esp The Iron Deficiency Response of Corynebacterium glutamicum and a Link to Thiamine Biosynthesis [Physiology] By aem.asm.org Published On :: 2020-05-05T08:00:35-07:00 The response to iron limitation of the Gram-positive soil bacterium Corynebacterium glutamicum was analyzed with respect to secreted metabolites, the transcriptome, and the proteome. During growth in glucose minimal medium, iron limitation caused a shift from lactate to pyruvate as the major secreted organic acid complemented by l-alanine and 2-oxoglutarate. Transcriptome and proteome analyses revealed that a pronounced iron starvation response governed by the transcriptional regulators DtxR and RipA was detectable in the late, but not in the early, exponential-growth phase. A link between iron starvation and thiamine pyrophosphate (TPP) biosynthesis was uncovered by the strong upregulation of thiC. As phosphomethylpyrimidine synthase (ThiC) contains an iron-sulfur cluster, limiting activities of the TPP-dependent pyruvate–2-oxoglutarate dehydrogenase supercomplex probably cause the excretion of pyruvate and 2-oxoglutarate. In line with this explanation, thiamine supplementation could strongly diminish the secretion of these acids. The upregulation of thiC and other genes involved in thiamine biosynthesis and transport is presumably due to TPP riboswitches present at the 5' end of the corresponding operons. The results obtained in this study provide new insights into iron homeostasis in C. glutamicum and demonstrate that the metabolic consequences of iron limitation can be due to the iron dependency of coenzyme biosynthesis. IMPORTANCE Iron is an essential element for most organisms but causes problems due to poor solubility under oxic conditions and due to toxicity by catalyzing the formation of reactive oxygen species (ROS). Therefore, bacteria have evolved complex regulatory networks for iron homeostasis aiming at a sufficient iron supply while minimizing ROS formation. In our study, the responses of the actinobacterium Corynebacterium glutamicum to iron limitation were analyzed, resulting in a detailed view on the processes involved in iron homeostasis in this model organism. In particular, we provide evidence that iron limitation causes TPP deficiency, presumably due to insufficient activity of the iron-dependent phosphomethylpyrimidine synthase (ThiC). TPP deficiency was deduced from the upregulation of genes controlled by a TPP riboswitch and secretion of metabolites caused by insufficient activity of the TPP-dependent enzymes pyruvate dehydrogenase and 2-oxoglutarate dehydrogenase. To our knowledge, the link between iron starvation and thiamine synthesis has not been elaborated previously. Full Article
esp Deprivation and mortality related to pediatric respiratory tract infection: a cohort study in 3 high-income jurisdictions By www.cmajopen.ca Published On :: 2020-04-28T01:30:11-07:00 Background: Deaths from respiratory tract infections (RTIs) in children are preventable through timely access to public health and medical interventions. We aimed to assess whether socioeconomic disparities in mortality related to pediatric RTI persisted after accounting for health status at birth. Methods: We compared the prevalence of and risk factors for RTI-related death in singletons aged 28 days to 4 years across Ontario (Canada), Scotland and England (jurisdictions with universal health care) using linked administrative data for 2003–2013. We estimated rates of RTI-related mortality for children living in deprived areas and those born to teenage girls; we estimated both crude rates and those adjusted for health status at birth. Results: A total of 1 299 240 (Ontario), 547 556 (Scotland) and 3 910 401 (England) children were included in the study. Across all jurisdictions, children born in the most deprived areas experienced the highest rates of RTI-related mortality. After adjustment for high-risk chronic conditions and prematurity, we observed differences in mortality according to area-level deprivation in Ontario and England but not in Scotland. In Ontario, teenage motherhood was also an independent risk factor for RTI-related mortality. Interpretation: Socioeconomic disparities played a substantial role in child mortality related to RTI in all 3 jurisdictions. Context-specific investigations around the mechanisms of this increased risk and development of programs to address socioeconomic disparities are needed. Full Article
esp Insight into the structure and tasks of the Early Career Members Committee of the European Respiratory Society By breathe.ersjournals.com Published On :: 2020-03-18T06:44:39-07:00 The Early Career Members Committee (ECMC) of the European Respiratory Society (ERS) consists of 14 members, one Early Career Member (ECM) representative per assembly. In September 2019, seven recently elected representatives joined the ECMC. An overview is given of the tasks performed by each representative within the ECMC (table 1). In addition, a short summary about the content of these tasks is provided. Full Article
esp Screening and surveillance in respiratory medicine By breathe.ersjournals.com Published On :: 2020-03-18T06:44:39-07:00 We are already a couple of months into 2020 and I hope you had a good start to the new year. I wish you, our readers, reviewers, authors and editors, happiness, success and health in this new decade. Full Article
