-dependent manner with IC₅₀ values of 13.2 and 19.8 µg/mL for the colon and lung cancer cell lines, respectively. Zn-BTC@CS stimulated the apoptotic process through up-regulating P53 expression and down-regulating Bcl-2 expression. Moreover, Zn-BTC@CS induced in vitro DNA fragmentation in both cancer cell lines with significantly different affinity by 66% (A549) and 20% (DLD-1) versus 52% reduction by Cisplatin. Zn-BTC@CS (IC50) exhibited anti-invasive activity and dramatically inhibited the migration of lung and colon cancer cell lines. This study provides evidence that Zn-BTC@CS targets the essential proteins involved in proliferation, metastasis, and apoptosis. Thus, Zn-BTC@CS has chemotherapeutic potential for inhibiting lung and colon cancer viability and growth.

Growth Optimization and Secondary Metabolites Evaluation of Anabaena variabilis for Acetylcholinesterase Inhibition Activity

Cyanobacteria comprise a good natural resource of a potential variety of neuro-chemicals, including acetylcholinesterase inhibitors essential for Alzheimer’s disease treatment. Accordingly, eight different cyanobacterial species were isolated, identified, and evaluated on their growth on different standard nutrient media. It was found that the modified Navicula medium supported the highest growth of the test cyanobacteria. The effects of methylene chloride/methanol crude extracts of the test cyanobacteria on acetylcholinesterase activity were examined and compared. Anabaena variabilis (KU696637.1) crude extract recorded the highest acetylcholinesterase inhibition (62 ± 1.3%). Navicula medium chemical components were optimized through a Plackett–Burman factorial design. The biomass of Anabaena variabilis increased significantly when grown on the optimized medium compared to that of control. The chemical analysis of the fractions derived from Anabaena variabilis showed the presence of two compounds in significant amounts: the flavonoid 5,7-dihydroxy-2-phenyl-4H-chrome-4-one and the alkaloid 4-phenyl-2-(pyridin-3-yl) quinazoline. Molecular docking studies revealed that both compounds interact with the allosteric binding site of acetylcholinesterase at the periphery with π-π stackings with Tyr341 and Trp286 with good, predicted partition coefficient. The compounds obtained from this study open the door for promising drug candidates to treat Alzheimer’s disease for their better pharmacodynamics and pharmacokinetic properties.

Development of superior antibodies against the S-protein of SARS-Cov-2 using macrocyclic epitopes

One of the proven methods to prevent and inhibit viral infections is to use antibodies to block the initial Receptor Binding Domain (RBD) of SARS-CoV-2 S protein and avoid its binding with the host cells. Thus, developing these RBD-targeting antibodies would be a promising approach for treating the SARS-CoV-2 infectious disease and stop virus replication. Macrocyclic epitopes constitute closer mimics of the receptor's actual topology and, as such, are expected to be superior epitopes for antibody generation. This work demonstrated the vital effect of the three-dimensional shape of epitopes on the developed antibodies' activity against RBD protein of SARS-CoV-2. The molecular dynamics studies showed the greater stability of the cyclic epitopes in comparison with the linear counterpart, which was reflected in the activity of their produced antibodies. Indeed, the antibodies we developed using macrocyclic epitopes showed superiority with respect to binding to RBD proteins compared to antibodies formed from a linear peptide. The results of the present work constitute a roadmap for developing superior antibodies that could be used to inhibit the activity of the SARS-CoV-2 and prevent its reproduction.

