Translocation of bacterial LPS is associated with self-reported cognitive abilities in men living with HIV receiving antiretroviral therapy

BACKGROUND

Gut damage allows translocation of bacterial lipopolysaccharide (LPS) and fungal β-D-glucan (BDG) into the blood. This microbial translocation contributes to systemic inflammation and risk of non-AIDS comorbidities in people living with HIV, including those receiving antiretroviral therapy (ART). We assessed whether markers of gut damage and microbial translocation were associated with cognition in ART-treated PLWH.

METHODS

Eighty ART-treated men living with HIV from the Positive Brain Health Now Canadian cohort were included. Brief cognitive ability measure (B-CAM) and 20-item patient deficit questionnaire (PDQ) were administered to all participants. Three groups were selected based on their B-CAM levels. We excluded participants who received proton pump inhibitors or antiacids in the past 3 months. Cannabis users were also excluded. Plasma levels of intestinal fatty acid binding protein (I-FABP), regenerating islet-derived protein 3 α (REG3α), and lipopolysaccharides (LPS = were quantified by ELISA, while 1-3-β-D-glucan BDG) levels were assessed using the Fungitell assay. Univariable, multivariable, and splines analyses were performed.

RESULTS

Plasma levels of I-FABP, REG3α, LPS and BDG were not different between groups of low, intermediate and high B-CAM levels. However, LPS and REG3α levels were higher in participants with PDQ higher than the median. Multivariable analyses showed that LPS association with PDQ, but not B-CAM, was independent of age and level of education. I-FABP, REG3α, and BDG levels were not associated with B-CAM nor PDQ levels in multivariable analyses.

CONCLUSION

In this well characterized cohort of ART-treated men living with HIV, bacterial but not fungal translocation was associated with presence of cognitive difficulties. These results need replication in larger samples.

Influence of letermovir treatment on gut inflammation in people living with HIV on antiretroviral therapy: protocol of the open-label controlled randomised CIAO study

INTRODUCTION

Chronic cytomegalovirus (CMV) infection is very frequent in people living with HIV (PLWH). High anti-CMV IgG titres, which may be linked to transient CMV replication, have been associated with earlier mortality, CD8 T-cell expansion, lower CD4/CD8 ratio and increased T-cell senescence. We previously showed that anti-CMV IgG titres correlated with gut permeability in PLWH on antiretroviral therapy (ART), which was associated with microbial translocation, systemic inflammation and non-infectious/non-AIDS comorbidities. Letermovir, a novel anti-CMV drug with a good safety profile, was recently approved for anti-CMV prophylaxis in allogeneic haematopoietic stem cell transplant recipients. A drastic and selective reduction of both low-grade replication and clinically significant CMV infections, combined with an improved immune reconstitution have been reported. In vitro, letermovir prevented CMV-induced epithelial disruption in intestinal tissues. Based on these findings, we aim to assess whether letermovir could inhibit CMV subclinical replication in CMV-seropositive PLWH receiving ART and, in turn, decrease CMV-associated gut damage and inflammation.

METHOD AND ANALYSIS

We will conduct a multi-centre, open-label, randomised, controlled clinical trial, including a total of 60 CMV-seropositive ART-treated PLWH for at least 3 years, with a viral load <50 copies/mL and CD4+ count >400 cells/µL. Forty participants will be randomised to receive letermovir for 14 weeks and 20 participants will receive standard of care (ART) alone. Plasma, pheripheral blood mononuclear cells (PBMCs), and stool samples will be collected. Colon biopsies will be collected in an optional substudy. We will assess the effect of letermovir on gut damage, microbial translocation, inflammation and HIV reservoir size.

ETHICS AND DISSEMINATION

The study was approved by Health Canada and the Research Ethics Boards of the McGill University Health Centre (MUHC-REB, protocol number: MP37-2022-8295). Results will be made available through publications in open access peer-reviewed journals and through the CIHR/CTN website.

TRIAL REGISTRATION NUMBER

NCT05362916.

Camu Camu effects on microbial translocation and systemic immune activation in ART-treated people living with HIV: protocol of the single-arm non-randomised Camu Camu prebiotic pilot study (CIHR/CTN PT032)

INTRODUCTION

Despite the success of antiretroviral therapy (ART) in transforming HIV disease into a chronic infection, people living with HIV (PLWH) remain at risk for various non-AIDS inflammatory comorbidities. Risk of non-AIDS comorbidities is associated with gut dysbiosis, epithelial gut damage and subsequent microbial translocation, and increased activation of both circulating CD4+ and CD8+ T-cells. Therefore, in addition to ART, novel gut microbiota-modulating therapies could aid in reducing inflammation and immune activation, gut damage, and microbial translocation. Among various gut-modulation strategies under investigation, the Amazonian fruit Camu Camu (CC) presents itself as a prebiotic candidate based on its anti-inflammatory and antioxidant properties in animal models and tobacco smokers.