esp Respiratory surveillance in mineral dust-exposed workers By breathe.ersjournals.com Published On :: 2020-03-18T06:44:39-07:00 Recently, there has been a worldwide resurgence in pneumoconiosis, or pulmonary fibrosis due to occupational mineral dust exposure. In Queensland, Australia, there has been a re-emergence of coal workers' pneumoconiosis and silicosis. Some coal mining communities have experienced a resurgence of progressive massive fibrosis in the USA and a worldwide epidemic is occurring of accelerated silicosis due to exposure to artificial stone. These diseases are all preventable and should not be occurring in the 21st century. Best practice prevention includes reduction of exposure to mineral dusts or, ideally, prevention of exposure altogether. However, where dust exposure has occurred, respiratory surveillance can provide a strategy for early disease detection. It is important to identify early signs of occupational lung disease at a stage where intervention may be beneficial, though it must be acknowledged that progression may occur even after cessation of exposure to dusts. Respiratory surveillance should be distinguished from population screening and case finding, which are different methods used for disease investigation and control. Designing an ideal respiratory surveillance programme is challenging, as there is no single test that accurately identifies early disease. Several different respiratory disorders may occur related to the same exposure(s). Physicians organising and interpreting tests used in respiratory surveillance must be aware of the broad range of potential work-related respiratory conditions, complexities in diagnosis, and appropriate interpretation of the exposure history, as well as current management options. A working knowledge of the compensation and medicolegal avenues available to workers in individual jurisdictions is also useful. Key points Mineral dust exposure causes a number of conditions, including those specific to dust exposures, such as the pneumoconioses (or pulmonary fibroses due to mineral dust exposure), and others that may additionally be related to other causes, such as COPD. Identification of multiple conditions using respiratory investigations requires expert interpretation and understanding of the range of potential conditions. The frequency and content of a respiratory surveillance programme will vary according to the relevant occupational exposures, and be affected by both medical and nonmedical factors, including the background prevalence of local diseases. A programme will also need to consider other factors such as local legislation, availability of resources, worker convenience and cost. Educational aims To identify the large range of respiratory diseases caused by exposure to mineral dusts and identify the range of tests that may be used in a surveillance programme for occupational respiratory disorders. To highlight difficulties that might be experienced by medical practitioners in designing and operating an effective surveillance programme, while incorporating rapidly advancing medical technology and practice. Full Article
esp Asthma and hypercapnic respiratory failure By breathe.ersjournals.com Published On :: 2020-03-18T06:44:39-07:00 A 40-year-old, male non-smoker was diagnosed with asthma 6 years ago. He now presents with a 1-week history of worsening breathlessness with fever, cough, and purulent expectoration. He has had >10 emergency department visits and two admissions to hospital in the last 3 months. At each admission, he received bronchodilators and systemic steroids resulting in rapid improvement within 24 h. However, in the current presentation, the patient has no relief with corticosteroids and bronchodilators. His pulse is 140 per min, respiratory rate is 40 per min, blood pressure is 90/60 mmHg and room air oxygen saturation is 80%. Arterial blood gas (ABG) analysis shows hypercapnic respiratory failure. In view this respiratory failure, the patient is intubated and mechanical ventilation initiated. A chest radiograph is shown in figure 1. The therapy initiated includes bronchodilators, a systemic steroid, antibiotics and supportive care. Full Article
esp The authors respond to "The future of colorectal cancer screening: Parentalism or shared decision-making?" [Letters] By www.cmaj.ca Published On :: 2020-05-03T21:05:14-07:00 Full Article
esp Plasma cfDNA in Glioblastoma--Response By clincancerres.aacrjournals.org Published On :: 2020-05-01T00:05:37-07:00 Full Article
esp Predominance of Central Memory T Cells with High T-Cell Receptor Repertoire Diversity is Associated with Response to PD-1/PD-L1 Inhibition in Merkel Cell Carcinoma By clincancerres.aacrjournals.org Published On :: 2020-05-01T00:05:36-07:00 Purpose: Merkel cell carcinoma (MCC) is an aggressive neuroendocrine skin cancer, which can be effectively controlled by immunotherapy with PD-1/PD-L1 checkpoint inhibitors. However, a significant proportion of patients are characterized by primary therapy resistance. Predictive biomarkers for response to immunotherapy are lacking. Experimental Design: We applied Bayesian inference analyses on 41 patients with MCC testing various clinical and biomolecular characteristics to predict treatment response. Further, we performed a comprehensive analysis of tumor tissue–based immunologic parameters including multiplexed immunofluorescence for T-cell activation and differentiation markers, expression of immune-related genes and T-cell receptor (TCR) repertoire analyses in 18 patients, seven objective responders, and 11 nonresponders. Results: Bayesian inference analyses demonstrated that among currently discussed biomarkers only unimpaired overall performance status and absence of immunosuppression were associated with response to therapy. However, in responders, a predominance of central memory T cells and expression of genes associated with lymphocyte attraction and activation was evident. In addition, TCR repertoire usage of tumor-infiltrating lymphocytes (TILs) demonstrated low T-cell clonality, but high TCR diversity in responding patients. In nonresponders, terminally differentiated effector T cells with a constrained TCR repertoire prevailed. Sequential analyses of tumor tissue obtained during immunotherapy revealed a more pronounced and diverse clonal expansion of TILs in responders indicating an impaired proliferative capacity among TILs of nonresponders upon checkpoint blockade. Conclusions: Our explorative study identified new tumor tissue–based molecular characteristics associated with response to anti–PD-1/PD-L1 therapy in MCC. These observations warrant further investigations in larger patient cohorts to confirm their potential value as predictive markers. Full Article