Structure-Based Epitope Design: Toward a Greater Antibody-SARS-CoV-2 RBD Affinity

Efficient COVID-19 vaccines are widely acknowledged as the best way to end the global pandemic. SARS-CoV-2 receptor-binding domain (RBD) plays fundamental roles related to cell infection. Antibodies could be developed to target RBD and represent a potential approach for the neutralization of the virus. Epitopes used to produce antibodies are generally linear peptides and thus possess multiple confirmations that do not reflect the actual topology of the targeted part in the native protein. On the other hand, macrocyclic epitopes could constitute closer mimics of the native protein topology and, as such, could generate superior antibodies. In this study, we demonstrated the vital effect of the size and the three-dimensional shape of epitopes on the activity of the developed antibodies against the RBD of SARS-CoV-2. The molecular dynamics studies showed the greater stability of the cyclic epitopes compared with the linear counterparts, which was reflected in the affinity of the produced antibodies. The antibodies developed using macrocyclic epitopes showed superiority with respect to binding to RBD compared to antibodies formed from linear peptides. This study constitutes a roadmap for developing superior antibodies that could be used to inhibit the activity of SARS-CoV-2.

Zinc oxide nanoparticles augment CD4, CD8, and GLUT-4 expression and restrict inflammation response in streptozotocin-induced diabetic rats

This study evaluated the biochemical, molecular, and histopathological mechanisms involved in the hypoglycaemic effect of zinc oxide nanoparticles (ZnONPs) in experimental diabetic rats. ZnONPs were prepared by the sol-gel method and characterised by scanning and transmission electron microscopy (SEM and TEM). To explore the possible hypoglycaemic and antioxidant effect of ZnONPs, rats were grouped as follows: control group, ZnONPs treated group, diabetic group, and diabetic + ZnONPs group. Upon treatment with ZnONPs, a significant alteration in the activities of superoxide dismutase, glutathione peroxidase, and the levels of insulin, haemoglobin A1c, and the expression of cluster of differentiation 4+ (CD4+), CD8+ T cells, glucose transporter type-4 (GLUT-4), tumour necrosis factor, and interleukin-6 when compared to diabetic and their control rats. ZnONPs administration to the diabetic group showed eminent blood glucose control and restoration of the biochemical profile. This raises their active role in controlling pancreas functions to improve glycaemic status as well as the inflammatory responses. Histopathological investigations showed the non-toxic and therapeutic effect of ZnONPs on the pancreas. TEM of pancreatic tissues displayed restoration of islets of Langerhans and increased insulin-secreting granules. This shows the therapeutic application of ZnONPs as a safe anti-diabetic agent and to have a potential for the control of diabetes.

Prunus Armeniaca L. Seed Extract and Its Amygdalin Containing Fraction Induced Mitochondrial-Mediated Apoptosis and Autophagy in Liver Carcinogenesis

BACKGROUND

Despite significant advances in therapeutic interventions, liver cancer is the leading cause of cancer mortality in the world. Potential phytochemicals have shown to be promising agents against many life-threatening diseases because of their low toxicity and potential effectiveness.

OBJECTIVE

The current study aims to conduct an in vitro investigation of the anticancer activity of Apricot Extract (AE) and Amygdalin Containing Fraction (ACF), additionally studying their therapeutic effects on DMBAinduced liver carcinogenesis mice model to highlight their related biochemical and molecular mechanisms.

METHODS AND RESULTS

Amygdalin was isolated from the seeds of P. armeniaca L. Male mice received AE or ACF, DMBA, DMBA+AE, DMBA+ACF, and vehicles. The oxidative stress and antioxidant markers, cell proliferation by flow cytometric analysis of Proliferating Cell Nuclear Antigen (PCNA) expression, angiogenesis marker (VEGF), inflammatory marker (TNF-α), apoptotic, anti-apoptotic and autophagy genes expression (caspase-3, Bcl-2, and Beclin-1) were investigated. AE and ACF were found to stimulate the apoptotic process by up-regulating caspase-3 expression and down-regulating Bcl-2 expression. They also reduced VEGF and PCNA levels and increased the antioxidant defense system. Moreover, AE and ACF treatments also inhibited HepG2 and EAC cell proliferation and up-regulated Beclin-1 expression.

CONCLUSION

This study provides evidence that, in DMBA-induced hepatocarcinogenesis, the key proteins involved in the proliferation, angiogenesis, autophagy, and apoptosis are feasible molecular targets for hepatotherapeutic potential using AE and ACF.

