A Multicentered, Randomized Phase III Study of Definitive vs. Palliative Radiotherapy to Primary Tumor for Stage IV Non-Small Cell Lung Cancer with Less than Three Metastatic Organs: CSWOG China

PURPOSE/OBJECTIVE(S)

To investigate the local-regional progression-free survival (LPFS), overall survival (OS), progression-free survival (PFS), local control rate of primary tumor (LCRP), and toxicity of definitive radiotherapy (concurrent chemoradiotherapy of 63 Gy) compared with palliative radiotherapy (concurrent chemoradiotherapy of 45 Gy) to primary tumor in newly diagnosed stage Ⅳ non-small cell lung cancer with less than three metastatic organs.

MATERIALS/METHODS

A randomized, multicentered phase Ⅲ study (ChicTR-TRC-13003749), in a 1:1 ratio, included patients with newly diagnosed stage Ⅳ NSCLC with less than three metastatic organs. The EGFR mutation was wide type or unknown mainly. The patients were divided into 63 Gy of definitive radiotherapy (D63) and 45 Gy of palliative radiotherapy (P45). The primary endpoints were LPFS, OS. Secondary endpoints included PFS, LCRP, objective response rate (ORR) and toxicity.

RESULTS

Three hundred forty-four patients were enrolled in 14 cancer centers. The median LPFS for group D63 was 18 months (95% CI, 13.02 to 22.98) better than 13 months for group P45 (95% CI, 10.13 to 15.87). LPFS for 1, 2, and 5 years were 62.9% vs. 50.4%, 36.9% vs. 24%, 20.5% vs. 5.5%, respectively (χ2 = 9.997, P = 0.002). The 36.1% reduction in the hazard ratio for local-regional progression or death for D63. The MST for group D63 was 19 months (95% CI, 14.59 to 23.41) better than 15 months for group P45 (95% CI, 10.72 to 19.28), and the 1-, 2-, and 5-years OS were 70.2% vs. 52.2%, 41.3% vs. 30.7%, 16.2% vs. 11.3%, respectively (χ2 = 3.874, P = 0.049). PFS was 37% reduction in the hazard ratio for disease progression or death for D63 (χ2 = 12.49, P = 0.000). The 1, 2, 5-year LCRP of group D63 is better than group P45 (χ2 = 8.747, P = 0.003). The incidences of RE and grade Ⅲ-Ⅳ RP in group D63 were higher than in group P45 (P<0.05).

CONCLUSION

Phase Ⅲ clinical trials achieved satisfactory results. LPFS, OS and PFS was longer with definitive than palliative radiotherapy of primary tumor for stage Ⅳ NSCLC with less than three metastatic organs. Significantly prolonged. The toxicity was accepted.

Prevalence estimation of ATTRv in China based on genetic databases

Introduction: Amyloid transthyretin (ATTR) is divided into either hereditary (ATTRv) or sporadic (ATTRwt) and ATTRv is a rare hereditary disease transmitted as an autosomal dominant manner. Its global prevalence is traditionally estimated as 5,000 to 10,000 persons. However, it may be underestimated and the exact prevalence of ATTRv in China mainland remains unknown. Methods: The Genome Aggregation database (gnomAD) database (containing 125,748 exomes) and two genomic sequencing databases--China Metabolic Analytics Project (ChinaMAP) (containing 10588 individuals) and Amcarelab gene database (containing 45392 exomes), were integrated to estimate the prevalence of ATTRv in the world and mainland Chinese populations. Pathogenic variants allele frequency and the prevalence of ATTRv was calculated. Results: Six variants, counting 470 alleles, were defined as pathogenic variants in gnomAD. The prevalence of ATTRv in the world population was 57.4/100,000. Two variants (2 allele counts) and 15 variants (34 individuals) were defined as pathogenic variants in the ChinaMAP database and the Amcarelab exome database, respectively. Thus, the estimated prevalence interval of ATTRv in mainland China was 18.9/100,000-74,9/100,000. Conclusion: The present study demonstrated that the previous prevalence was greatly underestimated using traditional methods. Therefore, raising awareness of the disease is essential for recognizing ATTRv in its early stage.

AB0390 COST-EFFECTIVENESS OF IGURATIMOD IN PATIENTS WITH RHEUMATOID ARTHRITIS (RA) BY USING A CLAIMS-BASED ALGORITHM: RETROSPECTIVE ANALYSIS OF REAL‑WORLD DATA

Background

Iguratimod (IGU), as one of the conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), has been approved by National Medical Products Administration (NMPA) to treat Rheumatoid arthritis (RA).

