Is High-Dose Leuprorelin Acetate Effective and Safe in Asian Men with Prostate Cancer? An Open-Label,Non-Comparative,Multi-Center Clinical Trial

Purpose

Leuprorelin is a well known luteinizing hormone releasing hormone agonist. However, there are insufficient data on the efficacy and safety of high dose leuprorelin acetate, especially in Asian patients with prostate cancer. We aimed to investigate the safety and efficacy of leuprorelin acetate 22.5 mg administered at three-month intervals in patients with prostate cancer.

Materials and Methods

In an open, prospective clinical trial enrolling 47 patients, we aimed to assess the efficacy and safety of leuprorelin acetate 22.5 mg in treating patients with histologically confirmed prostate cancer. The primary objective of this study was to evaluate the efficacy of the leuprorelin acetate 22.5 mg in producing and maintaining castration levels of testosterone over a 6-month follow-up period and to determine its safety profile.

Results

All 42 patients achieved serum testosterone levels within the castration range by 4 weeks. A breakthrough response was observed in one of 36 patients by 8 weeks. However, this patient was medically castrated by 12 weeks. There were no significant prostate-specific antigen (PSA) or testosterone changes according to clinical stage or body mass index. Twenty adverse events (AEs) in 15 of 42 patients (35.7%) were observed during this study. The most common AEs were hot flushes (n=4, 20.0%) with mild intensity, pain (n=2, 10.0%), and infection (n=2, 10.0%). No patient withdrew from the study due to AEs.

Conclusion

Leuprorelin acetate 22.5 mg was shown to be effective and safe in Asian patients with prostate cancer, even though sexual function decreased.     

Antimycobacterial activity of Pichia pastoris-derived mature bovine neutrophil β-defensins 5

Tuberculosis (TB) is an ongoing threat to global health, and the lack of effective therapies for treating it is also a global problem. Previous studies have shown that human cathelicidin and defensins have effective antimicrobial activity against Mycobacterium spp. To our knowledge, there are no reports on the antimycobacterial effects of bovine neutrophil β-defensins so far. Here, we identified the antimicrobial effect of mature bovine neutrophil β-defensins (mBNBD) 5 against Mycobacterium infection both in vitro and in vivo. The mBNBD5 protein was expressed in Pichia pastoris. To increase the yield of β-defensins, a purification method was employed by adding a 6-His·tag to the C-terminus of the mBNBD5 gene. Our results indicated that recombinant mBNBD5 protein was successfully expressed and purified from Pichia pastoris with intact antimicrobial activity. The recombinant protein exhibited potent bactericidal activity in vitro against M. smegmatis and M. bovis, with a dose-dependent manner and a time-dependent manner. The electron microscope results showed that the bacterial cell wall of M. bovis was disrupted when incubated with mBNBD5 for 72 h. Our data also indicated that the exogenous addition of mBNBD5 could reduce the survival of Mycobacterium spp., especially M. tuberculosis and M. bovis in RAW 264.7 macrophages. These results provide foundations for the development of mBNBD5 as a potential new therapeutic agent for TB treatment.     

Apnea‐related sleep fragmentation and poor vigilance in children with well‐controlled asthma

It has been reported that sleep problems and neurocognitive deficit in asthmatic children is prevalent. However, systematic studies on these problems in stable asthma using polysomnography have rarely been performed. We therefore investigated sleep and neurocognitive functioning in children with well‐controlled asthma. Forty‐three children with well‐controlled, stable asthma and 31 controls (age range: 6–9 years) were enrolled in the study. Subjects were questioned for daytime sleepiness using the Paediatric Daytime Sleepiness Scale. Complete overnight polysomnography and neurocognitive function tests were performed on all subjects. Children with stable asthma had lower pulmonary function in comparison to their age‐matched controls. Asthmatic children had a higher apnea–hypopnea index (P < 0.001) and apnea–hypopnea‐related arousal index (P < 0.001) as compared with non‐asthmatics. Deep sleep was decreased in asthmatics (P = 0.001). In the vigilance test, the mean number of correct answers was lower (P = 0.005) and the mean reaction time was slower (P = 0.002) in asthmatic children. A hierarchical multiple linear regression showed that deep sleep and apnea–hypopnea‐related arousal index were significant predictors of vigilance. The data suggest that the prevalence of paediatric sleep‐disordered breathing and sleep fragmentation could be very high among children with well‐controlled asthma. Moreover, vigilance, the ability to maintain attention and alertness, was worse in stable asthmatic children when compared with healthy controls. Sleep‐disordered breathing should be checked even in stable asthmatic children as they are at risk for developing neurobehavioural deterioration associated with frequent arousals during sleep. Furthermore, early treatment for asthma may be required in order to prevent airway remodelling that could cause sleep problems.     

