Sensitivity and significance of disease outcome measures in inflammatory bowel disease

In inflammatory bowel disease (IBD), proxy measures of clinical outcome are often collected into summary indices of qualitative self-rated disease markers, clinical observations, and quantitative biochemical analyses. In Crohn's disease (CD), a frequently used index is the Crohn's disease activity index (DCAI). This index consists of six qualitative variables and two quantitative variables. The aim of this presentation is to illustrate the use of this index to calculate its range, to estimate errors in the index, its sensitivity, and the number of significant steps in the index. The measure of sensitivity of the summary index was analyzed for the signal-to-noise ratio (SNR), the reference change value (RCV) and the confidence interval (CI). If identical errors were assumed in patient self-rated health and clinically judged disease manifestations, such as tumours and fistulas, the majority of the variance of the index was caused by the self-rated experience of health, the number of days over which the individual variable was rated, and the prognostic multiplier of each variable.The range of the index has no upper limit, but can be estimated to 403 units, of which patient self-rating of well-being account for up to one-third of the summary index maximal score range. The median signal noise measure of index sensitivity was 18 SDs. The two disease classification limits of 150 units for moderate disease and 450 for severe disease on average cover an interval of limit ±41.5 units vs. ±60.5 units. In judgments on change in clinical outcome the RCV interval of steps of 121 units are valid. Conclusion: Both variance and range of the CDAI summary score are primarily decided by the self-rated experience of well-being. Variables on disease signs have a minor impact on the index. Rating of the two important outcome parameters: Self-experienced health and medical outcome would favourably be given in two individual scores.Presented at the 10th Conference Quality in the Spotlight, March 2005, Antwerp, Belgium.     

The sulphate radical is not involved in aqueous radiation oxidation processes

The H₂O₂/persulphate systems are of enormous environmental and commercial importance with the sulphate radical (SO₄⁻) being assumed as the oxidizing/bleaching species. We show that under normal conditions (air-saturated) no SO₄⁻ is produced and, most likely, a much longer-lived species, the adduct of O₂ and the persulphate radical, is formed.     

Emerging nanomedicine and prodrug delivery strategies for the treatment of inflammatory bowel disease

Inflammatory bowel disease (IBD) is a chronic and recurrent disease of the gastrointestinal tract, mainly including Crohn's disease (CD) and ulcerative colitis (UC). However, current approaches against IBD do not precisely deliver drugs to the inflammatory site, which leads to life-long medication and serious side effects that can adversely impact patients’ adherence. It is necessary to construct optimal drug delivery systems (DDSs) that can target drugs to the region of inflammation, thereby improve therapeutic efficacy and reduce side effects. With the burgeoning development of nanotechnology-based nanomedicines (NMs) and prodrug strategy, remarkable progresses in the treatment of IBD have been made in recent years. Herein, the latest advances are outlined at the intersection of IBD treatment and nanotherapeutics as well as prodrug therapy. First, the pathophysiological microenvironment of inflammatory sites of IBD is introduced in order to rationally design potential NMs and prodrugs. Second, the necessity of NMs for the IBD therapy is elaborated, and the representative nanotherapeutics via passive targeted and active targeted NMs developed to treat the IBD are overviewed. Furthermore, the emerging prodrug-based therapeutics are summarized, including 5-aminosalicylic acid-, amino acid-, and carbohydrate-conjugated prodrugs. Finally, the design considerations and perspectives of these NMs and prodrugs-driven IBD therapeutics in the clinical translation are spotlighted.     

