Designing new drug candidates as inhibitors against wild and mutant type neuraminidases: molecular docking, molecular dynamics and binding free energy calculations

Influenza virus is the cause of the death of millions of people with about 3-4 pandemics every hundred years in history. It also turns into a seasonal disease, bringing about approximately 5-15% of the population to be infected and 290,000-650,000 people to die every year. These numbers reveal that it is necessary to be on the alert to work towards influenza in order to protect public health. There are FDA-approved antiviral drugs such as oseltamivir and zanamivir recommended by the World Center for Disease Prevention. However, after the recent outbreaks such as bird flu and swine flu, increasing studies have shown that the flu virus has gained resistance to these drugs. So, there is an urgent need to find new drugs effective against this virus. This study aims to investigate new drug candidates targeting neuraminidase (NA) for the treatment of influenza by using computer aided drug design approaches. They involve virtual scanning, de novo design, rational design, docking, MD, MMGB/PBSA. The investigation includes H1N1, H5N1, H2N2 and H3N2 neuraminidase proteins and their mutant variants possessing resistance to FDA-approved drugs. Virtual screening consists of approximately 30 thousand molecules while de novo and rational designs produced over a hundred molecules. These approaches produced three lead molecules with binding energies for both non-mutant (-34.84, -59.99 and -60.66 kcal/mol) and mutant (-40.40, -58.93, -76.19 kcal/mol) H2N2 NA calculated by MM-PBSA compared with those of oseltamivir -25.64 and -18.40 respectively. The results offer new drug candidates against influenza infection.Communicated by Ramaswamy H. Sarma.

Towards a better understanding of commonly used medicinal plants from Turkiye: Detailed phytochemical screening and biological activity studies of two Teucrium L. species with in vitro and in silico approach

ETHNOPHARMACOLOGICAL RELEVANCE

Since ancient times, Teucrium L. species have been among the most commonly used traditional medicinal plants mainly in the Mediterranean region. From tackling gastrointestinal problems to maintaining the healthy functioning of endocrine glands, and from treating malaria to severe dermatological disorders, Teucrium species are known to have extensive therapeutic applications. Teucrium polium L. and Teucrium parviflorum Schreb. are the two members of the genus that have been used in Turkish folk medicine for various medicinal purposes.

AIM OF THE STUDY

To determine the phytochemical compositions of the essential oils and ethanol extracts of Teucrium polium and Teucrium parviflorum collected from different locations in Turkiye along with the investigation of in vitro antioxidant, anticancer, antimicrobial activities, and both in vitro and in silico enzyme inhibitory activities of the extracts.

MATERIALS AND METHODS

Ethanol extracts of Teucrium polium aerial parts and roots, and aerial parts of Teucrium parviflorum were prepared. Volatile profiling of the essential oils by GC-MS, phytochemical profiling of the ethanol extracts by LC-HRMS, antioxidant activity by DPPH radical scavenging, ABTS cation radical scavenging, CUPRAC, and metal chelating activity assays, anticholinesterase, antityrosinase, antiurease, activities by different enzyme inhibitory activity assays, anticancer activity by SRB cell viability assay, and antimicrobial activity against a standard panel of bacteria and fungi by the microbroth dilution technique. Molecular docking studies were performed by Autodock Vina (Ver. 1.1.2).

RESULTS

The studied extracts were found to be quite rich in various biologically important volatile and phenolic compounds. (-)-Epigallocatechin gallate, which is a molecule renowned for having great therapeutic potential, was the major compound of all extracts. Teucrium polium aerial parts extract was revealed as a great source for naringenin with 16327 ± 685.23 μg/g extract. All extracts exerted significant antioxidant activity by different methods. All extracts demonstrated antibutrylcholinesterase, antityrosinase, and antiurease activities by in vitro and in silico assays. Teucrium polium roots extract stood out with remarkable tyrosinase and urease inhibitory and cytotoxic activities.

CONCLUSION

The obtained results from this multi-disciplinary study proves that the traditional use of these two Teucrium species is justified, and the mechanisms behind are enlightened.

Pneumonia severity indices predict prognosis in coronavirus disease-2019

Background

Early recognition of the severe illness is critical in coronavirus disease-19 (COVID-19) to provide best care and optimize the use of limited resources.

Objectives

We aimed to determine the predictive properties of common community-acquired pneumonia (CAP) severity scores and COVID-19 specific indices.

