Loss of Ftsj1 perturbs codon-specific translation efficiency in the brain and is associated with X-linked intellectual disability

FtsJ RNA 2'-O-methyltransferase 1 (FTSJ1) gene has been implicated in X-linked intellectual disability (XLID), but the molecular pathogenesis is unknown. We show that Ftsj1 is responsible for 2'-O-methylation of 11 species of cytosolic transfer RNAs (tRNAs) at the anticodon region, and these modifications are abolished in Ftsj1 knockout (KO) mice and XLID patient-derived cells. Loss of 2'-O-methylation in Ftsj1 KO mouse selectively reduced the steady-state level of tRNA^Phe in the brain, resulting in a slow decoding at Phe codons. Ribosome profiling showed that translation efficiency is significantly reduced in a subset of genes that need to be efficiently translated to support synaptic organization and functions. Ftsj1 KO mice display immature synaptic morphology and aberrant synaptic plasticity, which are associated with anxiety-like and memory deficits. The data illuminate a fundamental role of tRNA modification in the brain through regulation of translation efficiency and provide mechanistic insights into FTSJ1-related XLID.

Efficacy and safety of tisagenlecleucel in Japanese pediatric and young adult patients with relapsed/refractory B cell acute lymphoblastic leukemia

Tisagenlecleucel is an autologous T cell genetically modified ex vivo using a lentiviral vector encoding an anti-CD19 chimeric antigen receptor. Here, we present the efficacy and safety of tisagenlecleucel in a subgroup of Japanese patients with relapsed/refractory (r/r) B-cell acute lymphoblastic leukemia (ALL). ELIANA was a single-arm, open-label, multicenter, phase 2 study. Patients were aged ≥ 3 years at screening to ≤ 21 years at the time of diagnosis, and had ≥ 5% lymphoblasts in bone marrow at screening. Primary endpoint was overall remission rate [ORR; complete remission (CR) + CR with incomplete blood recovery (CRi)] within 3 months after infusion. As of April 13, 2018, eight patients were enrolled and six had been infused. ORR was 66.7% (95% confidence interval 22.3-95.7); three patients achieved CR and one patient had CRi. All patients with CR/CRi were negative for minimal residual disease. One patient had CR/CRi lasting 19.5 + months. Cytokine release syndrome (CRS) and neurological events occurred in 83% and 17% of patients, respectively. CRS resolved with anti-cytokine therapy and supportive care. Two deaths occurred due to disease progression. No cases of cerebral edema were observed. Tisagenlecleucel produced high remission rates and durable responses offering a new treatment option for Japanese pediatric and young adults with r/r B-ALL.

Phase I dose-escalation study of capmatinib (INC280) in Japanese patients with advanced solid tumors

Capmatinib is a highly specific, potent and selective MET inhibitor. This was an open‐label, multicenter, dose‐escalation, phase I study conducted in Japanese patients with advanced solid tumors (not selected based on their MET status). The primary objective was to determine the maximum tolerated dose (MTD) and/or highest studied dose being safe. Secondary objectives included safety, pharmacokinetics and preliminary antitumor activity. Dose escalation was guided by a Bayesian Logistic Regression Model dependent on dose‐limiting toxicities (DLT) in cycle 1. Of 44 adult Japanese patients with confirmed advanced solid tumors enrolled, 29 received capmatinib capsules (doses ranging from 100 mg once daily [q.d.] to 600 mg twice daily [b.i.d.]) and 15 received tablets (200 mg b.i.d. and 400 mg b.i.d.). DLT occurred in two patients: grade 2 suicidal ideation (600 mg b.i.d. capsule) and grade 3 depression (400 mg b.i.d. tablet). MTD was not reached. The highest studied dose determined to be safe as tablet was 400 mg b.i.d., whereas it is not yet determined for capsules. Most common adverse events suspected to be drug‐related were increased blood creatinine, nausea, decreased appetite, vomiting and diarrhea. Following repeated daily dosing up to day 15 by q.d. or b.i.d. regimen using capsules, median time to reach maximum plasma drug concentration (T_max) was 1.0‐4.0 hours; absorption was more rapid after dosing using tablets, with median T_max of 1.0 hour on both days 1 and 15. Eight patients had a best overall response of stable disease. These data support further clinical development of capmatinib.

