mRNA-based vaccines and therapeutics: an in-depth survey of current and upcoming clinical applications

mRNA-based drugs have tremendous potential as clinical treatments, however, a major challenge in realizing this drug class will promise to develop methods for safely delivering the bioactive agents with high efficiency and without activating the immune system. With regard to mRNA vaccines, researchers have modified the mRNA structure to enhance its stability and promote systemic tolerance of antigenic presentation in non-inflammatory contexts. Still, delivery of naked modified mRNAs is inefficient and results in low levels of antigen protein production. As such, lipid nanoparticles have been utilized to improve delivery and protect the mRNA cargo from extracellular degradation. This advance was a major milestone in the development of mRNA vaccines and dispelled skepticism about the potential of this technology to yield clinically approved medicines. Following the resounding success of mRNA vaccines for COVID-19, many other mRNA-based drugs have been proposed for the treatment of a variety of diseases. This review begins with a discussion of mRNA modifications and delivery vehicles, as well as the factors that influence administration routes. Then, we summarize the potential applications of mRNA-based drugs and discuss further key points pertaining to preclinical and clinical development of mRNA drugs targeting a wide range of diseases. Finally, we discuss the latest market trends and future applications of mRNA-based drugs.

The value of disease-free survival (DFS) and osimertinib in adjuvant non-small-cell lung cancer (NSCLC): an international Delphi consensus report

Background

Rates of disease recurrence and death following surgery remain high in early-stage non-small-cell lung cancer (NSCLC), despite adjuvant treatment and curative intent. Recently, osimertinib showed overwhelming evidence for disease-free survival (DFS), as demonstrated by an overall reduction in the risk of disease recurrence or death in the adjuvant setting of 80% versus control in the ADAURA study (stage IB-IIIA; hazard ratio 0.20; 99.12% confidence interval 0.14-0.30; P < 0.001). However, due to the early unblinding of ADAURA and lack of mature overall survival data, there is a need to qualitatively confirm consensus on the clinical and patient relevance of DFS.

Materials and methods

We conducted a modified Delphi panel study consisting of two rounds of surveys, followed by a consensus meeting. An international panel of experts in the field of NSCLC and epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) (n = 13) was asked to rate agreement and comment on a list of pre-defined statements covering key consensus gaps. Statements were eliminated or updated between surveys, depending on the level of agreement. A final list of agreed-upon statements was drafted in the consensus meeting.

Results

Consensus was reached on 32 qualitative statements, with topics including unmet needs in early-stage NSCLC, the value of DFS, and the value of osimertinib. Crucially, DFS was agreed to be a clinically and patient-relevant endpoint in adjuvant NSCLC. The relevance of DFS was found to relate to the ability of an adjuvant therapy, such as osimertinib, to keep patients in the clinically valuable curative intent setting, while preventing the burden associated with distant and locoregional recurrence, and progressive disease.

Conclusions

Addressing the need for measures that reflect clinical benefit is essential to continue improving outcomes for NSCLC patients. To that end, this work provides a qualitative framework for clinicians to consider the clinical and patient relevance of DFS in adjuvant NSCLC and the benefit demonstrated in ADAURA thus far.

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There is a need for qualitative consensus assessment of the clinical and patient relevance of DFS in the adjuvant setting.

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An international panel of experts viewed DFS as a clinically and patient-relevant endpoint in adjuvant NSCLC.

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DFS relevance in adjuvant therapy, e.g. osimertinib, relates to keeping early-stage patients in a curative intent setting.

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Curative intent prevents or significantly delays locoregional and distant (CNS) recurrence burden and progressive disease.

A booster dose of Delta × Omicron hybrid mRNA vaccine produced broadly neutralizing antibody against Omicron and other SARS-CoV-2 variants

BACKGROUND

With the continuous emergence of new SARS-CoV-2 variants that feature increased transmission and immune escape, there is an urgent demand for a better vaccine design that will provide broader neutralizing efficacy.

METHODS

We report an mRNA-based vaccine using an engineered "hybrid" receptor binding domain (RBD) that contains all 16 point-mutations shown in the currently prevailing Omicron and Delta variants.

RESULTS

A booster dose of hybrid vaccine in mice previously immunized with wild-type RBD vaccine induced high titers of broadly neutralizing antibodies against all tested SARS-CoV-2 variants of concern (VOCs). In naïve mice, hybrid vaccine generated strong Omicron-specific neutralizing antibodies as well as low but significant titers against other VOCs. Hybrid vaccine also elicited CD8+/IFN-γ+ T cell responses against a conserved T cell epitope present in wild type and all VOCs.

CONCLUSIONS

These results demonstrate that inclusion of different antigenic mutations from various SARS-CoV-2 variants is a feasible approach to develop cross-protective vaccines.

Visualization of Cytosolic Galectin Accumulation Around Damaged Vesicles and Organelles

Galectins are animal lectins that recognize β-galactoside and bind glycans. Recent studies have indicated that cytosolic galectins recognize cytosolically exposed glycans and accumulate around endocytic vesicles or organelles damaged by various disruptive substances. Accumulated galectins engage other cytosolic proteins toward damaged vesicles, leading to cellular responses, such as autophagy. Disruptive substances include bacteria, viruses, particulate matters, and protein aggregates; thus, this process is implicated in the pathogenesis of various diseases. In this chapter, we describe methods for studying three disruptive substances: photosensitizers, Listeria monocytogenes, and Helicobacter pylori. We summarize the tools used for the detection of cytosolic galectin accumulation around damaged vesicles.