Prognostic value of vascular endothelial growth factor in both conventional and drug eluting beads transarterial chemoembolization for treatment of unresectable hepatocellular carcinoma in HCV patients

OBJECTIVES

This work aimed to measure serum vascular endothelial growth factor (VEGF) levels before and after Conventional transarterial chemoembolization (cTACE) versus drug-eluting beads (DEB)-TACE and evaluate its efficacy in predicting response to therapy and tumor recurrence.

METHODS

114 patients with unresectable hepatocellular carcinoma complicating hepatitis C virus-related cirrhosis were included. They underwent cTACE (58) or DEB-TACE (56). VEGF serum levels were measured before and on days 1 and 30 after TACE. Patients with complete response (CR) after TACE were followed-up for one year. Statistical analysis was done.

RESULTS

VEGF level was higher than baseline after cTACE (P < 0.001), and DEB-TACE (P = 0.004). It was also significantly higher in patients with progressive disease (P < 0.001). VEGF level at cut off values of 97.3, 149.8, and 104.1 pg/ml could discriminate disease progression from treatment success with area under ROC curves of 0.806, 0.775, and 0.771, respectively. The sensitivity was 88.9%, 88.9%, and 77.8% and specificity was 62.5%, 64.6 and 66.7%, respectively. However, no relation to tumor recurrence in CR group could be detected after one year.

CONCLUSION

VEGF serum levels may predict response to therapy in patients treated by DEB-TACE or cTACE but it has no relation to tumor recurrence.

Oleanolic Acid Suppressed DMBA-Induced Liver Carcinogenesis through Induction of Mitochondrial-Mediated Apoptosis and Autophagy

Phytochemicals appeared as a rich source of efficient and safe agents against many diseases like cancer. Various herbal sources are rich in oleanolic acid (OA). The scope of this study was to assess the biochemical and molecular mechanisms implicated in the ameliorative potency of OA against DMBA-induced liver carcinogenesis. Forty-eight male albino mice were assigned randomly to five groups (eight mice each) as follows: control healthy group, olive oil group, OA group, DMBA group, and DMBA with OA. Apoptosis, autophagy, inflammation, proliferation, and angiogenesis were investigated in the tissue samples. Histopathological examination was carried out as well as liver enzymes activity and other hepatic antioxidant and inflammatory biomarkers. The treatment with OA effectively suppressed the DMBA-initiated liver carcinogenesis via modulation of antioxidant status, induction of apoptosis and autophagy through modulating the expression of Caspase-3, Bcl-2 and Beclin-1, inhibiting angiogenesis (VEGF), proliferation (PCNA), and improved liver function and histological picture with a reduction in AFP level. Additionally, OA applies its antitumor effects by inhibition of proinflammatory transcription factor NF-κB and inflammatory markers (TNF-α and Cox-2) associated with DMBA administration. The present study shows that OA treatment efficiently suppressed the DMBA-initiated liver carcinogenesis through induction of mitochondrial-mediated apoptosis and autophagy and modulating inflammation.

THU0484 FIBROMYALGIA AND MULTIPLE SWITCHING OF BIOLOGICS IN SPONDYLOARTHRITIS

Background:

Fibromyalgia (FM) is a condition characterized by chronic widespread pain, tender points, fatigue and disturbed sleep rhythm. Some of these symptoms such as fatigue, tender points and diffuse pain seen in patients with spondylarthritis (SpA). Moreover, FM and SpA can coexist creating a diagnostic challenge, particularly in early disease course and influence clinical disease activity assessment.

Objectives:

With this cross-sectional study, we aim to estimate the prevalence of FM in SpA and to elaborate its effect on biological treatments.

Methods:

FM was identified according to the ACR 2010 diagnostic criteria. SpA patients identified according to rheumatologist using various SpA subsets criteria. A review of the electronic medical files for SpA patients attending the rheumatology outpatient clinic and infusion unit at a major tertiary hospital during the period from June to December 2018 were included. Patients’ demographics, socioeconomics, disease characteristics, activity, HLA status and abnormal MRI sacroiliac were explored. Regarding SpA medications, number, frequency and dose of DMARDs and biological agents were obtained.

