RNA Sequencing Identifies Novel NRG1 Fusions in Solid Tumors that Lack Co-Occurring Oncogenic Drivers

NRG1 gene fusions are rare, therapeutically relevant, oncogenic drivers that occur across solid tumor types. To understand the landscape of NRG1 gene fusions, 4397 solid tumor formalin-fixed, paraffin-embedded samples consecutively tested by comprehensive genomic and immune profiling during standard care were analyzed. Nineteen NRG1 fusions were found in 17 unique patients, across multiple tumor types, including non-small-cell lung (n = 7), breast (n = 2), colorectal (n = 3), esophageal (n = 2), ovarian (n = 1), pancreatic (n = 1), and unknown primary (n = 1) carcinomas, with a cumulative incidence of 0.38%. Fusions were identified with breakpoints across four NRG1 introns spanning 1.4 megabases, with a mixture of known (n = 8) and previously unreported (n = 11) fusion partners. Co-occurring driver alterations in tumors with NRG1 fusions were uncommon, except colorectal carcinoma, where concurrent alterations in APC, BRAF, and ERBB2 were present in a subset of cases. The overall lack of co-occurring drivers highlights the importance of identifying NRG1 gene fusions, as these patients are unlikely to harbor other targetable alterations. In addition, RNA sequencing is important to identify NRG1 gene fusions given the variety of fusion partners and large genomic areas where breakpoints can occur.

BIOM-03. COMPREHENSIVE GENOMIC AND IMMUNE PROFILING OF NON-SMALL CELL LUNG CANCER BRAIN METASTASES REVEALS LOW TUMOR INFLAMMATION AND ELEVATED CANCER TESTIS ANTIGEN BURDEN

BACKGROUND

Non-small cell lung cancer (NSCLC) accounts for ~50% of brain metastases. We present the genomic and immune biomarker landscape for a cohort with metastatic NSCLC to the brain.

METHODS

We analyzed brain metastases FFPE tissue (n=137; ages 40-85y (mean 65y), 52% female, 48% male) vs. primary sites (n=5533; ages 24-100+y (mean 71y), 51% female, 49% male) for advanced or metastatic NSCLC patients with comprehensive genomic and immune biomarker profiling, including PD-L1 IHC, tumor mutational burden (TMB), Tumor Immunogenic Signature (TIGS), Cell Proliferation (CP), and Cancer Testis Antigen Burden (CTAB).

RESULTS

Genomic alteration (GA) frequency for NSCLC brain metastasis versus primary sites were similar among the most frequently mutated genes except for KRAS which was significantly higher among brain metastases (39.9% vs 25.5%, p< 0.0005). No significant differences were observed for TP53 (50.7% vs 50.2%), STK11 (11.5% vs 10.9%), CDKN2A (10.1% vs 7%), or EGFR (8.0% vs 11.5%). PD-L1 expression for all cases by IHC was not significantly different (mean TPS 29.9% vs 26.3%); however, brain metastases were more likely to be PD-L1 negative (TPS< 1%) (46.3% vs 33.3%, p< 0.005). Conversely, TMB was higher in brain metastases versus primary sites (12.9 vs 10.2 muts/MB, p< 8x10-10), with more TMB-high cases (10 muts/Mb) (57.0% vs 33.5%, p< 3x10-8). Similarly, brain metastases had a higher proportion of CTAB-high cases (68.6% vs 57.6%, p=0.01). The immune response biomarker score, TIGS, was more often weak in brain metastases (52.6% vs 34.0%, p< 9x10-6).

CONCLUSION

In NSCLC, metastatic brain lesions have a larger antigen burden, with increased TMB and CTAB, likely due to the immune privileged nature of the brain, which is reflected in the lower TIGS scores and PD-L1 positivity. Despite lower PD-L1 positivity, NSCLC brain metastases with negative PD-L1 IHC may potentially benefit from immunotherapy strategies given the high TMB and CTAB.

