Developing a Copper(II) Isopropyl 2-Pyridyl Ketone Thiosemicarbazone Compound Based on the IB Subdomain of Human Serum Albumin-Indomethacin Complex: Inhibiting Tumor Growth by Remodeling the Tumor Microenvironment

To develop a next-generation metal agent and dual-agent multitargeted combination therapy, we developed a copper (Cu) compound based on the properties of the human serum albumin (HSA)-indomethacin (IND) complex to remodel the tumor microenvironment (TME). We optimized a series of Cu(II) isopropyl 2-pyridyl ketone thiosemicarbazone compounds to obtain a Cu(II) compound (C4) with significant cytotoxicity and then constructed an HSA-IND-C4 complex (HSA-IND-C4) delivery system. IND and C4 bind to the hydrophobic cavities of the IB and IIA domains of HSA, respectively. In vivo, the HSA-IND-C4 not only showed enhanced antitumor efficacy relative to C4 and C4 + IND but also improved their targeting ability and decreased their side effects. The antitumor mechanism of C4 + IND involved acting on the different components of the TME. IND inhibited tumor-related inflammation, while C4 not only induced apoptosis and autophagy of cancer cells but also inhibited tumor angiogenesis.

Developing a Hetero-Trinuclear Erbium(III)-Copper(II) Complex Based on Apoferritin: Targeted Photoacoustic Imaging and Multimodality Therapy of Tumor

For the integration of targeted diagnosis and treatment of tumor, we innovatively designed and synthesized a single-molecule hetero-multinuclear Er(III)-Cu(II) complex (ErCu2) and then constructed an ErCu2@apoferritin (AFt) nanoparticle (NP) delivery system. ErCu2 and ErCu2@AFt NPs not only provided an evident photoacoustic imaging (PAI) signal of the tumor but also effectively inhibited tumor growth by integrating photothermal therapy, chemotherapy, and immunotherapy. ErCu2@AFt NPs improved the targeting ability and decreased the systemic toxicity of ErCu2 in vivo. Furthermore, we confirmed that ErCu2 and ErCu2@AFt NPs inhibited tumor growth by inducing apoptosis and autophagy of tumor cells and activating the immune system. The study not only provides a novel strategy to develop therapeutic metal agents but also reveals their potential for targeted accurate diagnosis and multimodality therapy of cancer.

Developing a Ruthenium(III) Complex to Trigger Gasdermin E-Mediated Pyroptosis and an Immune Response Based on Decitabine and Liposomes: Targeting Inhibition of Gastric Tumor Growth and Metastasis

To develop next-generation metal drugs with high efficiency and low toxicity for targeting inhibition of gastric tumor growth and metastasis, we not only optimized a series of ruthenium (Ru, III) 2-hydroxy-1-naphthaldehyde thiosemicarbazone complexes to obtain a Ru(III) complex (4b) with remarkable cytotoxicity in vitro but also constructed a 4b-decitabine (DCT)/liposome (Lip) delivery system (4b-DCT-Lip). The in vivo results showed that 4b-DCT-Lip not only had a stronger capacity to inhibit gastric tumor growth and metastasis than 4b-DCT but also addressed the co-delivery problems of 4b-DCT and improved their targeting ability. Furthermore, we confirmed the mechanism of 4b-DCT/4b-DCT-Lip inhibiting the growth and metastasis of a gastric tumor. DCT-upregulated gasdermin E (GSDME) was cleaved by 4b-activated caspase-3 to afford GSDME-N terminal and then was aggregated to form nonselective pores on the cell membrane of a gastric tumor, thereby inducing pyroptosis and a pyroptosis-induced immune response.

Developing a Multitargeted Anticancer Palladium(II) Agent Based on the His-242 Residue in the IIA Subdomain of Human Serum Albumin

To obtain next-generation metal drugs that can overcome the deficiencies of platinum (Pt) drugs and treat cancer more effectively, we proposed to develop a multitargeted palladium (Pd) agent to the tumor microenvironment (TME) based on the specific residue(s) of human serum albumin (HSA). To this end, we optimized a series of Pd(II) 2-benzoylpyridine thiosemicarbazone compounds to obtain a Pd agent (5b) with significant cytotoxicity. The HSA-5b complex structure revealed that 5b bound to the hydrophobic cavity in the HSA IIA subdomain and then His-242 replaced a leaving group (Cl) of 5b, coordinating with the Pd center. The in vivo results showed that the 5b/HSA-5b complex had significant capacity of inhibiting tumor growth, and HSA optimized the therapeutic behavior of 5b. In addition, we confirmed that the 5b/HSA-5b complex inhibited tumor growth through multiple actions on different components of TME: killing cancer cells, inhibiting tumor angiogenesis, and activating T cells.

