壳寡糖协同双歧杆菌对荷瘤鼠免疫功能的影响

背景与目的:建立H22肝癌荷瘤鼠实验动物模型,研究壳寡糖协同双歧杆菌对荷瘤鼠免疫功能的影响.材料与方法:采用体内注射的方法将壳寡糖和双歧杆菌注入荷瘤小鼠体内,观察肿瘤生长情况,并进行免疫功能的测定,及观察肿瘤病理变化.结果:壳寡糖协同双歧杆菌对肿瘤的生长有抑制作用,可提高荷瘤小鼠血清的IL-2和INF-γ含量,增加荷瘤小鼠免疫器官脾脏和胸腺的重量,显微镜下观察显示肿瘤组织出现坏死.结论:壳寡糖协同双歧杆菌可抑制肿瘤生长,提高机体免疫功能,促使肿瘤细胞坏死.     

过继回输腺病毒介导的白细胞介素10基因转染CTL对机体抗肿瘤免疫功能的增强效应

本研究探讨了白细胞介紊10(IL-10)对小鼠体内抗肿瘤免疫功能的影响。鉴于C26结肠癌细胞转染了IL-10基因后在体内的致瘤性明显下降，本研究构建了一株对C26结肠癌细胞具有杀伤括性的CD8^ CTL并观察了IL-10基因转染的该细胞株对肿瘤的治疗作用。携带IL-10基因的重组腺病毒能有效介导小鼠琳巴细胞的基因转染并使之分泌较高水平的IL-10。IL-10基因转染的CTL过继回输荷瘤小鼠体内能明显增强荷瘤小鼠的体内抗肿瘤免疫功能，使实验性肺转移小鼠肺部转移结节数明显减少．这表明，IL-10对于过继回输的肿瘤特异性CTL的免疫功能具有明显的增强作用。     

腺病毒介导IL-2基因转染的瘤苗体内抗肿瘤作用

目的 :探讨重组腺病毒介导的 IL- 2基因转染的瘤苗的体内抗肿瘤作用及其免疫学机制。方法 :应用腺病毒介导的鼠 IL- 2基因转染 CT2 6小鼠结肠癌细胞 ,灭活后用作瘤苗治疗荷瘤小鼠 ,观察皮下肿瘤生长及其存活期。采用乳酸脱氢酶释放法检测荷瘤小鼠脾细胞 CTL、L AK、NK细胞的杀伤活性。结果 :鼠 IL- 2基因转染瘤苗治疗能显著抑制荷瘤小鼠皮下肿瘤生长并明显延长其存活期 (P<0 .0 1)。体内免疫功能检测表明 ,鼠 IL- 2基因转染疫苗治疗组小鼠脾细胞 CTL 活性、L AK活性和 NK活性显著高于对照组 (P<0 .0 1)。结论 :腺病毒介导鼠 IL- 2基因转染的瘤苗体内具有较强的抗肿瘤效应 ,其机制可能是提高了荷瘤小鼠特异性和非特异性抗肿瘤免疫反应     

人乳头瘤病毒16型E6/E7基因shRNA真核表达载体构建及其对人宫颈癌SiHa细胞增殖及迁移能力的影响

目的 构建针对人乳头瘤病毒16型E6/E7基因的shRNA真核表达载体,获得稳定表达干扰质粒的人宫颈癌SiHa细胞系并探讨其对SiHa细胞增殖及迁移能力的影响。方法 合成3条特异性干扰HPV16 E6/E7基因的shRNA片段并定向插入psilencer 2.1-U6 hygro载体,构建重组质粒psilencer 2.1-U6hygro-shE6/E7并转染入人宫颈癌SiHa细胞, Real- time PCR检测转染后细胞E6/E7 mRNA的表达,选择沉默效应最好的重组质粒并用潮霉素B稳筛,获得稳定表达重组质粒的SiHa细胞,并用real time-PCR和Western blot方法进行鉴定;分别运用CCK-8细胞增殖实验和细胞划痕愈合实验检测细胞的增殖及迁移能力。结果　测序证实针对HPV16 E6/E7的shRNA真核表达载体psilencer 2.1-U6 hygro-shE6/E7构建正确;转染psilencer 2.1-U6 hygro-shE6/E7的SiHa细胞HPV16 E6/E7表达明显受抑,同时其增殖及迁移能力也明显受抑制。结论 psilencer 2.1-U6 hygro-shE6/E7真核表达载体的成功构建并获得稳定沉默表达HPV16 E6/E7的人宫颈癌SiHa细胞系,证实沉默表达HPV16 E6/E7的SiHa细胞增殖及迁移能力会明显受到抑制,这为进一步研究HPV 16 E6/E7基因在宫颈癌发生发展过程中的功能奠定了实验基础。     