Safeguards and weightless of electronic chain of command consolidated for virtual patient evaluation

The Internet of Things (IoT), 5G cellular technology, and Cyber-Physical Systems (CPS) are enabling a wide range of IoT-based application cases that are both intelligent. As one of the most impactful applications of the Internet of Things (IoT), healthcare makes use of AAL (Ambient Assisted Living), mobile health (mHealth), and electronic health (eHealth). Spending on health is a significant portion of people's income. Traditional medicine is prone to long delays, waste of money and effort, and even death. RVO (Remote Victim Observation) can be utilized to circumvent problems associated with traditional healthcare facilities because of IoT's intelligence and predictive power. With the help of IoT-based RVO and wearable devices, sensor networks, and other digital infrastructure, we can detect oncoming situations before they become life-threatening or even fatal. IoT integration with healthcare units was demonstrated in order to build a trustworthy, available, and secure RVO system. Secure end to end communication, encryption of RFID data, and privacy protection are all part of the proposed solution. An android wearable watch (Biosensor | Body sensor), a server using REST framework, and a smartphone app to monitor and detect falls, blood pressure, and heart rate are all part of the system. As a bonus, the peace and quiet of this secluded location contribute to the attraction. Using this RVO could improve health care and quality of life, according to an empirical investigation.

Forage type and transportation stress effects on gut microbial counts and meat quality in goats

An experiment was conducted to determine the effects of feeding highly condensed tannin legume (sericea lespedeza, SL; Lespedeza cuneata) forage on gastrointestinal tract microbial counts and meat quality in goats. Intact male Spanish kids were kept in 0.40 ha paddocks of SL, bermudagrass (BG; Cynodon dactylon; control), or a combination of SL + BG (n = 10 goats per treatment group) for 8 wk. All goats were supplemented with a commercial feed pellet at 0.45 kg·head−1·d−1 for the first 4 wk and 0.23 kg·head−1·d−1 for the final 4 wk of the trial. At the end of the experiment, half the goats from each paddock were subjected to 3 h transportation stress, then all animals were humanely slaughtered. Diet or stress did not have a significant effect on skin Escherichia coli, coliform, or aerobic plate counts, and carcass, rumen, and fecal bacterial counts. Muscle pH at 24 h postmortem tended (P = 0.06) to be higher in transported compared with non-transported goats. The results indicate that SL consumption by goats for 8 wk did not significantly affect gastrointestinal tract, skin, and carcass microbial counts or meat quality, although preslaughter stress could influence meat quality due to changes in the course of postmortem pH decline.

Identification of sources resistant to a virulent Fusarium wilt strain (VCG 0124) infecting Cavendish bananas

Bananas are vital for food security in many countries, and half of banana production relies solely on ‘Cavendish’ (AAA), which is presently threatened by the fungal pathogen Fusarium oxysporum f. sp. cubense (Foc) tropical race 4. This particular virulent Foc strain was also found to attack other banana varieties of commercial importance. As there is no single effective management practice available so far, this study was undertaken to determine resistant sources from the genotype collection available at the ICAR-National Research Centre for Banana, Tiruchirappalli, Tamil Nadu, India for direct use by farmers and/or in breeding programmes to develop resistant hybrids. A total of 258 genotypes of different ploidies and genomic constitutions were tested against Foc race 1 (VCG 0124). In total, 19 genotypes (AA Unique-6, BB type-2, AAA Unique-1, AAA Cavendish-1, AAB Mysore-3, AAB Pome-1, AAB Plantain-4 and AAAB-1) were found to be immune; eight genotypes (AA Unique-1, BB type-3, AAA Cavendish-1, AAB Mysore-1, AAB Unique-1, AAB Plantain-1) were highly resistant; and nine genotypes (AA Unique-1, AAA Cavendish-3, AAB Silk-1, AAB Pome-4) were resistant. The genotypes that are resistant to the virulent Foc race 1 (VCG 0124) strain can be exploited directly for commercialization and/or in breeding programs to develop resistant hybrids.

