A prospective observational study of estimating drug related problems and clinical outcomes in subtypes of stroke patients

BACKGROUND

Stroke is a neurological disease and a leading cause of mortality worldwide. Strokes mainly consist of two types: hemorrhage and ischemia. Stroke patients are being administered multiple drug therapy and are at risk of drug-related problems.

AIM

To estimate drug-related problems (DRPs) and clinical end outcomes in hospitalized stroke patients.

METHODS

Current study was a multicenter, cross-sectional prospective observational study including 250 stroke patients admitted to tertiary care hospitals in Karachi, Pakistan. The study included all clinical subtypes of stroke patients i.e. Stroke, Ischemic stroke, Hemorrhagic stroke, CVA, and TIA. Associations among patient-clinical end outcomes and drug therapy-related variables like DRPs, mortality, and morbidity rates were estimated using Pearson's chi-squared test. Statistical analysis was done by using SPSS software, version 25.

RESULTS

A total of 250 patients participated in this study suffering from different clinical subtypes of stroke i.e. Ischemic stroke, hemorrhagic stroke, TIA, and CVA, including 46% male and 54% female patients. The majority of patients' stay at the hospital was between 1-10 days. The overall mortality rate in stroke patients was 51%. HAIs were observed in 70% of patients, HAIs faced by patients were SAP, CAP, UTI, sepsis, and VAP. Drugs were assessed according to NEML i.e. access group antibiotics, watch group antibiotics, reserve group antibiotics, statins, antiepileptics, and proton pump inhibitors. Majorly ceftriaxone was administered to 79% of patients, piperacillin-tazobactam to 52%, and cefixime to 48%, whereas meropenem was administered to 42% of patients along with vancomycin to 39% of total patients. A high mortality rate was observed in the case of Klebsiella pneumoniae and Staphylococcus aureus i.e. 78% and in the case of streptococcus pneumoniae 61% mortality rate was observed. Due to the presence of DRPs and various other clinical factors like comorbidities, DDIs, HAIs, administration of potentially nephrotoxic drugs, and administration of antibiotics without having CST, hospitalized stroke patients faced many problems.

CONCLUSION

This study helped determine DRPs along with various clinical factors affecting the clinical end outcomes of patients suffering from any clinical subtype of stroke. Due to the enhancement in the evidence of the incidence of DRPs in tertiary care hospitals, pharmacist-led drug therapy review by interfering with doctors and other medical professionals at the patient bed site is needed and should be done to avoid any negative end outcomes and serious issues related to DRPs.

A trial-based economic evaluation of the CaFaSpA referral strategy for axial spondyloarthritis

OBJECTIVE

To assess the cost-utility from healthcare and societal perspectives of the digital CaFaSpA referral strategy (CS) for axial spondyloarthritis (axSpA) in primary care patients with chronic low back pain (CLBP).

METHOD

A cluster randomized controlled trial was performed in the Netherlands. General practice units were randomized into CS or usual care (UC). Economic evaluation was performed from the healthcare and societal perspectives within a 12-month time horizon. Outcome measures encompassed disability [Roland-Morris Disability Questionnaire (RMDQ)] and health-related quality of life (EQ-5D-3L). Direct medical (iMTA Medical Consumption Questionnaire) and indirect costs (iMTA Productivity Cost Questionnaire), including productivity loss, were evaluated. Incremental cost-utility ratios (ICURs) were calculated.

RESULTS

The study included 90 GP clusters with 563 patients (CS: n = 260; UC: n = 303) (mean ± sd age 36.3 ± 7.5 years; 66% female). After 12 months, no minimal important differences in outcomes were observed for RMDQ (-0.21, 95%CI -1.52 to 1.13) or EQ-5D (-0.02, 95%CI -0.08 to 0.05). However, total costs were significantly lower in the CS group owing to lower productivity loss costs. The ICUR for RMDQ was €18,059 per point decrease and €220,457 per quality-adjusted life year increase.

CONCLUSIONS

Digital referral did not decrease the overall healthcare status of patients after 1 year of follow-up and appears to be more cost-effective than UC. Therefore, CS can be used as an appropriate primary care referral model for CLBP patients at risk for axSpA. This will accelerate timely provision of care by the right caregiver.

Matrin-3 acts as a potential biomarker and promotes hepatocellular carcinoma progression by interacting with cell cycle-regulating genes

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. The oncogenic role of Matrin-3 (MATR3), an a nuclear matrix protein, in HCC remains largely unknown. Here, we document the biological function of MATR3 in HCC based on integrated bioinformatics analysis and functional studies. According to the TCGA database, MATR3 expression was found to be positively correlated with clinicopathological characteristics in HCC. The receiver operating characteristic (ROC) curve and Kaplan-Meier (KM) curve displayed the diagnostic and prognostic potentials of MATR3 in HCC patients, respectively. Pathway enrichment analysis represented the enrichment of MATR3 in various molecular pathways, including the regulation of the cell cycle. Functional assays in HCC cell lines showed reduced proliferation of cells with stable silencing of MATR3. At the same time, the suppressive effects of MATR3 depletion on HCC development were verified by xenograft tumor experiments. Moreover, MATR3 repression also resulted in cell cycle arrest by modulating the expression of cell cycle-associated genes. In addition, the interaction of MATR3 with cell cycle-regulating factors in HCC cells was further corroborated with co-immunoprecipitation and mass spectrometry (Co-IP/MS). Furthermore, CIBERSORT and TIMER analyses showed an association between MATR3 and immune infiltration in HCC. In general, this study highlights the novel oncogenic function of MATR3 in HCC, which could comprehensively address how aberrant changes in the cell cycle promote HCC development. MATR3 might serve as a prognostic predictor and therapeutic target for HCC patients.

The essential impact of stress appraisals on work engagement

This paper explains the contradictory findings on the relationship between stress and work engagement by including appraisals as a driving mechanism through which job stressors influence engagement. In doing so, it explores whether stressors categorised as either challenging or hindering can be appraised simultaneously as both. Second, it investigates whether stress mindset explains not only how stressors are appraised, but also how appraisals influence engagement. Over five workdays, 487 Canadian and American full-time employees indicated their stress mindset and appraised numerous challenging and hindering stressors, after which they self-reported their engagement at work. Results showed that employees rarely appraised stress as uniquely challenging or hindering. Moreover, when employees harbored positive views about stress, stressors overall were evaluated as less hindering and hindrance stressors were particularly more challenging. Stress mindset appears to be critical in modulating the genesis of stress appraisals. In turn, appraisals explained the stressor-engagement relationship, with challenge and hindrance stressors boosting and hampering engagement, respectively. Finally, positive stress mindset buffered the negative effect of hindrance appraisals on engagement. Our findings clarify misconceptions about how workplace stressors impact engagement and offer novel evidence that stress mindset is a key factor in stress at work.

Propagation and reflection of thermoelastic wave in a rotating nonlocal fractional order porous medium under Hall current influence

This investigation relates to the research on Hall current on propagation and reflection of elastic waves through non-local fractional-order thermoelastic rotating medium with voids. The system is split up into longitudinal and transverse components using the Helmholtz vector rule. It is observed that, through the frequency dispersion relation four coupled quasi-waves exist in the medium. The rotating solid modifies the nature of purely longitudinal and transverse waves toward the quasi-type waves. All the propagating waves are dispersive as they depend upon angular frequency. The quasi-longitudinal wave qP and quasi-transverse wave qSV faces cut-off frequencies. The nonlocal parameter affect all the waves except the quasi void wave. Analytically, the reflection coefficients of the wave are computed using suitable boundary conditions. MATLAB software is used to perform numerical computations for a chosen solid material. The amplitude ratios and the speed of propagation of the wave are plotted graphically for rotational frequency, nonlocal, fractional order, and Hall current parameter. The significant effect of the physical parameters on the computed results has been observed. The cut-off frequency of the waves is also presented graphically. The energy conservation law is proved in the form of energy ratios. The earlier findings in the literature are obtained as special case in the absence of rotation, Hall current parameter and porous voids.