表达HPV16 E6和E7蛋白的非复制型重组痘苗病毒诱发的抗肿瘤免疫反应

目的　观察表达人乳头瘤病毒 (HPV) 16E6和E7蛋白的非复制型重组痘苗病毒的抗肿瘤免疫效果。方法　以重组痘苗病毒NTVJmE6E7免疫C5 7BL/ 6小鼠 ,检测特异性的细胞毒性T淋巴细胞 (CTL)活性 ;经免疫后的小鼠以TC 1肿瘤细胞攻击 ,观察免疫保护效果 ;荷瘤小鼠切除肿瘤后接种重组痘苗病毒 ,观察肿瘤复发情况。结果　以重组痘苗病毒NTVJmE6E7免疫小鼠 ,可诱导产生针对TC 1细胞的特异性的CTL反应 ;加强免疫后的小鼠能耐受 1× 10 4TC 1细胞的攻击 ;以重组痘苗病毒NTVJmE6E7免疫肿瘤术后小鼠 ,能有效地预防肿瘤复发。结论　非复制型重组痘苗病毒NTVJmE6E7可作为HPV16的相关肿瘤及其癌前病变免疫治疗的候选疫苗。     

短发夹状RNA抑制子宫颈癌CaSki细胞HPV 16 E7基因的研究

目的：研究短发夹状RNA（short hairpin RNA，shRNA）构建的人乳头瘤病毒（human papillomavirus，HPV）16E7siRNA表达载体转染宫颈癌细胞株CaSki细胞后，在体内外对CaSki细胞E7基因的抑制作用。方法：利用脂质体将构建有HPV16E7特异性小干扰RNA（small interfering RNA，siRNA）的表达载体P1、P2、P3转染CaSki细胞，以实时荧光定量RT—PCR及流式细胞仪检测不同时间点E7mRNA和蛋白的变化，并将载体P1转染后的细胞接种到裸鼠皮下，4周后观察裸鼠体内皮下移植瘤体积和质量的差异，并用免疫组化检测瘤体组织中E7蛋白的表达变化。结果：表达载体P1、P2、P3均能抑制Caski细胞E7mRNA和蛋白的表达。其中载体P1抑制作用最强，在抗性克隆形成后1周，对E7mRNA和蛋白的抑制率分别为92．86％、84．21％；在抗性克隆形成后4周，抑制率仍分别为68．95％、62．50％。在接种后4周载体P1组裸鼠体内皮下移植瘤的体积和重量明显小于空载体组和对照组，同时E7蛋白的表达也被有效抑制，抑制率为74．75％。结论：构建有shRNA的E7siRNA表达载体在体内外可明显抑制E7基因的表达。     

重组腺病毒抗小鼠移植瘤生长

目的:研究携带细胞因子基因hIL-2、hTNF-a的重组腺病毒对小鼠移植瘤生长抑制作用。方法:将分别携带有hIL-2基因、hTNF-a基因的重组腺病毒感染人肺腺癌Anip973细胞系,应用ELISA试剂盒检测转染后的细胞IL-2、TNF-α的分泌量;通过肿瘤局部注射重组腺病毒的方法观察其在小鼠体内的抗肿瘤作用。结果:转基因的肿瘤细胞生长能力、克隆形成率等无明显变化。24h细胞培养上清IL-2的分泌量为50pg/2×105细胞,TNF-α的分泌量为20pg/2×105细胞。体内实验表明注射重组腺病毒后小鼠肿瘤生长缓慢,体积明显小于对照组(P<0.05),存活期显著延长。结论:瘤内注射重组腺病毒具有明显抗肿瘤作用。     

