Antimicrobial Efficacy of Allium cepa and Zingiber officinale Against the Milk-Borne Pathogen Listeria monocytogenes

Listeria monocytogenes is an important food-borne pathogen that causes listeriosis and has a high case fatality rate despite its low incidence. Medicinal plants and their secondary metabolites have been identified as potential antibacterial substances, serving as replacements for synthetic chemical compounds. The present studies emphasize two significant medicinal plants, Allium cepa and Zingiber officinale, and their efficacy against L. monocytogenes. Firstly, a bacterial isolate was obtained from milk and identified through morphology and biochemical reactions. The species of the isolate were further confirmed through 16S rRNA analysis. Furthermore, polar solvents such as methanol and ethanol were used for the extraction of secondary metabolites from A. cepa and Z. officinale. Crude phytochemical components were identified using phytochemical tests, FTIR, and GC-MS. Moreover, the antibacterial activity of the crude extract and its various concentrations were tested against L. monocytogenes. Among all, A. cepa in methanolic extracts showed significant inhibitory activity. Since, the A. cepa for methanolic crude extract was used to perform autography to assess its bactericidal activity. Subsequently, molecular docking was performed to determine the specific compound inhibition. The docking results revealed that four compounds displayed strong binding affinity with the virulence factor Listeriolysin-O of L. monocytogenes. Based on the above results, it can be concluded that the medicinal plant A. cepa has potential antibacterial effects against L. monocytogenes, particularly targeting its virulence.

Abstract P2-21-10: Tumour associated macrophages in Breast Cancer - Are they critical players in response to Neo Adjuvant Chemotherapy?

Background Breast Cancer (BC) patients who do not obtain pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) present higher rate of relapse and worse overall survival. Recent evidence suggests that chemotherapy (CT) efficacy relies on the capacity of chemotherapeutic agents to interact with the immune system. BC features a unique tumor microenvironment (TME) comprising of multiple immune cell types including Macrophages that share a double-edged relationship with cancer as they get polarised from M1 (anti-tumour) to M2 (Pro-tumour). Pro-tumour M2 macrophages are referred to as tumor-associated macrophages (TAMs) and are implicated extensively in angiogenesis, metastasis and therapy resistance. Establishing role of TAMs, facilitates the emergence of novel strategies that exploit them as theranostic targets/tools of interest for treating cancer. Utility of using Drugs like Zoledronic Acid, Trabectedin, Rebastinib in combination with 5-fu have shown promising anti-TAM activity and improved response to CT in clinical trials. In this study, we have characterized presence of M2-TAM and its correlation to NACT response in matched primary and residual tumours by examining expression of several biomarkers. Methods Treatment naïve primary and their matched residual tumour specimens from 45 women treated at a single center were accessed through IERB approved protocols. The study included locally advanced HR+HER2-ve and TNBC tumours treated with standard NACT regimes between 2018 to 2020. To determine the association of TAM population with response to NACT, expression levels of CD68 (pan macrophage marker) & CD163 (marker of М2 macrophages), were detected by immunohistochemistry (IHC) and represented as combined H score. We also performed gene expression of chemokines, inflammatory cytokines and interleukins involved in M1-M2 polarization by q-RT-PCR. Residual Cancer Burden Scoring was used to assess response and patients were divided into three groups (complete responders, partial responders and non-responders). Univariate and multi variate analysis were performed between gene expression groups and IHC groups with clinicopathological parameters. Findings from this study was validated on public data bases like TCGA, METABRIC and GEO. Results: 20% of all patients included in the study were complete responders. We arrived at a Macrophage Polarisation Score (MPS) by Gene expression and also a combined H score by IHC. MPS and H-score had a positive correlation (p=0.083) overall. Interestingly, Combined analysis of H-Score and MPS with response to treatment showed a greater and statistically significant correlation with residual tumours as compared to treatment naïve tumours (p=0.009). We also observed that high MPS and high combined H score in residual tumours were associated with increased tumour size and LVI (p=0.055 and p=0.03). Other clinicopathological parameters like receptor status, grade and stage at diagnosis were not significantly associated with H score or MPS. Taken together we found that 11% of patients who exhibited high TAM score by both H sascore and MPS fell into the non-responders category. We therefore report TAMs in residual tumours being more indicative for response to therapy compared to primary tumours. Conclusion Although primary tumours are useful for building predictive models to therapy response, we have demonstrated that there is utility in examining residual tumours as well for choice to adjuvant chemotherapy, since the tumour is constantly evolving through the NACT period. More work to arrive at a “TAM score” that could aid in choice of additional adjuvant treatment strategies is underway. We believe our work is helping us to move one step closer to Precision Medicine in a low and middle income country like India that has a higher burden of locally advanced disease. Our analysis also lends itself to becoming a clinical test since it is performed on an FFPE specimen

Citation Format: Lohita Krishna, Aruna Korlimarla, B S Srinath, Anugnya Ranjolkar, Sudipta Nascar, Hari PS, Durga Devi, Nidhi l, Rekha V Kumar. Tumour associated macrophages in Breast Cancer - Are they critical players in response to Neo Adjuvant Chemotherapy? [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-21-10.