Methods

In this retrospective cohort, COVID-19 patients hospitalized in a teaching hospital between 18 March-20 May 2020 were included. Demographic, clinical, and laboratory characteristics related to severity and mortality were measured and CURB-65, PSI, A-DROP, CALL, and COVID-GRAM scores were calculated as defined previously in the literature. Progression to severe disease and in-hospital/overall mortality during the follow-up of the patients were determined from electronic records. Kaplan-Meier, log-rank test, and Cox proportional hazard regression model was used. The discrimination capability of pneumonia severity indices was evaluated by receiver-operating-characteristic (ROC) analysis.

Results

Two hundred ninety-eight patients were included in the study. Sixty-two patients (20.8%) presented with severe COVID-19 while thirty-one (10.4%) developed severe COVID-19 at any time from the admission. In-hospital mortality was 39 (13.1%) while the overall mortality was 44 (14.8%). The mortality in low-risk groups that were identified to manage outside the hospital was 0 in CALL Class A, 1.67% in PSI low risk, and 2.68% in CURB-65 low-risk. However, the AUCs for the mortality prediction in COVID-19 were 0.875, 0.873, 0.859, 0.855, and 0.828 for A-DROP, PSI, CURB-65, COVID-GRAM, and CALL scores respectively. The AUCs for the prediction of progression to severe disease was 0.739, 0.711, 0,697, 0.673, and 0.668 for CURB-65, CALL, PSI, COVID-GRAM, A-DROP respectively. The hazard ratios (HR) for the tested pneumonia severity indices demonstrated that A-DROP and CURB-65 scores had the strongest association with mortality, and PSI, and COVID-GRAM scores predicted mortality independent from age and comorbidity.

Conclusion

Community-acquired pneumonia (CAP) scores can predict in COVID-19. The indices proposed specifically to COVID-19 work less than nonspecific scoring systems surprisingly. The CALL score may be used to decide outpatient management in COVID-19.

Investigation of angucycline compounds as potential drug candidates against SARS Cov-2 main protease using docking and molecular dynamic approaches

Abstract

The emerged Coronavirus disease (COVID-19) causes severe or even fatal respiratory tract infection, and to date there is no FDA-approved therapeutics or effective treatment available to effectively combat this viral infection. This urgent situation is an attractive research area in the field of drug design and development. One of the most important targets of SARS-coronavirus-2 (SARS Cov-2) is the main protease (3CLpro). Actinomycetes are important resources for drug discovery. The angucylines that are mainly produced by Streptomyces genus of actinomycetes exhibit a broad range of biological activities such as anticancer, antibacterial and antiviral. This study aims to investigate the binding affinity and molecular interactions of 157 available angucycline compounds with 3CLpro using docking and molecular dynamics simulations. MM-PBSA calculations showed that moromycin A has a better binding energy (− 30.42 kcal mol⁻¹) compared with other ligands (in a range of − 18.66 to − 22.89 kcal mol⁻¹) including saquayamycin K4 (− 21.27 kcal mol⁻¹) except the co-crystallized ligand N3. However, in vitro and in vivo studies are essential to assess the effectiveness of angucycline compounds against coronavirus.

Graphic abstract

Supplementary Information

The online version contains supplementary material available at 10.1007/s11030-021-10219-1.

Magnetite nanoparticles grafted with murexide-terminated polyamidoamine dendrimers for removal of lead (II) from aqueous solution: synthesis, characterization, adsorption and antimicrobial activity studies

In this study, new, efficient, eco-friendly and magnetically separable nanoadsorbents, MNPs-G1-Mu and MNPs-G2-Mu, were successfully prepared by covalently grafting murexide-terminated polyamidoamine dendrimers on 3-aminopropyl functionalized silica-coated magnetite nanoparticles, and used for rapid removal of lead (II) from aqueous medium. After each adsorption process, the supernatant was successfully acquired from reaction mixture by the magnetic separation, and then analyzed by employing ICP-OES. Chemical and physical characterizations of new nanomaterials were confirmed by XRD, FT-IR, SEM, TEM, and VSM. Maximum adsorption capacities (q_m) of both prepared new nanostructured adsorbents were compared with each other and also with some other adsorbents. The kinetic data were appraised by using pseudo-first-order and pseudo-second-order kinetic models. Adsorption isotherms were found to be suitable with both Langmuir and Freundlich isotherm linear equations. The maximum adsorption capacities for MNPs-G1-Mu and MNPs-G2-Mu were calculated as 208.33 mg g^-1 and 232.56 mg g^-1, respectively. Antimicrobial activities of nanoparticles were also examined against various microorganisms by using microdilution method. It was determined that MNPs-G1-Mu, MNPs-G2-Mu and lead (II) adsorbed MNPs-G2-Mu showed good antimicrobial activity against S. aureus ATTC 29213 and C. Parapsilosis ATTC 22019. MNPs-G1-Mu also showed antimicrobial activity against C. albicans ATTC 10231.