METHOD AND ANALYSIS

A total of 22 PLWH on ART for more than 2 years, with a viral load <50 copies/mL, a CD4 +count >200 and a CD4+/CD8 +ratio <1 (suggesting increased inflammation and risk for non-AIDS comorbidities), will be recruited in a single arm, non-randomised, interventional pilot trial. We will assess tolerance and effect of supplementation with CC in ART-treated PLWH on reducing gut damage, microbial translocation, inflammation and HIV latent reservoir by various assays.

ETHICS AND DISSEMINATION

The Canadian Institutes of Health Research (CIHR)/Canadian HIV Trials Network (CTN) pilot trial protocol CTNPT032 was approved by the Natural and Non-prescription Health Products Directorate of Health Canada and the research ethics board of the McGill university Health Centre committee (number 2020-5903). Results will be made available as free access through publications in peer-reviewed journals and through the CIHR/CTN website.

TRIAL REGISTRATION NUMBER

NCT04058392.

Gut Leakage of Fungal-Related Products: Turning Up the Heat for HIV Infection

The intestinal epithelial layer serves as a physical and functional barrier between the microbiota in the lumen and immunologically active submucosa. Th17 T-cell function protects the gut epithelium from aggression from microbes and their by-products. Loss of barrier function has been associated with enhanced translocation of microbial products which act as endotoxins, leading to local and systemic immune activation. Whereas the inflammatory role of LPS produced by Gram-negative bacteria has been extensively studied, the role of fungal products such as β-D-glucan remains only partially understood. As HIV infection is characterized by impaired gut Th17 function and increased gut permeability, we critically review mechanisms of immune activation related to fungal translocation in this viral infection. Additionally, we discuss markers of fungal translocation for diagnosis and monitoring of experimental treatment responses. Targeting gut barrier dysfunction and reducing fungal translocation are emerging strategies for the prevention and treatment of HIV-associated inflammation and may prove useful in other inflammatory chronic diseases.

A Preclinical Trial and Molecularly Annotated Patient Cohort Identify Predictive Biomarkers in Homologous Recombination–deficient Pancreatic Cancer

Purpose:

Pancreatic ductal adenocarcinoma (PDAC) arising in patients with a germline BRCA1 or BRCA2 (gBRCA) mutation may be sensitive to platinum and PARP inhibitors (PARPi). However, treatment stratification based on gBRCA mutational status alone is associated with heterogeneous responses.

Experimental Design:

We performed a seven-arm preclinical trial consisting of 471 mice, representing 12 unique PDAC patient-derived xenografts, of which nine were gBRCA mutated. From 179 patients whose PDAC was whole-genome and transcriptome sequenced, we identified 21 cases with homologous recombination deficiency (HRD), and investigated prognostic biomarkers.

Results:

We found that biallelic inactivation of BRCA1/BRCA2 is associated with genomic hallmarks of HRD and required for cisplatin and talazoparib (PARPi) sensitivity. However, HRD genomic hallmarks persisted in xenografts despite the emergence of therapy resistance, indicating the presence of a genomic scar. We identified tumor polyploidy and a low Ki67 index as predictors of poor cisplatin and talazoparib response. In patients with HRD PDAC, tumor polyploidy and a basal-like transcriptomic subtype were independent predictors of shorter survival. To facilitate clinical assignment of transcriptomic subtype, we developed a novel pragmatic two-marker assay (GATA6:KRT17).

Conclusions:

In summary, we propose a predictive and prognostic model of gBRCA-mutated PDAC on the basis of HRD genomic hallmarks, Ki67 index, tumor ploidy, and transcriptomic subtype.

