Multifunctional anti-cancer nano-platforms are moving to clinical trials.

Cancer management needs rapid, non-invasive diagnosis and tumour-specific therapeutics which is unfortunately lacking for most cancer types. Novel approaches for cancer management aim at providing customized therapy according to individual diagnoses, determined by gene expression profiling, in particular, targeting highly selective monoclonal antibodies (mAbs) to single cancer cell antigens, in combination with highly cytotoxic drugs, thereby avoiding the unwanted side effects of conventional chemotherapy. Multifunctional nano-vectors that combine new and more powerful drugs and/or probes for diagnostic imaging with tumour surface-specific ligands/antibodies have been developed. These nano-vectors have displayed superior selective anti-tumour activity compared to antibodies or standard anti-cancer drugs/agents alone both in-vitro, and in preclinical and clinical models. Anti-cancer nano-platforms can significantly improve early cancer detection and ameliorate therapeutic strategies. In the immediate future nano-technology may enable the simultaneous early detection and selective inactivation of cancer cells before they develop into full blown tumours.

Emergency treatment of violent trauma: clinical cases and surgical treatment of penetrating thoracoabdominal, perineal and anorectal trauma.

AIM: The authors analyse clinical cases of penetrating thoracic, abdominal, perineal and anorectal injury and describe the traumatic event and type of lesion, the principles of surgical treatment, the complication rate and follow up. MATERIALS AND METHODS: In the last 24 months, we analyzed 10 consecutive cases of penetrating thoracic and abdominal wounds [stab wound (n=7), with evisceration (n=4), gunshot wound (n=1)], and penetrating perineal and anorectal wounds (impalement n=4). In addition, we report an unusual case of neck injury from a stab wound. All the patients underwent emergency surgery for the lesions reported. RESULTS: In 7 cases of perforating vulnerant thoracoabdominal trauma from stab wounds there was hemoperitoneum due to bleeding from the abdominal wall (n=3), the omentum (n=1), the vena cava (n=1) and the liver (n=2). Evisceration of the omentum was observed in 4 cases. In 2 cases laparoscopy was performed. In one case laparotomy and thoracoscopy was performed. In a patient with an abdominoperineal gunshot wound, exploration was extraperitoneal. The 4 cases of perineal and anorectal impalement were treated with primary reconstruction, while in one case a laparotomy was needed to suture the rectum and fashion a temporary colostomy. In one case of anorectal injury rehabilitation resulted in a gradual improvement of fecal continence, while in the patient with the colostomy follow up at 2 months was scheduled to plan colostomy closure. CONCLUSIONS: Based on the our clinical experience and the literature, in penetrating abdominal trauma laparotomy may be required if patients are hemodynamically unstable (or in hemorrhagic shock), in patients with evisceration and peritonitis, or for exploration of penetrating thoracoabdominal and epigastric lesions. In anterior injuries of the abdominal wall from gunshot or stab wounds, laparotomy is indicated when there is peritoneal violation and significant intraperitoneal damage. In patients with actively bleeding wounds of the abdominal wall muscles minimal laparotomy is often necessary for control of hemorrhage and abdominal wall reconstruction to avoid herniation. If patients are asymptomatic, in cases of anterior lesions the indications for diagnostic laparoscopy are uncertain. Selective conservative treatment is reserved for asymptomatic patients who are hemodynamically stable. Further controlled studies are needed. Early surgery for perineal and anorectal trauma, and also for complex injuries, is the gold standard for treatment.

Early self-reproduction, the emergence of division mechanisms in protocells.

Synthetic Biology approaches are proposing model systems and providing experimental evidences that life can arise as spontaneous chemical self-assembly process where the ability to reproduce itself is an essential feature of the living system. The appearance of early cells has required an amphiphilic membrane compartment to confine molecular information against diffusion, and the ability to self-replicate the boundary layer and the genetic information. The initial spontaneous self-replication mechanisms based on thermodynamic instability would have evolved in a prebiotic and later biological catalysis. Early studies demonstrate that fatty acids spontaneously assemble into bilayer membranes, building vesicles able to grow by incorporation of free lipid molecules and divide. Early replication mechanisms may have seen inorganic molecules playing a role as the first catalysts. The emergence of a short ribozyme or short catalytic peptide may have initiated the first prebiotic membrane lipid synthesis required for vesicle growth. The evolution of early catalysts towards the simplest translation machine to deliver proteins from RNA sequences was likely to give early birth to one single enzyme controlling protocell membrane division. The cell replication process assisted by complex enzymes for lipid synthesis is the result of evolved pathways in early cells. Evolution from organic molecules to protocells and early cells, thus from chemistry to biology, may have occurred in and out of the boundary layer. Here we review recent experimental work describing membrane and vesicle division mechanisms based on chemico-physical spontaneous processes, inorganic early catalysis and enzyme based mechanisms controlling early protocell division and finally the feedback from minimal genome studies.

