Objective Isocitrate dehydrogenase gene(IDH)mutations are associated with tumor angiogenesis and therefore play an important role in glioma management.This study compared the performance of tumor blood vessels counted...Objective Isocitrate dehydrogenase gene(IDH)mutations are associated with tumor angiogenesis and therefore play an important role in glioma management.This study compared the performance of tumor blood vessels counted from contrast-enhanced 3D brain volume(3D-BRAVO)sequence and dynamic contrast-enhanced(DCE)MRI in differentiating IDH1 status in gliomas.Methods Forty-four glioma patients[16 with IDH1 mutant-type(IDH1-MT),28 with IDH1 wild-type(IDH1-WT)]were retrospectively analyzed.A blood vessel entering a tumor was defined as an intratumoral vessel;a blood vessel adjacent to the edge of a tumor was defined as a peritumoral vessel.Combined vessels were defined as the sum of the intratumoral and peritumoral vessels.DCE-derived metrics of tumor were normalized to the contralateral normal-appearing white matter.Results Intratumoral,peritumoral,and combined tumor blood vessels were all significantly different between IDH1-MT and IDH1-WT gliomas,and the range of area under curves(AUCs)was 0.816–0.855.For DCE-derived parameters,cerebral blood volume,cerebral blood flow,mean transit time,and volume transfer constant were significantly different between IDH1-MT and IDH1-WT gliomas,and the range of AUCs was 0.703–0.756.Combined vessels possessed the best performance for identifying IDH1 mutations in gliomas(AUC:0.855,sensitivity:0.857,specificity:0.812,P<0.001).Conclusion The number of tumor blood vessels has comparable diagnostic performance with DCE-derived parameters for differentiating IDH1 mutations and can serve as a potential imaging biomarker to reflect IDH1 mutations in gliomas.展开更多
When devoured by macrophages,Mycobacterium tuberculosis remains persistent in macrophages and gains energy through the glyoxylate bypass to maintain its long-term existence in host cells.Therefore it is possible to st...When devoured by macrophages,Mycobacterium tuberculosis remains persistent in macrophages and gains energy through the glyoxylate bypass to maintain its long-term existence in host cells.Therefore it is possible to stop persistent infections by interdicting the glyoxylate bypass in which the isocitrate lyase（ICL） is the key rate-limiting enzyme and a persistence factor.ICL is the target of anti-TB（TB：tubercular） drugs,which could screen ICL out and effectively inhibit the activity of ICL in Mycobacterium tuberculosis,and because of this,anti-TB drugs can be used to kill persistent Mycobacterium tuberculosis.In this study,the ICL gene of the Mycobacterium tuberculosis H37Rv was cloned successfully and recombinant protein with bioactivity was obtained through the enzyme characteristic appraisal.The specific activity of the recombined ICL is 24μmol·mg-1·min-1.The recombined ICL protein was used as the target,and phages which can specifically combine to ICL were screened in the phage 7 peptide library.According to the results of the ELISA and DNA sequence detection,eventually three 7-peptide chains were synthesized.Then the peptide chains were reacted with ICL,respectively,to detect their inhibitory effects on ICL.The results show that all the three 7-peptide chains possessed varying inhibitory effects on the activity of ICL.This study provided lead compounds for the research and development of new peptide anti-TB drugs.展开更多
Background:Mutations in the isocitrate dehydrogenase 1(IDH1)and IDH2 genes are important for both the integrated diagnosis and the prognosis of diffuse gliomas.The p.R132H mutation of IDH1 is the most frequently obser...Background:Mutations in the isocitrate dehydrogenase 1(IDH1)and IDH2 genes are important for both the integrated diagnosis and the prognosis of diffuse gliomas.The p.R132H mutation of IDH1 is the most frequently observed IDH mutation,while IDH2 mutations were relatively rarely studied.The aim of the study was to determine the pathological and genetic characteristics of lowergrade gliomas that carry IDH2 mutations.Methods:Data from 238 adult patients with lower-grade gliomas were retrospectively analyzed.The status of IDH1/2 gene mutations,telomerase reverse transcriptase(TERT)promoter mutations,O^6-methylguanine-DNA-methyltransferase(MGMT)promoter methylation,1p/19q co-deletion and the expressions of IDH1 R132H,alpha-thalassemia X-linked mental retardation,and p53 were evaluated.Progression-free survival(PFS)and overall survival(OS)were calculated via Kaplan-Meier estimation using the log-rank test.Results:Totally,71%(169/238)of patients were positive for IDH mutations,including 12 patients harboring mutations in IDH2.Among the 12 patients with IDH2 mutations,ten patients harbored the R172K mutation,one patient harbored the R172S mutation and one harbored the R172W mutation.Of these,11 tumors occurred in the frontal lobe and showed morphology typical of oligodendroglioma.The proportion of grade II tumors was higher than that of grade III tumors in IDH2 mutant-gliomas.IDH2 mutations were frequently associated with TERT promoter mutations,1p/19q co-deletion and MGMT promoter methylation.IDH2 mutations were associated with better outcomes compared with IDH wild-type gliomas(P<0.05).However,the PFS and OS did not differ from that of IDH1 mutant patients(P=0.95 and P=0.60,respectively).Conclusions:IDH2 mutations are more frequent in oligodendrogliomas and associated with a better prognosis.IDH2 mutations may segregate in distinct clinico-pathological and genetic subtypes of gliomas,and therefore may merit routine investigation.展开更多
Background Isocitrate lyase （ICL） was previously demonstrated to play a pivotal role in the intracellular metabolism of Mycobacterium tuberculosis （MTB）. Presently several lines of evidence suggest that ICL from M...Background Isocitrate lyase （ICL） was previously demonstrated to play a pivotal role in the intracellular metabolism of Mycobacterium tuberculosis （MTB）. Presently several lines of evidence suggest that ICL from MTB （MTB-ICL） may play some roles in the interaction between MTB and host macrophage. However, there has been no research on the interaction between MTB-ICL and host macrophage.Methods MTB-icl and M. smegmatis （MS）-icl genes were amplified by polymerase chain reaction （PCR） and cloned into the E. coli-mycobacterium shuttle plasmid pUV15 to obtain recombinant shuttle plasmids pMTB-icl and pMS-icl. Following transformation into MS by electroporation, the expression of pMTB-icl and pMS-icl was verified by reverse transcriptase （RT）-PCR. The expression of recombinant plasmids derived from pUV15 when rMS was phagocytized by macrophage was also verified via fluorescence microscope. Ms 1-2c, rMS-pUV15, rMS-pMS-icl and rMS-pMTB-icl were used to infect RAW264.7 cells and the survival of intracellular MS was monitored by bacterial culture at 0, 24 and 48 hours after infection. The culture supernatants from macrophage infected by Ms 1-2c, rMS-pUV15, rMS-pMS-icl and rMS-pMTB-icl were collected and the interferon （IFN）-y and nitric oxide （NO） concentrations were measured by ELISA or by Griess assay, respectively. The apoptosis of macrophage was assayed by the in situ TUNEL technique.Results RT-PCR showed that both pMTB-icl and pMS-icl could be expressed in MS. Fluorescence microscopic observation showed that recombinant plasmids derived from pUV15 （pUV15-iG） could also be expressed in MS when MS were phagocytized by macrophage. Bacterial culture data demonstrated that rMS-pMTB-icl exhibited significantly increased intracellular survival in the murine macrophage cell line RAW264.7 compared with Ms 1-2c, rMS-pUV15 and rMS-pMS-icl. This increased intracellular survival was not accompanied by the upregulation of IFN-y and NO in host macrophage. But a lower apoptosis rate of macrophages infected with rMS-pMTB-icl was observed when compared with macrophages infected with other strains of MS.Conclusions MTB-ICL could promote the intracellular survival of MS. Suppressing the apoptosis of host macrophage may be one of the important mechanisms involved in this increased intracellular survival.展开更多
