Abiraterone, Orteronel, Enzalutamide and Docetaxel: Sequential or Combined Therapy?

Objective: To summarize the current therapeutic status using chemotherapeutic agent docetaxel and endocrine therapeutic agents (ARAT, abiraterone, orteronel or enzalutamide) for the treatment of metastatic castration-resistant prostate cancer (mCRPC), including sequential therapy and combined therapy, to promote the consensus on the optimal regimen for achieving superior treatment efficacy.

Methods: Through literature search in PubMed, articles with the following relevant keywords were collected and anlyzed: CRPC, abiraterone, orteronel and enzalutamide, median survival, overall survival, prostate specific antigen (PSA), PSA response rate and median radiologic progression-free survival.

Results: Fifty-eight articles were obtained and analyzed in this review. These articles included androgen axis-targeting agents after docetaxel, docetaxel after androgen axis-targeting agents, Triple sequential and combination therapy, covering four current drugs for mCRPC treatment: docetaxel, abiraterone, orteronel, and enzalutamide. It was found that there may be some cross-resistance between androgen axis-targeting agents, which will reduce the efficacy of subsequent drug treatment. Although neither of the studies of using combination therapy showed serious drug toxicity, the efficacy of sequential therapy was not as good as expected. Most adverse reactions after treatment were reported to be level 1–2.

Conclusion: Based on the results of the current studies, abiraterone followed by enzalutamide treatment is the best sequential treatment for most docetaxel-naïve patients. This treatment achieves not only good OS, but also PFS and PSA response rates. In addition, for patients who have previously failed docetaxel treatment, enzalutamide is the best choice as the subsequent treatment.

Identification of UAP1L1 as a critical factor for prostate cancer and underlying molecular mechanism in tumorigenicity

Background

Prostate cancer is the second most common cancer in men, and some new target genes are needed to predict the risk of prostate cancer progression and the treatment.

Methods

In this study, the effects of UAP1L1 (UAP1-like-1) on prostate cancer were investigated by detecting the proliferation, migration, invasion and apoptosis of prostate cancer cells in vitro using MTT, wound healing, Transwell and flow cytometry assay, and the tumor growth in vivo. The downstream genes and pathways of UAP1L1 were explored using Ingenuity Pathway Analysis (IPA), and screened by qRT-PCR and western blot. The effects of CDCA8 on prostate cancer cells were also verified in vitro, which was through detecting the change of proliferation, migration, invasion and apoptosis of prostate cancer cells after CDCA8 knockdown.

Results

The results indicated that UAP1L1 promoted the proliferation, migration and invasion of prostate cancer cells, which was inhibited by downregulating CDCA8. Furthermore, the promotion of CDCA8 knockdown on cell apoptosis was reduced when UAP1L1 was simultaneously overexpressed.

Conclusions

In conclusion, the results in this study revealed that UAP1L1 promoted the progression of prostate cancer through the downstream gene CDCA8.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12967-022-03291-0.

Progress and prospect of stem cell therapy for diabetic erectile dysfunction

Diabetic erectile dysfunction (DED) is a common complication of diabetes mellitus, significantly impairing the quality of life of patients. The conventional clinical treatment still has limitations. Stem cells (SCs), as a type of cells with multidirectional or directional differentiation capability and sustainable self-renewal potential, are widely used in regenerative medicine and tissue engineering. With the continuous update of regenerative medicine theory and the success of animal experiments, SCs as a treatment for male erectile dysfunction, especially DED, have attracted widespread attention because of curable possibility. This review focus on the current progress in the clinical application of SC treatment for DED. Moreover, we summarize the development prospects of SCs in the field of DMED therapy.

[L-carnitine-astaxanthin compound nutrients for the treatment of idiopathic oligospermia and asthenozoospermia: A multicenter clinical observation]

OBJECTIVE

To investigate the clinical effects of the L-carnitine-astaxanthin compound nutrients Menglankang (MLK) on idiopathic oligospermia (OS) and asthenospermia (AS).