姜黄素对骨髓瘤细胞迁移和侵袭能力的影响及其机制研究

 目的：探讨姜黄素对骨髓瘤细胞迁移侵袭能力的影响及其机制。方法：shRNA表达质粒沉默含IQ模序的RasGTP酶活化蛋白1(IQ motif-containing GTPase-activating protein 1,IQGAP1)后转染RPMI8226细胞,Western blotting法检测RPMI8226-shIQGAP1组、RPMI8226-shRNA阴性对照组和未转染RPMI8226组细胞IQGAP1表达;不同浓度姜黄素作用于各组细胞后,Transwell迁移实验和Matrigel侵袭实验检测细胞的迁移及侵袭力,RT-PCR法检测姜黄素作用后IQGAP1 mRNA的表达,Western blotting检测姜黄素对各组细胞IQGAP1蛋白表达的影响。结果：使用shRNA表达质粒沉默IQGAP1后,RPMI8226细胞IQGAP1表达减少;RPMI8226-shIQGAP1组较RPMI8226-shRNA 阴性对照组和未转染RPMI8226 组细胞迁移及侵袭力下降,姜黄素可降低RPMI8226-shRNA 阴性对照组和未转染RPMI8226组细胞迁移及侵袭力,无浓度相关性,不同浓度的姜黄素对RPMI8226-shIQGAP1组作用后细胞的迁移及侵袭力无明显变化。对于RPMI8226-shRNA阴性对照组及未转染RPMI8226组,姜黄素作用后IQGAP1 mRNA及蛋白的表达下降。结论：姜黄素通过抑制IQGAP1的表达降低骨髓瘤细胞的迁移力和侵袭力。     

Blockade of the T cell immunoglobulin and mucin domain protein 3 pathway exacerbates sepsis-induced immune deviation and immunosuppression

Sepsis is a life-threatening condition, but the pathophysiological basis and biomarkers for the monitoring of sepsis and as targets for therapy remain to be determined. We have shown previously that T cell immunoglobulin and mucin domain protein 3 (Tim-3), a negative immune regulator, is involved in the physiopathology of sepsis, but the underlying mechanisms remain unclear. In the present study, we showed that Tim-3 signalling modulated the response patterns of both macrophages and T helper cells in sepsis. Blockade of the Tim-3 pathway exacerbated sepsis-induced proinflammatory macrophage responses and lymphocyte apoptosis during the early phase of sepsis, and enhanced the shift to anti-inflammatory responses for both macrophages and T helper cells during the late phase of sepsis. Tim-3 signalling was found to regulate CD80 and CD86 expression on macrophages both in vivo and in vitro. Co-culture of T cells with Tim-3 knock-down macrophages led to a biased T helper type 2 (Th2) response, partially explaining how Tim-3 signalling shapes inflammation patterns in vivo. Further studies on this pathway might shed new light on the pathogenesis of sepsis and suggest new approaches for intervention.     

An efficient Au catalyst supported on hollow carbon spheres for acetylene hydrochlorination

Mesoporous hollow carbon spheres (HCSs) were prepared using SiO₂ spheres as a hard template, and Au nanoparticles were then synthesized using NaBH₄ as a reducing agent on the surface of the HCS support. Transmission electron microscopy characterization indicated that Au nanoparticles were much smaller on the HCS support than those on the active carbon (AC) support. HCl-TPD showed that the Au/HCS catalyst displayed a more active site than on Au/AC. The resulting Au/HCS catalyst showed excellent catalytic activity and stability for acetylene hydrochlorination. Acetylene conversion of Au/HCS can be maintained above 92% even after 500 h of lifetime. The excellent catalytic performance of Au/HCS was attributed to the presence of the HCS support, which limited the aggregation of Au nanoparticles.

Mesoporous hollow carbon spheres (HCS) were prepared and applied as the support of Au catalyst for acetylene hydrochlorination. Au/HCS exhibited excellent stability for acetylene hydrochlorination.     

Vaccinia‐based influenza vaccine overcomes previously induced immunodominance hierarchy for heterosubtypic protection

Growing concerns about unpredictable influenza pandemics require a broadly protective vaccine against diverse influenza strains. One of the promising approaches was a T cell‐based vaccine, but the narrow breadth of T‐cell immunity due to the immunodominance hierarchy established by previous influenza infection and efficacy against only mild challenge condition are important hurdles to overcome. To model T‐cell immunodominance hierarchy in humans in an experimental setting, influenza‐primed C57BL/6 mice were chosen and boosted with a mixture of vaccinia recombinants, individually expressing consensus sequences from avian, swine, and human isolates of influenza internal proteins. As determined by IFN‐γ ELISPOT and polyfunctional cytokine secretion, the vaccinia recombinants of influenza expanded the breadth of T‐cell responses to include subdominant and even minor epitopes. Vaccine groups were successfully protected against 100 LD₅₀ challenges with PR/8/34 and highly pathogenic avian influenza H5N1, which contained the identical dominant NP₃₆₆ epitope. Interestingly, in challenge with pandemic A/Cal/04/2009 containing mutations in the dominant epitope, only the group vaccinated with rVV‐NP + PA showed improved protection. Taken together, a vaccinia‐based influenza vaccine expressing conserved internal proteins improved the breadth of influenza‐specific T‐cell immunity and provided heterosubtypic protection against immunologically close as well as distant influenza strains.     

