Quantification of carboxyl groups in carbodiimide cross-linked collagen sponges

Glutaraldehyde (GA) fixation of bioprosthetic tissue is a well adapted technique, with commercial products on the market for almost 40 years. Amine groups present in tissue react with GA to form different types of cross-links. An estimation of the degree of cross-linking of the tissue can be obtained by measuring the concentration of residual amine groups, which is frequently carried out with the 2,4,6 trinitrobenzene sulphonic acid (TNBS) assay. Cross-linked tissue and collagen matrices are usually further characterized by determining their physical properties (such as the shrinkage temperature), biological properties (such as resistance to enzymatic degradation), and mechanical properties before in vivo evaluation takes place. In an effort to improve the properties of cross-linked tissue and collagen, alternative cross-linking methods have been developed. One of these methods is based on the use of water soluble carbodiimides (CDI). It is generally accepted that this cross-linking method leads only to the formation of amide linkages between tissue carboxyl and amine groups. Therefore, until recently the TNBS assay was also used to determine the degree of cross-linking of CDI cross-linked tissue and collagen. However, it cannot be excluded that after activation of carboxyl groups of tissue and collagen by CDI, these groups can react with other nucleophiles (like hydroxyl groups) present in the matrix. To obtain a better insight in the degree of cross-linking of CDI cross-linked matrices a reliable assay for quantification of residual carboxyl groups is required. Up to now such an assay was not available. In this study a new assay to determine residual carboxyl groups in CDI cross-linked collagen matrices is presented. Reconstituted dermal bovine collagen matrices (RDBC) were cross-linked with a water soluble CDI and N-hydroxysuccinimide (NHS) and residual carboxyl groups were labeled using 5-bromomethyl fluorescein. Subsequently, the fluorescent label was released by mild hydrolysis and quantified with capillary zone electrophoresis. A calibration curve relating the concentration of carboxyl groups with peak intensities was obtained using SephadexTM standards with known concentrations of carboxyl groups. The concentration of carboxyl groups in unprocessed RDBC as determined with this new technique was equal to the concentration of carboxyl groups measured by amino acid analysis. On the basis of the concentration of residual carboxyl groups determined for CDI/NHS cross-linked RDBC and RDBC, in which the amine groups were blocked with propionaldehyde before CDI/NHS cross-linking, it was concluded that activated carboxyl groups can also react with other groups (such as hydroxyl groups) present in the matrix. This implies that the crosslink density of RDBC matrices after treatment with CDI/NHS is higher than expected on the basis of amide bond formation only, as determined by the TNBS assay

Synthesis and biodistribution of immunoconjugates of a human IgM and polymeric drug carriers

The synthesis and purification of radiolabelled immunoconjugates, composed of a human IgM monoclonal antibody directed against an intracellular tumour-associated antigen and either poly (alpha-L-glutamic acid) (PGA) or poly[N5-(2-hydroxyethyl)-L-glutamine] (PHEG) is described. Coupling of polymers to the antibody was performed through disulfide bond formation involving a single thiol group at the C-terminus of the polymer chain and 2-pyridyldisulfide groups introduced onto the antibody. The antibody was iodinated with 131I before conjugation. The polymers contained tyrosinamide in a low degree of substitution and were radiolabelled with 125I. 125I-labelled PGA and PHEG were found to be stable for at least 3 days in murine and human plasma. The biodistribution in mice of the doubly labelled immunoconjugates was studied and was compared with the pharmacokinetics of the individual components.\ud \ud PHEG showed a relatively slow blood clearance, the half-life being approximately 10 h with low uptake in liver, kidneys and spleen. PGA was rapidly cleared from the circulation and was significantly taken up in liver, kidneys and spleen. The biodistribution of both immunoconjugates was indistinguishable from that of the IgM proper, with plasma half-lives of approximately 6 h, indicating that the pharmacokinetic properties of the immunoconjugates are largely determined by the antibody part