Continuous variables were reported by their mean and standard deviation (SD) and qualitative variables by frequency and percentage. Statistical significance was set at p <0.05. Statistical analysis was performed using SPSS version 23.

Results:

Of the 305 enrolled SpA patients, 43 (14.1%) had FM. Females represents 57.4% of the patients, mean age was 44.07 ± 11.85 years. Arab ethnicity represents most of our cohort 84.9%, the majority were Emirati 64.6%. Smokers were 8.2% and ex-smokers were 3.3%. Axial SpA represents 38.4% while peripheral SpA 61.6% of our cohort according to ASAS classification.

HLA B27 tested in a sample of 180 patients; it was positive in only 17.8%. CRP found to be elevated in 20.3% of the patients at baseline. Abnormal MRI SIJ bone marrow edema changes were found in 10.8%, while other SIJ changes was seen in additional 20.6%. The prevalence of FM showed no statistically significant difference between axial and peripheral SpA. Patients SpA and FM have longer disease duration than SpA alone, P= 0.034. Table.1 show demographics, socioeconomics and clinical data of our cohort.

Regarding medication, the use of biologics among SpA patients with FM is more frequent than SpA patients without FM (74.4% vs 51.5 % respectively), P= 0.005. Interestingly, the likelihood ratio testing showed that SpA patient with Fibromyalgia switch more frequently to another biologics than SpA without fibromyalgia, P= 0.015.

Cramer’s V test showed that there is a high statistically significant (P= 0.002) and very strong association (> 0.25) between presence of Fibromyalgia and multiple switching of biologics in SpA.

There was no difference in the exposure to prednisolone nor conventional DMARDs between SpA patients with or without FM, P= 0.64 & 1 respectively.

Gender, Female, n (%)175 (57.4)Age, mean ± SD (min- max), years44.07 ± 11.85 (18- 78)Type of A, n (%)AxialPeripheral117 (38.4)188 (61.6)Fibromyalgia, n (%)FM in axial SpAFM in Peripheral SpA43 (14.1)18 (41.9)25 (58.1)SpA Disease duration (months)FM+, mean ±SDFM-, mean ±SD107.7± 50.486± 57.9Elevated CRP, n (%)62 (20.3)HLA B27 in180 patients, n (%)PositiveNegative32 (17.8)148 (82.2)Abnormal MRI SIJ, n (%)Bone marrow edemaSubchondral sclerosisFatty transformation of bone marrowErosion92 (30.2)33 (10.8)21 (6.9)5 (1.6)2 (0.7)Number of conventional DMARDs ever tired, n (%)NoneOneTwoThree81 (26.6)166 (54.4)46 (15.1)12 (3.9)Frequency of DMARDs usage, n, (%)Conventional DMARDsPrednisoloneBiologic DNARDs224 (73.4)56 (18.4)164 (53.8)

Conclusion:

FM coexistence with SpA might impact clinical evaluation of disease activity and possibly negatively affect self-measurement of treatment response. In our study, SPA patients exposed to more biologics if they have coexisting FM; Moreover, they are more frequent switchers among biologics including TNFi and IL17i.

Acknowledgments:

N Elsidig, A Al Marzooqi, N Zamani, A Hossaini

Disclosure of Interests: :

None declared

AB0666 A COMPARISON OF CLINICAL FEATURES AND PREDICTORS OF TREATMENT RESPONSE IN SPONDYLOARTHRITIS PATIENTS IN THE MIDDLE EAST: A CROSS-SECTIONAL MULTINATIONAL STUDY

Background:

Spondylarthritis it is a chronic inflammatory disease with heterogenous clinical features. Its prevalence ranges between 0.2%-2%. Over the years biological therapy has improved work productivity and activity impairment in people with SpA. Unlike in rheumatoid arthritis, the concept of treat-to-target is still debatable among rheumatologist. However, there is a consensus that treatment in patient with SpA should be personalized. There are several challenges in the Middle East that might affect providing personalized medicine to patients with SpA in this region.

