Stabilization and formulation of a recombinant Human Cytomegalovirus vector for use as a candidate HIV-1 vaccine

Live attenuated viral vaccine/vector candidates are inherently unstable and infectivity titer losses can readily occur without defining appropriate formulations, storage conditions and clinical handling practices. During initial process development of a candidate vaccine against HIV-1 using a recombinant Human Cytomegalovirus vector (rHCMV-1), large vector titer losses were observed after storage at 4 °C and after undergoing freeze-thaw. Thus, the goal of this work was to develop candidate frozen liquid formulations of rHCMV-1 with improved freeze-thaw and short-term liquid stability for potential use in early clinical trials. To this end, a virus stability screening protocol was developed including use of a rapid, in vitro cell-based immunofluorescence focus assay to quantitate viral titers. A library of ∼50 pharmaceutical excipients (from various known classes of additives) were evaluated for their effect on vector stability after freeze-thaw cycling or incubation at 4 °C for several days. Certain additives including sugars and polymers (e.g., trehalose, sucrose, sorbitol, hydrolyzed gelatin, dextran 40) as well as removal of NaCl (lower ionic strength) protected rHCMV-1 against freeze-thaw mediated losses in viral titers. Optimized solution conditions (e.g., solution pH, buffers and sugar type) slowed the rate of rHCMV-1 titer losses in the liquid state at 4 °C. After evaluating various excipient combinations, three new candidate formulations were designed and rHCMV-1 stability was benchmarked against both the currently-used and a previously reported formulation. The new candidate formulations were significantly more stable in terms of reducing rHCMV-1 titer losses after 5 freeze-thaw cycles or incubation at 4 °C for 30 days. This case study highlights the utility of semi-empirical design of frozen liquid formulations of a live viral vaccine candidate, where protection against infectivity titer losses due to freeze-thaw and short-term liquid storage are sufficient to enable more rapid initiation of early clinical trials.     

Seawater activated TiO2 photocatalyst for degradation of organic compounds

The world's oceans are polluted by a continuous inflow of plastic. Plastic fragments finally into microplastic, which can be taken up, for example by plankton, and subsequently by the entire ocean food web. An approach to reduce plastic pollution constitutes the accelerated microplastic degradation in marine environments. TiO₂ (anatase) is commonly used as an oxidative photocatalyst and well known to catalyze the degradation of organic compounds upon UV irradiation.In this study, a selective activation of TiO₂ (anatase) particles encapsulated by Ca- or Sr-polyphosphate is presented. The TiO₂ polyphosphate core-shell particles are envisaged as additives in plastic products. The highly concentrated cations from seawater, viz. Na⁺ and Mg²⁺, displace the Ca²⁺ or Sr²⁺ cations from the polyphosphate shell. As a result, the polyphosphate coating dissolves and thus the photocatalytically active TiO₂ core is released. The stability of the TiO₂ polyphosphate particles in potable water and the seawater activated disintegration of methylene blue, methyl methacrylate, terephtalic acid, and poly(vinyl alcohol) was shown. It has been demonstrated, that the sweetwater stable polyphosphate coating degrades in the presence of seawater, which could be monitored by the activation of the TiO₂ (anatase) photocatalyst.     

Exercise Intolerance in Patients With Heart Failure: JACC State-of-the-Art Review

Exercise intolerance is the cardinal symptom of heart failure (HF) and is of crucial relevance, because it is associated with a poor quality of life and increased mortality. While impaired cardiac reserve is considered to be central in HF, reduced exercise and functional capacity are the result of key patient characteristics and multisystem dysfunction, including aging, impaired pulmonary reserve, as well as peripheral and respiratory skeletal muscle dysfunction. We herein review the different modalities to quantify exercise intolerance, the pathophysiology of HF, and comorbid conditions as they lead to reductions in exercise and functional capacity, highlighting the fact that distinct causes may coexist and variably contribute to exercise intolerance in patients with HF.     