esp Adenosine Signaling Is Prognostic for Cancer Outcome and Has Predictive Utility for Immunotherapeutic Response By clincancerres.aacrjournals.org Published On :: 2020-05-01T00:05:36-07:00 Purpose: There are several agents in early clinical trials targeting components of the adenosine pathway including A2AR and CD73. The identification of cancers with a significant adenosine drive is critical to understand the potential for these molecules. However, it is challenging to measure tumor adenosine levels at scale, thus novel, clinically tractable biomarkers are needed. Experimental Design: We generated a gene expression signature for the adenosine signaling using regulatory networks derived from the literature and validated this in patients. We applied the signature to large cohorts of disease from The Cancer Genome Atlas (TCGA) and cohorts of immune checkpoint inhibitor–treated patients. Results: The signature captures baseline adenosine levels in vivo (r2 = 0.92, P = 0.018), is reduced after small-molecule inhibition of A2AR in mice (r2 = –0.62, P = 0.001) and humans (reduction in 5 of 7 patients, 70%), and is abrogated after A2AR knockout. Analysis of TCGA confirms a negative association between adenosine and overall survival (OS, HR = 0.6, P < 2.2e–16) as well as progression-free survival (PFS, HR = 0.77, P = 0.0000006). Further, adenosine signaling is associated with reduced OS (HR = 0.47, P < 2.2e–16) and PFS (HR = 0.65, P = 0.0000002) in CD8+ T-cell–infiltrated tumors. Mutation of TGFβ superfamily members is associated with enhanced adenosine signaling and worse OS (HR = 0.43, P < 2.2e–16). Finally, adenosine signaling is associated with reduced efficacy of anti-PD1 therapy in published cohorts (HR = 0.29, P = 0.00012). Conclusions: These data support the adenosine pathway as a mediator of a successful antitumor immune response, demonstrate the prognostic potential of the signature for immunotherapy, and inform patient selection strategies for adenosine pathway modulators currently in development. Full Article
esp Prospective Evaluation of Bone Metabolic Markers as Surrogate Markers of Response to Radium-223 Therapy in Metastatic Castration-resistant Prostate Cancer By clincancerres.aacrjournals.org Published On :: 2020-05-01T00:05:36-07:00 Purpose: Radium-223 is approved for metastatic castration-resistant prostate cancer (mCRPC) based on improved overall survival, and delay in skeletal related events. However, it is not associated with PSA or radiographic response, which poses a challenge in real-time assessment of its efficacy. Surrogate markers of treatment outcomes may facilitate tailoring treatment duration with radium-223, by limiting the duration of therapy with radium-223 in these patients. Here, we sought to investigate the utility of bone metabolic markers (BMMs) as surrogate markers of response to radium-223 in mCRPC. Patients and Methods: A prospective phase II trial of radium-223 plus enzalutamide (RE) versus enzalutamide alone was designed to assess surrogacy of BMMs with respect to response to radium-223. Enzalutamide was used as a comparator in lieu of placebo due to the progressive disease. Co-primary endpoints were relative change in serum BMM N-telopeptide (NTP) levels from baseline to 6 months between the two arms and safety and feasibility of the combination. Results: Thirty-nine men were randomized to RE (n = 27) or enzalutamide (n = 12). Combination was safe and feasible. Primary endpoint was met. A statistically significant relative change to NTP ratios between arms (0.64, 95% confidence interval, 0.51–0.81; P = 0.00048) favored RE versus enzalutamide. Overall, BMMs decreased with the RE therapy compared with enzalutamide. Improved PSA response rate in RE versus enzalutamide (P = 0.024), correlated with decline in BMMs. Conclusions: BMMs declined significantly with combination therapy, and were associated with improved outcomes. Upon external validation, BMMs may emerge as surrogate markers to monitor treatment with radium-223 in real-time. Full Article
esp Scope and Predictive Genetic/Phenotypic Signatures of Bicarbonate (NaHCO3) Responsiveness and {beta}-Lactam Sensitization in Methicillin-Resistant Staphylococcus aureus [Susceptibility] By aac.asm.org Published On :: 2020-04-21T08:01:10-07:00 Addition of sodium bicarbonate (NaHCO3) to standard antimicrobial susceptibility testing medium reveals certain methicillin-resistant Staphylococcus aureus (MRSA) strains to be highly susceptible to β-lactams. We investigated the prevalence of this phenotype (NaHCO3 responsiveness) to two β-lactams among 58 clinical MRSA bloodstream isolates. Of note, ~75% and ~36% of isolates displayed the NaHCO3 responsiveness phenotype to cefazolin (CFZ) and oxacillin (OXA), respectively. Neither intrinsic β-lactam MICs in standard Mueller-Hinton broth (MHB) nor population analysis profiles were predictive of this phenotype. Several genotypic markers (clonal complex 8 [CC8]; agr I and spa t008) were associated with NaHCO3 responsiveness for OXA. Full Article