宫颈癌组织HPV58的检测及其E7基因的克隆和表达

目的　检测宫颈癌组织中人乳头瘤病毒 5 8型 (HPV5 8)并克隆表达其E7基因。方法采用GP5 /GP6 引物系统扩增 5 8例宫颈癌组织 ,将荧光偏振 (FP)检测技术与模板指导的末端延伸反应 (TDI FP)结合 ,检测HPV5 8,确定HPV5 8感染阳性宫颈癌组织。用特异引物从HPV5 8阳性标本中扩增HPV5 8早期表达蛋白E7基因 ,将其连入pGEM TEasy载体 ,获得克隆重组体HPV5 8E7 pGEM T ,并测序验证。将E7基因与pRSET A融合表达载体连接 ,获得E7表达重组体pRSET 5 8E7,转化大肠杆菌BL2 1(DE3) ,并用IPTG诱导表达。结果　 5 8例宫颈癌标本中 ,HPV5 8阳性 10例 ,占 5 2例HPV阳性标本的 19.2 %。从其中扩增到了HPV5 8E7基因并构建了其克隆和表达重组体。其表达重组体经IPTG诱导后 ,可表达Mr16× 10 3 的HPV5 8E7His6融合蛋白 ,表达量占菌体蛋白的 30 %。结论　欧美国家少见的高危HPV5 8在中国陕西人宫颈癌组织中并不少见。HPV5 8E7重组表达体可在大肠杆菌中高效表达 ,为HPV5 8相关肿瘤诊断试剂及疫苗的研制奠定了初步基础     

HPV16编码蛋白与宫颈癌细胞内CALCA和TFPI-2表达的关系

目的：研究人乳头瘤病毒16（HPV16）编码蛋白的表达与宫颈癌细胞内CALCA和TFPI-2基因表达水平的关系,探讨依赖于HPV感染的宫颈癌发病机制。方法：设计与合成HPV16编码基因E6和E7序列特异性短发夹RNA（shRNA）寡聚核苷酸片段,构建表达shRNA的pRNAi载体,其中携带绿色荧光蛋白（GFP）报告基因,以此感染HPV16阳性的SiHa宫颈癌细胞,采用荧光成像和实时荧光定量PCR（qPCR）分析等方法,评价载体转染效率、抑制效率及候选基因转录表达水平的变化。结果：在激光共聚焦显微镜下,观察到释放绿色荧光的细胞群,转染成功;根据定量qPCR分析,HPV16编码基因E6和E7的mRNA表达水平明显下降,shRNA表达载体转染产生抑制效率;CDK4和BCL-2 mRNA表达水平明显下降,推测抑制HPV基因转录后,可能抑制宫颈癌细胞生长,引起细胞周期停滞;抑制E7基因表达后,CALCA和TFPI-2 mRNA表达水平明显上升,而抑制E6基因表达后,对上述基因表达水平的影响不明显。结论：HPV16编码蛋白质E7可能引起宫颈癌细胞内CALCA和TFPI-2基因表达下调,此为揭示依赖于HPV感染的宫颈癌发病机制提供了依据。     

