Hypoxic extracellular vesicles from hiPSCs protect cardiomyocytes from oxidative damage by transferring antioxidant proteins and enhancing Akt/Erk/NRF2 signaling.

BACKGROUND: Stem cell-derived extracellular vesicles (EVs) are an emerging class of therapeutics with excellent biocompatibility, bioactivity and pro-regenerative capacity. One of the potential targets for EV-based medicines are cardiovascular diseases (CVD). In this work we used EVs derived from human induced pluripotent stem cells (hiPSCs; hiPS-EVs) cultured under different oxygen concentrations (21, 5 and 3% O2) to dissect the molecular mechanisms responsible for cardioprotection. METHODS: EVs were isolated by ultrafiltration combined with size exclusion chromatography (UF + SEC), followed by characterization by nanoparticle tracking analysis, atomic force microscopy (AFM) and Western blot methods. Liquid chromatography and tandem mass spectrometry coupled with bioinformatic analyses were used to identify differentially enriched proteins in various oxygen conditions. We directly compared the cardioprotective effects of these EVs in an oxygen-glucose deprivation/reoxygenation (OGD/R) model of cardiomyocyte (CM) injury. Using advanced molecular biology, fluorescence microscopy, atomic force spectroscopy and bioinformatics techniques, we investigated intracellular signaling pathways involved in the regulation of cell survival, apoptosis and antioxidant response. The direct effect of EVs on NRF2-regulated signaling was evaluated in CMs following NRF2 inhibition with ML385. RESULTS: We demonstrate that hiPS-EVs derived from physiological hypoxia at 5% O2 (EV-H5) exert enhanced cytoprotective function towards damaged CMs compared to EVs derived from other tested oxygen conditions (normoxia; EV-N and hypoxia 3% O2; EV-H3). This resulted from higher phosphorylation rates of Akt kinase in the recipient cells after transfer, modulation of AMPK activity and reduced apoptosis. Furthermore, we provide direct evidence for improved calcium signaling and sustained contractility in CMs treated with EV-H5 using AFM measurements. Mechanistically, our mass spectrometry and bioinformatics analyses revealed differentially enriched proteins in EV-H5 associated with the antioxidant pathway regulated by NRF2. In this regard, EV-H5 increased the nuclear translocation of NRF2 protein and enhanced its transcription in CMs upon OGD/R. In contrast, inhibition of NRF2 with ML385 abolished the protective effect of EVs on CMs. CONCLUSIONS: In this work, we demonstrate a superior cardioprotective function of EV-H5 compared to EV-N and EV-H3. Such EVs were most effective in restoring redox balance in stressed CMs, preserving their contractile function and preventing cell death. Our data support the potential use of hiPS-EVs derived from physiological hypoxia, as cell-free therapeutics with regenerative properties for the treatment of cardiac diseases.

Molecular Analysis of Retrogradation of Corn Starches.

Changes of the molecular dynamics of water in 5% corn starch pastes and 5% systems composed of starch and non-starchy hydrocolloid were studied during short and long term retrogradation. Low Field NMR was used to record mean correlation times (τc) of water molecules. This molecular parameter reflects the rotation of water molecules within the network of paste. Starches of different amylose and amylopectin content were selected for this study. Comparison of the changes of τc shows how particular polymers bind water molecules. During 90 days of storage, over 50% increase in mean correlation time was recorded in pastes of starches with high amylose content. This suggests that the formation of polymeric network is controlled by amylose to which water is binding. Amylopectin was found to influence the mobility of water in the pastes to a lesser extent with changes in mean correlation times of approximately 10-15% over 90 days. On retrogradation, amylopectin, Arabic and xanthan gums hindered the formation of solid phase structures. Guar gum evoked an increase in mean correlation times of approximately 40-50% during the prolonged process of changes of the molecular dynamics of water. This indicates continued expansion of the polymeric network. Mean correlation time available from spin-lattice and spin-spin relaxation times can be useful in the analysis of the rotational vibrations of the water molecules in biopolymeric structures.