Objectives

This study aimed to compare the cost-effectiveness of well-established RA therapies using a claims-based algorithm in RA patients.

Methods

An electronic medical record (EMR) database from Zhujiang Hospital was utilized to estimate the cost-effectiveness of medication for RA patients, including IGU with MTX, biological DMARDs (bDMARDs) with MTX, and MTX alone for more than 6 months from 2014 to 2020. Patients who were deemed effective must meet all the following criteria according to the algorithm, high adherence; no bDMARDs or IGU switch or addition; no prescription of new csDMARDs; no increase in dose or frequency of index drug; no new use of chronic glucocorticoids or increase in glucocorticoid dose; and no more than one glucocorticoid injection. Average cost was calculated by summing total cost of effective treatment and dividing by number of patients achieving efficacy in each group.

Results

A total of 263 patients were included in the analysis. Based on a claims-based algorithm, the effective rate was 27.1 % (26/96) for IGU with MTX group, 11.2% (7/62) for bDMARDs with MTX group, and 13.3% (14/105) for MTX alone group, respectively. Average cost of effective treatment was $833.46 for IGU with MTX therapy, $2554.57 for bDMARDs with MTX therapy, and $171.48 for MTX alone (Table 1).

Table 1.

Effectiveness and Cost per Effectively Treated Patient with RA

CriteriaAll patients (n=263)IGU with MTX group(n=96)bDMARDs with MTX group (n=62)MTX (n=105)Effectiveness:no. of patients (%)a47(17.87%)26 (27.1%)7 (11.2/%)14 (13.3%)Cost of all RA-related medication per effectively treated patient(SD)$892.75(911.57)$833.46 (252.67)$2554.5 (1273.13)$171.4 (110.33)Average cost of all RA medications postindex (excluding biologic DMARDs) per patient (SD)b$146.38(114.60)$148.81 (123.12)$86.90 (74.53)$171.4 (110.33)Average cost of only biologicDMARDs postindex per patient (SD)b$746.38(926.35)$684.27(188.67)$2468.67(1285.91)/

a χ2showed significant difference in percentage effectiveness for the original algorithm (p<0.05).

bMedication cost was 2020 U.S. dollars.

Conclusion

IGU with MTX therapy was revealed to be both effective and modestly priced, which seemed to be a cost-effective strategy for RA therapy and warranted further cost-effectiveness investigation.

References

[1](2018) [2018 Chinese guideline for the diagnosis and treatment of rheumatoid arthritis]. Zhonghua Nei Ke Za Zhi 57 (4), 242-251. https://doi.org/10.3760/cma.j.issn.0578-1426.2018.04.004

[2]Hitchon, C. A., & El-Gabalawy, H. S. (2011). The synovium in rheumatoid arthritis. The open rheumatology journal, 5, 107–114. https://doi.org/10.2174/1874312901105010107

[3]Smolen, J. S., Landewé, R., Bijlsma, J., Burmester, G. R., Dougados, M., Kerschbaumer, A., McInnes, I. B., Sepriano, A., van Vollenhoven, R. F., de Wit, M., Aletaha, D., Aringer, M., Askling, J., Balsa, A., Boers, M., den Broeder, A. A., Buch, M. H., Buttgereit, F., Caporali, R., Cardiel, M. H., … van der Heijde, D. (2020). EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Annals of the rheumatic diseases, 79(6), 685–699. https://doi.org/10.1136/annrheumdis-2019-216655

[4]Fraenkel, L., Bathon, J. M., England, B. R., St Clair, E. W., Arayssi, T., Carandang, K., Deane, K. D., Genovese, M., Huston, K. K., Kerr, G., Kremer, J., Nakamura, M. C., Russell, L. A., Singh, J. A., Smith, B. J., Sparks, J. A., Venkatachalam, S., Weinblatt, M. E., Al-Gibbawi, M., Baker, J. F., … Akl, E. A. (2021). 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis care & research, 73(7), 924–939. https://doi.org/10.1002/acr.24596

Disclosure of Interests

None declared

Negative emotions in community-dwelling adults with prediabetes and hypertension

Objective

The purpose of this study was to investigate negative emotions and factors related to the risk of mental disorders in individuals with prediabetes and hypertension.

Methods

A total of 504 community-dwelling adult men and women in Suzhou, China, were enrolled and questionnaires used to obtain sociodemographic data, anxiety and depression scores, and current status of common metabolic indicators, including blood glucose level and blood pressure.

