Management of Hyperuricemia with Rasburicase Review

Tumor lysis syndrome (TLS) is a serious complication in patients with hematological malignancies. Massive lysis of tumor cells can lead to hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcaemia. These metabolic disturbances may result in renal failure, because of precipitation of uric acid crystals and calcium phosphate salts in the kidney. The standard prophylaxis or treatment of hyperuricemia consists of decreasing uric acid production with allopurinol and facilitating its excretion by urinary alkalinization and hyperhydration. By inhibiting the enzyme xanthine oxidase, allopurinol blocks the conversion of hypoxanthine and xanthine into uric acid. An alternative treatment is urate oxidase which oxidates uric acid into allantoin. Allantoin is 5–10 times more soluble than uric acid and is therefore excreted easily. In several clinical trials rasburicase, the recombinant form of urate oxidase, has shown to be very effective in preventing and treating hyperuricemia. Rasburicase, in contrast with the non‐recombinant form of urate oxidase uricozyme, is associated with a low incidence of hypersensitivity reactions. In addition to the demonstrated clinical benefit, rasburicase also proved to be a cost‐effective option in the management of hyperuricemia.     

Highly potent anti-CD20-RLI immunocytokine targeting established human B lymphoma in SCID mouse

Rituximab (RTX), a chimeric IgG1 monoclonal antibody directed against the CD20 antigen, has revolutionized the treatment of B-cell malignancies. Nevertheless, the relapsed/refractory rates are still high. One strategy to increase the clinical effectiveness of RTX is based on antibody-cytokine fusion protein (immunocytokine; ICK) vectorizing together at the tumor site the antibody effector activities and the cytokine co-signal required for the generation of cytotoxic cellular immunity. Such ICKs linking various antibody formats to interleukin (IL)-2 are currently being investigated in clinical trials and have shown promising results in cancer therapies. IL-15, a structurally-related cytokine, is now considered as having a better potential than IL-2 in antitumor immunotherapeutic strategies. We have previously engineered the fusion protein RLI, linking a soluble form of human IL-15Rα-sushi+ domain to human IL-15. Compared with IL-15, RLI displayed better biological activities in vitro and higher antitumor effects in vivo in murine and human cancer models. In this study, we investigated the advantages of fusing RLI to RTX. Anti-CD20-RLI kept its binding capacity to CD20, CD16 and IL-15 receptor and therefore fully retained both antibody effector functions (ADCC and CDC), and the cytokine potential of RLI. In a severe combined immunodeficiency (SCID) mouse model of disseminated residual lymphoma, anti-CD20-RLI was found to induce long-term survival of 90% of mice up to at least 120 days whereas RLI and RTX, alone or in combination, just delayed the disease onset (100% of death at 28, 40 and 51 days respectively). These findings suggest that such ICK could improve the clinical efficacy of RTX, particularly in patients with refractory B-cell lymphoma.     

右美托咪定对腹腔镜下子宫恶性肿瘤手术患者炎症因子及认知功能的影响

目的:探讨右美托咪定对腹腔镜下子宫恶性肿瘤手术患者炎症因子以及认知功能的影响,为右美托咪定在腹腔镜下子宫恶性肿瘤手术的临床应用提供参考。方法:选择武汉科技大学附属普仁医院2015年7月至2017年6月收治的100例行腹腔镜下子宫恶性肿瘤手术患者作为研究对象,根据不同麻醉方式分为观察组和对照组两组,各50例,其中观察组患者在给予麻醉诱导前30 min,负荷剂量1.0μg/kg的右美托咪定静脉输注10 min,之后给予患者0.5μg/kg的右美托咪定持续性静脉输注至手术结束前30 min为止,对照组患者按照上述给药方法静脉输注同等容量的生理盐水。然后分别于麻醉诱导前(T0)、手术结束时(T1)、手术结束后4 h(T2)以及手术结束后1天(T3)取患者的外周静脉血,测定比较两组患者各相应时间点的血清C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白细胞介素(IL-6)等炎症因子水平,外周血皮质醇(cor)、肾上腺素(E)、去甲肾上腺素(NE)等应激水平,MMSE评分、TMT完成时间等认知功能;并分析两组患者术后的不良反应发生情况。结果:两组患者T0时间的血清IL-6、TNF-α、CRP、cor、E、NE水平以及TMT、MMSE认知功能评分差异不具有统计学意义(P0.05),具有可比性;而观察组患者T1、T2、T3各相应时间点的血清IL-6、TNF-α、CRP、cor、E以及NE水平明显低于对照组(P0.05);观察组患者T2、T3各相应时间点的MMSE评分明显高于对照组,TMT评分值明显低于对照组(P0.05);且术后观察组患者的不良反应发生率明显低于对照组(P0.05)。结论:右美托咪定可以明显降低腹腔镜下子宫恶性肿瘤手术患者血清应激反应以及炎症因子水平,改善术后认知功能,减少术后不良反应的发生,效果显著,值得临床推广使用。     