[The rupture of splenic artery aneurysm in Erdheim disease]. / La rottura di aneurisma dell'arteria lienale nella malattia di Erdheim.

Splenic vessel aneurysm is often a casual pathology during strumental imaging or laparotomy. The first cause for the formation of the aneurysm is a vessel primitive degenerative pathology of the medium wall, or idiopathic cystic medionecrosis, that to develop in aneurysmatic dissection. In the early diagnosis, in the selective patients, resulted indicate an endovascular therapy, while in emergency the laparotomy is a gold strandard for reduction morbility and mortality. In this paper, the Authors described a rare case of rupture of the lienal vessel aneurysm in Erdheim disease, and reported clinical features, indications and procedures for better treatment.

[Anal Masson's tumor]. / Il tumore di Masson a localizzazione anale.

The Authors report on an extremely rare case of anal Masson's tumour and has described clinical and histological considerations. Is important the surgical resection of the lesion because this tumour is similar to angiosarcoma.

Internal lipid synthesis and vesicle growth as a step toward self-reproduction of the minimal cell.

One of the major properties of the semi-synthetic minimal cell, as a model for early living cells, is the ability to self-reproduce itself, and the reproduction of the boundary layer or vesicle compartment is part of this process. A minimal bio-molecular mechanism based on the activity of one single enzyme, the FAS-B (Fatty Acid Synthase) Type I enzyme from Brevibacterium ammoniagenes, is encapsulated in 1-palmitoyl-2oleoyl-sn-glycero-3-phosphatidylcholine (POPC) liposomes to control lipid synthesis. Consequently molecules of palmitic acid released from the FAS catalysis, within the internal lumen, move toward the membrane compartment and become incorporated into the phospholipid bilayer. As a result the vesicle membranes change in lipid composition and liposome growth can be monitored. Here we report the first experiments showing vesicles growth by catalysis of one enzyme only that produces cell boundary from within. This is the prototype of the simplest autopoietic minimal cell.

Artificial assembly of a minimal cell.

Synthetic Biology approaches can assemble and/or reconstruct cell parts in synthetic compartments. A minimal cell as a model for early living cells can be artificially constructed in the laboratory resuming the main properties of a basic cell living system: a synthetic cell compartment or liposome to host a minimal metabolism based on protein synthesis, and a shell and core reproduction mechanism, all in an artificial cell assembly and remaining in the realm of minimal living. It is becoming realistic to construct artificial cells, starting from a minimal cell assembly, and deliver cell-like bioreactors to synthesize pure proteins/enzymes or isolate single pathways. These artificial cell-like systems could perform different tasks in antimicrobial drug development, drug delivery and diagnostic applications.

Protein synthesis in liposomes with a minimal set of enzymes.

In a significant step towards the construction of the semi-synthetic minimal cell, a protein expression system with a minimal set of pure and specific enzymes is required. A novel cell-free transcription and translation system named PURESYSTEM (PS), consisting of a specified set of 36 enzymes and ribosomes, has been entrapped in POPC liposomes for protein synthesis. The PS has been used to transcribe and translate an Enhanced Green Fluorescent Protein (EGFP) gene from plasmid DNA. The synthesis is confirmed by the EGFP fluorescence emitting liposomes on fluorometric analysis and on confocal microscopy analysis. Furthermore the PS encapsulated into POPC liposomes can drive the expression of the plsB and plsC genes encoding for the sn-glycerol-3-phosphate acyltransferase (GPAT) and 1-acyl-sn-glycerol-3-phosphate acyltransferase (LPAAT) involved in the first step of the "salvage pathway" for synthesis of POPC. The expression of GPAT and LPAAT in liposomes would in principle allow the production of the cell boundary from within.

Question 7: construction of a semi-synthetic minimal cell: a model for early living cells.

Using a Synthetic Biology approach we are building a semi-synthetic minimal cell. This represents an exercise to shape a minimal-cell model system recalling the simplicity of early living cells in early evolution. We have recently introduced into liposome compartments a minimal set of enzymes named "Puresystem" (PS) synthesizing EGFP proteins. To establish reproduction of the shell compartment with a minimal set of genes we have cloned the genes for the Fatty Acid Synthase (FAS) type I enzymes. These FAS genes introduced into liposomes, translated into FAS enzymes by PS and in the presence of precursors produce fatty acids. The resulting release of fatty acid molecules within liposome vesicles should promote vesicle growth and reproduction. The core reproduction of a minimal cell corresponding to the replication of the minimal genome will require a few genes for the DNA replication and the PS, and a minimum set of genes for the synthesis of t-RNAs. In future the reconstruction of a minimal ribosome will bring the number of genes for ribosomal proteins from 54 of an existing minimal genome down to 30-20 genes. A Synthetic Biology approach could bring the number of essential genes for a minimal cell down to 100 or less.