Results

Anxiety and depression scores in participants with prediabetes and hypertension were significantly higher than those in participants with normal blood glucose levels and normal blood pressure. Correlation analysis revealed that age, sex, smoking, duration of disease, physical activity, blood pressure and fasting plasma glucose levels were key factors accelerating the progression to both anxiety and depression in all participants.

Conclusions

More attention should be paid to negative emotions in individuals with prediabetes and hypertension. These findings could help to inform health providers in developing interventions for this population.

[Single-photon emission computed tomography for the diagnosis of mandibular invasion caused by oral cancers: a systematic review and Meta-analysis]

Objective This review aimed at assessing the diagnostic efficacy of contrast-enhanced single-photon emission computed tomography (SPECT) in the diagnosis of mandibular invasion by oral cancers. Methods Five databases were searched electronically on August 5, 2016. The reference lists of included studies were hand searched. Quality assessment was performed by two reviewers in duplicate with tools suggested by Cochrane's handbook. Furthermore, the data extraction of included studies was delivered. Meta-analysis was performed using STATA 11.0. Results Ten studies with 460 participants were included. One study had a low risk of bias, and two studies had a high risk of bias. The remaining seven studies had an unclear risk of bias. Meta-analysis results showed that SPECT had a pooled sensitivity of 0.99 [95% confidence interval=0.87-
1.00]. Sensitivity was 0.99 on Q* point. The specificity of 0.61 and the area under summary receiver operating characteristic curve (SROC) were 0.93 [95% confidence interval=0.90-
0.95]. The pooled positive likelihood ratio was 2.555. The negative likelihood ratio was 0.015. The diagnostic odd ratio was 5.115. Conclusion SPECT had high sensitivity, which became suitable for excluding bone invasion by oral cancers. However, its specificity was relatively low, indicating its limited capability in confirming diagnosis. Therefore, surgeons should perform this method under certain conditions.

[In vitro investigation on the mechanism of cyclooxygenase-2 upregulation induced by spleen tyrosine kinase-nuclear factor κB signaling in cancer pain caused by oral cancer-associated macrophage]

OBJECTIVE

This study explores the mechanism of cyclooxygenase-2 (COX-2) upregulation in oral cancers associated with macrophage by using molecular biology techniques and primary culture of murine macrophage.

METHODS

Murine macrophage was induced by macrophage colony-stimulating factor (M-CSF) and Cal27 conditional medium (CM). Purity of the macrophage was detected through CD68 immunofluorescence staining. Inhibitors of spleen tyrosine kinase (Syk) and nuclear factor κB (NFκB) were used to inhibit these pathways. In addition, real-time polymerase chain reaction and Western blot analysis were used to detect alterations in COX-2 and pathway-related proteins.

RESULTS

All of the induced cells specifically expressed CD68. Cal27 CM could significantly induce COX-2 expression (P<0.001). Moreover, inhibition of Syk pathway attenuated NFκB-P65 phosphorylation and reduced COX-2 expression (P<0.01), and inhibition of NFκB pathway exerted no effects on Syk phosphorylation but significantly inhibited COX-2 upregulation (P<0.01).

CONCLUSIONS

Syk-NFκB is responsible for COX-2 overexpression in oral cancer associated with macrophages. Targeting this pathway is possibly a new approach to control oral cancer-related pain.
.

2′-Deoxyuridines with a 5-Heteroaromatic Substituent: Synthesis and Biological Evaluation

A series of novel 2′-deoxyuridines with a thienyl substituent in the 5-position were synthesized as potential anti-HSV-1 agents. The brominated derivatives (1d, 1e and 3b) were obtained via halogenation reactions of the protected 5-(thien-2-yl)-2′-deoxyuridine and 5-(thien-3-yl)-2′-deoxyuridine, respectively. The palladium-catalysed cross-coupling reaction with stannylated thiophene was used for the synthesis of ( E)-5-(2-thienylvinyl)-2′-deoxyuridine and 5-(5,2′-dithien-2-yl)-2′-deoxyuridine. These compounds show moderate to good activity against herpes simplex virus type 1 (HSV-1) in the order of decreasing activity 1d>4>1e>3b∼5. Finally, two substituted 5-isoxazol derivatives of 2′-deoxyuridine (6a and 6b) were obtained via a 1,3-dipolar cycloaddition of the protected 5-ethynyl-2′-deoxyuridine. These new compounds demonstrated poor affinity for the virus-specific enzyme thymidine kinase.