esp In Vitro Activity of Ceftazidime-Avibactam against Isolates from Respiratory and Blood Specimens from Patients with Nosocomial Pneumonia, Including Ventilator-Associated Pneumonia, in a Phase 3 Clinical Trial [Susceptibility] By aac.asm.org Published On :: 2020-04-21T08:01:10-07:00 Nosocomial pneumonia (NP), including ventilator-associated pneumonia (VAP), is increasingly associated with multidrug-resistant Gram-negative pathogens. This study describes the in vitro activity of ceftazidime-avibactam, ceftazidime, and relevant comparator agents against bacterial pathogens isolated from patients with NP, including VAP, enrolled in a ceftazidime-avibactam phase 3 trial. Gram-positive pathogens were included if coisolated with a Gram-negative pathogen. In vitro susceptibility was determined at a central laboratory using Clinical and Laboratory Standards Institute broth microdilution methods. Of 817 randomized patients, 457 (55.9%) had ≥1 Gram-negative bacterial pathogen(s) isolated at baseline, and 149 (18.2%) had ≥1 Gram-positive pathogen(s) coisolated. The most common isolated pathogens were Klebsiella pneumoniae (18.8%), Pseudomonas aeruginosa (15.8%), and Staphylococcus aureus (11.5%). Ceftazidime-avibactam was highly active in vitro against 370 isolates of Enterobacteriaceae, with 98.6% susceptible (MIC90, 0.5 μg/ml) compared with 73.2% susceptible for ceftazidime (MIC90, >64 μg/ml). The percent susceptibility values for ceftazidime-avibactam and ceftazidime against 129 P. aeruginosa isolates were 88.4% and 72.9% (MIC90 values of 16 μg/ml and 64 μg/ml), respectively. Among ceftazidime-nonsusceptible Gram-negative isolates, ceftazidime-avibactam percent susceptibility values were 94.9% for 99 Enterobacteriaceae and 60.0% for 35 P. aeruginosa. MIC90 values for linezolid and vancomycin (permitted per protocol for Gram-positive coverage) were within their respective MIC susceptibility breakpoints against the Gram-positive pathogens isolated. This analysis demonstrates that ceftazidime-avibactam was active in vitro against the majority of Enterobacteriaceae and P. aeruginosa isolates from patients with NP, including VAP, in a phase 3 trial. (This study has been registered at ClinicalTrials.gov under identifier NCT01808092.) Full Article
esp Thiostrepton Reactivates Latent HIV-1 through the p-TEFb and NF-{kappa}B Pathways Mediated by Heat Shock Response [Antiviral Agents] By aac.asm.org Published On :: 2020-04-21T08:01:10-07:00 Antiretroviral therapy (ART) suppresses HIV-1 replication but fails to cure the infection. The presence of an extremely stable viral latent reservoir, primarily in resting memory CD4+ T cells, remains a major obstacle to viral eradication. The "shock and kill" strategy targets these latently infected cells and boosts immune recognition and clearance, and thus, it is a promising approach for an HIV-1 functional cure. Although some latency-reversing agents (LRAs) have been reported, no apparent clinical progress has been made, so it is still vital to seek novel and effective LRAs. Here, we report that thiostrepton (TSR), a proteasome inhibitor, reactivates latent HIV-1 effectively in cellular models and in primary CD4+ T cells from ART-suppressed individuals ex vivo. TSR does not induce global T cell activation, severe cytotoxicity, or CD8+ T cell dysfunction, making it a prospective LRA candidate. We also observed a significant synergistic effect of reactivation when TSR was combined with JQ1, prostratin, or bryostatin-1. Interestingly, six TSR analogues also show reactivation abilities that are similar to or more effective than that of TSR. We further verified that TSR upregulated expression of heat shock proteins (HSPs) in CD4+ T cells, which subsequently activated positive transcriptional elongation factor b (p-TEFb) and NF-B signals, leading to viral reactivation. In summary, we identify TSR as a novel LRA which could have important significance for applications to an HIV-1 functional cure in the future. Full Article
esp Compounds with Therapeutic Potential against Novel Respiratory 2019 Coronavirus [Minireviews] By aac.asm.org Published On :: 2020-04-21T08:01:09-07:00 Currently, the expansion of the novel human respiratory coronavirus (known as SARS-CoV-2 [severe acute respiratory syndrome coronavirus 2], COVID-2019 [coronavirus disease 2019], or 2019-nCoV [2019 novel coronavirus]) has stressed the need for therapeutic alternatives to alleviate and stop this new epidemic. The previous epidemics of infections by high-morbidity human coronaviruses, such as SARS-CoV in 2003 and the Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, prompted the characterization of compounds that could be potentially active against the currently emerging novel coronavirus, SARS-CoV-2. The most promising compound is remdesivir (GS-5734), a nucleotide analog prodrug currently in clinical trials for treating Ebola virus infections. Remdesivir inhibited the replication of SARS-CoV and MERS-CoV in tissue cultures, and it displayed efficacy in nonhuman animal models. In addition, a combination of the human immunodeficiency virus type 1 (HIV-1) protease inhibitors lopinavir/ritonavir and interferon beta (LPV/RTV–IFN-β) was shown to be effective in patients infected with SARS-CoV. LPV/RTV–IFN-β also improved clinical parameters in marmosets and mice infected with MERS-CoV. Remarkably, the therapeutic efficacy of remdesivir appeared to be superior to that of LPV/RTV–IFN-β against MERS-CoV in a transgenic humanized mouse model. The relatively high mortality rates associated with these three novel human coronavirus infections, SARS-CoV, MERS-CoV, and SARS-CoV-2, have suggested that proinflammatory responses might play a role in the pathogenesis. It remains unknown whether the generated inflammatory state should be targeted. Therapeutics that target the coronavirus alone might not be able to reverse highly pathogenic infections. This minireview aims to provide a summary of therapeutic compounds that have shown potential in fighting SARS-CoV-2 infections. Full Article