减毒沙门氏菌靶向携带共表达质粒p53/siRNA-survivin抗前列腺癌的体内研究

目的：以人减毒沙门氏菌为基因运载体，探讨其携带p53、siRNA-survivin及其共表达质粒p53／siRNA-survivin对肿瘤的靶向性及抗人前列腺癌效应，方法：复制裸鼠前列腺癌皮下移植瘤模型，分别将已构建的重组表达质粒siRNA-scramble，p53，siRNA-survivin及共表达质粒p53／siRNA-survivin转化到减毒人伤寒沙门菌Ty21a，制备成对应重组减毒沙门菌，通过灌胃及瘤内注射到前列腺癌荷瘤裸鼠体内，观察成瘤时间及瘤块大小；以携有绿色荧光蛋白siRNA-survivin的重组茵作为报告基因，流式细胞术检测其在肝、脾、肿瘤组织中靶向分布及基因呈递作用；应用RT-PCR，Western blot，及免疫组织化学染色方法检测治疗后肿瘤组织p53和Survivin基因及蛋白表达。结果：各治疗组均较对照组肿瘤生长缓慢，肿瘤体积小，共表达质粒组与单独基因治疗组比较，肿瘤体积明显缩小，抑瘤率高；荷瘤裸鼠肿瘤组织可测及survivin mRNA表达下降，p53基因表达增强，p53相关基因GRIM-19 mRNA和蛋白表达增强；FCM检测结果发现，减毒人沙门氏菌可在肝、脾及肿瘤组织中存活及表达，但以肿瘤中绿色荧光聚集明显且维持时间较长，其他脏器仅见极少的绿色荧光，结论：人减毒沙门氏菌可作为外源基因载体携带重组质粒，对前列腺癌移植瘤有明显的靶向性，其靶向介导的p53，siRNA-survivin及其表达基因p53／siRNA-survivin，对前列腺癌荷瘤裸鼠有治疗作用，共表达基因较单基因治疗效果好，具有显著的协同作用。     

The medically important dematiaceous fungi and their identification

Dematiaceous fungi include a large group of organisms that are darkly pigmented (dark brown, olivaceous, or black). In most cases the pigment is melanin, and specifically, dihydroxynaphthalene melanin. The diseases produced include chromoblastomycosis, eumycotic mycetoma, and phaeohyphomycosis. Phaeohyphomycosis is a new classification for a diverse group of previously known entities grouped together on the basis of finding dematiaceous hyphal and/or yeast-like forms in tissue; tissue involvement may be superficial, cutaneous and corneal, subcutaneous, or systemic. Identification of these fungi is based mostly upon morphology. Important structures include annellides (Phaeoannellomyces, Exophiala), phialides (Phialophora, Wangiella), adelophialides (Phialemonium without collarettes, Lecythophora with collarettes), differentiation of conidiophores (Xylohypha versus Cladosporium) and conidial hilum, septation and germination (Bipolaris, Drechslera, Exserohilum). Useful laboratory tests include the 12% gelatin test (controversial), nitrate assimilation (W. dermatitidis is negative, most other species are positive), and determination of temperature maxima (especially 37 degrees C for E. jeanselmei, 40 degrees C for W. dermatitidis and B. spicifera, 42 degrees C for X. bantiana, and 45 degrees C for Dactylaria constricta var. gallopava and Scedosporium inflatum).     