CCR9 overexpression promotes T-ALL progression by enhancing cholesterol biosynthesis

Introduction: T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive hematological malignancy of the lymphoid progenitor cells, contributing to ∼ 20% of the total ALL cases, with a higher prevalence in adults than children. Despite the important role of human T-ALL cell lines in understanding the pathobiology of the disease, a detailed comparison of the tumorigenic potentials of two commonly used T-ALL cell lines, MOLT4 and JURKAT cells, is still lacking. Methodology: In the present study, NOD-Prkdc scid IL2rgd ull (NTG) mice were intravenously injected with MOLT4, JURKAT cells, and PBS as a control. The leukemiac cell homing/infiltration into the bone marrow, blood, liver and spleen was investigated for bioluminescence imaging, flow cytometry, and immunohistochemistry staining. Gene expression profiling of the two cell lines was performed via RNA-seq to identify the differentially expressed genes (DEGs). CCR9 identified as a DEG, was further screened for its role in invasion and metastasis in both cell lines in vitro. Moreover, a JURKAT cell line with overexpressed CCR9 (Jurkat-OeCCR9) was investigated for T-ALL formation in the NTG mice as compared to the GFP control. Jurkat-OeCCR9 cells were then subjected to transcriptome analysis to identify the genes and pathways associated with the upregulation of CCR9 leading to enhanced tumirogenesis. The DEGs of the CCR9-associated upregulation were validated both at mRNA and protein levels. Simvastatin was used to assess the effect of cholesterol biosynthesis inhibition on the aggressiveness of T-ALL cells. Results: Comparison of the leukemogenic potentials of the two T-ALL cell lines showed the relatively higher leukemogenic potential of MOLT4 cells, characterized by their enhanced tissue infiltration in NOD-PrkdcscidIL2rgdull (NTG) mice. Transcriptmoe analysis of the two cell lines revealed numerous DEGs, including CCR9, enriched in vital signaling pathways associated with growth and proliferation. Notably, the upregulation of CCR9 also promoted the tissue infiltration of JURKAT cells in vitro and in NTG mice. Transcriptome analysis revealed that CCR9 overexpression facilitated cholesterol production by upregulating the expression of the transcriptional factor SREBF2, and the downstream genes: MSMO1, MVD, HMGCS1, and HMGCR, which was then corroborated at the protein levels. Notably, simvastatin treatment reduced the migration of the CCR9-overexpressing JURKAT cells, suggesting the importance of cholesterol in T-ALL progression. Conclusions: This study highlights the distinct tumorigenic potentials of two T-ALL cell lines and reveals CCR9-regulated enhanced cholesterol biosynthesis in T-ALL.

Exploring multi-level risk factors and post-war burdens of trachomatous trichiasis among displaced population in Raya Kobo districts, implication for urgent action

AIM

To estimate post-war burdens of trachomatous trichiasis (TT) and multi-level risk factors among displaced population in Raya Kobo districts, implication for urgent action.

METHODS

A community-based cross-sectional study was conducted among 603 participants from randomly selected 14 displaced slums in the Raya Kobo district. The data was collected from February 16th to March 30th, 2023. Study participants were selected using the multistage sampling technique. A structured questionnaire and ophthalmic loupe with ×2.5 magnificence were used to collect from participants. Multi-level binary logistic regression was used to determine associated factors with TT infection. Adjusted odds ratio (AOR) with 95% confidence interval (CI) were claimed for the strength of association at P<0.05.

RESULTS

We recruited 602 (99.9%) participants for the final analysis. From the total, 126 (20.9%) and 98 (16.3%, 95%CI: 13.5%-19.4%) participants were diagnosed with active trachoma & TT infection, respectively. Being age ≥45y (AOR=7.9, 95%CI: 2.4-25.3), having multiple eye infections (AOR=2.73, 95%CI: 1.47-5.29), poor wealth index (AOR=9.2; 95%CI: 2.7-23.7) and twice face washing per day (AOR=0.082, 95%CI: 0.03-0.21) has identified as individual as factors for TT infection. Whereas, distance between clean water source ≥10 km (AOR=6.5, 95%CI: 3.9-31.3), and latrine availability (AOR=0.35, 95%CI: 0.21-0.58) were the two community-level factors associated with TT infections.

CONCLUSION

The high prevalence of TT infection post-war throughout the study districts indicates a need for urgent clinical intervention in addition to rapid scaling up surgery, antibiotics, facial cleanliness, and environmental improvement (SAFE) strategies, strategy for high-risk population. Age≥45y, distance from the clean water source, poor wealth indexes, and eye infection are identified to be risk factors for TT infection. Furthermore, community-level preventative factors for TT infection are found as latrine availability and face washing practice.

Prevalence of active trachoma infection and associated factors post-war resettled population in raya kobo districts, North East Ethiopia: A community-based cross-sectional study in 2022

Background

Active trachoma infection poses a serious threat to public health, particularly for those who live in an unprivileged area and has practiced open-field defecation. This study aimed to estimate the prevalence of active trachoma infection and associated factors in the post-war resettled population in Raya Kobo district, North East Ethiopia: a community-based cross-sectional study in 2022.

Methods

A community-based cross-sectional study was conducted among 602 participants randomly selected in 14 slum villages in Raya Kobo from February 16th to March 30th, 2023. After the data was collected using a semi-structured questionnaire and entered into Epi-data version 3.2. The study participants were chosen using a two-stage sampling process. Binary logistic regression was used to identify factors for active trachoma infection. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were claimed for the strength of association at p < 0.05.

Results

Overall, 602 (99.9%) study participants were included in the final analysis. At the end of the study period, 126 (20.9) participants developed active trachoma infection. On multivariable analysis, were aged ≥45 years (AOR = 7.9, 95% CI = 2.4-25.3), history of eye infection (AOR = 3.7, 95% CI = 2.4-10.4, p = 0.001), were poor wealth index (AOR = 9.2, 95% CI = 2.7-23.7), having separated kitchen (AOR = 4.05, 95% CI = 1.86-8.86), living with animals (AOR = 5.92, 95% CI = 2.31-14.7) and having got administration of mass-drug (AOR = 8.9, 95% CI = 2.36-33.6) were significant risk factors for active trachoma infection. Whereas, face washing practice regularly (AOR = 0.23, 95% CI = 0.127-0.43), and toilet availability (AOR = 0.35, 95% CI = 0.20-0.97) were preventive factors for active trachoma infection.

Conclusion

A significant prevalence of active trachoma infection was reported in the area as compared with previous findings and urgent clinical intervention, and the WHO critical SAFE strategies (surgery, antibiotics, facial cleanliness, and environmental improvement) implementation is highly needed in the area. In addition, healthcare providers should focus on information dissemination on proper latrine utilization, and washing the face regularly to prevent active trachoma infection is highly recommended.

Silver diamine fluoride: A stem cell cytotoxicity and dentin growth factor release in-vitro study

AIM

To investigate the effect of 38% SDF and its serial dilutions on the Stem cells from Human Exfoliated Deciduous teeth (SHED) and its ability to release growth factors from deciduous dentine.

METHODS

The viability of SHED post-exposure to 38%, 3.8%, 0.38%, 0.038%, and 0.0038% SDF were assessed at 2, 5, and 7 days using the CyQuant assay, and results were validated using the MTT assay. The osteogenic differentiation of the cells was also investigated post-exposure to 0.0038% SDF. The release of the growth factors; TGF-β1, FGF-b, BMP-2, and VEGF from deciduous dentin discs exposed to 38% SDF, 0.0038% SDF, Ca(OH)2, MTA, and 17% EDTA were examined using ELISA. Statistical analysis was performed using means and standard deviations (p < 0.05). Two-way ANOVA compared the means of more than two groups with Tukey's multiple comparison test. The unpaired t-test was also used to compare the differences between the two data sets.

CONCLUSION

38% SDF released dentinogenic growth factors from dentin discs, potentially explaining its role in reactionary dentinogenesis. Moreover, 0.0038% SDF resulted in a non-cytotoxic concentration that enhanced cellular proliferation and released bioactive molecules from dentin comparable to the 38% concentration. After further investigations, the 0.0038% dilution of SDF could present itself as a clinical concentration.