esp Levonadifloxacin, a Novel Benzoquinolizine Fluoroquinolone, Modulates Lipopolysaccharide-Induced Inflammatory Responses in Human Whole-Blood Assay and Murine Acute Lung Injury Model [Pharmacology] By aac.asm.org Published On :: 2020-04-21T08:01:09-07:00 Fluoroquinolones are reported to possess immunomodulatory activity; hence, a novel benzoquinolizine fluoroquinolone, levonadifloxacin, was evaluated in lipopolysaccharide-stimulated human whole-blood (HWB) and mouse acute lung injury (ALI) models. Levonadifloxacin significantly mitigated the inflammatory responses in an HWB assay through inhibition of proinflammatory cytokines and in the ALI model by lowering lung total white blood cell count, myeloperoxidase, and cytokine levels. The immunomodulatory effect of levonadifloxacin, along with promising antibacterial activity, is expected to provide clinical benefits in the treatment of infections. Full Article
esp Strong HPV Vaccine Response Predicts Better Survival with Chemotherapy [Clinical Trials] By cancerdiscovery.aacrjournals.org Published On :: 2020-05-01T00:05:26-07:00 Patients with HPV16+ cervical cancer and high T-cell responses to an HPV16 vaccine survived longer. Full Article
esp Neoantigens Elicit Protumorigenic Immune Responses in Pancreatic Cancer [Pancreatic Cancer] By cancerdiscovery.aacrjournals.org Published On :: 2020-05-01T00:05:26-07:00 Neoantigen-expressing pancreatic cancers had hastened progression and poor immunotherapy response. Full Article
esp A Previously Unknown Dendritic Cell Type Reduces Antitumor Response [Immunology] By cancerdiscovery.aacrjournals.org Published On :: 2020-05-01T00:05:26-07:00 A cluster of dendritic cells (termed mregDCs), observed in humans and mice, restricted antitumor immunity. Full Article
esp Increased B-cell ICOSL Expression Improves Chemotherapy Response [Immunology] By cancerdiscovery.aacrjournals.org Published On :: 2020-05-01T00:05:26-07:00 A chemotherapy-induced shift to ICOSL+ B cells in breast tumors correlated with better survival. Full Article
esp Retinoic Acid Mediates Monocyte Differentiation and Immune Response [Immunology] By cancerdiscovery.aacrjournals.org Published On :: 2020-05-01T00:05:26-07:00 Tumor-derived retinoic acid promotes monocyte differentiation into immunosuppressive macrophages. Full Article
esp RNA sequencing profiles and diagnostic signatures linked with response to ramucirumab in gastric cancer [RESEARCH REPORT] By molecularcasestudies.cshlp.org Published On :: 2020-04-01T06:30:17-07:00 Gastric cancer (GC) is the fifth-ranked cancer type by associated mortality. The proportion of early diagnosis is low, and most patients are diagnosed at the advanced stages. First-line therapy standardly includes fluoropyrimidines and platinum compounds with trastuzumab for HER2-positive cases. For recurrent disease, there are several alternative options including ramucirumab, a monoclonal therapeutic antibody that inhibits VEGF-mediated tumor angiogenesis by binding with VEGFR2, alone or in combination with other cancer drugs. However, overall response rate following ramucirumab or its combinations is 30%–80% of the patients, suggesting that personalization of drug prescription is needed to increase efficacy of treatment. We report here original tumor RNA sequencing profiles for 15 advanced GC patients linked with data on clinical response to ramucirumab or its combinations. Three genes showed differential expression in the tumors for responders versus nonresponders: CHRM3, LRFN1, and TEX15. Of them, CHRM3 was up-regulated in the responders. Using the bioinformatic platform Oncobox we simulated ramucirumab efficiency and compared output model results with actual tumor response data. An agreement was observed between predicted and real clinical outcomes (AUC ≥ 0.7). These results suggest that RNA sequencing may be used to personalize the prescription of ramucirumab for GC and indicate potential molecular mechanisms underlying ramucirumab resistance. The RNA sequencing profiles obtained here are fully compatible with the previously published Oncobox Atlas of Normal Tissue Expression (ANTE) data. Full Article
esp BRAF V600E-mutated metastatic pediatric Wilms tumor with complete response to targeted RAF/MEK inhibition [RESEARCH REPORT] By molecularcasestudies.cshlp.org Published On :: 2020-04-01T06:30:17-07:00 Wilms tumor (WT) is the most common renal malignancy of childhood and accounts for 6% of all childhood malignancies. With current therapies, the 5-yr overall survival (OS) for children with unilateral favorable histology WT is greater than 85%. The prognosis is worse, however, for the roughly 15% of patients who relapse, with only 50%–80% OS reported in those with recurrence. Herein, we describe the extended and detailed clinical course of a rare case of a child with recurrent, pulmonary metastatic, favorable histology WT harboring a BRAF V600E mutation. The BRAF V600E mutation, commonly found in melanoma and other cancers, and previously undescribed in WT, has recently been reported by our group in a subset of epithelial-predominant WT. This patient, who