Phase I study of alpelisib (BYL719), an α-specific PI3K inhibitor, in Japanese patients with advanced solid tumors

This phase I study aimed to determine tolerability and preliminary efficacy of single‐agent alpelisib (BYL719) in Japanese patients with advanced solid malignancies. The primary objective of the study was to estimate the maximum tolerated dose (MTD) and/or recommended phase II dose (RP2D) of oral alpelisib in patients with advanced solid tumors who had progressed despite standard therapy. The expansion part included patients with PIK3CA mutation/amplification; safety, preliminary efficacy, pharmacokinetic (PK)/pharmacodynamic profile, and food effect on the PK profile of alpelisib at the MTD/RP2D were determined. Oral alpelisib was given as a single agent on a continuous 28‐day treatment cycle once daily. Overall, 33 patients received alpelisib. Dose‐limiting toxicities were observed in 2 patients in the escalation part (at 400 mg/day) and 1 patient in the expansion part (at 350 mg/day). The RP2D of alpelisib was determined as 350 mg/day based on overall safety profile in the dose escalation part and previous data from a Western population; the MTD was not determined. The most common all‐grade treatment‐suspected adverse events were hyperglycemia and maculopapular rash (48.5% each) and diarrhea (45.5%). The PK of alpelisib in the Japanese population was similar to that reported in the Western population. The overall response rate, disease control rate, and median progression‐free survival at 350 mg/day were 3%, 57.6%, and 3.4 months, respectively. Alpelisib as single agent showed a favorable safety profile and encouraging preliminary efficacy in Japanese patients with advanced solid tumors.

A phase I study of single-agent BEZ235 special delivery system sachet in Japanese patients with advanced solid tumors

Purpose

BEZ235 is a dual kinase inhibitor of phosphatidylinositol 3-kinase (PI3K) and mammalian target of rapamycin, which are key components of the PI3K pathway. This was an open-label, multicenter, dose-escalation, phase I study of single-agent BEZ235 in Japanese oncology patients to determine the maximum tolerated dose (MTD) of BEZ235 based on dose-limiting toxicities (DLTs).

Methods

Dose escalation was guided by a standard 3 + 3 method and was based on DLTs observed in Cycle 1 and other safety, pharmacokinetic, and pharmacodynamic information. A total of 35 adult Japanese patients with advanced solid tumors received BEZ235 according to once daily (qd; n = 27) or twice daily (bid; n = 8) dosing schedules.

Results

Two DLTs, namely, allergic reaction and thrombocytopenia, were observed at 1200 and 1400 mg qd, respectively, while liver dysfunction was reported as a DLT at 400 mg bid. The most common adverse events suspected to be related to BEZ235 in both dosing schedules were diarrhea, nausea, decreased appetite, stomatitis, and thrombocytopenia.

Conclusions

Although the MTD was not established, the maximum clinically tolerable dose was determined to be 1200 mg because two out of six patients required dose reduction in Cycle 2. The recommended dose was determined to be 1000 mg qd, which was comparable with the results of the first-in-human BEZ235 study in Western patients with advanced solid tumors (NCT00620594). Additionally, the tolerability of BEZ235 400 mg bid in Japanese oncology patients was confirmed in this study.

ClinicalTrials.gov identifier

NCT01195376.

Electronic supplementary material

The online version of this article (10.1007/s00280-018-3725-2) contains supplementary material, which is available to authorized users.

Abstract A167: A phase I study of single-agent BEZ235 (SDS sachet), once- or twice-daily, in Japanese patients with advanced solid tumors

Background: BEZ235 is an oral, ATP-competitive inhibitor that targets class l PI3K and downstream effectors mTORC1/2. In previous phase I studies in mainly Western patients, the maximum tolerated dose (MTD) of single-agent BEZ235 solid dispersion system (SDS) sachet once daily (QD) was declared as 1200 mg and the recommended dose (RD) as 1000 mg; the MTD of the same formulation of BEZ235 twice daily (BID) was declared as 400 mg (Rodon EORTC-NCI-AACR 2012, Arkenau ASCO 2012). Here we present the results of a phase I, multicenter, open-label, dose escalation study of single-agent BEZ235 SDS sachet, administered QD or BID, in adult Japanese patients with advanced solid tumors (NCT01195376).