Evaluation of the impact of passive smoke on arterial elasticity via echo-tracking technology in a rabbit model

OBJECTIVES

The purpose of this study was to evaluate the elasticity of the abdominal aorta in passively smoking rabbits using echo-tracking technology and pathologic examination.

METHODS

Fifty-four male New Zealand White rabbits were randomly divided into a passive smoking group and a normal control group. The elasticity indicators for the abdominal aorta of the rabbits were measured by means of echo tracking, which was performed before and 1, 2, and 3 months after passive smoking. Measured indicators included the pressure-strain elastic modulus, stiffness, arterial compliance, augmentation index, and pulse wave velocity. After the completion of the in vivo measurements, rabbits were euthanized randomly, and the corresponding arterial sites were resected for pathologic examination and in vitro measurement of vascular elasticity.

RESULTS

The echo-tracking technology used in our research proved that the elastic modulus, stiffness, and pulse wave velocity gradually increased with time by passive smoking, whereas arterial compliance decreased by passive smoking. Pathologic examination and in vitro measurements were performed and further confirmed the observed in vivo results.

CONCLUSIONS

Passive smoking can injure arteries and reduce arterial elasticity. Echo-tracking technology is an accurate, noninvasive, and reliable method for analysis of the impact of passive smoking on arterial elasticity and detection arterial injury, which also can provide a new instructional basis for prevention and treatment of several arterial diseases.

Association between MTHFR C677T polymorphism and congenital heart disease. A family-based meta-analysis

Congenital heart disease (CHD) is the most common type of birth defect. It is suspected that polymorphisms in folate metabolism are associated with an increased risk of CHD, but the conclusion remains unclear. Studies have reported that the MTHFR C677T polymorphism was associated with the development of structural congenital heart malformations. The objective of this study was to conduct a meta-analysis of available studies to identify common polymorphisms in the MTHFR gene in children with CHD and their mothers and to test for an association between genotype and disease. In all, 19 eligible studies comprising 4,219 cases and 20,123 controls were included in this meta-analysis. A significant association was found between the MTHFR C677T polymorphism and CHD risk (OR: 1.26; 95 % CI = 1.06-1.51; p = 0.009) with no strong evidence of heterogeneity (I(2) = 39 %) in the fetal analysis. In the maternal analysis, the MTHFR C677T polymorphism was significantly associated with CHD risk (OR = 1.52; 95 % CI =  1.09-2.11; p = 0.01) with significant heterogeneity (I(2) = 63 %).

Risk assessment of esophageal adenocarcinoma using γ-H2AX assay

BACKGROUND

Mutagen-induced DNA damage as measured in peripheral blood lymphocytes (PBL) has been associated with increased risks of cancers. The formation of γ-H2AX is an early cellular response to DNA double-strand breaks (DSB). We hypothesize that higher level of radiation-induced γ-H2AX in PBLs may be associated with an increased risk of esophageal adenocarcinoma.

METHODS

Laser scanning cytometer-based immunocytochemical method was used to measure baseline and irradiation-induced γ-H2AX levels in PBLs from 211 patients with esophageal adenocarcinoma and 211 healthy controls. The ratio of induced γ-H2AX level to baseline level was used to evaluate individual susceptibility to DSBs. Relative risks for esophageal adenocarcinoma associated with γ-H2AX were assessed by multivariable logistic regression analysis.

RESULTS

Radiation-induced γ-H2AX level and the γ-H2AX ratio were significantly higher in cases than in controls. Dichotomized at the median in controls, a significantly increased risk for esophageal adenocarcinoma was observed in association with high γ-H2AX ratio [OR = 2.94; 95% confidence interval (CI), 1.83-4.72]. Quartile analyses showed significant dose-response associations between higher γ-H2AX ratio and increased risk of esophageal adenocarcinoma (Ptrend, 1.64E-06). In addition, joint effect between γ-H2AX ratio and smoking was observed: smokers who had high γ-H2AX ratio exhibited the highest risk of esophageal adenocarcinoma (OR = 5.53; 95% CI, 2.71-11.25) compared with never smokers with low γ-H2AX ratio.

CONCLUSION

Radiation-induced DNA damage assessed by γ-H2AX ratio is associated with an increased risk of esophageal adenocarcinoma.

IMPACT

γ-H2AX assay is a new and robust method to measure DSB damage in PBLs, which can be used to assess mutagen sensitivity and esophageal adenocarcinoma risk.