Cloud-Based Remote RFID Authentication for Security of Smart Internet of Things Applications

Radio frequency is the technology which enables smart labels to things. Thus, even physical things can participate in computing process. It is becoming popular due to its technological innovation and ability to overcome line of sight problem. With Internet of Things (IoT) technology, RFID usage became ubiquitous in smart applications or IoT use the cases like smart education, smart homes, smart healthcare and smart cities to mention a few. Integration of digital and physical worlds is made possible with IoT, RFID and host of other technologies and standards. When connected devices and things are uniquely identified using RFID technology, it is essential to know its utility in authentication process and security challenges thrown as well. RFID tag and RFID reader are involved in wireless communication and identification. RFID tags may carry sensitive information and its vulnerabilities if any are exploited by adversaries. Moreover, heavy computation is involved in RFID-based authentication. To overcome issues like privacy, security and overhead improvements have been proposed as found in the literature. Researchers used cryptographic tools, hash functions and symmetric key encryption for secure RFID communications. However, the level of security is still inadequate. In this paper, we proposed a cloud-based remote RFID authentication scheme with smart home as the case study. The proposed scheme has features like forward secrecy, anonymity and untraceability besides being light weight. It can withstand various security attacks. Our simulation study revealed that the proposed system model and the cloud-based remote RFID authentication scheme are effective in providing privacy and security as part of access control system in smart home IoT use case.

Targetable BRAF and RAF1 Alterations in Advanced Pediatric Cancers

RAF family protein kinases signal through the MAPK pathway to orchestrate cellular proliferation, survival, and transformation. Identifying BRAF alterations in pediatric cancers is critically important as therapeutic agents targeting BRAF or MEK may be incorporated into the clinical management of these patients. In this study, we performed comprehensive genomic profiling on 3,633 pediatric cancer samples and identified a cohort of 221 (6.1%) cases with known or novel alterations in BRAF or RAF1 detected in extracranial solid tumors, brain tumors, or hematological malignancies. Eighty percent (176/221) of these tumors had a known-activating short variant (98, 55.7%), fusion (72, 40.9%), or insertion/deletion (6, 3.4%). Among BRAF altered cancers, the most common tumor types were brain tumors (74.4%), solid tumors (10.8%), hematological malignancies (9.1%), sarcomas (3.4%), and extracranial embryonal tumors (2.3%). RAF1 fusions containing intact RAF1 kinase domain (encoded by exons 10-17) were identified in seven tumors, including two novel fusions TMF1-RAF1 and SOX6-RAF1. Additionally, we highlight a subset of patients with brain tumor with positive clinical response to BRAF inhibitors, demonstrating the rationale for incorporating precision medicine into pediatric oncology. IMPLICATIONS FOR PRACTICE: Precision medicine has not yet gained a strong foothold in pediatric cancers. This study describes the landscape of BRAF and RAF1 genomic alterations across a diverse spectrum of pediatric cancers, primarily brain tumors, but also encompassing melanoma, sarcoma, several types of hematologic malignancy, and others. Given the availability of multiple U.S. Food and Drug Administration-approved BRAF inhibitors, identification of these alterations may assist with treatment decision making, as described here in three cases of pediatric cancer.

Prediction of stress responses in goats: comparison of artificial neural network and multiple regression models

