Salmonella-induced immune response reduces recurrence and tumor dissemination in preclinical melanoma model.

Localized melanoma is easy to remove by surgery, resulting in a high five-year relative survival rate. However, when disseminated the disease management is challenging. The use of immunotherapies, such as anti-checkpoint monoclonal antibodies, has improved treatment options but still only a small percentage of patients responds to these expensive treatments. In this work, we apply a bacteria-based immunotherapy using LVR01, an attenuated Salmonella enterica serovar Typhimurium, as neoadjuvant therapy one week before surgery in a preclinical disseminated murine melanoma model. LVR01 administration resulted in tumor growth retardation prior to tumor resection, due to a rapid upregulation of inflammatory genes in the tumor microenvironment. As a consequence, cell infiltration increased, particularly neutrophils, macrophages and NK cells, being the latter involved in Salmonella anti-tumor activity. Besides, tumor-draining lymph node infiltration is characterized by reinvigorated CD4+ and CD8+ lymphocytes. Induced immune response could account for the prevention or delay of tumor recurrence and appearance of metastasis, resulting in a prolonged overall survival after surgery. Furthermore, upon rechallenge mice show partial protection, suggesting the existence of specific memory against melanoma. We propose that neoadjuvant LVR01 treatment could represent an interesting inexpensive alternative that may ease tumor resection, while preventing tumor recurrence in patients with melanoma.

Preclinical Evaluation of LVR01 Attenuated Salmonella as Neoadjuvant Intralesional Therapy in Combination with Chemotherapy for Melanoma Treatment.

Treatment of malignant melanoma has improved in the last few years owing to early detection and new therapeutic options. Still, management of advanced disease remains a challenge because it requires systemic treatment. In such cases, dacarbazine-based chemotherapy has been widely used, despite low efficacy. Neoadjuvant therapies emerge as alternative options that could help chemotherapy to achieve increased benefit. In this work, we evaluate LVR01, an attenuated Salmonella enterica serovar typhimurium, as neoadjuvant intralesional therapy in combination with dacarbazine in a preclinical melanoma model. B16F1 melanoma‒bearing mice received intraperitoneal administration of dacarbazine for 3 consecutive days. LVR01 treatment, consisting of one single intratumoral injection, was applied 1 day before chemotherapy began. This therapeutic approach retarded tumor growth and prolonged overall survival, revealing a strong synergistic antitumor effect. Dacarbazine induced a drastic reduction of secondary lymphoid organ cellularity, which was partially restored by Salmonella, particularly potentiating activated cytotoxic cell compartments. Systemic immune reactivation could be a consequence of the intense inflammatory tumor microenvironment induced by LVR01. We propose that the use of LVR01 as neoadjuvant intralesional therapy could be considered as an interesting strategy with close clinical application to boost chemotherapy effect in patients with melanoma.

Effectiveness of the Diabetes Prevention Program for Obesity Treatment in Real World Clinical Practice in a Middle-Income Country in Latin America.

The Diabetes Prevention Program (DPP) is effective for the prevention of type 2 diabetes by weight loss with diet and physical activity. However, there is little evidence as to whether this program could be translated into real-world clinical practice in Latin American countries. The objective of this work was to evaluate the effectiveness of the DPP for the management of overweightness and obesity at 6 and 12 months in clinical practice in Mexico. This was a non-controlled intervention study implemented in five public clinics in northern Mexico. Two hundred and thirty-seven adults aged 45.7 ± 9.9 years with a Body Mass Index (BMI) of 34.4 ± 5.4 kg/m2 received group sessions with an adaptation of the DPP, in addition to nutrition counseling. One hundred and thirty-three (56%) participants concluded the 6 month phase. They showed a significant weight loss, ranging from 2.76 ± 4.76 to 7.92 ± 6.85 kg (p ≤ 0.01) in the clinics. The intention-to-treat analysis showed a more conservative weight loss. Participant retention at the end of 12 months was low (40%). The implementation of the DPP in different public clinics in Mexico was effective in the management of obesity in the short term, but better strategies are required to improve participant retention in the long term.

Intervención educativa con docentes: fortalecimiento de habilidades psicosociales para la vida y hábitos saludables con escolares en Bogotá / An educational intervention with teachers: strengthening the psychosocial life skills and healthy habits of school students in Bogotá / Intervenção educativa com professores: fortalecimento de habilidades psicossociais para a vida e hábitos saudáveis com crianças escolares em Bogotá

Objetivo: Determinar los resultados de la intervención educativa dirigida a docentes para el fortalecimiento de hábitos saludables y habilidades psicosociales para la vida en niños y niñas de básica primaria en instituciones públicas de la ciudad de Bogotá. Metodología: Se realizó un estudio cualitativo con enfoque descriptivo para lo cual se utilizó como técnica de recolección de información el grupo focal, buscando ahondar con las personas participantes su experiencia, metodología, implementación y resultados del proceso formativo con enfoque de promoción de la salud con énfasis en Habilidades psicosociales para la Vida y Hábitos Saludables con los grupos de escolares. Para el análisis de la información se tuvo en cuenta el enfoque propuesto por Taylor y Bogdan, y para apoyar el análisis se utilizó el software ATLAS ti (v. 6.2). Resultados: La participación de docentes en los procesos formativos tuvo una repercusión en diferentes escenarios de sus vidas, es así como se identifican vivencias en su vida personal, familiar y laboral. Lo cual se explica desde tres ámbitos: lo novedoso del proceso formativo, la creatividad generada en su práctica docente y la solidaridad a la hora de la implementación en las instituciones educativas. Conclusiones: Las personas participantes de la investigación identifican la metodología participativa utilizada en el proceso formativo como innovador y elemento importante para su adherencia al programa, superando así sus predisposiciones iniciales a participar. De la misma manera, el fortalecimiento de la creatividad de docentes es un factor que contribuye al ejercicio docente.

Objective: to determine the results of an educational intervention aimed at teachers to strengthen the healthy habits and psychosocial life skills of children attending elementary schools in public institutions in the city of Bogotá. Methodology: a qualitative study with a descriptive approach whose data collection technique was the focus group. The study sought to use the help of the participants to further understand their experience, methodology, implementation and results of an educational process focusing on health promotion while emphasizing the psychosocial skills for life and healthy habits of school students. The approach proposed by Taylor and Bogdan was taken into account when analyzing the data. Moreover, the analysis was further supported with the ATLAS ti (v. 6.2) software.6.2). Results: participation of teachers in training processes had an impact on various scenarios of their lives. This is how experiences are identified in their personal, family and work life. This can be explained by the following factors: the training process is a novelty, there is a great deal of creativity applied to its teaching and its implementation in educational institutions involves a lot of solidarity. Conclusions: the individuals who took part in the research perceived the participation methodology used in the training process as innovative and important for their adherence to the program, surpassing their initial predisposition to participate. Furthermore, strengthening the creativity of educators contributes to the teaching practice.