ApoA-I Nanotherapy Rescues Postischemic Vascular Maladaptation by Modulating Endothelial Cell and Macrophage Phenotypes in Type 2 Diabetic Mice

BACKGROUND

Diabetes is a major risk factor for peripheral arterial disease. Clinical and preclinical studies suggest an impaired collateral remodeling and angiogenesis in response to atherosclerotic arterial occlusion in diabetic conditions, although the underlying mechanisms are poorly understood.

OBJECTIVE

To clarify the cellular and molecular mechanisms underlying impaired postischemic adaptive vascular responses and to evaluate rHDL (reconstituted HDL)-ApoA-I nanotherapy to rescue the defect in type 2 diabetic mouse model of hindlimb ischemia.

METHODS AND RESULTS

Hindlimb ischemia was induced by unilateral femoral artery ligation. Collateral and capillary parameters together with blood flow recovery were analyzed from normoxic adductor and ischemic gastrocnemius muscles, respectively, at day 3 and 7 post-ligation. In response to femoral artery ligation, collateral lumen area was significantly reduced in normoxic adductor muscles. Distally, ischemic gastrocnemius muscles displayed impaired perfusion recovery and angiogenesis paralleled with persistent inflammation. Muscle-specific mRNA sequencing revealed differential expression of genes critical for smooth muscle proliferation and sprouting angiogenesis in normoxic adductor and ischemic gastrocnemius, respectively, at day 7 post-ligation. Genes typical for macrophage (Mϕ) subsets were differentially expressed across both muscle types. Cell-specific gene expression, flow cytometry, and immunohistochemistry revealed persistent IFN-I response gene upregulation in arterial endothelial cells, ECs and Mϕs from T2DM mice associated with impaired collateral remodeling, angiogenesis and perfusion recovery. Furthermore, rHDL nanotherapy rescued impaired collateral remodeling and angiogenesis through dampening EC and Mϕ inflammation in T2DM mice.

CONCLUSIONS

Our results suggest that an impaired collateral remodeling and sprouting angiogenesis in T2DM mice is associated with persistent IFN-I response in ECs and Mϕs. Dampening persistent inflammation and skewing ECs and Mϕ phenotype toward less inflammatory ones using rHDL nanotherapy may serve as a potential therapeutic target for T2DM peripheral arterial disease.

Frequency of Celiac Disease in Type 1 Diabetic Children Presenting at Tertiary Care People Medical College Hospital Nawabshah Pakistan

Objective: The goal of this research has been to find out how common celiac disease is in type 1 children with type 1 diabetes who visit multispecialty hospitals. Methodology: This was a cross-sectional research. This study was directed at Pediatric Medicine Department, Mother and Child Healthcare (M&CH) ⁄ People Medical College (PMC) Hospital Nawabshah Shaheed Benazeerabad. The length of research was from 07/09/2020 to 06/03/2021, (6 months) next to the authorization of synopsis. Current research included 124 children of together sex aged between 1 to 12 years diagnosed of Type-I diabetes mellitus who were assessed for concomitant presence of celiac disease which was labeled on duodenal biopsy revealing crypt hyperplasia and villous atrophy. Frequency of celiac disease was noted and compared across various subgroups of diabetic children based on age, gender, duration of diabetes, BMI and glycemic control. Each kid's parents signed written consent form. Results: The average ages of the children were 8.6±2.6 years. The majority of the children (n=68, 54.8 %) were aged 10 and over, preceded by kids aged 6-9 years (36.3 %), and children aged less than 5 years (08.9%). There were 56 (45.2%) boys and 68 (54.8%) girls with boys to girls ratio of 1.1.2. The average lengths of diabetes were 03.2±1.4 year. 51 (41.1%) children had poor glycemic control (HbA1c ≥8.0%). Celiac disease were established in 14 (11.3%) youngsters having Type-I diabetes. Statistically no substantial variance in the frequency of celiac disease across various subgroups of Type-I diabetic children based on age (p =0.966), sex (p =0.854), length of diabetes (p-value=0.985), BMI (p =0.835) & status of glycemic control (p =0.889). Conclusion: A significant number of children with Type I diabetes had celiac disease in the current study, indicating that regular screening of diabetic children is necessary for prompt detection and management of celiac disease in upcoming clinical settings.