Orale Langzeitbehandlung von Onychomykosen mit Ketoconazol

Zusammenfassung: An der Studie zur Wirksamkeit und Anwendungssicherheit von Ketoconazol nahmen 27 Männer im Alter von 20 bis 80 (Median: 57) Jahre, davon 18 mit Onychomykosen und 9 als KontroUen bei den Laborwertbestimmungen, teil. Während des ersten Behandlungsmonats erhielten je 9 Patienten 200 mg und 400 mg Ketoconazol täglich. Danach wurden beide Gruppen 6 Monate mit 200 mg/d weiterbehandelt. Die klinische Beurteilung sowie hämatologische, biochemische und Plasmaspiegeluntersu-chungen erfolgten mindestens monafich, mykologische Untersuchungen wurden vor Aufnahme und bei Beendigung der Therapie vorgenommen. Erne letzte klinische Unter-suchung erfolgte 1 Jahr nach Beginn der Studie. Nach 7 Monaten Behandlung wurden 23 von 30 Nägeln mit “gebessert” bis “stark gebessert” beurteilt, nach dem behandlungsfreien Intervall galt dies für 28 von 30 Nägeln. Die Plasmaspiegel waren mit 200 mg/d ausreichend und uber den Behandlungszeit-raum konstant. Dies spricht für gute orale Resorption und Abwesenheit von Enzyminduktion. Die Laborwerte zeigten im Vergleich zu den Kontrollen und den Werten vor Behandlung keine signifikanten Abweichungen, so daß myelo-, nephro- und hepatotoxische Wirkungen von 400 bzw. 200 mg/d ausgeschlossen werden können. Der Lipidhaushalt wurde nicht beeinfluat und es trat unter Therapie als Folge der Ketoconazolwirkung lediglich Lanosterin im Serum auf. Nach Beendigung der Therapie ging der Lanosteringehalt schnell zurück. Damit erweist sich Ketoconazol in den angewandten Dosen als ein gut verträgliches und zur Langzeitbehandlung von Onychomykosen geeignetes Antimykotikum. Summary: Twenty-seven males with a median age of 57 (range: 20 to 80) years took part in this study on the efficacy and safety of ketoconazole. Eighteen men suffered from onychomycosis; nine served as controls in the safety evaluation. During the first month of treatment, nine patients received 200 mg and the nine other 400 mg ketoconazole daily. Then the treatment was uniformly continued with 200 mg/d for 6 months. Clinical evaluation and haematological, biochemical and plasma level investigations were carried out at least at monthly intervals; mycological controls were performed at the start and end of therapy. A final clinical evaluation was carried out one year after the start of the study. After 7 months of treatment, moderate or definite clinical improvement was obtained in 23 out of 30 nails. After 5 more months without antimycotic treatment this was the case in 28 of 30 nails. Plasma levels obtained with 200 mg ketoconazole daily were adequate and constant during the entire treatment period. This indicates a good oral resorption as well as the absence of induction of hepatic enzymes. The laboratory values did not show significant deviations as compared with the controls or with the pretreatment values. This excludes myelo-, nephro- and hepatotoxic effects of 400 and 200 mg ketoconazole daily. The lipid metabolism was not influenced, the only difference was the occurrence of lanosterol in the serum, which is a result of the mechanism of action of ketoconazole. After the medication period the lanosterol levels subsided rapidly. In the applied doses ketoconazole is a well-tolerated and effective drug for the systemic long-term treatment of onychomycosis.     

Laboratory Techniques Alternative to In Vivo Experiments for Studying the Liberation, Penetration and Fungicidal Action of Topical Antimycotic Agents in the Skin, Including Ciclopiroxolamine