Objectives:

The of objective of the study is to explore factors that interfere with achieving clinical targets in patients with SpA clinical practice in the Middle East.

Methods:

We conducted a cross-sectional, multicentre study to explore the factors that interfere with achieving clinical targets in SpA patients from four countries in the Middle East (Lebanon, Oman, Qatar, and the United Arab Emirates). A total of 404 patients who attended participating centers from January 2019 to June 2019 and who met the ASAS 2010 classification criteria for axial and peripheral SpA; and were at least 18 years of age were enrolled in the study. We excluded patients with peripheral arthritis only. We extracted demographics, clinical data, and conducted patients survey. We used Compliance Questionnaire for Rheumatology (CQR) is a self-reported adherence measure created specifically for and validated in rheumatic diseases.

Demographic data and disease and treatment characteristics were described as median and the 25th–75th interquartile range (IQR). Multiple regression analysis was used to investigate the impact of different factors on ASDAS-CRP in patients with SpA. Statistical analysis was performed using Minitab version 18.1 software.

Results:

A total of 404 patients initially enrolled in the study, we excluded 95 patients as they had peripheral involvement only. We analysed the data of 309 patients with axial only or axial and peripheral SpA. There median age was 43 years and 53.7% were females. The median disease duration was six years. At the time of the study, 72.1% patients were within the arbitrary clinical target of ASDAS < 2.1. Detail description of the studied population and subgroups outlined in table 1.

Enthesitis (OR: 2.9; P value: 0.004), Psoriasis (OR: 2.74; P value: 0.007), low compliance score (OR: -4.36; P value: < 0.0001) and HLA B27 (OR: 2.12; P value: < 0.04) were independent predictors of a higher ASDAS –CRP.

Conclusion:

Enthesitis, psoriasis, noncompliance, and HLA B27 were independent predictors for ASDAS in our cohort.

Table 1.

Demographic and clinical characteristics of all patients and for achiever and non-achievers

VariablesAll patients (309)Achiever (223)Non-achieves (86)Age, Median, (IQR) yrs43, (36-51)43, (35-51.5)42, (37-51)Female %53.7%54.2%51.9%Disease Duration, Median, (IQR)yrs6, (3-9)6, (2-8)7.5, (3-10)Patient has medical insurance/ Medical coverage94.5%95.0%93.1%Smoking13.9%12.1%18.6%ASDAS-CRP, Median (IQR)1.56, (1.24-2.1)1.56, (1.07-1.6)2.75, (2.36-3.3)Arthritis40.1%36.3%48.1%Dactylitis13.6%11.3%18.50%Enthesitis29.1%22.4%43.2%Family history of SPA18.4%14.3%25.9%Good response to NSAIDs21.7%18.8%22.2%HLA B2730.0%25.6%40.0%Inflammatory bowel disease7.1%7.3%6.20%Inflammatory low back pain68.6%68.1%69.8%Onycholysis10.9%10.7%11.1%Psoriasis39.4%25.1%40.7%Sacroiliitis (Radiographic)50.4%49.8%51.9%Uveitis6.1%4.0%11.1%SpA- classificationAxial49.8%55.7%35.6%Axial & peripheral50.2%44.3%64.4%

Acknowledgments:

ArLAR 2018 Scientific committee for initiating SpA special interest group meeting

Disclosure of Interests:

Jamal Al-Saleh Grant/research support from: Novartis, AbbVie, Majid Philippe Abi Saab: None declared, Ahmed Negm Speakers bureau: El-lilly, Farida Balushi: None declared, Rajaie Namas: None declared, Nelly Ziade Speakers bureau: Abbvie, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi

New approach for the synthesis, docking of new porphyrins and their antitumor activity

A new methodology for the synthesis of a new series of mesotetrakis[aryl]-21H,23H-porphyrin derivatives 5a–5d, 6a–6c, 7 and 8 is presented. Structures of new compounds were established based on both elemental and spectral data. Cytotoxicity activity of the newly synthesized compounds was investigated against two human cell lines MCF-7 and HepG2. Molecular docking was performed to investigate the binding between the most active porphyrin derivatives and Bcl-2 molecular biomarkers in HepG2 cells.

