Gemcitabine Mechanism of Action Confounds Early Assessment of Treatment Response by 3'-Deoxy-3'-[18^{18}F]Fluorothymidine in Preclinical Models of Lung Cancer

3'-Deoxy-3'-[$^{18}$F]fluorothymidine positron emission tomography ([$^{18}$F]FLT-PET) and diffusion-weighted MRI (DW-MRI) are promising approaches to monitor tumor therapy response. Here, we employed these two imaging modalities to evaluate the response of lung carcinoma xenografts in mice after gemcitabine therapy. Caliper measurements revealed that H1975 xenografts responded to gemcitabine treatment, whereas A549 growth was not affected. In both tumor models, uptake of [$^{18}$F]FLT was significantly reduced 6 hours after drug administration. On the basis of the gemcitabine concentration and [$^{18}$F]FLT excretion measured, this was presumably related to a direct competition of gemcitabine with the radiotracer for cellular uptake. On day 1 after therapy, [$^{18}$F]FLT uptake was increased in both models, which was correlated with thymidine kinase 1 (TK1) expression. Two and 3 days after drug administration, [$^{18}$F]FLT uptake as well as TK1 and Ki67 expression were unchanged. A reduction in [$^{18}$F]FLT in the responsive H1975 xenografts could only be noted on day 5 of therapy. Changes in ADC$_{mean}$ in A549 xenografts 1 or 2 days after gemcitabine did not seem to be of therapy-related biological relevance as they were not related to cell death (assessed by caspase-3 IHC and cellular density) or tumor therapy response. Taken together, in these models, early changes of [$^{18}$F]FLT uptake in tumors reflected mechanisms, such as competing gemcitabine uptake or gemcitabine-induced thymidylate synthase inhibition, and only reflected growth-inhibitory effects at a later time point. Hence, the time point for [$^{18}$F]FLT-PET imaging of tumor response to gemcitabine is of crucial importance.The research leading to these results has received support from the Innovative Medicines Initiative Joint Undertaking (www.imi.europa.eu) under grant agreement number 115151, resources of which are composed of financial contribution from the European Union's Seventh Framework Programme (FP7/2007-2013) and EFPIA companies' in kind contribution. This work was also supported by the Deutsche Forschungsgemeinschaft (DFG), Cells-in-Motion Cluster of Excellence (EXC1003 – CiM), University of Munster (Münster, Germany)

Gemcitabine Mechanism of Action Confounds Early Assessment of Treatment Response by 3'-Deoxy-3'-[18^{18}F]Fluorothymidine in Preclinical Models of Lung Cancer

3'-Deoxy-3'-[$^{18}$F]fluorothymidine positron emission tomography ([$^{18}$F]FLT-PET) and diffusion-weighted MRI (DW-MRI) are promising approaches to monitor tumor therapy response. Here, we employed these two imaging modalities to evaluate the response of lung carcinoma xenografts in mice after gemcitabine therapy. Caliper measurements revealed that H1975 xenografts responded to gemcitabine treatment, whereas A549 growth was not affected. In both tumor models, uptake of [$^{18}$F]FLT was significantly reduced 6 hours after drug administration. On the basis of the gemcitabine concentration and [$^{18}$F]FLT excretion measured, this was presumably related to a direct competition of gemcitabine with the radiotracer for cellular uptake. On day 1 after therapy, [$^{18}$F]FLT uptake was increased in both models, which was correlated with thymidine kinase 1 (TK1) expression. Two and 3 days after drug administration, [$^{18}$F]FLT uptake as well as TK1 and Ki67 expression were unchanged. A reduction in [$^{18}$F]FLT in the responsive H1975 xenografts could only be noted on day 5 of therapy. Changes in ADC$_{mean}$ in A549 xenografts 1 or 2 days after gemcitabine did not seem to be of therapy-related biological relevance as they were not related to cell death (assessed by caspase-3 IHC and cellular density) or tumor therapy response. Taken together, in these models, early changes of [$^{18}$F]FLT uptake in tumors reflected mechanisms, such as competing gemcitabine uptake or gemcitabine-induced thymidylate synthase inhibition, and only reflected growth-inhibitory effects at a later time point. Hence, the time point for [$^{18}$F]FLT-PET imaging of tumor response to gemcitabine is of crucial importance.The research leading to these results has received support from the Innovative Medicines Initiative Joint Undertaking (www.imi.europa.eu) under grant agreement number 115151, resources of which are composed of financial contribution from the European Union's Seventh Framework Programme (FP7/2007-2013) and EFPIA companies' in kind contribution. This work was also supported by the Deutsche Forschungsgemeinschaft (DFG), Cells-in-Motion Cluster of Excellence (EXC1003 – CiM), University of Munster (Münster, Germany)