LncRNA15691 promotes T-ALL infiltration by upregulating CCR9 via increased MATR3 stability

Our previous studies demonstrated that CCR9 plays an important role in several aspects of T-cell acute lymphoblastic leukemia progression and that CCR9 is a potential therapeutic target. However, the underlying mechanism that regulates CCR9 expression remains incompletely understood. In this study, bioinformatics analysis and validation in clinical samples revealed the lncRNA15691 to be positively correlated with CCR9 mRNA expression and significantly upregulated in T-cell acute lymphoblastic leukemia samples and CCR9high T-cell acute lymphoblastic leukemia cell lines. LncRNA15691, a previously uncharacterized lncRNA, was found to be located in both the cytoplasm and the nucleus via fluorescence in situ hybridization assay. In addition, lncRNA15691 upregulated the expression of CCR9 and was involved in T-cell acute lymphoblastic leukemia cell invasion. In vivo experiments showed that lncRNA15691 promoted leukemia cell homing/infiltration into the bone marrow, blood, and spleen, whereas the CCR9 ligand, CCL25, augmented the extramedullary infiltration of CCR9low leukemia cells overexpressing lncRNA15691 into blood, spleen, and liver. Subsequently, RNA protein pull-down assays, coupled with liquid chromatography-tandem mass spectrometry, were used to uncover potential lncRNA15691-interacting proteins, which were then validated by RNA immunoprecipitation. These mechanistic studies revealed that lncRNA15691 upregulated CCR9 expression via directly binding to and stabilizing MATR3 by inhibiting its nuclear degradation mediated by PKA. Collectively, our study revealed a novel mechanism of regulating CCR9 expression and implicated lncRNA15691 as a potential novel biomarker for T-cell acute lymphoblastic leukemia infiltration.

Combination of metformin and sub-therapeutic dose of valproic acid prevent valproic acid-induced toxicity in animal model of epilepsy

Valproic acid (VPA) is one of the most prescribed drugs for epilepsy. Extended use of VPA not only induces hepatotoxicity but also impairs the cognitive functions. Metformin has been reported to prevent epileptogenesis and enhance memory. To counter the VPA-induced adverse events, it is hypothesized that combination of sub-therapeutic dose of VPA with metformin may attenuate the toxicity stemming from the therapeutic dose of VPA. Pentylenetetrazole (PTZ)-induced kindling model of epilepsy in mice was used to assess the combined effects of sub-therapeutic dose of VPA (100 mg/kg) and metformin (200 mg/kg). The memory performance was analyzed by passive avoidance test, while alkaline comet assay was used to determine genotoxicity. Histopathological examination and serum biochemical analysis was performed to determine hepatotoxicity. Results showed that combination dose of VPA with metformin reduced seizure scores. VPA (300 mg/kg) administered as a single agent did not enhance memory impairment caused by PTZ, however, combination of sub-therapeutic dose of VPA with metformin enhanced memory function. Furthermore, in alkaline comet assay, combination therapy demonstrated reduced genotoxicity compared to the VPA 300 mg/kg. Histopathological examination of liver and analysis of serum hepatic enzymes revealed that combination therapy (VPA + metformin) reversed the toxicity as seen in case of PTZ or VPA (300 mg/kg) treated animals with no other treatment given. Based on the study data, it is concluded that the combination of sub-therapeutic dose of VPA with metformin might be used for epileptic seizures. This will prevent the hepatotoxicity and enhanced memory functions as compared to the VPA given as a single agent therapy.

Short Communication: Rare grouper Epinephelus miliaris from market surveys in South Sulawesi, Indonesia

Abstract. Kadir NN, Husain AAA, Irmawati, Priosambodo D, Jamal M, Ilyas M, Malkab ANI, Fasirah E, Moore AM. 2022. Short Communication: Rare grouper Epinephelus miliaris from market surveys in South Sulawesi, Indonesia. Biodiversitas 23: 6070-6074. Groupers of the genusEpinephelus are tropical demersal fishes of both ecological and economic importance. However, knowledge is still limited regarding the diversity of fish caught and traded as well as the fine-scale distribution of many species. During a series of market surveys to photograph and identify groupers exploited in South Sulawesi, Indonesia, a small number of specimens of a widespread but rare grouper, Epinephelus miliaris, were found. The purpose of this study was to contribute to the body of knowledge on E. miliaris by analyzing and presenting spatial, morphological, and meristic data collected on these specimens and discussing the findings with respect to the current state of knowledge regarding this species. Our findings add Sulawesi, including the Makassar Strait and Gulf of Bone, to the recorded distribution of E. miliaris, to the south of the range according to the International Union for Conservation of Nature (IUCN) Red List. Both specimens were within the juvenile or sub-adult size range for this species. We conclude that there is a need to re-evaluate the range of this species, specifically within Indonesia, in fisheries and fish biodiversity databases.

TTYH3, a potential prognosis biomarker associated with immune infiltration and immunotherapy response in lung cancer

PURPOSE

The recognition of new diagnostic and prognostic biological markers for lung cancer is an essential and eager study. It's shown that ion channels play important roles in regulating various cellular processes and have been suggested to be associated with patient survival. However, tweety family member 3 (TTYH3), as a maxi-Cl^- channel, its role in lung cancer remains elusive.

METHODS

The expression, diagnostic and prognostic efficacy of TTYH3 were analyzed by public databases and clinical samples. Cell functional experiments were used to explore the effects of TTYH3 on cell viability. GO and KEGG enrichment analysis revealed underlying pathways that TTYH3 and its co-expressed genes were enriched in. TIMER, TIDE and R language analyses were used to detect the correlation between TTYH3 and immune infiltration cell and immunotherapy response.

RESULTS

TTYH3 was up-regulated in lung cancer tissues compared to normal tissues and possessed a prominent diagnostic and prognostic value. TTYH3 knockdown significantly inhibited the proliferation of lung cancer cells. Enrichment analyses showed that TTYH3 and its co-expressed genes were mainly involved in immune related signaling pathways. Further investigation clarified that TTYH3 had a positive correlation with the infiltration of TAMs, Treg infiltration as well as T cell exhaustion and high TTYH3 expression indicated worse immunotherapy response and shorter survival after immune checkpoint blockade treatment.

CONCLUSION

This study not only revealed the diagnostic and prognostic value of TTYH3 but also provided TTYH3-based estimation of immunotherapy response for lung cancer patients, which might provide new strategies like anti-TTYH3 combined with immune therapy for the treatment of lung cancer.

Performance of waste plastic bio-oil as a rejuvenator for asphalt binder

Pavement recycling is actively applied on asphalt roads due to ageing problems associated with bituminous binders when exposed to weathering and trafficking during their service life. Recycling of asphalt occurs through rejuvenator agents. This study utilised bio-oil produced from hydrothermal liquefaction of waste plastic films (linear low-density polyethylene - LLDPE) to rejuvenate laboratory-aged bitumen. Initially, the neat bitumen was aged through thermal ageing (Pressure Ageing Vessel - PAV) and then the aged binder was mixed with bio-oil from waste plastics at 5% and 8% bio-oil (BO) by weight of aged binder. All four binders including neat bitumen, aged bitumen, aged bitumen/BO-5% and aged bitumen/BO-8% were analysed for thermogravimetric analysis, Fourier Transform Infra-Red analysis, rheology in the linear viscoelastic region, multiple stress creep and recovery analysis, and linear amplitude sweep analysis. The ageing of neat binder resulted in hardening of the binder; however, the bio-oil rejuvenator softened the aged binder significantly. The thermo-chemical and rheological performance of aged binder was significantly improved after the addition of bio-oil. The outcomes suggest how bio-oil produced from hydrothermal liquefaction of waste plastics (possibly non-recyclable) may serve as potential rejuvenator for aged asphalt binders in an effort to recycle more using non-recyclable material.