Antibacterial activity of ruthenium polypyridyl complexes against Staphylococcus aureus and biofilms

There is clearly a need for the development of new classes of antimicrobials to fight against multidrug-resistant bacteria. Here, we designed and synthesized of three ruthenium polypyridyl complexes: [Ru(bpy)₂(BTPIP)](ClO₄)₂ (Ru(II)-1), [Ru(bpy)₂(ETPIP)](ClO₄)₂ (Ru(II)-2) and [Ru(bpy)₂(CAPIP)](ClO₄)₂ (Ru(II)-3) (N-N = bpy = 2,2'-bipyridine), their antimicrobial activities against S. aureus were assessed. The lead complexes of this set, Ru(II)-1(MIC = 0.016 mg/mL), was tested against biofilm. We also investigated whether bacteria can easily develop resistance to Ru(II)-1. The result demonstrated that S. aureus could not easily develop resistance to the ruthenium complexes. In addition, aimed to test whether ruthenium complexes treatment could increase the susceptibility of S. aureus to antibiotics, the synergism between Ru(II)-1 and common antibiotics against S. aureus were investigated using the checkerboard method. Interesting, Ru(II)-1 could increased the susceptibility of S. aureus to some aminoglycoside antibiotics(kanamycin and gentamicin). Finally, in vivo bacterial infection treatment studies were also conducted through murine skin infection model. These results confirmed ruthenium complexes have good antimicrobial activity in vitro and in vivo.

Mussel-inspired nanofibrous sheet for suture-less stomach incision surgery

We report a dopamine-based crosslinker-conjugated gelatin/polycaprolactone nanofibrous sheet. The nanosheet was then employed to treat stomach incisions without sutures during surgery.

Physician-patient-companion communication and decision-making: a systematic review of triadic medical consultations

OBJECTIVE

To systematically review quantitative and qualitative studies exploring physician-adult patient-adult companion (triadic) communication and/or decision-making within all medical encounters.

METHODS

Studies were identified via database searches and reference lists. One author assessed eligibility of studies, verified by two co-authors. Data were extracted by one author and cross-checked for accuracy. Two authors assessed the quality of included articles using standardized criteria.

RESULTS

Of the 8409 titles identified, 52 studies were included. Summary statements and tables were developed for each of five identified themes. Results indicated companions regularly attended consultations, were frequently perceived as helpful, and assumed a variety of roles. However, their involvement often raised challenges. Patients with increased need were more often accompanied. Some companion behaviours were felt to be more helpful (e.g. informational support) and less helpful (e.g. dominating/demanding behaviours), and preferences for involvement varied widely.

CONCLUSION

Triadic communication in medical encounters can be helpful but challenging. Based on analysis of included studies, preliminary strategies for health professionals are proposed.

PRACTICE IMPLICATIONS

Preliminary strategies for health professionals include (i) encourage/involve companions, (ii) highlight helpful companion behaviours, (iii) clarify and agree upon role preferences of patient/companions. Future studies should develop and evaluate specific strategies for optimizing triadic consultations.

Recovery of nickel ions from simulated electroplating rinse water by electrodeionization process

Pure water production and recovery of Ni(2+) from dilute NiSO(4) solution via improved electrodeionization (EDI) process were investigated. It was indicated that, with the feed water containing 50 mg L(-1) Ni(2+), the dilute resistivity of the EDI could achieve 3 MOmega cm which gave a Ni(2+) rejection more than 99.8% while the Ni(2+) was concentrated as high as 1,583 mg L(-1) in the concentrate stream. The current efficiency was as high as 40% and the concentrate factor could reach 31.7. The experiment results demonstrated that, just in a single process, it was feasible to purifying and concentrating dilute nickel wastewater synchronously by the EDI technology.

GroEL-GroES solubilizes abundantly expressed xylulokinase in Escherichia coli

AIMS

The aims of the present work were to solubilize the abundantly expressed recombinant xylulokinase in Escherichia coli and to develop a reliable xylulokinase assay.

METHODS AND RESULTS

Three mutants of xylulokinase of Bacillus megaterium that were expressed at high level but formed insoluble protein in E. coli BL21(DE3)pLysS were selected for solubility study. The solubility of xylulokinase increased eight to 77-fold after introduction of molecular chaperones GroEL-GroES into the host.

CONCLUSION

This investigation reports that GroEL-GroES minimizes the formation of insoluble protein in three highly expressed recombinant xylulokinases and an improved xylulokinase assay.

SIGNIFICANCE AND IMPACT OF THE STUDY

Commercial production of bioethanol is critically dependent on the development of an efficient and low-cost process of enzymatic conversion of xylan, a major component in lignocellulose biomass, to xylulose-5-phosphate, which can then be channelled into pentose phosphate pathway and metabolized to ethanol. The improved intracellular xylulokinase activity is expected to facilitate the xylose degradation.

Control of hyperchaos

A general method for controlling chaotic systems with one or more positive Lyapunov exponents is investigated analytically and numerically. The method retains the formal features of the adaptive adjustment mechanism and can be equally applied to various types of the unstable fixed points. It is shown that the method proposed here neither asks for any prior analytical knowledge of the system, nor any internal or external controlling parameters in advance.