METHODS

This study included 73 cases of OS and 220 cases of AS treated with MLK once a bag, bid, for 3 successive months. Before and at 1, 2 and 3 months after treatment, we obtained and analyzed the semen parameters and sperm DNA fragmentation index (DFI) of the patients.

RESULTS

Compared with the baseline, the OS patients showed remarkable increases after 1 and 2 months of treatment in the semen volume (［3.07 ± 1.47］ vs ［3.26 ± 1.26］ and ［3.30 ± 1.28］ ml), sperm concentration (［10.96 ± 6.09］ vs ［16.74 ± 11.15］ and ［17.56 ± 9.92］ ×10⁶/ml, P < 0.05), total sperm count (［29.78 ± 17.48］ vs ［52.98 ± 32.07］ and ［57.67 ± 36.98］ ×106, P < 0.05) and the percentages of progressively motile sperm (PMS) (［39.8 ± 11.66］% vs ［45.3 ± 14.03］% and ［46.42 ± 10.69］%, P < 0.05) and morphologically normal sperm (MNS) (［1.71 ± 1.07］% vs ［1.79 ± 0.91］% and ［1.84 ± 0.96］%), and so did the AS patients in PMS (［19.23 ± 8.32］% vs ［25.46 ± 13.86］% and ［27.33 ± 12.88］%, P < 0.05). After 3 months of medication, the OS patients exhibited even more significant increases in the semen volume (［3.63 ± 1.39］ ml) (P < 0.05), sperm concentration (［20.56 ± 14.7］ ×10⁶/ml) (P < 0.05), total sperm count (［66.35 ± 55.91］ ×106) (P < 0.05), PMS (［49.24 ± 13.45］%) (P < 0.05) and MNS (［2.59 ± 0.93］%) (P < 0.05), and so did the AS patients in the semen volume (［3.27 ± 1.42］ vs ［3.85 ± 1.59］ ml, P < 0.05), PMS (［29.11 ± 13.58］%) (P < 0.05) and NMS (［2.01 ± 1.14］% vs ［2.57 ± 1.15］%, P < 0.05). In comparison with the baseline, the sperm DFI was not significantly improved at 1 month after treatment, but remarkably decreased at 2 and 3 months in the OS patients (［25.87 ± 13.76］% vs ［18.66 ± 10.83］% and ［16.48 ± 11.46］%, P < 0.05) and the AS patients as well (［26.40 ± 12.28］% vs ［19.35 ± 11.54］% and ［15.32 ± 10.89］%, P < 0.05).

CONCLUSIONS

The L-carnitine-astaxanthin compound nutrients Menglankang can significantly improve the semen quality of the patients with idiopathic oligospermia or asthenospermia.

Immunotolerant indoleamine-2,3-dioxygenase is increased in condyloma acuminata

BACKGROUND

The tryptophan-depleting enzyme indoleamine-2,3-dioxygenase (IDO) is critical for the regulation of immunotolerance and plays an important role in immune-associated skin diseases.

OBJECTIVES

To analyse the level of IDO in condyloma acuminata (CA) and its role in this condition.

METHODS

IDO expression was assessed in the skin and peripheral blood of healthy controls and patients with CA. To assess the role of skin IDO in immunity, the ability of isolated epidermal cells to metabolize tryptophan and the influence on polyclonal T-cell mitogen (PHA)-stimulated T-cell proliferation were explored.

RESULTS

IDO median fluorescence intensities in peripheral blood mononuclear cells from patients with CA were similar to those from healthy controls. Immunohistochemistry showed that IDO⁺ cells were rare in normal skin and the control skin of patients with CA, but were greatly accumulated in wart tissue. Most fluorescence signals of IDO⁺ cells did not overlap with those of CD1a⁺ Langerhans cells. Human papillomavirus (HPV) DNA probe in situ hybridization showed a large number of IDO⁺ cells in the HPV^- site. Keratinocytes in the skin of healthy controls and the circumcised skin of patients with CA could minimally transform tryptophan into kynurenine, but IDO-competent epidermal cells from warts could transform tryptophan. In addition, these IDO-competent epidermal cells could inhibit PHA-stimulated T-cell proliferation. The addition of an IDO inhibitor, 1-methyl-d-tryptophan, restored the inhibited T-cell proliferation.