Hematopoietic Stem and Progenitor Cells (HSPCs) and Hematopoietic Microenvironment: Molecular and Bioinformatic Studies of the Zebrafish Models

Hematopoietic stem cells (HSCs) reside in a specialized microenvironment in a peculiar anatomic location which regulates the maintenance of stem cells and controls its functions. Recent scientific progress in experimental technologies have enabled the specific detection of epigenetic factors responsible for the maintenance and quiescence of the hematopoietic niche, which has improved our knowledge of regulatory mechanisms. The aberrant role of RNA-binding proteins and their impact on the disruption of stem cell biology have been reported by a number of recent studies. Despite recent modernization in hematopoietic microenvironment research avenues, our comprehension of the signaling mechanisms and interactive pathways responsible for integration of the hematopoietic niche is still limited. In the past few decades, zebrafish usage with regards to exploratory studies of the hematopoietic niche has expanded our knowledge for deeper understanding of novel cellular interactions. This review provides an update on the functional roles of different genetic and epigenetic factors and molecular signaling events at different sections of the hematopoietic microenvironment. The explorations of different molecular approaches and interventions of latest web-based tools being used are also outlined. This will help us to get more mechanistic insights and develop therapeutic options for the malignancies.

Frequency of Impacted Third Molar in Mandibular Angle Fractures in Patients Presenting to Ayub Teaching Hospital

Mandibular fractures are one of the commonest maxillofacial injury. Fractures take place at various locations. Mandibular angle fracture susceptibility in addition to being associated to the type and direction of impact is also associated with impacted 3rd molar.The objective of the study is to determine the frequency of impacted third molar in mandibular angle fracture.This descriptive cross-sectional study was performed for a period of six months on one hundred and twenty-two patients with mandibular. OPG was done to determine the state of 3rd molar tooth. The states of 3rd molar tooth along with its inclination were noted on a proforma.The frequency of 3rd molar impaction in fractures of angle of mandible was 36.1%. Young age (less than 31 years in this study) was significantly associated with development of impacted 3rd molar tooth (p < 0.05).Individuals with impacted 3rd molar should be educated about the possibility of the fracture of mandibular angle so that preventive measures can be adopted.

Immune dysregulation and system pathology in COVID-19

The coronavirus disease 19 (COVID-19) caused by the novel coronavirus known as SARS-CoV-2 has caused a global public health crisis. As of 7 January 2021, 87,640,402 confirmed cases and 1,891,692 mortalities have been reported worldwide. Studies focusing on the epidemiological and clinical characteristics of COVID-19 patients have suggested a dysregulated immune response characterized by lymphopenia and cytokine storm in these patients. The exaggerated immune response induced by the cytokine storm causes septic shock, acute respiratory distress syndrome (ARDS), and/or multiple organs failure, which increases the fatality rate of patients with SARS-CoV-2 infection. Herein, we review the recent research progress on epidemiology, clinical features, and system pathology in COVID-19. Moreover, we summarized the recent therapeutic strategies, which are either approved, under clinical trial, and/or under investigation by the local or global health authorities. We assume that treatments should focus on the use of antiviral drugs in combination with immunomodulators as well as treatment of the underlying comorbidities.

Anticonvulsant activity of methanolic extract of Withania cogulans in mice

Mental and neurological diseases including depression, Parkinson's disease, dementia, epilepsy, anxiety disorders and bipolar disorders account for a considerable amount of the world's disease burden. Unfortunately, drugs used in the treatment of neurological diseases are expensive, symptomatic and they produce undesirable side effects. People from different cultures prefer to use medicinal plants for the treatment of various ailments ranging from plain to perplex disorders because they are most affordable, cost effective and easily accessible source of treatment in the primary healthcare system throughout the world. Withania coagulans, an erect grayish under-shrub belongs to family Solanaceae. It is common in Pakistan, East India, Iran and Afghanistan. The objective of this study was to analyze the anti-seizure activity of crude methanolic extract of Withania coagulans fruits (MeWc). For screening of this activity, maximal electroshock seizures model (MES) and chemically-induced seizures models were used. In maximal electroshock seizures test MeWc showed significant dose dependent percent protection against hind-limb tonic extension; significant and dose-dependent increase in latency to myoclonic jerks and tonic clonic convulsions and decrease in seizures duration were observed in PTZ-induced seizures. In strychnine-induced convulsions MeWc significantly increased latency to hind-limb tonic extension and percent protection from death in a dose-dependent manner. Thus, it was inferred from the experiments that extract of Withania coagulans showed anticonvulsant activity.

Recent Progress on Primary Central Nervous System Lymphoma-From Bench to Bedside

Primary central nervous system lymphoma (PCNSL) is a rare subtype of extra-nodal lymphoma. The high relapse rate of PCNSL remains a major challenge to the hematologists, even though patients exhibit high sensitivity to the methotrexate-based chemotherapeutic regimens. Recently, the advent of Bruton's tyrosine kinase inhibitor (BTKi) and CAR T treatment has made more treatment options available to a proportion of patients. However, whether BTKi monotherapy should be given alone or in combination with conventional chemotherapy is still a clinical question. The status of CAR T therapy for PCNSLs also needs to be elucidated. In this review, we summarized the latest progress on the epidemiology, pathology, clinical manifestation, diagnosis, and treatment options for PCNSLs.

Hydatigera taeniaeformis in urban rats (Rattus rattus) in Faisalabad, Pakistan

Hydatigera taeniaeformis formerly referred to as Taenia taeniaeformis is a cestode of cats (definitive hosts) and rodents (intermediate hosts). The prevalence of the metacestode larval stage has been reported in rodents in many parts of the world even though the genetic polymorphisms or intraspecies variation is still understudied. Here, we report a prevalence of 22.09% (38/172) from an urban rodent population in Pakistan and a nucleotide diversity (cox1) of 0.00463 among the population. Infection was higher in male (27.85%) and adult (32.29%) rats than female and sub-adult/young rats. Interestingly, The median-joining network and phylogenetic construction comprising isolates from China, Japan, Kenya, Laos, Malaysia, Senegal, the United Arab Emirates, and countries in Europe demonstrated that Pakistani H. taeniaeformis are closer to Asian and African population than those of European origin. The results of the study will add-in preliminary data for H. taeniaeformis and will also contribute to understand the global molecular epidemiology and population structure of H. taeniaeformis.

Recycling of low-value packaging films in bitumen blends: A grey-based multi criteria decision making approach considering a set of laboratory performance and environmental impact indicators

Many road construction and maintenance projects are increasingly using recycled material as pavement material. Most of the times, generic sustainability evaluations are ascribed to recycled products without fully considering their performance. The potential environmental benefits of various alternatives can be analytically evaluated with Life Cycle Assessment while many performance indicators can be found through laboratory and field tests. However, it is highly uncommon for these two approaches to be combined in the same assessment methodology and most of the analyses rely on one or the other. Trading off between environmental advantages and performance and durability in the field is considered of utmost importance when evaluating construction alternatives, especially on large projects. This study utilizes recycled plastic packaging films for bitumen modification. The recycled polyolefin blend is a combination of linear low-density polyethylene and low-density polyethylene (LLDPE/LDPE). LLDPE/LDPE was added in bitumen at various dosages (i.e., from 3% to 12% by weight of the bitumen) to assess the effect of recycled LLDPE/LDPE on the binder physio-chemical, rheological and thermal performance. In addition to the various laboratory performance tests, the environmental sustainability of the alternatives was evaluated through an LCA study. Finally, the outcomes from the two approaches (laboratory performance and environmental impact assessment) were combined via grey relational analysis to identify the best overall alternative. It was found that the storage stability of LLDPE/LDPE modified blends varied from 6 °C to 57 °C whereas the storage stability value of A35P was 2 °C. Softening point of bitumen was 44.1 °C which improved to 55.7-104.1 °C at different content of LLDPE/LDPE. The melting temperature of LLDPE/LDPE modified blends was 100.22, 101.44, 101.87 and 102.49 for LLDPE/LDPE-3%, LLDPE/LDPE-6%, LLDPE/LDPE-9% and LLDPE/LDPE-12%. The methodology highlighted in the paper can be easily adapted to other scenarios, hence facilitating multi-attribute decision-making processes when incorporating recycled materials in roads and leading to better informed decisions.