was included in that series, presented with unilateral, stage 1, favorable histology WT and was treated with standard chemotherapy. Following the completion of therapy, the patient relapsed with pulmonary metastatic disease, that then again recurred despite an initial response to salvage chemotherapy and radiation. Next-generation sequencing (NGS) on the metastatic pulmonary nodule revealed a BRAF V600E mutation. After weighing the therapeutic options, a novel approach with dual BRAF/MEK inhibitor combination therapy was initiated. Complete radiographic response was observed following 4 months of therapy with dabrafenib and trametinib. At 12 months following the start of BRAF/MEK combination treatment, the patient continues with a complete response and has experienced minimal treatment-related side effects. This represents the first case, to our knowledge, of effective treatment with BRAF/MEK molecularly targeted therapy in a pediatric Wilms tumor patient. Full Article
esp Tumoral and immune heterogeneity in an anti-PD-1-responsive glioblastoma: a case study [RESEARCH REPORT] By molecularcasestudies.cshlp.org Published On :: 2020-04-01T06:30:17-07:00 Clinical benefit of immune checkpoint blockade in glioblastoma (GBM) is rare, and we hypothesize that tumor clonal evolution and the immune microenvironment are key determinants of response. Here, we present a detailed molecular characterization of the intratumoral and immune heterogeneity in an IDH wild-type, MGMT-negative GBM patient who plausibly benefited from anti-PD-1 therapy with an unusually long 25-mo overall survival time. We leveraged multiplex immunohistochemistry, RNA-seq, and whole-exome data from the primary tumor and three resected regions of recurrent disease to survey regional tumor-immune interactions, genomic instability, mutation burden, and expression profiles. We found significant regional heterogeneity in the neoantigenic and immune landscape, with a differential T-cell signature among recurrent sectors, a uniform loss of focal amplifications in EGFR, and a novel subclonal EGFR mutation. Comparisons with recently reported correlates of checkpoint blockade in GBM and with TCGA-GBM revealed appreciable intratumoral heterogeneity that may have contributed to a differential PD-1 blockade response. Full Article
esp Diabetic Kidney Disease: It Don’t Get No Respect By clinical.diabetesjournals.org Published On :: 2020-04-15T12:00:21-07:00 Full Article
esp Pancreatic Cancer Risk in Relation to Lifetime Smoking Patterns, Tobacco Type, and Dose-Response Relationships By cebp.aacrjournals.org Published On :: 2020-05-01T00:05:36-07:00 Background: Despite smoking being a well-established risk factor for pancreatic cancer, there is a need to further characterize pancreatic cancer risk according to lifespan smoking patterns and other smoking features, such as tobacco type. Our aim was to deeply investigate them within a large European case–control study. Methods: Tobacco smoking habits and other relevant information were obtained from 2,009 cases and 1,532 controls recruited in the PanGenEU study using standardized tools. Multivariate logistic regression analysis was performed to evaluate pancreatic cancer risk by smoking characteristics and interactions with other pancreatic cancer risk factors. Fractional polynomials and restricted cubic splines were used to test for nonlinearity of the dose–response relationships and to analyze their shape. Results: Relative to never-smokers, current smokers [OR = 1.72; 95% confidence interval (95% CI), 1.39–2.12], those inhaling into the throat (OR = 1.48; 95% CI, 1.11–1.99) or chest (OR = 1.33; 95% CI, 1.12–1.58), and those using nonfiltered cigarettes (OR = 1.69; 95% CI, 1.10–2.61), were all at an increased pancreatic cancer risk. Pancreatic cancer risk was highest in current black tobacco smokers (OR = 2.09; 95% CI, 1.31–3.41), followed by blond tobacco smokers (OR = 1.43; 95% CI, 1.01–2.04). Childhood exposure to tobacco smoke relative to parental smoking was also associated with increased pancreatic cancer risk (OR = 1.24; 95% CI, 1.03–1.49). Dose–response relationships for smoking duration, intensity, cumulative dose, and smoking cessation were nonlinear and showed different shapes by tobacco type. Effect modification by family history of pancreatic cancer and diabetes was likely. Conclusions: This study reveals differences in pancreatic cancer risk by tobacco type and other habit characteristics, as well as nonlinear risk associations. Impact: This characterization of smoking-related pancreatic cancer risk profiles may help in defining pancreatic cancer high-risk populations. Full Article
esp Glial TIM-3 Modulates Immune Responses in the Brain Tumor Microenvironment By cancerres.aacrjournals.org Published On :: 2020-05-04T05:35:17-07:00 T-cell immunoglobulin and mucin domain–containing molecule 3 (TIM-3), a potential immunotherapeutic target for cancer, has been shown to display diverse characteristics in a context-dependent manner. Thus, it would be useful to delineate the precise functional features of TIM-3 in a given situation. Here, we report that glial TIM-3 shows distinctive properties in the brain tumor microenvironment. TIM-3 was expressed on both growing tumor cells and their surrounding cells including glia and T cells in an orthotopic mouse glioma model. The expression pattern of TIM-3 was distinct from those of other immune checkpoint molecules in tumor-exposed and tumor-infiltrating glia. Comparison of cells from tumor-bearing and contralateral hemispheres of a glioma model showed that TIM-3 expression was lower in tumor-infiltrating CD11b+CD45mid glial cells but higher in