Objective To highlight recent researches which may show promise for histomolecular classification and new treatments for gliomas.Data sources All articles cited in this review were mainly searched from PubMed, which w...Objective To highlight recent researches which may show promise for histomolecular classification and new treatments for gliomas.Data sources All articles cited in this review were mainly searched from PubMed, which were published in English from 1996 to 2010.Study selection Original articles and critical reviews selected were relevant to the isocitrate dehydrogenase-1/2 mutation in gliomas and other tumors.Results Extraordinary high rates of somatic mutations in isocitrate dehydrogenase-1/2 occur in the majority of World Health Organization grade Ⅱ and grade Ⅲ gliomas as well as grade Ⅳ secondary glioblastomas. Isocitrate dehydrogenase-1/2 mutations are associated with younger age at diagnosis and a better prognosis in patients with mutated tumors. The functional role of isocitrate dehydrogenase-1/2 mutations in the pathogenesis of gliomas is still unclear.Conclusion Isocitrate dehydrogenase-1/2 mutations define a specific subtype of gliomas and may have great significance in the diagnosis, prognosis, and treatment of patients with these tumors.展开更多
Background Site A132Arg mutations potentially impair the affinity of isocitrate dehydrogenase 1 （IDH1） for its substrate isocitrate （ICT）, consequently reducing the production of a-ketoglutarate and leading to tum...Background Site A132Arg mutations potentially impair the affinity of isocitrate dehydrogenase 1 （IDH1） for its substrate isocitrate （ICT）, consequently reducing the production of a-ketoglutarate and leading to tumor growth through the induction of the hypoxia-inducible factor-1 （HIF-1） pathway. However, given that the roles of other active sites in IDH1 substrate binding remain unclear, we aimed to investigate IDH1 mutation pattern and its influence on enzyme function. Methods Fifteen IDH1 catalytic active site candidates were selected for in silico mutagenesis and protein homology modeling. Binding free energy of the IDH1/ICT complexes with single-site mutations was compared with that of the wild type. The affinity of 10 IDH1 catalytic active sites for the ICT substrate was further calculated. Results The IDH1 active site included seven residues from chain A （A77Thr, A94Ser, A100Arg, A132Arg, A109Arg, A275Asp, and A279Asp） and three residues from chain B （B214Thr, B212Lys, and B252Asp） that constituted the substrate ICT-binding site. These residues were located within 0.5 nm of ICT, indicating a potential interaction with the substrate. IDH1 changes of binding free energy （AE） suggested that the A132Arg residue from chain A contributes three hydrogen bonds to the ICT a-carboxyl and 13-carboxyl groups, while the other nine residues involved in ICT binding form only one or two hydrogen bonds. Amino acid substitutes at A132Arg, A109Arg, and B212Lys sites, had the greatest effect on enzyme affinity for its substrate. Conclusions Mutations at sites A132Arg, A109Arg, and B212Lys reduced IDH1 affinity for ICT, indicating these active sites may play a central role in substrate binding. Mutations at sites A77Thr, A94Ser, and A275Asp increased the affinity of IDH1 for ICT, which may enhance IDN1 catalytic activity. Mutant IDH1 proteins with higher catalytic activity than the wild-tvDe IDH1 could potentially be used as a novel qene therapy for qlioblastoma multiforme.展开更多
Gliomas are primary brain tumors derived from glial cells of the central nervous system,afflicting both adults and children with distinct characteristics and therapeutic challenges.Recent developments have ushered in ...Gliomas are primary brain tumors derived from glial cells of the central nervous system,afflicting both adults and children with distinct characteristics and therapeutic challenges.Recent developments have ushered in novel clinical and molecular prognostic factors,reshaping treatment paradigms based on classi-fication and grading,determined by histological attributes and cellular lineage.This review article delves into the diverse treatment modalities tailored to the specific grades and molecular classifications of gliomas that are currently being discussed and used clinically in the year 2023.For adults,the therapeutic triad typically consists of surgical resection,chemotherapy,and radiotherapy.In contrast,pediatric gliomas,due to their diversity,require a more tailored approach.Although complete tumor excision can be curative based on the location and grade of the glioma,certain non-resectable cases demand a chemotherapy approach usually involving,vincristine and carboplatin.Addi-tionally,if surgery or chemotherapy strategies are unsuccessful,Vinblastine can be used.Despite recent advancements in treatment methodologies,there remains a need of exploration in the literature,particularly concerning the efficacy of treatment regimens for isocitrate dehydrogenase type mutant astrocytomas and fine-tuned therapeutic approaches tailored for pediatric cohorts.This review article explores into the therapeutic modalities employed for both adult and pediatric gliomas in the context of their molecular classification.展开更多
Gliomas originate from glial cells in the central nervous system.Approximately 80%-85%of malignant brain tumors in adults are gliomas.The most common central nervous system tumor in children is low-grade pediatric gli...Gliomas originate from glial cells in the central nervous system.Approximately 80%-85%of malignant brain tumors in adults are gliomas.The most common central nervous system tumor in children is low-grade pediatric glioma.Diagnosis was determined by histological features until 2016 when the World Health Organization classification integrated molecular data with anatomopathological information to achieve a more integral diagnosis.Molecular characterization has led to better diagnostic and prognostic staging,which in turn has increased the precision of treatment.Current efforts are focused on more effective therapies to prolong survival and improve the quality of life of adult and pediatric patients with glioma.However,improvements in survival have been modest.Currently,clinical guidelines,as well as the article by Mohamed et al accompanying this editorial piece,are adapting treatment recommendations(surgery,chemotherapy,and radiotherapy)according to diagnosis and prognosis guided by molecular biomarkers.Furthermore,this paves the way for the design of clinical trials with new therapies,which is especially important in pediatric gliomas.展开更多
Background:The dysregulation of Isocitrate dehydrogenase(IDH)and the subsequent production of 2-Hydroxyglutrate(2HG)may alter the expression of epigenetic proteins in Grade 4 astrocytoma.The interplay mechanism betwee...Background:The dysregulation of Isocitrate dehydrogenase(IDH)and the subsequent production of 2-Hydroxyglutrate(2HG)may alter the expression of epigenetic proteins in Grade 4 astrocytoma.The interplay mechanism between IDH,O-6-methylguanine-DNA methyltransferase(MGMT)-promoter methylation,and protein methyltransferase proteins-5(PRMT5)activity,with tumor progression has never been described.Methods:A retrospective cohort of 34 patients with G4 astrocytoma is classified into IDH-mutant and IDH-wildtype tumors.Both groups were tested for MGMT-promoter methylation and PRMT5 through methylation-specific and gene expression PCR analysis.Inter-cohort statistical significance was evaluated.Results:Both IDH-mutant WHO grade 4 astrocytomas(n=22,64.7%)and IDH-wildtype glioblastomas(n=12,35.3%)had upregulated PRMT5 gene expression except in one case.Out of the 22 IDH-mutant tumors,10(45.5%)tumors showed MGMT-promoter methylation and 12(54.5%)tumors had unmethylated MGMT.All IDH-wildtype tumors had unmethylated MGMT.There was a statistically significant relationship between MGMT-promoter methylation and IDH in G4 astrocytoma(p-value=0.006).Statistically significant differences in progression-free survival(PFS)were also observed among all G4 astrocytomas that expressed PRMT5 and received either temozolomide(TMZ)or TMZ plus other chemotherapies,regardless of their IDH or MGMT-methylation status(p-value=0.0014).Specifically,IDH-mutant tumors that had upregulated PRMT5 activity and MGMT-promoter methylation,who received only TMZ,have exhibited longer PFS.Conclusions:The relationship between PRMT5,MGMT-promoter,and IDH is not tridirectional.However,accumulation of D2-hydroxyglutarate(2-HG),which partially activates 2-OG-dependent deoxygenase,may not affect their activities.In IDH-wildtype glioblastomas,the 2HG-2OG pathway is typically inactive,leading to PRMT5 upregulation.TMZ alone,compared to TMZ-plus,can increase PFS in upregulated PRMT5 tumors.Thus,using a PRMT5 inhibitor in G4 astrocytomas may help in tumor regression.展开更多