Short- and long-term retrogradation of potato starches with varying amylose content.

BACKGROUND: Gels of potato starches with varying amylose content were prepared and the degree of pasting and the course of retrogradation were studied. The average molar masses of granular and pasted starches were estimated. Determination of the degree of pasting involved use of optical microscopy and the study of pasting characteristics. The studies of susceptibility to retrogradation considered mechanical spectra, hardness, syneresis, resistant starch content, and X-ray measurements. RESULTS: Heating of the starch suspensions at 95 °C resulted in almost complete deterioration of granules. Changes in storage modulus (G') exceeded these of loss modulus (G"). Values of G' and G", hardness and syneresis increased with the period of the sample storage and, simultaneously, the relevant tangent of the phase shift angle (tg (G"/G')) decreased. A tendency was observed for the resistant starch (RS) content to increase on prolonged storage of gels. The patterns of diffractograms for the pasted and lyophilized samples only differed slightly. CONCLUSION: The pastes of all the studied potato starches were characterized by a similar degree of pasting. The most essential changes in the physicochemical properties of the gels were observed between the 30th and 90th days of storage. The susceptibility of potato starch gels to retrogradation, especially within the first 2 h, was controlled, mainly by the amylose content. © 2018 Society of Chemical Industry.

Thixotropic properties of waxy potato starch depending on the degree of the granules pasting.

This paper presents the rheological instability (thixotropy/antithixotropy) of waxy potato starch (WPS) pastes depending on their concentration (1-5% w/w) and pasting temperature (80, 95 and autoclaved: 121°C, at 0.1MPa). The hysteresis loop, apparent viscosity at constant shear rate as well as the in-shear structural recovery tests with and without pre-shearing were applied. The pastes were also characterized by the granularity profile, molecular weight, polydispersity and optical transmittance. Differences in rheological properties of the pastes prepared at 80 and 95°C as well as autoclaved resulted from degree of granules pasting. At 121 °C dissolution of the granules occurred, while at the lower temperatures only the partial pasting of the granules took place. Pasting temperature of WPS significantly influenced rheological parameters of the resulted pastes which had thixotropic, antithixotropic or mixed thixotropic/antithixotropic behavior. Autoclaved pastes, regardless their concentration were antithixotropic as demonstrated by the areas of hysteresis loops derived from the flow curves signalized by the degree of structure recovery (DSR) which exceeded unity. The apparent viscosity of WPS pasted at 121°C strongly decreased as compared to the samples pasted at lower temperatures. Samples pasted at 80 and 95°C showed both thixotropic and antithixotropic behavior, with a predominance of the latter. The starch concentration played an important role in the formation of the rheological properties of the resulted pastes. Its influence was strongly connected with the degree of the granules pasting, therefore with the temperature of pastes preparation. For the pastes prepared at 80 and 95°C the values of thixotropy and apparent viscosity increased, while the values of DSR decreased with an increase of concentration. In the autoclaved pastes the antithixotropy, DSR and apparent viscosity increased with increasing starch concentration. It was also found that apart from the concentration and temperature also the shear rate influence the thixotropic behavior.

Thixotropic properties of normal potato starch depending on the degree of the granules pasting.

The aim of this paper was the study of the rheological instability (thixotropy and/or antithixotropy) of normal potato starch (NPS) pastes depending on their concentration (2-5%) and degree of pasting. Flow curves with hysteresis loops, apparent viscosity at constant shear rate and in-shear structural recovery tests were carried out. Granule size profiles, the pasting characteristic of corresponding starch suspensions and the transmittance of the pastes, the molecular weights and polydispersity of granular starch and its pastes prepared at 80, 95 and 121°C were also studied. The degree of pasting was dependent on the temperature and the concentration and influenced strongly the rheological behavior of the pastes. All pastes belonged to the non-Newtonian liquids thinned by shear and were rheologically unstable to the various extent. Thixotropic properties were connected to the size and the number of the starch granules in the pastes as well as depended on the measuring method used. In the 2 and 3% samples pasted at 80°C the swelling of the granules prevailed their destruction (thixotropy was observed). In the other samples the destruction predominated the swelling (antithixotropy observed).