Gender difference in hepatic toxicity of titanium dioxide nanoparticles after subchronic oral exposure in Sprague‐Dawley rats

Existing literature pointed out that the liver may be the target organ of toxicity induced by titanium dioxide nanoparticles (TiO₂ NPs) via oral exposure. Gender differences in health effects widely exist and relevant toxicological research is important for safety assessment. To explore the gender susceptibility of TiO₂ NP‐induced hepatic toxicity and the underlying mechanism, we examined female and male Sprague‐Dawley rats administrated with TiO₂ NPs orally at doses of 0, 2, 10 and 50 mg/kg body weight per day for 90 days. The serum biochemical indicators and liver pathological observation were used to assess hepatic toxicity. We found significant hepatic toxicity could be induced by subchronic oral exposure to TiO₂ NPs, which was more obvious and severe in female rats. No accumulation of TiO₂ NPs in the liver was observed, indicating that hepatic toxicity may not be caused through direct pathways. Oxidized glutathione, lipid peroxidation products increased significantly and reduced glutathione decreased significantly in the liver of rats in repeated TiO₂ NP‐exposed groups. Hematological parameters of white blood cells and inflammatory cytokines in serum including interleukin 1α, interleukin 4 and tumor necrosis factor also increased significantly. Indirect pathways through initiating oxidative stress and inflammatory responses were suggested as the possible mechanism of the hepatic toxicity in this experiment. The higher sensitivity to redox homeostasis imbalance and inflammation of female rats may be the main reason for gender differences. Our research suggested that gender should be a susceptible factor for identifying and monitoring long‐term oral toxicity of TiO₂ NPs.     

黄芪汤加减治疗急性加重期慢性阻塞性肺疾病疗效研究

摘 要 目的:探讨黄芪汤加减治疗慢性阻塞性肺疾病急性加重期（AECOPD）的临床疗效。方法:采用随机数字表法将166例AECOPD患者随机分为常规组和观察组各83例。常规组采用常规西医方法治疗，观察组在常规组的基础上给予黄芪汤加减治疗。观察两组治疗前后第1秒用力呼气量（FEV1）、用力肺活量（FVC）、FEV1占FVC的百分比（FEV1/FVC％）、动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、肿瘤坏死因子 α（TNF α）、白细胞介素 1β（IL 1β）、白细胞介素 6（IL 6）水平。结果:两组治疗后FEV1、FEV1/FVC、PaO2水平与治疗前相比较均显著升高（P＜0.05），且观察组与同期常规组相比较均显著升高（P＜0.05）；两组治疗后PaCO2、TNF α、IL 1β、IL 6水平与治疗前相比较均显著降低（P＜0.05），且观察组与同期常规组相比较均显著降低（P＜0.05）。结论:黄芪汤加减治疗AECOPD可降低患者炎症反应水平，改善动脉血气和肺功能，提高治疗效果，值得临床应用。     

Internalization of titanium dioxide nanoparticles by glial cells is given at short times and is mainly mediated by actin reorganization-dependent endocytosis

Many nanoparticles (NPs) have toxic effects on multiple cell lines. This toxicity is assumed to be related to their accumulation within cells. However, the process of internalization of NPs has not yet been fully characterized. In this study, the cellular uptake, accumulation, and localization of titanium dioxide nanoparticles (TiO₂ NPs) in rat (C6) and human (U373) glial cells were analyzed using time-lapse microscopy (TLM) and transmission electron microscopy (TEM). Cytochalasin D (Cyt-D) was used to evaluate whether the internalization process depends of actin reorganization. To determine whether the NP uptake is mediated by phagocytosis or macropinocytosis, nitroblue tetrazolium (NBT) reduction was measured and the 5-(N-ethyl-N-isopropyl)-amiloride was used. Expression of proteins involved with endocytosis and exocytosis such as caveolin-1 (Cav-1) and cysteine string proteins (CSPs) was also determined using flow cytometry.TiO₂ NPs were taken up by both cell types, were bound to cellular membranes and were internalized at very short times after exposure (C6, 30 min; U373, 2 h). During the uptake process, the formation of pseudopodia and intracellular vesicles was observed, indicating that this process was mediated by endocytosis. No specific localization of TiO₂ NPs into particular organelles was found: in contrast, they were primarily localized into large vesicles in the cytoplasm. Internalization of TiO₂ NPs was strongly inhibited by Cyt-D in both cells and by amiloride in U373 cells; besides, the observed endocytosis was not associated with NBT reduction in either cell type, indicating that macropinocytosis is the main process of internalization in U373 cells. In addition, increases in the expression of Cav-1 protein and CSPs were observed.In conclusion, glial cells are able to internalize TiO₂ NPs by a constitutive endocytic mechanism which may be associated with their strong cytotoxic effect in these cells; therefore, TiO₂ NPs internalization and their accumulation in brain cells could be dangerous to human health.     

Anaesthetic breathing systems

A breathing system is a series of components that allows the delivery of oxygen and other anaesthetic gases to the patient as well as aiding in the removal of carbon dioxide. There are key elements that feature in all anaesthetic breathing systems with numerous classification systems used. The layout of individual breathing systems determines their clinical application and use. All of the above will be discussed further in this article as well as a brief summary of the use of carbon dioxide absorbers and their function.