Stabilizing unstable discrete systems

A general method for stabilizing unstable discrete systems to a fixed point or high-period orbit is developed analytically and numerically in this paper. It is shown that the method can be equally applied to the systems with one or more positive Lyapunov exponents. Moreover, the method does not require a prior analytical knowledge of the system under investigation, nor any additional control parameters.

Smad7 mediates apoptosis induced by transforming growth factor beta in prostatic carcinoma cells

Transforming growth factor beta (TGF-beta) is an important regulator of apoptosis in some cell types, but the underlying molecular mechanisms are largely unknown. TGF-beta signals through type I and type II receptors and downstream effector proteins, termed Smads. TGF-beta induces the phosphorylation of Smad2 and Smad3 (receptor-activated Smads) which associate with Smad4 and translocate to the nucleus, where they regulate gene transcription [1]. Smad7 protein is induced by TGF-beta1 and has been classified as an inhibitory Smad. Smad7 prevents phosphorylation of receptor-activated Smads, thereby inhibiting TGF-beta-induced signaling responses [1]. Smad7 expression is increased in rat prostatic epithelial cells undergoing apoptosis as a result of castration [2]. Here we have shown that TGF-beta1 treatment or ectopic expression of Smad7 in human prostatic carcinoma cells (PC-3U) induces apoptosis. Furthermore, TGF-beta1-induced apoptosis was prevented by inhibition of Smad7 expression, by antisense mRNA in stably transfected cell lines or upon transient transfection with antisense oligonucleotides in several investigated cell lines. These findings provide evidence for a new effector function for Smad7 in TGF-beta1 signaling.

Effects of enzyme inducers and inhibitor on the pharmacokinetics of intravenous 2-(allylthio)pyrazine, a new chemoprotective agent, in rats

In order to find what types of hepatic cytochrome P450 (CYP) isozymes are involved in the metabolism of 2-(allylthio)pyrazine (2-AP) in rats, enzyme inducers, such as phenobarbital, 3-methylcholanthrene, dexamethasone, or isoniazid, and an enzyme inhibitor, such as SKF 525-A were pretreated. After 1-min intravenous administration of 2-AP, 50 mg/kg, to rats pretreated with SKF 525-A (a non-specific CYP inhibitor in rats), the plasma concentrations were significantly higher, and the area under plasma concentration-time curve from time zero to time infinity (AUC) was significantly greater (1365 compared with 1034 microg min/mL) as a result of significantly slower total body clearance (Cl) (36.6 compared with 48.3 mL/min/kg) than those in control rats, indicating that 2-AP was metabolized by CYP isozymes. After 1-min intravenous administration of 2-AP, 50 mg/kg, to rats pretreated with dexamethasone (an inducer of CYP3A in rats), phenobarbital (an inducer of CYP2B1/2, 2C6, 2C7, and 3A1/2 in rats), and 3-methylcholanthrene (an inducer of CYP1A1/2 and 2A1 in rats), the plasma concentrations were significantly lower, and AUC was significantly smaller (27, 41 and 60% decrease, respectively, compared with respective control rats) owing to faster Cl [37 (p>0.05), 70 (p<0.001), and 150% (p<0.001) increase, respectively, compared with respective control rats].

[Effect of Saikosaponin-d on up-regulating GR mRNA expression and inhibiting cell growth in human leukemia cells]

OBJECTIVE

To study the effect of Saikosaponin-d (SSd) on the expression of glucocorticoid receptor (GR) mRNA and cell growth in HL60 cells.

METHODS

Antiproliferation effects of SSd on HL60 cells were determined by 3H-thymidine incorporation. Cell cycle analysis was also performed by flow cytometry. GRmRNA was analyzed by northern blot analysis.

RESULTS

After 48 hours treatment with 10 micrograms/ml SSd, 3H-thymidine incorporation decreased in HL60 cells and the effect was time and dose dependent. The flow cytometry analysis showed HL60 cells were arrested at G0/G1 phase. The expression of GR mRNA increased.

CONCLUSION

SSd exhibits the inhibition effects on cell growth in HL60 cells and could up-regulate the expression of GR mRNA in HL60 cells.

[The influence of nerve growth factor on inferior alveolar nerves regeneration in the silicone tubes]

OBJECTIVE

To explore the effect of exogenous nerve growth factor(NGF) in the regeneration of adult white rabbits inferior alveolar nerve within the silicone tubes.

