Cancer: Global Health Perspectives

Chemotherapy to patients with cancer remains an effective mode of treatment of the disease, but it is associated with many side effects including mild or dose-­‐limiting toxicities such as alopecia, myelosuppression, gastrointestinal dysfunctions, neurologic toxicities, and immune suppression which results in infections and cancer cell proliferation. Although economic analysis of treatment in health care systems may be applied to the full range of interventions that make up a cancer service, the economic impact of cancer in health care systems remains one where much attention, in the context of complementary medicine, needs to be directed. Predicting the cost-­‐ effectiveness of developing prevention, screening and treatment strategies continue to be the focus strategies to optimize cancer care. KEY WORDS: Cancer; Global health perspectives; Palliative care; Stem cell cancer; Dietary components and chemopreventio

Metabolic Homeostasis, Biomarkers and Medical Education Assessment

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Rethinking conventional approaches to the detection, management and amelioration of disease

The linear-leafed water primrose (Ludwigia hyssopifolia), with its distinctive yellow flowers and matted undergrowth, is easily recognized along paddy fields and tropical wetlands especially in South and South-East Asia. Also known as the seedbox because of its distinctive dimorphic seeds, it has the potential of being an invasive pest and is classed a ‘serious’ or ‘principal’ weed in many countries. It is used locally for composting and in the concoction of traditional remedies in an unscientific and informal manner. In common with other plants of the willow herb or evening primrose family, this weed could turn out to have immense and economically viable pharmaceutical potential. Das et al have reported moderate anti-tumor and antibacterial activities in extracts and in an alkaloid piperine from L. hyssopifolia and Mohammad et al demonstrated anti-­‐diarrheal properties in a methanol extract. It is noteworthy along the same line that the work by Luximon‐Ramma, et al on Mauritian Exotic fruits strongly advocated the use of the red and yellow Psidium cattleianum Sabine ‘Chinese guava’, in nutritional programs due to their exceptionally high antioxidant potencies attributed to their rich vitamin C and phytophenolic profiles. These plants are also generally considered as invasive causing havoc amidst the protected endemics of the island and sing an ecological conservation approach, indeed legitimate, to safeguard threatened plants from extinction, the systematic removal of Chinese Guava trees may deprive us of important sources of active nutritional biofactors. In a study that features in this issue of the Archives Of Medical And Biomedical Research, Scientists at the University Of Dhaka have further formalized the pharmacotherapeutic potential that this much-­‐derided weed may hold. They studied the effects of hexane, ethyl acetate and methanol extracts of whole plant parts of Ludwigia hyssopifolia on carrageenan-induced paw edema, acetic acid‐induced writhing, and diuresis in mice. The Hexane extract and ethyl acetate extract showed significant inhibition of experimental paw edema. All three fractions significantly inhibited writhing and, in comparison to furosemide, exhibited good diuretic activity

Molecular Basis of ß-­arrestin Coupling to Formoterol-­Bound ß1-­adrenoceptor

The β1-adrenoceptor (β1AR) is a G-protein-coupled receptor (GPCR) that couples1 to the heterotrimeric G protein Gs. G-protein-mediated signalling is terminated by phosphorylation of the C terminus of the receptor by GPCR kinases (GRKs) and by coupling of β-arrestin 1 (βarr1, also known as arrestin 2), which displaces Gs and induces signalling through the MAP kinase pathway2. The ability of synthetic agonists to induce signalling preferentially through either G proteins or arrestins-known as biased agonism3-is important in drug development, because the therapeutic effect may arise from only one signalling cascade, whereas the other pathway may mediate undesirable side effects4. To understand the molecular basis for arrestin coupling, here we determined the cryo-electron microscopy structure of the β1AR-βarr1 complex in lipid nanodiscs bound to the biased agonist formoterol5, and the crystal structure of formoterol-bound β1AR coupled to the G-protein-mimetic nanobody6 Nb80. βarr1 couples to β1AR in a manner distinct to that7 of Gs coupling to β2AR-the finger loop of βarr1 occupies a narrower cleft on the intracellular surface, and is closer to transmembrane helix H7 of the receptor when compared with the C-terminal α5 helix of Gs. The conformation of the finger loop in βarr1 is different from that adopted by the finger loop of visual arrestin when it couples to rhodopsin8. β1AR coupled to βarr1 shows considerable differences in structure compared with β1AR coupled to Nb80, including an inward movement of extracellular loop 3 and the cytoplasmic ends of H5 and H6. We observe weakened interactions between formoterol and two serine residues in H5 at the orthosteric binding site of β1AR, and find that formoterol has a lower affinity for the β1AR-βarr1 complex than for the β1AR-Gs complex. The structural differences between these complexes of β1AR provide a foundation for the design of small molecules that could bias signalling in the β-adrenoceptors