Intracellular galectins sense cytosolically exposed glycans as danger and mediate cellular responses

Galectins are animal lectins that recognize carbohydrates and play important roles in maintaining cellular homeostasis. Recent studies have indicated that under a variety of challenges, intracellular galectins bind to host glycans displayed on damaged endocytic vesicles and accumulate around these damaged organelles. Accumulated galectins then engage cellular proteins and subsequently control cellular responses, such as autophagy. In this review, we have summarized the stimuli that lead to the accumulation of galectins, the molecular mechanisms of galectin accumulation, and galectin-mediated cellular responses, and elaborate on the differential regulatory effects among galectins.

Intracellular galectins control cellular responses commensurate with cell surface carbohydrate composition

Galectins are β-galactoside-binding animal lectins primarily found in the cytosol, while their carbohydrate ligands are mainly distributed in the extracellular space. Cytosolic galectins are anticipated to accumulate on damaged endocytic vesicles through binding to glycans initially displayed on the cell surface and subsequently located in the lumen of the vesicles, and this can be followed by cellular responses. To facilitate elucidation of the mechanism underlying this process, we adopted a model system involving induction of endocytic vesicle damage with light that targets the endocytosed amphiphilic photosensitizer disulfonated aluminum phthalocyanine. We demonstrate that the levels of galectins around damaged endosomes are dependent on the composition of carbohydrates recognized by the proteins. By super resolution imaging, galectin-3 and galectin-8 aggregates were found to be distributed in distinct microcompartments. Importantly, galectin accumulation is significantly affected when cell surface glycans are altered. Furthermore, accumulated galectins can direct autophagy adaptor proteins toward damaged endocytic vesicles, which are also significantly affected following alteration of cell surface glycans. We conclude that cytosolic galectins control cellular responses reflect dynamic modifications of cell surface glycans.

Incidence and mortality of nasopharyngeal carcinoma: interim analysis of a cluster randomized controlled screening trial (PRO-NPC-001) in southern China

BACKGROUND

Previous mass screening studies have shown that IgA antibodies against Epstein-Barr Virus (EBV) can facilitate early detection of nasopharyngeal carcinoma (NPC), but the impact of EBV-antibody screening for NPC-specific mortality remains unknown.

PATIENTS AND METHODS

A prospective, cluster randomized, controlled trial for NPC screening (PRO-NPC-001) was conducted in 3 selected towns of Zhongshan City and 13 selected towns of Sihui City in southern China beginning in 2008. Serum samples of the screening group were tested for two previously selected anti-EBV antibodies. Subjects with serological medium risk were subsequently retested annually for 3 years, and those with serological high risk were referred to otorhinolaryngologists for diagnostic check-up. An interim analysis was carried out to evaluate the primary end points of the NPC-specific mortality and the early diagnostic rate, and the secondary end point of the NPC incidence, through linkage with the database of Zhongshan City.

RESULTS

Among 70 296 total subjects, 29 413 screened participants (41.8% of the total subjects) in the screening group and 50 636 in the control group, 153 (43.3 per 100 000 person-year), 62 (55.3 per 100 000 person-year) and 99 (33.1 per 100 000 person-year) NPC cases were identified. The early diagnostic rates of NPC were significantly higher in the participants (79.0%, P < 0.0001) and the screening group (45.9%, P < 0.0001) compared with the control group (20.6%). Although no differences were found between NPC-specific mortality of the screening group and the control group [relative risk (RR)= 0.82, 95% confidence interval (CI) 0.37-1.79], lower NPC-specific mortality was noticed among participants from the screening group versus the control group (RR = 0.22, 95% CI 0.09-0.49).

CONCLUSION

IgA antibodies against EBV can identify high-risk population and was effective in screening for early asymptomatic NPC. Although the mortality reduction was not significant in the primary end point, we noted encouraging evidence of a mortality reduction in screening participants in this interim analysis.

CLINICAL TRIAL NUMBER

NCT00941538.

Hyperprogressive disease during PD-1/PD-L1 blockade in patients with non-small-cell lung cancer

BACKGROUND

Immune checkpoint blockade with Programmed cell death 1 (PD-1)/PD-L1 inhibitors has been effective in various malignancies and is considered as a standard treatment modality for patients with non-small-cell lung cancer (NSCLC). However, emerging evidence show that PD-1/PD-L1 blockade can lead to hyperprogressive disease (HPD), a flair-up of tumor growth linked to dismal prognosis. This study aimed to evaluate the incidence of HPD and identify the determinants associated with HPD in patients with NSCLC treated with PD-1/PD-L1 blockade.

PATIENTS AND METHODS

We enrolled patients with recurrent and/or metastatic NSCLC treated with PD-1/PD-L1 inhibitors between April 2014 and November 2018. Clinicopathologic variables, dynamics of tumor growth, and treatment outcomes were analyzed in patients with NSCLC who received PD-1/PD-L1 blockade. HPD was defined according to tumor growth kinetics (TGK), tumor growth rate (TGR), and time to treatment failure (TTF). Immunophenotyping of peripheral blood CD8+ T lymphocytes was conducted to explore the potential predictive biomarkers of HPD.

RESULTS

A total of 263 patients were analyzed. HPD was observed in 55 (20.9%), 54 (20.5%), and 98 (37.3%) patients according to the TGK, TGR, and TTF. HPD meeting both TGK and TGR criteria was associated with worse progression-free survival [hazard ratio (HR) 4.619; 95% confidence interval (CI) 2.868-7.440] and overall survival (HR, 5.079; 95% CI, 3.136-8.226) than progressive disease without HPD. There were no clinicopathologic variables specific for HPD. In the exploratory biomarker analysis with peripheral blood CD8+ T lymphocytes, a lower frequency of effector/memory subsets (CCR7-CD45RA- T cells among the total CD8+ T cells) and a higher frequency of severely exhausted populations (TIGIT+ T cells among PD-1+CD8+ T cells) were associated with HPD and inferior survival rate.

