The MUC1-HIF-1α signaling axis regulates pancreatic cancer pathogenesis through polyamine metabolism remodeling

Dysregulation of polyamine metabolism has been implicated in cancer initiation and progression; however, the mechanism of polyamine dysregulation in cancer is not fully understood. In this study, we investigated the role of MUC1, a mucin protein overexpressed in pancreatic cancer, in regulating polyamine metabolism. Utilizing pancreatic cancer patient data, we noted a positive correlation between MUC1 expression and the expression of key polyamine metabolism pathway genes. Functional studies revealed that knockdown of spermidine/spermine N1-acetyltransferase 1 (SAT1), a key enzyme involved in polyamine catabolism, attenuated the oncogenic functions of MUC1, including cell survival and proliferation. We further identified a regulatory axis whereby MUC1 stabilized hypoxia-inducible factor (HIF-1α), leading to increased SAT1 expression, which in turn induced carbon flux into the tricarboxylic acid cycle. MUC1-mediated stabilization of HIF-1α enhanced the promoter occupancy of the latter on SAT1 promoter and corresponding transcriptional activation of SAT1, which could be abrogated by pharmacological inhibition of HIF-1α or CRISPR/Cas9-mediated knockout of HIF1A. MUC1 knockdown caused a significant reduction in the levels of SAT1-generated metabolites, N1-acetylspermidine and N8-acetylspermidine. Given the known role of MUC1 in therapy resistance, we also investigated whether inhibiting SAT1 would enhance the efficacy of FOLFIRINOX chemotherapy. By utilizing organoid and orthotopic pancreatic cancer mouse models, we observed that targeting SAT1 with pentamidine improved the efficacy of FOLFIRINOX, suggesting that the combination may represent a promising therapeutic strategy against pancreatic cancer. This study provides insights into the interplay between MUC1 and polyamine metabolism, offering potential avenues for the development of treatments against pancreatic cancer.

Cancer-associated fibroblast-derived acetate promotes pancreatic cancer development by altering polyamine metabolism via the ACSS2-SP1-SAT1 axis

The ability of tumour cells to thrive in harsh microenvironments depends on the utilization of nutrients available in the milieu. Here we show that pancreatic cancer-associated fibroblasts (CAFs) regulate tumour cell metabolism through the secretion of acetate, which can be blocked by silencing ATP citrate lyase (ACLY) in CAFs. We further show that acetyl-CoA synthetase short-chain family member 2 (ACSS2) channels the exogenous acetate to regulate the dynamic cancer epigenome and transcriptome, thereby facilitating cancer cell survival in an acidic microenvironment. Comparative H3K27ac ChIP-seq and RNA-seq analyses revealed alterations in polyamine homeostasis through regulation of SAT1 gene expression and enrichment of the SP1-responsive signature. We identified acetate/ACSS2-mediated acetylation of SP1 at the lysine 19 residue that increased SP1 protein stability and transcriptional activity. Genetic or pharmacologic inhibition of the ACSS2-SP1-SAT1 axis diminished the tumour burden in mouse models. These results reveal that the metabolic flexibility imparted by the stroma-derived acetate enabled cancer cell survival under acidosis via the ACSS2-SP1-SAT1 axis.

DHODH inhibition enhances the efficacy of immune checkpoint blockade by increasing cancer cell antigen presentation

Pyrimidine nucleotide biosynthesis is a druggable metabolic dependency of cancer cells, and chemotherapy agents targeting pyrimidine metabolism are the backbone of treatment for many cancers. Dihydroorotate dehydrogenase (DHODH) is an essential enzyme in the de novo pyrimidine biosynthesis pathway that can be targeted by clinically approved inhibitors. However, despite robust preclinical anticancer efficacy, DHODH inhibitors have shown limited single-agent activity in phase 1 and 2 clinical trials. Therefore, novel combination therapy strategies are necessary to realize the potential of these drugs. To search for therapeutic vulnerabilities induced by DHODH inhibition, we examined gene expression changes in cancer cells treated with the potent and selective DHODH inhibitor brequinar (BQ). This revealed that BQ treatment causes upregulation of antigen presentation pathway genes and cell surface MHC class I expression. Mechanistic studies showed that this effect is 1) strictly dependent on pyrimidine nucleotide depletion, 2) independent of canonical antigen presentation pathway transcriptional regulators, and 3) mediated by RNA polymerase II elongation control by positive transcription elongation factor B (P-TEFb). Furthermore, BQ showed impressive single-agent efficacy in the immunocompetent B16F10 melanoma model, and combination treatment with BQ and dual immune checkpoint blockade (anti-CTLA-4 plus anti-PD-1) significantly prolonged mouse survival compared to either therapy alone. Our results have important implications for the clinical development of DHODH inhibitors and provide a rationale for combination therapy with BQ and immune checkpoint blockade.