Lack of transglutaminase 2 diminished T‐cell responses in mice

Transglutaminase 2 (TG2) has been reported to play a role in dendritic cell activation and B‐cell differentiation after immunization. Its presence and role in T cells, however, has not been explored. In the present study, we determined the expression of TG2 on mouse T cells, and evaluated its role by comparing the behaviours of wild‐type and TG2^?/? T cells after activation. In our results, naive T cells minimally expressed TG2, expression of which was increased after activation. T‐cell proliferation, expression of activation markers such as CD69 and CD25, and secretions of interleukin‐2 and interferon‐γ were suppressed in the absence of TG2, presumably due, in part, to diminished nuclear factor‐κB activation. These effects on T cells seemed to be reflected in the in vivo immune response, the contact hypersensitivity reaction elicited by 2,4‐dinitro‐1‐fluorobenzene, with lowered peak responses in the TG2^?/? mice. When splenic T cells from mice immunized with tumour lysate‐loaded wild‐type dendritic cells were re‐challenged ex vivo with the same antigen, the profile of surface markers including CD44, CD62L, and CD127 strongly indicated lesser generation of memory CD8⁺ T cells in TG2^?/? mice. In the TG2^?/? CD8⁺ T cells, moreover, Eomes expression was markedly decreased. These results indicate possible roles of TG2 in CD8⁺ T‐cell activation and CD8⁺ memory T‐cell generation.     

Teeth clenching reduces arm abduction force

It has been reported that the 90° arm abduction force counteracting external adduction loads appeared to be smaller under teeth clenching condition than under non-clenching condition. To elucidate the physiological mechanism underlying the possible inhibitory effect of teeth clenching on the arm abduction, we have attempted to quantify the difference in the force induced against the fast and slow ramp load between the arm abductions under teeth non-clenching and clenching conditions. When the load of adduction moment was linearly increased, the abductor force increased to a maximal isometric contraction force (MICF) and further increased to a maximal eccentric contraction force (MECF) with forced adduction. The MICF measured under teeth clenching was significantly lower than that under non-clenching, despite no significant difference in the MECF between the two conditions. The reduction in MICF caused by teeth clenching was enhanced by increasing the velocity of the load. These results suggest that clenching inhibits abduction force only during isometric contraction phase. The invariability of MECF would indicate the lack of involvement of fatigue in such inhibitory effects of clenching. To discover the source of the inhibition, we have examined the effects of teeth clenching on the stretch reflex in the deltoid muscle. The stretch reflex of deltoid muscles was inhibited during clenching, contrary to what was expected from the Jendrassik maneuver. Taken together, our results suggest that the teeth clenching reduced the MICF by depressing the recruitment of deltoid motoneurones presumably via the presynaptic inhibition of spindle afferent inputs onto those motoneurones.     

Mycobacterial Gene cuvA Is Required for Optimal Nutrient Utilization and Virulence

To persist and cause disease in the host, Mycobacterium tuberculosis must adapt to its environment during infection. Adaptations include changes in nutrient utilization and alterations in growth rate. M. tuberculosis Rv1422 is a conserved gene of unknown function that was found in a genetic screen to interact with the mce4 cholesterol uptake locus. The Rv1422 protein is phosphorylated by the M. tuberculosis Ser/Thr kinases PknA and PknB, which regulate cell growth and cell wall synthesis. Bacillus subtilis strains lacking the Rv1422 homologue yvcK grow poorly on several carbon sources, and yvcK is required for proper localization of peptidoglycan synthesis. Here we show that Mycobacterium smegmatis and M. tuberculosis strains lacking Rv1422 have growth defects in minimal medium containing limiting amounts of several different carbon sources. These strains also have morphological abnormalities, including shortened and bulging cells, suggesting a cell wall defect. In both mycobacterial species, the Rv1422 protein localizes uniquely to the growing cell pole, the site of peptidoglycan synthesis in mycobacteria. An M. tuberculosis ΔRv1422 strain is markedly attenuated for virulence in a mouse infection model, where it elicits decreased inflammation in the lungs and shows impaired bacterial persistence. These findings led us to name this gene cuvA (carbon utilization and virulence protein A) and to suggest a model in which deletion of cuvA leads to changes in nutrient uptake and/or metabolism that affect cell wall structure, morphology, and virulence. Its role in virulence suggests that CuvA may be a useful target for novel inhibitors of M. tuberculosis during infection.