CONCLUSION

HPD is common in NSCLC patients treated with PD-1/PD-L1 inhibitors. Biomarkers derived from rationally designed analysis may successfully predict HPD and worse outcomes, meriting further investigation of HPD.

Enhancing protein fluorescence detection through hierarchical biometallic surface structuring

The enhancement of bovine serum albumin (BSA) fluorescence detection using a hierarchical laser-induced periodic surface structure (LIPSS) at the TC4 titanium alloy substrate was experimentally demonstrated. The hierarchical structure, including microgrooves, submicrometer LIPSS, and nanoparticles, has been achieved by a femtosecond laser. Due to the surface plasmon polariton induced by the LIPSS and localized surface plasmon resonance induced by nanoparticles, the enhancement factor of BSA fluorescence detection reached 74. Further, a good linear relationship between the concentration of copper ion inside and BSA fluorescence intensity was found in the range between 5 and 35 μg/mL. Our method explores a simple, reproducible, and pollution-free technique for surface-enhanced fluorescence.

Galectin-3 Enhances Avian H5N1 Influenza A Virus-Induced Pulmonary Inflammation by Promoting NLRP3 Inflammasome Activation

Highly pathogenic avian influenza A H5N1 virus causes pneumonia and acute respiratory distress syndrome in humans. Virus-induced excessive inflammatory response contributes to severe disease and high mortality rates. Galectin-3, a β-galactoside-binding protein widely distributed in immune and epithelial cells, regulates various immune functions and modulates microbial infections. Here, we describe galectin-3 up-regulation in mouse lung tissue after challenges with the H5N1 influenza virus. We investigated the effects of endogenous galectin-3 on H5N1 infection and found that survival of galectin-3 knockout (Gal-3KO) mice was comparable with wild-type (WT) mice after infections. Compared with infected WT mice, infected Gal-3KO mice exhibited less inflammation in the lungs and reduced IL-1β levels in bronchoalveolar lavage fluid. In addition, the bone marrow-derived macrophages (BMMs) from Gal-3KO mice exhibited reduced oligomerization of apoptosis-associated speck-like proteins containing caspase-associated recruitment domains and secreted less IL-1β compared with BMMs from WT mice. However, similar levels of the inflammasome component of nucleotide oligomerization domain-like receptor protein 3 (NLRP3) were observed in two genotypes of BMMs. Co-immunoprecipitation data indicated galectin-3 and NLRP3 interaction in BMMs infected with H5N1. An association was also observed between galectin-3 and NLRP3/apoptosis-associated speck-like proteins containing caspase-associated recruitment domain complex. Combined, our results suggest that endogenous galectin-3 enhances the effects of H5N1 infection by promoting host inflammatory responses and regulating IL-1β production by macrophages via interaction with NLRP3.

Co-clinical trials demonstrate predictive biomarkers for dovitinib, an FGFR inhibitor, in lung squamous cell carcinoma

Background

We conducted co-clinical trials in patient-derived xenograft (PDX) models to identify predictive biomarkers for the multikinase inhibitor dovitinib in lung squamous cell carcinoma (LSCC).

Methods

The PDX01-02 were established from LSCC patients enrolled in the phase II trial of dovitinib (NCT01861197) and PDX03-05 were established from LSCC patients receiving surgery. These five PDX tumors were subjected to in vivo test of dovitinib efficacy, whole exome sequencing and gene expression profiling.

Results

The PDX tumors recapitulate histopathological properties and maintain genomic characteristics of originating tumors. Concordant with clinical outcomes of the trial enrolled-LSCC patients, dovitinib produced substantial tumor regression in PDX-01 and PDX-05, whereas it resulted in tumor progression in PDX-02. PDX-03 and -04 also displayed poor antitumor efficacy to dovitinib. Mutational and genome-wide copy number profiles revealed no correlation between genomic alterations of FGFR1-3 and sensitivity to dovitinib. Of note, gene expression profiles revealed differentially expressed genes including FGF3 and FGF19 between PDX-01 and 05 and PDX-02-04. Pathway analysis identified two FGFR signaling-related gene sets, FGFR ligand binding/activation and SHC-mediated cascade pathway were substantially up-regulated in PDX-01 and 05, compared with PDX-02-04. The comparison of gene expression profiles between dovitinib-sensitive versus -resistant lung cancer cell lines in the Cancer Cell Line Encyclopedia database also found that transcriptional activation of 18 key signaling components in FGFR pathways can predict the sensitivity to dovitinib both in cell lines and PDX tumors. These results highlight FGFR pathway activation as a key molecular determinant for sensitivity to dovitinib.

Conclusions

FGFR gene expression signatures are predictors for the response to dovitinib in LSCC.

Mantidis ootheca induces vascular relaxation through PI3K/AKT-mediated nitric oxide-cyclic GMP-protein kinase G signaling in endothelial cells

Mantidis ootheca (Sang Piao Xiao) is well known mantis eggs in a foamy pouch. The purpose of the present study was to investigate the underlying cellular mechanisms of the nitric oxide (NO)-releasing property of the aqueous extract of Mantidis ootheca (AMO) in rat aorta and vascular endothelial cells. AMO was examined for its vascular relaxant effect in isolated phenylephrine-precontracted rat thoracic aortic rings. The roles of the nitric oxide (NO) signaling in the AMO-induced effects were tested in human umbilical vein endothelial cells (HUVECs). HUVEC treated with AMO produced higher amount of NO compared to control. However, AMO-induced increases in NO production were blocked by pretreatment with N^G-nitro-L-arginine methylester (L-NAME) or wortmannin. AMO increased in phosphorylation levels of endothelial nitric oxide synthase (eNOS) and Akt in HUVECs, which were attenuated by a NOS and Akt inhibitors. In aortic ring, AMO-induced dose-dependent relaxation of phenylephrine-precontracted aorta was abolished by removal of functional endothelium. Pretreatment with L-NAME, ¹H-[1,2,4]-oxadiazolo-[4,3-alpha]-quinoxalin-1-one (ODQ), and KT5823 inhibited the AMO-induced vasorelaxation. Similarly, wortmannin and LY-294002, an inhibitors of the phosphatidylinositol 3-kinase (PI3K), an upstream signaling molecule of eNOS, attenuated the AMO-induced vasorelaxation. Moreover, AMO-induced increases in cGMP production were blocked by pretreatment with L-NAME or ODQ. The vasorelaxant effect of AMO was attenuated by tetraethylammonium, 4-aminopyridine, and glibenclamide. We conclude that AMO relaxed vascular smooth muscle via endothelium-dependent activation of PI3K/Akt-mediated NO-cGMP-PKG signaling pathway and possible involvement of K⁺ channel.