Vitamin B6 Competition in the Tumor Microenvironment Hampers Antitumor Functions of NK Cells

Nutritional factors play crucial roles in immune responses. The tumor-caused nutritional deficiencies are known to affect antitumor immunity. Here, we demonstrate that pancreatic ductal adenocarcinoma (PDAC) cells can suppress NK-cell cytotoxicity by restricting the accessibility of vitamin B6 (VB6). PDAC cells actively consume VB6 to support one-carbon metabolism, and thus tumor cell growth, causing VB6 deprivation in the tumor microenvironment. In comparison, NK cells require VB6 for intracellular glycogen breakdown, which serves as a critical energy source for NK-cell activation. VB6 supplementation in combination with one-carbon metabolism blockage effectively diminishes tumor burden in vivo. Our results expand the understanding of the critical role of micronutrients in regulating cancer progression and antitumor immunity, and open new avenues for developing novel therapeutic strategies against PDAC.

SIGNIFICANCE

The nutrient competition among the different tumor microenvironment components drives tumor growth, immune tolerance, and therapeutic resistance. PDAC cells demand a high amount of VB6, thus competitively causing NK-cell dysfunction. Supplying VB6 with blocking VB6-dependent one-carbon metabolism amplifies the NK-cell antitumor immunity and inhibits tumor growth in PDAC models. This article is featured in Selected Articles from This Issue, p. 5.

Household waste management behaviour amongst residents in an informal settlement in Durban, South Africa

In South Africa, household waste management is a significant challenge in informal settlements, as most of these lack basic waste management infrastructure, and the government's waste management services are limited. This contextual setting brings unique challenges that have not been extensively explored in existing research. Understanding waste management behaviour is therefore critical in addressing underlying challenges and improving waste management practices in such settlements. The purpose of this study was to assess the waste management behaviour among residents of the Shannon Drive informal settlement, in Durban, South Africa. Using the Theory of Planned Behaviour, this study conducted a cross-sectional survey amongst 226 residents at the Shannon Drive informal settlement in Durban, South Africa. The findings suggest that whilst individuals have a positive attitude towards managing their household waste, they believe that it is solely the responsibility of the municipality to manage this in their area, which could have implications for waste management policies and programs. The findings suggest that there is a need for continued education and outreach efforts to promote positive behaviour towards household waste management.

ENT1 blockade by CNX-774 overcomes resistance to DHODH inhibition in pancreatic cancer

Inhibitors of dihydroorotate dehydrogenase (DHODH), a key enzyme for de novo synthesis of pyrimidine nucleotides, have failed in clinical trials for various cancers despite robust efficacy in preclinical animal models. To probe for druggable mediators of DHODH inhibitor resistance, we performed a combination screen with a small molecule library against pancreatic cancer cell lines that are highly resistant to the DHODH inhibitor brequinar (BQ). The screen revealed that CNX-774, a preclinical Bruton tyrosine kinase (BTK) inhibitor, sensitizes resistant cell lines to BQ. Mechanistic studies showed that this effect is independent of BTK and instead results from inhibition of equilibrative nucleoside transporter 1 (ENT1) by CNX-774. We show that ENT1 mediates BQ resistance by taking up extracellular uridine, which is salvaged to generate pyrimidine nucleotides in a DHODH-independent manner. In BQ-resistant cell lines, BQ monotherapy slowed proliferation and caused modest pyrimidine nucleotide depletion, whereas combination treatment with BQ and CNX-774 led to profound cell viability loss and pyrimidine starvation. We also identify N-acetylneuraminic acid accumulation as a potential marker of the therapeutic efficacy of DHODH inhibitors. In an aggressive, immunocompetent pancreatic cancer mouse model, combined targeting of DHODH and ENT1 dramatically suppressed tumor growth and prolonged mouse survival. Overall, our study defines CNX-774 as a previously uncharacterized ENT1 inhibitor and provides strong proof of concept support for dual targeting of DHODH and ENT1 in pancreatic cancer.

Coated Controlled-Release Fertilizers: Potential Solution for Sustainable Agriculture

The use of fertilizer in the agricultural field is essential for plant growth but an excess amount of pure chemical contents in fertilizers becomes harmful to every living being. To reduce this chemical exposure, the use of materials coated with Controlled Release Fertilizers (CRFs) are being used. The coating of materials outside the fertilizer does not allow the chemicals to spread completely within one application of fertilizer but its spread can be extended as will be done in 2-3 applications of fertilizer. The features of the undercoating material are thus vital to attain this delayed or slow release of the nutrients present in the fertilizer. The longevity of CRFs depends upon the width of the material coating surrounding the fertilizer, temperature, and moisture. The review focuses on the consequences of conventional fertilizers, the need to control the release of fertilizers and types of coatings used, and their application in sustainable agriculture.