This study was conducted to determine if artificial neural networks (ANN) can be used to more accurately predict physiological stress responses in goats compared with statistical regression. Prediction models were developed for plasma cortisol and glucose concentrations, creatine kinase (CK) activity, neutrophil (N) and lymphocyte (L) counts, and N:L ratio as a function of time (0, 1, 2, 3, and 4 h; n = 16 goats per time) after a 2.5 h transportation (input 1) and stocking density (25 vs. 50 goats; input 2). However, input 2 was not included in the final models because density did not have a significant effect. The NeuralWorks Predict® software and SAS were used to develop ANN and regression models, respectively. Backpropagation (BP) and Kalman filter (KF) learning rules were used to develop nonparametric models. Correlations between predicted and observed values were better with ANN-BP (R values = 0.87, 0.67, 0.56, 0.27, 0.42, and 0.53) and ANN-KF (R values = 0.84, 0.67, 0.58, 0.27, 0.42, and 0.50) models for cortisol, glucose, CK, N, L, and N:L ratio, respectively, than with regression models (R values =0.85, 0.52, 0.27, 0.13, 0.31, and 0.12). The results showed that the ANN models can predict responses more robustly compared with statistical regression.

Pathogen-mediated NMDA receptor autoimmunity and cellular barrier dysfunction in schizophrenia

Autoantibodies that bind the N-methyl-D-aspartate receptor (NMDAR) may underlie glutamate receptor hypofunction and related cognitive impairment found in schizophrenia. Exposure to neurotropic pathogens can foster an autoimmune-prone environment and drive systemic inflammation leading to endothelial barrier defects. In mouse model cohorts, we demonstrate that infection with the protozoan parasite, Toxoplasma gondii, caused sustained elevations of IgG class antibodies to the NMDAR in conjunction with compromised blood-gut and blood-brain barriers. In human cohorts, NMDAR IgG and markers of barrier permeability were significantly associated with T. gondii exposure in schizophrenia compared with controls and independently of antipsychotic medication. Combined T. gondii and NMDAR antibody seropositivity in schizophrenia resulted in higher degrees of cognitive impairment as measured by tests of delayed memory. These data underscore the necessity of disentangling the heterogeneous pathophysiology of schizophrenia so that relevant subsets eligible for NMDAR-related treatment can be identified. Our data aid to reconcile conflicting reports regarding a role of pathological NMDAR autoantibodies in this disorder.

Ghrelin and its Association with Nutritional and Inflammatory Status of Patients on Maintenance Hemodialysis in a South Indian Tertiary Care Hospital

BACKGROUND

Malnutrition and inflammation are associated with morbidity and mortality in patients on maintenance hemodialysis (MHD). Ghrelin, an orexigenic peptide hormone, is speculated to be associated with nutritional and inflammatory status in MHD.

AIM

To assess the serum total ghrelin levels and its possible relationship with inflammation and nutritional status in patients on MHD.

SUBJECTS AND METHODS

The study was conducted on 90 patients on MHD for 6 months and above (56 males, 34 females, mean age 52.6 [11.7] years; mean dialysis vintage 20.9 [12.1] months) and 70 healthy volunteers as control (5 males, 25 females, mean age 50.6 [9.7] years). Demographics were obtained for the study population, and dialysis-related data were collected for cases. Anthropometry, biochemical parameters, serum total ghrelin and inflammatory markers tumor necrosis factor-alpha (TNF-α), and high-sensitivityC-reactive protein (hsCRP) were assessed for cases and control. Self-reported appetite (five questions of appetite and diet assessment tool) and nutritional status (subjective global assessment-dialysis malnutrition score) were assessed for cases.

RESULTS

Ghrelin (242.5 [62.3] pg/mL vs. 80.2 [19.6] pg/mL; P < 0.001), TNF-α (39.8 [15.2] pg/mL vs. 6.5 [1.2] pg/mL; P < 0.001), hsCRP (10.2 [2.8] mg/L vs. 2.7 [0.54] mg/L; P < 0.001) were significantly elevated in cases versus control, anthropometry, and biochemical parameters were significantly decreased in hemodialysis patient. Of 90 cases, (13/90 [14.4%]) were well-nourished, (28/90 [31%]) mild to moderately malnourished, and (49/90 [54.4%]) were moderate to severely malnourished. Appetite was very good for14.4%, good and fair for 47.8%, poor and very poor for 37.8% patients. There was a significant difference in appetite with respect to nutritional status (P < 0.001). Ghrelin had positive correlation with inflammatory markers and negative correlation with nutritional status (P < 0.001).