Fabrication of Laser-reduced Graphene Oxide in Liquid Nitrogen Environment

Porous structure of reduced graphene oxide (rGO) plays an important role in developing flexible graphene-based devices. In this work, we report a novel methodology for reduction of freestanding graphite oxide (GO) sheet by picosecond pulse laser direct writing in liquid nitrogen. Non-agglomerate and porous structure of rGO is fabricated successfully due to frozen effect during laser processing. Compared with laser-irradiated rGO developed in N₂ gas at ambient environment, the frozen rGO developed in liquid N₂ shows better ordered structure with less defects, crack-free morphology as well as better electron supercapacitor performance including 50–60 Ω/sq in sheet electrical resistance. Mechanism of cryotemperature photoreduction GO is also discussed.

Dual-wavelength passively Q-switched Nd:GYSGG laser by tungsten disulfide saturable absorber

A dual-wavelength passively Q-switched Nd:GYSGG laser using vacuum evaporating tungsten disulfide (WS₂) as a saturable absorber was demonstrated for the first time to the best of our knowledge. The WS₂ saturable absorber was prepared simply by evaporating nanometer WS₂ powders onto a quartz substrate in a vacuum. By inserting the WS₂ saturable absorber into the laser cavity, stable Q-switched laser operation was achieved with a maximum average output power of 367 mW, a pulse repetition rate of 70.7 kHz, the shortest pulse width of 591 ns, and pulse energy of about 1.05 μJ. By vacuum evaporation method, a high-quality WS₂ saturable absorber can be produced, and it seems to be a suitable method for fabrication of 2D transition metal dichalcogenides.

Modulation of photonic nanojets generated by microspheres decorated with concentric rings

A novel design of decorating microsphere surface with concentric rings to modulate the photonic nanojet (PNJ) is investigated. By introducing the concentric ring structures into the illumination side of the microspheres, a reduction of the full width at half maximum (FWHM) intensity of the PNJ by 29.1%, compared to that without the decoration, can be achieved numerically. Key design parameters, such as ring number and depth, are analyzed. Engineered microsphere with four uniformly distributed rings etched at a depth of 1.2 μm and width of 0.25 μm can generate PNJ at a FWHM of 0.485 λ (λ = 400nm). Experiments were carried out by direct observation of the PNJ with an optical microscope under 405 nm laser illumination. As a result, shrinking of PNJ beam size of 28.0% compared to the case without the rings has been achieved experimentally. Sharp FWHM of this design can be beneficial to micro/nanoscale fabrication, optical super-resolution imaging, and sensing.

Doxorubicin Activates Hepatitis B Virus Replication by Elevation of p21 (Waf1/Cip1) and C/EBPα Expression

Hepatitis B virus reactivation is an important medical issue in cancer patients who undergo systemic chemotherapy. Up to half of CHB carriers receiving chemotherapy develop hepatitis and among these cases a notable proportion are associated with HBV reactivation. However, the molecular mechanism(s) through which various chemotherapeutic agents induce HBV reactivation is not yet fully understood. In this study, we investigated the role of the cell cycle regulator p21 (Waf1/Cip1) in the modulation of HBV replication when a common chemotherapeutic agent, doxorubicin, is present. We showed that p21 expression was increased by doxorubicin treatment. This elevation in p21 expression enhanced the expression of CCAAT/enhancer-binding protein α (C/EBPα); such an increase is likely to promote the binding of C/EBPα to the HBV promoter, which will contribute to the activation of HBV replication. Our current study thus reveals the mechanism underlying doxorubicin modulation of HBV replication and provides an increased understanding of HBV reactivation in CHB patients who are receiving systemic chemotherapy.

High aspect ratio SiNW arrays with Ag nanoparticles decoration for strong SERS detection

Well-ordered silicon nanowires (SiNWs) are applied as surface-enhanced Raman scattering (SERS) substrates. Laser interference lithography is used to fabricate large-area periodic nanostructures. By controlling the reaction time of metal assisted chemical etching, various aspect ratios of SiNWs are generated. Ag nanoparticles are decorated on the substrates via redox reaction to allow a good coverage of Ag over the SiNWs. As the height of the SiNWs increases, the light scattering inside the structures is enhanced. The number of the probing molecules within the detection volume is increased as well. These factors contribute to stronger light-matter interaction and thus lead to higher SERS signal intensity. However, the light trapping effect is more significant for higher SiNWs, which prevents the detection of the SERS signals. An optimized aspect ratio ∼5:1 (1 μm height and 200 nm width) for the SiNW array is found. The well-ordered SiNWs demonstrate better SERS signal intensity and uniformity than the randomly arranged SiNWs.

