Methylation subgroup and molecular heterogeneity is a hallmark of glioblastoma: implications for biopsy targeting, classification and therapy.

BACKGROUND: Intratumoral heterogeneity at the cellular and molecular level is a hallmark of glioblastoma (GB) that contributes to treatment resistance and poor clinical outcome. Little is known regarding epigenetic heterogeneity and intratumoral phylogeny and their implication for molecular classification and targeted therapies. PATIENTS AND METHODS: Multiple tissue biopsies (238 in total) were sampled from 56 newly-diagnosed, treatment-naive GB patients from a prospective in-house cohort and publicly available data and profiled for DNA methylation using the Illumina MethylationEPIC array. Methylation-based classification using the glioma classifier developed by Ceccarelli et al. and estimation of the MGMT promoter methylation status via the MGMT-STP27 model were carried out. In addition, copy number variations (CNVs) and phylogeny were analyzed. RESULTS: Almost half of the patients (22/56, 39%) harbored tumors composed of heterogeneous methylation subtypes. We found two predominant subtype combinations: classic-/mesenchymal-like, and mesenchymal-/pilocytic astrocytoma-like. Nine patients (16%) had tumors composed of subvolumes with and without MGMT promoter methylation, whereas 20 patients (36%) were homogeneously methylated, and 27 patients (48%) were homogeneously unmethylated. CNV analysis revealed high variations in many genes, including CDKN2A/B, EGFR, and PTEN. Phylogenetic analysis correspondingly showed a general pattern of CDKN2A/B loss and gain of EGFR, PDGFRA, and CDK4 during early stages of tumor development. CONCLUSIONS: (Epi)genetic intratumoral heterogeneity is a hallmark of GB, both at DNA methylation and CNV level. This intratumoral heterogeneity is of utmost importance for molecular classification as well as for defining therapeutic targets in this disease, as single biopsies might underestimate the true molecular diversity in a tumor.

Folding induced supramolecular assembly into pH-responsive nanorods with a protein repellent shell.

We report the synthesis of ABA' triblock peptide-polysarcosine-peptide conjugates featuring two complementary phenylalanine-histidine pentapeptide strands A/A'. These sequences encode for antiparallel ß-sheet formation into folded conjugates, which promote the self-assembly into polysarcosine-shielded core-shell nanorods. These do not cause aggregation of serum proteins in human blood plasma underlining an enhanced stability.

From defined reactive diblock copolymers to functional HPMA-based self-assembled nanoaggregates.

This paper describes the synthesis of functional amphiphilic poly( N-(2-hydroxypropyl) methacrylamide)-block-poly(lauryl methacrylate) copolymers by RAFT polymerization via the intermediate step of activated ester block copolymers (pentafluoro-phenyl methacrylate). Block copolymers with molecular weights from 12000-28000 g/mol and PDIs of about 1.2 have been obtained. The amphiphilic diblock copolymers form stable super structures (nanoaggregates) by self-organization in aqueous solution. The diameters of these particles are between 100 and 200 nm and depend directly on the molecular weight of the block copolymer. Furthermore, we investigated the impact of these nanoaggregates on cell viability and on the motility of adherent cells. Cytotoxicity was investigated by the MTS test and the fluctuation in cell shape was monitored employing ECIS (electrical cell-substrate impedance sensing). In these investigations, the formed particles are not cell toxic up to a concentration of 2 mg/mL. Thus, our polymeric particles offer potential as polymer therapeutics.

[Puerperal infection]. / Zur puerperalen Infektion.

Puerperal infections are of great importance also under the conditions of modern obstetrics. There is a close connection with the problematic nature of hospitalism. The prospective study from 1,409 patients shows a puerperal fever at a percentage of 32.1%. Only 19.0% of the patients meet the criteria of a "standard puerperal morbidity". Within the complications occurring during the childbed period subinvolutio uteri holds the first place with 16.3%. The incidence of puerperal infections is influenced by predisposing factors dominated by the mode of accouchement. Ampicillin and chloramphenicol are the most used antibiotics. The preventive and therapeutic application of antibiotics is discussed. In the experimental part of the study the settlement of the vagina, the cervix, and the amniotic fluid is analysed. The evidence of causative organism for oxybiontic pathogenes partly also for anoxybiontic pathogenes and fungi is made. The fight against puerperal infections is particularly based on preventive measures. There must be mentioned a strict consideration of the antisepsis and asepsis as well as the restriction of predisposing factors. Under this precondition the wellaimed and indicated application of a therapy based on antibiotics will be successful.