CONCLUSION

The study identified the association of ghrelin with appetite, nutritional, and inflammatory status of the patients on MHD.

Improvement of banana cv. Rasthali (Silk, AAB) against Fusarium oxysporum f.sp. cubense (VCG 0124/5) through induced mutagenesis: Determination of LD50 specific to mutagen, explants, toxins and in vitro and in vivo screening for Fusarium wilt resistance

Shoot tips and in vitro grown proliferating buds of banana cv. Rasthali (Silk, AAB) were treated with various concentrations and durations of chemical mutagens viz., EMS, NaN3 and DES. LD50 for shoot tips based on 50% reduction in fresh weight was determined as 2% for 3 h, 0.02% for 5 h and 0.15% for 5 h, while for proliferating buds, they were 0.6% for 30 min, 0.01% for 2 h and 0.06% for 2 h for the mutagens EMS, NaN3 and DES, respectively. Subsequently, the mutated explants were screened in vitro against fusarium wilt using selection agents like fusaric acid and culture filtrate. LD50 for in vitro selection agents calculated based on 50% survival of explants was 0.050 mM and 7% for fusaric acid and culture filtrate, respectively and beyond which a rapid decline in growth was observed. This was followed by pot screening which led to the identification of three putative resistant mutants with an internal disease score of 1 (corm completely clean, no vascular discolouration). The putative mutants identified in the present study have also been mass multiplied in vitro.

Excitotoxicity as a Common Mechanism for Fetal Neuronal Injury with Hypoxia and Intrauterine Inflammation

Excitotoxicity is a mechanism of neuronal injury, implicated in the pathogenesis of many acute and chronic neurologic disorders, including perinatal brain injury associated with hypoxia-ischemia and exposure to intrauterine inflammation. Glutamate, the primary excitatory neurotransmitter, signals through N-methyl-d-aspartic acid (NMDA)/α-amino-3-hydroxy-5-methylisoxazole-4-propionate (AMPA) receptors. Proper functioning of both of these receptors, in conjunction with glutamate signaling, is crucial for normal development. However, even a small imbalance can result in perinatal neuronal injury. Therefore, a mechanistic understanding of the role of excitotoxicity and the NMDA/AMPA receptor functions is critical to establishing the pathogenesis of hypoxic-ischemic encephalopathy (HIE) and perinatal brain injury due to exposure to intrauterine inflammation. Evidence from experimental animal models and clinical studies indicates that both oxygen and glucose deficiencies play a major role in fetal neuronal injury. However, the connection between these deficiencies, excitotoxicity, and HIE is not well established. The excitotoxic mechanisms in animal models and humans have many parallels, suggesting that detailed animal studies can elicit clinically relevant discoveries. While current therapies for HIE include hypothermia and other neuroprotective measures, emphasizing prevention of acute injuries, increase of therapeutic time window, and increased neural repair, there are no effective widely used treatment modalities for fetuses and neonates exposed to intrauterine inflammation. Further studies of HIE and intrauterine inflammation (as in cases of preterm birth and chorioamnionitis) will provide a better insight into development of effective therapeutic interventions for these conditions.

Usage of complementary and alternative medicine among patients with chronic kidney disease on maintenance hemodialysis

Aim:

To determine the prevalence and the type of complementary and alternative medicine (CAM) use among chronic kidney disease (CKD) patients on maintenance hemodialysis (MHD).

Materials and Methods:

The study was conducted in 200 CKD patients who were on MHD. The patients were subjected to a validated interviewer-administered questionnaire adopted from the National Health Interview Survey Adult CAM. The knowledge on CAM and its usage by the patients were assessed based on the responses given by the patients.