What are the current outcomes of advanced gastrointestinal stromal tumors: who are the long-term survivors treated initially with imatinib?

The introduction of imatinib to clinical practice revolutionized therapy of advanced gastrointestinal stromal tumors (GIST), but its long-term results have been only just collected. We have attempted to identify factors related to the long-term survival. We have analyzed the data of 430 inoperable/metastatic/recurrent GIST patients treated with imatinib in reference centers, assessed the factors influencing the long-term overall survival (OS), and compared the outcomes in three periods of initiation of imatinib therapy during one decade (2001-2003, 2004-2006, 2007-2010). During analyzed time periods, we have found decrease in median largest tumor size at the start of imatinib therapy: 90.5 mm (2001-2003) versus 74 mm (2004-2006) versus 58 mm (2007-2010) (p = 0.002). Median progression-free survival (PFS) on 1st line imatinib was 37.5 months, without differences in PFS between three groups. Median OS was 5.8 years, 8-year OS rate was 43%, and no difference in OS was demonstrated for patients treated in analyzed time periods. Independent good prognostic factors for longer OS were as follows: surgery of residual disease, initial WHO performance status 0/1, normal baseline albumin level, and the presence of exon 11 KIT mutations. Current median OS in advanced GIST reaches 6 years. The long-term survivors were characterized by smaller maximal tumors at imatinib start, better blood tests results, better performance status, and the surgical removal of residual disease. The latter might reduce the impact of tumor size and equalize the long-term results of therapy during last decade from introduction of imatinib. After introduction of subsequent lines of therapy (as sunitinib), the effect of primary mutational status on the long-term OS is also less visible.

Functional features of gene expression profiles differentiating gastrointestinal stromal tumours according to KIT mutations and expression.

BACKGROUND: Gastrointestinal stromal tumours (GISTs) represent a heterogeneous group of tumours of mesenchymal origin characterized by gain-of-function mutations in KIT or PDGFRA of the type III receptor tyrosine kinase family. Although mutations in either receptor are thought to drive an early oncogenic event through similar pathways, two previous studies reported the mutation-specific gene expression profiles. However, their further conclusions were rather discordant. To clarify the molecular characteristics of differentially expressed genes according to GIST receptor mutations, we combined microarray-based analysis with detailed functional annotations. METHODS: Total RNA was isolated from 29 frozen gastric GISTs and processed for hybridization on GENECHIP HG-U133 Plus 2.0 microarrays (Affymetrix). KIT and PDGFRA were analyzed by sequencing, while related mRNA levels were analyzed by quantitative RT-PCR. RESULTS: Fifteen and eleven tumours possessed mutations in KIT and PDGFRA, respectively; no mutation was found in three tumours. Gene expression analysis identified no discriminative profiles associated with clinical or pathological parameters, even though expression of hundreds of genes differentiated tumour receptor mutation and expression status. Functional features of genes differentially expressed between the two groups of GISTs suggested alterations in angiogenesis and G-protein-related and calcium signalling. CONCLUSION: Our study has identified novel molecular elements likely to be involved in receptor-dependent GIST development and allowed confirmation of previously published results. These elements may be potential therapeutic targets and novel markers of KIT mutation status.

KIT codon 558 insertions in gastrointestinal stromal tumors. Analysis of 17 rare KIT mutants.