Summary: Short-term experiments on excised skin (human, pig) gave the following results: 1. In the tissue activity test with direct inoculation (D-TAT) commercial preparations of the non-azole antimycotics ciclopiroxolamine, tolnaftate and naftifine, produced higher inhibitory activity against Trichophyton mentagrophytes (standard strain) in various levels of the horny layer than were produced by the azole antimycotics econazole, miconazole, clotrimazole, oxiconazole and bifonazole. Fast drying solutions of antimycotics invariably gave higher inhibitory activities than creams. In the ultrafiltration tissue activity test (UFT- TAT) against Candida albicans (2 strains), antimycotic agents ranked in order of effectiveness as follows: ciclopiroxolamine – most of the azole antimycotics – bifonazole and naftifine. 2. In tests of fungicidal activity against T. mentagrophytes (2 strains) and Microsporum gypseum (1 strain) the first step was to inoculate the skin surface. After the horny layer had been penetrated by fungal mycelia, antimycotic agents of documented fungicidal potency, chiefly in the form of creams, were applied to the skin surface and left to act for up to 18 hours. The horny layer and epidermis were then scraped off and the concentration of viable fungi was determined. Ciclopiroxolamine cream and lotion produced by far the greatest diminution in viable fungi; creams containing oxiconazole and naftifine were moderately effective and those containing tioconazole and bifonazole produced a relatively small decrease in viable fungi. To avoid erroneous results it is important to homogenize and dilute the skin scrapings; if this is not done certain antimycotics will give misleadingly high fungal killing rates. At this early stage the scatter of results is still wide and minor differences in efficacy cannot as yet be detected with certainty. 3. From the results of various comparative tests it is evident that pig skin can be used as a substitute for human skin in the tests listed under 1. and 2. above. This discovery may make a valuable contribution towards limiting the need for experiments on living animals and trials on human beings. Zusammenfassung: In Kurzzeitversuchen an exzidierter Haut (Mensch, Schwein) wurde gefunden: 1. Im Gewebeaktivitätstest mit direkter Inokulation (D-GAT) wurde mit Handelspräparaten der Nichtazol-Antimykotika Ciclopiroxolamin, Tolnaftat und Naftifin in verschiedenen Hornschichtniveaus eine höhere Hemmaktivität gegenüber Trichophyton mentagrophytes (Standard-Stamm) erzielt als mit solchen der Azol-Antimykotika Econazol, Miconazol, Clotrimazol, Oxiconazol und Bifonazol. Rasch trocknende Lösungen von Antimykotika ergaben durchweg höhere Hemmaktivitäten als Cremes. Im Ultrafiltrations-Gewebeaktivitätstest (UFT-GAT) gegenüber Candida albicans (2 Stämme) ergab sich nach erzielter Wirksamkeit die Rangfolge Ciclopiroxolamine – Mehrzahl der Azolantimykotika – Bifonazol und Naftifin. 2. In Fungizidie-Testen gegenüber T. mentagrophytes (2 Stämme) und Microsporum gypseum (1 Stamm) wurde zunächst die Hautoberfläche inokuliert. Nach Durchdringung der Hornschicht mit Pilzmyzelien wirkten auf die Hautoberfläche bis zu 18 Stunden lang überwiegend Cremes von als fungizid publizierten Antimykotika ein. Während sich in abgeschabter Hornschicht und Epidermis der so bearbeiteten Hautoberflächen mit Ciclopiroxolamin-Creme und -Lotion die weitaus höchste Verminderung lebensfähiger Keime ergab, bewirkten Cremes mit Oxiconazol und Naftifin eine mittlere und solche mit Tioconazol und Bifonazol eine relativ niedrige Keimeliminierung. Zur Vermeidung von fehlerhaften Ergebuissen mußten Homogenisierung und Verdünnung der Hautschabsel erfolgen, anderenfalls bei mehreren Antimykotika eine zu hohe Keimabtötung vorgetäuscht worden wäre. Wegen der vorerst noch hohen Streuung der Ergebnisse können kleinere Wirksamkeitsunterschiede noch nicht sicher erfaßt werden. 3. Nach dem Ergebnis verschiedener Vergleichstests kann in den Testen zu 1. und 2. Schweinehaut als Ersatz für Haut vom Menschen dienen und dürfte damit wesentlich zur Einschränkung von Versuchen am lebenden Tier und von Prüfungen am Menschen beitragen.     

Efficiency of crude and purified fungal antigens in serodiagnosis to discriminate mycotic from other respiratory diseases

Mycotic immunodiagnosis was performed in 186 hospitalized patients with different respiratory diseases, mostly considered as tuberculosis and others with a doubtful diagnosis. Crude histoplasmin, coccidioidin, paracoccidioidin, blastomycin, candidin, aspergillin, and sporotrichin, as well as purified polysaccharide-protein complexes (PPC) of Histoplasma capsulatum, Coccidioides immitis, and Paracoccidioides brasiliensis were used as antigens. Immune tests used included skin test (ST), gel immunodiffusion (ID), counterimmunoelectrophoresis (CIE), complement fixation (CF), and ELISA. A possible association with candidosis was observed in 17% of patients with tuberculosis and diabetes; one presumptive paracoccidioidomycosis, one confirmed aspergillosis, and six cases of active histoplasmosis were determined. Candidin ST showed 29% of positive reactions with an increased frequency in patients between 31 and 55 years of age. CF test showed the highest positivity percentages with crude antigens, specially for Candida antigen (26.3%) and histoplasmin (18.2%). Cross reactions were evident with crude antigens but decreased when PPC's were used in ELISA.     