CONCLUSIONS

Abnormally localized high IDO expression might be involved in the formation of a local immunotolerant microenvironment.

[Suprapubis-assisted umbilical laparoendoscopic mini-dual-site surgery for varicocele: a report of 80 cases]

OBJECTIVE

To study the safety, effectiveness and feasibility of suprapubis-assisted umbilical laparoendoscopic mini-dual-site surgery (SAU-LEMDS) in the treatment of varicocele.

METHODS

This study included 80 varicocele patients aged 24 - 44 (mean 28.5 +/- 2.6) years, 25 cases of grade I, 45 cases of grade II and 10 cases of grade III, 58 cases in the left side, 6 in the right and 16 in both sides, and all with asthenospermia. The patients were treated by SAU-LEMDS under subarachnoid anesthesia combined with general anesthesia in a supine position with a head-down-feet-up slope of 15 degrees. Two 5 mm trocars were inserted bilaterally at the umbilical edge, one with a 5 mm 30 degrees laparoscope placed in it, and another into the abdominal cavity below the pubic hairline with a 5 mm laparoendoscopic clipper placed in it. The operation procedure was similar to that of standard laparoscopic ligation of spermatic veins, with reservation of the spermatic artery and double-ligation of spermatic veins. And the procedure was repeated for the contralateral lesion in the bilateral cases. Postoperative follow-up was conducted for the incidences of orchiatrophy and testicular hydrocele and changes of seminal parameters.

RESULTS

All the operations were successful, with the mean operation time of (10 +/- 5.0) min (range 8 to 25 min) for the unilateral cases and (18 +/- 6.5) min (range 15 to 30 min) for the bilateral cases, the mean blood loss of (1.5 +/- 0.5) ml (range 1 to 2 ml), and the mean postoperative hospital stay of (2 +/- 0.5) d (range 1.5 to 3 d). The patients were followed up for 6 -24 (12 +/- 2.5) months, which showed significant improvement in sperm motility as compared with the baseline ([28.53 +/- 5.21] vs [19.62 +/- 3.56]%, P < 0.05), with 28 cases (35.0%) restored to normal. Recurrence was found in 4 cases (5.0%). Testicular hydrocele occurred in 7 cases (8.75%), but orchiatrophy in none. The scars in the umbilicus and suprapubis were invisible because of the wrinkles and pubic hair.

CONCLUSION

SAU-LEMDS is safe, effective and feasible for the treatment of varicocele. It is superior to umbilical laparoendoscopic single-site surgery (U-LESS) for its less invasiveness, simpler operation, and better cosmetic appearance.

[Testicular microlithiasis influences seminal profile and testicular blood flow in infertile men]

OBJECTIVE

To investigate the testicular blood flow in patients with testicular microlithiasis (TM) and its correlation with the seminal profile in infertile men.

METHODS

We selected 88 infertile men and examined them by testicular color Doppler and routine seminal tests.

RESULTS

Testicular microlithiasis was found in 19 (19.3%) of the patients, classic testicular microlithiasis (CTM) in 7 (8.0%), and limited testicular microlithiasis (LTM) in 10 (11.3%). No significant differences were observed in the age of onset, bilateral testicular volume, resistance index (RI) of bilateral testicular arteries, semen amount and the rate of teratospermia. The bilateral testicular peak systolic velocity (PSV), sperm count and sperm motility were significantly lower in the CTM than in the LTM group (P < 0.05), but showed no statistically significant difference between the LTM and the non-calcification group.

CONCLUSION

TM may be one of the causes of poor sperm function in infertile men.

[Diagnosis and treatment of primitive neuroectodermal tumor of the penis: a case report and review of the literature]

OBJECTIVE

To investigate the clinical and pathological characteristics, treatment and prognosis of peripheral primitive neuroectodermal tumor (PNET) of the urinary tract and reproductive system.

METHODS

The clinical data and pathological characteristics of a PNET patient was analyzed and relevant literature reviewed.

RESULTS

The diagnosis was established by pathological and immunohistochemical method. The patient underwent radical surgery, followed by chemotherapy.