Human cytosolic NADP-1DH （IDH1） has recently been found to be involved in tumorigenesis. Notably, the tumorderived IDH1 mutations identified so far mainly occur at Arg132, and mutation R132H is the most prevalent on...Human cytosolic NADP-1DH （IDH1） has recently been found to be involved in tumorigenesis. Notably, the tumorderived IDH1 mutations identified so far mainly occur at Arg132, and mutation R132H is the most prevalent one. This mutation impairs the oxidative IDH activity of the enzyme, but renders a new reduction function of converting a-ketoglutarate （aKG） to 2-hydroxyglutarate. Here, we report the structures of the R132H mutant IDH1 with and without isocitrate OCT） bound. The structural data together with mutagenesis and biochemical data reveal a previ- ously undefined initial ICT-binding state and demonstrate that IDH activity requires a conformational change to a closed pre-transition state. Arg132 plays multiple functional roles in the catalytic reaction; in particular, the R132H mutation hinders the conformational changes from the initial ICT-binding state to the pre-transition state, leading to the impairment of the IDH activity. Our results describe for the first time that there is an intermediate conformation that corresponds to an initial ICT-binding state and that the R132H mutation can trap the enzyme in this conforma- tion, therefore shedding fight on the molecular mechanism of the ＂off switch＂ of the potentially tumor-suppressive IDH activity. Furthermore, we proved the necessity of Tyr139 for the gained aKG reduction activity and propose that Tyr139 may play a vital role by compensating the increased negative charge on the C2 atom of aKG during the trans- fer of a hydride anion from NADPH to aKG, which provides new insights into the mechanism of the ＂on switch＂ of the hypothetically oncogenic reduction activity of IDH1 by this mutation.展开更多
Objective:O6 methylguanine-DNA methyltransferase(MGMT)promoter methylation is a biomarker widely used to predict the sensitivity of IDH-wildtype glioblastoma to temozolomide therapy.Given that the IDH status has criti...Objective:O6 methylguanine-DNA methyltransferase(MGMT)promoter methylation is a biomarker widely used to predict the sensitivity of IDH-wildtype glioblastoma to temozolomide therapy.Given that the IDH status has critical effects on the survival and epigenetic features of glioblastoma,we aimed to assess the role of MGMT promoter methylation in IDH-mutant glioblastoma.Methods:This study included 187 IDH-mutant glioblastomas and used 173 IDH-wildtype glioblastomas for comparison.KaplanMeier curves and multivariate Cox regression were used to study the predictive effects.Results:Compared with IDH-wildtype glioblastomas,IDH-mutant glioblastomas showed significantly higher(P<0.0001)MGMT promoter methylation.We demonstrated that MGMT promoter methylation status,as determined by a high cutoff value(≥30%)in pyrosequencing,could be used to significantly stratify the survival of 50 IDH-mutant glioblastomas receiving temozolomide therapy(cohort A);this result was validated in another cohort of 25 IDH-mutant glioblastomas(cohort B).The median progression-free survival and median overall survival in cohort A were 9.33 and 13.76 months for unmethylated cases,and 18.37 and 41.61 months for methylated cases,and in cohort B were 6.97 and 9.10 months for unmethylated cases,and 23.40 and 26.40 months for methylated cases.In addition,we confirmed that the MGMT promoter methylation was significantly(P=0.0001)correlated with longer OS in IDH-mutant patients with GBM,independently of age,gender distribution,tumor type(primary or recurrent/secondary),and the extent of resection.Conclusions:MGMT promoter methylation has predictive value in IDH-mutant glioblastoma,but its cutoff value should be higher than that for IDH-wildtype glioblastoma.展开更多
Objective:To isolate,purify,and characterize gossypol from the fruits of Thespesia populnea(L)Sol.ex Correa,test its antidermatophytic activity,identify its targets on the dermatophyte,and confirm the binding of gossy...Objective:To isolate,purify,and characterize gossypol from the fruits of Thespesia populnea(L)Sol.ex Correa,test its antidermatophytic activity,identify its targets on the dermatophyte,and confirm the binding of gossypol with the fungal target by molecular docking study.Methods:Gossypol from Thespesia populnea was characterized by high performance liquid chromatography,liquid chromatographmass spectrometry,Fourier transform infrared spectroscopy,and nuclear magnetic resonance.The anti-dermatophytic activity of gossypol was tested against four different dermatophytes,viz.Trichophyton mentagrophytes,Trichophyton rubrum,Microsporum canis,and Microsporum gypseum.Trichophyton mentagrophytes was selected for further studies.The inhibitory mode of action of gossypol on Trichophyton mentagrophytes was determined by analyzing the modulation of gene expression in various pathways of the dermatophyte.Results:Gossypol inhibited all the dermatophytes.The minimum inhibitory concentrations were 12.5μg/mL for Trichophyton mentagrophytes and Microsporum canis and 25μg/mL for Trichophyton rubrum and Microsporum gypseum.The minimum fungicidal concentrations were 50μg/mL for Trichophyton mentagrophytes,100μg/mL for Microsporum canis and Trichophyton rubrum,and 200μg/mL for Microsporum gypseum.Gossypol inhibited the mRNA expression of metalloprotease(MEP4)and isocitrate lyase(ICL).The binding of gossypol with the enzymes was confirmed by molecular docking studies.The best docking poses were found and the low binding energies were recorded with the two target enzymes.Conclusions:Gossypol is a potential antifungal agent and can be further explored as an anti-dermatophytic drug.展开更多
Biliary tract cancers(BTC)are frequently identified at late stages and have a poor prognosis due to limited systemic treatment regimens.For more than a decade,the combination of gemcitabine and cis-platin has served a...Biliary tract cancers(BTC)are frequently identified at late stages and have a poor prognosis due to limited systemic treatment regimens.For more than a decade,the combination of gemcitabine and cis-platin has served as the first-line standard treatment.There are few choices for second-line chemo-therapy.Targeted treatment with fibroblast growth factor receptor 2 inhibitors,neurotrophic tyrosine receptor kinase inhibitors,and isocitrate dehydrogenase 1 inhibitors has had important results.Immune checkpoint inhibitors(ICI)such as pembrolizumab are only used in first-line treatment for microsatellite instability high patients.The TOPAZ-1 trial's outcome is encouraging,and there are several trials underway that might soon put targeted treatment and ICI combos into first-line options.Newer targets and agents for existing goals are being studied,which may represent a paradigm shift in BTC management.Due to a scarcity of targetable mutations and the higher toxicity profile of the current medications,the new category of drugs may occupy a significant role in BTC therapies.展开更多
Grade II oligodendrogliomas are rare and slow growing tumors, making long-term follow up difficult, but necessary for better understanding. In this retrospective study a review of all grade II oligodendrogliomas encou...Grade II oligodendrogliomas are rare and slow growing tumors, making long-term follow up difficult, but necessary for better understanding. In this retrospective study a review of all grade II oligodendrogliomas encountered in the last 20 years at one institution, was undertaken to determine if specific tumor location and immunohistochemical analysis had any impact on recurrence rate, progression free survival, or life expectancy. Eighty-nine grade II oligodendroglioms cases were reviewed (38 females and 51 males;mean age was 40.3 ± 13.8 years). Tumor location was: frontal lobe (44, 49.4%) and superior frontal gyrus (30, 33.7%). 1p19q data were available in 49 patients. Twenty-nine cases were co-deleted (59.2%). There was no significant difference in the incidence of 1p19q co-deletion between superior frontal gyrus tumors vs. other frontal tumors or extra-frontal tumors (p?= 0.45). Follow up of at least 3 months after diagnosis was available in 79 patients (mean follow up: 93.2 months). In recurrence analysis, recurrence by 1p19q status and recurrence by location revealed no significant differences. In analysis of progression, progression by 1p19q status and progression by location revealed no significant differences. An analysis of deaths for the sample, deaths by 1p19q status and deaths by location revealed no significant differences. There was a higher death rate among patients >50 years of age, however this, too, was not significant.?There did not appear to be any advantage in recurrence rate, progression free survival, or life expectancy for tumors located in the frontal lobe or superior frontal gyrus. 1p19q co-deletion did not appear to confer an advantage as measured by time to recurrence, time to progression, or overall survival. Other than age, eloquent location, Karnofsky status, and overall tumor size as reported by others, tumor location and 1p19q status in low grade oligodendrogliomas are not currently predictive of survival.展开更多