Homocysteine Levels in Acute Ischemic Stroke

Objective: The objective of this study was to determine the frequency of elevated homocysteine levels in acute ischemic stroke patients presenting to the medical department, civil hospital, Nawabshah. Methodology: A cross-sectional study was conducted at the Department of Medicine Civil Hospital, Nawabshah from 13/02/2021 to 12/08/2021. It included ischemic stroke patients and evaluated their homocysteine levels (≥15µmol/L were elevated). Homocysteine levels was compared then in relation with the other sub-groups of patients based on the age group, gender and obesity, smoking, hypertensive and diabetic status, and hyperlipidemia. Results: There were 171 (64.5%) males and 94 (35.5%) females with mean age 49.9 ± 5.8 years Elevated levels of homocysteine were recorded in 140 (52.8%) patients with acute ischemic stroke. The frequency of elevated levels of homocysteine across various subgroups of patients in relation to age, gender, obesity, smoking, hypertension, diabetes, and hyperlipidemia was found to be insignificant. Conclusion: The findings of this study show patients with acute ischemic stroke had elevated levels of homocysteine which suggests potential implications of homocysteine level assessment in the diagnostic workup as well as risk stratification and management planning of patients with acute ischemic stroke presenting in future medical practice.

Subcutaneous Panniculitis-Like T Cell Lymphoma: Approach to Differential Diagnosis on Cytology

Sighting a case of subcutaneous panniculitis-like T cell lymphoma (SPTCL) in cytology is very rare in a clinical scenario. Among the differential diagnoses (D/D) of a subcutaneous nodule undergoing fine needle aspiration cytology (FNAC), it is hardly considered in the list. The common D/D on cytology would be panniculitis or a non-SPTCL lymphoma. To make a correct cytological diagnosis, the pathologist has to meticulously observe the type of inflammatory infiltrate, their morphology, the intimate admixture of the fat lobules, and background necrosis or macrophages. This article describes the cytological picture, D/D, and the prognostic factors associated with SPTCL in a young male. He was suspected of SPTCL after FNAC and later confirmed on histopathology with specific immunomarkers. We do not recommend the confirmation of SPTCL on cytology however, we would like to stress that it can be picked up and differentiated from its mimickers on FNAC.

A complete duplication of the right and a segmental duplication of the left great saphenous vein - a case report

Abnormalities of the lower limb veins lead to venous disorders such as obstructive or the ones associated with venous insufficiency. Varicose veins, deep vein thrombosis and ulcers are the common disorders. As many variations are noted in veins in comparison to arteries, the present case report expresses the need for a detailed evaluation of the veins of the lower limb. During the routine dissection of a 65 year old male cadaver, a complete duplication of the Great Saphenous vein (GSV) was noted from the medial malleolus of the tibia till the saphenofemoral junction in the right lower limb and a segmental duplication was noted in the thigh region of left lower limb. Such findings would be of great value to surgeons, orthopaedicians and interventional radiologists as iatrogenic varicosity can be prevented and for cardiovascular surgeons who can use the duplicated vein as vascular grafts in cases of Ischemia and arterial blocks.

A questionnaire-based study on the role of environmental factors in allergic bronchopulmonary aspergillosis

Background and Aims:

Allergic bronchopulmonary aspergillosis (ABPA) is an immunological disorder caused by hypersensitivity against Aspergillus fumigatus. The pathogenesis of ABPA remains unknown. Few studies have investigated the role of environmental factors in pathogenesis of ABPA. Herein, we investigate the role of environmental factors in ABPA.

Materials and Methods:

In this prospective case-control study, consecutive patients with asthma (Aspergillus sensitized and unsensitized) and ABPA were investigated using a standardized questionnaire to enquire into their demographic characteristics, clinical details, exposure to organic matter and living conditions (home environment, presence of moisture in the walls, and others). Asthma severity and control was assessed using the 2002 The Global Initiative for Asthma (GINA) recommendations and asthma control test, respectively.

Results:

During the study period, 202 subjects of asthma (103 and 99 Aspergillus unsensitized and sensitized asthma, respectively) and 101 ABPA with a mean (SD) age of 35.3 (14.7) years were included. The baseline characteristics were similar in the two groups except for a higher prevalence of severe persistent asthma in the ABPA group (79% vs. 44%, P = 0.0001). No significant differences in environmental factors were noted in the ABPA population compared to asthmatic patients except for a higher rural residence in ABPA (47% vs. 66%, P = 0.007).

Conclusions:

The study found no significant environmental differences in ABPA compared to asthmatic patients. It is likely that environmental factors are not the primary pathogenetic factors in causation of ABPA.