Methods: Patients with histologically confirmed, unresectable advanced solid tumors not amenable to standard therapy, received continuous oral BEZ235, QD or BID in 28-day cycles. The primary objective was to determine the MTD/RD of single-agent BEZ235 in adult Japanese patients, based on dose-limiting toxicity (DLT) using a standard 3+3 method for dose escalation. MTD was defined as the highest dose causing DLT in no more than 1/6 patients in Cycle 1. Secondary objectives included preliminary antitumor activity (RECIST v1), safety profiles (CTCAE v3), and pharmacokinetics (PK).

Results: As of Feb 10, 2013, 32 patients (mean age 58 yrs) were treated with BEZ235 at 2 dosing schedules; 27 patients received BEZ235 QD at 5 dose levels: 400, 800, 1000, 1200, or 1400 mg; and 5 patients received BEZ235 BID at 400 mg. 2 DLTs were reported with QD dosing: Grade 2 allergic reaction (1200 mg) and Grade 4 thrombocytopenia (1400 mg). Although equivalent DLT ratios were recorded at 1200 mg and 1400 mg (1/6 evaluable patients each), clinical observation led to 1200 mg being declared as the maximum, clinically tolerable dose and 1000 mg being declared as the RD of single-agent BEZ235 QD. The primary reason for discontinuation was disease progression (63%). Common suspected BEZ235-related AEs (≥40%) were diarrhea, decreased appetite, nausea, stomatitis, fatigue, vomiting, and rash; no difference in AE profile was observed between QD and BID schedules. Three patients experienced serious suspected BEZ235-related AEs: infectious enterocolitis, pneumonia, and diarrhea. No death related to treatment was reported. Best overall response was stable disease in 15/27 evaluable patients (56% disease control rate). After Feb 10, 2013, 3 additional patients were enrolled at 400 mg BID (8 in total) and 1 DLT (Grade 2 liver dysfunction) out of 6 evaluable patients was observed. PK data revealed a slow rate of absorption, less than dose-proportional exposure, and large interpatient variability for single-agent BEZ235 SDS sachet.

Conclusions: The maximum, clinically tolerable dose of BEZ235 QD was declared as 1200 mg and the RD was declared as 1000 mg, in agreement with previous studies in Western populations. In addition, the tolerability of 400 mg BEZ235 BID was confirmed. The findings of this first-in-Japanese study suggest no major difference in BEZ235 tolerability and PK profile between Japanese and Western populations.

Citation Information: Mol Cancer Ther 2013;12(11 Suppl):A167.

Citation Format: Koichiro Watanabe, Hironobu Minami, Satoshi Otsu, Yoshinori Hirashima, Ryotaro Morinaga, Kazuo Nishikawa, Yasushi Hisamatsu, Toru Mukohara, Naomi Kiyota, Naoko Chayahara, Masanori Toyoda, Yoshinori Imamura, Yutaka Fujiwara, Cornelia Quadt, Matthew Robson, Kazuto Natsume, Takuji Aoki, Kuniaki Shirao. A phase I study of single-agent BEZ235 (SDS sachet), once- or twice-daily, in Japanese patients with advanced solid tumors. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr A167.

Vertical-cavity organic lasers with distributed-feedback structures based on active Bragg reflectors

Optically pumped organic thin-film lasers were fabricated by stacking top and bottom Bragg reflectors with an inner-cavity active layer between the reflectors. We observed single-longitudinal-mode laser operation at 555 nm by doping pyrromethene-567 dye into all the stacked layers. The threshold of the laser was 30% less than that of a laser operated with nondoped Bragg reflectors, which was in good agreement with calculations.