Comparison of acute and chronic effects of Bacopa monnieri, Ginkgo biloba, and Lavandula angustifolia and their mixture on learning and memory in mice

Forty-seven million people are living with memory-related disorders worldwide. Phytomedicines are gaining extensive interest in the treatment of these ailments. Memory-enhancing (acute and chronic) potentials of commercial grade extracts of Bacopa monnieri (200 mg/kg, po), Ginkgo biloba (150 mg/kg, po), and Lavandula angustifolia (200 mg/kg, po) and their mixture (B. monnieri 100 mg/kg, G. biloba 75 mg/kg, and L. angustifolia 100 mg/kg, po) were compared for their synergistic/additive effects on the Morris water maze (MWM) test and elevated plus maze (EPM) test in scopolamine-induced amnesia in mice. Escape latency and accumulative path length were significantly reduced both in acute (up to day 6) and chronic trials (days 8-14) in B. monnieri-, G. biloba-, and L. angustifolia-treated animals and their mixtures (n = 8, p < .05) in MWM. Furthermore, in probe trials (acute on day 7 and chronic on day 15), the number of crossing-overs at platform position and time spent in platform quadrant were significantly increased, while transfer latency in EPM was decreased in treated animals as compared to the saline group (n = 8, p < .05). The mixture showed synergistic effects on memory enhancement as compared to each extract individually in mice. Further studies may be carried out on the active compounds of B. monnieri at the cellular and molecular levels.

Targeting chemokines for acute lymphoblastic leukemia therapy

Acute lymphoblastic leukemia (ALL) is a hematological malignancy characterized by the malignant clonal expansion of lymphoid hematopoietic precursors. It is regulated by various signaling molecules such as cytokines and adhesion molecules in its microenvironment. Chemokines are chemotactic cytokines that regulate migration, positioning and interactions of cells. Many chemokine axes such as CXCL12/CXCR4 and CCL25/CCR9 have been proved to play important roles in leukemia microenvironment and further affect ALL outcomes. In this review, we summarize the chemokines that are involved in ALL progression and elaborate on their roles and mechanisms in leukemia cell proliferation, infiltration, drug resistance and disease relapse. We also discuss the potential of targeting chemokine axes for ALL treatments, since many related inhibitors have shown promising efficacy in preclinical trials, and some of them have entered clinical trials.

Effectiveness of Mavrilimumab in Viral Infections Including SARS-CoV-2 Infection - A Brief Review

Hyperinflammation and cytokine storm has been noted as a poor prognostic factor in patients with severe pneumonia related to coronavirus disease 2019 (COVID-19). In COVID-19, pathogenic myeloid cell overactivation is found to be a vital mediator of damage to tissues, hypercoagulability, and the cytokine storm. These cytokines unselectively infiltrate various tissues, such as the lungs and heart, and nervous system. This cytokine storm can hence cause multi-organ dysfunction and life-threatening complications. Mavrilimumab is a monoclonal antibody (mAb) that may be helpful in some cases with COVID-19. During an inflammation, Granulocyte-macrophage colony-stimulating factor (GM-CSF) release is crucial to driving both innate and adaptive immune responses. The GM-CSF immune response is triggered when an antigen attaches to the host cell and induces the signaling pathway. Mavrilimumab antagonizes the action of GM-CSF and decreases the hyperinflammation associated with pneumonia in COVID-19, therefore strengthening the rationale that mavrilimumab when added to the standard protocol of treatment could improve the clinical outcomes in COVID-19 patients, specifically those patients with pneumonia. With this review paper, we aim to demonstrate the inhibitory effect of mavrilimumab on cytokine storms in patients with COVID-19 by reviewing published clinical trials and emphasize the importance of extensive future trials.

Novel biomarkers for the prediction of COVID-19 progression a retrospective, multi-center cohort study

A pandemic designated as Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading worldwide. Up to date, there is no efficient biomarker for the timely prediction of the disease progression in patients. To analyze the inflammatory profiles of COVID-19 patients and demonstrate their implications for the illness progression of COVID-19. Retrospective analysis of 3,265 confirmed COVID-19 cases hospitalized between 10 January 2020, and 26 March 2020 in three medical centers in Wuhan, China. Patients were diagnosed as COVID-19 and hospitalized in Leishenshan Hospital, Zhongnan Hospital of Wuhan University and The Seventh Hospital of Wuhan, China. Univariable and multivariable logistic regression models were used to determine the possible risk factors for disease progression. Moreover, cutoff values, the sensitivity and specificity of inflammatory parameters for disease progression were determined by MedCalc Version 19.2.0. Age (95%CI, 1.017 to 1.048; P < 0.001), serum amyloid A protein (SAA) (95%CI, 1.216 to 1.396; P < 0.001) and erythrocyte sedimentation rate (ESR) (95%CI, 1.006 to 1.045; P < 0.001) were likely the risk factors for the disease progression. The Area under the curve (AUC) of SAA for the progression of COVID-19 was 0.923, with the best predictive cutoff value of SAA of 12.4 mg/L, with a sensitivity of 83.9% and a specificity of 97.67%. SAA-containing parameters are novel promising ones for predicting disease progression in COVID-19.

CLEC3B as a potential diagnostic and prognostic biomarker in lung cancer and association with the immune microenvironment

Background

Lung cancer is the leading cause of cancer-related mortality globally. Discovering effective biomarkers for early diagnosis and prognosis is important to reduce the mortality rate and ensure efficient therapy for lung cancer patients. C-type lectin domain family 3 member B (CLEC3B) has been reported in various cancers, but its correlation with lung cancer remains elusive.

Methods

The GEO, TCGA and Oncomine databases were analyzed to examine the expression of CLEC3B in lung cancer. The CLEC3B mRNA levels in 15 patient tissue samples were detected by real-time PCR and the CLEC3B protein levels in 34 patient tissue samples were detected by immunohistochemistry. A Chi-square test was performed to analyze the correlation of CLEC3B expression and clinicopathological factors. The diagnostic value of CLEC3B was revealed by receiver operating characteristic (ROC) curves. Univariate and multivariate Cox proportional hazards regression models and Kaplan–Meier plots were used to evaluate the prognostic value of CLEC3B in lung cancer. The TIMER database was used to evaluate the correlation of CLEC3B and immune infiltration. Gene set enrichment analysis revealed tumor‐associated biological processes related to CLEC3B.

Results

CLEC3B is significantly downregulated in lung cancer patients compared with nontumor controls according to database analysis and patient tissue sample detection (p < 0.001). Specifically, CLEC3B is significantly downregulated in stage IA lung cancer patients (p < 0.001) and has a high diagnostic accuracy (area under the receiver operating characteristic curve > 0.9). Moreover, low expression of CLEC3B is related to poor progression-free survival (HR = 0.60, 95% CI 0.49–0.74, p = 8.3e−07) and overall survival (HR = 0.66, 95% CI 0.58–0.75, p = 2.1e−10), indicating it as a risk factor for lung cancer. Multivariate analysis value showed that low expression of CLEC3B may be an independent risk factor for disease‐free survival in lung cancer patients (HR = 0.655, 95% CI 0.430–0.996, Cox p = 0.048). In addition, we also investigated the potential role of CLEC3B in tumor-immune interactions and found that CLEC3B might be associated with the immune infiltration and immune activation of lung cancer, especially in squamous cell carcinoma.

Conclusions

Our findings indicate that CLEC3B expression is downregulated in lung cancer and reveal the diagnostic and prognostic potential of CLEC3B in lung cancer and its potential as an immune-related therapeutic target in lung cancer.

Recent Progress on Circular RNA Research in Acute Myeloid Leukemia

Acute myeloid leukemia (AML) is a myeloid malignancy characterized by the proliferation of abnormal and immature myeloid blasts in the bone marrow. Circular RNA (circRNA) is a novel class of long non-coding RNA with a stable circular conformation that regulates various biological processes. The aberrant expression of circRNA and its impact on AML progression has been reported by a number of studies. Despite recent advances in circRNA research, our understanding of the leukemogenic mechanism of circRNA remains very limited, and translating the current circRNA-related research into clinical practice is challenging. This review provides an update on the functional roles of and research progress on circRNAs in AML with an emphasis on mechanistic insights. The challenges and opportunities associated with circRNA-based diagonostic and therapeutic development in AML are also outlined.

