37 research outputs found

    A Fe2+-dependent self-inhibited state influences the druggability of human collagen lysyl hydroxylase (LH/PLOD) enzymes

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    Multifunctional human collagen lysyl hydroxylase (LH/PLOD) enzymes catalyze post-translational hydroxylation and subsequent glycosylation of collagens, enabling their maturation and supramolecular organization in the extracellular matrix (ECM). Recently, the overexpression of LH/PLODs in the tumor microenvironment results in abnormal accumulation of these collagen post-translational modifications, which has been correlated with increased metastatic progression of a wide variety of solid tumors. These observations make LH/PLODs excellent candidates for prospective treatment of aggressive cancers. The recent years have witnessed significant research efforts to facilitate drug discovery on LH/PLODs, including molecular structure characterizations and development of reliable high-throughput enzymatic assays. Using a combination of biochemistry and in silico studies, we characterized the dual role of Fe2+ as simultaneous cofactor and inhibitor of lysyl hydroxylase activity and studied the effect of a promiscuous Fe2+ chelating agent, 2,2'-bipyridil, broadly considered a lysyl hydroxylase inhibitor. We found that at low concentrations, 2,2'-bipyridil unexpectedly enhances the LH enzymatic activity by reducing the inhibitory effect of excess Fe2+. Together, our results show a fine balance between Fe2+-dependent enzymatic activity and Fe2+-induced self-inhibited states, highlighting exquisite differences between LH/PLODs and related Fe2+, 2-oxoglutarate dioxygenases and suggesting that conventional structure-based approaches may not be suited for successful inhibitor development. These insights address outstanding questions regarding druggability of LH/PLOD lysyl hydroxylase catalytic site and provide a solid ground for upcoming drug discovery and screening campaigns

    Cheese trademarks: Italian dairy firms’ practices during the 20th century

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    Trademarks have recently become a very useful sources for business historians. This longitudinal analysis of the twentieth-century trademarking activities of the most important Italian dairy firms of the era, namely Galbani, Invernizzi and Locatelli, demonstrates that trademarks were used both as a protective weapon against competitors and as an innovation carrier to open up new markets. This article also argues that trademark registrations had another dual purpose – not only were they used as buffers against negative shocks but they were also used to support periods of economic growth. A fundamental finding of this work is that trademarks, across various types of registrations, were closely connected to the features on which the companies based their sales strategies

    Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

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    Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

    Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

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    Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

    [Clinical significance of the role of left ventricular cavitation ratio in the assessment of coronary artery disease with 99mTc-tetrofosmin]

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    This study was aimed at assessing the increase in left ventricular cavity volume in patients with induced stress ischemia, by the quantitative analysis of myocardial SPECT perfusion images obtained 30-45 min after 99mTc-Tetrofosmin injection. PATIENTS AND METHODS: 31 consecutive patients with suspected CAD (group A) and 16 low risk CAD subjects (group B) underwent the study. Global (GMPR) and regional myocardial perfusion reserve indices were assessed superimposing a 17 ROI mask on stress and rest bull's eye images. Ventricular cavitation index (VCI) was calculated manually, outlining the left ventricular cavity on stress and rest midventricular SPECT slices. L/H ratio was determined on anterior SPECT images. RESULTS: On the basis of perfusion patterns, group A was divided into two subgroups: subgroup 1 included the patients with reversible perfusion defects (n = 20) and subgroup B those with irreversible perfusion defects (n = 11). Average stress CI was significantly higher in group A than in group B (p < 0.01) and in subgroup 1 than in group B (p < 0.005). Rest CVI, GMPR and L/H ratio showed no significant intergroup differences. The stress VCI to rest VCI ratio (VCI ratio) was higher in subgroup 1 than group B (p < 0.0001) and in subgroup 1 than in subgroup 2 (p < 0.01). Moreover, VCI ratio was higher in group A than in group B. CONCLUSION: These preliminary data show that, in ischemic patients, left ventricular cavity volume increases after stress also in 99mTc-Tetrofosmin images. Since our images were acquired 30-45 min after stress, when the dilatation due to ventricular dysfunction is usually resolved, the volume increase may be caused by a cavitation effect due to reduced intracardiac blood flow

    Tc-99m tetrofosmin lymph node uptake in myocardial perfusion imaging

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    A 60-year-old man, who was believed to have angina, underwent Tc-99m Tetrofosmin SPECT imaging during rest myocardial perfusion study, which showed an abnormal uptake with visualization of left axillary lymph nodes. Further investigation with Tc-99m nanocolloid lymphoscintigraphy and left axillary echography did not show neoplastic axillary lymph node enlargement. Abnormal lymph node uptake was probably due to lymphatic drainage after partial extravasation of radiopharmaceutical during left arm intravenous injection
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