Activation of the IL-10 gene promoter following photodynamic therapy of murine keratinocytes

Photodynamic therapy (PDT), an anticancer treatment modality, has recently been shown to be an effective treatment for several autoimmune disease models including antigen-induced arthritis. PDT was found to induce the expression of IL-10 messenger RNA (mRNA) and protein in the skin, and this expression has similar kinetics to the appearance of PDT-induced suppression of skin-mediated immune responses such as the contract hypersensitivity (CHS) response. Some aspects of the UVB-induced suppression of the immune response have been linked to the induction of IL-10. IL-10 has been shown to inhibit the development and activation of Th1 cells, which are critical for many cell-mediated immune responses, including CHS. We have examined the effect of PDT and UVB irradiation on the activity of the IL-10 gene promoter and on IL-10 mRNA stability using the murine keratinocyte line, PAM 212. In vitro PDT induces IL-10 mRNA and protein expression from PAM 212 cells, which can be correlated with an increase in AP-1 DNA binding activity and activation of the IL-10 gene promoter by PDT. Deletion of an AP-1 response element from the IL-10 gene promoter was shown to abrogate the PDT-induced promoter activity indicating that the AP-1 response element is critical to IL-10 induction by PDT. In addition, PDT results in an increase in IL-10 mRNA stability, which may also contribute to the increased IL-10 expression in PAM 212 cells following PDT. In vitro UVB irradiation also results in activation of the IL-10 promoter. However, in contrast to PDT, UVB-induced activation of the IL-10 promoter is not AP-1 dependent and did not increase IL-10 mRNA stability.     

Excited state proton transfer is not involved in the ultrafast deactivation of Guanine-Cytosine pair in solution

Different derivatives of Guanine (G) and Cytosine (C), which sterically enforce the Watson-Crick (WC) conformer, have been studied in CHCl(3) by means of broad-band transient absorption spectroscopy. Our experiments rule out the involvement of an Excited State Proton Transfer (ESPT), which dominates the excited state decay of GC in the gas phase. Instead, the ultrafast dynamics via internal conversion occurs in a polar environment mainly by relaxation in the monomer moieties. Time-dependent density functional theory (TD-DFT) calculations in solution indeed indicate that population transfer from the bright excited states toward the charge transfer state is not effective in CHCl(3) and a noticeable energy barrier is associated with the ESPT reaction. ESPT is therefore not expected to be a main deactivation route for GC pairs within DNA.     

Elemental composition of hair and bone density measurements at diagnosis in paediatric inflammatory bowel disease

A dual energy X-ray absorptiometry (DEXA) system has been employed to measure the bone mineral density (BMD) of children with inflammatory bowel disease (IBD); Crohn's disease (CD) and ulcerative colitis (UC) at diagnosis. The results of the study indicate that even at diagnosis, a significantly reduced bone mineral density measured in terms of the Z-score, was observed in the lumbar spine and whole body of the IBD subjects. This was found to be more pronounced in Crohn's disease than in the ulcerative colitis subjects. Furthermore, the study was extended to investigate the elemental composition of hair of IBD subjects and age matched controls using instrumental neutron activation analysis (INAA). The concentrations of 11 elements; Al, Br, Ca, Cl, Cu, I, K, Mg, Mn, Na and V were determined. A significantly reduced concentration of Ca, Cu, K, Mn, and V were observed in the hair of IBD subjects as compared to the control group. This revised version was published online in August 2006 with corrections to the Cover Date.     

Colon targeting of fluticasone propionate inclusion complex: a novel approach in inflammatory bowel disease

Purpose of the present research was to present fluticasone propionate, a glucocorticoid, as a novel formulation exhibiting improved aqueous solubility, and targeting the drug directly to colon for the treatment of inflammatory bowel disease. Inclusion complex of the drug with hydroxypropyl betacyclodextrin were prepared by solvent evaporation and subsequently the granules of the inclusion complex were coated with Eudragit S100, in order to achieve colon targeting. Inclusion complex was characterized by FTIR, DSC, XRD and ¹H-NMR studies. In vitro drug release from coated granules and the drug transport across excised rat colon using modified Ussing chamber were also attempted. The drug was found to be present in amorphous form, when included in HPβCD cavities. Furthermore, intrinsic dissolution of the drug was found to increase by ~18 times. Coated granules exhibited no drug release in 0.01 N HCl as dissolution medium, indicating gastro-resistance, while 92 % of the drug was released in 120 min, in phosphate buffer (pH 7.4) as dissolution medium. The drug transport studies with rat colon led to more drug transport and concentration in target tissue, when presented as inclusion complex. The formulation releases the drug with improved aqueous solubility in colonic region, and thus concentrating the drug at the target tissue itself.     