Molecular profiling of radical prostatectomy tissue from patients with no sign of progression identifies ERG as the strongest independent predictor of recurrence

BACKGROUND

As a major cause of morbidity and mortality among men, prostate cancer is a heterogenous disease, with a vast heterogeneity in the biology of the disease and in clinical outcome. While it often runs an indolent course, local progression or metastasis may eventually develop, even among patients considered "low risk" at diagnosis. Therefore, biomarkers that can discriminate aggressive from indolent disease at an early stage would greatly benefit patients. We hypothesized that tissue specimens from early stage prostate cancers may harbor predictive signatures for disease progression.

METHODS

We used a cohort of radical prostatectomy patients with longitudinal follow-up, who had tumors with low grade and stage that revealed no signs of future disease progression at surgery. During the follow-up period, some patients either remained indolent (non-BCR) or progressed to biochemical recurrence (BCR). Total RNA was extracted from tumor, and adjacent normal epithelium of formalin-fixed-paraffin-embedded (FFPE) specimens. Differential gene expression in tumors, and in tumor versus normal tissues between BCR and non-BCR patients were analyzed by NanoString using a customized CodeSet of 151 probes.

RESULTS

After controlling for false discovery rates, we identified a panel of eight genes (ERG, GGT1, HDAC1, KLK2, MYO6, PLA2G7, BICD1 and CACNAID) that distinguished BCR from non-BCR patients. We found a clear association of ERG expression with non-BCR, which was further corroborated by quantitative RT-PCR and immunohistochemistry assays.

CONCLUSIONS

Our results identified ERG as the strongest predictor for BCR and showed that potential prognostic prostate cancer biomarkers can be identified from FFPE tumor specimens.

Evaluation of safety profile and stress suppressant activity of Rosa moschata in mice

Stress is a state that seriously disturbs psychological or physiological homeostasis of the body and subsequently affects the morphology and function of the hippocampus. Currently available anti-stress medications provide limited benefits with cost of severe adverse effects. In the present study, effect of Rosa moschata extract was evaluated using acute restraint model in mice. The stress suppressant activity of Rosa moschata was evaluated by using elevated plus maze test (EPM), dark light box test and open field test (OFT) following restraint stress protocol. Results showed that the Rosa moschata extract significantly enhanced the number of transitions and the time spent in the open arm in the EPM, increased the number of transitions and time spent in the light compartment of the dark light box, and also enhanced the locomotor activity in OFT, as compared to the stress group. In addition, LD₅₀ of the plant extract is greater than 5000mg/Kg. Thus the findings of our studies show that Rosa moschata significantly alleviates stress following the acute restraint stress in mice. Further studies dealing with underlying mechanism and characterization of active fraction/compound may provide an alternative therapy for stress and related neurological conditions.

Minichromosome maintenance protein 10 as a marker for proliferation and prognosis in lung cancer

DNA replication is a vital process in cell division where anomalies can lead to tumorigenesis. Minichromosome maintenance complex component 10 (MCM10) plays a crucial role in this process. However, the role of MCM10 in lung cancer pathogenesis remains to be elucidated. In current study, using the publicly available lung cancer Gene Expression Omnibus (GEO) datasets, and Oncomine and the Cancer Genome Atlas databases, an increased expression of MCM10 was found in lung cancer tissues compared to normal lung tissues. The high expression of MCM10 was subsequently validated in clinical specimens by reverse transcription‑quantitative PCR and immunohistochemistry. Analysis of the GEO datasets revealed that the high MCM10 expression was significantly associated with early and late recurrence, pathological stage and worse overall survival (OS). Cox's proportional hazards regression analyses revealed that MCM10 expression was an independent risk factor for poor OS and worse recurrence‑free survival both in univariate and multivariate analysis. Furthermore, the increased expression of MCM10 was enriched in cell cycle‑related processes, while in vitro transfection with small interfering RNA targeting MCM10 significantly suppressed cell viability, clone formation and induced G1 phase arrest in A549 and H661 cell lines by regulating the expression of cyclin D1 (CCND1). In addition, the current results indicated a combined effect of MCM10‑CCND1 in predicting the prognosis of lung cancer patients. Altogether, the present study provided a novel potential molecular mechanism of lung cancer progression and may aid in development of novel treatment strategies.

Uridine-cytidine kinase 2 (UCK2): A potential diagnostic and prognostic biomarker for lung cancer

Lung cancer has the highest morbidity and mortality among all cancers. Discovery of early diagnostic and prognostic biomarkers of lung cancer can greatly facilitate the survival rate and reduce its mortality. In our study, by analyzing Gene Expression Omnibus and Oncomine databases, we found a novel potential oncogene uridine‐cytidine kinase 2 (UCK2), which was overexpressed in lung tumor tissues compared to adjacent nontumor tissues or normal lung. Then we confirmed this finding in clinical samples. Specifically, UCK2 was identified as highly expressed in stage IA lung cancer with a high diagnostic accuracy (area under the receiver operating characteristic curve > 0.9). We also found that high UCK2 expression was related to poorer clinicopathological features, such as higher T stage and N stage and higher probability of early recurrence. Furthermore, we found that patients with high UCK2 expression had poorer first progression survival and overall survival than patients with low UCK2 expression. Univariate and multivariate Cox regression analyses showed that UCK2 was an independent risk factor related with worse DFS and OS. By gene set enrichment analysis, tumor‐associated biological processes and signaling pathways were enriched in the UCK2 overexpression group, which indicated that UCK2 might play a vital role in lung cancer. Furthermore, in cytology experiments, we found that knockdown of UCK2 could suppress the proliferation and migration of lung cancer cells. In conclusion, our study indicated that UCK2 might be a potential early diagnostic and prognostic biomarker for lung cancer.

Nicotinamide increases the sensitivity of chronic myeloid leukemia cells to doxorubicin via the inhibition of SIRT1

The NAD-dependent deacetylase Sirtuin 1 (SIRT1) plays a vital role in leukemogenesis. Nicotinamide (NAM) is the principal NAD⁺ precursor and a noncompetitive inhibitor of SIRT1. In our study, we showed that NAM enhanced the sensitivity of chronic myeloid leukemia (CML) to doxorubicin (DOX) via SIRT1. We found that SIRT1 high expression in CML patients was associated with disease progression and drug resistance. Exogenous NAM efficiently repressed the deacetylation activity of SIRT1 and induced the apoptosis of DOX-resistant K562 cells (K562R) in a dose-dependent manner. Notably, the combination of NAM and DOX significantly inhibited tumor cell proliferation and induced cell apoptosis. The knockdown of SIRT1 in K562R cells enhanced NAM+DOX-induced apoptosis. SIRT1 rescue in K562R reduced the NAM+DOX-induced apoptosis. Mechanistically, the combinatory treatment significantly increased the cleavage of caspase-3 and PARP in K562R in vitro and in vivo. These results suggest the potential role of NAM in increasing the sensitivity of CML to DOX via the inhibition of SIRT1.

An Essential Role of Innate Lymphoid Cells in the Pathophysiology of Graft-vs.-Host Disease

Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) is the only curative treatment for multiple hematologic malignancies and non-malignant hematological diseases. However, graft-vs.-host disease (GVHD), one of the main complications after allo-HSCT, remains the major reason for morbidity and non-relapse mortality. Emerging evidence has demonstrated that innate lymphoid cells (ILCs) play a non-redundant role in the pathophysiology of GVHD. In this review, we will summarize previously published data regarding the role of ILCs in the pathogenesis of GVHD.

