A multi-modality approach for enhancing the diagnosis of cholangiocarcinoma

Background: Cholangiocarcinoma (CC) is a malignancy of the bile ducts and mortality is high as patients present too late for curative surgery. In most cases of CC the aetiology is unknown, whilst diagnosis and staging are challenging. The hepatobiliary system excretes carcinogenic toxins and genetic mutations in biliary transporters lead to dysfunction and cholestasis, potentially contributing to cholangiocarcinogenesis. Polymorphisms in the NKG2D receptor have previously been associated with CC in primary sclerosing cholangitis (PSC). Such a role has not been investigated in sporadic CC. CC is difficult to diagnose, particularly in those with PSC. The transition from benign to malignant biliary disease is likely to be reflected in changes to the plasma proteome. However, current plasma biomarkers do not reliably distinguish benign from malignant biliary strictures. Elevation of neutrophil gelatinase-associated lipocalin (NGAL) has been demonstrated in the bile of patients with CC but has not been investigated as a plasma protein biomarker. Staging of CC is inaccurate, with only a minority of operated patients cured. Higher resolution MRI would improve diagnosis and staging. The work presented in this thesis represents a multimodality approach to enhance the diagnosis of CC: Genetic studies: Genetic variation in major biliary transporter proteins, and the NKG2D receptor, were investigated. Single nucleotide polymorphisms (SNPs) in candidate genes were selected using HapMap. DNA from 173 CC patients and 265 healthy controls was genotyped. SNPs in ABCB11, MDR3 and ATP8B1 were nominally associated with altered susceptibility to CC, suggesting a potential role in cholangiocarcinogenesis. The previous association of NKG2D variation with CC in PSC was not replicated in sporadic CC, suggesting a possible difference in pathogenesis. Protein studies: Plasma from subjects with CC, benign disease, and from healthy controls was studied. Two proteomic techniques, liquid chromatography-tandem mass spectrometry (LCMS/ MS) and surfaced enhanced laser desorption ionization time-of-flight MS (SELDITOF MS), were utilised. Differentially expressed proteins were identified where possible. LC-MS/MS fully identified six proteins that were differentially expressed in CC compared to gall stone disease patients. SELDI-TOF MS identified seven m/z peaks that showed significant utility in discriminating CC from PSC controls. An ELISA approach was used to study plasma NGAL levels in CC. Although differentially expressed between CC and healthy control groups, the utility of NGAL in discriminating CC from PSC was limited. Imaging studies: An endoscope-mounted MR coil and intraductal MR detector coil were developed. Quantitative resolution and signal-to-noise-ratio (SNR) testing, and qualitative tissue discrimination appraisal, were undertaken. Sub-0.7mm resolution and excellent SNRs have been demonstrated. High-resolution has been demonstrated in imaged tissue. Imaging with the new devices compares favourably with endoscopic ultrasound imaging

A polymer coated cicaprost-eluting stent increases neointima formation and impairs vessel function in the rabbit iliac artery

Drug-eluting stents have been successful in reducing in-stent restenosis but are not suitable for all lesion types and have been implicated in causing late stent thrombosis due to incomplete regeneration of the endothelial cell layer. In this study we implanted stents coated with cicaprost, a prostacyclin analogue with a long plasma half-life and antiproliferative effects on vascular smooth muscle cells, into the iliac arteries of rabbits. At 28-day follow-up we compared neointima formation within the stented vessels and vascular function in adjacent vessels, to assess if cicaprost could reduce restenosis without impairing vessel function. Arteries implanted with cicaprost eluting stents had significantly more neointima compared to bare metal stents. In adjacent segments of artery, endothelium-dependent relaxation was impaired by the cicaprost-eluting stent but vasodilation to an endothelium-independent vasodilator was maintained. We conclude that the presence of the polymer and sub-optimal release of cicaprost from the stent may be responsible for the increased neointma and impaired functional recovery of the endothelium observed. Further experiments should be aimed at optimising release of cicaprost and exploring different stent polymer coatings

Axon Guidance: Ephrins at WRK on the Midline

Recent findings indicate that the embryonic motor neurons act as gatekeepers to regulate midline crossing during development of the nematode Caenorhabditis elegans. The newly identified protein WRK-1 and ephrins cooperate to prevent longitudinal axons from crossing the midline

A polymer coated cicaprost-eluting stent increases neointima formation and impairs vessel function in the rabbit iliac artery