tumor-infiltrating CD8+ T cells. In TIM-3 mutant mice with intracellular signaling defects and Cre-inducible TIM-3 mice, TIM-3 affected the expression of several immune-associated molecules including iNOS and PD-L1 in primary glia-exposed conditioned media (CM) from brain tumors. Further, TIM-3 was cross-regulated by TLR2, but not by TLR4, in brain tumor CM- or Pam3CSK4-exposed glia. In addition, following exposure to tumor CM, IFNγ production was lower in T cells cocultured with TIM-3–defective glia than with normal glia. Collectively, these findings suggest that glial TIM-3 actively and distinctively responds to brain tumor, and plays specific intracellular and intercellular immunoregulatory roles that might be different from TIM-3 on T cells in the brain tumor microenvironment.Significance:TIM-3 is typically thought of as a T-cell checkpoint receptor. This study demonstrates a role for TIM-3 in mediating myeloid cell responses in glioblastoma. Full Article
esp Systemic Immune Response and Cancer Risk: Filling the Missing Piece of Immuno-Oncology By cancerres.aacrjournals.org Published On :: 2020-05-04T05:35:17-07:00 While immuno-oncology has made significant advances in activating local tumor immune responses, leading to improved outcomes, the role of systemic immunity in cancer incidence remains poorly understood. Le Cornet and colleagues prospectively studied circulating immune cells quantified by DNA methylation markers in relation to incidence of breast, colorectal, lung, and prostate cancer among initially healthy individuals. A positive association with cancer risk was observed for higher FOXP3+ T-cell–mediated immune tolerance and lower CD8+ T-cell–mediated cytotoxicity. Further studies of systemic immunity in cancer development are crucial to identify novel prediction markers and interventional targets for cancer immunoprevention.See related article by Le Cornet et al., p. 1885 Full Article
esp Immunotherapeutic Response in Tumors Is Affected by Microenvironmental ROS By cancerres.aacrjournals.org Published On :: 2020-05-04T05:35:17-07:00 Carcinoma-associated fibroblasts (CAF) are a potential therapeutic target for both direct and indirect regulation of cancer progression and therapy response. In this issue of Cancer Research, Ford and colleagues investigate the influence of CAF on the immune environment of tumors, specifically focusing on the regulation of CD8+ T cells, required for immune therapy response. Their work suggests a role for stromally expressed NADPH oxidase 4 (NOX4) as a modulator of reactive oxygen species that in turn can reduce the number of CD8+ T cells locally. Inhibition of NOX4 increased CD8+ T cells and restored responsiveness to immune therapy, suggesting an indirect stromally targeted avenue for therapy resensitization.See related article by Ford et al., p. 1846 Full Article
esp COVID-19 crisis unveils socially responsible Asia Property Awards (Singapore) winning developers By batdongsan.com.vn Published On :: 11:44 05/05/2020 As they implement stricter measures and distribute millions worth of donations to communities in need. Full Article
esp Piaggio Vespa VXL 149 और SXL 149 BS6 इंजन के साथ भारत में लॉन्च, जानें कीमत और फीचर्स By www.amarujala.com Published On :: Tue, 05 May 2020 10:22:39 +0530 भारत में स्कूटर सेगमेंट में कई खिलाड़ी मौजूद हैं। देश में सबसे लोकप्रिय स्कूटर बेशक Honda Activa (होंडा एक्टिवा) है, लेकिन इस सेगमेंट में TVS (टीवीएस), Hero (हीरो), Yamaha (यामाहा) जैसे अन्य ब्रांड्स की भी खासी मौजूदगी है। Full Article
esp Maruti Vitara Brezza से भी महंगा है Vespa का यह स्कूटर, अब 2 लाख रुपये हुआ सस्ता By www.amarujala.com Published On :: Wed, 06 May 2020 12:10:08 +0530 Piaggio India कंपनी ने Vespa 946 Emporio Armani नाम का एक स्कूटर लॉन्च किया था। इस स्कूटर को दुनिया के जानेमाने डिजाइनर Emporio Armani ने डिजाइन किया था। Full Article
esp UK government approves Huawei 5G deal despite security fears By www.newscientist.com Published On :: Tue, 28 Jan 2020 13:33:05 +0000 Chinese telecomms firm Huawei will be allowed to provide technology for key parts of the UK's super-fast 5G infrastructure, prime minister Boris Johnson has said, despite opposition from the US Full Article
esp Scientists Cry Foul After Government Redacts Criticism of Its Response in Key Coronavirus Report By feedproxy.google.com Published On :: Fri, 08 May 2020 18:30:04 +0000 "This government has failed to show any self-criticism whatsoever, when it is glaringly obvious to everybody that big mistakes have been made." Full Article
esp Despite Record Streaming Subscriptions, Disney Is Tiptoeing Around the Cinema Drama – For Now By feedproxy.google.com Published On :: Fri, 08 May 2020 20:00:05 +0000 As a very ugly standoff develops between legacy cinemas and legacy studios, Disney appears to be playing its cards close to its chest. Full Article
esp The Queen’s Coronavirus Message to Britain: ‘Never Give Up, Never Despair’ By feedproxy.google.com Published On :: Sat, 09 May 2020 02:11:53 GMT via YouTubeThe Queen gave a 75th anniversary VE Day speech Friday night that doubled as a rallying cry against coronavirus. “Never give up, never despair, that was the message of VE Day,” she told the British people. Second World War heroes would “recognize and admire,” the sacrifices the British were making today in the fight against coronavirus, the Queen added. It was her second major coronavirus-themed speech to the nation.“It may seem hard that we cannot mark this special anniversary as we would wish. Instead we remember from our homes and our doorsteps. But our streets are not empty,” the Queen said, “They are filled with the love and the care that we have for each other.” Read more at The Daily Beast. Full Article Arts and Culture