Results:

Of the 200 patients, 52 (26%) patients were identified to be using CAM therapy. The most commonly used CAM modality by these patients was Ayurveda both alone (30.4%) and in combination with other CAM modalities (23.2%), followed by acupuncture in 17.3% patients. CAM usage was high in the age range of 50–64 years (67%). Of the CAM users, 21% of patients were from a rural area; 16.5% of patients were from upper middle class, and 24% were on dialysis for 1–4 years. There was a statistically significant association between CAM usage and age, gender, place of living, socioeconomic status, and duration of dialysis (P < 0.01).

Conclusion:

The present survey provides the data on the usage of CAM among dialysis patients and adds to the increasing evidence about CAM use. Because many products are at risk to either accumulate or cause interactions with medication, a better education on the risks and benefits of the CAM therapy by the health care providers to the end stage renal disease patients is needed.

Pharmacokinetic evaluation of Paclitaxel in South Indian cancer patients: a prospective study

Paclitaxel is a promising drug in the treatment of different solid tumors. It exhibits nonlinear pharmacokinetics, particularly when administered as a constant rate infusion for shorter duration (e.g., 3 h). Because of the nonlinearity, relatively small changes in dose may lead to large changes in peak plasma concentration and total drug exposure. The study was conducted to evaluate the pharmacokinetics of different doses of paclitaxel administered intravenously as an infusion. A prospective study was conducted in 23 cancer patients aged between 28 and 74 years, treated with paclitaxel (130, 200, 230, and 260 mg/m²) over 3 h as constant rate infusion. Plasma samples were collected from all patients at 0, 1, and 3 h and for five patients at 5 and 13 h and paclitaxel concentrations were determined using high-performance liquid chromatography method. The overall mean clearance was found to be 47.5847 ± 142.028 l/h; the mean volume of distribution was 142.028 ± 73.438 l; mean elimination rate constant was 0.336 ± 0.002/h; mean half-life was 2.086 ± 0.009 h; mean area under the curve (AUC) was 5.5917 ± 2.707 mg/ml*h; and the mean of mean residence time was 2.980 ± 0.0131 h. Paclitaxel showed nonlinear kinetics and the pharmacokinetic parameters calculated were similar to those quoted in the literature. The peak plasma concentration at 130 mg dose level was 2 μ/ml, but an increase in dose was not associated with proportional increase in plasma concentration. No significant difference was found between pharmacokinetic parameters such as clearance, volume of distribution, and AUC at different dose levels.

Prediction of Malnutrition Using Modified Subjective Global Assessment-dialysis Malnutrition Score in Patients on Hemodialysis

Malnutrition is widely prevalent among patients on hemodialysis. Malnutrition can be estimated using a fully quantitative scoring system Subjective Global Assessment-Dialysis Malnutrition Score which is simple, reliable and dynamic. The primary objective of the study was to assess the severity of malnutrition in patients with end stage renal disease and undergoing hemodialysis in a tertiary care teaching hospital in Chennai, using Subjective Global Asses sment-Dialysis Malnutrition Score and correlate it with standard indicators of malnutrition like anthropometric and biochemical parameters of the study population by Pearson's correlation. Anthropometric assessment included height, body weight, triceps skin fold thickness, mid arm circumference, mid arm muscle circumference % and biochemical parameters included serum albumin, transferrin, ferritin, total protein, total cholesterol, blood urea nitrogen and creatinine. Based on the scores, of the 66 patients, 91% were moderately malnourished. There was a significant negative correlation between modified Subjective Global Assessment-Dialysis Malnutrition Score and anthropometric measures such as triceps skin fold thickness, mid arm circumference, mid arm muscle circumference; biochemical markers such as albumin, transferrin and ferritin. The data obtained from this study confirm that a high degree of malnutrition was prevalent in patients on hemodialysis, as shown by anthropometric assessment, biochemical markers of malnutrition and Subjective Global Assessment-Dialysis Malnutrition Score. Nutritional status as determined by Subjective Global Assessment-Dialysis Malnutrition Score is a useful and reliable index for identifying patients at risk for malnutrition and it correlates well with anthropometric and biochemical assessment. may be integrated in regular assessment of malnutrition in patients on maintenance hemodialysis.