THU0621-HPR SARC-F SCALE ON SCREENING SARCOPENIA AND PHYSICAL FUNCTION IN PATIENTS WITH KNEE OSTEOARTRITIS

Background:

Sarcopenia has been defined as a loss of muscle mass and consequently of muscle function. In patients affected by osteoarthritis (OA) a more likely and accelerated development of sarcopenia has been reported. The SARC-F is a simple sarcopenia screening tool includes five assessment items: strength, assistance walking, rising from a chair, climbing stairs, and falls. SARC-F ≥ 4 is defined as sarcopenia.

Objectives:

The present study aimed to examine the utility of SARC-F in the patients with knee osteoarthritis.

Methods:

Patients with radiographic and clinic evidence of tibiofemoral OA (Kellgren-Lawrence score ≥2) were included. Sarcopenia were identified using the SARC-F scale. Patients with a total score 4 and higher than 4 were classified as having sarcopenia. Patients were assessed by The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), four-meter walking test, hand grip test, shortened version of the falls efficacy scale-international (the short FES-I) and EuroQol- 5 Dimension (EQ-5D). A multiple linear regression model was used to identify independent predictors of SARC-F.

Results:

A total 76 patients with median age 61 ranged 55 to 78 years old (72.4% female) were screened in this study (Table 1). Of the sample, 38.1% of patients were sarcopenic as a SARC-F (Figure 1). Through multiple regression analyses, SARC-F scores was significantly associated with four-meter walking test, hand grip, WOMAC-Function, EQ-5D and short FES-I describing between 57% and 63% of the variance (adjusted R2) (Table 2). Also, poor physical performance and grip strength were associated with SARC-F ≥ 4 independently (P<0.005).

Table 1.

Summary Table of Characteristics of sarcopenic vs non-sarcopenic patients with knee OA

MeasuresSarcopenic patients with knee OA (n:47)Sarc-F≥4Non-Sarcopenic patients with knee OA (n:29)Sarc-F<4p valueφAge,mean(SD)62.7(6.9)59.3 (6.9)0.294BMI,mean(SD)27.84 (9.56)28.54 (8.38)0.327WOMAC,mean(SD)43.52 (10.83)28.06 (14.9)0.001*GRADE (K-L) med (min-max)3(2-4)2(2-4)0.008*Hand Grip,mean(SD)20 33 (4.89)28.22 (7.13)0.001*4 m Walking Test, mean(SD)11.88 (4.24)9.55 (4.30)0.001*EQ-5D,mean(SD)9.41 (1.52)7. 13 (1.75)0.001*EQ-5D-VAS,mean(SD)44.31 (14.12)66.90 (16.25)0.001*Short FES-I,mean(SD)18. 06 (9.45)9.04 (5.32)0.001*Number of falls the past year,mean(SD)4.01 (1.24)3.14 (2.74)0.674

φMann Whitney U test; *p< 0.05; BMI, Body mass index; WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index EQ-5D, EuroQol-5 Dimension; FES-I, Falls Efficacy Scale-International

Table 2.

Multiple linear regression analysis for SARC-F

βtP value95% Confidence Interval(lower-upper bound)Walking Speed0.111.200.23-0.31/ 0.12Hand Grip-0.35-1.730.04-0.20 / 0.01WOMAC-Function0.262.310.010.00 / 0.05Short FES-I0.181.960.010.04 / 0.01EQ-5D0.222.290.020.02 / 0.39EQ-5D VASR2= 0.61-0.24-2.730.001-0.04 / -0.00

WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index, EQ-5D, EuroQol-5 Dimension; FES-I, Falls Efficacy Scale-International

Figure 1.

Sarcopenic vs non-sarcopenic patients according to sex

Conclusion:

In this study, sarcopenia defined by the SARC-F questionnaire has a predictive value of clinical characteristics of patients to predict sarcopenia parameters and poor physical performance in patients with knee OA.

References:

[1]Papalia, R., Zampogna, B., Torre, G., Lanotte, A., Vasta, S., Albo, E., ... & Denaro, V. (2014). Sarcopenia and its relationship with osteoarthritis: risk factor or direct consequence?.Musculoskeletal surgery,98(1), 9-14.