CONCLUSION

Pathology and immunohistochemistry help the diagnosis of PNET. For the treatment of the tumors in the early stage, surgery is the best choice, and for that in the late stage, it can be followed by chemotherapy. The PNET of the penis is a rare disease and evidence still lacks for the evaluation of its prognosis.

[An experimental study of the culture, isolation and biological characteristics of rat adipose tissue-derived stromal cells in vitro]

OBJECTIVE

To establish a method for the isolation and culture of rat adipose tissue-derived stromal cells (ADSCs) and explore some biological characteristics of the acquired ADSCs.

METHODS

Adipose tissues were isolated from the inguinal fat of SD rats. Primary ADSCs were obtained by the method of collagenase I digestion, inoculated, cultured in the Dulbecco modified Eagle medium with 10% fetal bovine serum, and subcultured at the right moment. The morphology and proliferation characteristics of the cells were observed under the inverted phase contrast microscope every day. Their growth curves were detected and experiments of freezing and resuscitation performed. The third passage ADSCs were induced into osteoblasts by osteogenic inducing fluid and into adipocytes by adipogenic inducing fluid. The osteogenic phenotypes were examined by Von Kossa staining and the adipocytes by Oil Red O staining.

RESULTS

ADSCs were successfully obtained and cultured from the rat adipose tissue. They appeared fibroblast-like and could proliferate rapidly in vitro, the third passage having the most active proliferative ability. Calcium nodes characteristic of osteoblasts were observed in the ADSCs on Von Kossa staining after induction with dexamethasone, ascorbic acid and beta-sodium glycerophosphate, and red-stained fats characteristic of adipocytes were noted in the cytoplasm on Oil Red O staining after induction with IBMX, indomethacin and insulin. The ADSCs showed no significant decrease in their proliferation activity and capability of differentiating into diverse cell types after cryopreserved in liquid nitrogen for a month.

CONCLUSION

A simple and effective method for the isolation and culture of rat ADSCs was successfully established. The ADSCs obtained could grow and proliferate rapidly in vitro, capable of differentiating into diverse cell types, easy to be preserved and promising to be seed cells for cell therapy and tissue engineering. The procedure of schizolysising erythrocytes with NH4Cl could be omitted in the isolation of the rat ADSCs and dexamethasone is not indispensable in the induction of ADSCs into adipocytes.

[Value of transrectal ultrasonography in the diagnosis of midline prostatic cysts]

OBJECTIVE

To assess the value of transrectal ultrasonography (TRUS) in the diagnosis of midline prostatic cysts.

METHODS

We retrospectively analyzed the TRUS manifestations of 87 cases of midline prostatic cysts.

RESULTS

Of the total number, 33 cases were diagnosed as Müllerian duct cysts, 21 cases ejaculatory duct cysts and the other 33 cases undifferentiated midline prostatic cysts; 19 cases had dilated seminal vesicles, 19 seminal vesicle agenesis, 9 seminal vesiculitis and 5 dilation of the ejaculatory duct.

CONCLUSION

TRUS, convenient, sensitive, safe and non-invasive, is a desirable method for the diagnosis of midline prostatic cysts.

Influence of OSEM, elliptical orbits and background activity on SPECT 3D resolution recovery

In maximum-likelihood expectation-maximization (MLEM) reconstruction of SPECT images, if both attenuation correction (AC) and detector response correction (DRC) are included, the reconstruction can be too time consuming to be clinically useful. With use of the ordered-subset expectation-maximization (OSEM) reconstruction, it has been reported that the reconstruction time can be substantially reduced. We investigated the reconstruction of point sources in a non-uniform attenuation medium in terms of the normalized FWHM of these sources. We compared MLEM versus OSEM reconstructions; circular versus elliptical orbits; and the presence versus the absence of background activity in the object. We found: (i) that OSEM does speed up the reconstruction by a factor of 10 over MLEM; (ii) that the resolution recovery does not depend on the type of orbit if both AC and DRC are included in the reconstruction; however, when there is background activity, a significant number of iterations are required to alleviate the effect of orbit; (iii) that background activity significantly slows down the resolution recovery of the point sources; and (iv) that if reconstruction only includes AC, and not DRC, changing orbit can change isotropy of recovered resolution, whereas introducing background activity may degrade the recovered resolution and also changes the isotropy.