Isoconazole nitrate in the treatment of tropical dermatomycoses

Summary. A total of 54 patients with culturally proven tropical dermatomycoses, comprising 23 with various types of dermatophytoses, one with foot infection due to Trichosporon beigelii and one with foot infection due to Geotrichum candidum , two with candidoses of the groin and 27 with pityriasis versicolor, were included in a clinical trial of efficacy of 1% isoconazole cream (Travogen^R, Schering, Berlin, Germany). Five patients were not evaluable. A clinical and mycological cure was achieved in 29 cases in 3–4 weeks. In 15 (31%) of the remaining patients treatment was required for 5–6 weeks, while another three patients required treatment for 8 weeks. In two patients the disease proved to be resistant to treatment with the drug.
Zusammenfassung. Insgesamt 54 Patienten mit kulturell gesicherter Dermatomykose, (23 unterschiedliche Dermatophytosen, eine Trichosporon beigelii - und eine Geotrichum candidum -Fußinfektion, 2 Candidosen der Leistengegend und 27 Pityriasis versicolor) wurden in einer klinischen Wirksamkeits-studie mit 1% iger Isoconazol-Creme (Travogen^R, Schering, Berlin, Deutschland) behandelt. Fünf Patienten waren nicht auswertbar. Eine klinische und mykologische Heilung wurde bei 47 von 49 Patienten (96%) erreicht. Bei 29 patienten (59%) wurde die Heilung bereits nach 3–4 Wochen Behandlung erreicht. Weitere 15 Patienten (31%) benötigten 5–6 Wochen und drei Patienten 8 Wochen Behandlungsdauer. Zwei Mykosesituationen erwiesen sich als therapieresistent.     

Large-scale molecular characterization and analysis of gastric cancer

The recent effort by The Cancer Genome Atlas （TCGA） Network has revealed that gastric cancer, which is a leading cause of cancerrelated deaths worldwide with a 5-year survival rate less than 25%, is a much more heterogeneous disease than previously thought. And yet, conventional treatment approaches and clinical trials have assumed it is a single disease. Although it is well known that under the microscope, gastric cancer cells appear quite different, the current classification scheme recognizes two main categories of gastric cancer： diffuse and intestinal.     

A conceptually new treatment approach for relapsed glioblastoma: Coordinated undermining of survival paths with nine repurposed drugs (CUSP9) by the International Initiative for Accelerated Improvement of Glioblastoma Care

To improve prognosis in recurrent glioblastoma we developed a treatment protocol based on a combination of drugs not traditionally thought of as cytotoxic chemotherapy agents but that have a robust history of being well-tolerated and are already marketed and used for other non-cancer indications. Focus was on adding drugs which met these criteria: a) were pharmacologically well characterized, b) had low likelihood of adding to patient side effect burden, c) had evidence for interfering with a recognized, well-characterized growth promoting element of glioblastoma, and d) were coordinated, as an ensemble had reasonable likelihood of concerted activity against key biological features of glioblastoma growth. We found nine drugs meeting these criteria and propose adding them to continuous low dose temozolomide, a currently accepted treatment for relapsed glioblastoma, in patients with recurrent disease after primary treatment with the Stupp Protocol. The nine adjuvant drug regimen, Coordinated Undermining of Survival Paths, CUSP9, then are aprepitant, artesunate, auranofin, captopril, copper gluconate, disulfiram, ketoconazole, nelfinavir, sertraline, to be added to continuous low dose temozolomide. We discuss each drug in turn and the specific rationale for use- how each drug is expected to retard glioblastoma growth and undermine glioblastoma''s compensatory mechanisms engaged during temozolomide treatment. The risks of pharmacological interactions and why we believe this drug mix will increase both quality of life and overall survival are reviewed.