Activation of clinically used anthracyclines by the formaldehyde-releasing prodrug pivaloyloxymethyl butyrate

The anthracycline group of compounds is extensively used in current cancer chemotherapy regimens and is classified as topoisomerase II inhibitor. However, previous work has shown that doxorubicin can be activated to form DNA adducts in the presence of formaldehyde-releasing prodrugs and that this leads to apoptosis independently of topoisomerase II-mediated damage. To determine which anthracyclines would be useful in combination with formaldehyde-releasing prodrugs, a series of clinically relevant anthracyclines (doxorubicin, daunorubicin, idarubicin, and epirubicin) were examined for their capacity to form DNA adducts in MCF7 and MCF7/Dx (P-glycoprotein overexpressing) cells in the presence of the formaldehyde-releasing drug pivaloyloxymethyl butyrate (AN-9). All anthracyclines, with the exception of epirubicin, efficiently yielded adducts in both sensitive and resistant cell lines, and levels of adducts were similar in mitochondrial and nuclear genomes. Idarubicin was the most active compound in both sensitive and resistant cell lines, whereas adducts formed by doxorubicin and daunorubicin were consistently lower in the resistant compared with sensitive cells. The adducts formed by doxorubicin, daunorubicin, and idarubicin showed the same DNA sequence specificity in sensitive and resistant cells as assessed by lambda-exonuclease-based sequencing of alpha-satellite DNA extracted from drug-treated cells. Growth inhibition assays were used to show that doxorubicin, daunorubicin, and idarubicin were all synergistic in combination with AN-9, whereas the combination of epirubicin with AN-9 was additive. Although apoptosis assays indicated a greater than additive effect for epirubicin/AN-9 combinations, this effect was much more pronounced for doxorubicin/AN-9 combinations.     

Elucidation of the physicomechanical and ab initio quantum energy transitions of a crosslinked PLGA scaffold

This study elucidated the in vitro physicomechanical transitions of a crosslinked polylactic-co-glycolic acid (PLGA) scaffold, utilizing quantum mechanics to compute the ab initio energy requirements of a salted-out and subsequently crosslinked PLGA scaffold interacting with simulated physiological fluid, phosphate buffered saline (PBS) (pH 7.4, 37 degrees C) at a molecular level. Twenty-six salted-out PLGA scaffolds were formulated using a four factor, two centerpoint quadratic Face-Centered Central Composite Design (FCCD). PLGA molecular mass, PLGA concentration, water volume and salting-out reaction time were the dependant formulation variables. Subsequent to PLGA solubilization in dimethyl formamide (DMF), protonated water was added to induce salting-out of PLGA into a scaffolds that were immersed in PBS, oscillated at 100 rpm, and analyzed at pre-determined time intervals for their physicomechanical and ab initio quantum energy transitions. Results indicated that the matrix resilience (MR) decreased with longer incubation periods (MR=35-45%) at day 30. Scaffolds salted-out using higher PLGA concentrations exhibited minimal changes in MR and the matrix ability to absorb energy was found to closely correlate with the scaffold residence time in PBS. Spartan-based ab initio quantum energy predictions elucidated the potential scaffold stability from a molecular viewpoint and its suitability for use in rate-modulated drug delivery.     

Synthesis of N-doped ZnO nanoparticles with cabbage morphology as a catalyst for the efficient photocatalytic degradation of methylene blue under UV and visible light

