Antiangiogenic activity and cytotoxicity of triterpenoids and homoisoflavonoids from 'Massonia pustulata' and 'Massonia bifolia'

The Hyacinthaceae family (sensu APGII) with approximately 900 species in around 70 genera, plays a significant role in traditional medicine in Africa as well as across Europe and the Middle and Far East. The dichloromethane extract of the bulbs of Massonia pustulata (Hyacinthaceae sensu APGII) yielded two known homoisoflavonoids, (R)-5-hydroxy-3-(4-hydroxybenzyl)-7-methoxy-4-chromanone 1 and 5-hydroxy-3-(4-hydroxybenzyl)-7-methoxy-4-chromone 2 and four spirocyclic nortriterpenoids, eucosterol 3, 28-hydroxyeucosterol 4 and two previously unreported triterpenoid derivatives, (17S,23S)-17α,23-epoxy-3β,22β,29-trihydroxylanost-8-en-27,23-olide 5 and (17S, 23S)-17α,23-epoxy-28,29-dihydroxylanost-8-en-3-on-27,23-olide 6. Compounds 1, 2, 3, and 5 were assessed for cytotoxicity against CaCo-2 cells using a neutral red uptake assay. Compounds 1, 2 and 5 reduced cell viability by 70% at concentrations of 30, 100 and 100 μM respectively. Massonia bifolia yielded three known homoisoflavonoids, (R)-(4’-hydroxy)-5-hydroxy-7-methoxy-4-chromanone 1, (R)-(4’-hydroxy)-5,7-dihydroxy-4-chromanone 7 and (R)-(3’-hydroxy-4’-methoxy)-5,7-dihydroxy-4-chromanone 9, two previously unreported homoisoflavonoids, (E)-3-benzylidene-(3’,4’-dihydroxy)-5-hydroxy-7-methoxy-4-chromanone 8 and (R)-(3’,4’-dihydroxy)-5-hydroxy-7-methoxy-4-chromanone 10, and a spirocyclic nortriterpenoid, 15-deoxoeucosterol 11. Compounds 1, 1Ac, 7, 8, 9 and 10 were screened for antiangiogenic activity against human retinal microvascular endothelial cells. Some compounds showed dose-dependent antiproliferative activity and blocked endothelial tube formation, suggestive of antiangiogenic activity

Low flow controls on benthic and hyporheic macroinvertebrate assemblages during supra-seasonal drought

Despite the widely accepted importance of the hyporheic zone as a habitat for stream macroinvertebrates during floods, few data exist regarding community composition and distribution during periods of low flow or drought in perennial streamsi Integrating research on hyporheic invertebrates with results from a long-term study of a U K river provided the opportunity to examine how surface and hyporheic macroinvertebrate communities respond to inter-annual variability in river flow and periods of groundwater drought. Changes in the riverine macroinvertebrate community associated with low flow included a reduction in species richness and the number of individuals per sample, particularly aquatic insects. The hyporheic community was characterized by a relatively homogeneous composition during a period of severe low flow, punctuated by short-term changes associated with variation in water temperature rather than changes in discharge. We present a conceptual model of the processes influencing benthic and hyporheic invertebrates under low-flow conditions. Previous studies have seldom integrated these two assemblages and their interactions. The model presented highlights the potential importance of surface water and hyporheic zone linkages for riverine invertebrate communities under a range of flow conditions

The antiangiogenic activity of naturally occurring and synthetic homoisoflavonoids from the Hyacinthaceae (sensu APGII)

Excessive blood vessel formation in the eye is implicated in wet age-related macular degeneration, proliferative diabetic retinopathy, neovascular glaucoma, and retinopathy of prematurity, which are major causes of blindness. Small molecule antiangiogenic drugs are strongly needed to supplement existing biologics. Homoisoflavonoids have been previously shown to have potent antiproliferative activities in endothelial cells over other cell types. Moreover, they demonstrated a strong antiangiogenic potential in vitro and in vivo in animal models of ocular neovascularization. Here, we tested the antiangiogenic activity of a group of naturally occurring homoisoflavonoids isolated from the family Hyacinthaceae and related synthetic compounds, chosen for synthesis based on structure–activity relationship observations. Several compounds showed interesting antiproliferative and antiangiogenic activities in vitro on retinal microvascular endothelial cells, a disease-relevant cell type, with the synthetic chromane, 46, showing the best activity (GI50 of 2.3 × 10–4 μM)

Bufadienolides and anti-angiogenic homoisoflavonoids from 'Rhodocodon cryptopodus', 'Rhodocodon rotundus' and 'Rhodocodon cyathiformis'