Mechanistic interrogation of combination Bevacizumab/dual PI3K/mTOR inhibitor response in Glioblastoma implementing novel MR and PET imaging biomarkers.

Purpose: Resistance to bevacizumab (BEV) in glioblastoma (GBM) is believed to occur via activation of molecular networks including the mTOR/PI3K pathway. Implementing an MRI/PET molecular imaging biomarker approach, we sought to interrogate response to combining BEV with the mTOR/PI3K inhibitor BEZ235. Methods: Tumors were established by orthotopically implanting U87MG-luc2 in mice. Animals were treated with BEZ235 and/or BEV, and imaged using diffusion weighted-MRI, T2 weighted (T2w), and T2* weighted (T2*w) before and following delivery of superparamagnetic iron oxide (SPIO) contrast. Maps for changes in relaxation rates: ΔR2, ΔR2* and apparent diffusion coefficient (ADC) were calculated. Vessel Size Index (VSI) and micro vessel density index (MDI) were derived. 3´-deoxy-3´-[18F]fluorothymidine ([18F]FLT)- and O-(2-[18F]fluoroethyl)-L-tyrosine ([18F]FET) PET was further performed and tumor endothelium/proliferation markers assessed by immunohistochemistry. Results: Treatment with BEV resulted in a pronounced decrease in tumor volume (T2w MRI). No additive effect on tumour volume was observed in BEV/BEZ235 combination compared with BEV monotherapy. Ki67 proliferation index staining and [18F]FLT uptake studies were used to support observations. Using ΔR2* and ΔR2 values respectively, BEZ235 + BEV combination significantly reduced tumor microvessel volume in comparison to BEV alone. Decreased MDI was further observed in the combination group; supported by von Willebrand Factor (vWF) immunohistochemistry. We observed decreased [18F]FET uptake following BEV, but failed to observe further reduced [18F]FET uptake in the combination cohort. vWF IHC analysis showed mean tumor vessel size increased in all cohorts. Conclusions: Assessing MR imaging biomarker parameters together with [18F]FET and [18F]FLT PET, informed drug combination mechanism of action and provided clues as to potential clinical response. Translation of a BEZ35/BEV combination regimen could support reduction of peritumoral edemaobviating the requirement for steroids. Implementing hypothesis driven molecular imaging studies facilitates the interrogation of drug response in the pre-clinic. These data may more accurately predict the clinical potential of novel therapeutic approaches in oncology

Thymidine Metabolism as Confounding Factor of 3'-Deoxy-3'-[18F]Fluorothymidine Uptake after Therapy in a Colorectal Cancer Model.

Non-invasive monitoring of tumor therapy response helps in developing personalized treatment strategies. Here, we performed sequential positron emission tomography (PET) and diffusion-weighted magnetic resonance imaging (DW-MRI) to evaluate changes induced by a FOLFOX-like combination chemotherapy in colorectal cancer (CRC) xenografts, to identify the cellular and molecular determinants of these imaging biomarkers. Methods: Tumor bearing CD1 nude mice, engrafted with FOLFOX-sensitive Colo205 CRC xenografts, were treated with FOLFOX (5 fluorouracil, leucovorin and oxaliplatin) in weekly intervals. On d1, d2, d6, d9 and d13 of therapy, tumors were assessed by in vivo imaging and ex vivo analyses. In addition, HCT116 xenografts, which did not respond to the FOLFOX treatment, were imaged on d1 of therapy. Results: In Colo205 xenografts, FOLFOX induced a profound increase in uptake of the proliferation PET tracer 3'-deoxy-3'-[18F]fluorothymidine ([18F]FLT), which was accompanied by increases in markers for proliferation (Ki67, TK1) and for activated DNA damage response (DDR; γH2AX), whereas the effect on cell death was minimal. As tracer uptake was unaltered in the HCT116 model, these changes appear to be specific for tumor response. Conclusion: We demonstrate that [18F]FLT PET can non-invasively monitor molecular alterations induced by a cancer treatment, including thymidine metabolism and DDR. The cellular or imaging changes may not, however, be directly related to therapy response as assessed by volumetric measurements