IL-10 does not play a role in cutaneous Photofrin photodynamic therapy-induced suppression of the contact hypersensitivity response.

Photodynamic therapy (PDT) treatment of both malignant and benign skin diseases has proven to be effective, and its use is increasing worldwide. However, preclinical studies using murine models have shown that PDT of the skin inhibits cell-mediated immune reactions, as measured by the suppression of the contact hypersensitivity (CHS) reaction. We have previously demonstrated that PDT enhances IL-10 expression in treated skin, and that the kinetics of induction of IL-10 is similar to the kinetics of suppression of systemic CHS reactions by cutaneous PDT. In the following report we have expanded upon these studies to demonstrate that cutaneous PDT, using Photofrin, induces elevated levels of systemic IL-10 that persist for at least 28 days following treatment. The increase in systemic IL-10 correlates to a prolonged suppression of CHS of at least 28 days following cutaneous PDT. IL-10 has been implicated as the causative agent in the suppression of cell-mediated immune reactions by UVB and transdermal PDT. However, in the studies reported here we demonstrate that the suppression of CHS by cutaneous PDT occurs via an IL-10 independent mechanism, as administration of anti-IL-10 antibodies had no effect on the ability of PDT to induce CHS suppression. These results were further confirmed using IL-10 knockout (KO) mice. Cutaneous PDT of IL-10 KO mice resulted in CHS suppression that was not significantly different from suppression induced in wild-type mice. Thus, it appears as though IL-10 does not play a role in CHS suppression by cutaneous PDT. Suppression of cell-mediated immune reactions by UVB and transdermal PDT is reversible by IL-12, which is critical for the development of these reactions. We show that administration of exogenous IL-12 is also able to reverse CHS suppression induced by cutaneous PDT, suggesting that whereas suppression of cell-mediated immune reactions by UVB, transdermal PDT and cutaneous PDT occurs via different mechanisms, a common regulatory point exists.     

The stimulatory effect of IL-1beta on the insulin secretion of rat pancreatic islet is not related with iNOS pathway

Interleukin 1 (IL-1) is a pleiotropic cytokine with the potential to destroy pancreatic beta-cells, and thought to be involved in the pathogenesis of type I diabetes mellitus. Expression of inducible nitric oxide synthase (iNOS) and subsequent NO formation induced by IL-1beta may impair an islet function in rodents. Inhibition of iNOS may protect against cytokine-induced beta-cell suppression, although cytokines might also induce NO-independent impairment. To examine the role of NO in the IL-1beta treated cells, rat islets were treated with various concentrations (0, 0.5, 5, 50, 500 pmol/L) of IL-1beta with or without NG-monomethyl-L-arginine (NMMA; a competitive inhibitor of nitiric oxide synthase) for 2 or 6 h. Insulin secretion was stimulated in islets treated with 5, 50, and 500 pmol/ L of IL-1beta for 2 h and 0.5 pmol/L for 6 h, respectively. The stimulatory effect of IL-1beta on the insulin secretion of rat islets was not prevented by NMMA. Nitrate concentration was increased in a time- and concentration-dependent manner. Nitrate production was inhibited by NMMA. iNOS mRNA expression was increased at concentrations more than 5 pmol/L of IL-1beta in a dose dependent manner. iNOS mRNA was detectable after 2 h and peaked at 6 h but decreased after 24 h. These results suggested that the stimulatory effect of IL-1beta on the insulin secretion of rat islets is independent of iNOS-related NO production of IL-1beta and the enzyme activity of nitric oxide synthase.     