Assessment of Drinking Water Accessibility and Quality in the Indo-Bhutan Himalayan Foothill Region of Assam, India

Despite fairly heavy rainfall, the Bhutan Himalayan foothill region of Assam has been facing serious water scarcity problems mainly due to the subsurface structure and soil condition. The local people of the region with their community efforts and traditional knowledge have developed a water management system locally known as Dong-bandh. This traditional canal water system provides the most reliable source of water to the people residing in the area. Besides the canals, they also collect water from the streams, natural springs, and wells. The quality of water is getting deteriorated over time under the influence of the growing population and their activities in the upstream areas. The present study is an attempt to investigate the status of water accessibility in the area and the quality of the drinking water used by the people. For this study, data and information have collected through field investigation, GPS survey, focus group discussion, and interviews with some key informants. A total of 14 drinking water samples were collected randomly from 14 foothill villages (both from the ground and surface) and tested to determine various physiochemical characteristics. The results were compared with the WHO and BIS/ ICMR water quality standards. Finally, the status of water quality was analyzed in terms of the Water Quality Index (WQI). The WQI values were found to lie between 21.75 to 502.38.

Retrospective Observational Study to Evaluate Causality, Preventability and Severity of Adverse Drug Reaction Associated with Anticancer Drugs in A Tertiary Care Hospital in Northern India

BACKGROUND

Chemotherapy has high efficacy, but it is associated with several adverse drug reactions (ADRs).

OBJECTIVES

A retrospective observational study to explore the prevalence, causality, and preventability of ADRs of anticancer agents was conducted.

METHODS

The study was carried out at Punjab Institute of Medical Sciences Jalandhar, Punjab after obtaining IEC approval. The data was collected from cancer patients undergoing treatment at the hospital. The causality assessment of the collected data was done by using WHO causality assessment criteria. The preventability and severity of the reported ADRs were also assessed.

RESULTS

From 50 medical records, a total of 47 ADRs were recorded among 25 patients out of which 16 were females and the rest were males. The cancer cases observed were breast carcinoma, leukaemia, lung, colon, and ovarian cancer. The highest number of ADRs were observed with alkylating agents, followed by taxanes, antimetabolites, kinase inhibitors, and monoclonal antibodies. The most affected organ systems were the gastrointestinal system, blood, and lymphatic system. According to the causality assessment, the majority of the ADRs were of the "possible" category. Preventability analysis showed that 85.11% of ADRs were unavoidable reactions, while 14.89% of ADRs were possibly avoidable. Severity analysis of ADRs showed that 87.23% of ADRs were mild and 12.77% were of moderate severity. The majority of the ADRs were unavoidable and mild to moderate in severity.

CONCLUSION

Since the majority of the ADRs were of the unavoidable category, indicate that the treatment regimens are acceptable as per the current clinical management of cancer patients.

CD73 induces GM-CSF/MDSC-mediated suppression of T cells to accelerate pancreatic cancer pathogenesis

Metabolic alterations regulate cancer aggressiveness and immune responses. Given the poor response of pancreatic ductal adenocarcinoma (PDAC) to conventional immunotherapies, we investigated the link between metabolic alterations and immunosuppression. Our metabolic enzyme screen indicated that elevated expression of CD73, an ecto-5'-nucleotidase that generates adenosine, correlates with increased aggressiveness. Correspondingly, we observed increased interstitial adenosine levels in tumors from spontaneous PDAC mouse models. Diminishing CD73 by genetic manipulations ablated in vivo tumor growth, and decreased myeloid-derived suppressor cells (MDSC) in orthotopic mouse models of PDAC. A high-throughput cytokine profiling demonstrated decreased GM-CSF in mice implanted with CD73 knockdowns. Furthermore, we noted increased IFN-γ expression by intratumoral CD4⁺ and CD8⁺ T cells in pancreatic tumors with CD73 knockdowns. Depletion of CD4⁺ T cells, but not CD8⁺ T cells abrogated the beneficial effects of decreased CD73. We also observed that splenic MDSCs from Nt5e knockdown tumor-bearing mice were incompetent in suppressing T cell activation in the ex vivo assays. Replenishing GM-CSF restored tumor growth in Nt5e knockout tumors, which was reverted by MDSC depletion. Finally, anti-CD73 antibody treatment significantly improved gemcitabine efficacy in orthotopic models. Thus, targeting the adenosine axis presents a novel therapeutic opportunity for improving the anti-tumoral immune response against PDAC.

Seroprevalence and risk factor investigation for the exposure of Toxoplasma gondii among veterinary personnel in Punjab, India

