Olfaction in the Anthropocene: NO3 negatively affects floral scent and nocturnal pollination

There is growing concern about sensory pollutants affecting ecological communities. Anthropogenically enhanced oxidants [ozone (O3) and nitrate radicals (NO3)] rapidly degrade floral scents, potentially reducing pollinator attraction to flowers. However, the physiological and behavioral impacts on pollinators and plant fitness are unknown. Using a nocturnal flower-moth system, we found that atmospherically relevant concentrations of NO3 eliminate flower visitation by moths, and the reaction of NO3 with a subset of monoterpenes is what reduces the scent's attractiveness. Global atmospheric models of floral scent oxidation reveal that pollinators in certain urban areas may have a reduced ability to perceive and navigate to flowers. These results illustrate the impact of anthropogenic pollutants on an animal's olfactory ability and indicate that such pollutants may be critical regulators of global pollination.

P11.65.B GBM AGILE: A global, phase 2/3 adaptive platform trial to evaluate multiple treatment regimens in newly diagnosed and recurrent glioblastoma

Background

GBM AGILE (Glioblastoma Adaptive, Global, Innovative Learning Environment) is a biomarker based, multi-arm, international, seamless Phase 2/3 Response Adaptive Randomization platform trial designed to rapidly identify experimental therapies that improve overall survival and confirm efficacious experimental therapies and associated biomarker signatures to support new drug approvals and registration. It is a collaboration between academic investigators, patient organizations and industry, under the sponsorship of the non-profit organization, Global Coalition for Adaptive Research, to support new drug applications for newly diagnosed and recurrent GBM.

Material and Methods

The primary objective of GBM AGILE is to identify therapies that effectively improve overall survival in patients with newly diagnosed or recurrent GBM. Bayesian response adaptive randomization is used within subtypes of the disease to assign participants to investigational arms based on their performance. Operating under a master protocol, GBM AGILE allows multiple drugs from different pharmaceutical companies to be evaluated simultaneously and/or over time against a common control arm. Based on performance, a drug may graduate and move to a Stage 2 (Phase 3) within the trial, and the totality of the data can be used for a new drug application and registration process. New experimental therapies are added as information about promising new drugs is identified while other therapies are removed as they complete their evaluation. The master protocol/ trial infrastructure includes efficiencies through an adaptive trial design, shared control arm and operational processes such as risk-based monitoring and enhanced remote activities. With its adaptable structure, GBM AGILE has continued trial activation, inclusion of new investigational therapies, and enrollment globally through the challenges of a global pandemic.GBM AGILE provides an efficient mechanism to screen and develop robust information regarding the efficacy of proposed novel therapeutics and associated biomarkers for GBM and to quickly move therapies and biomarkers into clinic. GBM AGILE received initial approval from the United States FDA in April 2019, and in Europe through the Voluntary Harmonization Procedure (VHP) in April, 2021. As of 2022, AGILE has screened over 1000 patients studying multiple investigational treatments. Enrollment rates are 3 to 4 times greater than traditional GBM trials, with active sites averaging 0.75 to 1 patients/site/month.

Currently, there are 41 sites activated in the US, 4 in Canada and 2 in Switzerland and an estimated 24 sites yet to open in Germany, France, Switzerland, Italy and Austria. In addition to the continued expansion in Europe, effort is undergoing to extend the trial to China and Australia as well. Clinical trial information: NCT03970447

Post-discharge oral antimicrobial use among hospitalized patients across an integrated national healthcare network

OBJECTIVES

Antimicrobial stewardship programmes have focused on reducing inappropriate inpatient antimicrobial prescribing, but several small studies have found a large portion of antimicrobial exposure occurs immediately after hospital discharge. In this study, we describe the prescribing of oral antimicrobials at hospital discharge across an integrated national healthcare system. At the hospital level, we also compare total inpatient antimicrobial use and post-discharge oral antimicrobial use.

METHODS

This retrospective cross-sectional study used national administrative data to identify all acute-care admissions during 2014-2016 within the Veterans Health Administration (VHA). We evaluated inpatient days of therapy (DOT) and post-discharge DOT, defined as oral outpatient antimicrobials dispensed at the time of hospital discharge. At the hospital level, inpatient DOT/100 admissions were compared with post-discharge DOT/100 admissions using Spearman's rank-order correlation.

RESULTS

There were 1 681 701 acute-care admissions across 122 hospitals, and 335 369 (19.9%) were prescribed an oral antimicrobial at discharge. Fluoroquinolones (38.3%) were the most common post-discharge antimicrobial. At the hospital level, median inpatient antimicrobial use was 331.3 (interquartile range (IQR) 284.9-367.9) DOT/100 admissions and median post-discharge use was 209.5 (IQR 181.5-239.6) DOT/100 admissions. Thirty-nine per cent of the total duration of antimicrobial exposure occurred after discharge. At the hospital-level, the metrics of inpatient DOT/100 admissions and post-discharge DOT/100 admissions were weakly positively correlated with rho=0.44 (p < 0.001).