Developing a Gadolinium(III) Compound Based on Apoferritin for Targeted Magnetic Resonance Imaging and Dual-Modal Therapy of Cancer

To integrate targeted diagnosis and treatment of cancer, we proposed to develop a gadolinium (Gd) agent based on the properties of apoferritin (AFt). To this end, we not only optimized a series of Gd(III) 8-hydroxyquinoline-2-carboxaldehyde-thiosemicarbazone compounds to obtain a Gd(III) compound (C4) with remarkable T₁-weighted magnetic resonance imaging (MRI) performance and cytotoxicity to cancer cells in vitro but also constructed an AFt-C4 nanoparticle (NP) delivery system. Importantly, AFt-C4 NPs improved the targeting ability of C4 in vivo and showed enhanced MRI performance and tumor growth inhibition ratio relative to C4 alone. Furthermore, we confirmed that C4 and AFt-C4 NPs inhibited tumor growth through apoptosis, ferroptosis, and ferroptosis-induced immune response.

Developing a Copper(II) Agent Based on His-146 and His-242 Residues of Human Serum Albumin Nanoparticles: Integration To Overcome Cisplatin Resistance and Inhibit the Metastasis of Nonsmall Cell Lung Cancer

To overcome the resistance of nonsmall cell lung cancer (NSCLC) cells to cisplatin and inhibit their metastasis, we proposed to develop a Cu(II) agent based on the specific residue(s) of HSA nanoparticles (NPs) for multitargeting the tumor microenvironment (TME). To this end, we not only synthesized four Cu(II) 2-hydroxy-3-methoxybenzaldehyde thiosemicarbazone compounds (C1-C4), obtaining a Cu compound (C4) with significant cytotoxicity by studying their structure-activity relationships, but also revealed the binding mechanism of C4 to HSA through X-ray crystallography and confirmed the successful construction of a new HSA-C4 NPs delivery system. C4 and HSA-C4 NPs inhibited the A549cisR tumor growth and metastasis, and HSA NPs optimized the anticancer behavior of C4. We further confirmed the anticancer mechanism of the C4/HSA-C4 NP multitargeting TME to overcome cisplatin resistance: killing tumor cells by acting on the mtDNA and inducing apoptosis, polarizing M2-type macrophages to the M1-type, and inhibiting angiogenesis.

Gout-like hands

A 65-year-old man presented to our hospital with a 1-year history of multiple nodules on his arms and hands without itching or pain.

Emergency management of 2019 novel coronavirus: implications for the dermatology department

Since cases first emerged in December 2019, COVID‐19 (a type of coronavirus) has rapidly become pandemic. This fast‐tracked paper (published quickly) from China on COVID‐19 is written by dermatologists at the epicentre of the outbreak in Wuhan.

Dermatology clinic staff may be at risk because protective equipment is not routinely available, and skin lesions might possibly transmit the virus indirectly. These authors suggest preventive measures based on experience in this and previous coronavirus outbreaks.

Online consultation for non‐urgent patients reduces the numbers of patients attending clinics. Nurse‐led triage, to identify patients with possible COVID‐19, at the entrances of hospital and skin clinics directs patients with a cough or fever to a specific COVID‐19 area and a dermatologist is consulted if the fever might be related to skin disease.

Clinic staff wear N95 masks and observe hand hygiene during consultations. Patients are admitted to a ward only if routine blood tests and chest CT scans exclude COVID‐19. Triage will not detect patients who are showing no symptoms but who are developing the disease, so the hospital should provide an on‐call expert team to discuss inpatients suspected or diagnosed with COVID‐19 and refer them to radiology, respiratory or intensive care colleagues as required.

Confirmed cases are managed following local policies. Skin disorders in COVID‐19 inpatients can usually be managed remotely using photographs, email and teleconferencing. If necessary a multidisciplinary team (a team of medical staff from different specialties) can meet in the clean area of the isolation ward. If the dermatologist must see the patient, all records should be provided in advance to minimise exposure time.

With these precautions, as of 20th February 2020 no infected patients were detected in the Wuhan Dermatology Department.