Hippocampal theta-related cellular activity in the superior colliculus of the urethane-anesthetized rat

In the present study, 93 cells in the superior colliculus (SC) were recorded extracellularly during the simultaneous occurrence of spontaneous theta field activity, sensory-induced (tail pinch) theta field activity, and large amplitude irregular (LIA) field activity, recorded from an electrode located in the stratum moleculare of the hippocampal formation (HPC). The effect of the intravenous administration of atropine sulfate (ATSO4) was also tested on SC cellular activity. The field activities of theta and LIA were recorded from all layers of the SC and were found to be temporally coherent with the same activities recorded simultaneously from the HPC, during all conditions tested. By using the criteria of Colom and Bland (1987) for the classification of theta-related cells, 75 of 93 cells (81%) were found to be related to the generation of theta field activity in the HPC and 18 of 93 (19%) were nonrelated. All cells recorded discharged in a tonic, nonrhythmic pattern during the theta HPC field states. Of the 75 theta-related cells, 61 (81%) were classified as tonic theta-ON cells and 14 (19%) as tonic theta-OFF cells. Although these cell types were found in all three layers of the SC, the majority of tonic theta-ON cells were recorded in the intermediate layer, and the tonic theta-OFF cells were dispersed evenly between the intermediate layer and the deep layer of the SC. The intravenous administration of ATSO4 abolished theta field activity in the HPC and SC, and the theta-related increase in the discharge rate of all tonic theta-ON cells tested. However, the same treatment did not have any effect on the discharge properties of tonic theta-OFF cells. The same stimuli that resulted in the inhibition of the discharge rates of these cells (tail pinch and electrical stimulation of the PH) in the predrug condition did so after the administration of ATSO4.

Desynchronization of carbachol-induced theta-like activities by alpha-adrenergic agents in guinea pig hippocampal slices

The effect of alpha-adrenergic agents on theta-like activity (TLA) in guinea-pig hippocampal slices was studied. TLA was induced by a cholinergic agent, carbachol. TLA had a frequency of 4.66+/-0.08 Hz (mean+/-S.E.M.) and an amplitude of 96.3+/-8.3 microV in the dentate gyrus (DG). The alpha-adrenergic agents epinephrine and clonidine increased the frequency and decreased the amplitude of TLA in a concentration-dependent manner. The agents also increased antidromic and orthodromic population spike (PS) amplitudes of the granule cells, but did not have any effect on population EPSP. Another alpha-adrenergic agent, guanabentz, had the same effect as clonidine. The adenylate cyclase inhibitor SQ22536 suppressed the increase in PS amplitude by clonidine. The results suggest that these alpha2-adrenergic agents facilitate the activity of granule cells through the activation of the alpha2-adrenoreceptor and cAMP pathway, and the facilitation causes the desynchronization of TLA.

Suppression of pair-pulse depression of the population spike in the dentate gyrus during carbachol-induced theta-like activity in guinea pig hippocampal slices

In pair-pulse stimulation experiments, pair-pulse depression (PPD) of the population spike (PS) occurred at intervals shorter than 20 ms in the dentate gyrus in guinea pig hippocampal slices. Application of 50 microM carbachol resulted in an increase in the test PS amplitude and caused suppression of PPD. This suppression was antagonized by atropine sulfate, a muscarinic receptor antagonist. Carbachol at 50 microM induced intermittent bursts of theta-like activity (TLA). We compared the pair-pulse index (PPI) during TLA with that in a rest period between bursts of TLA. The PPI was defined as the ratio of the amplitude of the test PS to that of the conditioning PS. The PPI during TLA were significantly larger than that during the rest period, although there were no significant differences in the conditioning PS amplitude and the test pEPSP slope. When TLA was induced, the PPI during the rest period was increased by bicuculline. The PPI during TLA did not change significantly with the drug. The increase by bicuculline in the PPI during the rest period was caused by increase in the test PS amplitude. PPD can occur due to inhibition of granule cell activity by inhibitory neurons. Our findings suggest that the action of inhibitory neurons on granule cell activity is suppressed by activation of muscarinic receptors, with stronger suppression during TLA than during the rest period between bursts of TLA.