Composite resin reinforced with pre-tensioned fibers: a three-dimensional finite element study on stress distribution

Pre-tensioned construction material is utilized in engineering applications of high strength demands. The purpose of this study was to evaluate the effect of the pre-tensioning fibers of fiber-reinforced composite (FRC) using three-dimensional finite element (FE) analysis. The 3D FE models of particulate composite resin (CR), FRC and composite resin reinforced with pre-tensioned fibers (PRE-T-FRC) were constructed. The uniaxial three-point bending test was simulated using FE analysis to calculate the principal stress distribution. In the FRC and PRE-T-FRC, stresses were higher than CR, and they were located in the fiber. However, the maximum principal stress value at the composite of PRE-T-FRC was lower than the FRC and CR. Composite resin reinforced with pre-tensioned fibers was advantageous for stress distribution and lowering the stress at the composite itself. Experimental studies on physical properties of pre-tensioned FRC are encouraged to be conducted.

Effects of nasal immunization of multi-target preventive vaccines on atherosclerosis

Previous investigations have demonstrated that anti-inflammatory or lipid-lowering treatments could be useful for alleviating morbidity and mortality of atherosclerotic cardiovascular diseases. However, whether a vaccine designed to target inflammation and lipid simultaneously is more powerful to control the process of atherosclerosis remain to be unknown. Here, a vaccine was designed to target heat shock protein-65(Hsp65) and cholesteryl ester transfer protein (CETP) simultaneously and the effects of nasal immunization of multi-target vaccine on high-cholesterol-diet-driven rabbit atherosclerosis lesions were evaluated. Sera, nasal lavages and lung washes were used to ELISA assay for the analysis of IgG and IgA against Hsp65 and CETP. Sera were also used to the analysis of the avidity of combination of anti-Hsp65 and anti-CETP IgG antibodies with corresponding antigen, cytokines IL-10 and IFN-γ, and lipoproteins. In addition, aortas were harvested for analysis of atherosclerotic lesions. The results showed that lower and lasting specific anti-Hsp65 IgG and high anti-CETP IgG in sera and protective anti-Hsp65 and anti-CETP IgA in nasal cavity and lung were induced, the avidity of combination of anti-Hsp65 and anti-CETP IgG with antigen were higher, and more protective IL-10 and less adverse IFN-γ were produced. In addition, sera TC, and LDL-C were decreased. As a result, the size of aorta atherosclerotic plaques was significantly reduced. We conclude that multifaceted vaccine combining lipid-regulating with anti-inflammation was a potential remedy, especially for atherosclerosis with complicated etiology.

Visualization of the internal cerebral veins on MR phase-sensitive imaging: comparison with 3D gadolinium-enhanced MR venography and fast-spoiled gradient recalled imaging

The purpose of this article is to compare the visualization quality of ICV and their tributaries on PSI-MRV, 3D CE-MRV, and 3D CE-FSPGR. PSI-MRV has been shown to delineate the ICV, TSV, SV, anterior caudate nucleus veins, and medial atrial veins effectively. Due to its advantages of no contrast material injection, acceptable examination times, and no arterial contamination, PSI-MRV should be considered in the evaluation of deep cerebral veins.

Role of vascular endothelial growth factor in protection of intrahepatic cholangiocytes mediated by hypoxic preconditioning after liver transplantation in rats

OBJECTIVE

To investigate the effect on intrahepatic cholangiocytes mediated by hypoxic preconditioning (HP) after liver transplantation and the role of vascular endothelial growth factor (VEGF).

MATERIALS AND METHODS

This experiment was based on a model of rat orthotopic liver autotransplantation. Sprague-Dawley rats were randomly divided into 3 groups: normal control, autotransplantation (AT), and HP. The HP group was subjected to 8% oxygen atmosphere for 90 minutes before surgery. At 6, 12, 24, and 48 hours after autotransplantation, the rats were killed for testing .Serum total bilirubin, direct bilirubin, and alkaline phosphatase concentrations were determined. The microstructure of cholangiocytes and the ultramicrostructure of cholangioles were determined. Immunohistochemistry was used to detect the expression of VEGF and the proliferation rate of cholangiocytes.

RESULTS

Total bilirubin, direct bilirubin, and alkaline phosphatase concentrations in the AT group increased considerably more than in the HP group during the entire interval (P < .05). Light microscopy demonstrated that the microstructure of cholangiocytes in the AT group was damaged more seriously than in the HP group. At transmission electron microscopy, the ultramicrostructure of cholangioles was changed more obviously than in the HP group. The expression of VEGF on cholangiocytes and the proliferation rate of cholangiocytes were higher in the HP group than in the AT group over the entire experiment (P < .05).