Toxoplasma gondii, a globally important food borne zoonotic parasite, infects most of the warm-blooded animals as well as people. Veterinarians and para vets are considered at risk of T. gondii exposure. We determined the seroprevalence of T. gondii in veterinary personnel and investigated the associated risk factors in Punjab, India. Two hundred and five blood samples collected from veterinary personnel were tested for the presence of Toxoplasma IgG and IgM antibodies using ELISA. The apparent and true seroprevalence of T. gondii with 95% confidence interval (CI) were estimated. Information about participant demographics, and possible routes of exposure was collected using a self-completed questionnaire at the time of blood collection. For risk factor investigation, a veterinary person was considered Toxoplasma seropositive using a combination of tests in parallel, i.e. if it was positive in either IgG or IgM ELISA. A mixed effects logistic regression model was constructed to evaluate the association of demography, occupational and non-occupational factors with Toxoplasma seropositive status. The apparent and estimated true seroprevalence of T. gondii antibodies using Toxoplasma IgG ELISA was 8.78% (95% CI 5.63-13.45%) and 7.36% (95% CI 4.04-12.29%), respectively. The apparent and estimated true seroprevalence using Toxoplasma IgM ELISA was 0.49% (95% CI inestimable - 2.71%) and 0.51% (95% CI inestimable - 2.83%), respectively. After adjusting other variables in the final model, consuming mutton and owning a cat were associated with large odds of being Toxoplasma seropositive. In this study occupational exposure does not seem to play an important role for the exposure of T. gondii in veterinary personnel in Punjab state of India. The seroprevalence of toxoplasmosis in veterinary personnel is comparatively low in occupationally exposed veterinary personnel in Punjab, India.

A Rare Case of Simultaneous Fracture Neck of Femur on One Side and Contralateral Intertrochanteric Fracture Femur in a 41-Year-Old Female - A Case Report

Introduction

Simultaneous fractures in the neck of femur on the one side and contralateral intertrochanteric fracture of the femur with only trivial injury are among rarest injuries. Fracture neck of femur or intertrochanteric fracture either isolated or in combination such as simultaneous bilateral fracture neck of femur and simultaneous bilateral intertrochanteric fractures are relatively commonly reported in literature. Herein, we report a very rare case of a young female with chronic kidney disease who presented with simultaneous fractures neck of femur on the one side and contralateral intertrochanteric fracture of femur after a fall from standing height.

Case Report

A 41-year-old female with chronic kidney disease from the past 5 years presented to us with severe pain at both hip and inability to stand after a fall from standing height. Clinical examination and investigations were done. She suffered fracture neck of femur on the right side and intertrochanteric fracture femur on the left side. Single stage fixation of both these fractures by two different methods was done successfully after optimization of her medical condition with multidisciplinary approach. She was advised weight bearing according to fixation method used and progress of fracture union. She regained her preoperative walking status gradually in 6 months.

Conclusion

Simultaneous fractures in the neck of femur on the one side and intertrochanteric fracture of the femur on the other side are very rare presentation and can happen in patients with primary or secondary bone disease. Multidisciplinary team effort is needed for overall effective management and prompt surgical treatment can help achieve favorable outcome.

Metabolic Rewiring by Loss of Sirt5 Promotes Kras-Induced Pancreatic Cancer Progression

BACKGROUND & AIMS

SIRT5 plays pleiotropic roles via post-translational modifications, serving as a tumor suppressor, or an oncogene, in different tumors. However, the role SIRT5 plays in the initiation and progression of pancreatic ductal adenocarcinoma (PDAC) remains unknown.

METHODS

Published datasets and tissue arrays with SIRT5 staining were used to investigate the clinical relevance of SIRT5 in PDAC. Furthermore, to define the role of SIRT5 in the carcinogenesis of PDAC, we generated autochthonous mouse models with conditional Sirt5 knockout. Moreover, to examine the mechanistic role of SIRT5 in PDAC carcinogenesis, SIRT5 was knocked down in PDAC cell lines and organoids, followed by metabolomics and proteomics studies. A novel SIRT5 activator was used for therapeutic studies in organoids and patient-derived xenografts.

RESULTS

SIRT5 expression negatively regulated tumor cell proliferation and correlated with a favorable prognosis in patients with PDAC. Genetic ablation of Sirt5 in PDAC mouse models promoted acinar-to-ductal metaplasia, precursor lesions, and pancreatic tumorigenesis, resulting in poor survival. Mechanistically, SIRT5 loss enhanced glutamine and glutathione metabolism via acetylation-mediated activation of GOT1. A selective SIRT5 activator, MC3138, phenocopied the effects of SIRT5 overexpression and exhibited antitumor effects on human PDAC cells. MC3138 also diminished nucleotide pools, sensitizing human PDAC cell lines, organoids, and patient-derived xenografts to gemcitabine.

CONCLUSIONS

Collectively, we identify SIRT5 as a key tumor suppressor in PDAC, whose loss promotes tumorigenesis through increased noncanonic use of glutamine via GOT1, and that SIRT5 activation is a novel therapeutic strategy to target PDAC.

A multidisciplinary early mobility model for cardiac patients in coronary intensive care unit

Funding Acknowledgements

This is an unfunded project

Background

Early mobilization is considered as a complex task in an intensive care unit (ICU) and patients are often on prolonged bed rest leading to physical deconditioning. Intensive care early mobility programs have been recognized to be safe and have shown positive outcomes. However, implementing early mobility program as a standard of care remains a challenge.

Coronary Intensive Care Unit (CICU) provides complex care for cardiac critically ill patients. In February 2018, the CICU multidisciplinary team (MDT) started a quality improvement project to implement early mobility program in the unit.