Theta-activity-dependent and -independent muscarinic facilitation of long-term potentiation in guinea pig hippocampal slices

Cholinergic input to the hippocampus originates in the septum and diagonal band. Guinea pig hippocampal slices in a bath of carbachol, a cholinergic agonist, displayed different patterns of rhythmical activities depending on the carbachol concentration. Exposure to 50 or 100 microM led to intermittent induction of theta-like activities (TLAs). Long-term potentiation (LTP), induced by tetanus. was facilitated at concentrations within the optimum range for generating TLAs. This facilitation was blocked by the muscarinic receptor antagonist atropine. Augmentation of LTP during TLAs was greater than that during the rest period of TLAs which, in turn, was greater than that induced without activation of the muscarinic receptors. These results suggest that there are two muscarinic facilitation processes of LTP, one dependent on and the other independent of TLAs, with the former being more easily facilitated than the latter.

Synthesis of novel poly(ethylene glycol) derivatives having pendant amino groups and aggregating behavior of its mixture with fatty acid in water

Novel poly(ethylene glycol) (PEG) derivatives having pendant amino groups were prepared by copolymerization of allyl glycidyl ether with ethylene oxide followed by chemical modification of the double bond side chains. Dropwise addition of the mixture of monomers to the anionic initiator gave an almost monodisperse (Mw/Mn = 1.05) random copolymer. 1H NMR spectra showed that addition of 2-aminoethanethiol to the pendant allyl groups of the copolymer was completely carried out in methanol without catalyst, and an aminated PEG derivative with a definite structure was obtained. Acetylation of the pendant amino groups was readily performed by acetic anhydride with triethylamine. A gel permeation chromatogram of the acetylated polymer showed a very narrow molecular weight distribution (Mw/Mn = 1.06) of the polyamine. These cationic PEG derivatives make amphiphilic polyion complexes with fatty acids, and then aggregate in water. A fluorescence study using pyrene as a microenvironment probe revealed that the aminated PEG-lauric acid ion complex could take up the hydrophobic fluorescence probe into the lipophilic field inside, and they also had a critical aggregation concentration at [lauric acid] = 0.7 mM. It is much lower than the critical micelle concentration of the corresponding fatty acid sodium salts, indicating high stability of the polymer-fatty acid aggregate.

[Extraction and purification of the three major vitamin D metabolites using C18 and NH2 cartridges and measurement of 25-hydroxyvitamin D]

In this study, the three major vitamin D metabolites: 25-hydroxyvitamin D [25(OH)D], 24,25-dihydroxy-vitamin D [24,25(OH)2D], 1,25-dihydroxyvitamin D [1,25(OH)2D] were clearly separated using a NH2 cartridge after acetonitrile and C18 cartridge extraction. In the NH2 cartridge purification procedure, 25(OH)D was eluted with hexane/dichloromethane (50:50), 24,25(OH)2D was eluted with hexane/dichloromethane (20:80) and 1,25(OH)2D was eluted with hexane/isopropanol (75:25). Contamination of each fraction with two other metabolites were less than 1.4%. Recoveries of added 3H-25(OH)D, 3H-24,25-(OH)2D and 3H-1,25(OH)2D were 73.2 +/- 2.45%, 60.0 +/- 2.98% and 63.5 +/- 3.37%, respectively. Using the 25(OH)D fraction after the NH2 cartridge procedure, we measured 25(OH)D using a competitive protein binding assay. The intra- (n = 10) and interassay (n = 8) coefficients of variation were 4.60-8.41% and 6.62-16.4%, respectively. Analytical recovery of added 25(OH)D was in the range of 81.2-130%. The 25(OH)D values were 17.4 +/- 6.02 ng/ml (mean +/- SD) in serum from 110 healthy volunteer collected in May. The correlation of 25(OH)D values was good between cartridge purification and high performance liquid chromatography (HPLC) purification. (gamma = -0.38 + 1.03x, r = 0.953, n = 36). This purification using a simple cartridge procedure was suitable for the measurement of 25(OH)D, and preferable to the time-consuming HPLC purification.