Arc-minute-scale studies of the interstellar gas towards HESS \,J1804−-216: Still an unidentified TeV γ\gamma-ray source

The Galactic TeV $\gamma$-ray source HESS$\,$J1804$-$216 is currently an unidentified source. In an attempt to unveil its origin, we present here the most detailed study of interstellar gas using data from the Mopra Southern Galactic Plane CO Survey, 7 and 12$\,$mm wavelength Mopra surveys and Southern Galactic Plane Survey of HI. Several components of atomic and molecular gas are found to overlap HESS$\,$J1804$-$216 at various velocities along the line of sight. The CS(1-0) emission clumps confirm the presence of dense gas. Both correlation and anti-correlation between the gas and TeV $\gamma$-ray emission have been identified in various gas tracers, enabling several origin scenarios for the TeV $\gamma$-ray emission from HESS$\,$J1804$-$216. For a hadronic scenario, SNR$\,$G8.7$-$0.1 and the progenitor SNR of PSR$\,$J1803$-$2137 require cosmic ray (CR) enhancement factors of $\mathord{\sim} 50$ times the solar neighbour CR flux value to produce the TeV $\gamma$-ray emission. Assuming an isotropic diffusion model, CRs from both these SNRs require a slow diffusion coefficient, as found for other TeV SNRs associated with adjacent ISM gas. The morphology of gas located at 3.8$\,$kpc (the dispersion measure distance to PSR$\,$J1803$-$2137) tends to anti-correlate with features of the TeV emission from HESS$\,$J1804$-$216, making the leptonic scenario possible. Both pure hadronic and pure leptonic scenarios thus remain plausible.Comment: 29 pages, 23 figures, 5 tables, accepted for publication in PAS

Synthesis and biological evaluation of immunoconjugates of adriamycin and a human IgM linked by poly[N5-(2-hydroxyethyl)-l-glutamine

The synthesis and purification of radiolabelled immunoconjugates, composed of a human IgM monoclonal antibody (IgM 16.88) directed against an intracellular tumour-associated antigen, the drug carrier poly[N5-(2-hydroxyethyl)--glutamine] (PHEG) and the cytostatic drug adriamycin (ADR) are described. The immunoconjugates were constructed to allow selective release of ADR in the putatively acidic environment of the tumour through a novel acid-labile maleamic acid linker. The conjugate of PHEG and the acid-labile ADR derivative effectively released ADR in cytotoxic amounts at a pH of 6.0 as judged from incubation in buffer and from inhibition of the growth of HT-29 colon tumour cells in vitro. Immunoconjugates were prepared by coupling of PHEG-ADR having a hydrolytically stable amide bond with 131I-labelled antibody through thioether bond formation involving a single thiol group at the C-terminus of the polymer chain and maleimido groups introduced onto th

Segmented multifunctional poly(ether ester) polymers containing H-bonding units. Preparation and charactization

A series of poly(ether ester)s containing amide and carbamate groups as H-bonding units and 13-50 mol-% of poly(ethylene glycol) (PEG) segments were prepared by polycondensation in bulk using Ti(OBu)4 as a catalyst. The copolymers were obtained starting from PEG/1,4-butanediol mixtures and a synthetic monomer carrying H-bonding groups. These polymers were designed for biomedical applications, where material biodegradability is required. The influence of the nature of the H-bonding units, the length of the polymethylene spacer between the H-bonding groups and the PEG content on the thermal and solubility properties of the copolymers was investigated. Amide-containing copolymers were more thermally stable than those containing carbamate groups. The PEG content also slightly affected the polymer thermal stability. The DSC traces of all samples presented multiple transitions, whose shape and peak temperature were strongly dependent on the PEG content. Polymer hydrophilicity, surface free energy and equilibrium swelling in phosphate buffer solution (PBS) at 37 °C were mainly influenced by the PEG content, whereas the nature of the H-bonding groups had little effect