Acute myeloid leukaemia(AML) is the most common form of acute leukaemia in adults,with increasing incidence with age and a generally poor prognosis.Almost 20% of AML patients express mutant isocitrate dehydrogenase 2(...Acute myeloid leukaemia(AML) is the most common form of acute leukaemia in adults,with increasing incidence with age and a generally poor prognosis.Almost 20% of AML patients express mutant isocitrate dehydrogenase 2(mIDH2),which leads to the accumulation of the carcinogenic metabolite 2-hydroxyglutarate(2-HG),resulting in poor prognosis.Thus,global institutions have been working to develop mIDH2 inhibitors.SH1573 is a novel mIDH2 inhibitor that we independently designed and synthesised.We have conducted a comprehensive study on its pharmacodynamics,pharmacokinetics and safety.First,SH1573 exhibited a strong selective inhibition of mIDH2 R140 Q protein,which could effectively reduce the production of 2-HG in cell lines,serum and tumors of an animal model.It could also promote the differentiation of mutant AML cell lines and granulocytes in PDX models.Then,it was confirmed that SH1573 possessed characteristics of high bioavailability,good metabolic stability and wide tissue distribution.Finally,toxicological data showed that SH1573 had no effects on the respiratory system,cardiovascular system and nervous system,and was genetically safe.This research successfully promoted the approval of SH1573 for clinical trials(CTR20200247).All experiments demonstrated that,as a potential drug against mIDH2 R140 Q acute myeloid leukaemia,SH1573 was effective and safe.展开更多
Aim:Patients with glioblastomas demonstrate well‑documented immunological impairments including decreased numbers of mature dendritic cells(DCs).Recent data identified karyopherin a2(KPNA2),a nucleocytoplasmic shuttli...Aim:Patients with glioblastomas demonstrate well‑documented immunological impairments including decreased numbers of mature dendritic cells(DCs).Recent data identified karyopherin a2(KPNA2),a nucleocytoplasmic shuttling receptor,as diagnostic and prognostic biomarker for gliomas.The aim of this ongoing study is to correlate parameters of immunity and nucleocytoplasmic transport in glioblastoma patients.Methods:We preoperatively collected serum from 17 patients with glioblastomas and determined DC subsets(HLA DR+Lin-,CD34-,CD45+,CD123+,CD11+were analyzed)using a 6‑color flow cytometry panel.Expression levels of KPNA2 and nuclear accumulation of p53 were evaluated semi‑quantitatively by immunohistochemistry.O6‑methylguanine DNA methyltransferase(MGMT)and isocitrate dehydrogenase‑1(IDH‑1)status were assessed by pyrosequencing and immunohistochemistry,respectively.Results:Median expression levels for both KPNA2 and p53 were 5-10%.IDH‑1‑R132H mutation and MGMT promoter hypermethylation was detected in 3/16 and 1/9 patients,respectively.Mean counts of total mature DCs,myeloid DCs and plasmacytoid DCs were 9.6,2.1,3.4 cells/μL.A preliminary analysis suggests an association between low KPNA2 nuclear expression and increased numbers of mature DCs.However,this correlation did not reach statistical significance so far(P=0.077).Conclusion:Our preliminary data may indicate a role of KPNA2 in the impaired maturation of DCs observed in glioblastoma patients.展开更多
This study aimed to explore the value of deep learning(DL)-assisted quantitative susceptibility mapping(QSM)in glioma grading and molecular subtyping.Forty-two patients with gliomas,who underwent preoperative T2 fluid...This study aimed to explore the value of deep learning(DL)-assisted quantitative susceptibility mapping(QSM)in glioma grading and molecular subtyping.Forty-two patients with gliomas,who underwent preoperative T2 fluid-attenuated inversion recovery(T2 FLAIR),contrast-enhanced T1-weighted imaging(T1WI+C),and QSM scanning at 3.0T magnetic resonance imaging(MRI)were included in this study.Histopathology and immunohistochemistry staining were used to determine glioma grades,and isocitrate dehydrogenase(IDH)1 and alpha thalassemia/mental retardation syndrome X-linked gene(ATRX)subtypes.Tumor segmentation was performed manually using Insight Toolkit-SNAP program(www.itksnap.org).An inception convolutional neural network(CNN)with a subsequent linear layer was employed as the training encoder to capture multi-scale features from MRI slices.Fivefold cross-validation was utilized as the training strategy(seven samples for each fold),and the ratio of sample size of the training,validation,and test dataset was 4:1:1.The performance was evalu-ated by the accuracy and area under the curve(AUC).With the inception CNN,single modal of QSM showed better perfor-mance in differentiating glioblastomas(GBM)and other grade gliomas(OGG,grade II–III),and predicting IDH1 mutation and ATRX loss(accuracy:0.80,0.77,0.60)than either T2 FLAIR(0.69,0.57,0.54)or T1WI+C(0.74,0.57,0.46).When combining three modalities,compared with any single modality,the best AUC/accuracy/F1-scores were reached in grading gliomas(OGG and GBM:0.91/0.89/0.87,low-grade and high-grade gliomas:0.83/0.86/0.81),predicting IDH1 mutation(0.88/0.89/0.85),and predicting ATRX loss(0.78/0.71/0.67).As a supplement to conventional MRI,DL-assisted QSM is a promising molecular imaging method to evaluate glioma grades,IDH1 mutation,and ATRX loss.展开更多
Patients with unresectable cholangiocarcinoma(CCA)face a poor prognosis,and there are few effective treatment options for the disease.The standard of care for patients with locally advanced or metastatic CCA is chemot...Patients with unresectable cholangiocarcinoma(CCA)face a poor prognosis,and there are few effective treatment options for the disease.The standard of care for patients with locally advanced or metastatic CCA is chemotherapy with a gemcitabine-based doublet.Unfortunately,the clinical benefit obtained with these regimens is modest,with a median overall survival of about one year.For CCA that is chemotherapy-refractory or recurs after first-line chemotherapy,the treatment options are even more limited,and no relevant randomized controlled data are available.In recent years,molecular profiling has shed light on the molecular basis of CCA and identified subgroups of patients that might benefit from a personalized treatment approach.These efforts resulted in the recent FDA approval of the fibroblast growth factor receptor(FGFR)inhibitor,pemigatinib,as a second-line treatment for patients with advanced CCA harboring an FGFR2-fusion or rearrangement.Several other targeted agents also are under evaluation in patients with CCA,of which the isocitrate dehydrogenase inhibitor has had the most promising results.Finally,immunotherapy is being explored as a new treatment approach for advanced CCA patients;indeed,the immune checkpoint inhibitor pembrolizumab can already be used to treat CCAs that are mismatch repair deficient.This review is a comprehensive overview of the treatment options for CCA and offers a glimpse into what the future could hold for these patients.展开更多
Biliary tract cancers(BTCs)are usually diagnosed at an advanced stage and have a dismal prognosis.The treatment of advanced disease is mainly based on systemic chemotherapy,which is demonstrated to improve survival in...Biliary tract cancers(BTCs)are usually diagnosed at an advanced stage and have a dismal prognosis.The treatment of advanced disease is mainly based on systemic chemotherapy,which is demonstrated to improve survival in the first-and second-line setting.Following the results of phase III clinical trials,the combination of cisplatin and gemcitabine is the regimen of choice in the frontline,while 5-fluorouracil plus oxaliplatin is considered the standard after first-line progression in unselected patients.Recent advances in molecular biology have unravelled the molecular heterogeneity of BTCs and identified patient subgroups harbouring unique molecular aberrations such as isocitrate dehydrogenase(IDH)mutations and fibroblast growth factor receptor(FGFR)fusions that can be targeted by specific agents.This knowledge has opened the way to personalised medicine in BTCs.Molecules targeting IDH and FGFR are currently approved for the treatment of advanced,refractory,intrahepatic cholangiocarcinoma.Beyond targeted therapies,novel combinatorial approaches that target the immune microenvironment and the crosstalk between cancer and stroma are being explored based on strong preclinical rationale.This review discusses the current therapeutic opportunities for the management of patients with advanced BTCs and provides an overview of the promising new strategies on the horizon with a particular focus on ongoing clinical trials.展开更多
基金the National Natural Science Foundation of China(No.81730049 and No.81801666)the Fundamental Research Funds for the Central Universities,HUST(No.2019JYCXJJ044).