Purpose

This project aimed to investigate the feasibility of implementing an Early Mobility Protocol in CICU to increase the number of patients mobilized to more than 95%. Secondary objective was to explore the impact of the protocol on the mobility level of the patients at the time of discharge or transfer from the CICU.

Methods

A multidisciplinary mobility task force including Physicians, nurses, physiotherapists and respiratory therapists was formed to analyze the barriers in implementing an early mobility program. A staff survey was conducted to identify the need for a standard early mobility protocol. Root cause analysis and Pareto analysis was done. An evidence based early mobility protocol was developed and implemented. All non-mechanical ventilated patients were included in the first phase and all mechanical ventilated patients were included in the second phase of the project. A standard ICU Mobility scale (IMS) was used for scoring the mobility level of the patients. This quality improvement project is based on "Institute for Healthcare Improvement" model. Periodical staff education and training programs about early mobilization were conducted to improve staff confidence. Change ideas were implemented using multiple Plan Do Study Act cycles.

Results

The total number of patients included from 1st March 2018 till 31st December 2019 was 2356. This included both the genders. In March 2018, only 68% of non-mechanical ventilated patients were mobilized, that reached to 88% by November 2018. This gradually increased to 100% in May 2019 and is currently sustained at 100%.

In November 2019, only 50% of mechanical ventilated patients were mobilized which gradually increased to 66.66% and 75% in middle and end of December 2019. The mean IMS score at discharge or transfer from CICU was "8". From patient-family experience survey, 93.75% of patients perceived that the program was helpful in regaining mobility and 96.25% of patients felt that the program helped in regaining their autonomy.

Conclusion

The result shows that it is safe and feasible to implement an early mobility program in a Coronary Intensive Care Unit. A standardized mobility protocol can lead to efficient mobilization practice facilitating early transfers from ICUs without any complications. This could further enhance the collaboration of the MDT members leading to culture change in ICUs.

Physiologic Specialization and Genetic Differentiation of Puccinia triticina Causing Leaf Rust of Wheat on the Indian Subcontinent During 2016 to 2019

Wheat is the second most cultivated cereal crop in the world and is an important crop in India. Leaf (brown) rust, caused by Puccinia triticina, was the most prevalent among the three rusts found in all the wheat-growing areas of India, Bhutan, and Nepal during 2016 to 2019. Leaf rust samples from wheat crops in these countries were pathotyped using the wheat differential genotypes and binomial Indian system of nomenclature. To facilitate international communication, each pathotype identified was also tested using the North American differentials. A total of 33 pathotypes were identified from 1,086 samples, including three new pathotypes: 61R47 (162-5 = KHTPM) and 93R49 (49 = NHKTN) from India and 93R57 (20-1 = NHKTN) from Nepal. Two pathotypes, 121R60-1 (77-9/52 = MHTKL) and 121R63-1 (77-5 = THTTM), accounted for 79.46% of the population. Virulence on Lr19 was identified in 0.27% of the samples from Nepal only. The proportion of pathotype 121R60-1 (77-9 = MHTKL) increased to 57.55% during these years. Virulence was not observed on Lr9, Lr24, Lr25, Lr28, Lr32, Lr39, Lr45, and Lr47 in the population of the Indian subcontinent. Eighteen polymorphic simple sequence repeat (SSR) primer pairs tested on the isolates amplified 48 alleles with an average of 2.66 alleles per primer pair. Based on SSR genotyping, these pathotypes could be grouped into two clades with another two subclades each. Many of the Lr genes present in Indian wheat germplasm (Lr1, Lr3a, Lr10, Lr11, Lr14a, Lr15, Lr16, Lr17, Lr20, Lr23, and Lr26) were ineffective for a majority of pathotypes. Most of these varieties possessed a high degree of leaf rust resistance. The field resistance of wheat varieties could be attributed to the interaction of genes, unknown resistance, or adult plant resistance.

Molecular Subtypes of Pancreatic Cancer: A Proteomics Approach

Through molecular subtyping, therapeutic vulnerabilities can be exploited for developing personalized medicine. The real utility of molecular subtyping lies in the clinical translation for disease characterization. Proteomic methods with defined marker sets hold great promise for improving therapy outcomes by improving the speed of predictions for devising treatment strategies.See related article by Son et al., p. 3370.

SIRT1-NOX4 signaling axis regulates cancer cachexia

Approximately one third of cancer patients die due to complexities related to cachexia. However, the mechanisms of cachexia and the potential therapeutic interventions remain poorly studied. We observed a significant positive correlation between SIRT1 expression and muscle fiber cross-sectional area in pancreatic cancer patients. Rescuing Sirt1 expression by exogenous expression or pharmacological agents reverted cancer cell–induced myotube wasting in culture conditions and mouse models. RNA-seq and follow-up analyses showed cancer cell–mediated SIRT1 loss induced NF-κB signaling in cachectic muscles that enhanced the expression of FOXO transcription factors and NADPH oxidase 4 (Nox4), a key regulator of reactive oxygen species production. Additionally, we observed a negative correlation between NOX4 expression and skeletal muscle fiber cross-sectional area in pancreatic cancer patients. Knocking out Nox4 in skeletal muscles or pharmacological blockade of Nox4 activity abrogated tumor-induced cachexia in mice. Thus, we conclude that targeting the Sirt1–Nox4 axis in muscles is an effective therapeutic intervention for mitigating pancreatic cancer–induced cachexia.