The effect of three-dimensional visualisation on performance in endoscopic sinus surgery:A clinical training study using surgical navigation for movement analysis in a randomised crossover design

Objectives: Endoscopic imaging techniques and endoscopic endonasal surgery (EES) expertise have evolved rapidly. Only few studies have assessed the effect of three-dimensional (3D) endoscopy on endoscopic sinus surgery (ESS). The present study aimed to objectively and subjectively assess the additional value of 3D high-definition (HD) endoscopy in ESS. Design: A randomized crossover study of endoscopic surgery performance, using five ESS tasks of varying complexity, performed on Thiel embalmed human specimens. Setting: Simulated surgical environment. Participants: Thirty participants, inexperienced in ESS. Main outcome measures: Performance was assessed using video imaging, surgical navigation and questionnaires. Main outcome measures were as follows: efficiency (defined by time to task completion), distance covered inside the nose, average velocity towards target, accuracy (measured by error rate), and subjective assessment of endoscope characteristics. Results: During ESS tasks, both efficiency and accuracy did not differ significantly between 2D HD and 3D HD endoscopy. Subjectively, imaging characteristics of the 3D HD endoscope were rated significantly better. Conclusions: ESS performance of inexperienced participants was not significantly improved by the use of 3D HD endoscopy during ESS tasks, although imaging characteristics of the 3D HD endoscope were rated significantly better. Surgical field characteristics and surgical techniques are likely to influence any additional value of 3D HD endoscopy

Fluorescence grid analysis for the evaluation of piecemeal surgery in sinonasal inverted papilloma:a proof-of-concept study

PURPOSE: Local recurrence occurs in ~ 19% of sinonasal inverted papilloma (SNIP) surgeries and is strongly associated with incomplete resection. During surgery, it is technically challenging to visualize and resect all SNIP tissue in this anatomically complex area. Proteins that are overexpressed in SNIP, such as vascular endothelial growth factor (VEGF), may serve as a target for fluorescence molecular imaging to guide surgical removal of SNIP. A proof-of-concept study was performed to investigate if the VEGF-targeted near-infrared fluorescent tracer bevacizumab-800CW specifically localizes in SNIP and whether it could be used as a clinical tool to guide SNIP surgery.METHODS: In five patients diagnosed with SNIP, 10 mg of bevacizumab-800CW was intravenously administered 3 days prior to surgery. Fluorescence molecular imaging was performed in vivo during surgery and ex vivo during the processing of the surgical specimen. Fluorescence signals were correlated with final histopathology and VEGF-A immunohistochemistry. We introduced a fluorescence grid analysis to assess the fluorescence signal in individual tissue fragments, due to the nature of the surgical procedure (i.e., piecemeal resection) allowing the detection of small SNIP residues and location of the tracer ex vivo.RESULTS: In all patients, fluorescence signal was detected in vivo during endoscopic SNIP surgery. Using ex vivo fluorescence grid analysis, we were able to correlate bevacizumab-800CW fluorescence of individual tissue fragments with final histopathology. Fluorescence grid analysis showed substantial variability in mean fluorescence intensity (FImean), with SNIP tissue showing a median FImean of 77.54 (IQR 50.47-112.30) compared to 35.99 (IQR 21.48-57.81) in uninvolved tissue (p &lt; 0.0001), although the diagnostic ability was limited with an area under the curve of 0.78.CONCLUSIONS: A fluorescence grid analysis could serve as a valid method to evaluate fluorescence molecular imaging in piecemeal surgeries. As such, although substantial differences were observed in fluorescence intensities, VEGF-A may not be the ideal target for SNIP surgery.TRIAL REGISTRATION: NCT03925285.</p

Detection by fluorescence of pituitary neuroendocrine tumour (PitNET) tissue during endoscopic transsphenoidal surgery using bevacizumab-800CW (DEPARTURE trial):study protocol for a non-randomised, non-blinded, single centre, feasibility and dose-finding trial