Hybrid phase-change plasmonic crystals for active tuning of lattice resonances

Tunable lattice resonances are demonstrated in a hybrid plasmonic crystal incorporating the phase-change material Ge2Sb2Te5 (GST) as a 20-nm-thick layer sandwiched between a gold nanodisk array and a quartz substrate. Non-volatile tuning of lattice resonances over a range Δλ of about 500 nm (1.89 µm to 2.27 µm) is achieved experimentally via intermediate phase states of the GST layer. This work demonstrates the efficacy and ease of resonance tuning via GST in the near infrared, suggesting the possibility to design broadband non-volatile tunable devices for optical modulation, switching, sensing and nonlinear optical devices.

Enhancement of laser-induced rear surface spallation by pyramid textured structures on silicon wafer solar cells

Pulsed laser ablation is increasingly being applied to locally open the rear dielectric layer of advanced silicon wafer solar cell structures, such as aluminum local back surface field solar cells. We report that the laser ablation process on the rear surface of the solar cell at a relatively low laser fluence can cause undesirable spallation at the front surface which is textured with random upright pyramids. This phenomenon is attributed to the enhancement of the surface spallation effect by up to 3 times due to the confinement of the pressure waves at the tips of these random pyramids. Laser ablation at different laser focus positions and laser fluences is carried out to achieve optimized laser processing of the solar cells.

An efficacy analysis for nasopharyngeal carcinoma screening of different screening intervals

OBJECTIVE

To evaluate the impact of different screening intervals on screening for nasopharyngeal carcinoma (NPC).

METHODS

A Markov model was constructed, based on the natural history of NPC. The 5-year mortality rate of NPC was the major measurement to evaluate the efficacies of 16 screening strategies. Parameters for the model were derived from published literature.

RESULTS

Screening reduced the 5-year mortality rate for NPC by 20.4 - 43.3%, compared with the equivalent rate without screening. The 5 year mortality rate and the NPC pick-up rate with strategy A1 (annual screening) were 23.6% and 83.9%, respectively. Compared with strategy A1, strategy B1 (annual screening for seropositive subjects; biennial screening for seronegative subjects) had a similar 5-year mortality rate (24.0%) and a slightly smaller NPC pick-up rate (81.7%), but led to a 39.3% reduction in total screenings. Compared with all other strategies excluding strategy A1, strategy B1 achieved the lowest 5-year mortality rate and the largest NPC pick-up rate.

CONCLUSIONS

Strategy B1 had the highest efficacy for NPC screening.

Transforming growth factor-β1 suppresses hepatitis B virus replication by the reduction of hepatocyte nuclear factor-4α expression

Several studies have demonstrated that cytokine-mediated noncytopathic suppression of hepatitis B virus (HBV) replication may provide an alternative therapeutic strategy for the treatment of chronic hepatitis B infection. In our previous study, we showed that transforming growth factor-beta1 (TGF-β1) could effectively suppress HBV replication at physiological concentrations. Here, we provide more evidence that TGF-β1 specifically diminishes HBV core promoter activity, which subsequently results in a reduction in the level of viral pregenomic RNA (pgRNA), core protein (HBc), nucleocapsid, and consequently suppresses HBV replication. The hepatocyte nuclear factor 4alpha (HNF-4α) binding element(s) within the HBV core promoter region was characterized to be responsive for the inhibitory effect of TGF-β1 on HBV regulation. Furthermore, we found that TGF-β1 treatment significantly repressed HNF-4α expression at both mRNA and protein levels. We demonstrated that RNAi-mediated depletion of HNF-4α was sufficient to reduce HBc synthesis as TGF-β1 did. Prevention of HNF-4α degradation by treating with proteasome inhibitor MG132 also prevented the inhibitory effect of TGF-β1. Finally, we confirmed that HBV replication could be rescued by ectopic expression of HNF-4α in TGF-β1-treated cells. Our data clarify the mechanism by which TGF-β1 suppresses HBV replication, primarily through modulating the expression of HNF-4α gene.

Lattice resonances in antenna arrays for liquid sensing in the terahertz regime

Terahertz antenna arrays supporting narrow lattice resonances are proposed as an alternative sensor-on-chip approach to liquid sensing. An array of metallic rectangular antennas fabricated on a polyethylene naphthalate (PEN) substrate is used to demonstrate the sensing of a number of fluids. Good agreement is shown between experiment and simulation with Q-factors of around 20 and a figure-of-merit (FOM) of 3.80 being achieved. Liquid sensing with antenna arrays is simple both in terms of fabrication and setup. The working frequency can be tuned with a suitable choice of substrates and array parameters. The nature of the lattice resonance means that the whole sample is used to provide the conditions required for resonance occurrence, eliminating the need to preferentially locate the sample in small areas of high field concentration. The antenna arrays could also potentially be coupled with a microfluidic system for in situ sensing or used in a reflection setup.

Influence of plasmon destructive interferences on optical properties of gold planar quadrumers

Arrays of planar symmetric gold quadrumers consisting of a central nano-disc surrounded by three similar nano-discs belonging to the D(3h) point group were designed and fabricated. Since the geometrical configuration of quadrumers is the same as planar trigonal molecules, nano-discs can play the roles of artificial atoms to study the coupling trends among them. The plasmonic properties of the nano-disc structures are investigated by reflection spectrum measurement and finite-difference time-domain calculation with good agreement. Plasmon interaction among the nano-discs is also studied via a mass-spring coupled oscillator model. A pronounced Fano resonance (FR) is observed for the fabricated nano-discs with inter-disk gaps of around 18 nm during light irradiation at normal incidence. Although the obtained FR is independent of the excitation polarization, the near-field energy spatial distribution can be flexibly tuned by the polarization direction. This has potential applications in nano-lithography, optical switching and nonlinear spectroscopy.

