The ADAM17 sheddase complex regulator iTAP/Frmd8 modulates inflammation and tumor growth

The metalloprotease ADAM17 is a sheddase of key molecules, including TNF and epidermal growth factor receptor ligands. ADAM17 exists within an assemblage, the "sheddase complex," containing a rhomboid pseudoprotease (iRhom1 or iRhom2). iRhoms control multiple aspects of ADAM17 biology. The FERM domain-containing protein iTAP/Frmd8 is an iRhom-binding protein that prevents the precocious shunting of ADAM17 and iRhom2 to lysosomes and their consequent degradation. As pathophysiological role(s) of iTAP/Frmd8 have not been addressed, we characterized the impact of iTAP/Frmd8 loss on ADAM17-associated phenotypes in mice. We show that iTAP/Frmd8 KO mice exhibit defects in inflammatory and intestinal epithelial barrier repair functions, but not the collateral defects associated with global ADAM17 loss. Furthermore, we show that iTAP/Frmd8 regulates cancer cell growth in a cell-autonomous manner and by modulating the tumor microenvironment. Our work suggests that pharmacological intervention at the level of iTAP/Frmd8 may be beneficial to target ADAM17 activity in specific compartments during chronic inflammatory diseases or cancer, while avoiding the collateral impact on the vital functions associated with the widespread inhibition of ADAM17.

Autophagy is a pro-survival adaptive response to heat shock in bovine cumulus-oocyte complexes

Autophagy is a physiological mechanism that can be activated under stress conditions. However, the role of autophagy during oocyte maturation has been poorly investigated. Therefore, this study characterized the role of autophagy on developmental competence and gene expression of bovine oocytes exposed to heat shock (HS). Cumulus-oocyte-complexes (COCs) were matured at Control (38.5 °C) and HS (41 °C) temperatures in the presence of 0 and 10 mM 3-methyladenine (3MA; autophagy inhibitor). Western blotting analysis revealed that HS increased autophagy marker LC3-II/LC3-I ratio in oocytes. However, there was no effect of temperature for oocytes matured with 3MA. On cumulus cells, 3MA reduced LC3-II/LC3-I ratio regardless of temperature. Inhibition of autophagy during IVM of heat-shocked oocytes (3MA-41 °C) reduced cleavage and blastocyst rates compared to standard in vitro matured heat-shocked oocytes (IVM-41 °C). Therefore, the magnitude of HS detrimental effects was greater in the presence of autophagy inhibitor. Oocyte maturation under 3MA-41 °C reduced mRNA abundance for genes related to energy metabolism (MTIF3), heat shock response (HSF1), and oocyte maturation (HAS2 and GREM1). In conclusion, autophagy is a stress response induced on heat shocked oocytes. Inhibition of autophagy modulated key functional processes rendering the oocyte more susceptible to the deleterious effects of heat shock.

Utility of a chemotherapy toxicity prediction tool for older patients in a community setting

Background

Expert groups have recommended incorporation of a geriatric assessment into clinical practice for older patients starting oncologic therapy. However, that practice is not standard primarily because of resource limitations. In the present study, we evaluated the effect on treatment decisions by oncologists in the community oncology setting of a brief geriatric assessment tool that estimates risk of toxicity.

Methods

This prospective longitudinal study in 5 community oncology practices in British Columbia involved patients 70 years of age and older starting a new cytotoxic chemotherapy regimen. Clinical personnel completed a brief validated geriatric assessment tool-the Cancer and Aging Research Group chemotherapy toxicity tool (carg-tt)-that estimates the risk of grade 3 or greater toxicity in older patients. Physicians were asked if the carg-tt changed their treatment plan or prompted extra supports. Patients were followed to assess the incidence of toxicity during treatment.

Results

The study enrolled 199 patients between July 2016 and February 2018. Mean age was 77 years. Treatment was palliative in 61.4% of the group. Compared with physician judgment, the carg-tt predicted higher rates of toxicity. In 5 patients, treatment was changed based on the carg-tt. In 38.5% of the patients, data from the tool prompted extra supports. Within the first 3 cycles of treatment, 21.3% of patients had experienced grade 3 or greater toxicity.

Conclusions

This study demonstrates that use of a brief geriatric assessment tool is possible in a broad community oncology practice. The tool modified the oncologist's supportive care plan for a significant number of older patients undertaking cytotoxic chemotherapy.

Real-world benefit of nivolumab in a Canadian non-small-cell lung cancer cohort

Background

Nivolumab was the first immuno-oncology agent available for the treatment of lung cancer in Canada. In the present study, we evaluated the real-world benefit of nivolumab in Canadian patients with lung cancer.

Methods

Patients included in the cohort were identified from a registry of patients treated through expanded access to nivolumab before and after Health Canada approval. Demographics were collected from the application forms. Outcome data for the duration of treatment and survival were collected retrospectively.

Results

In contrast to the randomized clinical trial populations, our study cohort included patients who were older (median age: 66 years; range: 36-92 years) and who had an Eastern Cooperative Oncology Group performance status of 2 (8.9%). Despite the poorer-prognosis cohort, median overall survival was 12.0 months, which is comparable to the survival demonstrated in the randomized phase iii trials of nivolumab in lung cancer. Median time to treatment discontinuation was 3.45 months and was similar for all patient subgroups, including poorer-prognosis groups such as those with a performance status of 2, those 75 years of age and older, and those with brain metastases.