METHODS

In 24 adults white rabbits. A bilateral 8 mm inferior alveolar nerve gaps were created, and the proximal and distal stumps were inserted into a 12 mm silicone tube. The silicone tube of the right side was filled with exogenous NGF(experimental group) and the contralateral side was filled with saline (control group). Regeneration of the nerves was assessed by histological exam and nerve electrophysiological appreciation. Total number of the regenerating myelinated nerve fibers, the conduction velocities of nerves the thickness of myelin sheaths and the cross section area of myelinated nerve fibers between the experimental and the control groups were compared.

RESULTS

The results showed that: 1. The experimental groups demonstrated more myelinated nerve fibers than that of the controls in 12 and 18 weeks. 2. At the same time following surgery, the myelin sheath thickness and the cross section area of myelinated nerves in the experimental groups were significantly greater than that in the controls. 3. In 12 and 18 weeks, the conduction velocities of regenerating nerves in the experimental groups were faster than that of the controls.

CONCLUSION

This study suggested that exogenous NGF can enhance regeneration of inferior alveolar nerve with necovery of its sensory function.

[Saikosaponin-d up-regulates GR mRNA expression and induces apoptosis in HL-60 cells]

OBJECTIVE

To research the effect of saikosaponin-d (SSd) on the expression of glucocorticoid receptor (GR) mRNA and induction of apoptosis in HL-60 cells.

METHODS

Antiproliferation effects of SSd on HL-60 cells were determined by 3H-thymidine incorporation. Apoptosis of the SSd-treated cells was determined by DNA fragmentation analysis and flow cytometry. GR mRNA was analyzed by Northern blot analysis.

RESULTS

After 48 h treatment with 10 micrograms/ml SSd, 3H-thymidine incorporation was decreased in HL-60 cells and the effects were time and dose dependent. DNA ladder appeared after 60 h treatment with SSd. The flow cytometry analysis showed HL-60 cells was arrested at G0/G1 phase and apoptotic peak appeared in sub-G1 phase. The expression of GR mRNA was increased.

CONCLUSION

SSd up-regulates the expression of GR mRNA, inhibits the cell growth and induces apoptosis in HL-60 cells.

[Surgical reconstruction of laryngeal and tracheal stenosis]

OBJECTIVE

Reconstruction of laryngotracheal stenosis.

METHOD

According to the pathologic condition of the larynx and trachea, various surgical procedures were designed for the treatment of laryngotracheal stenosis. These techniques included endoscopic management, laser therapy and laryngotrachoetomy with autogenous tissue and stent.

RESULT

Among 36 patients, 32 were decannulated. The success rate was 88.8%.

CONCLUSION

In order to improve the curation effects of laryngjotrachal stenosis, the choice of surgical procedure must be individualized to the pathologic condition of larynx and trachea, as well as the experience of the surgeon. Learning previous successful experience is also very important for a good result.

[Effect of Gengnianjian on up regulated estrogen receptor mRNA to substance P and beta-endorphin in hypothalamus of aging female rats]

OBJECTIVE

To investigate the effect of Chinese herbal formula Gengnianjian on estrogen receptor (ER), ERmRNA substance P (SP) and beta-endorphin (beta-EP) in the hypothalamus of aging female rats.

METHODS

ER proteins were determined by radioligand binding assay, ER mRNA was analyzed by Northern blot analysis and the levels of beta-EP and SP were detected by immunohistochemistry.

RESULTS

In aging rats, lowered ER and ER mRNA in the hypothalamus were still up-regulated by low serum E2 level, but not in rats of after the age of 21 months; Gengnianjian significantly increased ER protein level and ER mRNA expression, decreased SP and increased the level of beta-EP in the hypothalamus in aging female rats before 21 months of age, without changing of serum E2 level. In EB group, serum E2 and beta-EP levels increased and SP level decreased but ER expression suppressed in the hypothalamus except after 21 months.

CONCLUSION

Enhance estrogen bioactivity can decrease the level of SP and increase the level of beta-EP in hypothalamus of aging female rats. Herbal formula Gengnianjian increase-EP level and decrease SP level by raising the level of ER and ER mRNA.

[Clinical experience of coronal flap approach in surgery of anterior skull base tumor]

Surgery of the anterior skull base tumor has been undertaken in 7 cases by coronal flap approach, of which 4 cases were malignant tumors and 3 cases were benign tumors. The dura became torn in 3 cases and resected in 2 cases due to tumor invasion. The dura and bony defects could be repaired with galea, pericranial flaps and fascia flaps of temporalis. The bigger bony defect was consolidated with scalp flap. Three out of 4 cases with malignant tumors were free of tumors for 6 years, 4 years and 17 months, respectively: 1 case died of tumor recurrence after 18 months. No case had postoperative complications.