Disclosure of Interests:

None declared

Dual inhibitor design for HIV-1 reverse transcriptase and integrase enzymes: a molecular docking study

HIV-1, a member of Retroviruses' Lentivirus family, is the causative agent of AIDS. The virus is common throughout the world and leaves the body vulnerable to infections by suppressing the human immune system. Reverse transcriptase and integrase are two of three HIV-1 essential enzymes which perform important virus life cycle functions. In recent years, researchers started to design new inhibitors which could inhibit multiple targets for treatment of AIDS. In respect to this, RT and IN are two enzymes suitable for the development of dual inhibitors. To realize this aim, here we have designed new inhibitors by using approved reverse transcriptase and integrase inhibitors as drug design templates. Totally 426 ligands, which are filtered from 858 ligands by druggability properties were docked to crystal structure of reverse transcriptase and since there was no full-length structure of HIV-1 IN, same ligands were docked to Prototype Foamy Virus integrase structure. From the docking results, B099 was determined to be the best binding ligand to RT enzyme with a binding free energy of -12.63 kcal/mole and B249 was the best ligand for IN enzyme with a score of -19.83 kcal/mole. These binding scores demonstrate that these ligands are more active than Raltegravir for integrase and Rilpivirine for reverse transcriptase which are also used for docking method validation. B205, B214, B233, B242, B246, B249, B253 and B254 are the some of ligands found to have good binding scores for both enzymes and could be considered as new inhibitor candidates as dual inhibitors.Communicated by Ramaswamy H. Sarma.

Role of nicotinic acetylcholine receptor subtypes on nicotine's enhancing effect on electrical field stimulation elicited contractile responses in rabbit urine bladder

OBJECTIVE

This study aims to investigate the contribution of presynaptic nicotinic acetylcholine receptors (nAChRs) sub-types to nicotine-induced enhancement in electrical field stimulation (EFS) EFS-mediated contractile responses in rabbit urine bladder smooth muscle preparations.

MATERIALS AND METHODS

Rabbit urine bladder smooth muscle strips were placed in organ baths containing 20 ml of an aerated Krebs-Henseleit solution, and contractions were recorded using isometric force displacement transducers. Following the acquisition of control EFS (60 V, 8 Hz, 1 ms) responses, nicotine was added to the bath at a 3×10-5 M concentration, and EFS responses were obtained. The effect of nAChR antagonists on nicotine-induced augmentation in EFS-mediated responses was investigated in the presence of hexamethonium, dihydro-β-erythroidine, mecamylamine, and α-bungarotoxin.

RESULTS

Tetrodotoxin (TTX; 10-6 M) completely blocked EFS-induced contractile responses in smooth muscle strips. Similarly, Atropine (10-6 M), when administered with α,β-methylene adenosine triphosphate (α,β-methylene-ATP) (10-5 M), completely blocked EFS responses. Nicotine significantly enhanced EFS-mediated contractile responses (23.67% ± 1.75). Nicotine-induced increases in EFS responses were largely inhibited by hexamethonium, mecamylamine, and dihydro-β-erythroidine, whereas α-bungarotoxin only partly inhibited these enhancements.

CONCLUSIONS

These findings demonstrate that EFS-induced neurogenic contractions in rabbit urine bladder smooth muscle strips are mediated by purinergic and cholinergic transmissions, and the α4β2, α3β4, and α7 sub-types of nAChRs contribute to the enhancement effect of nicotine on EFS-induced contractile responses.

Relationship between coronary in-stent restenosis and plasma urotensin II level

AIM

In-stent restonosis is an important limitation for coronary stenting. The cause of in-stent restenosis is neointimal hyperplasia developed from smooth muscle and matrix. We aimed to investigate the association between urotensin II (U-II) and in-stent restenosis after coronary stenting, which causes endothelial and muscle proliferation and accumulation of collagen.

METHODS

Total 153 patient was enrolled to the study who meet criteria for angiographic indication underwent coronary artery angiography. All patients have history undergone for coronary stent implantation 3 to 9 months ago. In-stent restenosis is identified as ≥50% narrowing inside the stent. In-stent restenosis was observed in 73 and remaining of 80 patients revealed no critical lesion in stent on angiographic evaluation. Plasma level measurement of U-II was performed in all subjects.

RESULTS

Urotensin II levels were found to be significantly higher in Group I compared to Group II (1.44±0.74 ng/mL and 1.21±0.59 ng/mL, respectively, P=0.03). In a subgroup analysis, U-II levels were significantly higher in group I than group II in patients treated with bare metal stent (BMS) (1.50±0.76 ng/mL and 1.18±0.56 ng/mL, P=0.016); however, there was not significant change in patients treated with drug-eluted stent (1.26±0.64 ng/mL and 1.27±0.63 ng/mL, P=0.9). Multivariate statistical significance: negative correlation was found between in-stent restenosis and renin-angiotensin-system (RAS) blocker usage (P=0.040) and right coronary artery (RCA) lesion interventions (P=0.018).