The first wave of pandemic influenza (H1N1) 2009 in Germany: From initiation to acceleration

<p>Abstract</p> <p>Background</p> <p>The first imported case of pandemic influenza (H1N1) 2009 in Germany was confirmed in April 2009. However, the first wave with measurable burden of disease started only in October 2009. The basic epidemiological and clinical characteristics of the pandemic were analysed in order to understand the course of the pandemic in Germany.</p> <p>Methods</p> <p>The analysis was based on data from the case-based, mandatory German surveillance system for infectious diseases. Cases notified between 27 April and 11 November 2009 and fulfilling the case definition were included in the study.</p> <p>Results</p> <p>Two time periods with distinct epidemiologic characteristics could be determined: 23,789 cases (44.1%) occurred during the initiation period (IP, week 18 to 41), and 30,179 (55.9%) during the acceleration period (AP, week 42 to 45). During IP, coinciding with school summer holidays, 61.1% of cases were travel-related and one death occurred. Strict containment efforts were performed until week 32. During AP the majority of cases (94.3%) was autochthonous, 12 deaths were reported. The main affected age group shifted from 15 to 19 years in IP to 10 to 14 years in AP (median age 19 versus 15 years; p < 0.001). The proportion of cases with underlying medical conditions increased from 4.7% to 6.9% (p < 0.001). Irrespective of the period, these cases were more likely to be hospitalised (OR = 3.6 [95% CI: 3.1; 4.3]) and to develop pneumonia (OR = 8.1 [95% CI: 6.1; 10.7]). Furthermore, young children (0 to 2 years) (OR = 2.8 [95% CI: 1.5; 5.2]) and persons with influenza-like illness (ILI, OR = 1.4 [95% CI: 1.0; 2.1]) had a higher risk to develop pneumonia compared to other age groups and individuals without ILI.</p> <p>Conclusion</p> <p>The epidemiological differences we could show between summer and autumn 2009 might have been influenced by the school summer holidays and containment efforts. The spread of disease did not result in change of risk groups or severity. Our results show that analyses of case-based information can advise future public health measures.</p

Fusion of Small Peroxisomal Vesicles in Vitro Reconstructs an Early Step in the in Vivo Multistep Peroxisome Assembly Pathway of Yarrowia lipolytica

We have identified and purified six subforms of peroxisomes, designated P1 to P6, from the yeast, Yarrowia lipolytica. An analysis of trafficking of peroxisomal proteins in vivo suggests the existence of a multistep peroxisome assembly pathway in Y. lipolytica. This pathway operates by conversion of peroxisomal subforms in the direction P1, P2→P3→P4→P5→P6 and involves the import of various peroxisomal proteins into distinct vesicular intermediates. We have also reconstituted in vitro the fusion of the earliest intermediates in the pathway, small peroxisomal vesicles P1 and P2. Their fusion leads to the formation of a larger and more dense peroxisomal vesicle, P3. Fusion of P1 and P2 in vitro requires cytosol and ATP hydrolysis and is inhibited by antibodies to two membrane-associated ATPases of the AAA family, Pex1p and Pex6p. We provide evidence that the fusion in vitro of P1 and P2 peroxisomes reconstructs an actual early step in the peroxisome assembly pathway operating in vivo in Y. lipolytica

Organic-rich sediments in brine-filled Shaban- and Kebrit Deeps, Northern Red Sea