文摘Objective Isocitrate dehydrogenase gene(IDH)mutations are associated with tumor angiogenesis and therefore play an important role in glioma management.This study compared the performance of tumor blood vessels counted from contrast-enhanced 3D brain volume(3D-BRAVO)sequence and dynamic contrast-enhanced(DCE)MRI in differentiating IDH1 status in gliomas.Methods Forty-four glioma patients[16 with IDH1 mutant-type(IDH1-MT),28 with IDH1 wild-type(IDH1-WT)]were retrospectively analyzed.A blood vessel entering a tumor was defined as an intratumoral vessel;a blood vessel adjacent to the edge of a tumor was defined as a peritumoral vessel.Combined vessels were defined as the sum of the intratumoral and peritumoral vessels.DCE-derived metrics of tumor were normalized to the contralateral normal-appearing white matter.Results Intratumoral,peritumoral,and combined tumor blood vessels were all significantly different between IDH1-MT and IDH1-WT gliomas,and the range of area under curves(AUCs)was 0.816–0.855.For DCE-derived parameters,cerebral blood volume,cerebral blood flow,mean transit time,and volume transfer constant were significantly different between IDH1-MT and IDH1-WT gliomas,and the range of AUCs was 0.703–0.756.Combined vessels possessed the best performance for identifying IDH1 mutations in gliomas(AUC:0.855,sensitivity:0.857,specificity:0.812,P<0.001).Conclusion The number of tumor blood vessels has comparable diagnostic performance with DCE-derived parameters for differentiating IDH1 mutations and can serve as a potential imaging biomarker to reflect IDH1 mutations in gliomas.
基金Supported by the Technology Development Funds of Education Department of Jilin Province,China(No.2008110)
文摘When devoured by macrophages,Mycobacterium tuberculosis remains persistent in macrophages and gains energy through the glyoxylate bypass to maintain its long-term existence in host cells.Therefore it is possible to stop persistent infections by interdicting the glyoxylate bypass in which the isocitrate lyase（ICL） is the key rate-limiting enzyme and a persistence factor.ICL is the target of anti-TB（TB：tubercular） drugs,which could screen ICL out and effectively inhibit the activity of ICL in Mycobacterium tuberculosis,and because of this,anti-TB drugs can be used to kill persistent Mycobacterium tuberculosis.In this study,the ICL gene of the Mycobacterium tuberculosis H37Rv was cloned successfully and recombinant protein with bioactivity was obtained through the enzyme characteristic appraisal.The specific activity of the recombined ICL is 24μmol·mg-1·min-1.The recombined ICL protein was used as the target,and phages which can specifically combine to ICL were screened in the phage 7 peptide library.According to the results of the ELISA and DNA sequence detection,eventually three 7-peptide chains were synthesized.Then the peptide chains were reacted with ICL,respectively,to detect their inhibitory effects on ICL.The results show that all the three 7-peptide chains possessed varying inhibitory effects on the activity of ICL.This study provided lead compounds for the research and development of new peptide anti-TB drugs.
基金This work was supported by grants from the Capital Health Research and Development of Special Program(No.2014-2-2013)the Beijing Excellent Talent Training Project Grant(No.201600026833ZK07)+1 种基金the National Science-Technology Support Plan(No.2014BAI04B02)the Project of Beijing Municipal Health Commission(No.PXM 2019_026283_000002).
文摘Background:Mutations in the isocitrate dehydrogenase 1(IDH1)and IDH2 genes are important for both the integrated diagnosis and the prognosis of diffuse gliomas.The p.R132H mutation of IDH1 is the most frequently observed IDH mutation,while IDH2 mutations were relatively rarely studied.The aim of the study was to determine the pathological and genetic characteristics of lowergrade gliomas that carry IDH2 mutations.Methods:Data from 238 adult patients with lower-grade gliomas were retrospectively analyzed.The status of IDH1/2 gene mutations,telomerase reverse transcriptase(TERT)promoter mutations,O^6-methylguanine-DNA-methyltransferase(MGMT)promoter methylation,1p/19q co-deletion and the expressions of IDH1 R132H,alpha-thalassemia X-linked mental retardation,and p53 were evaluated.Progression-free survival(PFS)and overall survival(OS)were calculated via Kaplan-Meier estimation using the log-rank test.Results:Totally,71%(169/238)of patients were positive for IDH mutations,including 12 patients harboring mutations in IDH2.Among the 12 patients with IDH2 mutations,ten patients harbored the R172K mutation,one patient harbored the R172S mutation and one harbored the R172W mutation.Of these,11 tumors occurred in the frontal lobe and showed morphology typical of oligodendroglioma.The proportion of grade II tumors was higher than that of grade III tumors in IDH2 mutant-gliomas.IDH2 mutations were frequently associated with TERT promoter mutations,1p/19q co-deletion and MGMT promoter methylation.IDH2 mutations were associated with better outcomes compared with IDH wild-type gliomas(P<0.05).However,the PFS and OS did not differ from that of IDH1 mutant patients(P=0.95 and P=0.60,respectively).Conclusions:IDH2 mutations are more frequent in oligodendrogliomas and associated with a better prognosis.IDH2 mutations may segregate in distinct clinico-pathological and genetic subtypes of gliomas,and therefore may merit routine investigation.
基金This work was supported by a grant from the National Natural Science Foundation of China （No. 30600528）.
文摘Background Isocitrate lyase （ICL） was previously demonstrated to play a pivotal role in the intracellular metabolism of Mycobacterium tuberculosis （MTB）. Presently several lines of evidence suggest that ICL from MTB （MTB-ICL） may play some roles in the interaction between MTB and host macrophage. However, there has been no research on the interaction between MTB-ICL and host macrophage.Methods MTB-icl and M. smegmatis （MS）-icl genes were amplified by polymerase chain reaction （PCR） and cloned into the E. coli-mycobacterium shuttle plasmid pUV15 to obtain recombinant shuttle plasmids pMTB-icl and pMS-icl. Following transformation into MS by electroporation, the expression of pMTB-icl and pMS-icl was verified by reverse transcriptase （RT）-PCR. The expression of recombinant plasmids derived from pUV15 when rMS was phagocytized by macrophage was also verified via fluorescence microscope. Ms 1-2c, rMS-pUV15, rMS-pMS-icl and rMS-pMTB-icl were used to infect RAW264.7 cells and the survival of intracellular MS was monitored by bacterial culture at 0, 24 and 48 hours after infection. The culture supernatants from macrophage infected by Ms 1-2c, rMS-pUV15, rMS-pMS-icl and rMS-pMTB-icl were collected and the interferon （IFN）-y and nitric oxide （NO） concentrations were measured by ELISA or by Griess assay, respectively. The apoptosis of macrophage was assayed by the in situ TUNEL technique.Results RT-PCR showed that both pMTB-icl and pMS-icl could be expressed in MS. Fluorescence microscopic observation showed that recombinant plasmids derived from pUV15 （pUV15-iG） could also be expressed in MS when MS were phagocytized by macrophage. Bacterial culture data demonstrated that rMS-pMTB-icl exhibited significantly increased intracellular survival in the murine macrophage cell line RAW264.7 compared with Ms 1-2c, rMS-pUV15 and rMS-pMS-icl. This increased intracellular survival was not accompanied by the upregulation of IFN-y and NO in host macrophage. But a lower apoptosis rate of macrophages infected with rMS-pMTB-icl was observed when compared with macrophages infected with other strains of MS.Conclusions MTB-ICL could promote the intracellular survival of MS. Suppressing the apoptosis of host macrophage may be one of the important mechanisms involved in this increased intracellular survival.