Background: Homoisoflavonoids have been shown to have potent anti-proliferative activities in endothelial cells over other cell types and have demonstrated a strong antiangiogenic potential in vitro and in vivo in animal models of ocular neovascularization. Three species of Rhodocodon (Scilloideaea subfamily of the Asparagaceae family), endemic to Madagascar, R. cryptopodus, R. rotundus and R. cyathiformis, were investigated. Purpose: To isolate and test homoisoflavonoids for their antiangiogenic activity against human retinal microvascular endothelial cells (HRECs), as well as specificity against other ocular cell lines. Methods: Plant material was extracted at room temperature with EtOH. Compounds were isolated using flash column chromatography and were identified using NMR and CD spectroscopy and HRESIMS. Compounds were tested for antiproliferative effects on primary human microvascular retinal endothelial cells (HRECs), ARPE19 retinal pigment epithelial cells, 92–1 uveal melanoma cells, and Y79 retinoblastoma cells. HRECs exposed to compounds were also tested for migration and tube formation ability. Results: Two homoisoflavonoids, 3S-5,7-dihydroxy-(3′-hydroxy-4′-methoxybenzyl)-4-chromanone (1) and 3S-5,7-dihydroxy-(4′-hydroxy-3′-methoxybenzyl)-4-chromanone (2), were isolated along with four bufadienolides. Compound 1 was found to be non-specifically antiproliferative, with GI50 values ranging from 0.21–0.85 μM across the four cell types, while compound 2 showed at least 100-fold specificity for HRECs over the other tested cell lines. Compound 1, with a 3S configuration, was 700 times more potent that the corresponding 3R enantiomer recently isolated from a Massonia species. Conclusion: Select homoisoflavonoids have promise as antiangiogenic agents that are not generally cytotoxic

Levels of pneumococcal conjugate vaccine coverage and indirect protection against invasive pneumococcal disease and pneumonia hospitalisations in Australia: An observational study.

BackgroundThere is limited empiric evidence on the coverage of pneumococcal conjugate vaccines (PCVs) required to generate substantial indirect protection. We investigate the association between population PCV coverage and indirect protection against invasive pneumococcal disease (IPD) and pneumonia hospitalisations among undervaccinated Australian children.Methods and findingsBirth and vaccination records, IPD notifications, and hospitalisations were individually linked for children aged ConclusionsIn this study, we observed substantial indirect protection at lower levels of PCV coverage than previously described-challenging assumptions that high levels of PCV coverage (i.e., greater than 90%) are required. Understanding the association between PCV coverage and indirect protection is a priority since the control of vaccine-type pneumococcal disease is a prerequisite for reducing the number of PCV doses (from 3 to 2). Reduced dose schedules have the potential to substantially reduce program costs while maintaining vaccine impact

Forcing single-column models using high-resolution model simulations

To use single column models (SCMs) as a research tool for parametrisation development and process studies, the SCM must be supplied with realistic initial profiles, forcing fields and boundary conditions. We propose a new technique for deriving these required profiles, motivated by the increase in number and scale of high-resolution convection-permitting simulations. We suggest that these high-resolution simulations be coarse-grained to the required resolution of an SCM, and thereby be used as a proxy for the ‘true’ atmosphere. This paper describes the implementation of such a technique. We test the proposed methodology using high-resolution data from the UK Met Office’s Unified Model (MetUM), with a resolution of 4 km, covering a large tropical domain. This data is coarse grained and used to drive the European Centre for Medium-Range Weather Forecast’s (ECMWF) Integrated Forecasting 26 System (IFS) SCM. The proposed method is evaluated by deriving IFS SCM forcing profiles from a consistent T639 IFS simulation. The SCM simulations track the global model, indicating a consistency between the estimated forcing fields and the ‘true’ dynamical forcing in the global model. We demonstrate the benefits of selecting SCM forcing profiles from across a large-domain, namely robust statistics, and the ability to test the SCM over a range of boundary conditions. We also compare driving the SCM with the coarse-grained datase to driving it using the ECMWF operational analysis. We conclude by highlighting the importance of understanding biases in the high-resolution dataset, and suggest that our approach be used in combination with observationally derived forcing datasets

Role Models or Gateways to Resources?: Contemporary Confusions in Mentoring Practice