Fabrication of a Self-Curling Cuff with a Soft, Ionically Conducting Neural Interface

Direct current (DC) has the potential not only to excite but also to inhibit neurons. This property of DC stimulus has been used for generating peripheral nerve blocks. One translational challenge of DC-based neuromodulation technologies, especially for pain suppression, is that the commercially available cuff electrodes have metal-tissue interfaces that are incapable of delivering DC safely. Passing DC through any metal-tissue interface generates harmful electrochemical products which can damage the target nerve. To address this issue, we present a fabrication process for making self-curling silicone cuffs with paper/agar based, ionically conducting neural interface. We fabricate monopolar as well as bipolar cuffs and demonstrate that the electrode impedances can be easily controlled by modulating the paper/agar channel dimensions. Further, we perform in-vivo implantation of these electrodes on a rat sciatic nerve to qualitatively validate the self-curling action.

Knowledge, Attitude and Practice of Health Science Students/Researcher on Status of Usage of Animals, 3R’s Strategy and their Alternatives for Pharmacological Studies: An Exploratory Study

Introduction: The number of students in health science education is increasing day by day due to mushrooming of the private institutes. Hence, there is an increase in number of animals that have been used for animal experimentation irrespective of any known significance. Aim: To assess the Knowledge, Attitude and Practice of health science students/researchers on status of usage of animals, 3R’s strategy (Reduction, Refinement, Replacement) and their alternatives for pharmacological studies. Materials and Methods: This was a cross-sectional paper-based survey that was conducted between June 2019 to September 2019 using a semi-structured questionnaire to assess the knowledge, attitude and practice of the students. The study was conducted at the Guru Gobind Singh Medical College and Hospital, Faridkot and ISF College of Pharmacy, Moga, Punjab, India. The questionnaire consisted of three domains: Socio-demographic and professional characteristics, Knowledge (10 questions), attitude and practice of participants (9 questions). Out of 440 questionnaires distributed to the participants, 310 filled the survey (response rate was 70.5%) and were included in the study. The study participants comprised of MBBS interns, Junior residents/MD students, B pharmacy students, M pharmacy students and the PhD scholars. Results: Majority of the students belonged to the age group of 19-23 years. It was observed that 79.6% (n=247) students didn’t know about the 3Rs (i.e., Reduction, Refinement, Replacement) Strategy. A 39.6% (n=123) respondents knew about the various alternatives to animal experimentation. Majority of the students 90.9% (n=282) believed that animal experiments are useful for medical research and human benefit. Conclusion: There was an almost complete lack of knowledge among participants regarding alternative animal models and 3R’s strategy. Therefore, there is a need to incorporate education intervention about alternative animal use in their curriculum.

Proteome Analysis Revealed Jak/Stat Signaling and Cytoskeleton Rearrangement Proteins in Human Lung Epithelial Cells During Interaction with Aspergillus terreus

Background:

Aspergillus terreus is an emerging etiological agent of invasive and allergic aspergillosis in immunocompromised individuals. The main risk groups are individuals having cancer, acute leukemia and those who undergo bone marrow transplantation. The human lung epithelial cells constitute the first line of defense against inhaled conidia of A. terreus. The aim of the study was to understand how human lung epithelial cells respond to A. terreus conidia during the interaction and to decipher proteins/pathways underlying in host defense.

Methods:

Protein samples were extracted from human lung epithelial cells (A549) infected with and without A. terreus conidia. Proteins were identified using QTOF-LC-MS/MS followed by analysis using Protein Lynx Global Services software (2.2.5) against Homo sapiens UniProt database.

Results:

A total of 1253 proteins in human lung epithelial cells were identified during the interaction with Aspergillus terreus conidia, whereas 427 proteins were identified in uninfected lung epithelial cells. We have observed 63 proteins in both the conditions. Gene ontology and KEEG pathway analysis of proteins from infected lung epithelial cells showed proteins from cytoskeleton rearrangement, transport, transcription and signal transduction pathways, such as Jak/Stat, NOD like receptor signaling, Toll–like receptor signaling, NF-kβ signaling and TNF signaling pathways. These signaling proteins suggested the strong immune response in lung epithelial cells against A. terreus conidia. Also, cytoskeleton rearrangement proteins depicted the internalization of A. terreus conidia by human lung epithelial cells.

Conclusion:

Our study has contributed to understand the interaction response of human lung epithelial cells during A. terreus infection. Also, our study may facilitate the identification of inflammatory biomarker against A. terreus.