Cutaneous vasodilatation responses synchronize with sweat expulsions

To examine whether cutaneous active vasodilatation is mediated by sudomotor nerve fibres we recorded cutaneous blood flow and sweat rates continuously with laser-Doppler flowmetry and capacitance hygrometry, respectively, from the dorsal and plantar aspects of the foot in 11 male subjects at varying ambient temperatures (Ta) between 22 and 40 degrees C (relative humidity 40%). In a warmer environment (Ta 29-40 degrees C), predominant responses of the blood flow curve from the sole of the foot were transient depressions (negative blood flow responses, NBR), whereas those from the dorsal foot were transient increases (positive blood flow responses, PBR). The PBR on the dorsal foot occurred spontaneously or in response to mental or sensory stimuli, and when PBR did not fuse with each other the rate of PBR was linearly related to tympanic temperature. When dorsal foot sweating was continuous, PBR on the dorsal foot almost entirely synchronized with sweat expulsion. When dorsal foot sweating was intermittent PBR sometimes occurred on the dorsal foot without corresponding sweat expulsions, but these PBR showed a complete correspondence with subthreshold sweat expulsion seen on a methacholine-treated area. The amplitude and the duration of PBR showed a significant linear relationship with the amplitude and the duration of the corresponding sweat expulsion. In a thermoneutral or cooler environment (Ta 22-29 degrees C), PBR occurred on the sole of the foot when mental or sensory stimuli elicited sweating in that area. Thus, PBR occurred when and where sweating appeared. Atropine failed to abolish PBR on the dorsal foot. Blockade of the peroneal nerve eliminated both PBR and NBR on the dorsal foot.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of body and head positions on bilateral difference in tympanic temperatures

We have examined the nonparallel changes in tympanic membrane temperatures (Tty) from the two ears in response to various changes in body and head positions. Upon assuming a lateral recumbent position, the Tty on the lower side increased while that on the upper side decreased. Pressure application over a wide area of the lateral chest only caused inconsistent and obscure asymmetric changes in Tty. A lateral flexion of the head with the subject sitting upright and a rotation of the head to the side in a supine position induced an increase in the Tty on the lower side compared to that on the upper side. The temperature and blood flow of the forehead often decreased on the lower side and increased on the upper side, although such responses were not always concomitant with the asymmetric changes in Tty. A dorsal flexion of the head with the subject in a reclining position caused a slight increase in the Tty, whereas raising the head upright induced a slight decrease in them. Two additional experiments were carried out with single photon emission computed tomography using 99mTc-hexamethylpropyleneamine oxime as tracer, and a slight, relative decrease in counts was noted in the right hemisphere during rotation of the head to the right. These results would strongly suggest that unilateral increases and decreases in Tty could have been caused by one-sided decreases and increases, respectively, in blood flow to the brain and/or the tympanic membrane, induced by a vasomotor reflex involving vestibular stimulation.

Information propagation by spatio-temporal pattern change of Ca2+ concentration throughout Physarum polycephalum with repulsive stimulation

The development of a spatio-temporal pattern of Ca2+ concentration (Ca2+ pattern) in the plasmodium of Physarum polycephalum during repulsive response was studied using fura-2. In the migrating cell, the gradient of the Ca2+ concentration (Ca2+ gradient) immediately showed a decrease in local concentration in the area (S-site) stimulated by 50 mM KCl. The concentration rose and then decreased in a site neighboring the S-site. This transient increase of Ca2+ concentration, the duration of which was approx. 10 minutes, was propagated to the site most distant from the S-site. There, the Ca2+ concentration gradually rose and remained at a high level. Twenty-five minutes after stimulation, a new Ca2+ gradient was established throughout the plasmodium. The migratory direction of the cell as a whole then changed. In this process, although the period of Ca2+ oscillation changed at the S-site, this change was only local to the site. During the information processing of the local repulsive stimulus, the transient Ca2+ increase propagated the local information about the stimulus to the non-stimulation sites (NS-sites), leading to the generation of a new pattern and the start of coordinated migration of the plasmodium.

Seasonal changes of circadian pattern in human rectal temperature rhythm under semi-natural conditions

A phase delay of the circadian rectal temperature rhythm existed in three human subjects leading normal lives under semi-natural conditions: the rectal temperature began to increase later in summer than in the other three seasons.

[Atrophic macular degeneration in a patient with olivopontocerebellar atrophy]

Description of a man with heredoataxia, presenting with an isolated primary atrophic maculopathy in which the participation of the posterior pole was disclosed by photopic and scotopic ERG irrespective of the localized appearance of this condition. Ophthalmoscopically, the patient's sister showed only fine pigment migrations at the macula, whereas local ERG revealed a macular lesion.