The prognostic value of matrix metalloproteinase-7 and matrix metalloproteinase-15 in acute myeloid leukemia

Matrix metalloproteinases (MMPs), a family of zinc-dependent endopeptidases, are involved in a variety of physiological and pathological processes. We analyzed 11 data sets from Gene Expression Omnibus Database and found that MMP7 and MMP15 were highly expressed in multiple carcinomas. GSE13204 showed that MMP7 and MMP15 were overexpressed in acute myeloid leukemia (AML) patients. The Cancer Genome Atlas data set exhibited that high expression of MMP7 or MMP15 in bone marrow (BM) of AML patients predicted poor overall survival. The χ ² test results indicated that high expression level of MMP7 and MMP15 were correlated with high-risk stratification and high BM blast cell percentage in AML patients. To confirm these findings, we performed reverse-transcription quantitative polymerase chain reaction (RT-qPCR) and found that MMP7 and MMP15 were highly expressed in three AML cell lines. Further study showed that MMP7 and MMP15 were highly expressed both in BM and peripheral blood in collected AML samples compared with healthy individuals. Additionally, long noncoding RNA (lncRNA) microarray of BM samples of AML patients revealed that multiple lncRNAs were correlated with MMP7 and MMP15, suggesting that lncRNAs might be involved in the pathogenesis of AML via modulating MMPs. In conclusion, our study uncovers the potential roles of MMP7 and MMP15 in the prognosis of AML.

Abstract A010: ETS-related gene mediated androgen receptor aggregation and endoplasmic reticulum stress in prostate cancer development

Introduction: AR-mediated activation of ETS Related Gene (ERG) represents one of the most common and validated prostate cancer driver genes. Recently, we have shown novel morphologic phenotypes of endoplasmic reticulum (ER) stress in prostate glands of ARR2PB-ERG transgenic mouse. Since AR regulates ERG expression through TMPRSS2 promoter in human prostate cancer, we continue to investigate the post-translational interactions between ERG and AR leading to ER stress and subsequently to cell survival mechanisms. Understanding these mechanisms will potentially have major therapeutic implications.

Methods: Light and electron microscopy were used to examine the morphologic and subcellular differences. AR aggregations, Co-IP and Proximal Ligation Assay for protein-protein interactions were studied in LNCaP, HEK293 cells. N-terminal and C-deletions of AR were utilized to identify specific AR domain interactions with ERG. Luminal cell surface markers on the isolated mouse prostate glands and spontaneously immortalized mouse prostate epithelial cells from ERG transgenic mouse (MoE1) were analyzed by FACS analysis.

Results: Coexpression of ERG and AR showed significant aggregation of AR in filter assays. Co-IP experiments and PLA assays revealed that significant interactions occur through N-terminal domain of AR with ERG. Epithelial cells of ERG-Tg mouse prostates showed ~70% increase in CD49f (low) and Sca-1 (med) population with increased sphere formation capability and resistance to radiation-induced cell death. Both epithelial cells grown into spheres and established MoE1 cells displayed increased CD49f (low) and significant increase in the EpCAM negative population.

Conclusions: Overall, our experiments demonstrate the mechanistic link that the physical interactions between ERG and AR lead to ER stress in prostate epithelium through AR misfolding/aggregation. Our observations of ERG-induced AR aggregation as one of the initial events that lead to ER stress and to cell survival indicate a critical function for ERG in the etiology of prostate cancer initiation and progression.

Citation Format: Taduru L. Sreenath, Shiela S. Macalindong, Natallia Mikhalkevich, Shashwat Sharad, Ahmed Mohamed, Denise Young, Borbiev Talaibek, Charles Xavier, Rishita Gupta, Muhammad Jamal, Kevin Babcock, Shyh-Han Tan Tan, Marja T. Nevalainen, Albert Dobi, Gyorgy Petrovics, Isabell A. Sesterhenn, Inger L. Rosner, Charles J. Bieberich, Peter Nelson, Valeri Vasioukhin, Shiv Srivastava. ETS-related gene mediated androgen receptor aggregation and endoplasmic reticulum stress in prostate cancer development [abstract]. In: Proceedings of the AACR Special Conference: Prostate Cancer: Advances in Basic, Translational, and Clinical Research; 2017 Dec 2-5; Orlando, Florida. Philadelphia (PA): AACR; Cancer Res 2018;78(16 Suppl):Abstract nr A010.

PEG10 as an oncogene: expression regulatory mechanisms and role in tumor progression

Cancer is a major public health problem as one of the leading causes of death worldwide. Deciphering the molecular regulation mechanisms of tumor progression can make way for tumor diagnosis and therapy. Paternally expressed gene 10 (PEG10), located on human chromosome 7q21.3, has turned out to be an oncogene implicated in the proliferation, apoptosis and metastasis of tumors. PEG10 has been found to be positively expressed in a variety of cancers with seemingly complex expression regulation mechanisms. In this review, we focus on the most vital factors influencing PEG10 expression and recapitulate some of the currently known and potential mechanisms of PEG10 affecting tumor progression, as understanding the molecular regulatory mechanisms of tumor progression can provide potential PEG10 related diagnosis and biomarker specific targeted therapies.

Reducible problem for a class of almost-periodic non-linear Hamiltonian systems

This paper studies the reducibility of almost-periodic Hamiltonian systems with small perturbation near the equilibrium which is described by the following Hamiltonian system: d x d t = J [ A + ε Q ( t , ε ) ] x + ε g ( t , ε ) + h ( x , t , ε ) . It is proved that, under some non-resonant conditions, non-degeneracy conditions, the suitable hypothesis of analyticity and for the sufficiently small ε, the system can be reduced to a constant coefficients system with an equilibrium by means of an almost-periodic symplectic transformation.

Rabies viruses leader RNA interacts with host Hsc70 and inhibits virus replication

Viruses have been shown to be equipped with regulatory RNAs to evade host defense system. It has long been known that rabies virus (RABV) transcribes a small regulatory RNA, leader RNA (leRNA), which mediates the transition from viral RNA transcription to replication. However, the detailed molecular mechanism remains enigmatic. In the present study, we determined the genetic architecture of RABV leRNA and demonstrated its inhibitory effect on replication of wild-type rabies, DRV-AH08. The RNA immunoprecipitation results suggest that leRNA inhibits RABV replication via interfering the binding of RABV nucleoprotein with genomic RNA. Furthermore, we identified heat shock cognate 70 kDa protein (Hsc70) as a leRNA host cellular interacting protein, of which the expression level was dynamically regulated by RABV infection. Notably, our data suggest that Hsc70 was involved in suppressing RABV replication by leader RNA. Finally, our experiments imply that leRNA might be potentially useful as a novel drug in rabies post-exposure prophylaxis. Together, this study suggested leRNA in concert with its host interacting protein Hsc70, dynamically down-regulate RABV replication.

Adaptive gene profiling of Mycobacterium tuberculosis during sub-lethal kanamycin exposure

Resistance to anti-tuberculosis drugs is a formidable obstacle to effective tuberculosis (TB) treatment and prevention globally. New forms of multidrug, extensive drug and total drug resistance Mycobacterium tuberculosis (Mtb) causing a serious threat to human as well as animal's population. Mtb shows diverse adaptability under stress conditions especially antibiotic treatment, however underlying physiological mechanism remained elusive. In present study, we investigated Mtb's response and adaptation with reference to gene expression during sub-lethal kanamycin exposure. Mtb were cultured under sub-lethal drug and control conditions, where half were sub-cultured every 3-days to observe serial adaptation under same conditions and the remaining were subjected to RNA-seq. We identified 98 up-regulated and 198 down-regulated responsive genes compared to control through differential analysis, of which Ra1750 and Ra3160 were the most responsive genes. In adaptive analysis, we found Ra1750, Ra3160, Ra3161, Ra3893 and Ra2492 up-regulation at early stage and gradually showed low expression levels at the later stages of drug exposure. The adaptive expression of Ra1750, Ra3160 and Ra3161 were further confirmed by real time qPCR. These results suggested that these genes contributed in Mtb's physiological adaptation during sub-lethal kanamycin exposure. Our findings may aid to edify these potential targets for drug development against drug resistance tuberculosis.

Improving CRISPR-Cas9 On-Target Specificity

The CRISPR-Cas9 has revolutionized the field of molecular biology, medical genetics and medicine. The technology is robust, facile and simple to achieve genome targeting in cells and organisms. However, to propagate these nucleases for therapeutic application, the on-target specificity is of paramount importance. Although the binding and cleavage of off-target sites by Cas9 is issue of concern, however the specificity of CRISPR technology is greatly improved in current research employing the use of engineer nucleases, improved gRNA selection, novel Cas9 orhtologs and the advancement in methods to detect and screen off-target sites and its effects. Here we summarize the advances in this state-of-the-art technology that will equip the genome editing tools to be applied in clinical research. The researcher should optimize these methods with emphasize to achieve perfection in the specificity.

