A molecular biology and phase II trial of lapatinib in children with refractory CNS malignancies: a pediatric brain tumor consortium study.

High expression of ERBB2 has been reported in medulloblastoma and ependymoma; EGFR is amplified and over-expressed in brainstem glioma suggesting these proteins as potential therapeutic targets. We conducted a molecular biology (MB) and phase II study to estimate inhibition of tumor ERBB signaling and sustained responses by lapatinib in children with recurrent CNS malignancies. In the MB study, patients with recurrent medulloblastoma, ependymoma, and high-grade glioma (HGG) undergoing resection were stratified and randomized to pre-resection treatment with lapatinib 900 mg/m(2) dose bid for 7-14 days or no treatment. Western blot analysis of ERBB expression and pathway activity in fresh tumor obtained at surgery estimated ERBB receptor signaling inhibition in vivo. Drug concentration was simultaneously assessed in tumor and plasma. In the phase II study, patients, stratified by histology, received lapatinib continuously, to assess sustained response. Eight patients, on the MB trial (four medulloblastomas, four ependymomas), received a median of two courses (range 1-6+). No intratumoral target inhibition by lapatinib was noted in any patient. Tumor-to-plasma ratios of lapatinib were 10-20 %. In the 34 patients (14 MB, 10 HGG, 10 ependymoma) in the phase II study, lapatinib was well-tolerated at 900 mg/m(2) dose bid. The median number of courses in the phase II trial was two (range 1-12). Seven patients (three medulloblastoma, four ependymoma) remained on therapy for at least four courses range (4-26). Lapatinib was well-tolerated in children with recurrent or CNS malignancies, but did not inhibit target in tumor and had little single agent activity.Fil: Fouladi, Maryam. St. Jude Children’s Research Hospital; Estados UnidosFil: Stewart, Clinton F.. St. Jude Children’s Research Hospital; Estados UnidosFil: Blaney, Susan M.. Baylor College of Medicine. Texas Children’s Cancer Center; Estados UnidosFil: Onar Thomas, Arzu. St. Jude Children’s Research Hospital; Estados UnidosFil: Schaiquevich, Paula Susana. St. Jude Children’s Research Hospital; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Packer, Roger J.. Children’s National Medical Center; Estados UnidosFil: Goldman, Stewart. Anne and Robert H. Lurie Children’s Hospital of Chicago; Estados UnidosFil: Geyer, J. Rusell. Children’s Hospital and Regional Medical Center; Estados UnidosFil: Gajjar, Amar. St. Jude Children’s Research Hospital; Estados UnidosFil: Kun, Larry E.. St. Jude Children’s Research Hospital; Estados UnidosFil: Boyett, James M.. St. Jude Children’s Research Hospital; Estados UnidosFil: Gilbertson, Richard J.. St. Jude Children’s Research Hospital; Estados Unido

The Cstf2t Polyadenylation Gene Plays a Sex-Specific Role in Learning Behaviors in Mice

Polyadenylation is an essential mechanism for the processing of mRNA 30 ends. CstF-64 (the 64,000 Mr subunit of the cleavage stimulation factor; gene symbol Cstf2) is an RNAbinding protein that regulates mRNA polyadenylation site usage. We discovered a paralogous form of CstF-64 called τCstF-64 (Cstf2t). The Cstf2t gene is conserved in all eutherian mammals including mice and humans, but the τCstF-64 protein is expressed only in a subset of mammalian tissues, mostly testis and brain. Male mice that lack Cstf2t (Cstf2t-/- mice) experience disruption of spermatogenesis and are infertile, although female fertility is unaffected. However, a role for τCstF-64 in the brain has not yet been determined. Given the importance of RNA polyadenylation and splicing in neuronal gene expression, we chose to test the hypothesis that τCstF-64 is important for brain function. Male and female 185-day old wild type and Cstf2t-/- mice were examined for motor function, general activity, learning, and memory using rotarod, open field activity, 8-arm radial arm maze, and Morris water maze tasks. Male wild type and Cstf2t-/- mice did not show differences in learning and memory. However, female Cstf2t-/- mice showed significantly better retention of learned maze tasks than did female wild type mice. These results suggest that τCstf-64 is important in memory function in female mice. Interestingly, male Cstf2t-/- mice displayed less thigmotactic behavior than did wild type mice, suggesting that Cstf2t may play a role in anxiety in males. Taken together, our studies highlight the importance of mRNA processing in cognition and behavior as well as their established functions in reproduction

P-glycoprotein, but not multidrug resistance protein 4, plays a role in the systemic clearance of irinotecan and SN-38 in mice

