Preparing pharmacists to manage gene therapies.

This commentary provides a background on gene therapy and identifies a critical gap in pharmacy practice education. The history and handling of gene therapy is contextualized with current pharmacy practice. With the increasing numbers of gene and cell-based therapies approaching the market, the need for appropriate training is greater than ever. There are few gene therapy training resources for pharmacists, and gene therapies require complex handing and administration. Pharmacists play a vital role in bringing new therapies to health care institutions and training other health care providers. Pharmacy organizations and health systems should work to develop gene therapy training resources for health-system pharmacists.

Bile Acid 7α-Dehydroxylating Gut Bacteria Secrete Antibiotics that Inhibit Clostridium difficile: Role of Secondary Bile Acids.

Clostridium scindens biotransforms primary bile acids into secondary bile acids, and is correlated with inhibition of Clostridium difficile growth in vivo. The aim of the current study was to determine how C. scindens regulates C. difficile growth in vitro and if these interactions might relate to the regulation of gut microbiome structure in vivo. The bile acid 7α-dehydroxylating gut bacteria, C. scindens and C. sordellii, were found to secrete the tryptophan-derived antibiotics, 1-acetyl-ß-carboline and turbomycin A, respectively. Both antibiotics inhibited growth of C. difficile and other gut bacteria. The secondary bile acids, deoxycholic acid and lithocholic acid, but not cholic acid, enhanced the inhibitory activity of these antibiotics. These antibiotics appear to inhibit cell division of C. difficile. The results help explain how endogenously synthesized antibiotics and secondary bile acids may regulate C. difficile growth and the structure of the gut microbiome in health and disease.

Information storage and retrieval in a single levitating colloidal particle.

The binary switch is a basic component of digital information. From phase-change alloys to nanomechanical beams, molecules and atoms, new strategies for controlled bistability hold great interest for emerging technologies. We present a generic methodology for precise and parallel spatiotemporal control of nanometre-scale matter in a fluid, and demonstrate the ability to attain digital functionalities such as switching, gating and data storage in a single colloid, with further implications for signal amplification and logic operations. This fluid-phase bit can be arrayed at high densities, manipulated by either electrical or optical fields, supports low-energy, high-speed operation and marks a first step toward 'colloidal information'. The principle generalizes to any system where spatial perturbation of a particle elicits a differential response amenable to readout.

Mucosal and serosal changes after gastric stapling determined by a new "real-time" surface tissue oxygenation probe: a pilot study.

BACKGROUND: Although tissue ischemia at surgical anastomoses can cause leakage, stricture, and ulceration, surgeons rely on nonquantitative measures of detecting ischemia (e.g., color changes, pulsation), which are not likely to detect transient or small degrees of ischemia. A new microvascular tissue oximeter probe (T-Stat) provides noninvasive real-time measurement of tissue hemoglobin oxygen saturation (StO(2)). We measured local gastric StO(2) during stapling for transection/pouch creation to assess the reproducibility of measurements, the sensitivity of the mucosa versus serosa to ischemia, and the effect of the proximity to the staple line on the measurement. METHODS: Anesthetized adult swine (n = 8) underwent laparotomy to transect gastric tissue in vivo with measurements made in 2 locations using 4.8-mm staple height cartridges. RESULTS: Both mucosal and serosal StO(2) decreased significantly when measured adjacent to the staple line compared with baseline (mucosa 3.0% +/- 5.6% versus 42.1% +/- 13.5%, serosa 48.2% +/- 15.1% versus 64.9% +/- 7.6%, P <.05). No significant change was found in the mucosal or serosal StO(2) at baseline compared with 2 cm away (mucosa 42.1% +/- 13.5% versus 32.3% +/- 18.7%, serosa 64.9% +/- 7.6% versus 59.9 +/- 9.4; P >.05). No color or pulsation changes were observed. CONCLUSION: Although significant reproducible mucosal and serosal decreases in StO(2) were seen in proximity to the gastric staple lines, the decrease in mucosal StO(2) was dramatic in the absence of any visible changes. The persistence of tissue ischemia with gastric stapling or in the creation of an anastomosis might contribute to the development of complications. The use of a real-time, noninvasive tissue probe could ultimately assist surgeons in identifying patients at risk of complications.