Drug-eluting stents have been successful in reducing in-stent restenosis but are not suitable for all lesion types and have been implicated in causing late stent thrombosis due to incomplete regeneration of the endothelial cell layer. In this study we implanted stents coated with cicaprost, a prostacyclin analogue with a long plasma half-life and antiproliferative effects on vascular smooth muscle cells, into the iliac arteries of rabbits. At 28 day follow-up we compared neointima formation within the stented vessels and vascular function in adjacent vessels, to assess if cicaprost could reduce restenosis without impairing vessel function. Arteries implanted with cicaprost eluting stents had significantly more neointima compared to bare metal stents. In adjacent segments of artery, endothelium-dependent relaxation was impaired by the cicaprost-eluting stent but vasodilation to an endothelium-independent vasodilator was maintained. We conclude that the presence of the polymer and sub-optimal release of cicaprost from the stent may be responsible for the increased neointma and impaired functional recovery of the endothelium observed. Further experiments should be aimed at optimising release of cicaprost and exploring different stent polymer coatings

Modelling arterial wall drug concentrations following the insertion of a drug-eluting stent

A mathematical model of a drug-eluting stent is proposed. The model considers a polymer region, containing the drug initially, and a porous region consisting of smooth muscle cells embedded in an extracellular matrix. An analytical solution is obtained for the drug concentration both in the target cells and the interstitial region of the tissue in terms of the drug release concentration at the interface between the polymer and the tissue. When the polymer region and the tissue region are considered as a coupled system it can be shown, under certain assumptions, that the drug release concentration satisfies a Volterra integral equation which must be solved numerically in general. The drug concentrations, both in the cellular and extracellular regions, are then determined from the solution of this integral equation and used in deriving the mass of drug in the cells and extracellular space

Fish Suppressors of Cytokine Signaling (SOCS): Gene Discovery, Modulation of Expression and Function

The intracellular suppressors of cytokine signaling (SOCS) family members, including CISH and SOCS1 to 7 in mammals, are important regulators of cytokine signaling pathways. So far, the orthologues of all the eight mammalian SOCS members have been identified in fish, with several of them having multiple copies. Whilst fish CISH, SOCS3, and SOCS5 paralogues are possibly the result of the fish-specific whole genome duplication event, gene duplication or lineage-specific genome duplication may also contribute to some paralogues, as with the three trout SOCS2s and three zebrafish SOCS5s. Fish SOCS genes are broadly expressed and also show species-specific expression patterns. They can be upregulated by cytokines, such as IFN-γ, TNF-α, IL-1β, IL-6, and IL-21, by immune stimulants such as LPS, poly I:C, and PMA, as well as by viral, bacterial, and parasitic infections in member- and species-dependent manners. Initial functional studies demonstrate conserved mechanisms of fish SOCS action via JAK/STAT pathways

The application of deep eutectic solvent ionic liquids for environmentally-friendly dissolution and recovery of precious metals

publisher: Elsevier articletitle: The application of deep eutectic solvent ionic liquids for environmentally-friendly dissolution and recovery of precious metals journaltitle: Minerals Engineering articlelink: http://dx.doi.org/10.1016/j.mineng.2015.09.026 content_type: article copyright: Copyright © 2015 The Authors. Published by Elsevier Ltd.© 2015 Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Development and evaluation of tailored specific real-time RT-PCR assays for detection of foot-and-mouth disease virus serotypes circulating in East Africa

AbstractRapid, reliable and accurate diagnostic methods provide essential support to programmes that monitor and control foot-and-mouth disease (FMD). While pan-specific molecular tests for FMD virus (FMDV) detection are well established and widely used in endemic and FMD-free countries, current serotyping methods mainly rely either on antigen detection ELISAs or nucleotide sequencing approaches. This report describes the development of a panel of serotype-specific real-time RT-PCR assays (rRT-PCR) tailored to detect FMDV lineages currently circulating in East Africa. These assays target sequences within the VP1-coding region that share high intra-lineage identity, but do not cross-react with FMD viruses from other serotypes that circulate in the region. These serotype-specific assays operate with the same thermal profile as the pan-diagnostic tests making it possible to run them in parallel to produce CT values comparable to the pan-diagnostic test detecting the 3D-coding region. These assays were evaluated alongside the established pan-specific molecular test using field samples and virus isolates collected from Tanzania, Kenya and Ethiopia that had been previously characterised by nucleotide sequencing. Samples (n=71) representing serotype A (topotype AFRICA, lineage G-I), serotype O (topotypes EA-2 and EA-4), serotype SAT 1 (topotype I (NWZ)) and serotype SAT2 (topotype IV) were correctly identified with these rRT-PCR assays. Furthermore, FMDV RNA from samples that did not contain infectious virus could still be serotyped using these assays. These serotype-specific real-time RT-PCR assays can detect and characterise FMDVs currently circulating in East Africa and hence improve disease control in this region

Potent selective inhibitors of protein kinase C

AbstractA series of potent, selective inhibitors of protein kinase C has been derived from the structural lead provided by the microbial broth products, staurosporine and K252a. Our inhibitors block PCK in intact cells (platelets and T cells), and prevent the proliferation of mononuclear cells in response to interleukin 2 (IL2)