Estimation of attenuation maps from scatter and photopeak window single photon-emission computed tomographic images of technetium 99m-labeled sestamibi

BACKGROUND

In single photon-emission computed tomographic imaging of the chest, nonuniform attenuation correction requires use of a patient-specific attenuation map. The aim of this study was to determine whether an estimate of the regions of the lungs and nonpulmonary tissues of the chest could be obtained by segmenting the photopeak and Compton scatter window images in a phantom and in patients to estimate patient-specific attenuation maps.

METHODS AND RESULTS

The photopeak and scatter window slices from 16 consecutive 99mTc-labeled sestamibi perfusion studies were segmented interactively. In these studies, visually reasonable regions could be obtained by estimating a "cold" lung region from scatter window data with additional anatomic information of the myocardium region, the backbone and sternum locations, the liver, and the rib cage from the photopeak window data. In an anthropomorphic torso phantom study and a patient study, comparison was made between the attenuation maps based on segmentation of the emission images and transmission imaging with a slant-hole collimator. It was determined that good agreement in the estimation of the body regions can be achieved with segmentation of the emission images in both the phantom and patient data. Attenuation correction using the maximum-likelihood expectation maximization method was performed on the phantom and the patient data. In both studies, attenuation correction with the segmented attenuation map improved uniformity of the inferior wall region in comparison with the other walls.

CONCLUSIONS

The estimation of patient-specific attenuation maps by segmenting the scatter and photopeak window slices of 99mTc-labeled sestamibi studies may be a way of reducing the loss of specificity due to attenuation artifacts. The potential limitations on the accuracy of correction inherent in the method due to the estimation of the regions and assignment of the attenuation coefficients need to be determined further, and the method needs to be further automated before it can be considered for routine clinical use.

A Kalman filtering approach to stochastic global and region-of-interest tomography

We define two forms of stochastic tomography. In global tomography, the goal is to reconstruct an object from noisy observations of all of its projections. In region-of-interest (ROI) tomography, the goal is to reconstruct a small portion of an object (an ROI) from noisy observations of its projections densely sampled in and near the ROI and sparsely sampled away from the ROI. We solve both problems by expanding the object and its projections in a circular harmonic (Fourier) series in the angular variable so that the Radon transform becomes Abel transforms of integer orders applied to the harmonics. The algorithm has three major components. First, we fit state-space models to each order of Abel transform and thus represent the Radon transform operation as a parallel bank of systems, each of which computes the appropriate Abel transform of a circular harmonic. A variable transformation here allows either the global or ROI problem to be solved. Second, the object harmonics are modeled as a Brownian branch. This is a two-point boundary value system, which is Markovianized into a form suitable for the Kalman filter. Finally, a parallel bank of Kalman smoothing filters independently estimates each circular harmonic from the noisy projection data. Numerical examples illustrate the proposed procedure.

In vitro responses of rainbow trout (Oncorhynchus mykiss) somatotrophs to carp growth hormone-releasing factor (GRF) and somatostatin

To study the hypothalamic control of growth hormone (GH) release in lower vertebrates, we employed an in vitro technique using a monolayer cell culture system of rainbow trout pituitary glands. Two newly purified carp brain growth hormone-releasing factors, carp GRF(1-45) and carp GRF(1-29), and synthetic somatostatin-14 (SST-14) were applied to the cultured pituitary cells. The results indicate that: (1) The carp GRFs had a dose-related potency in stimulating growth hormone release. The dose of half maximum effect (ED50) for carp GRF(1-45) was 0.107 nM, and an equal potency for carp GRF(1-29) was 0.388 nM. (2) SST-14 inhibited GH release having a dose-dependent potency with an ED50 of 0.186 nM. (3) Osmotic pressure did not influence SST-14 inhibited GH secretion but did affect spontaneous GH release. (4) The response of cultured cells was not affected by length of incubation period with SST-14 or carp GRF but was affected by cell density.