Conclusions

Nivolumab given in a real-world clinical setting was associated with results similar to those reported in the phase iii clinical trial setting.

Meeting the Needs of the Aging Population: The Canadian Network on Aging and Cancer—Report on the First Network Meeting, 27 April 2016

The aging of the Canadian population represents the major risk factor for a projected increase in cancer incidence in the coming decades. However, the evidence base to guide management of older adults with cancer remains extremely limited. It is thus imperative that we develop a national research agenda and establish a national collaborative network to devise joint studies that will help to accelerate the development of high-quality research, education, and clinical care and thus better address the needs of older Canadians with cancer. To begin this process, the inaugural meeting of the Canadian Network on Aging and Cancer was held in Toronto, 27 April 2016. The meeting was attended by 51 invited researchers and clinicians from across Canada, as well as by international leaders in geriatric oncology from the United States and France. The objectives of the meeting were to (1) review the present landscape of education, clinical care, and research in the area of cancer and aging in Canada; (2) identify issues of high research priority in Canada within the field of cancer and aging; (3) identify current barriers to geriatric oncology research in Canada and develop potential solutions; (4) develop a Canadian collaborative multidisciplinary research network between investigators to improve health outcomes for older adults with cancer; (5) learn from successful international efforts to stimulate the geriatric oncology research agenda in Canada. In the present report, we describe the education, clinical care, and research priorities that were identified at the meeting.

Effect of clay content and speed screw rotation on the crystallization and thermal behaviors of recycled PET/clay nanocomposites

Nanocomposites of recycled poly(ethylene terephthalate) (rPET) containing 2.5 wt% and 5.0 wt% of montmorillonite modified with organophilic quaternary ammonium salt (DELLITE 67G) were prepared by melt compounding using a co-rotating twin-screw type extruder with two organoclay contents were used: 2.5 wt% and 5.0 wt% and were prepared using two different rotation speeds: 150 and 250 rpm. Thermal characterization (analysis) of the nanocomposites was performed using differential scanning calorimetry (DSC) analysis. The results from DSC measurements showed that the addition of organoclay affects recycled PET's crystallization for two screw rotation speeds studies. The nucleating effect of organoclay was investigated. Morphological analysis using Transmission Electron Microscopy (TEM) revealed the presence of fully exfoliated clay platelets in samples prepared at 150 rpm.

Multiple pregnancy, multiple needs

Every year, more than 4,000 sets of twins and 80 sets of triplets are born in Canada. And those numbers are growing: Canadian women are two-and-a-half times more likely to have triplets, quadruplets or quintuplets today than 20 years ago, mainly due to increasing maternal age and the use of fertility drugs and reproductive technologies.

Nutrition and health status assessment of community-residing elderly in New York City: a pilot study

Ninety-five percent of persons over the age of 65 years live in the community and benefit from community-based health and nutrition services. The purpose of this project was to evaluate diet, function, and mental health in 40 men and women aged 65 years and older who were residing in a large metropolitan community. Nutritional status was assessed using two 24-hour recalls, 5 days of food records, a food frequency, and anthropometric measurements. Participants responded to standardized activities of daily living and instrumental activities of daily living instruments and an investigator-developed, performance-based appraisal of food preparation and management. Cognition and mood were assessed using the Folstein Mini-Mental Examination and the Yesavage Depression Scale. The nutrient intakes for individuals were compared with the Recommended Dietary Allowances (RDAs) and the Food Guide Pyramid. Mean energy intake was 1,625 kcal (range = 787 to 2,910 kcal); 7 persons consumed more than 2,000 kcal. The mean vitamin and mineral intake for participants met the RDAs except for calcium, vitamin D, zinc, and magnesium intakes. The average percentages of carbohydrate, protein, and fat were 53%, 16%, and 30%, respectively. Nutritional assessments of subjects with and without congregate meals were contrasted. Six of the 13 congregate-meal participants were at nutritional risk, compared with 6 of 27 not receiving congregate meals. The interrelationships of diet, functional status, and mental health factors were examined along with recommendations for future data collection in similar studies.

Participatory decision making: issues and guidelines

The concept of shared responsibility in decision making through the use of participatory decision making has received considerable support in nursing education. There are important omissions in the discussions and applications of this concept. Problems in the use of participatory decision making as related to information transmission; conflict, consensus, and coalitions; and faculty/administrator role differences are analyzed. Criteria and guidelines for the appropriate use of participatory decision making are provided.

The case for interdisciplinary collaboration

With the complexity of modern societal and health issues, and with the knowledge explosion and concomitant escalation of specialization and fragmentation, interdisciplinary collaboration and teamwork will take on ever-increasing importance in the years ahead. For cooperation to become a generally accepted policy, there needs to be full understanding of interdisciplinarity and what promotes or hinders it. Resocialization, training, and new skills will be required of educators, practitioners, and administrators. Only then will faculty participate in and teach, practitioners practice, and institutions support interdisciplinary collaboration.