CONCLUSION

Hypoxic preconditioning has a protective effect on cholangiocytes after liver autotransplantation. The mechanism may be related to HP-induced overexpression of VEGF on cholangiocytes.

The Occupational Disease Prevention and Control Act of the People's Republic of China: an awareness assessment among workers at foreign-invested enterprises

The Occupational Disease Prevention and Control Act (ODPC-Act) of the People's Republic of China came into effect on May 1, 2002. Given the scope of foreign-invested enterprises (FIEs) in China and an unabated increasing trend of foreign investment, compliance with the ODPC-Act among FIEs is of particular interest, yet little is known. The extent to which an employer educates its workforce to understand the ODPC-Act may be a measure of an employer's compliance. Based on a 25-item questionnaire survey, we found that among 166 workers from three FIEs in Wuxi, Jiangsu Province, the majority had little knowledge regarding the ODPC-Act; many were unaware of their rights granted under the ODPC-Act. They were also unable to recognize employers' potential violations of the ODPC-Act. Improving FIE workers' awareness of the ODPC-Act is desirable.

Single-nucleotide polymorphisms in genes predisposing to asthma in children of Chinese Han nationality

BACKGROUND

Research increasingly suggests that asthma is a familial and hereditary disorder in the pathogenesis of which genetic and environmental factors play an important role.

OBJECTIVE

To investigate the single and combined associations between 8 single-nucleotide polymorphism (SNP) loci in 5 genes and the development of asthma in children of Chinese Han nationality.

METHODS

The study population comprised 192 children with asthma and an equal number of healthy controls. Asthma was diagnosed in accordance with American Thoracic Society criteria. Polymerase chain reaction-restriction fragment length polymorphism was used to detect the genotypes of the SNP loci.

RESULTS

No statistically significant differences (P>.05) were found between the experimental and control group in genotype distribution among 6 loci (IL-13 C- 1112T, IL-13 C1923T, IL-4 C-590T, IL-4RA 175V, FcepsilonR1beta E237G, and beta2-ADR Q27E). However, significant diversity was observed among FcepsilonR1beta C-109T (P=.002) and beta2-ADR R16G (P=.000). Furthermore, the frequency of FcepsilonR1beta C-109T T/T and beta2-ADR R16G A/A in the asthma group was significantly higher than in the control group (odds ratio [OR]=1.96, P=.001; OR=2.58, P=.000, respectively). Carriers of both FcepsilonR1beta C-109T T/T and beta2-ADR R16G A/A had a more significant risk of developing asthma than those with only a single polymorphism.

CONCLUSION

The 6 loci (IL-13 C-1112T, IL-13 C1923T, IL-4 C-590T, IL-4RA 175V, FcER1B E237G and 12-ADR Q27E) make little contribution to the development of asthma in children of Chinese Han nationality. FcepsilonR1beta C-109T and beta2-ADR R16G are significantly associated with childhood asthma. FcepsilonR1beta C-109T T/T and beta2-ADR R16G A/A have a significant and combined effect on the development of asthma.

Asparaginase display of polypeptides in the periplasm of Escherichia coli: Potential rapid pepscan technique for antigen epitope mapping

Asparaginase of Escherichia coli, a tetramer of identical subunits, was tested as a vector to display linear peptides on the surface of each enzyme subunit. A recombinant gene encoding a chimeric protein composed of asparaginase, a tetanus toxin peptide (TTP) spacer (831-854 fragment), and the foreign cholesteryl ester transfer protein C-terminal fragment (CETPC) was expressed and targeted to the periplasm of E. coli. The purified chimeric enzyme exhibited approximately 83% activity of the native enzyme, allowing the rapid screening of recombinant clones. In contrast, an asparaginase-CETPC fusion protein without the TTP spacer produced only about 23% activity of the native enzyme. Rats immunized with bacterial cells containing the chimeric enzymes induced CETP-specific immunoresponse. In contrast, rats inoculated with the cells expressing asparaginase only did not generate specific anti-CETP antibodies. Our study showed that asparaginase of E. coli was an effective carrier for displaying foreign peptides or epitopes. Moreover, the use of the TTP spacer appeared to play a critical role in maintaining the catalytic activity of the chimeric enzymes by redirecting the foreign CETPC peptide to the surface of the enzyme. The chimeric enzyme constructs fusing asparaginase with foreign peptides via a TTP spacer could be utilized as a rapid pepscan technique for antigen epitope mapping. The fusion protein of asparaginase-TTP-CETPC could also be useful for the development of a vaccine against atherosclerosis.