Computational modeling and in-vitro/in-silico correlation of phospholipid-based prodrugs for targeted drug delivery in inflammatory bowel disease

Targeting drugs to the inflamed intestinal tissue(s) represents a major advancement in the treatment of inflammatory bowel disease (IBD). In this work we present a powerful in-silico modeling approach to guide the molecular design of novel prodrugs targeting the enzyme PLA₂, which is overexpressed in the inflamed tissues of IBD patients. The prodrug consists of the drug moiety bound to the sn-2 position of phospholipid (PL) through a carbonic linker, aiming to allow PLA₂ to release the free drug. The linker length dictates the affinity of the PL-drug conjugate to PLA₂, and the optimal linker will enable maximal PLA₂-mediated activation. Thermodynamic integration and Weighted Histogram Analysis Method (WHAM)/Umbrella Sampling method were used to compute the changes in PLA₂ transition state binding free energy of the prodrug molecule (??G^tr) associated with decreasing/increasing linker length. The simulations revealed that 6-carbons linker is the optimal one, whereas shorter or longer linkers resulted in decreased PLA₂-mediated activation. These in-silico results were shown to be in excellent correlation with experimental in-vitro data. Overall, this modern computational approach enables optimization of the molecular design of novel prodrugs, which may allow targeting the free drug specifically to the diseased intestinal tissue of IBD patients.     

Reactive species involved in the regioselective photooxidation of heptamethine cyanines

Heptamethine cyanines are important near-IR fluorophores used in many fluorescence applications. Despite this utility, these molecules are susceptible to light-promoted reactions (photobleaching) involving photochemically generated reactive oxygen species (ROS). Here, we have sought to define key chemical aspects of this nearly inescapable process. Near-IR photolysis of a model heptamethine cyanine leads to the regioselective oxidative cleavage of the characteristic polyene. We report the first quantitative analysis of the major reaction pathway following either photolysis or exposure to candidate ROS. These studies clearly indicate that only singlet oxygen (¹O₂), and not other feasible ROS, recapitulates the direct photolysis pathway. Computational studies were employed to investigate the regioselectivity of the oxidative cleavage process, and the theoretical ratio is comparable to observed experimental values. These results provide a more complete picture of heptamethine cyanine photooxidation, and provide insight for the design of improved compounds for future applications.     

Vitamin D3对儿童桥本甲状腺炎IL-10、IL-12的调节作用

目的:分别以IL-12、IL-10作为Th1、Th2的代表,在1,α25(OH)2D3的干预下,在单核细胞水平分析人外周血单核细胞(PBMC)中IL-10、IL-12在儿童桥本甲状腺炎(HT)中的细微变化,并探讨1α,25(OH)2D3的免疫调节作用。方法:以27例HT患儿为研究对象,17名健康儿童作对照,采集外周静脉血,一部分用于分离并培养单核细胞,设1,α25(OH)2D3干预组和对照组,收集培养上清液,ELISA检测上清液中IL-10、IL-12水平。另一部分静脉血分离出血清,再提取25(OH)D3,用放射免疫法(RIA)测定25(OH)D3水平。结果:HT组25(OH)D3显著低于健康对照,分别为(21.85±5.73)ng/mL和(27.56±7.46)ng/mL(P<0.01),且HT组PBMC产生IL-12水平显著高于健康对照,分别为(119.18±28.65)pg/mL和(102.84±23.86)pg/mL(P<0.01),而IL-10的表达显著低于健康对照,分别为(132.99±12.04)pg/mL和(171.41±35.72)pg/mL(P<0.01)。1α,25(OH)2D3干预后HT患儿IL-12表达显著下调为(98.57±11.98)pg/mL(P<0.01),IL-10表达在HT组和健康对照组均上调,分别为(184.15±35.34)pg/mL(P<0.01)、(223.77±53.36)pg/mL(P<0.01),HT组ρ(IL-10)/ρ(IL-12)比值显著升高。结论:HT患儿的25(OH)D3水平不足。1α,25(OH)2D3参与单核细胞分泌细胞因子的调节过程,能抑制HT增强的Th1型细胞因子IL-12分泌,增加IL-10表达,纠正n(Th1)/n(Th2)细胞因子失衡。     

A promotor polymorphism in the Interleukin 11 gene is associated with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a multifactorial disorder characterized by irreversible airflow obstruction due to chronic inflammation. Hence, the gene encoding the anti-inflammatory cytokine IL 11 is a good candidate for being involved in the genetic predisposition to COPD. In order to evaluate the role of the Interleukin 11 (IL 11) gene in the genetic predisposition for COPD, a dinucleotide microsatellite polymorphism in the promoter region has been genotyped in 153 patients with COPD (including 25 non-smokers) and 463 healthy controls. Frequencies of the IL 11.A2 microsatellite allele and of IL 11.A2 homozygous individuals were significantly decreased among the patients with COPD (p < 0.012 and p < 0.022, respectively) as compared to controls. Both frequencies were even more drastically reduced among the nonsmoking patients. Tight linkage of this microsatellite allele with another polymorphism in the promotor region was established. Altered expression of IL 11 may be involved in the genetic predisposition to COPD.     

