Intrahost Selection Pressures Drive Rapid Dengue Virus Microevolution in Acute Human Infections.

Dengue, caused by four dengue virus serotypes (DENV-1 to DENV-4), is a highly prevalent mosquito-borne viral disease in humans. Yet, selection pressures driving DENV microevolution within human hosts (intrahost) remain unknown. We employed a whole-genome segmented amplification approach coupled with deep sequencing to profile DENV-3 intrahost diversity in peripheral blood mononuclear cell (PBMC) and plasma samples from 77 dengue patients. DENV-3 intrahost diversity appears to be driven by immune pressures as well as replicative success in PBMCs and potentially other replication sites. Hotspots for intrahost variation were detected in 59%-78% of patients in the viral Envelope and pre-Membrane/Membrane proteins, which together form the virion surface. Dominant variants at the hotspots arose via convergent microevolution, appear to be immune-escape variants, and were evolutionarily constrained at the macro level due to viral replication defects. Dengue is thus an example of an acute infection in which selection pressures within infected individuals drive rapid intrahost virus microevolution

IN VITRO AND IN VIVO DISPOSITION OF 2,2-DIMETHYL-N-(2,4,6- TRIMETHOXYPHENYL)DODECANAMIDE (CI-976) Identification of a Novel Five-Carbon Cleavage Metabolite in Rats

ABSTRACT: The metabolism of CI-976, a potent inhibitor of liver and intestinal acyl coenzyme A:cholesterol acyltransferase, was investigated in isolated rat hepatocytes and Wistar rats after oral administration. The major metabolite observed both in vitro and in vivo was identified as the 6-carbon, chain-shortened 5,5-dimethyl-6-oxo-[(2,4,6-trimethoxyphenyl)amino]hexanoic acid (M-4). M-4 was determined to be formed from the -carboxylic acid 11,11-dimethyl-12-oxo ACAT 2 , (E.C. 2.3.1.1.26) is a key enzyme involved in cholesterol absorption from the gastrointestinal tract and cholesterol deposition in the body (1). The therapeutic potential of ACAT inhibitors as lipid lowering and antiatherosclerotic agents has been postulated for the treatment of hypercholesterolemia (2). The fatty acid anilide, CI-976 ( In vivo pharmacokinetic studies in male rats found CI-976 to have moderate absorption and bioavailability (29%), with an intravenous elimination half-life of 8 hr (6). After intravenous or oral administration to male rats, CI-976 was extensively metabolized to a single major urinary metabolite identified as M-4 ( To understand further the metabolism of CI-976, studies to determine the disposition and metabolism in rats were performed. The metabolism of CI-976 was examined both in hepatocyte suspensions and after oral administration to both male and female rats. In these studies, the metabolic pathways leading to the formation of M-4 were explored using metabolic intermediates as substrates, and by examining the effects of various inhibitors and inducers on the metabolism of CI-976 in hepatocyte incubations. Metabolites found in postreaction hepatocyte incubations and rat urine were characterized by HPLC, LC/MS, and GC/MS. Similar types of experiments were conducted with a new metabolite observed both in vitro and in vivo, which arises from an unusual mechanism (i.e. removal of 5-carbon units from the CI-976 fatty acid side chain). Materials and Methods CI-976 and [ 14 C]CI-976 (20.72 Ci/mg ring-labeled, 99.5% chemical and radiochemical purity); methyl-5,5-dimethyl-6-oxo-6-[(2,4,6-trimethoxyphe

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

“Second chance to save your tooth” - A case report

Retreatment in endodontics provides a second chance for the patient to save the tooth that would otherwise be deemed for extraction. Treatment approach can be either surgical or non surgical. Treatment failure can be due to many reasons from missed canal to iatrogenic perforation which has to be evaluated carefully before initiating the treatment. Sometimes a clinician also has to deal with inter appointment fl are ups requiring prompt and efficient patient management. This case report describes the non surgical management of failed root filled teeth. &nbsp

Intrahost Selection Pressures Drive Rapid Dengue Virus Microevolution in Acute Human Infections.

Dengue, caused by four dengue virus serotypes (DENV-1 to DENV-4), is a highly prevalent mosquito-borne viral disease in humans. Yet, selection pressures driving DENV microevolution within human hosts (intrahost) remain unknown. We employed a whole-genome segmented amplification approach coupled with deep sequencing to profile DENV-3 intrahost diversity in peripheral blood mononuclear cell (PBMC) and plasma samples from 77 dengue patients. DENV-3 intrahost diversity appears to be driven by immune pressures as well as replicative success in PBMCs and potentially other replication sites. Hotspots for intrahost variation were detected in 59%-78% of patients in the viral Envelope and pre-Membrane/Membrane proteins, which together form the virion surface. Dominant variants at the hotspots arose via convergent microevolution, appear to be immune-escape variants, and were evolutionarily constrained at the macro level due to viral replication defects. Dengue is thus an example of an acute infection in which selection pressures within infected individuals drive rapid intrahost virus microevolution