A nuclear protease required for flowering-time regulation in Arabidopsis reduces the abundance of SMALL UBIQUITIN-RELATED MODIFIER conjugates.

The Arabidopsis mutant early in short days4 (esd4) shows extreme early flowering and alterations in shoot development. We have identified ESD4 and demonstrate that it encodes a nuclear protein located predominantly at the periphery of the nucleus. ESD4 contains a segment of >200 amino acids with strong similarity to yeast and animal proteases that are specific for the protein modifier SMALL UBIQUITIN-RELATED MODIFIER (SUMO). ESD4 shows a similar function to these proteases in vitro and processes the precursor of Arabidopsis SUMO (AtSUMO) to generate the mature form. This activity of ESD4 is prevented by mutations that affect the predicted active site of the protease or the cleavage site of the AtSUMO precursor. In yeast, these proteases also recycle SUMO from conjugates, and this appears to be the major role of ESD4 in vivo. This is suggested because esd4 mutants contain less free AtSUMO and more SUMO conjugates than wild-type plants, and a transgene expressing mature SUMO at high levels enhanced aspects of the esd4 phenotype. ESD4 defines an important role for protein modification by AtSUMO in the regulation of flowering.

early in short days 4, a mutation in Arabidopsis that causes early flowering and reduces the mRNA abundance of the floral repressor FLC.

The plant shoot is derived from the apical meristem, a group of stem cells formed during embryogenesis. Lateral organs form on the shoot of an adult plant from primordia that arise on the flanks of the shoot apical meristem. Environmental stimuli such as light, temperature and nutrient availability often influence the shape and identity of the organs that develop from these primordia. In particular, the transition from forming vegetative lateral organs to producing flowers often occurs in response to environmental cues. This transition requires increased expression in primordia of genes that confer floral identity, such as the Arabidopsis gene LEAFY. We describe a novel mutant, early in short days 4 (esd4), that dramatically accelerates the transition from vegetative growth to flowering in Arabidopsis: The effect of the mutation is strongest under short photoperiods, which delay flowering of Arabidopsis: The mutant has additional phenotypes, including premature termination of the shoot and an alteration of phyllotaxy along the stem, suggesting that ESD4 has a broader role in plant development. Genetic analysis indicates that ESD4 is most closely associated with the autonomous floral promotion pathway, one of the well-characterized pathways proposed to promote flowering of Arabidopsis: Furthermore, mRNA levels of a floral repressor (FLC), which acts within this pathway, are reduced by esd4, and the expression of flowering-time genes repressed by FLC is increased in the presence of the esd4 mutation. Although the reduction in FLC mRNA abundance is likely to contribute to the esd4 phenotype, our data suggest that esd4 also promotes flowering independently of FLC. The role of ESD4 in the regulation of flowering is discussed with reference to current models on the regulation of flowering in Arabidopsis.

The circadian clock that controls gene expression in Arabidopsis is tissue specific.

The expression of CHALCONE SYNTHASE (CHS) expression is an important control step in the biosynthesis of flavonoids, which are major photoprotectants in plants. CHS transcription is regulated by endogenous programs and in response to environmental signals. Luciferase reporter gene fusions showed that the CHS promoter is controlled by the circadian clock both in roots and in aerial organs of transgenic Arabidopsis plants. The period of rhythmic CHS expression differs from the previously described rhythm of chlorophyll a/b-binding protein (CAB) gene expression, indicating that CHS is controlled by a distinct circadian clock. The difference in period is maintained in the wild-type Arabidopsis accessions tested and in the de-etiolated 1 and timing of CAB expression 1 mutants. These clock-affecting mutations alter the rhythms of both CAB and CHS markers, indicating that a similar (if not identical) circadian clock mechanism controls these rhythms. The distinct tissue distribution of CAB and CHS expression suggests that the properties of the circadian clock differ among plant tissues. Several animal organs also exhibit heterogeneous circadian properties in culture but are believed to be synchronized in vivo. The fact that differing periods are manifest in intact plants supports our proposal that spatially separated copies of the plant circadian clock are at most weakly coupled, if not functionally independent. This autonomy has apparently permitted tissue-specific specialization of circadian timing.