In this study, the synthesis of nitrogen-doped zinc oxide nanoparticles with a cabbage like morphology (N-ZnONCBs) by a hydrothermal method using zinc acetate dihydrate as a precursor and hydrazine monohydrate as a nitrogen source is reported. N-ZnONCB were characterized using UV-visible Spectroscopy (UV-Vis), Fluorescence Spectroscopy, Fourier Transmittance Infrared Spectroscopy (FTIR), X-ray diffraction (XRD), Raman Spectroscopy, Thermogravimetric Analysis (TGA), Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), Electron Dispersive Spectroscopy (EDS) and EDX elemental mapping. N-ZnONCBs were tested for their photocatalytic capabilities in the degradation of methylene blue (MB) under UV-light and visible light irradiation for about 0 to 80 minutes and 0 to 50 min respectively. The N-ZnONCB catalyst demonstrated improved photodegradation efficiency (98.6% and 96.2%) and kinetic degradation rates of MB (k = −0.0579 min⁻¹ and k = −0.0585 min⁻¹) under UV light and visible light irradiation at different time intervals. The photodegradation study was also evaluated with different dosages of N-ZnONCB catalyst, different initial concentrations of MB and variation in the pH (3, 5, 9 and 11) of the solution of MB under UV light and visible light irradiation. The photocatalytic degradation intermediate products were obtained by liquid chromatography mass spectra (LC-MS) and also complete mineralization was determined by using Total Organic Carbon (TOC) studies. This photocatalyst was also tested with 2,4-dichlorophenol (2,4-DCP) under visible light irradiation at different time intervals. Fluorescence and quenching studies were performed for the binding interaction between the N-ZnONCB catalyst and MB dye. A Zetasizer was used to find the charge and average size of the N-ZnONCB catalyst and also the charge of the N-ZnONCB catalyst before and after MB dye solution adsorption. The N-ZnONCB catalyst was also tested for its photostability and reusability with a percentage degradation rate of MB (93.2%) after 4 cycle experiments. These results have clearly demonstrated that the N-ZnONCB catalyst can be applied for the photocatalytic degradation of MB from wastewater samples.

In this study, the synthesis of nitrogen-doped zinc oxide nanoparticles with a cabbage like morphology (N-ZnONCBs) by a hydrothermal method using zinc acetate dihydrate as a precursor and hydrazine monohydrate as a nitrogen source is reported.     

Anterior thigh compartment syndrome after prone positioning for lumbosacral fixation

We report a case of a patient who developed anterior thigh compartment syndrome after being positioned prone for instrumented lumbar spine surgery. Although rare, clinicians should be aware that compartment syndrome is a possible complication of spinal surgery.     

Financing vaccinations - The South African experience

South Africa provides a useful country case study for financing vaccinations. It has been an early adopter of new vaccinations and has financed these almost exclusively from domestic resources, largely through general taxation. National vaccination policy is determined by the Department of Health, based on advice from a national advisory group on immunisation. Standard health economic criteria of effectiveness, cost-effectiveness, affordability and burden of disease are used to assess whether new vaccinations should be introduced. Global guidelines and the advice of local and international experts are also helpful in making the determination to introduce new vaccines. In terms of recent decisions to introduce new vaccines against pneumococcal disease and rotavirus diarrhoea in children, the evidence has proved unequivocal. Universal rollout has been implemented even though this has led to a fivefold increase in national spending on vaccines. The total cost to government remains below 1-1.5% of public expenditures for health, which is viewed by the South African authorities as affordable and necessary given the number of lives saved and morbidity averted. To manage the rapid increase in domestic spending, efforts have been made to scale up coverage over several years, give greater attention to negotiating price reductions and, in some cases, obtain initial donations or frontloaded deliveries to facilitate earlier universal rollout. There has been strong support from a wide range of stakeholders for the early introduction of new generation vaccines.     

Activin-A: a novel dendritic cell-derived cytokine that potently attenuates CD40 ligand-specific cytokine and chemokine production

Activin-A is a transforming growth factor-beta (TGF-beta) superfamily member that plays a pivotal role in many developmental and reproductive processes. It is also involved in neuroprotection, apoptosis of tumor and some immune cells, wound healing, and cancer. Its role as an immune-regulating protein has not previously been described. Here we demonstrate for the first time that activin-A has potent autocrine effects on the capacity of human dendritic cells (DCs) to stimulate immune responses. Human monocyte-derived DCs (MoDCs) and the CD1c(+) and CD123(+) peripheral blood DC populations express both activin-A and the type I and II activin receptors. Furthermore, MoDCs and CD1c(+) myeloid DCs rapidly secrete high levels of activin-A after exposure to bacteria, specific toll-like receptor (TLR) ligands, or CD40 ligand (CD40L). Blocking autocrine activin-A signaling in DCs using its antagonist, follistatin, enhanced DC cytokine (IL-6, IL-10, IL-12p70, and tumor necrosis factor-alpha [TNF-alpha]) and chemokine (IL-8, IP-10, RANTES, and MCP-1) production during CD40L stimulation, but not TLR-4 ligation. Moreover, antagonizing DC-derived activin-A resulted in significantly enhanced expansion of viral antigen-specific effector CD8(+) T cells. These findings establish an immune-regulatory role for activin-A in DCs, highlighting the potential of antagonizing activin-A signaling in vivo to enhance vaccine immunogenicity.     