Quantifying the burden of out-of-pocket health expenditure in India

OBJECTIVES

This study aims at analyzing the dimensions of the burden of out-of-pocket (OOP) health expenditure in rural and urban India between 1999-2000 and 2011-2012.

STUDY DESIGN

Consumer Expenditure Survey data of the National Sample Survey for the period of 1999-2000 (55th round), 2004-2005 (61st round), and 2011-2012 (68th round) have been used in this study.

METHODS

To analyze the dimension of OOP healthcare expenditure, this study has used headcount measure, which includes change in the percentage of population paying OOP health expenditure, concentration index of headcount, rank-weighted headcount, and gap measures, which includes average per capita gap (health expenditure), mean positive gap, concentration index, and rank-weighted gap for rural, urban, and all India level between 1999-2000 and 2011-2012.

RESULTS

The authors have found that a large percentage of the population in rural and urban India is still not reporting health expenditure. There is a huge difference between per capita health expenditure in rural and urban areas during the study period. The percentage of the population that reported OOP health expenditure has increased at the bottom level, but the expenditure got more concentrated toward better-off people in both rural and urban areas of the country in this time period. It is also clear from the results that the concentration of average per capita gap (Co) in rural areas leans towards better-off people more than in urban areas.

CONCLUSION

This study advocates for health sector reforms to protect households from the significant burden of expenditure on critical health care.

Abstract B124: A novel alkannin derivative suppresses breast cancer proliferation and angiogenesis through modulation of STAT3 signaling

Background: Angiogenesis is a cancer hallmark essential for establishment of tumor and metastasis. The elevated expression of the vascular endothelial growth factor (VEGF) in breast cancer is directly regulated by activated STAT-3 protein, and thus it represents a common molecular target for blocking angiogenesis induced by multiple signaling pathways in breast cancer. Therefore STAT3 inhibition is perceived as a promising anti-angiogenic therapy. The natural naphthoquinone compounds like shikonin/alkannin exhibit potent anticancer activities. However, poor solubility, low bioavailability, and unfavorable toxicity profiles limit their clinical efficacy and underscore the need for synthetic napthoquinone derivative-based therapeutic strategies. In the present back drop, we have analysed the anti-angiogenic effects of a novel alkannin derivative, 1-(5,8-dihydroxy-1,4-dioxo-1,4-dihydronaphthalen-2-yl)-4-methylpent-3-en-1-yl 3-(pyridine-2-yl)propanoate (ALKP), and explored its mechanism of action in breast cancer cells. Methods: We studied the effects of the alkannin derivative in vitro and in vivo. The effects of ALKP were evaluated in vitro using HUVEC and breast cancer cells (MDA-MB231, MDA-MB468) to assess proliferation, invasion, migration, and tube formation. Immunoblotting and gelatin zymography were done to measure the MMP activity, protein expression, and phosphorylation of signaling kinases. Fluorescent microscopy was used to study subcellular localization of proteins. The in vivo effects were analysed by using the matrigel plug assay and 4T1 induced syngeneic mice breast cancer model. Results: ALKP significantly inhibited proliferation, invasion, migration, MMP activity, and tube formation in MDA-MB231 as compared to the parent compound. A significant attenuation in microvessel sprouting from ex vivo rat aortic ring cultures was observed in ALKP-treated rings compared with alkannin. Our mechanistic studies revealed that ALKP inhibited phosphorylation of STAT3, Src, and FAK in MDAMB-231cells. ALKP exhibited potent inhibition of VEGF expression and nuclear localization of phospho-STAT3 in comparison to alkannin. A significant inhibition of in vivo angiogenesis in matrigel plug assay, tumor growth, and lung metastasis in 4T1-induced breast cancer model was shown by ALKP compared with alkannin, with lower toxicity in terms of body weight and other parameters. Immunohistochemical analysis of tumor and matrigel revealed marked decrease in PCNA, CD31, and VEGF-A markers. Conclusion: Collectively our findings demonstrate that ALKP inhibits tumor angiogenesis through inhibiting STAT3 and VEGF signaling.

Citation Format: Akanchha Shukla, Ravi Thakur, Sukanya Pandeti, Sabbu Sathish Reddy, Narender Tadigoppula, Durga Prasad Mishra. A novel alkannin derivative suppresses breast cancer proliferation and angiogenesis through modulation of STAT3 signaling [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2017 Oct 26-30; Philadelphia, PA. Philadelphia (PA): AACR; Mol Cancer Ther 2018;17(1 Suppl):Abstract nr B124.

ROS mediated pro-apoptotic effects of Tinospora cordifolia on breast cancer cells

The inevitable development of chemoresistance and unmanageable side effects are the major therapeutic challenges in management of breast cancer imposing an urgent need for identification of novel therapeutic agents. In the present investigation, we report anti-proliferative activity of chloroform fraction of Tinospora cordifolia (TcCF), an Ayurvedic medicinal plant, on breast cancer cells. We found that TcCF inhibited growth of breast cancer cells, MDA-MB-231 and MCF-7. More interestingly, we observed TcCF treatment increased intra-cellular ROS levels, altered expression of pro and anti-apoptotic genes, decreased colony formation ability and induced apoptosis in breast cancer cells. We also found that inhibition of ROS abrogated TcCF induced apoptosis in breast cancer cells, emphasizing the role ROS in TcCF induced breast cancer cell death. Furthermore, we identified the presence of pharmacologically active compounds like rutin and quercetin which account for the anti-cancer property of TcCF against breast cancer cells. These data show TcCF is a promising anti-cancer agent against breast cancer cells.