Broadband multi-layer terahertz metamaterials fabrication and characterization on flexible substrates

Microscopic split-ring-resonator (SRR) arrays are fabricated on 100 μm thick polyethylene naphthalate (PEN) films by femtosecond laser micro-lens array (MLA) lithography. The transmission properties of these metamaterials are characterized by THz Time Domain Spectroscopy (THz-TDS). Tunable resonance responses can be achieved by changing SRR structural design parameters. By stacking 2D PEN metamaterial films with different frequency responses together, a broadband THz filter with full width at half maximum (FWHM) of 0.38 THz is constructed. The bandwidth of the resonance response increases up to 4.2 times as compared to the bandwidths of single layer metamaterials. Numerical simulation reveals that SRR layers inside the multi-layer metamaterials are selectively excited towards specific frequencies within the broadband response. Meanwhile, more than one SRR layers respond to the chosen frequencies, resulting in the enhancement of the resonance properties. The multi-layer metamaterials provide a promising way to extend SRR based metamaterial operating region from narrowband to broadband with a tunable feature.

Generation of pronounced Fano resonances and tuning of subwavelength spatial light distribution in plasmonic pentamers

Arrays of plasmonic pentamers consisting of five metallic nano-disks were designed and fabricated to achieve a pronounced Fano Resonance with polarization-independent far-field spectral response at normal incidence due to the structure symmetry of pentamers. A mass-spring coupled oscillator model was applied to study plasmon interactions among the nano-disks. It was found that the direction of the excitation light polarization can flexibly tune the spatial localization of near-field energy at sub-wavelength scales while the collective optical properties are kept constant. It can lead to a selective storage of excited energy down to sub-20 nm gap at a normal incident with a single light source.

Converting carbon nanofibers to carbon nanoneedles: catalyst splitting and reverse motion

Carbon nanoneedles (CNNs) were grown using a plasma-enhanced chemical vapor deposition process in which the source gas (C(2)H(2)) was turned off 10 min before the NH(3) flow and plasma were turned off. It is demonstrated that tubular carbon nanofibers (CNFs) grow while the source gas is on. However, once the source gas is turned off, the Ni catalyst at the top of each CNF splits to form a small catalyst that remains at the top of the tube and a larger catalyst that travels down the interior of the tube. We postulate that the motion of the bottom (larger) catalyst is driven by etching of the graphitic walls and 'cups' inside the CNF. This process, combined with slowing growth of the CNFs and etching of the material above the bottom catalyst, converts the carbon nanofibers to the final nanoneedle shape.

Hybrid metamaterial design and fabrication for terahertz resonance response enhancement

Planar hybrid metamaterial with different split ring resonators (SRR) structure dimensions are fabricated on silicon substrates by femtosecond (fs) laser micro-lens array (MLA) lithography and lift-off process. The fabricated metamaterial structures consist of: (a) uniform metamaterial with 4 SRRs at same design and dimension as a unit cell and (b) hybrid metamaterial with 4 SRRs at same design but different dimensions as a unit cell. The electromagnetic field responses of these hybrid and single dimension metamaterial structures are characterized using a terahertz (THz) time-domain spectroscopy. Transmission spectra of these metamaterial show that a broader resonance peak is formed when 2 SRRs are close to each other. FDTD simulation proves that there is a strong mutual coupling between 2 SRRs besides a strong localized electric field at the split gap, which can enhance the electric field up to 364 times for tunable, broad band and high sensitivity THz sensing. Meanwhile, the strong coupling effect could lead to the formation of an additional resonance peak at approximately 0.2 THz in the THz spectra regime.

Interference lithographically defined and catalytically etched, large-area silicon nanocones from nanowires

We report a simple and cost effective method for the synthesis of large-area, precisely located silicon nanocones from nanowires. The nanowires were obtained from our interference lithography and catalytic etching (IL-CE) method. We found that porous silicon was formed near the Au catalyst during the fabrication of the nanowires. The porous silicon exhibited enhanced oxidation ability when exposed to atmospheric conditions or in wet oxidation ambient. Very well located nanocones with uniform sharpness resulted when these oxidized nanowires were etched in 10% HF. Nanocones of different heights were obtained by varying the doping concentration of the silicon wafers. We believe this is a novel method of producing large-area, low cost, well defined nanocones from nanowires both in terms of the control of location and shape of the nanocones. A wide range of potential applications of the nanocone array can be found as a master copy for nanoimprinted polymer substrates for possible biomedical research; as a candidate for making sharp probes for scanning probe nanolithography; or as a building block for field emitting tips or photodetectors in electronic/optoelectronic applications.

HBV replication is significantly reduced by IL-6

Interleukin-6 (IL-6) is a pleiotropic cytokine with pivotal functions in the regulation of the biological responses of several target cells including hepatocytes. The level of serum IL-6 has been reported to be elevated in patients with chronic hepatitis B, cirrhosis and hepatocellular carcinoma and represents the best marker of HBV-related clinical progression as compared with several other cytokines. In this study, we found that IL-6 was able to effectively suppress hepatitis B virus (HBV) replication and prevent the accumulation of HBV covalently closed circular DNA (cccDNA) in a human hepatoma cell line. We also demonstrated that the suppression of HBV replication by IL-6 requires concurrently a moderate reduction of viral transcripts/core proteins and a marked decrease in viral genome-containing nucleocapsids. Studies on the stability of existing viral capsids suggest that the IL-6 effect on the reduction of genome-containing nucleocapsids is mediated through the prevention of the formation of genome-containing nucleocapsids, which is similar to the effect of interferons. However, IFN-α/β and IFN-γ did not participate in the IL-6-induced suppression of HBV replication. Taken together, our results will provide important information to better understand the role of IL-6 in the course of HBV infection.