Sucrose diester of aryldihydronaphthalene-type lignans from Echium angustifolium Mill. and their antitumor activity

Four previously undescribed sucrose diester of aryldihydronaphthalene-type lignans, named echiumins A-D, were isolated from the butanol fraction of Echium angustifolium Mill, in addition to a known compound, trigonotin A, which is reported for the first time from the title plant. The structures of isolated compounds were elucidated using spectroscopic methods such as HRESIMS and 1D and 2D NMR spectroscopy. The isolated compounds displayed strong to weak antitumor activity against HepG2 and MCF7 cancer cell lines, with echiumins A and D showed the most potent activity.

Porcine skin gelatin-silver nanocomposites: synthesis, characterisation, cell cytotoxicity, and antibacterial properties

Silver nanoparticles (AgNPs) were synthesised with hydrothermal autoclaving technique by using AgNO₃ salt (silver precursor) at different concentrations (0.01, 0.1, 0.55, 1.1, 5.5, and 11 mM) and porcine skin (1% (w/v) ) gelatin polymeric matrix (reducing and stabiliser agent). The reaction was performed in an autoclave at 103 kPa and 121°C and the hydrothermal autoclaving exposure time and AgNO₃ molar concentration were varied at a constant porcine skin gelatin concentration. The as-prepared AgNPs were characterised by UV-visible spectroscopy, transmission electron microscopy, and Fourier transform infrared spectroscopy. The antibacterial properties of AgNPs were tested against gram-positive and gram-negative bacteria. Furthermore, 3-(4,5-dimethylthiazol-2-yl) 2,5-diphenyltetrazolium bromide and 2,2-diphenyl-1-picrylhydrazyl assays were used to test whether the synthesised AgNPs can be potentially applied in cancer therapy or used as an antioxidant. This approach is a promising simple route for synthesising AgNPs with a smaller average particle 10 nm diameter. Furthermore, AgNPs exhibited a good cytotoxicity activity, reducing the viability of the liver cancer cell line HepG2 with a moderate IC₅₀; they also showed a low-to-fair antioxidant activity. In addition, AgNPs had a remarkable preferential antibacterial activity against gram-positive bacteria than gram-negative bacteria. Therefore, these fabricated AgNPs can be used as an antibacterial agent in curative and preventive health care.

Combinatorial synthesis, in silico, molecular and biochemical studies of tetrazole-derived organic selenides with increased selectivity against hepatocellular carcinoma

Novel tetrazole-based diselenides and selenoquinones were synthesized via azido-Ugi and sequential nucleophilic substitution (SN) strategy. Molecular docking study into mammalian TrxR1 was used to predict the anticancer potential of the newly synthesized compounds. The cytotoxic activity of the compounds was evaluated using hepatocellular carcinoma (HepG2) and breast adenocarcinoma (MCF-7) cancer cells and compared with their cytotoxicity in normal fibroblast (WI-38) cells. The corresponding redox properties of the synthesized compounds were assessed employing 2,2-diphenyl-1-picrylhydrazyl (DPPH), glutathione peroxidase (GPx)-like activity and bleomycin dependent DNA damage. In general, diselenides showed preferential cytotoxicity to HepG2 compared to MCF-7 cells. These compounds exhibited also good GPx catalytic activity compared to ebselen (up to 5 fold). Selenoquinones 18, 21, 22 and 23 were selected to monitor the expression levels of caspase-8, Bcl-2 and Ki-67 molecular biomarkers. Interestingly, these compounds downregulated the Bcl-2 and Ki-67 expression levels and activated the expression of caspase-8 in HepG2 cells compared to untreated cells. These results indicate that some of the newly synthesized compounds possess anti-HepG2 activity.