The element compositions Si, Ca and Al of up to 2 1.1 ka old sediments in about 10 in long cores from the southern basin of the Shaban and Kebrit deeps in the northern Red Sea allowed a classification of major sediment types in carbonate sands and -muds and siliceous oozes. A FeOOH-enriched sediment horizon and a few samples with high Zn values in the Kebrit core indicate a hydrothermal origin probably near the brine-sea water interface with subsequent transport of hydrothermal compounds into the deep sediments. High organic carbon contents up to 8.4% are positively correlated with the Ba concentrations, which suggests that high bioproductivity, and rapid deposition (C-14 dating suggests a sedimentation rate near 70 cm/ka) led to the formation of sapropelic sediments between 11.8 and 13.6 ka (Younger Dryas). Organic petrological observations showed that the sediment organic material largely consists of <20 gm-sized roundish fecal pellets (intimate mixtures of organic matter and inorganic constituents) and bituminite. Terrestrial organic matter (pollens of land plants, fusinite etc.) is very rare in the sediment cores from both deeps. Organic-geochemical investigations of kerogens and organic extracts show that a significant (hydrothermal) hydrocarbon production did not occur in near-surface sediments of the Shaban and Kebrit deeps. Rock Eval pyrolysis of kerogens characterised the organic matter to be of type II quality. The delta C-13 values of the kerogens from the most prominent sapropel in the Shaban deep indicate an enrichment of(C-12-rich) nutrients in the water column during postglacial sapropel formation in the Younger Dryas. The n-alkane spectra are dominated by short chain lengths between n-C-15 and n-C-25 Prevailing n-C-15 to n-C-25 alkanes in low mature sediments are indicative of algal and microbial source. Pristane/phytane ratios are generally low (< I to similar to 1) which suggests that anoxic conditions prevailed within the anaerobic brine-filled deeps for the whole time covered by the sediments. This again indicates that sapropel formation was caused by high bioproductivity in the northern Red Sea rather than episodic stagnation with better preservation of the organic matter. Long-chain alkenones and sterols are the dominating compounds of the lipid fraction. Cholesterol contents in the sediment cores reflect phases of eukaryotes production in the water column, whereas the positive correlations of dinosterol with TOC and the amounts of total extract suggests that the major organic carbon source in the northern Red Sea during postglacial high-productivity stages were dinoflagellates. Another important carbon source, however, is indicated by the occurrence of 22,29,30-trisnorhopan-21 -one (TNH). Although the formation of TNH from its precursors is not fully understood, this compound probably results from microbial. degradation of intact bacteriohopanepolyols (BHP), which can be used as indicators for bacterial abundances and phyla. TNH is most likely produced at the brine-sea water interface where sedimenting organic matter accumulates and, if the redoxcline corresponds to the density gradient, the organic matter is subjected to efficient aerobic bacterial degradation processes. However, during high bioproductivity stage (Younger Dryas) the redoxcline was probably higher in the water column and thus, a significant TNH production at the brine-sea water interface did not occur at times of sapropel formation in the northern Red Sea deeps. (C) 2007 Elsevier B.V All rights reserved

Social and health epidemiology of immigrants in Germany: past, present and future

Razum O, Wenner J. Social and health epidemiology of immigrants in Germany: past, present and future. Public Health Reviews. 2016;37(1): 4.Germany has experienced different forms of immigration for many decades. At the end of and after the Second World War, refugees, displaced persons and German resettlers constituted the largest immigrant group. In the 1950s, labor migration started, followed by family reunification. There has been a constant migration of refugees and asylum seekers reaching peaks in the early 1990s as well as today. Epidemiological research has increasingly considered the health, and the access to health care, of immigrants and people with migration background. In this narrative review we discuss the current knowledge on health of immigrants in Germany. The paper is based on a selective literature research with a focus on studies using representative data from the health reporting system. Our review shows that immigrants in Germany do not suffer from different diseases than non-immigrants, but they differ in their risk for certain diseases, in the resources to cope with theses risk and regarding access to treatment. We also identified the need for differentiation within the immigrant population, considering among others social and legal status, country of origin and duration of stay. Though most of the studies acknowledge the need for differentiation, the lack of data currently rules out analyses accounting for the existing diversity and thus a full understanding of health inequalities related to migration to Germany