CONCLUSIONS

A large proportion of antimicrobial exposure among hospitalized patients occurred immediately following discharge. Antimicrobial-prescribing at hospital discharge provides an opportunity for antimicrobial stewardship. Hospital-level stewardship metrics need to include both inpatient and post-discharge antimicrobial-prescribing to provide a comprehensive assessment of hospital-associated antimicrobial use.

The Effects of Bile Salts on Some Coagulation Components and Related Enzymes

Certain purified bile salts, individually or in a mixture, profoundly affect - either inhibiting or enhancing - the esterolytic activities of thrombin, trypsin, and plasmin, the clotting activity of thrombin, and caseinolysis by trypsin. They also promote SK-induced fibrinolysis and impair FI clottability. These effects are directly related to bile salt concentration but not to the critical micellar concentration.

A very unusual effect was observed with deoxycholate and FI : besides inhibiting FI clottability, the salt induces spontaneous gelation. In addition, it binds strongly to the protein, as has been already reported for another plasma protein, albumin, and to a lesser degree, to alpha- and beta-globulins.

Noteworthy is the fact that activation of pancreatic juice trypsinogen by thrombin also was increased by prior thrombin exposure to the salts. On the other hand, thrombin-induced platelet aggregation was slightly inhibited by the bile salt mixture, which, when added to PRP moderately inhibited the ADP-induced aggregation. No effect was observed on the conversion of F II in plasma via the thromboplastic mechanism when deoxycholate, or cholate, or glycocholate was added to the system.

It is postulated that the bile salt mixture enhances SK-induced fibrinolysis by direct action, either on SK, or on the SK-activator complex, attributable to the detergent properties of the salts.

The physiologic and pathologic implications of our results with respect to hemostasis and pancreatitis are discussed.

Assay of Some Thromboplastin Generation Factors

A method for measuring six plasma or serum factors required for intrinsic thromboplastin formation is described by which various dilutions of normal serum are used to correct the abnormal TGT obtained with specifically deficient blood. When the arithmetic product of the minimum clotting time and the corresponding incubation time are plotted against the logarithm of the concentration of the particular factor in question, a rectilinear relationship is obtained for factors V, VIII, IX, XI and XII, and a hitherto unrecognized new serum factor (Thorium Vulnerable Factor, TVF). This correlation does not hold for factor X. Thus far no mathematical or biochemical equation could be formulated to explain the empiric observations.

Other reported assay procedures are discussed.

Action of Water-Insoluble Trypsin Derivatives on Fibrinogen Clottability

Two water-insoluble derivatives of trypsin, one prepared by coupling polytyrosyl trypsin to diazotized p-amino-phenylalanine-leucine copolymer (IPTT), the other by coupling trypsin to ethylene maleic anhydride copolymer (IMET), quickly compromise the clotting of fibrinogen by thrombin, as does native trypsin. When used in equivalent caseinolytic or esterolytic activity IMET is much more potent than IPTT. The effects, temperature and concentration dependent, are blocked by trypsin inhibitors. Clotting kinetics are far more affected than the ultimate fibrin yield obtained by thrombin. Marked impairment of clottability is associated with cleavage of 1-2 peptide bonds of the fibrinogen molecule. The early changes are paralleled by release of very small amounts of TCA-soluble tyrosine-containing fragments, and associated with the appearance in the ultracentrifuge of a small amount of a fast sedimenting material. The electrophoretic mobility of the altered fibrinogen remains uniform, but it is significantly slower than the original intact fibrinogen. Fibrinogen that is exposed to the water-insoluble trypsin derivatives for relatively short time intervals will under certain conditions clot spontaneously, indicating that the trypsin splits inter alia the same bonds cleaved by thrombin. The differences between IPTT and IMET in their actions on fibrinogen are attributed to the different nature of the carrier to which trypsin is attached in these water-insoluble derivatives.