The role of HSP27 in the development of drug resistance of gastrointestinal malignancies: Current status and perspectives

Heat-shock protein 27 (HSP27) is a chaperone molecule that plays a critical role in the refolding and activity of several proteins responsible for cancer cell drug toxicity. Upregulation of HSP27 is associated with decreased drug sensitivity as well as poorer survival in gastrointestinal (GI) malignancies. It is, therefore, possible that HSP27 may be of value in the assessment of prognostic and therapeutic efficacy in the treatment of GI cancers. Pharmacological and biological inhibitors of HSP27 enhance tumor cell chemosensitivity. This review summarizes the potential role of HSP27 in chemotherapy drug resistance and the therapeutic potential of HSP27 inhibitors as a novel strategy in the treatment of GI cancers.     

Human leukocyte formin: a novel protein expressed in lymphoid malignancies and associated with Akt

The very large family of Formin proteins is involved in processes such as morphogenesis, embryonic differentiation, cell polarity, and cytokinesis. A novel human gene from the Formin family, denominated human leukocyte formin gene, was cloned. The cDNA of the gene was determined to be 3959bp long with an open reading frame of 3302bp and computational analysis located this gene on chromosome 17, suggesting that it is composed of 27 exons. Northern blot analysis revealed a restricted expression of mRNA in the thymus, spleen, and peripheral blood leukocytes in normal human tissues. Western blot analysis demonstrated that the protein encoded by this gene is overexpressed in lymphoid malignancies; cancer cell lines and peripheral blood leukocyte from chronic lymphocytic leukemia (CLL) patients. Furthermore, the human leukocyte formin protein was observed to associate with Akt, a critical survival regulator in many different cell types.     

Apoptosis: Molecular regulation of cell death and hematologic malignancies

We describe the molecular mechanisms of apoptosis and its relationships with hematologic malignancies, stressing the concept that, both positive and negative deregulation of apoptosis, may be involved in hematologic human diseases. So, this fundamental process must be balanced by so far unknown mechanisms, involving caspases (cysteine proteases, cleaving the protein substrate after an aspartate residue). These, so far known, ten proteases, are interconnected in a molecular cascade, initiated by the release of cytochrome C from mitochondrial membranes and its interaction with APAF-1 (the homolog of the Caenorhabditis e. CED-4) and with caspase 9, that initiates the proteolitic cascade (1,2). The conclusion is that apoptosis is a very important process, but yet poorly known in molecular details, in spite of the efforts of many scientists. Even the role of bcl-2, the main gene protecting from apoptosis, is still unknown. We close this chapter with a list of ten different technical approaches that can be useful tools to study apoptosis, and tracing the molecular principles on which they are based.     