Treating Genetic Disorders Using State-Of-The-Art Technology

CRISPR-Cas9 (clustered regularly interspaced short palindromic repeats-CRISPR associated Protein 9), basically a bacterial immune system is now widely applicable to engineer genomes of a number of cells and organisms because of its simplicity and robustness. In research avenue the system has been optimized to regulate gene expression, modify epigenome and edit target locus. These applications make CRISPR/Cas9, a technology of choice to edit disease causing mutations as well as the epigenome more efficiently than ever before. Meanwhile its application in in vivo and ex vivo cells is encouraging the scientific community for more vigorous gene therapy and in clinical setups for therapeutic genome editing. Here we review the recent advances that CRISPR-Cas9 mediated genome editing has achieved and is reported in previous studies and address the challenges associated with it.

An Era of CRISPR/ Cas9 Mediated Plant Genome Editing

Recently the engineered nucleases have revolutionized genome editing to perturb gene expression at specific sites in complex eukaryotic genomes. Three important classes of these genome editing tools are Moreover, the more recent type II Clustered Regularly Inter-spaced Short Palindromic Repeats/Crispr associated protein (CRISPR/Cas9) system has become the most favorite plant genome editing tool for its precision and RNA based specificity unlike its counterparts which rely on protein based specificity. Plasmid-mediated co-delivery of multiple sgRNAs and Cas9 to the Plant cell can simultaneously alter more than one target loci which enable multiplex genome editing. In this review, we discuss recent advancements in the CRISPR/ Cas9 technology mechanism, theory and its applications in plants and agriculture. We also suggest that the CRISPR/ Cas9 as an effective genome editing tool, has vast potential for crop improvement and studying gene regulation mechanism and chromatin remodeling.

Abstract 4504: Androgen receptor aggregation is a key regulator of endoplasmic reticulum stress and cell survival in ETS-related gene driven prostate carcinogenesis

Introduction and Objectives: Deregulated androgen receptor (AR) signaling due to either mutations or altered expression of the AR and its cofactors (activators or suppressors) has been identified as critical in prostate cancer development and progression. AR regulated oncogenic activation of Ets Related Gene (ERG) represents one of the most common and validated prostate cancer driver gene. In our recent studies using prostate specific ERG transgenic mouse prostate glands, we observed novel morphological phenotypes of endoplasmic reticulum (ER) stress. Since AR was the critical regulator of ERG expression through TMPRSS2 promoter in human prostate cancer, the present study was aimed towards understanding the post-translational interactions between ERG and AR in ER stress and subsequent cell survival mechanisms in mouse and cell culture models. Understanding such mechanistic insights will potentially have major therapeutic implications.

Methods: Histological phenotype in the mouse prostate glands were examined by light and electron microscopy. Cell culture models of LNCaP, HEK293 and COS7 cells were utilized to examine the AR aggregations, Co-IP and Proximal Ligation Assay in the presence and absence of ERG. Various domain deletions of AR were utilized to identify specific AR domain interactions with ERG and its contribution in AR aggregation. Luminal cell surface markers on the isolated mouse prostate glands and spontaneously immortalized mouse prostate epithelial cells from ERG transgenic mouse (MoE1) were analyzed by FACS analysis.

Results: Co-expression of ERG and AR in LNCaP and COS-7 cells showed significant aggregation of AR in filter assays. Co-IP experiments and PLA assays in VCaP, LNCaP and HEK 293 cell revealed that ERG physically interacts with AR. Epithelial cells of ERG-Tg mouse prostates showed ~70% increase in CD49f (low) and Sca-1 (med) population with increased sphere formation capability and resistance to radiation induced cell death. Both epithelial cells grown into spheres and established MoE1 cells displayed increased CD49f (low) and significant increase in the EpCAM negative population.

Conclusions: Overall, our experiments demonstrate the mechanistic link that the physical interactions between ERG and AR initiate the ER stress in prostate epithelium through AR misfolding/aggregation. Our observation of ERG induced AR aggregation is one of the initial events that lead to ER stress to cell survival indicate a critical function for ERG in the etiology of prostate cancer initiation and progression.

Funding: This research in part was supported by the National Cancer Institute R01CA162383 (S. S.) and HU0001-10-2-0002 funds.

Citation Format: Taduru L. Sreenath, Natallia Mikhalkevich, Shashwat Sharad, Rishita Gupta, Oluwatosin Diaro, Kevin Babcock, Charles Xavier, Ahmed Mohamed, Muhammad Jamal, Shyh-Han Tan, Albert Dobi, Gyorgy Petrovics, Isabell A. Sesterhenn, David G. McLeod, Inger L. Rosner, Shiv Srivastava. Androgen receptor aggregation is a key regulator of endoplasmic reticulum stress and cell survival in ETS-related gene driven prostate carcinogenesis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4504. doi:10.1158/1538-7445.AM2017-4504

Abstract 1183: Structure-activity studies and biological evaluations of ERGi-USU, a highly selective inhibitor for ERG-positive prostate cancer cells

Introduction and objectives: While new prostate cancer (CaP) treatments (Abiraterone and Enzalutamide) have improved survival in castration-resistant prostate cancer (CRPC), their benefits are short-lived and drug resistance develops likely due to numerous adaptive mutations. Therefore it is a critical to develop effective novel inhibitors to target other signaling pathways that promote or contribute to prostate tumorigenesis. Accumulating evidence has established the androgen regulated TMPRSS2-ERG fusion as a common oncogenic driver that contributes to the early development and progression of over half of CaP. Therefore, ERG oncoprotein and ERG dependent pathways are promising targets for CaP therapy in early stages when cancer is most responsive to treatment. We previously identified a small molecule inhibitor, ERGi-USU, which selectively inhibits ERG protein and cell growth in ERG positive tumor cell lines and mouse xenograft models. In an effort to further develop ERGi-USU with enhanced efficacy we performed detailed structure-activity relationship (SAR) evaluation of ERGi-USU core structure and developed new derivatives.

Methods: Based on SAR of the core structure of ERGi-USU, 48 new derivatives were designed and synthesized by substitutions with alkyl, alkoxy, cycloalkyl, heterocycloalkyl, aryl, heteroaryl or hydroxyl groups. The new ERGi-USU derivatives were evaluated for inhibition of cell growth and ERG protein levels in the TMPRSS2-ERG fusion harboring CaP cell line, VCaP. Four of these compounds have been selected for evaluation of ERG selectivity by defining IC50 in ERG positive malignant cells (VCaP, KG1, MOLT-4 and COLO320), ERG negative CaP cell line (LNCaP) or ERG positive normal primary endothelium-derived cells (HUVEC).

Result: Like parental compound, four new ERGi-USU derivatives exhibited inhibition of cell growth and ERG protein levels in ERG positive VCaP, KG1, MOLT-4 and COLO320 cell lines, with no or minimal effects on LNCaP and HUVEC cells. One of the new derivatives (ERGi-USU#6) showed increased efficacy for cell growth inhibition (IC50=0.074µM) compared to the parental ERGi-USU (IC50=0.200µM). Other three new compounds showed similar IC50 as the ERGi-USU.

Conclusion: Comprehensive evaluation of ERGi-USU derivatives along with parental compound has continued to underscore selective inhibition of ERG positive tumor cells by these small molecules.

Citation Format: Ahmed A. Mohamed, Charles P. Xavier, Gauthaman Sukumar, Samuel D. Banister, Vineet Kumar, Shyh-Han Tan, Shilpa Katta, Lakshmi Ravindranath, Muhammad Jamal, Taduru Sreenath, David G. McLeod, Gyorgy Petrovics, Albert Dobi, Meera Srivastava, Sanjay Malhotra, Clifton Dalgard, Shiv Srivastava. Structure-activity studies and biological evaluations of ERGi-USU, a highly selective inhibitor for ERG-positive prostate cancer cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 1183. doi:10.1158/1538-7445.AM2017-1183