Mentoring has become increasingly popular in recent years in the criminal justice system, presented across the UK and internationally as a service that can address the specific ‘needs’ of women involved with the criminal justice system. This article draws on original qualitative research with mentors and mentees to explore their experiences and to establish the aims and processes of mentoring. The rhetoric of mentoring offered by mentors and staff suggested that mentoring was based on an individualistic approach that contained responsibilising strategies. In practice, however, mentors were helping women to resolve issues related to the welfare system and other services outwith the criminal justice system. If positive outcomes of mentoring are viewed by policy makers to be the result of an individualistic approach aimed at fostering ‘pro-social’ interventions, rather than the result of attempts to mitigate wider structural failures outwith the criminal justice system, then this takes responsibility away from the state and distracts from the deeper effects of criminalising processes

Real-world experience of nintedanib for progressive fibrosing interstitial lung disease in the UK

Background Nintedanib slows progression of lung function decline in patients with progressive fibrosing (PF) interstitial lung disease (ILD) and was recommended for this indication within the United Kingdom (UK) National Health Service in Scotland in June 2021 and in England, Wales and Northern Ireland in November 2021. To date, there has been no national evaluation of the use of nintedanib for PF-ILD in a real-world setting.Methods 26 UK centres were invited to take part in a national service evaluation between 17 November 2021 and 30 September 2022. Summary data regarding underlying diagnosis, pulmonary function tests, diagnostic criteria, radiological appearance, concurrent immunosuppressive therapy and drug tolerability were collected via electronic survey.Results 24 UK prescribing centres responded to the service evaluation invitation. Between 17 November 2021 and 30 September 2022, 1120 patients received a multidisciplinary team recommendation to commence nintedanib for PF-ILD. The most common underlying diagnoses were hypersensitivity pneumonitis (298 out of 1120, 26.6%), connective tissue disease associated ILD (197 out of 1120, 17.6%), rheumatoid arthritis associated ILD (180 out of 1120, 16.0%), idiopathic nonspecific interstitial pneumonia (125 out of 1120, 11.1%) and unclassifiable ILD (100 out of 1120, 8.9%). Of these, 54.4% (609 out of 1120) were receiving concomitant corticosteroids, 355 (31.7%) out of 1120 were receiving concomitant mycophenolate mofetil and 340 (30.3%) out of 1120 were receiving another immunosuppressive/modulatory therapy. Radiological progression of ILD combined with worsening respiratory symptoms was the most common reason for the diagnosis of PF-ILD.Conclusion We have demonstrated the use of nintedanib for the treatment of PF-ILD across a broad range of underlying conditions. Nintedanib is frequently co-prescribed alongside immunosuppressive and immunomodulatory therapy. The use of nintedanib for the treatment of PF-ILD has demonstrated acceptable tolerability in a real-world setting

Implementation of corticosteroids in treating COVID-19 in the ISARIC WHO Clinical Characterisation Protocol UK:prospective observational cohort study

BACKGROUND: Dexamethasone was the first intervention proven to reduce mortality in patients with COVID-19 being treated in hospital. We aimed to evaluate the adoption of corticosteroids in the treatment of COVID-19 in the UK after the RECOVERY trial publication on June 16, 2020, and to identify discrepancies in care. METHODS: We did an audit of clinical implementation of corticosteroids in a prospective, observational, cohort study in 237 UK acute care hospitals between March 16, 2020, and April 14, 2021, restricted to patients aged 18 years or older with proven or high likelihood of COVID-19, who received supplementary oxygen. The primary outcome was administration of dexamethasone, prednisolone, hydrocortisone, or methylprednisolone. This study is registered with ISRCTN, ISRCTN66726260. FINDINGS: Between June 17, 2020, and April 14, 2021, 47 795 (75·2%) of 63 525 of patients on supplementary oxygen received corticosteroids, higher among patients requiring critical care than in those who received ward care (11 185 [86·6%] of 12 909 vs 36 415 [72·4%] of 50 278). Patients 50 years or older were significantly less likely to receive corticosteroids than those younger than 50 years (adjusted odds ratio 0·79 [95% CI 0·70–0·89], p=0·0001, for 70–79 years; 0·52 [0·46–0·58], p80 years), independent of patient demographics and illness severity. 84 (54·2%) of 155 pregnant women received corticosteroids. Rates of corticosteroid administration increased from 27·5% in the week before June 16, 2020, to 75–80% in January, 2021. INTERPRETATION: Implementation of corticosteroids into clinical practice in the UK for patients with COVID-19 has been successful, but not universal. Patients older than 70 years, independent of illness severity, chronic neurological disease, and dementia, were less likely to receive corticosteroids than those who were younger, as were pregnant women. This could reflect appropriate clinical decision making, but the possibility of inequitable access to life-saving care should be considered. FUNDING: UK National Institute for Health Research and UK Medical Research Council