Effectiveness of physical activity promotion in blood pressure and blood sugar reduction: a community-based intervention study in rural south India

CONTEXT

Physical activity of moderate intensity for 30 minutes a day, on most days substantially reduces the risk of many chronic diseases.

AIM

To assess the effect of regular physical activity on blood pressure and blood sugar levels in a rural Indian community

SETTINGS AND DESIGN

This community-based study was carried out in Periakattupalayam and Rangareddipalayam in south India, with 485 subjects, aged 20 to 49 years.

MATERIALS AND METHODS

THE STUDY WAS DONE IN FIVE PHASES: Awareness campaign, baseline assessment of participants, intervention phase (10 weeks), interim, and final assessment. Physical activity of moderate intensity (brisk walking for 30 minutes on four days / week) was promoted by forming 30 small walking groups, in a home-based setting, with professional supervision. Village leaders and Self-Help Group members were the resource people for the promotion of physical activity.

STATISTICAL ANALYSIS

Analysis was done by using paired 't' test; the 'Intention-to-Treat' approach was utilized for the interpretation of the findings of the study.

RESULTS

Of the 485 subjects, 265 (54.6%) complied with walking on more than four days / week, while 156 (32.2%) walked on one to four days / week, and 64 (13.2%) dropped out during the intervention period. This study has shown that a 10-week intervention to promote physical activity was effective in significantly decreasing the population's BP by 1.56 / 0.74 mm Hg, fasting blood sugar levels by 2.82 mg%, body weight by 0.17 kg, and BMI by 0.06 kg / m(2).

CONCLUSIONS

This study has proved the functional feasibility of enabling people to undertake physical activity in a rural Indian community, and the effectiveness of using physical activity, to significantly reduce the population's mean BP and blood sugar levels.

Safety and efficacy of nicotinamide in the management of hyperphosphatemia in patients on hemodialysis

Hyperphosphatemia is an important modifiable risk factor for death and cardiovascular events in patients on hemodialysis (HD). As nicotinamide has been shown as an inhibitor of sodium–dependent phosphate co–transport in rat renal tubule and small intestine, we examined whether nicotinamide reduces hyperphosphatemia in patients undergoing HD. The study was conducted in 30 end-stage renal disease (ESRD) patients [20 (66.7%) males and 10 (33.3%) females; mean age 54 ± 14.9 years] undergoing twice/thrice weekly HD for more than 3 months. Patients on other phosphate binders were given a 2-week wash-out period. Nicotinamide 250 mg capsules were given twice daily for 25 patients with serum phosphorus greater than 5 mg/dL and thrice daily for 5 patients with serum phosphorus greater than 8 mg/dL immediately after food for 8 weeks. Serum phosphate and calcium levels were estimated every month prior to HD session, and complete blood count, blood sugar, renal profile, liver function tests were estimated at beginning and end of the study. Patients were regularly monitored for side effects. There were significant decreases in the serum phosphate (6.85 ± 1.35 mg/dL at the baseline to 5.74 ± 1.18 mg/dL at the 4^th week and to 4.54 ± 0.86 mg/dL at the 8^th week), the serum calcium-phosphorus product (57.8 ± 12.21 at the baseline to 48.3 ± 10.71 on 4^th week and to 38.201 ± 8.21 at the 8^th week), and alkaline phosphatase levels (130.23 ± 50.13 IU/L at the baseline to 116.40 ± 48.27 IU/L after 8 weeks) on treatment with nicotinamide (P < 0.001). Other parameters remained unchanged. Watery stools reported by seven patients resolved during the course of the therapy. Nicotinamide is safe, cheap and effective in controlling serum phosphorus, Ca × P product and alkaline phosphatase levels in patients on maintenance HD.