esp Rafael Nadal: ATP Tour chairman responds to 2020 season cancellation fears By feedproxy.google.com Published On :: Sat, 09 May 2020 15:50:00 +0100 Rafael Nadal revealed this week he was doubtful there will be further tennis in 2020. Full Article
esp It Shouldn’t Be This Hard to Responsibly Fly a Drone By feedproxy.google.com Published On :: Tue, 03 Sep 2019 20:44:00 GMT The FAA’s app—which tells you where you can and can’t fly your drone—ignores both local and national regulations Full Article robotics robotics/drones
esp RPGCast – Episode 328: “Nobody Likes You, Especially Your Turkey” By feedproxy.google.com Published On :: Sat, 22 Nov 2014 19:11:32 +0000 Chris drowns in potions. Anna Marie hits one hundred. Alice shops with e’s. And Manny plays some 360 games now that he finally has an... Full Article News Podcasts RPG Cast
esp RPGCast – Episode 352: “Paws Responds To Allegations of Feline Scandal” By feedproxy.google.com Published On :: Sat, 27 Jun 2015 22:25:01 +0000 As Anna prepares her statement, Alice introduces us to a new form of missile delivery. Chris plays really old games instead of the other old... Full Article News Podcasts RPG Cast
esp RPGCast – Episode 432: “The Dark Souls Of eSports” By feedproxy.google.com Published On :: Sat, 15 Jul 2017 22:42:09 +0000 EVE discovers new planets. FFXV gets super sentais. We all get eggs. But we don’t get Ni no Kuni. At least, not yet. We probably... Full Article News Podcasts RPG Cast
esp Regularly attending religious services associated with lower risk of deaths of despair, study finds By www.sciencedaily.com Published On :: Wed, 06 May 2020 13:36:27 EDT People who attended religious services at least once a week were significantly less likely to die from 'deaths of despair,' including deaths related to suicide, drug overdose, and alcohol poisoning, according to new research. Full Article
esp California Gov. Newsom Endorses Biden, Despite Attempts to Avoid Partisan Politics By www.newsweek.com Published On :: Fri, 08 May 2020 23:39:51 -0400 "I just couldn't be more proud of you and the prospect of your presidency," Newsom told Biden Friday during a campaign event. Full Article
esp Obama Slams Dropping of Michael Flynn Case, Calls White House COVID-19 Response 'Absolute Chaotic Disaster': Report By www.newsweek.com Published On :: Sat, 09 May 2020 07:02:27 -0400 Audio of a private conversation shows the 44th president's unvarnished views about the former national security adviser's case and the White House's COVID-19 response. Full Article
esp Chrissy Teigen Responds to Alison Roman's Digs at Her and Marie Kondo: 'This is a Huge Bummer' By www.newsweek.com Published On :: Sat, 09 May 2020 08:17:16 -0400 Jameela Jamil also came to Teigen and Kondo's defense, calling Roman "distasteful" and "cliche" for criticizing women of color for being successful in business. Full Article
esp Ousted Scientist Tears Up While Ripping Trump Coronavirus Response: 'We Could've Done Something And We Didn't' By www.newsweek.com Published On :: Sat, 09 May 2020 10:30:32 -0400 Trump administration whistleblower Rick Bright teared up while ripping the Trump's response to the coronavirus: "We could've done something and we didn't." Full Article
esp 7 VCs talk about today’s esports opportunities By feedproxy.google.com Published On :: Thu, 30 Apr 2020 13:30:01 +0000 Even before the COVID-19 shutdown, venture funding rounds and total deal volume of VC funding for esports were down noticeably from the year prior. The space received a lot of attention in 2017 and 2018 as leagues formed, teams raised money and surging popularity fostered a whole ecosystem of new companies. Last year featured some […] Full Article Advertising Tech Artificial Intelligence Entertainment Extra Crunch Gaming Investor Surveys Startups TC Venture Capital coronavirus COVID-19 esports machine learning
esp Twitch launches an esports directory to cater to growing streaming audience By feedproxy.google.com Published On :: Thu, 30 Apr 2020 16:20:19 +0000 Twitch is doubling down on esports in this new era of social distancing as a number of traditional sporting events have been cancelled. The company this week introduced a new esports directory on its site that will make it easier for viewers to find live matches, information on players, games with active competition leagues, a […] Full Article Gaming Media esports streaming Twitch
esp Coronavirus Lockdown 3.0: Suspension of labour laws by fiat can only be an immediate-term response to the current crisis By in.news.yahoo.com Published On :: Sat, 09 May 2020 05:32:45 -0500 There has been talk for some time now about easing labour laws, already seen in industry circles as being too rigid and acting as a drag on growth, specifically to facilitate emerging from the lockdown. And it’s not just a question of emerging from it, there’s also the issue of surviving what looks like being a brutal and prolonged global economic downturn. It was reported on Friday that ordinances were being issued in some states. Full Article
esp Andrew Garfield, Michael Shannon and Other 2017 Oscar Nominees Respond to Academy Nod By blogs.wsj.com Published On :: Tue, 24 Jan 2017 18:28:06 +0000 Some of this year's Oscar nominees, including Andrew Garfield and Michael Shannon, react to news of their nomination. Full Article Arts + Culture Awards Ceremonies Celebrity Film Movie Biz movies News People Photos 2017 Oscars Allison Schroeder Andrew Garfield August Wilson Constanza Romero Wilson Denzel Washington Desmond Doss Fences Hacksaw Ridge Hidden Figures Martin Scorsese Michael Shannon Nocturnal Animals Oscar nominations Oscars Silence