CONCLUSION

This study revealed high plasma U-II level might be accepted as a risk factors for in-stent restenosis with BMS. In-stent restenosis is less developed after RCA interventions and taking drug of RAS blockages. Our study findings need to be confirmed in further studies.

Experimental and theoretical study of the mechanism of hydrolysis of substituted phenyl hexanoates catalysed by globin in the presence of surfactant

The bimolecular rate constants for the globin- and alkali-catalysed hydrolysis of substituted phenyl hexanoates in the absence and presence of cetyltrimethylammonium bromide (CTAB) obey Brønsted equations with β(lg) = -0.53 (globin-catalysed), -0.68 (globin-catalysed in CTAB), -0.34 (in water) and -0.74 (in CTAB), respectively. The slopes indicate that the microsolvation environments associated with the transition states of the catalysed reactions are different from those that occur in aqueous medium. The slope (-0.74) for the reaction in CTAB implies that it proceeds in a less polar medium. The larger β(lg) value (-0.53) obtained for the globin-catalysed reaction compared to that for the uncatalysed one may be attributed to either the less polar microenvironments of the transition states or the involvement of one of the imidazole groups as a nucleophile. The results from a study of the effect of pH on the reactivity provide evidence for the latter assumption. All of the ligands were docked into the hydrophobic pocket of the protein, and the resulting docking scores ranged from -30.76 to -23.61 kcal mol⁻¹. Molecular dynamic simulations and MM-PBSA/GBSA calculations performed for the complexes gave insight into the binding modes of globin to the esters, which are consistent with experimental results. The calculations yielded comparable free energies of binding to the experimental ones for 4-nitrophenyl and 4-chloro-2-nitrophenyl hexanoates. In conclusion, information obtained from the linear free-energy relationship is still very useful for elucidating the mechanisms of organic reactions, including enzyme-catalysed reactions. This approach is further supported by the utilization of computational tools.

The effect of bevacizumab and 5-Fluorouracil combination on epidural fibrosis in a rat laminectomy model

OBJECTIVE

An animal model of laminectomy in rats was used to study scar tissue formation around the spinal cord. Bevacizumab (BV) [a recombinant, humanized, monoclonal antibody targeting vascular endothelial growth factor], 5-Fluorouracil (5-FU) and BV+5-FU was tested in this system for its ability to decrease fibrous tissue formation.

MATERIALS AND METHODS

Twenty-eight Sprague Dawley rats were used in this sudy. Rats were divided into four groups; a control group, a BV group, a 5-FU group and a BV+5-FU group. L1-2 laminectomies were performed on the rats. The medicated groups were treated with topical drug administration. After 6 weeks, the rats were sacrified and histologic sections prepared from the spines were examined and graded by a pathologist. Epidural fibrosis and fibroblast density were evaluated under light microscope.

RESULTS

BV (Avastin: Genentech, San Francisco, CA, USA) significantly reduced the density of the scar tissue undermining the laminas (p < 0.005). Monotherapy with 5-FU did not change the scar formation in the back (p = 0.317). Combination of 5-FU and BV was more effective on reducing the epidural fibrosis after laminectomy on rats (p < 0.001).

CONCLUSIONS

Bevacizumab reduced the spinal epidural fibrosis significantly that developed in rats after laminectomy and 5-Fluorouracil combination had a synergic effect. Further investigations under the light of these findings may help to reduce epidural fibrosis formation after laminectomy.

Highly stable laccase from repeated-batch culture of Funalia trogii ATCC 200800

The effect of temperature, pH, different inhibitors and additives on activity and stability of crude laccase obtained from repeated-batch culture of white rot fungus Funalia trogii ATCC 200800 was studied. The crude enzyme showed high activity at 55-90 degrees C, which was maximal at 80-95 degrees C. It was highly stable within the temperature intervals 20-50 degrees C. The half life of the enzyme was about 2 h and 5 min at 60 degrees C and 70 degrees C, respectively. pH optimum of fungal laccase activity was revealed at pH 2.5. The enzyme from F. trogii ATCC 200800 was very stable between pH values of 3.0-9.0. NaN3 and KCN were detected as the most effective potent enzyme inhibitors among different compounds tested. The fungal enzyme was highly resistant to the various metal ions, inorganic salts, and organic solvents except propanol, at least for 5 min. Because of its high stability and efficient decolorization activity, the use of the crude F. trogii ATCC 200800 laccase instead of pure enzyme form may be a considerably cheaper solution for biotechnological applications.