文摘Objective To highlight recent researches which may show promise for histomolecular classification and new treatments for gliomas.Data sources All articles cited in this review were mainly searched from PubMed, which were published in English from 1996 to 2010.Study selection Original articles and critical reviews selected were relevant to the isocitrate dehydrogenase-1/2 mutation in gliomas and other tumors.Results Extraordinary high rates of somatic mutations in isocitrate dehydrogenase-1/2 occur in the majority of World Health Organization grade Ⅱ and grade Ⅲ gliomas as well as grade Ⅳ secondary glioblastomas. Isocitrate dehydrogenase-1/2 mutations are associated with younger age at diagnosis and a better prognosis in patients with mutated tumors. The functional role of isocitrate dehydrogenase-1/2 mutations in the pathogenesis of gliomas is still unclear.Conclusion Isocitrate dehydrogenase-1/2 mutations define a specific subtype of gliomas and may have great significance in the diagnosis, prognosis, and treatment of patients with these tumors.
文摘Background Site A132Arg mutations potentially impair the affinity of isocitrate dehydrogenase 1 （IDH1） for its substrate isocitrate （ICT）, consequently reducing the production of a-ketoglutarate and leading to tumor growth through the induction of the hypoxia-inducible factor-1 （HIF-1） pathway. However, given that the roles of other active sites in IDH1 substrate binding remain unclear, we aimed to investigate IDH1 mutation pattern and its influence on enzyme function. Methods Fifteen IDH1 catalytic active site candidates were selected for in silico mutagenesis and protein homology modeling. Binding free energy of the IDH1/ICT complexes with single-site mutations was compared with that of the wild type. The affinity of 10 IDH1 catalytic active sites for the ICT substrate was further calculated. Results The IDH1 active site included seven residues from chain A （A77Thr, A94Ser, A100Arg, A132Arg, A109Arg, A275Asp, and A279Asp） and three residues from chain B （B214Thr, B212Lys, and B252Asp） that constituted the substrate ICT-binding site. These residues were located within 0.5 nm of ICT, indicating a potential interaction with the substrate. IDH1 changes of binding free energy （AE） suggested that the A132Arg residue from chain A contributes three hydrogen bonds to the ICT a-carboxyl and 13-carboxyl groups, while the other nine residues involved in ICT binding form only one or two hydrogen bonds. Amino acid substitutes at A132Arg, A109Arg, and B212Lys sites, had the greatest effect on enzyme affinity for its substrate. Conclusions Mutations at sites A132Arg, A109Arg, and B212Lys reduced IDH1 affinity for ICT, indicating these active sites may play a central role in substrate binding. Mutations at sites A77Thr, A94Ser, and A275Asp increased the affinity of IDH1 for ICT, which may enhance IDN1 catalytic activity. Mutant IDH1 proteins with higher catalytic activity than the wild-tvDe IDH1 could potentially be used as a novel qene therapy for qlioblastoma multiforme.
文摘Gliomas are primary brain tumors derived from glial cells of the central nervous system,afflicting both adults and children with distinct characteristics and therapeutic challenges.Recent developments have ushered in novel clinical and molecular prognostic factors,reshaping treatment paradigms based on classi-fication and grading,determined by histological attributes and cellular lineage.This review article delves into the diverse treatment modalities tailored to the specific grades and molecular classifications of gliomas that are currently being discussed and used clinically in the year 2023.For adults,the therapeutic triad typically consists of surgical resection,chemotherapy,and radiotherapy.In contrast,pediatric gliomas,due to their diversity,require a more tailored approach.Although complete tumor excision can be curative based on the location and grade of the glioma,certain non-resectable cases demand a chemotherapy approach usually involving,vincristine and carboplatin.Addi-tionally,if surgery or chemotherapy strategies are unsuccessful,Vinblastine can be used.Despite recent advancements in treatment methodologies,there remains a need of exploration in the literature,particularly concerning the efficacy of treatment regimens for isocitrate dehydrogenase type mutant astrocytomas and fine-tuned therapeutic approaches tailored for pediatric cohorts.This review article explores into the therapeutic modalities employed for both adult and pediatric gliomas in the context of their molecular classification.
文摘Gliomas originate from glial cells in the central nervous system.Approximately 80%-85%of malignant brain tumors in adults are gliomas.The most common central nervous system tumor in children is low-grade pediatric glioma.Diagnosis was determined by histological features until 2016 when the World Health Organization classification integrated molecular data with anatomopathological information to achieve a more integral diagnosis.Molecular characterization has led to better diagnostic and prognostic staging,which in turn has increased the precision of treatment.Current efforts are focused on more effective therapies to prolong survival and improve the quality of life of adult and pediatric patients with glioma.However,improvements in survival have been modest.Currently,clinical guidelines,as well as the article by Mohamed et al accompanying this editorial piece,are adapting treatment recommendations(surgery,chemotherapy,and radiotherapy)according to diagnosis and prognosis guided by molecular biomarkers.Furthermore,this paves the way for the design of clinical trials with new therapies,which is especially important in pediatric gliomas.
文摘Background:The dysregulation of Isocitrate dehydrogenase(IDH)and the subsequent production of 2-Hydroxyglutrate(2HG)may alter the expression of epigenetic proteins in Grade 4 astrocytoma.The interplay mechanism between IDH,O-6-methylguanine-DNA methyltransferase(MGMT)-promoter methylation,and protein methyltransferase proteins-5(PRMT5)activity,with tumor progression has never been described.Methods:A retrospective cohort of 34 patients with G4 astrocytoma is classified into IDH-mutant and IDH-wildtype tumors.Both groups were tested for MGMT-promoter methylation and PRMT5 through methylation-specific and gene expression PCR analysis.Inter-cohort statistical significance was evaluated.Results:Both IDH-mutant WHO grade 4 astrocytomas(n=22,64.7%)and IDH-wildtype glioblastomas(n=12,35.3%)had upregulated PRMT5 gene expression except in one case.Out of the 22 IDH-mutant tumors,10(45.5%)tumors showed MGMT-promoter methylation and 12(54.5%)tumors had unmethylated MGMT.All IDH-wildtype tumors had unmethylated MGMT.There was a statistically significant relationship between MGMT-promoter methylation and IDH in G4 astrocytoma(p-value=0.006).Statistically significant differences in progression-free survival(PFS)were also observed among all G4 astrocytomas that expressed PRMT5 and received either temozolomide(TMZ)or TMZ plus other chemotherapies,regardless of their IDH or MGMT-methylation status(p-value=0.0014).Specifically,IDH-mutant tumors that had upregulated PRMT5 activity and MGMT-promoter methylation,who received only TMZ,have exhibited longer PFS.Conclusions:The relationship between PRMT5,MGMT-promoter,and IDH is not tridirectional.However,accumulation of D2-hydroxyglutarate(2-HG),which partially activates 2-OG-dependent deoxygenase,may not affect their activities.In IDH-wildtype glioblastomas,the 2HG-2OG pathway is typically inactive,leading to PRMT5 upregulation.TMZ alone,compared to TMZ-plus,can increase PFS in upregulated PRMT5 tumors.Thus,using a PRMT5 inhibitor in G4 astrocytomas may help in tumor regression.