An X-prolyl dipeptidyl aminopeptidase from Lactococcus lactis: cloning, expression in Escherichia coli, and application for removal of N-terminal Pro-Pro from recombinant proteins

A novel pepX gene was cloned from isolated DNA of Lactococcus lactis by PCR. The deduced amino acid sequence of the 89-kDa protein showed 94, 93, 65, and 44% identity with the pepX protein from Lactococcus lactis subsp. cremoris, Lactococcus lactis subsp. lactis, Lactobacillus delbruecki subsp. bulgaricus, and Lactobacillus helveticus, respectively, and contained a serine protease G-K-S-Y-L-G consensus motif. The pepX gene has been cloned into pET17b and was expressed at a high level in Escherichia coli BL21 (DE3) LysS. PepX was purified to approximate homogeneity with ammonium sulfate precipitation and DEAE Sephadex A-50 chromatography. Optimal pepX activity was observed at pH 8.0 and 37 degrees C. According to SDS-PAGE analysis, pepX has a molecular mass of approximately 89 kDa. The peptidase can remove completely the unwanted X-Pro from the N-terminal of the target protein, releasing the naturally active protein and peptide, revealing a prospective application of pepX in large-scale production of pharmaceutical protein and peptide products.

The association of Ala54Thr variant of intestinal fatty acid binding protein gene with general and regional adipose tissue depots

OBJECTIVE

To ascertain the relationship between the Ala54Thr variation of FABP2 gene and general as well as regional adipose tissue depots.

SUBJECTS

165 subjects, in which 86 were subjects with normal glucose tolerance (NGT) [age 54.45+/-9.80, male/female 1.05, body mass index (BMI) 26.48+/-4.01] and 79 were subjects with non-insulin-dependent diabetes mellitus (NIDDM) (age 55.86+/-10.00, male/female 1.08, BMI 26.75+/-3.30).

DESIGN AND MEASUREMENTS

An association study of FABP2-Ala54Thr variation detected by PCR/HhaI digestion with general and regional adipose tissue depots determined by BMI and magnetic resonance imaging [abdominal subcutaneous and visceral adipose tissue area (SA and VA) and femoral subcutaneous adipose tissue area (FA)].

RESULTS

The geneotype and allele frequencies of FABP2-Ala54Thr variation in Chinese were quite close to the frequencies in American Caucasians and Pima Indians reported in the literature. Significant difference in genotype frequency distribution was observed between FA subgroups comparisons (FA > or = 75 cm2 versus FA < 75 cm2) in NIDDM subjects (X2 = 11.460, P = 0.003), with significantly increased in Thr54-carrier [Thr54 (+)] genotype frequency and Thr54 allele frequency in NIDDM subject with FA < 75 cm2 (odd ratio for genotype was 4.62, X2 = 10.112, P = 0.001; and for allele = 2.36, X2 = 5.379, P = 0.020). The FA in NIDDM-Thr54 (+) subgroup was significantly lower than that in subjects with NIDDM-Thr54 (-) subgroup (61.19+/-21.51 cm2 versus 75.36+/-31.70 cm2, P = 0.021). Stepwise regression analysis revealed that FABP2-Thr54 genotype variation was an independent factor contributing to the variation of FA in NIDDM (P = 0.003).

CONCLUSION

FABP2 is associated with regional adipose tissue depot. The decreased femoral subcutaneous adipose tissue depot in NIDDM subjects is related to FABP2-Thr54 variant.

Longitudinal surveillance after filariasis control in Guangdong Province, China

This paper reports the longitudinal surveillance with epidemiology, entomology and serology after filariasis has been controlled. The results showed that the microfilarial rate, natural infection rate of vectors and the positive rate of filarial antibodies decreased year by year.

Expression of a biologically active human granulocyte-macrophage colony stimulating factor fusion protein in Escherichia coli

A gene encoding human granulocyte-macrophage colony stimulating factor(GM-CSF), was cloned into plasmid pEZZ318 and fused to a DNA segment coding for the signal peptide of staphylococcal protein A and a synthetic gene coding for a protein with ability to bind immunoglobulin G(IgG). The fusion protein was expressed in Escherichia coli and biologically actively secreted into the growth medium. Approximately all of the total activity was secreted into the culture medium, where levels of activity approached 1.96 x 10(8) units/liter. Purification of the fusion protein was performed in a single step by affinity chromatography with immobilized IgG to a specific activity of 1.2 x 10(8) units/mg.