Stenotrophomonas sp. RZS 7, a novel PHB degrader isolated from plastic contaminated soil in Shahada, Maharashtra, Western India

This paper reports an isolation and identification of novel poly-β-hydroxybutyrate (PHB) degrading bacterium Stenotrophomonas sp. RZS 7 and studies on its extracellular PHB degrading depolymerase enzyme. The bacterium isolated from soil samples of plastic contaminated sites of municipal area in Shahada, Maharashtra, Western India. It was identified as Stenotrophomonas sp. RZS 7 based on polyphasic approach. The bacterium grew well in minimal salt medium (MSM) and produced a zone (4.2 mm) of PHB hydrolysis on MSM containing PHB as the only source of nutrient. An optimum yield of enzyme was obtained on the fifth day of incubation at 37 °C and at pH 6.0. Further increase in enzyme production was recorded with Ca²⁺ ions, while other metal ions like Fe²⁺ (1 mM) and chemical viz. mercaptoethanol severally affected the production of enzyme.

Titanium elastic nailing in femoral diaphyseal fractures in children of 6-14 years age

BACKGROUND

Traditionally conservative methods were used in managing paediatric femoral diaphyseal fractures. There has been a renewed interest for operative treatment with Titanium elastic nail system (TENS) in the age group of 6-14 years.

MATERIALS AND METHODS

This prospective study was done on 20 patients. Two titanium nails were used for stabilization. We followed them for maximum of two years. The results were evaluated using Flynn's scoring criteria.

RESULTS

In our study we had fifteen males and five females with average age 10.35 years. Average time for fracture union was 9.0 weeks, full weight bearing 9.2 weeks, hospital stay 8.6 days and return to school at 10 weeks. The results were excellent in 14, good in 5 and poor in 1 patient. Most common complication was irritation at nail entry site. No delayed union or nonunion seen.

CONCLUSION

Treatment of diaphyseal femoral fracture in selected pediatric patients by TENS is reasonably effective.

Relation between Serum Intact Parathyroid Hormone Level and Hematocrit in Chronic Kidney Disease Patients

Background Anemia is a common complication of chronic kidney disease. There are various causes of anemia in chronic kidney disease patients on hemodialysis. Secondary hyperparathyroidism is one of the less recognized causes of anemia in chronic kidney disease patients. Objectives The main objective of the study is to find the correlation between intact parathyroid hormone and hematocrit level in chronic kidney disease (CKD) patients undergoing hemodialysis. Method Verbal consent was taken from all the participants. Eighty participants between the age of 29 and 70 years with chronic kidney disease having indication of hemodialysis were included in this study. Hematocrit was measured by bioelectrical impedance method and serum intact parathyroid hormone was by using Chemi Luminescence Immuno Assay (CLIA) method. Result A weak reverse correlation was found between serum intact parathyroid level and hematocrit (r= -0.33). Conclusion In chronic kidney disease patient, there is reverse correlation between level of serum intact parathyroid and hematocrit level. This association may have clinical relevance in assessing the cause of unexplained low hemoglobin level in CKD patients.

Layered double hydroxides as effective carrier for anticancer drugs and tailoring of release rate through interlayer anions

Hydrophobic anticancer drug, raloxifene hydrochloride (RH) is intercalated into a series of magnesium aluminum layered double hydroxides (LDHs) with various charge density anions through ion exchange technique for controlled drug delivery. The particle nature of the LDH in presence of drug is determined through electron microscopy and surface morphology. The release of drug from the RH intercalated LDHs was made very fast or sustained by altering the exchangeable anions followed by the modified Freundlich and parabolic diffusion models. The drug release rate is explained from the interactions between the drug and LDHs along with order-disorder structure of drug intercalated LDHs. Nitrate bound LDH exhibits greater interaction with drug and sustained drug delivery against the loosely interacted phosphate bound LDH-drug, which shows fast release. Cell viability through MTT assay suggests drug intercalated LDHs as better drug delivery vehicle for cancer cell line against poor bioavailability of the pure drug. In vivo study with mice indicates the differential tumor healing which becomes fast for greater drug release system but the body weight index clearly hints at damaged organ in the case of fast release system. Histopathological experiment confirms the damaged liver of the mice treated either with pure drug or phosphate bound LDH-drug, fast release system, vis-à-vis normal liver cell morphology for sluggish drug release system with steady healing rate of tumor. These observations clearly demonstrate that nitrate bound LDH nanoparticle is a potential drug delivery vehicle for anticancer drugs without any side effect.