Increased epicardial fat thickness is related with body mass index in women with polycystic ovary syndrome

AIM

We aimed to investigate the relationship between PCOS and epicardial fat thickness with transthoracic echocardiography.

PATIENTS AND METHODS

PCOS patients were divided into two groups according to the lean or obesity status: PCOS patients with lean 34 subjects (BMI: 23.3±2.8; mean age: 25.5±4), PCOS patients with obese16 subjects (BMI: 32.3±7.6; mean age: 27.2±3.7) were compared with control healthy lean subjects (BMI: 23.5±1.7; mean age: 25.9±2.2).

RESULTS

There was increased epicardial thickness in obese PCOS subjects compared to lean PCOS subjects (6.3±0.9 mm, 4.7±0.5, respectively, p < 0.001). However, epicardial fat thickness between lean PCOS subjects and lean healthy control groups were not significantly varied (4.7±0.5 mm, 4.5±0.5, respectively, p = 0.6). There was increased epicardial thickness in obese PCOS subjects compared to lean healthy control subjects (6.3±0.9 mm, 4.5±0.5, respectively, p < 0.001). This sudy showed for the first time that increased epicardial fat thickness measured using transthoracic echocardiography is associated with increased BMI in PCOS subjects.

CONCLUSIONS

Epicardial fat thickness between lean PCOS subjects and lean healty control group were similar which indicate the importance of obesity in PCOS subjects.

The prevalence and significance of autoantibodies in patients with non-Hodgkin's lymphoma: are they correlated with clinicopathological features?

PURPOSE

It is well known that an association exists between the pathogenesis of lymphomas and autoimmune diseases. Autoantibodies are detected at higher frequency in lymphoproliferative diseases, but neither the precise role of the immune system nor the cause of this is comprehensively understood. In this study we evaluated the presence and significance of some autoantibodies for patients with non- Hodgkin's lymphoma (NHL).

METHODS

150 patients with NHL who had either newly diagnosed disease, or active disease being under chemotherapy or were disease-free during follow-up, were analyzed. The frequency of autoantibodies and the relationship between autoantibodies and several clinicopathological factors were evaluated.

RESULTS

The majority of the patients (50%) had diffuse large B-cell lymphoma (DLBCL). Thirty-two patients (21.4%) were newly diagnosed, 81 (54%) had active disease and were receiving chemotherapy and 37 (24.6%) were disease-free and followed-up. Fifty-one patients (34%) had stage IV disease. Antinuclear antibodies (ANA) were found in 7 (4.7%) patients, perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) in 10 (6.7%), anti dsDNA in 1 (0.7%), anti ssDNA in 16 (10.7%), anti Jo-1 in 3 (2%), anti-scleroderma antibody (anti Scl-70) in 4 (2.7%), and rheumatoid factor (RF) in 85 (56.7%) patients. No c7horbar;ANCA positivity was found. The mean levels of anti Jo-1 (p=0.028), anti ssDNA (p=0.014), c-ANCA (p=0.015), ANA (p=0.026) and RF (p=0.046) were significantly higher in cases with DLBCL compared to patients with non-DLBCL. In addition, in patients with newly diagnosed NHL the mean levels of anti Scl- 70 (p=0.023), anti Jo-1 (p7equals;0.017), and RF (p=0.046) were significantly higher than the other patient groups. No significant correlation was detected between the presence of autoantibodies and other clinicopathological factors.

CONCLUSION

Our results show that the frequency of autoantibodies is high in NHL patients, especially in DLBCL and newly diagnosed cases. Autoantibodies may be helpful for the diagnosis of autoimmune diseases, but regular and long follow-up is needed in NHL patients with high levels of autoantibodies.

Perioperative airway management strategy and posttransplant successful tracheal resection and reconstruction in a heart transplant candidate with post-intubation stenosis

Post-intubation tracheal stenosis (PTS) is an important clinical situation. It is estimated to occur in approximately 5% to 20% of intubated or tracheostomized patients. PTS most commonly occurs after prolonged intubation, and the treatment options have been well discussed in the literature. However, in solid organ transplantation, the necessity of administering high doses of corticosteroids as well as immunosuppressive therapies may compromise the healing processes following tracheal resection and reconstruction, requiring different treatment strategies for simultaneous PTS. We present a patient suffering from end-stage heart failure and post-intubation tracheal stenosis along with our treatment strategy.