Preliminary crystallographic analysis of a cruciferin protein from seeds of Moringa oleifera

A 55 kDa cruciferin protein has been purified and characterized from seeds of Moringa oleifera plant. Protein blast of N-terminal amino-acid sequence showed 60 % sequence similarity with cruciferin from Brassica napus. The M. oleifera protein has been crystallized applying the sitting drop method using 5 % polyethylene glycol 8,000, 38.5 % 3-methyl-1,5-pentanediol and 0.1 M sodium cacodylate pH 6.5. The crystals belonged to the P6322 hexagonal space group with cell dimensions, a = b = 98.4, c = 274.3 Å. Initial diffraction data have been collected to a resolution of 6 Å.

Chemotherapeutic agents for the treatment of hepatocellular carcinoma: efficacy and mode of action

Hepatocellular carcinoma (HCC) is a dreaded malignancy that every year causes half a million deaths worldwide. Being an aggressive cancer, its incidence exceeds 700,000 new cases per year worldwide with a median survival of 6-8 months. Despite advances in prognosis and early detection, effective HCC chemoprevention or treatment strategies are still lacking, therefore its dismal survival rate remains largely unchanged. This review will characterize currently available chemotherapeutic drugs used in the treatment of HCC. The respective mode(s) of action, side effects and recommendations will be also described for each drug.

Efficacy of low frequency pulsed subsensory threshold electrical stimulation vs placebo on pain and physical function in people with knee osteoarthritis: systematic review with meta-analysis

OBJECTIVE

To determine if low frequency (≤100 Hz) pulsed subsensory threshold electrical stimulation produced either through pulsed electromagnetic field (PEMF) or pulsed electrical stimulation (PES) vs sham PEMF/PES intervention is effective in improving pain and physical function at treatment completion in adults with knee osteoarthritis (OA) blinded to treatment.

METHOD

The relevant studies were identified by searching eight electronic databases and hand search of the past systematic reviews on the same topic till April 5, 2012. We included randomized controlled trials (RCTs) of people with knee OA comparing the outcomes of interest for those receiving PEMF/PES with those receiving sham PEMF/PES. Two reviewers independently selected studies, extracted relevant data and assessed quality. Pooled analyses were conducted using inverse-variance random effects models and standardized mean difference (SMD) for the primary outcomes.

RESULTS

Seven small trials (459 participants/knees) were included. PEMF/PES improves physical function (SMD = 0.22, 95% confidence interval (CI) = 0.04, 0.41, P = 0.02, I(2) = 0%), and does not reduce pain (SMD = 0.08, 95% CI = -0.17, 0.32, P = 0.55, I(2) = 43%). The strength of the body of evidence was low for physical function and very low for pain.

CONCLUSION

Current evidence of low and very low quality suggests that low frequency (≤100 Hz) pulsed subsensory threshold electrical stimulation produced either through PEMF/PES vs sham PEMF/PES is effective in improving physical function but not pain intensity at treatment completion in adults with knee OA blinded to treatment. Methodologically rigorous and adequately powered RCTs are needed to confirm the findings of this review.

Peripapillary duodenal varices as a rare cause of severe bleeding in a patient with no other signs of portal hypertension--successful endoscopic treatment with cyanoacrylate injection

Duodenal varices (DVs) are a rare cause of upper gastrointestinal bleeding and rather suspected in patients with portal hypertension. Bleeding DVs are difficult to manage and often fatal due to delayed diagnosis. We report on a 71-year-old patient with massive upper gastrointestinal haemorrhage, who did not show any clinical signs of portal hypertension; however, he had a history of duodenal segmental resection 8 years before. The source of bleeding could not be detected with different imaging methods such as angiography and computed tomography. Upper gastrointestinal endoscopy finally revealed DVs, which were located just adjacent to the papilla. After endoscopic injection therapy with n-butyl 2-cyanoacrylate the bleeding stopped immediately and the patient soon stabilised. Despite the peripapillar localisation no signs of pancreatitis or cholestasis occurred; during 10-month follow-up a marked regression of the varices without further signs of variceal bleeding was observed.