The ATP-binding cassette transporters P-glycoprotein (ABCB1, MDR1) and multidrug resistance protein 4 (MRP4) efflux irinotecan and its active metabolite SN-38 in vitro, and thus may contribute to system clearance of these compounds. Mdr1a/b(-/-), Mrp4(-/-), and wild-type mice were administered 20 or 40 mg/kg irinotecan, and plasma samples were collected for 6 hours. Irinotecan and SN-38 lactone and carboxylate were quantitated and data were analyzed with nonlinear mixed-effects modeling. Mdr1a/b genotype was a significant covariate for the clearance of both irinotecan lactone and SN-38 lactone. Exposures to irinotecan lactone and SN-38 lactone after a 40 mg/kg dose were 1.6-fold higher in Mdr1a/b(-/-) mice compared to wild-type mice. Plasma concentrations of irinotecan lactone, irinotecan carboxylate, and SN-38 lactone in Mrp4(-/-) mice were similar to the wild-type controls. These results suggest that P-gp plays a role in irinotecan and SN-38 elimination, but Mrp4 does not affect irinotecan or SN-38 plasma pharmacokinetics.Fil: Tagen, Michael. St. Jude Children's Research Hospital; Estados UnidosFil: Zhuang, Yanli. St. Jude Children's Research Hospital; Estados UnidosFil: Zhang, Fan. St. Jude Children's Research Hospital; Estados UnidosFil: Harstead, K. Elaine. St. Jude Children's Research Hospital; Estados UnidosFil: Shen, Jun. St. Jude Children's Research Hospital; Estados UnidosFil: Schaiquevich, Paula Susana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. St. Jude Children's Research Hospital; Estados UnidosFil: Fraga, Charles H.. St. Jude Children's Research Hospital; Estados UnidosFil: Panetta, John C.. St. Jude Children's Research Hospital; Estados UnidosFil: Waters, Christopher M.. St. Jude Children's Research Hospital; Estados UnidosFil: Stewart, Clinton F.. St. Jude Children's Research Hospital; Estados Unido

Quantified Pore-Scale Nanoparticle Transport in Porous Media and the Implications for Colloid Filtration Theory

This study evaluates the pore-scale distribution of silver nanoparticles during transport through a sandy porous medium via quantitative synchrotron X-ray computed microtomography (qSXCMT). The associated distributions of nanoparticle flow velocities and mass flow rates were obtained by coupling these images with computational fluid dynamic (CFD) simulations. This allowed, for the first time, the comparison of nanoparticle mass flow with that assumed by the standard colloid filtration theory (CFT) modeling approach. It was found that (i) 25% of the pore space was further from the grain than assumed by the CFT model; (ii) the average pore velocity agreed well between results of the coupled qSXCMT/CFD approach and the CFT model within the model fluid envelope, although the former were 2 times larger than the latter in the centers of the larger pores and individual velocities were upwards of 20 times those in the CFT model at identical distances from grain surfaces ; and (iii) approximately 30% of all nanoparticle mass and 38% of all nanoparticle mass flow occurred further away from the grain surface than expected by the CFT model. This work suggests that a significantly smaller fraction of nanoparticles than expected will contact a grain surface by diffusion via CFT models, likely contributing to inadequate CFT model nanoparticle transport predictions

A systematic review and meta-analysis of enzyme replacement therapy in late-onset Pompe Disease

Pompe disease (PD) is a glycogen storage disorder caused by deficient activity of acid alpha-glucosidase (GAA). We sought to review the latest available evidence on the safety and efficacy of recombinant human GAA enzyme replacement therapy (ERT) for late-onset PD (LOPD). Methods: We systematically searched the MEDLINE (via PubMed), Embase, and Cochrane databases for prospective clinical studies evaluating ERT for LOPD on pre-specified outcomes. A meta-analysis was also performed. Results: Of 1601 articles identified, 22 were included. Studies were heterogeneous and with very low certainty of evidence for most outcomes. The following outcomes showed improvements associated with GAA ERT, over a mean follow-up of 32.5 months: distance walked in the 6-min walking test (6MWT) (mean change 35.7 m (95% confidence interval [CI] 7.78, 63.75)), physical domain of the SF-36 quality of life (QOL) questionnaire (mean change 1.96 (95% CI 0.33, 3.59)), and time on ventilation (TOV) (mean change -2.64 h (95% CI -5.28, 0.00)). There were no differences between the pre- and post-ERT period for functional vital capacity (FVC), Walton and Gardner-Medwin Scale score, upper-limb strength, or total SF-36 QOL score. Adverse events (AEs) after ERT were mild in most cases. Conclusion: Considering the limitations imposed by the rarity of PD, our data suggest that GAA ERT improves 6MWT, physical QOL, and TOV in LOPD patients. ERT was safe in the studied population. PROSPERO register: 135102