CYP2C19 Polymorphisms in Patients with Gastric and Colorectal Carcinoma

BACKGROUND

It has been reported that up to 80% of human cancers arise as a consequence of environmental exposure and host susceptibility factors. Environmental carcinogens are predominantly metabolized by the cytochrome P450 (CYP) superfamily of drug- or xenobiotic-metabolizing enzymes. Genetic variations in these enzymes affect individuals' susceptibility to carcinogens.

AIM OF THE STUDY

The aim of this study was to evaluate the relationship between CYP2C19 polymorphism and susceptibility to these cancers by means of CYP2C19 genotyping among Turkish subjects.

METHODS

DNAof subjects were isolated from leukocytes by high pure template preparation kit (Roche Diagnostics, GmbH, Mannheim, Germany) and genotypes were detected by LightCycler CYP2C19 Mutation Detection Kit by real-time PCR with LightCycler instrument (Roche Diagnostics, cat. no. 3113914).

RESULTS

Being male was associated with a 3.5-fold (OR: 4.27, CI: 2.27-8.05) and 4.27-fold (OR: 3.50, CI: 1.948-6.301) risk for colorectal and gastric carcinoma, respectively. The CYP2C19*3 heterozygote genotype was not found in either gastric or colorectal carcinoma patients. Although the frequency of CYP2C19*2 heterozygote genotype is high in patients with gastric and colorectal carcinoma, it is not significantly associated with cancer (OR: 1.79, CI: 0.829-3.865 and OR: 1.998, CI: 0.961-4.154, respectively).

CONCLUSION

Although the frequency of CYP2C19*2 heterozygote genotype is high in our patients with gastric and colorectal carcinoma, there is no the relationship between CYP2C19 polymorphism and susceptibility to these cancer.

Intra-arterial simultaneous administration of anandamide attenuates endothelin-1 induced vasospasm in rabbit basilar arteries

BACKGROUND

Anandamide induces not only endothelium-dependent vasodilatation through cannabinoid receptors but also some endothelium- independent vasodilator effect by calcitonin gene-related peptide release through vanilloid receptors. Endothelin-1, a powerful vasoconstrictive peptide derived from endothelial cells, has been shown to be converted to its active form after cleaving by a vascular matrix metalloproteinase which is also involved in inactivation of calcitonin gene-related peptide. The purpose of this study was to investigate whether anandamide inhibits the acute vascular and morphological effects of Endothelin-1 applied intra-arterially on rabbit basilar arteries.

METHOD

Fifteen albino rabbits were anaesthetised and underwent placement of a vertebral artery catheter for angiography of the basilar artery. Animals were divided, arbitrarily, into animals in which there was either intra-arterial injection of saline (Group I, n=5), Endothelin-1 (Group II, n=5) and Endothelin-1 and anandamide (Group III, n=5). The diameter of the basilar artery between the pre and post injection angiograms was measured in each of the three groups and transmission electron microscopic investigations on basilar arteries were performed.

FINDINGS

Angiographic studies showed that simultaneous administration of anandamide significantly attenuated Endothelin-1 induced vasoconstriction. Furthermore, it was demonstrated that anandamide reversed the morphological changes induced by Endothelin-1 on the vessel wall.

INTERPRETATION

These results indicated that anandamide overcomes the angiographic and morphological effects of intrarterially administered ET-1 induced vasospasm in rabbit basilar arteries probably by induction of CGRP related vasodilatation through vanilloid receptors and prevents the acute ET-1 induced ultrastructural vessel wall damage.

Reservoir and globe-type antireflux surgical techniques in intrathoracic esophagogastrostomies

Gastroesophageal reflux is a major postoperative problem in esophageal patients with cancer, and the principal cause is resection of the lower esophageal sphincter. Two new antireflux operations to solve this problem were investigated. The number of patients studied was 139, with a male to female ratio of 5. The reservoir technique was applied to the first 50 patients and the globe technique was used in the remaining 89. Hospital mortality was 9.35%. Patient satisfaction from a reflux standpoint was excellent in 91.4%, good to fair in 6.5%, and poor in 2.1%. Postoperative barium swallow at the first, third, and sixth months showed no reflux in 93% of cases. Postoperative preanastomotic mean pressure was 14.2 mmHg. Postoperative mucosal biopsies revealed a remarkable reduction in esophagitis. The radiologic, manometric, and histologic findings as well as the patient satisfaction rate suggest that these antireflux operations are suitable and effective for patients undergoing esophageal resection and intrathoracic esophagogastric anastomosis.