Laser micro/nano fabrication in glass with tunable-focus particle lens array

Based on medium-tuned optical field enhancement effect around a self-assembled particle-lens array (PLA) irradiated with a femtosecond (fs) laser source, we demonstrated that high-precision periodical array of micro/nano-structures can be readily fabricated on glass surface or inside glass in large areas in parallel without any cracks or debris. The technique has potential for rapid fabrication of three-dimensional structures in multiple layers inside glass.

Synthesis of silicon nanowires and nanofin arrays using interference lithography and catalytic etching

We report results on the synthesis of silicon nanostructures that were fabricated using a combination of interference lithography and catalytic etching. With this technique, we were able to create nanostructures that are perfectly periodic over very large areas (1 cm(2) or more), where the cross-sectional shapes and the array ordering can be varied. Furthermore this technique can readily and independently control the sizes and spacings of the nanostructures down to spacings of 200 nm or less. These characteristics cannot be achieved using other known techniques.

Generation of radially polarized beam with a segmented spiral varying retarder

We convert a linearly polarized Gaussian beam into a radially polarized doughnut beam with an eight-segment spirally varying retarder (SVR) at wavelength of 808 nm. The SVR is designed based on the linear birefringence of alpha-barium borate (alpha-BBO) crystal and fabricated using a dry etching process. Radially polarized light of high purity (> 96% at far-field distribution) was generated experimentally using the segmented SVR positioned between two quarter waveplates with orthogonal slow axes. The emergent polarization can be switched between radially and azimuthally polarized cylindrical vector beams with a pair of half-wave plates.

Surface enhanced Raman scattering of silver sensitized cobalt nanoparticles in metal-dielectric nanocomposites

We report the preparation of a new type of nanocomposite containing cobalt and silver nanoparticles organized in parallel layers with a well controlled separation. This arrangement allows the observation of an enhanced low-frequency Raman signal at the vibration frequency of cobalt nanoparticles excited through the surface plasmons of silver nanoparticles. Numerical simulations of the electric field confirm the emergence of hot spots when the separation between silver and cobalt nanoparticles is small enough.

Bimetallic structure fabricated by laser interference lithography for tuning surface plasmon resonance

Tuning of surface plasmon resonance by gold and silver bimetallic thin film and bimetallic dot array is investigated. Laser interference lithography is applied to fabricate the nanostructures. A bimetallic dot structure is obtained by a lift-off procedure after gold and silver thin film deposition by an electron beam evaporator. Surface plasmon behaviors of these films and nanostructures are studied using UV-Vis spectroscopy. It is observed that for gold thin film on quartz substrate, the optical spectral peak is blue shifted when a silver thin film is coated over it. Compared to the plasmon band in single metal gold dot array, the bimetallic nanodot array shows a similar blue shift in its spectral peak. These shifts are both attributed to the interaction between gold and silver atoms. Electromagnetic interaction between gold and silver nanostructures is discussed using a simplified spring model.

Photonic bandgap crystal resonator enhanced, laser controlled modulations of optical interconnects for photonic integrated circuits

Ultrafast high-density photonic integrated circuit devices (PICDs) are not easily obtained using traditional index-guiding mechanisms. In this paper, photonic bandgap crystal resonator enhanced, laser-controlled modulations of optical interconnect PICDs were achieved in slab-type mix-guiding configuration - through developed CMOS-compatible processing technologies. The devices, with smallest critical dimensions of 90 nm have footprints of less than 5 x 5 microm(2). Quality-factors an order larger than previously realized was achieved. Through use of effective coupling structures; simultaneous alignment for probing and pumping laser beams, optical measurements of both instantaneous free carriers induced device modulations were obtained together with thermo-optical effects characterizations.

Fast switchable electro-optic radial polarization retarder

A fast and switchable electro-optic radial polarization retarder (EO-RPR) fabricated using the electro-optic ceramic Pb(Mg(1/3)Nb(2/3))O(3)-PbTiO(3) is presented. This EO-RPR is useful for fast and switchable generation of a pure cylindrical vector beam. When used together with a pair of half-wave plates, the EO-RPR can change circularly polarized light into any cylindrical vector beam of interest, such as radially or azimuthally polarized light. Radially and azimuthally polarized light with purities greater than 95% are generated experimentally. The advantages of using EO-RPR include fast response time, low driving voltage, and transparency in a wide spectral range (500 to 7,000 nm).

Mimicking optical activity for generating radially polarized light

We propose a new scheme for generating radially polarized light by mimicking optical activity using linear birefringence. It involves a birefringent spirally varying retarder sandwiched between two orthogonally oriented quarter-wave plates. Using Poincaré sphere representation, we show that the polarization transformation of such a scheme is equivalent to that of a spirally varying optical activity and is capable of generating radially polarized light. We demonstrate the proof-of-concept using y-cut crystalline quartz.

Post-marketing surveillance study of the safety and efficacy of sildenafil prescribed in primary care to erectile dysfunction patients

In order to investigate the safety and efficacy of sildenafil prescribed in primary care, a post-marketing surveillance study was undertaken. A total of 651 men with erectile dysfunction (ED) were enrolled from 31 family physicians in Korea from December 1999 to July 2002. Patients were regularly followed up to ascertain the safety and efficacy of sildenafil. Of the 651 patients enrolled, 572 (87.9%) returned for safety evaluation and efficacy assessment. In all, 458 (80.1%) of 572 patients reported improved erectile function with sildenafil. Hypertension, diabetes and low-dose sildenafil were associated with poor efficacy. A total of 71 adverse events were reported among 56 patients (8.6%), with the most frequent being hot flushes (5.6%), followed by headache (2.6%), palpitation (1.0%), anxiety (0.5%) and elevated ALT (0.5%). Only six patients (1.0%) discontinued sildenafil as a direct result of adverse events. These results suggest that sildenafil prescribed by primary care physicians was well tolerated and improved erectile function in patients with ED.