MicroRNAs in Lymphoma: Regulatory Role and Biomarker Potential

Although it is now evident that microRNAs (miRNAs) play a critical regulatory role in many, if not all, pathological and physiological processes, remarkably they have only formally been recognized for less than fifteen years. These endogenously produced short non-coding RNAs have created a new paradigm of gene control and have utility as both novel biomarkers of cancer and as potential therapeutics. In this review we consider the role of miRNAs in lymphoid biology both under physiological (i.e. lymphopoiesis) and malignant (i.e. lymphomagenesis) conditions. In addition to the functional significance of aberrant miRNA expression in lymphomas we discuss their use as novel biomarkers, both as a in situ tumour biomarker and as a non-invasive surrogate for the tumour by testing miRNAs in the blood of patients. Finally we consider the use of these molecules as potential therapeutic agents for lymphoma (and other cancer) patients and discuss some of the hurdles yet to be overcome in order to translate this potential into clinical practice     

共振喇曼光谱技术在恶性肿瘤诊断中的应用

目的：探讨共振喇曼光谱技术用于早期恶性肿瘤诊断的研究。方法：利用氩离子激光作为线偏振光的特点,采集偏振荧光光谱,对荧光光谱的偏振态进行分析。利用不同荧光物质的荧光可能具有不同偏振态的特点减少其它荧光物质的荧光对光谱分析的影响。血清样品产生的荧光也具有确定的偏振性。对所检测病人血清经激光分析仪进行喇曼光谱技术分析,光谱数据经计算机软件处理,自动显示图谱和数据,并直接给出各项指标及诊断提示。本结果与细胞病理学结果进行了对照研究。结果：恶性肿瘤样本176例,检测出阳性病例141例,阳性符合率为80.1%;良性肿瘤样本52例,4例阳性,假阳性率为7.7%;正常体检样本248例,检测结果均为阴性。结论：喇曼光谱技术适用于肿瘤初筛、普查及早期诊断,有推广应用前途。     

Antibody-targeted chemotherapy of B-cell lymphoma using calicheamicin conjugated to murine or humanized antibody against CD22

Antibody-targeted chemotherapy with immunoconjugates of calicheamicin is a clinically validated strategy in cancer therapy. This study describes the selection of a murine anti-CD22 mAb, m5/44, as a targeting agent, its conjugation to a derivative of calicheamicin (CalichDM) via either acid-labile or acid-stable linkers, the antitumor activity of CalichDM conjugated to m5/44, and its subsequent humanization by CDR grafting. Murine IgG1 mAb m5/44 was selected based on its subnanomolar affinity for CD22 and ability to be internalized into B cells. CalichDM conjugated to m5/44 caused potent growth inhibition of CD22⁺ human B-cell lymphomas (BCLs) in vitro. The conjugate of m5/44 with an acid-labile linker was more potent than an acid-stable conjugate, a nonbinding conjugate with a similar acid-labile linker, or unconjugated CalichDMH in inhibiting BCL growth. CalichDM conjugated to m5/44 caused regression of established BCL xenografts in nude mice. In contrast, both unconjugated m5/44 and a nonbinding conjugate were ineffective against these xenografts. Based on the potent antitumor activity of m5/44-CalichDM conjugates, m5/44 was humanized by CDR grafting to create g5/44, an IgG4 anti-CD22 antibody. Both m5/44 and g5/44 bound CD22 with subnanomolar affinity. Competitive blocking with previously characterized murine anti-CD22 mAbs suggested that g5/44 recognizes epitope A located within the first N-terminal Ig-like domain of human CD22. Antitumor efficacy of CalichDM conjugated to g5/44 against BCL xenografts was more potent than its murine counterpart. Based on these results, a calicheamicin conjugate of g5/44, CMC-544, was selected for further development as a targeted chemotherapeutic agent for the treatment of B-cell malignancies.Abbreviations AcBut 4-(4-Acetylphenoxy) butanoic acid - AcPAc (3-Acetylphenyl) acetic acid - ATC Antibody-targeted chemotherapy - BCL B-cell lymphoma - CalichDM N-Acetyl--calicheamicin dimethyl disulfide derivative(s) - CalichDMA CalichDM acid - CalichDMH CalichDM hydrazide - CDR Complementarity determining region - NHL Non-Hodgkins lymphoma - PBMC Peripheral blood mononuclear cell - TAA Tumor-associated antigen