Abstract P3-03-16: Molecular iodine impairs chemoresistance and invasive mechanisms, enhances doxorubicin retention and induces downregulation of CD44+/CD24+ and E-Cad+/Vim+ subpopulations in MCF-7 cells resistant model

The main problem in the treatment of breast cancer is the ability of the cells to become chemoresistant and metastatic. Both components involved complex mechanisms based on alterations of apoptosis, the cell cycle and drug metabolism, and its correlates with the cancer stem cell phenotype and/or epithelial-mesenchymal transition. In this study, Doxorubicin (DOX), a member of the anthracycline family used as first-line therapy for several cancers, given chronically to establish a low-dose DOX-resistant mammary cancer model to analyze the effect of molecular iodine (I2) on the chemoresistant and invasive mechanisms. I2 exerts an antitumor effect on different types of iodine-capturing neoplasm through its oxidant/antioxidant properties and formation of iodolipids. Wild-type breast carcinoma cells (MCF-7/W) were treated chronically with low DOX concentration (10 nM) to generate a clinically relevant model of DOX-resistance (MCF-7/D). After treatment with I2 and DOX alone or in combination, the proliferation assay (Trypan Blue exclusion), RT-qPCR expression (p21, Bax, Bcl-2, Survivin, PPARγ, E-Cadherin and Vimentin), flow cytometry (CD24, CD44, E-Cadherin, and Vimentin) and DOX retention (DOX fluorescence) were performed. Tumorogenic capacity was analyzed by xenograft induction in Foxn1 nu/nu mice. MCF-7/D was established after 30 days of treatment when the culture showed a proliferation rate similar to that of MCF-7/W. These DOX-resistant cells also showed increases in p21, Bcl-2 and MDR-1 expression. Supplementation with 200 μM I2 exerted similar effects in both cell lines: it decreased the proliferation rate by approximately 40%, and I2 co-administration with DOX significantly increased the inhibitory effect (~ 60%) and also increased apoptosis (Bax/Bcl-2 index), principally by inhibiting Bcl-2 expression. The inhibition by I2+DOX was also accompanied by impaired MDR-1 induction as well as by a significant increase in PPARγ expression. All these changes could be attributed to enhanced DOX retention and differential down selection of CD44+/CD24+ and E-Cad+/Vim+ subpopulations. I2+DOX selected cells (CD44-/CD24- and E-Cad+/Vim-) showed a weak induction of xenografts, indicating that the iodine supplements reversing the tumorogenic capacity of MCF-7/D. In conclusion, molecular iodine reduces the drug resistance and invasive capacity of mammary cancer cells exposed to DOX and represents an anti-chemoresistance agent with clinical potential.

This work was partially supported by grant PAPIIT-UNAM IN201516. We thank Juana Cardenas for technical support. Alexander Bontempo is a student of Programa de Doctorado en Ciencias Biomédicas, UNAM and receives a fellowship from CONACYT 262489.

Citation Format: Carmen A, Alexander B, Brenda U-V, Evangelina D-G, Ángel Luis R. Molecular iodine impairs chemoresistance and invasive mechanisms, enhances doxorubicin retention and induces downregulation of CD44+/CD24+ and E-Cad+/Vim+ subpopulations in MCF-7 cells resistant model [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-03-16.

Ureteroscopy and laser lithotripsy: technologic advancements

Ureteroscopic lithotripsy has evolved since the first reported cases employing rigid rod-lens endoscopes and stiff ultrasonic lithotrites. Fiber optics facilitated rigid endoscope miniaturization and the development of a steerable, deflectable flexible ureteroscopes. Over 30 years of technical innovations culminating in digital imagers and powerful, precise laser lithotrites, complimented by progressive endoscopic techniques have produced efficient endoscopic therapies with minimal morbidity and commonly performed in an outpatient setting.

In vitro development of bison embryos using interspecies somatic cell nuclear transfer

Interspecies somatic cell nuclear transfer (interspecies SCNT) has been explored in many domestic and non-domestic animal species. However, problems arise during the development of these embryos, which may be related to species-specific differences in nuclear-cytoplasmic communication. The objectives of this study were to investigate the possibility of producing bison embryos in vitro using interspecies SCNT and assess the developmental potential of these embryos. Treatment groups consisted of cattle in vitro fertilization (IVF) and cattle SCNT as controls and wood bison SCNT, plains bison SCNT and wisent SCNT as experimental groups. Cleavage and blastocyst rates were assessed, and blastocyst quality was determined using total cell number, apoptotic incidence and relative quantification of mitochondria-related genes NRF1, MT-CYB and TFAM. These results indicate that embryos can be produced by interspecies SCNT in all bison species/subspecies (13.34-33.54% blastocyst rates). Although increased incidence of apoptosis was observed in bison SCNT blastocysts compared to cattle SCNT controls (10.45-12.69 vs 8.76, respectively) that corresponded with significantly lower cell numbers (80-87 cells vs >100 cells, respectively), no major differences were observed in the expression of NRF1, MT-CYB and TFAM. This study is the first to report the production of bison embryos by interspecies SCNT. Blastocyst development in all three bison species/subspecies was greater than the rates obtained in previous studies by IVF, which supports the potential role of SCNT for in vitro embryo production in this species. Yet, further investigation of developmental competence and the factors influencing blastocyst quality and viability is required.