Gastrointestinal stromal tumors are the most common mesenchymal neoplasms of gastrointestinal tract often driven by oncogenic KIT exon 11 mutations. Although deletions and substitutions are most frequent KIT exon 11 mutations, duplications and insertions have been reported as well. In contrast to duplications, which cluster in 3'KIT exon 11, insertions affect 5'KIT, particularly codon 558. Clinicopathologic profile of gastrointestinal stromal tumors with insertions in codon 558 is not known. In this study, 17 gastrointestinal stromal tumors with codon 558 insertions are reported. Fifteen (88.2%) KIT codon 558 insertions consisted of 1694_1695insTCC leading to Lys558delinsAsnPro. However, 2 variant mutants Lys558delinsAsnGln and Lys558delinsAsnAsn were also identified. Based on analysis of inserted and flanking sequences, the insertions contain inverted DNA sequences of the opposite strand. Therefore, these insertions may develop due to a DNA strand switch during replication by DNA polymerases and by the effects of several different DNA repair processes. Patient median age was 61 years, and male-to-female ratio was 1:1.8. gastrointestinal stromal tumors were diagnosed in stomach (n = 4), small intestine (n = 7), and rectum (n = 3). Three tumors were disseminated and primary location could not be established. Fourteen tumors had spindle cell morphology, and epithelioid cell features were seen in 2 intestinal and 1 disseminated gastrointestinal stromal tumor. Based on size and mitotic activity, 2 (50%) of 4 gastric and 3 (48.9%) of 7 small intestinal gastrointestinal stromal tumors had more than 50% risk of metastases according to previous studies of gastrointestinal stromal tumor prognosis. All 3 rectal gastrointestinal stromal tumors were malignant. Metastases were verified in 8 (66.7%) of 12 patients with known clinical and follow-up data. In summary, KIT codon 558 insertions are rare mutations accounting for less than 1% of all KIT mutants. Gastrointestinal stromal tumors with these mutations appear to have predilection to female patients and intestinal location. Moreover, KIT codon 558 insertions might indicate an increased risk of malignant behavior for gastric gastrointestinal stromal tumors.

Different factors are responsible for predicting relapses after primary tumors resection and for imatinib treatment outcomes in gastrointestinal stromal tumors.

BACKGROUND: The development of accurate diagnostic methods in gastrointestinal stromal tumors (GISTs) and the introduction of imatinib (IM) therapy has focused attention on the factors influencing the prognosis of patients with primary lesions as well as of patients with advanced disease treated with imatinib. MATERIAL/METHODS: The clinico-pathological and genetic factors influencing disease-free survival (DFS) in 335 patients with primary CD117-immunopositive tumors (group A; calculated from primary tumor resection) and progression-free survival (PFS) in 232 metastatic/unresectable GIST patients treated with IM (group B; calculated from the start of imatinib therapy) were analyzed. RESULTS: In group A, statistically significant factors negatively influencing DFS(five-year DFS: 38%), both in univariate and multivariate analysis, were: primary tumor size >5 cm, mitotic index >5/50 HPF (high-power fields), male gender, primary tumor R1 resection or tumor rupture, non-gastric primary tumor localization. In group B, five factors negatively affecting PFS (three-year PFS: 54%) were identified, which were statistically significant both in univariate and multivariate analyses: WHO performance status >/=2, tumor genotype indicating other than exon 11 KIT mutation, high baseline pre-IM granulocyte count, mitotic index >10/50 HPF, and age <45 years at diagnosis. CONCLUSIONS: Different sets of independent biological and pathological prognostic factors were identified for the assessment of the natural course of primary GIST and for the prediction of PFS during IM therapy for advanced GIST.

Presence of homozygous KIT exon 11 mutations is strongly associated with malignant clinical behavior in gastrointestinal stromal tumors.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of gastrointestinal tract. GISTs range from benign indolent neoplasms to highly malignant sarcomas. Gain-of-function mutations of tyrosine kinase receptors, KIT or PDGFRA, have been identified in most GISTs. In this study, we report 36 GIST patients whose tumors had homozygous KIT exon 11 mutations detected by direct sequencing of PCR products. Loss of heterozygosity in KIT locus and other chromosome 4 loci were documented in majority of these tumors. However, fluorescence in situ hybridization with KIT locus-specific probe and chromosome 4 centromeric enumeration probe showed no evidence of KIT hemizygosity in a majority of analyzed cases. These findings are consistent with duplication of chromosome 4 with KIT mutant allele. Homozygous KIT exon 11 mutations were found in 33 primary tumors and 7 metastatic lesions. In two cases, shift from heterozygosity to homozygosity was documented during tumor progression being present in metastases, but not in primary tumors. Among primary GISTs, there were 16 gastric, 18 intestinal and 2 from unknown locations. An average primary tumor size was 12 cm and average mitotic activity 32/50 HPFs. Out of 32 tumors 29 (90.6%) with complete clinicopathologic data were diagnosed as sarcomas with more than 50% risk of metastatic disease, and 26 of 29 patients with follow-up had metastases or died of disease. An average survival time among pre-imatinib patients, who died of the disease was 33.4 months. Based on these findings, we conclude that presence of homozygous KIT exon 11 mutations is associated with malignant course of disease and should be considered an adverse prognostic marker in GISTs.