Improving sensitivity of electrophoretic heteroduplex analysis using nucleosides as additives: Application to the breast cancer predisposition gene BRCA2

A new method for the detection of unknown mutations, enhanced mismatch mutation analysis (EMMA), is proposed. It is based on electrophoretic heteroduplex analysis (HDA). The resolution is considerably improved, thanks to the combination of high-resolution block-copolymer sieving matrix, and nucleosides as additives in the electrophoretic medium. The EMMA method is compared to denaturing HPLC (DHPLC) in a large-scale study of mutations in the breast cancer-associated gene BRCA2, involving 4655 DNA amplicons from 94 patients. The rate of false positives was 0.09%. The raw success rate, without optimization of the amplicons tiling, was 94%, a value much higher than that achieved earlier with HDA, and comparable with that obtained with DHPLC. An analysis of the missed mutations suggest that the success rate could be improved up to about 97%, simply by redesigning the amplicons, while retaining the speed, cost effectiveness, and simplicity of the method.     

Akt is involved in the inhibition of cell proliferation by EGF

Axin is a negative regulator of the Wnt/beta-catenin pathway and is involved in the regulation of axis formation and proliferation. Involvement of Axin in the regulation of other signaling pathways is poorly understood. In this study, we investigated the involvement of Akt in growth regulation by Axin in L929 fibroblasts stimulated by EGF. Akt activity was increased by EGF treatment and Ras activation, respectively. Both the EGF- and Ras-induced Akt activations were abolished by Axin induction, as revealed by both Western blot and immunocytochemical analyses. The proliferation and Akt activation induced by EGF were decreased by Axin induction, and the effects of EGF were abolished by treatment of an Akt-specific inhibitor. Therefore, Axin inhibits EGF-induced proliferation of L929 fibroblasts by blocking Akt activation.     

The turnover rate for the catalytic combustion of methane over palladium is not sensitive to the structure of the catalyst

The kinetics for the catalytic combustion of methane on Pd in its metal and oxide forms was measured on a foil and on large single crystals exposing initially the (111), (100), and (110) planes. The rates, reaction orders, and activation energies were not dependent on the structure of the active phase. Turnover rates were strictly proportional to the total surface area. The kinetic data were in agreement with the ones for supported catalysts. The values reported can be used as benchmark kinetic values for this reaction since purity and effect of support could be controlled.     

Activated oxygen is formed by the mycelium and is involved mainly in the primary attack of LCC byP. chrysosporium

Convincing evidence demonstrating the involvement of activated forms of oxygen in the fungal degradation of LCC have been obtained by different research groups. Among the most active intermediates stands ·OH, which is the subject of this work. We describe here a method for the accurate detection of ·OH based on the specific decarboxylation of benzoic acid. Using this method, we have demonstrated that the decarboxylating system is not diffusible in the culture medium, but is strongly associated with the mycelium. The 6-d-old fungus is able to form ·OH even after transferring to new medium. Cell wall fractions were not able to decarboxylate benzoate. Another topic that has been considered is the role of hydroxyl radical in LCC degradation. In agreement with others, we have established that ·OH scavengers severely inhibit the degradation fo LCC when added to the cultures. If LCC was pretreated by chemically generated ·OH, it turns out thatP. chrysosporium is able to use the solubilized fractions. However, in contrast to that of “native LCC” the metabolization of the solubilized moiety of LCC was not inhibited by -OH scavengers. It is concluded that -OH may act only during the primary attack on LCC and not during the course of its subsequent degradative pathway.