Stimulation of asiaticoside accumulation in the whole plant cultures of Centella asiatica (L.) urban by elicitors

The effects of a number of different elicitors on asiaticoside production in whole plant cultures of Centella asiatica were studied, including yeast extract, CdCl(2), CuCl(2) and methyl jasmonate (MJ). Only MJ and yeast extract stimulated asiaticoside production--1.53 and 1.41-fold, respectively. Maximum asiaticoside production was achieved following treatment with 0.1 mM MJ (116.8 mg/l). The highest asiaticoside production (342.72 mg/l) was obtained after 36 days of elicitation in cultures treated with 0.1 mM MJ and 0.025 mg/l 1-phenyl-3-(1,2,3-thidiazol-5-yl)urea (TDZ). Interestingly, MJ not only stimulated the production of asiaticoside but also had an important role in the senescence of C. asiatica. Although asiaticoside content did not change when TDZ was added to medium containing an elicitor, TDZ did increase shoot growth of C. asiatica. We discuss the interactive roles of MJ and TDZ in secondary metabolic production and biomass in whole plants of C. asiatica.

Prevalence and risk factors for erectile dysfuntion in primary care: results of a Korean study

In order to assess the prevalence and associated factors for erectile dysfunction (ED) in primary care, a cross-sectional study was undertaken by questionnaire distributed to consecutive adult male attendees at 32 family practices. ED was assessed by the Korean five-item version of the International Index of Erectile Function (IIEF-5). In total, 3501 completed questionnaires were available for analysis. The prevalence of ED was severe (IIEF-5 score: 5-9) in 1.6% of cases, moderate (10-13) in 10.2%, mild (14-17) in 24.7%, and normal (18-25) in 63.4%. The prevalence of ED increased with age, lower educational status, heavy job-related physical activity, and lower income. ED prevalence was significantly higher in patients with chronic diseases such as diabetes, depression, and anxiety. These results suggest that the age-adjusted prevalence of ED among Korean men can be estimated as 32.2% (95% CI 30.6-33.7). Low socioeconomic status and several diseases such as diabetes, anxiety, and depression, as well as age, were associated with ED.

Is the 1997 AJCC staging system for nasopharyngeal carcinoma prognostically useful for Chinese patient populations?

PURPOSE

The 5th edition of the American Joint Committee on Cancer (AJCC) staging manual defines new rules for classifying nasopharyngeal carcinoma (NPC). The study was conducted to assess its effectiveness in predicting the prognosis for Chinese patient populations.

METHODS AND MATERIALS

Between June 1993 and June 1994, 621 consecutively admitted patients with nondisseminated NPC were treated with definitive-intent radiation therapy alone. All had computed tomography of the nasopharynx, skull base, and the upper neck. A computer database containing all information for staging was formed on presentation. The extent of disease of each patient was restaged according to the 1997 AJCC system.

RESULTS

Of the 621 patients, The 5-year overall survival (OS) rate was 60%. The 1997 AJCC system creates subgroups (Stages I to IV) that are assigned to 38 (6.1%), 270 (43.5%), 157 (25.3%), and 156 (25.1%) patients, respectively. The incidence of parapharyngeal extension was 74.1% (460/621). Of these patients (460) with parapharyngeal extension, 310 (67.4%) patients were classified as T2b disease. The 1997 AJCC system showed highly significant differences between the overall stages for both OS and relapse-free survival (RFS). The 1997 AJCC T classifications showed significant correlation with local failure, and N classification was accurate in predicting FDM. Multivariate analysis showed that paraoropharyngeal involvement was an independently significant prognostic factor for OS, freedom from local recurrence (FLR), and freedom form distant metastasis (FDM).

CONCLUSION

The 1997 AJCC staging system for NPC is prognostically useful for Chinese patient populations. We proposed that subdivision of parapharyngeal extension should be included in future revisions of the staging system.

Results of a prospective randomized trial comparing neoadjuvant chemotherapy plus radiotherapy with radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma

PURPOSE

A prospective randomized trial was performed to evaluate the contribution of neoadjuvant chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma.

PATIENTS AND METHODS

Patients with locoregionally advanced nasopharyngeal carcinoma were treated either with radiotherapy alone (RT group) or neoadjuvant chemotherapy plus radiotherapy (CT/RT group). Neoadjuvant chemotherapy consisting of two to three cycles of cisplatin (100 mg/m(2), day 1), bleomycin (10 mg/m(2), days 1 and 5), and fluorouracil (5-FU; 800 mg/m(2), days 1 through 5, continuous infusion) followed by radiotherapy was given to the CT/RT group. All patients were treated in a uniform fashion by definitive-intent radiation therapy in both groups.

RESULTS

Between July 1993 and July 1994, 456 patients were entered onto the study, with 228 patients randomized to each treatment arm, and 449 patients (225 in the RT group and 224 in the CT/RT group) were assessable. All 456 patients were included in survival analysis according to the intent-to-treat principle. The 5-year overall survival (OS) rates were 63% for the CT/RT group and 56% for the RT group (P =.11). The median relapse-free survival (RFS) time was 50 months for the RT group and not reached for the CT/RT group. The 5-year RFS rate was 49% for the RT group versus 59% for the CT/RT group (P =.05). The 5-year freedom from local recurrence rate was 82% for the CT/RT group and 74% for the RT group (P =.04). There was no significant difference in freedom from distant metastasis between the two treatment groups (CT/RT group, 79%; RT group, 75%; P =.40).

CONCLUSION

This randomized study failed to demonstrate any significant survival benefit with the addition of neoadjuvant chemotherapy for patients with locoregionally advanced nasopharyngeal carcinoma. Therefore, neoadjuvant chemotherapy for nasopharyngeal carcinoma should not be used outside of the context of a clinical trial.