文摘Human cytosolic NADP-1DH （IDH1） has recently been found to be involved in tumorigenesis. Notably, the tumorderived IDH1 mutations identified so far mainly occur at Arg132, and mutation R132H is the most prevalent one. This mutation impairs the oxidative IDH activity of the enzyme, but renders a new reduction function of converting a-ketoglutarate （aKG） to 2-hydroxyglutarate. Here, we report the structures of the R132H mutant IDH1 with and without isocitrate OCT） bound. The structural data together with mutagenesis and biochemical data reveal a previ- ously undefined initial ICT-binding state and demonstrate that IDH activity requires a conformational change to a closed pre-transition state. Arg132 plays multiple functional roles in the catalytic reaction; in particular, the R132H mutation hinders the conformational changes from the initial ICT-binding state to the pre-transition state, leading to the impairment of the IDH activity. Our results describe for the first time that there is an intermediate conformation that corresponds to an initial ICT-binding state and that the R132H mutation can trap the enzyme in this conforma- tion, therefore shedding fight on the molecular mechanism of the ＂off switch＂ of the potentially tumor-suppressive IDH activity. Furthermore, we proved the necessity of Tyr139 for the gained aKG reduction activity and propose that Tyr139 may play a vital role by compensating the increased negative charge on the C2 atom of aKG during the trans- fer of a hydride anion from NADPH to aKG, which provides new insights into the mechanism of the ＂on switch＂ of the hypothetically oncogenic reduction activity of IDH1 by this mutation.
基金funded by the National Natural Science Foundation of China(Grant Nos.81903078 and 81773208)the Beijing Nova Program(Grant No.Z201100006820118)+4 种基金the National Key Research and Development Program of China(Grant No.2018YFC0115604)the National Natural Science Foundation of China(NSFC)/Research Grants Council(RGC)Joint Research Scheme(Grant No.81761168038)the Beijing Municipal Administration of Hospitals’Mission Plan(Grant No.SML20180501)the CAMS Innovation Fund for Medical Sciences(Grant No.2019-I2M-5-021)the Public Welfare Development and Reform Pilot Project of the Beijing Medical Research Institute(Grant No.JYY 2019-5)。
文摘Objective:O6 methylguanine-DNA methyltransferase(MGMT)promoter methylation is a biomarker widely used to predict the sensitivity of IDH-wildtype glioblastoma to temozolomide therapy.Given that the IDH status has critical effects on the survival and epigenetic features of glioblastoma,we aimed to assess the role of MGMT promoter methylation in IDH-mutant glioblastoma.Methods:This study included 187 IDH-mutant glioblastomas and used 173 IDH-wildtype glioblastomas for comparison.KaplanMeier curves and multivariate Cox regression were used to study the predictive effects.Results:Compared with IDH-wildtype glioblastomas,IDH-mutant glioblastomas showed significantly higher(P<0.0001)MGMT promoter methylation.We demonstrated that MGMT promoter methylation status,as determined by a high cutoff value(≥30%)in pyrosequencing,could be used to significantly stratify the survival of 50 IDH-mutant glioblastomas receiving temozolomide therapy(cohort A);this result was validated in another cohort of 25 IDH-mutant glioblastomas(cohort B).The median progression-free survival and median overall survival in cohort A were 9.33 and 13.76 months for unmethylated cases,and 18.37 and 41.61 months for methylated cases,and in cohort B were 6.97 and 9.10 months for unmethylated cases,and 23.40 and 26.40 months for methylated cases.In addition,we confirmed that the MGMT promoter methylation was significantly(P=0.0001)correlated with longer OS in IDH-mutant patients with GBM,independently of age,gender distribution,tumor type(primary or recurrent/secondary),and the extent of resection.Conclusions:MGMT promoter methylation has predictive value in IDH-mutant glioblastoma,but its cutoff value should be higher than that for IDH-wildtype glioblastoma.
文摘Objective:To isolate,purify,and characterize gossypol from the fruits of Thespesia populnea(L)Sol.ex Correa,test its antidermatophytic activity,identify its targets on the dermatophyte,and confirm the binding of gossypol with the fungal target by molecular docking study.Methods:Gossypol from Thespesia populnea was characterized by high performance liquid chromatography,liquid chromatographmass spectrometry,Fourier transform infrared spectroscopy,and nuclear magnetic resonance.The anti-dermatophytic activity of gossypol was tested against four different dermatophytes,viz.Trichophyton mentagrophytes,Trichophyton rubrum,Microsporum canis,and Microsporum gypseum.Trichophyton mentagrophytes was selected for further studies.The inhibitory mode of action of gossypol on Trichophyton mentagrophytes was determined by analyzing the modulation of gene expression in various pathways of the dermatophyte.Results:Gossypol inhibited all the dermatophytes.The minimum inhibitory concentrations were 12.5μg/mL for Trichophyton mentagrophytes and Microsporum canis and 25μg/mL for Trichophyton rubrum and Microsporum gypseum.The minimum fungicidal concentrations were 50μg/mL for Trichophyton mentagrophytes,100μg/mL for Microsporum canis and Trichophyton rubrum,and 200μg/mL for Microsporum gypseum.Gossypol inhibited the mRNA expression of metalloprotease(MEP4)and isocitrate lyase(ICL).The binding of gossypol with the enzymes was confirmed by molecular docking studies.The best docking poses were found and the low binding energies were recorded with the two target enzymes.Conclusions:Gossypol is a potential antifungal agent and can be further explored as an anti-dermatophytic drug.
文摘Biliary tract cancers(BTC)are frequently identified at late stages and have a poor prognosis due to limited systemic treatment regimens.For more than a decade,the combination of gemcitabine and cis-platin has served as the first-line standard treatment.There are few choices for second-line chemo-therapy.Targeted treatment with fibroblast growth factor receptor 2 inhibitors,neurotrophic tyrosine receptor kinase inhibitors,and isocitrate dehydrogenase 1 inhibitors has had important results.Immune checkpoint inhibitors(ICI)such as pembrolizumab are only used in first-line treatment for microsatellite instability high patients.The TOPAZ-1 trial's outcome is encouraging,and there are several trials underway that might soon put targeted treatment and ICI combos into first-line options.Newer targets and agents for existing goals are being studied,which may represent a paradigm shift in BTC management.Due to a scarcity of targetable mutations and the higher toxicity profile of the current medications,the new category of drugs may occupy a significant role in BTC therapies.
文摘Grade II oligodendrogliomas are rare and slow growing tumors, making long-term follow up difficult, but necessary for better understanding. In this retrospective study a review of all grade II oligodendrogliomas encountered in the last 20 years at one institution, was undertaken to determine if specific tumor location and immunohistochemical analysis had any impact on recurrence rate, progression free survival, or life expectancy. Eighty-nine grade II oligodendroglioms cases were reviewed (38 females and 51 males;mean age was 40.3 ± 13.8 years). Tumor location was: frontal lobe (44, 49.4%) and superior frontal gyrus (30, 33.7%). 1p19q data were available in 49 patients. Twenty-nine cases were co-deleted (59.2%). There was no significant difference in the incidence of 1p19q co-deletion between superior frontal gyrus tumors vs. other frontal tumors or extra-frontal tumors (p?= 0.45). Follow up of at least 3 months after diagnosis was available in 79 patients (mean follow up: 93.2 months). In recurrence analysis, recurrence by 1p19q status and recurrence by location revealed no significant differences. In analysis of progression, progression by 1p19q status and progression by location revealed no significant differences. An analysis of deaths for the sample, deaths by 1p19q status and deaths by location revealed no significant differences. There was a higher death rate among patients >50 years of age, however this, too, was not significant.?There did not appear to be any advantage in recurrence rate, progression free survival, or life expectancy for tumors located in the frontal lobe or superior frontal gyrus. 1p19q co-deletion did not appear to confer an advantage as measured by time to recurrence, time to progression, or overall survival. Other than age, eloquent location, Karnofsky status, and overall tumor size as reported by others, tumor location and 1p19q status in low grade oligodendrogliomas are not currently predictive of survival.