Home use of a bihormonal bionic pancreas versus insulin pump therapy in adults with type 1 diabetes: a multicentre randomised crossover trial

The safety and effectiveness of a continuous, day-and-night automated glycaemic control system using insulin and glucagon has not been shown in a free-living, home-use setting. We aimed to assess whether bihormonal bionic pancreas initialised only with body mass can safely reduce mean glycaemia and hypoglycaemia in adults with type 1 diabetes who were living at home and participating in their normal daily routines without restrictions on diet or physical activity

Genetics and molecular study in group of patients with malformations of cerebral cortex

OBJECTIVES: Malformations of cerebral cortex (MCC) are an important cause of epilepsy. Our main goals were: to search for mutations in genes responsible for MCC (FLN1, LIS1, DCX and EMX2), to map the locus for familial perisylvian polymicrogyria and to investigate the molecular mechanisms of the mutations identified. Methods: Mutation screening was performed by PCR, DHPLC and sequencing. HUMARA and Real Time PCR were performed to study the molecular mechanisms of mutations. Linkage analysis was carried out by PCR, Fragment profiler® and MLINK® software. RESULTS: Deleterious mutations were identified in 3/108 patients. We found a G987C splicing mutation in the FLN1 in two related patients with periventricular nodular heterotopia. Skewed X-chromosome inactivation was detected as the possible mechanism responsible for clinical differences observed in the two patients. An A1385C transversion (H277P) in LIS1 was identified in one patient with lisencephaly. Only neutral variants were identified in DCX and EMX2. Linkage analysis has detected a locus in Xq27.2-Xq27.3 for familial polymicrogyria. CONCLUSION: We believe that the low frequency of mutations identified may be due to mosaicism, mutations in non-coding regions, deletions and patients with atypical neuroimaging findings. Deleterious mutations in EMX2 were not found in patients with schizencephaly and polymicrogyria. We found a locus for familial perisylvian polymicrogyria in Xq27.2-Xq27.3.OBJETIVOS: As malformações do córtex cerebral (MCC) são uma causa importante de epilepsia. Nossas metas foram: triagem de mutações em genes associados às MCC (FLN1, LIS1, DCX e EMX2), investigar funcionalmente as mutações e mapear o locus para polimicrogiria perisylviana familiar. MÉTODOS: A triagem de mutações foi realizada por PCR, DHPLC e sequênciamento. Estudo funcional foi realizado por RT-PCR, PCR em tempo real e HUMARA. O estudo de ligação foi realizado por PCR e análise com programas Fragment Profiler® e MLINK®. RESULTADOS: Mutações deletérias foram identificadas em 3/108 pacientes. Uma mutação de splicing (G987C) em FLN1 foi identificada em duas pacientes aparentadas com heterotopia nodular periventricular. Mudança no padrão de inativação do cromossomo X é responsável pelas diferenças clínicas entre as pacientes. Uma substituição A1385C (H277P) foi identificada em LIS1 em um indivíduo com lissencefalia. Alterações neutras foram identificadas em DCX e EMX2. A análise de ligação identificou um locus em Xq27.2-Xq27.3 para polimicrogiria familiar. CONCLUSÃO: Mosaicismo, mutações em regiões não codificantes, deleções, rearranjos e casos atípicos podem estar contribuindo para a baixa freqüência de mutações identificadas. Esquizencefalia e polimicrogiria parecem não ter base genética relacionada com o gene EMX2. Um novo locus candidato em Xq27.2-Xq27.3 foi identificado para polimicrogiria perisylviana familiar.101105Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

A Genome-Wide Association Study of Total Bilirubin and Cholelithiasis Risk in Sickle Cell Anemia

Serum bilirubin levels have been associated with polymorphisms in the UGT1A1 promoter in normal populations and in patients with hemolytic anemias, including sickle cell anemia. When hemolysis occurs circulating heme increases, leading to elevated bilirubin levels and an increased incidence of cholelithiasis. We performed the first genome-wide association study (GWAS) of bilirubin levels and cholelithiasis risk in a discovery cohort of 1,117 sickle cell anemia patients. We found 15 single nucleotide polymorphisms (SNPs) associated with total bilirubin levels at the genome-wide significance level (p value <5×10−8). SNPs in UGT1A1, UGT1A3, UGT1A6, UGT1A8 and UGT1A10, different isoforms within the UGT1A locus, were identified (most significant rs887829, p = 9.08×10−25). All of these associations were validated in 4 independent sets of sickle cell anemia patients. We tested the association of the 15 SNPs with cholelithiasis in the discovery cohort and found a significant association (most significant p value 1.15×10−4). These results confirm that the UGT1A region is the major regulator of bilirubin metabolism in African Americans with sickle cell anemia, similar to what is observed in other ethnicities