Early mobilization after sliding and Z-lengthening of heel cord: a preliminary experimental study in rabbits

Sliding lengthening and Z-lengthening techniques are widely used in heel cord lengthening. Even though most surgeons performing these procedures apply a short leg cast after surgery, their postoperative immobilization intervals vary from 3 to 7 weeks. Nather et al. showed that there was no need for immobilization after the musculotendinous lengthening of long, deep flexor tendons. In the present study, we aimed to show the healing process of heel cords lengthened by sliding and Z-plasty lengthening in rabbits that did not undergo any postoperative immobilization. We performed sliding lengthening in the right heel cords of the rabbits and Z-lengthening in the left heel cords. We compared these two techniques radiographically, biomechanically, and histopathologically. Even though the biomechanical study showed superior results in the sliding lengthening group on the 7th day, elongation of the tendons at both sites was seen radiographically. There was no statistically significant difference between the sites according to the biomechanical study done on the 28th day. We concluded that the ankle should be immobilized in the early healing phase and that both types of lengthening gain a similar level of strength by the 4th week.

Acetabular dysplasia in normal Turkish adults

The aim of this investigation was to examine normal hip joint morphometry and the acetabular dysplasia rate in Turkish adults. Center-edge angle, acetabular angle, acetabular depth, acetabular roof obliquity, and roof angle were measured in standardized pelvic radiographs of 495 adults without any hip symptoms. The center-edge angle was significantly different in the patients over the age of 70 than all other age groups except those in the 60 to 69 group. Additionally, there were differences between those in the 60 to 69 age group compared to those in the 20 to 29 age group. The acetabular angle showed a significant difference between gender and between the age groups over 60. The acetabular angle was negatively correlated with center-edge angle. Even though no significant differences were observed in the acetabular depth, differences in acetabular roof obliquity and roof angle were related to gender and age, all showed high standard deviations. The rate of acetabular dysplasia was 2.4% in the Turkish adult population aged 20 to 79. It is concluded that the center-edge angle may be a useful parameter in the evaluation of acetabular dysplasia if one is aware of its difference in patients over the age of 60.

Comparison of omentum, pleura and diaphragm for tracheal autograft survival in rats

Pleura, diaphragm, pericardial fat pad, intercostal muscles and omentum can be used to protect and revascularize the bronchial suture line. To compare the efficiency of pleura, diaphragm and omentum, an experimental study was designed. Heterotopic tracheal autotransplantation was performed in 15 rats. Animals were divided into three groups; omentum, diaphragm and pleura. Tracheal Segment Necrosis Scoring System was used for pathologic examinations. Pleural and diaphragmatic groups showed the least necrosis and there was significant statistical difference among these groups and omental group (P < 0.05). Our study showed that pleura and diaphragm could be used as safely as omentum for protection and survival of bronchial suture lines.

Ileal and colonic contractions by endothelin-1 in experimentally induced paralytic ileus in rats

The aim of the present study was to investigate the effect of endothelin-1 on the isolated distal ileum and proximal colon in an experimentally induced ileus in rats. Ileal and colonic contractions by endothelin-1, acetylcholine alone and with endothelin-1 were recorded both in normal and experimentally induced paralytic ileus in rats. In the control group, all the responses to acetylcholine were found to be potentiated significantly when used together with endothelin-1 but in paralytic ileus group, no detectable change was observed in the responses of the amine after administration of acetylcholine together with endothelin-1. This study indicates that endothelin-1 might have an effect on gastrointestinal motility and postoperative paralytic ileus.

Role of endogenous endothelin peptides in intestinal ischemia-reperfusion injury in rats

In this study, the effects of BQ123 (an ET(A) receptor antagonist), bosentan (a nonselective ET(A)-ET(B) antagonist), and phosphoramidon (an endothelin converting enzyme inhibitor) were investigated on intestinal mucosal lesion formation and changes in tissue PGE2 and LTC4 levels due to intestinal ischemia-reperfusion (I/R) injury in rats. Following 30 min of ischemia, the substances were given via the inferior caval vein, and 10 min later the intestine was subjected to reperfusion for 30 min. The intestinal specimens were evaluated both microscopically and the tissue PGE2 and LTC4 levels were obtained for each group. The histopathologic examination revealed a significant reduction in tissue injury in both BQ123 and phosphoramidon pretreated groups compared with the control group. Bosentan, on the contrary, did not decrease the injury. The pharmacologic examination revealed a significant reduction of PGE2-like activity in both BQ123 and phosphoramidon pretreated groups, compared with the control group, while LTC4-like activity remained unchanged except for an increase in the bosentan pretreated group.