INTRODUCTION: Achieving gross total resection and endocrine remission in pituitary neuroendocrine tumours (PitNET) can be challenging, especially in PitNETs with cavernous sinus (CS) invasion, defined as a Knosp grade of 3 or 4. A potential target to identify PitNET tissue is vascular endothelial growth factor A (VEGF-A), which expression is known to be significantly higher in PitNETs with CS invasion.METHODS AND ANALYSIS: The aim of this non-randomised, non-blinded, single centre, feasibility and dose-finding phase 1 trial is to determine the feasibility of intraoperative fluorescence imaging detection of PitNET tissue during endoscopic transsphenoidal surgery using the VEGF-A targeting optical agent bevacizumab-800CW (4, 5, 10 or 25 mg). Nine to fifteen patients with a PitNET with a Knosp grade of 3 or 4 will be included. Secondary objectives are: (1) To identify the optimal tracer dose for imaging of PitNET tissue during transsphenoidal surgery for further development in a phase 2 fluorescence molecular endoscopy trial. (2) To quantify fluorescence intensity in vivo and ex vivo with multidiameter single-fibre reflectance, single-fibre fluorescence (MDSFR/SFF) spectroscopy. (3) To correlate and validate both the in vivo and ex vivo measured fluorescence signals with histopathological analysis and immunohistochemical staining. (4) To assess the (sub)cellular location of bevacizumab-800CW by ex vivo fluorescence microscopy. Intraoperative, three imaging moments are defined to detect the fluorescent signal. The tumour-to-background ratios are defined by intraoperative fluorescence in vivo measurements including MDSFR/SFF spectroscopy data and by ex vivo back-table fluorescence imaging. After inclusion of three patients in each dose group, an interim analysis will be performed to define the optimal dose.ETHICS AND DISSEMINATION: Approval was obtained from the Medical Ethics Review Board of the University Medical Centre Groningen. Results will be disseminated through national and international journals. The participants and relevant patient support groups will be informed about the results.TRIAL REGISTRATION NUMBER: NCT04212793.</p

A deep spectromorphological study of the γ -ray emission surrounding the young massive stellar cluster Westerlund 1

Context. Young massive stellar clusters are extreme environments and potentially provide the means for efficient particle acceleration. Indeed, they are increasingly considered as being responsible for a significant fraction of cosmic rays (CRs) that are accelerated within the Milky Way. Westerlund 1, the most massive known young stellar cluster in our Galaxy, is a prime candidate for studying this hypothesis. While the very-high-energy γ-ray source HESS J1646-458 has been detected in the vicinity of Westerlund 1 in the past, its association could not be firmly identified. Aims. We aim to identify the physical processes responsible for the γ-ray emission around Westerlund 1 and thus to understand the role of massive stellar clusters in the acceleration of Galactic CRs better. Methods. Using 164 h of data recorded with the High Energy Stereoscopic System (H.E.S.S.), we carried out a deep spectromorphological study of the γ-ray emission of HESS J1646-458. We furthermore employed H I and CO observations of the region to infer the presence of gas that could serve as target material for interactions of accelerated CRs. Results. We detected large-scale (~2 diameter) γ-ray emission with a complex morphology, exhibiting a shell-like structure and showing no significant variation with γ-ray energy. The combined energy spectrum of the emission extends to several tens of TeV, and it is uniform across the entire source region. We did not find a clear correlation of the γ-ray emission with gas clouds as identified through H I and CO observations. Conclusions. We conclude that, of the known objects within the region, only Westerlund 1 can explain the majority of the γ-ray emission. Several CR acceleration sites and mechanisms are conceivable and discussed in detail. While it seems clear that Westerlund 1 acts as a powerful particle accelerator, no firm conclusions on the contribution of massive stellar clusters to the flux of Galactic CRs in general can be drawn at this point