Genetically encoded intrabody sensors report the interaction and trafficking of β-arrestin 1 upon activation of G protein-coupled receptors

Agonist stimulation of G protein-coupled receptors (GPCRs) typically leads to phosphorylation of GPCRs and binding to multifunctional proteins called β-arrestins (βarrs). The GPCR-βarr interaction critically contributes to GPCR desensitization, endocytosis, and downstream signaling, and GPCR-βarr complex formation can be used as a generic readout of GPCR and βarr activation. Although several methods are currently available to monitor GPCR-βarr interactions, additional sensors to visualize them may expand the toolbox and complement existing methods. We have previously described antibody fragments (FABs) that recognize activated βarr1 upon its interaction with the vasopressin V2 receptor C-terminal phosphopeptide (V2Rpp). Here, we demonstrate that these FABs efficiently report the formation of a GPCR-βarr1 complex for a broad set of chimeric GPCRs harboring the V2R C terminus. We adapted these FABs to an intrabody format by converting them to single-chain variable fragments (ScFvs) and used them to monitor the localization and trafficking of βarr1 in live cells. We observed that upon agonist simulation of cells expressing chimeric GPCRs, these intrabodies first translocate to the cell surface, followed by trafficking into intracellular vesicles. The translocation pattern of intrabodies mirrored that of βarr1, and the intrabodies co-localized with βarr1 at the cell surface and in intracellular vesicles. Interestingly, we discovered that intrabody sensors can also report βarr1 recruitment and trafficking for several unmodified GPCRs. Our characterization of intrabody sensors for βarr1 recruitment and trafficking expands currently available approaches to visualize GPCR-βarr1 binding, which may help decipher additional aspects of GPCR signaling and regulation

Patterning in Birthweight in India: Analysis of Maternal Recall and Health Card Data

National data on birthweight from birth certificates or medical records are not available in India. The third Indian National Family Health Survey included data on birthweight of children obtained from health cards and maternal recall. This study aims to describe the population that these data represent and compares the birthweight obtained from health cards with maternal recall data in terms of its socioeconomic patterning and as a risk factor for childhood growth failure.The analytic sample consisted of children aged 0 to 59 months with birthweight data obtained from health cards (n = 3227) and maternal recall (n = 16,787). The difference between the card sample and the maternal recall sample in the distribution across household wealth, parental education, caste, religion, gender, and urban residence was compared using multilevel models. We also assessed the ability of birthweight to predict growth failure in infancy and childhood in the two groups. The survey contains birthweight data from a majority of household wealth categories (>5% in every category for recall), both genders, all age groups, all caste groups, all religion groups, and urban and rural dwellers. However, children from the lowest quintile of household wealth were under-represented (4.73% in card and 8.62% in recall samples). Comparison of data across health cards and maternal recall revealed similar social patterning of low birthweight and ability of birthweight to predict growth failure later in life. Children were less likely to be born with low birthweight if they had mothers with over 12 years of education compared to 1-5 years of education with relative risk (RR) of 0.79 (95% confidence interval [CI]: 0.52, 1.2) in the card sample and 0.70 (95% CI: 0.59, 0.84) in the recall sample. A 100 gram difference in a child's birthweight was associated with a decreased likelihood of underweight in both the card (RR: 0.95; 95% CI: 0.94, 0.96) and recall (RR: 0.96; 95% CI: 0.96, 0.97) samples.Our results suggest that in the absence of other sources, the data on birthweight in the third Indian National Family Health Survey is valuable for epidemiologic research

Multiplicity Distributions and Charged-neutral Fluctuations

Results from the multiplicity distributions of inclusive photons and charged particles, scaling of particle multiplicities, event-by-event multiplicity fluctuations, and charged-neutral fluctuations in 158$\cdot A$ GeV Pb+Pb collisions are presented and discussed. A scaling of charged particle multiplicity as $N_{part}^{1.07\pm 0.05}$ and photons as $N_{part}^{1.12\pm 0.03}$ have been observed, indicating violation of naive wounded nucleon model. The analysis of localized charged-neutral fluctuation indicates a model-independent demonstration of non-statistical fluctuations in both charged particles and photons in limited azimuthal regions. However, no correlated charged-neutral fluctuations are observed.Comment: Talk given at the International Symposium on Nuclear Physics (ISNP-2000), Mumbai, India, 18-22 Dec 2000, Proceedings to be published in Pramana, Journal of Physic