基金supported by National Key Research and Development Program of China(No.2017YFA0205200)National Natural Science Foundation of China(Nos.81773766 and 81903845)+1 种基金the Natural Science Foundation of Jiangsu Province(BK20161458,China)the“Double First-Class”University project(No.CPU2018GY38,China)。
文摘Acute myeloid leukaemia(AML) is the most common form of acute leukaemia in adults,with increasing incidence with age and a generally poor prognosis.Almost 20% of AML patients express mutant isocitrate dehydrogenase 2(mIDH2),which leads to the accumulation of the carcinogenic metabolite 2-hydroxyglutarate(2-HG),resulting in poor prognosis.Thus,global institutions have been working to develop mIDH2 inhibitors.SH1573 is a novel mIDH2 inhibitor that we independently designed and synthesised.We have conducted a comprehensive study on its pharmacodynamics,pharmacokinetics and safety.First,SH1573 exhibited a strong selective inhibition of mIDH2 R140 Q protein,which could effectively reduce the production of 2-HG in cell lines,serum and tumors of an animal model.It could also promote the differentiation of mutant AML cell lines and granulocytes in PDX models.Then,it was confirmed that SH1573 possessed characteristics of high bioavailability,good metabolic stability and wide tissue distribution.Finally,toxicological data showed that SH1573 had no effects on the respiratory system,cardiovascular system and nervous system,and was genetically safe.This research successfully promoted the approval of SH1573 for clinical trials(CTR20200247).All experiments demonstrated that,as a potential drug against mIDH2 R140 Q acute myeloid leukaemia,SH1573 was effective and safe.
文摘Aim:Patients with glioblastomas demonstrate well‑documented immunological impairments including decreased numbers of mature dendritic cells(DCs).Recent data identified karyopherin a2(KPNA2),a nucleocytoplasmic shuttling receptor,as diagnostic and prognostic biomarker for gliomas.The aim of this ongoing study is to correlate parameters of immunity and nucleocytoplasmic transport in glioblastoma patients.Methods:We preoperatively collected serum from 17 patients with glioblastomas and determined DC subsets(HLA DR+Lin-,CD34-,CD45+,CD123+,CD11+were analyzed)using a 6‑color flow cytometry panel.Expression levels of KPNA2 and nuclear accumulation of p53 were evaluated semi‑quantitatively by immunohistochemistry.O6‑methylguanine DNA methyltransferase(MGMT)and isocitrate dehydrogenase‑1(IDH‑1)status were assessed by pyrosequencing and immunohistochemistry,respectively.Results:Median expression levels for both KPNA2 and p53 were 5-10%.IDH‑1‑R132H mutation and MGMT promoter hypermethylation was detected in 3/16 and 1/9 patients,respectively.Mean counts of total mature DCs,myeloid DCs and plasmacytoid DCs were 9.6,2.1,3.4 cells/μL.A preliminary analysis suggests an association between low KPNA2 nuclear expression and increased numbers of mature DCs.However,this correlation did not reach statistical significance so far(P=0.077).Conclusion:Our preliminary data may indicate a role of KPNA2 in the impaired maturation of DCs observed in glioblastoma patients.
基金supported in part by Science and Technology Commission of Shanghai Municipality(grant number 18411967300,20ZR1407800)Shanghai Municipal Science and Technology Major Project(2018SHZDZX01)the National Natural Science Foundation of China(81873893).
文摘This study aimed to explore the value of deep learning(DL)-assisted quantitative susceptibility mapping(QSM)in glioma grading and molecular subtyping.Forty-two patients with gliomas,who underwent preoperative T2 fluid-attenuated inversion recovery(T2 FLAIR),contrast-enhanced T1-weighted imaging(T1WI+C),and QSM scanning at 3.0T magnetic resonance imaging(MRI)were included in this study.Histopathology and immunohistochemistry staining were used to determine glioma grades,and isocitrate dehydrogenase(IDH)1 and alpha thalassemia/mental retardation syndrome X-linked gene(ATRX)subtypes.Tumor segmentation was performed manually using Insight Toolkit-SNAP program(www.itksnap.org).An inception convolutional neural network(CNN)with a subsequent linear layer was employed as the training encoder to capture multi-scale features from MRI slices.Fivefold cross-validation was utilized as the training strategy(seven samples for each fold),and the ratio of sample size of the training,validation,and test dataset was 4:1:1.The performance was evalu-ated by the accuracy and area under the curve(AUC).With the inception CNN,single modal of QSM showed better perfor-mance in differentiating glioblastomas(GBM)and other grade gliomas(OGG,grade II–III),and predicting IDH1 mutation and ATRX loss(accuracy:0.80,0.77,0.60)than either T2 FLAIR(0.69,0.57,0.54)or T1WI+C(0.74,0.57,0.46).When combining three modalities,compared with any single modality,the best AUC/accuracy/F1-scores were reached in grading gliomas(OGG and GBM:0.91/0.89/0.87,low-grade and high-grade gliomas:0.83/0.86/0.81),predicting IDH1 mutation(0.88/0.89/0.85),and predicting ATRX loss(0.78/0.71/0.67).As a supplement to conventional MRI,DL-assisted QSM is a promising molecular imaging method to evaluate glioma grades,IDH1 mutation,and ATRX loss.
文摘Patients with unresectable cholangiocarcinoma(CCA)face a poor prognosis,and there are few effective treatment options for the disease.The standard of care for patients with locally advanced or metastatic CCA is chemotherapy with a gemcitabine-based doublet.Unfortunately,the clinical benefit obtained with these regimens is modest,with a median overall survival of about one year.For CCA that is chemotherapy-refractory or recurs after first-line chemotherapy,the treatment options are even more limited,and no relevant randomized controlled data are available.In recent years,molecular profiling has shed light on the molecular basis of CCA and identified subgroups of patients that might benefit from a personalized treatment approach.These efforts resulted in the recent FDA approval of the fibroblast growth factor receptor(FGFR)inhibitor,pemigatinib,as a second-line treatment for patients with advanced CCA harboring an FGFR2-fusion or rearrangement.Several other targeted agents also are under evaluation in patients with CCA,of which the isocitrate dehydrogenase inhibitor has had the most promising results.Finally,immunotherapy is being explored as a new treatment approach for advanced CCA patients;indeed,the immune checkpoint inhibitor pembrolizumab can already be used to treat CCAs that are mismatch repair deficient.This review is a comprehensive overview of the treatment options for CCA and offers a glimpse into what the future could hold for these patients.
文摘Biliary tract cancers(BTCs)are usually diagnosed at an advanced stage and have a dismal prognosis.The treatment of advanced disease is mainly based on systemic chemotherapy,which is demonstrated to improve survival in the first-and second-line setting.Following the results of phase III clinical trials,the combination of cisplatin and gemcitabine is the regimen of choice in the frontline,while 5-fluorouracil plus oxaliplatin is considered the standard after first-line progression in unselected patients.Recent advances in molecular biology have unravelled the molecular heterogeneity of BTCs and identified patient subgroups harbouring unique molecular aberrations such as isocitrate dehydrogenase(IDH)mutations and fibroblast growth factor receptor(FGFR)fusions that can be targeted by specific agents.This knowledge has opened the way to personalised medicine in BTCs.Molecules targeting IDH and FGFR are currently approved for the treatment of advanced,refractory,intrahepatic cholangiocarcinoma.Beyond targeted therapies,novel combinatorial approaches that target the immune microenvironment and the crosstalk between cancer and stroma are being explored based on strong preclinical rationale.This review discusses the current therapeutic opportunities for the management of patients with advanced BTCs and provides an overview of the promising new strategies on the horizon with a particular focus on ongoing clinical trials.