Expression of a fibrinolytically active human pro-urokinase fusion protein in Escherichia coli

The gene encoding human pro-urokinase(pro-UK) was cloned into plasmid pEZZ318 and fused to the gene coding for the signal peptide of staphylococcal protein A and IgG bindinging domain. The fusion protein which was synthesized under the control of T7 promoter in Escherichia coli and secreted into the growth medium, was found to be fibrinolytically active. Approximately 60% of the total activity was secreted into the culture medium, where levels of activity approached 150,000 I.U./liter and about 40% of the total activity remained in the cell lysate with levels of activity around 100,000 I.U./liter. The fusion protein was purified in a single step by IgG affinity chromatography. These results demonstrate that human pro-UK can be synthesized and secreted by E. coli as a fibrinolytically active fusion protein.

[Study on infectious mechanism of type 1 fimbriated Escherichia coli in experimental cystitis of mice]

The course of experimental cystitis in mice with Escherichia coli was studied by electron microscopy. The inoculated E. coli did not adhere to the intact bladder epithelium. However, when the mouse bladder was treated with trypsin, superficial cells were exfoliated, and the inoculated type 1 fimbriated E. coli adhered to the exposed intermediate cells and caused cystitis. The nonfimbriated E. coli showing no adherence to the superficial cells or intermediate cells and failed to cause cystitis. The present study demonstrated that the type 1 fimbriated E. coli play a role in causing cystitis, and the bladder superficial cells play a role in resisting the adherence of E. coli. The removal of superficial cells is essential for the adhesion and colonization of type 1 fimbriated E. coli onto the bladder epithelium in vivo.

5'-O-phosphonomethyl-2',3'-dideoxynucleosides: synthesis and anti-HIV activity

5'-O-Phosphonomethylation of different pyrimidine 2',3'-dideoxynucleosides was accomplished by reaction of the latter with diethyl [(p-toylsulfonyl)oxy]methanephosphonate (1) in the presence of sodium hydride. The base-phosphonomethylated (15-19) and sugar-phosphonomethylated (8-12) derivatives could be readily distinguished by 1H and 13C NMR and MS analysis. Protection of the uracil or thymine residue with a N3-benzoyl group failed to prevent base modification. However, O4-methyl-protected 2',3'-dideoxyuridine readily afforded the 5'-O-phosphonomethylated derivative 12, which was converted to both the 2',3'-didoxyuridine analogue 27 and the 2',3'-dideoxycytidine counterpart 29. The 5'-O-phosphonomethyl derivatives of 3'-deoxythymidine (23), 2',3'-dideoxyuridine, (27), 2',3'-dideoxycytidine (29), 3'-O-methylthymidine (26), and 3'-amino-3'-deoxythymidine (28) did not show an appreciable anti-HIV activity in MT-4 cells. In contrast, the 5'-O-phosphonomethyl derivatives of 3'-deoxy-3'-fluorothymidine (24) and 3'-azido-3'-deoxythymidine (25) inhibited HIV-1 cytopathogenicity by 50% at a concentration of approximately 1 microM.

Synthesis and anti-HIV evaluation of 2',3'-dideoxyribo-5-chloropyrimidine analogues: reduced toxicity of 5-chlorinated 2',3'-dideoxynucleosides

In view of the selective anti-HIV activity of 2',3'-dideoxy-3'-fluoro-5-chlorouridine (11), a series of eight 2',3'-dideoxy-5-chloropyrimidines were synthesized and evaluated for their inhibitory activity against human immunodeficiency virus type 1 (HIV-1) replication in MT-4 cells. A marked improvement in selectivity was noted for the 5-chlorouracil derivatives of 2,3-dideoxyribofuranose, 3-azido-2,3-dideoxyribofuranose, and 3-fluoro-2,3-dideoxyribofuranose, mainly due to decreased toxicity of the compounds for the host cells. While chlorination of 2',3'-dideoxycytidine removed the anti-HIV activity, introduction of a chlorine at the C-5 position of 3'-fluoro-, 3'-azido- or 2',3'-didehydro-2',3'-dideoxycytidine led to reduced cytotoxicity with only slightly reduced anti-HIV activity. X-ray analysis showed compound 11 to have two molecules in the asymmetric unit with chi = -168.8 (3) degrees and -131.3 (3) degrees and P = 179 (1) degree and 163 (1) degree, respectively; thus revealing no close resemblance to 3'-azido-3'-deoxythymidine (AZT).