Prenatal interaction of mutant DISC1 and immune activation produces adult psychopathology

BACKGROUND

Gene-environment interactions (GEI) are involved in the pathogenesis of mental diseases. We evaluated interaction between mutant human disrupted-in-schizophrenia 1 (mhDISC1) and maternal immune activation implicated in schizophrenia and mood disorders.

METHODS

Pregnant mice were treated with saline or polyinosinic:polycytidylic acid at gestation day 9. Levels of inflammatory cytokines were measured in fetal and adult brains; expression of mhDISC1, endogenous DISC1, lissencephaly type 1, nuclear distribution protein nudE-like 1, glycoprotein 130, growth factor receptor-bound protein 2, and glycogen synthase kinase-3beta were assessed in cortical samples of newborn mice. Tissue content of monoamines, volumetric brain abnormalities, dendritic spine density in the hippocampus, and various domains of the mouse behavior repertoire were evaluated in adult male mice.

RESULTS

Prenatal interaction produced anxiety, depression-like responses, and altered social behavior that were accompanied by decreased reactivity of the hypothalamic-pituitary-adrenal axis, attenuated serotonin neurotransmission in the hippocampus, reduced enlargement of lateral ventricles, decreased volumes of amygdala and periaqueductal gray matter and density of spines on dendrites of granule cells of the hippocampus. Prenatal interaction modulated secretion of inflammatory cytokines in fetal brains, levels of mhDISC1, endogenous mouse DISC1, and glycogen synthase kinase-3beta. The behavioral effects of GEI were observed only if mhDISC1 was expressed throughout the life span.

CONCLUSIONS

Prenatal immune activation interacted with mhDISC1 to produce the neurobehavioral phenotypes that were not seen in untreated mhDISC1 mice and that resemble aspects of major mental illnesses. Our DISC1 mouse model is a valuable system to study GEI relevant to mental illnesses.

The effects of feeding sericea lespedeza hay on growth rate of goats naturally infected with gastrointestinal nematodes

Goat production is increasing in the United States due to high ethnic demand, but infection with gastrointestinal nematode (GIN) parasites is a major constraint to the industry. Increasing GIN resistance to chemical anthelmintics worldwide has led to the development of alternative control strategies, including use of forages containing condensed tannins (CT). An experiment was designed using infected and dewormed male kids (Kiko x Spanish, 6 mo old, 18.9 +/- 3.25 kg) fed diets containing 25% concentrate and either 75% sericea lespedeza [SL; Lespedeza cuneata (Dum-Cours.) G. Don], a high CT forage (87 to 181 g of CT/kg), or 75% bermudagrass [BG; Cynodon dactylon (L.) Pers.] hay (n = 10/treatment). The kids were weighed every 14 d, and fecal and blood samples were taken weekly for fecal egg counts and packed cell volume determination, respectively. Fecal cultures were processed every 14 d to determine CT effect on larval development. At slaughter, adult GIN were collected from the abomasum and small intestines for counting and speciation. Blood samples were also analyzed for plasma urea-N, and ruminal VFA and pH were determined. The infected SL-fed kids had consistently lower (P < 0.05) fecal egg counts than the infected BG goats throughout the trial and greater (P < 0.05) packed cell volume beginning by d 77. Average daily gain was greater (P < 0.001) in kids fed SL- than BG-based diets, regardless of infection status (104.3 +/- 5.0 and 75.5 +/- 4.8 g/d, respectively). Total VFA and acetate concentrations were greater (P < 0.001) in the BG- than in SL-fed goats, whereas propionate levels were unaffected by diet. Acetate:propionate ratio (P = 0.01) and plasma urea-N (P = 0.03) levels were greater in BG-fed goats, whereas rumen pH was greater (P < 0.001) in the SL-fed goats. Feeding SL hay can reduce GIN infection levels and increase performance of goats compared with BG hay.