This is a summary of the study: Emergency management for preventing and controlling nosocomial infection of 2019 novel coronavirus: implications for the dermatology department

Linked Article: Tao et al. Br J Dermatol 2020; 182:1477–1478

Emergency management for preventing and controlling nosocomial infection of the 2019 novel coronavirus: implications for the dermatology department

Plain language summary available online

Downregulation of 14-3-3β and 14-3-3ζ in lesions of psoriasis vulgaris

BACKGROUND

The 14-3-3 proteins are a family of conserved regulatory molecules expressed in all eukaryotic cells, which play essential roles in a wide range of vital regulatory processes, including differentiation, proliferation and transformation. In mammalian cells, seven 14-3-3 isoforms (β, γ, ε, η, θ/τ, σ and ζ) have been identified, and each of these seems to have distinct tissue localizations and isoform-specific functions. 14-3-3β and 14-3-3ζ are two important members of the 14-3-3 family.

AIM

To explore the role of 14-3-3β and 14-3-3ζ in normal skin and psoriasis vulgaris (PV) skin.

METHODS

Using immunohistochemistry and western blotting, we measured expression of 14-3-3β and 14-3-3ζ in 30 PV lesions and 15 normal skin samples. The average optical density (OD) of immunostaining and the relative grey scale of immunoblotting for 4-3-3β and 14-3-3ζ were analysed by the t-test.

RESULTS

The average OD of immunostaining for 14-3-3β and 14-3-3ζ was 0.17 ± 0.00 and 0.24 ± 0.01, respectively, in psoriatic lesions, which was significantly lower than in normal controls (0.22 ± 0.01 and 0.37 ± 0.02, respectively; P < 0.01 for both). There was also a significant difference in the relative grey scale of 14-3-3β and 14-3-3ζ (0.52 ± 0.03 and 1.44 ± 0.06, respectively) in psoriatic lesions compared with normal control tissue (3.32 ± 0.15 and 2.76 ± 0.11, respectively; P < 0.01 for both).

CONCLUSIONS

Expression of 14-3-3β and 14-3-3ζ were lower in psoriatic lesions than in normal human skin tissue. We speculate that 14-3-3β and 14-3-3ζ may be involved in the regulation of normal skin function, thus decreased expression of 14-3-3β and 14-3-3ζ might precipitate the disturbance in proliferation and differentiation of keratinocytes seen in psoriasis.

Dyspepsia and irritable bowel syndrome in China: a population-based endoscopy study of prevalence and impact

BACKGROUND

Dyspepsia and irritable bowel syndrome (IBS) are common in Western populations.

AIM

To determine the epidemiology of dyspepsia and IBS in China.

METHODS

A representative sample of 18 000 adults from five regions of China were asked to complete the modified Rome II questionnaire; 20% were asked to complete the 36-item Short Form Health Survey (SF-36). Participants from Shanghai were invited to provide blood samples and undergo oesophago-gastroduodenoscopy. Odds ratios (ORs) and 95% confidence intervals (CIs) were determined using a multivariate logistic regression model.

RESULTS

The survey was completed by 16 091 individuals (response rate: 89.4%). Overall, 387 participants (2.4%) had dyspepsia and 735 (4.6%) had IBS. All SF-36 dimension scores were at least five points lower in individuals with than without dyspepsia or IBS (P < or = 0.001). In Shanghai, 1030 (32.7%) of the 3153 respondents agreed to endoscopy; neither dyspepsia nor IBS was found to be associated with reflux oesophagitis, peptic ulcer disease or Helicobacter pylori infection.

CONCLUSIONS

Prevalence estimates for dyspepsia and IBS in China are lower than in Western populations. In China, dyspepsia or IBS symptoms are generally not associated with underlying organic disease.

[Research on fibrotic effect of Ni-Ti and 317L alloys in esophagus]

This study was conducted to examiune the fibrotic effect of Ni-Ti and 317L alloys in esophagus. The extract fluid from Ni-Ti, 317L alloys was made according to the ASTM standards of U.S.A. The Fb of esophageal scar was cultured primarily, then incubated with alloy abstract fluid. The proliferating activity of Fb was measured by MTT at 4, 24, 48, 72 hours in the course of culturing. The esophagus embedding test of Ni-Ti, 317L alloys was made according to ASTM standards of U.S.A. The tissue around the alloys was taken at weeks 2 and 12, and the pathologic changes were analysed. The results showed that Ni-Ti, 317L extract could depress the proliferating function of Fb gently, and the depressing action increased gradually with the culturing time. The result of embedding test was in accord with the ASTM standards of U.S.A. completely; the fibrotic membrane around the NiTi, 317L alloys became thinner with embedding time. These findings suggested that the scattering composition of Ni-Ti, 317L in body fluid might not activate the proliferating and secreting function of Fb, and the two alloys could not lead to fibrosis of esophagus aroun them.