Predictive factors for long-term effects of imatinib therapy in patients with inoperable/metastatic CD117(+) gastrointestinal stromal tumors (GISTs).

THE PURPOSE: To analyze the outcomes of treatment and factors predicting effects of imatinib (IM) therapy in inoperable/metastatic gastrointestinal stromal tumors (GIST) CD117(+) patients. MATERIALS AND METHODS: We identified 232 patients in a prospectively collected Clinical GIST Registry with advanced inoperable/metastatic GIST treated with IM 400-800 mg daily (129 males and 103 females and median age 56 years). Median follow-up time was 26 months. RESULTS: The estimated 3-year progression-free survival (PFS; calculated from the date of the start of IM) was 54% and median PFS was 40.5 months. The following factors significantly and negatively influenced PFS in univariate analysis: poor baseline World Health Organization (WHO) performance status > or = 2 (P < 0.00001), tumor genotype indicating other than KIT exon 11 isoform (P = 0.005), baseline high neutrophils count (P < 0.00001), age <45 years at the diagnosis (P = 0.04), mitotic index >10/50 high-power fields (HPF) (P = 0.001), GIST histological type other than spindle-cell (P = 0.03), baseline low albumin level (P = 0.0005), low baseline hemoglobin level (P < 0.00001), and primary overtly malignant tumors (unresectable and/or metastatic lesions at presentation) (P = 0.05). We identified four factors negatively affecting PFS, statistically significant (P < 0.05) in multivariate analysis: baseline poor WHO performance status > or = 2, high baseline neutrophils count (>5 x 10(9)/l), tumor genotype indicating the presence of non-exon 11 KIT mutant and mitotic index >10/50 HPF. CONCLUSIONS: We confirmed that many advanced GIST patients benefit from IM therapy for a prolonged time, although resistance to therapy is observed. We identified four independent biological factors influencing the PFS during long-term IM therapy.

Follow-up visits as a measure of adaptation process to removable prostheses.

OBJECTIVES: The paper was aimed to establish the influence of some general and local factors on adaptation process to removable prostheses (RPs). The adaptation process is a complex issue, which is often associated with painful reactions. Those complaints force patients to visit a dentist who makes alterations to reduce the patient's discomfort. MATERIAL AND METHODS: The study involved analysis of 300 dental records of patients who visited our Department for RPs. The authors analysed the influence of gender, age, condition of general health, maintenance of the prosthetic base tissues and the kind of prostheses on the process of adaptation. It was measured by means of a number of follow-up visits of the patients to our polyclinic. The findings were analysed statistically by means of chi-squared test. The level of significance was assumed to be p < 0.05. RESULTS AND CONCLUSIONS: Adaptation to RPs without any correction was revealed by about one-fifth of patients. Men adapted to RPs better than women. The biggest problems with adaptation to RPs were observed in patients using a complete and partial prosthesis simultaneously. The number of follow-up visits by patients who were treated with RPs for the first time or had been treated before was almost the same. Adaptation of RPs on an atrophic muco-osseous ridge was associated with more multiple visits than in the case of a well-preserved ridge. Healthy patients adapt to RPs better than patients with systemic disorders. Taking into account the limitations of the study, the number of follow-up visits may be used as a helpful indicator of the adaptation process.