Isolation of viruses from stools in stem cell transplant recipients: a prospective surveillance study

We prospectively examined stool specimens for enteric viruses in 75 stem cell transplant recipients (autologous 48, allogeneic 27) to determine the frequency and significance of these infections. Only six patients (8%) had a positive isolate. Five of these were allograft recipients (18%) compared to one autograft recipient (2%) (P = 0.02). Unrelated donor BMT recipients were at the highest risk for a viral isolate (OR = 10.5). Adenovirus was the commonest isolate (four patients). One patient each had an echovirus, enterovirus and small round structured virus identified. No correlation was found between the severity of gastro-intestinal symptoms and detection of a viral pathogen. There was no correlation with GVHD or CMV status. The only risk factor identified for isolation of an enterovirus was allogeneic BMT from an unrelated donor. There was a negative correlation with PBSC grafts. All the patients infected with an enteric virus had concomitant infection with other pathogens, compared to only 18% of uninfected patients (P = 0.001). The non-relapse mortality of the infected patients was 50% and only 7% in the uninfected patients (P = 0.01, OR = 12.5), although the isolated virus was the direct cause of death in one patient only. This study indicates a low rate of enteric virus isolation in recipients of PBSC grafts, both autologous and allogeneic. However, unrelated donor BMT is associated with a higher risk of enteric virus infection and an adverse outcome. Bone Marrow Transplantation (2000) 25, 277-282.     

Minimal variation in T-20 binding domain of different HIV-1 subtypes from antiretroviral-naive and -experienced patients

In-vitro differences in T-20 susceptibility among HIV-1 subtypes have been reported. We therefore studied the T-20 binding domain of a variety of virus subtypes from both antiretroviral-naive and -experienced patients. Minimal variation in the HR-1 region of gp41 was observed, especially within the region responsible for T-20 resistance. Any subtype differences in T-20 susceptibility do not appear to be related to HR-1 genetic variation.     

Morphology of sporadic colorectal cancer with DNA replication errors

Background—Up to 15% of colorectal cancers arecharacterised by DNA microsatellite instability (MIN), shown by thepresence of DNA replication errors (RERs).
Aims—To identify pathological features that arediscriminating for colorectal cancer (CRC) showing extensive MIN.
Subjects—A prospective series of 303 patientswith CRC and no family history of either familial adenomatous polyposisor hereditary non-polyposis colorectal cancer.
Methods—DNA was extracted from fresh tissuesamples and the presence of MIN was studied at nine loci that includedTGFβRII, IGFIIR, and BAX. The 61 cases showing RERs were comparedwith 63 RER negative cases with respect to a comprehensive set ofclinical and pathological variables. Predictive utility of thevariables was tested by decision tree analysis.
Results—Twenty seven patients with CRC showedextensive RERs (three loci or more) (RER+) and 34 had limited RERs only(28= one locus; 6 = two loci) (RER+/−), yielding a bimodaldistribution. RER+ cancers differed from RER− and RER+/− cases.Tumour type (adenocarcinoma, mucinous carcinoma, and undifferentiatedcarcinoma) (p=0.001), tumour infiltrating lymphocytes (p=0.001), andanatomical site (p=0.001) were the most significant of thediscriminating variables. Algorithms developed by decision treeanalysis allowed cases to be assigned to RER+ versus RER− and +/−status with a global sensitivity of 81.5%, specificity of 96%, andoverall accuracy of 93%.
Conclusion—Pathological examination of CRC allowsassignment of RER+ status; assignment is specific and relativelysensitive. Conversely RER− and RER+/− CRC are indistinguishable.

Keywords:colon; rectum; colorectal cancer; DNA replicationerrors; morphology; microsatellite instability