Utility of Circulating Tumor DNA Assessment in Characterizing Recurrence Sites after Optimal Resection for Metastatic Colorectal Cancer.

BACKGROUND: Plasma circulating tumor DNA (ctDNA) is a promising biomarker for metastatic colorectal cancer (mCRC); however, its role in characterizing recurrence sites after mCRC resection remains poorly understood. This single-institution study investigated the timing of ctDNA detection and its levels in the context of recurrence at different sites after mCRC resection. STUDY DESIGN: Patients who underwent optimal resection of CRC metastases involving the peritoneum, distant lymph nodes, or liver, with serial postoperative tumor-informed ctDNA assessments (Signatera) were included. Recurrence sites, as defined by surveillance imaging or laparoscopy, were categorized as peritoneal-only and other distant sites (liver, lung, lymph nodes, or body wall). RESULTS: Among the 31 included patients, ctDNA was detected in all 26 (83.4%) patients with postoperative recurrence and was persistently undetectable in 5 patients who did not experience recurrence. At 3 months postsurgery, ctDNA was detected in 2 (25%) of 8 patients with peritoneal-only recurrence and 17 (94.4%) of 18 patients with distant recurrence (p < 0.001). Beyond 3 months, ctDNA was detected in the remaining 6 patients with peritoneal-only disease and 1 patient with distant disease. ctDNA detection preceded the clinical diagnosis of recurrence by a median of 9 weeks in both groups. At recurrence, peritoneal-only recurrent cases exhibited lower ctDNA levels (median 0.4 mean tumor molecules/mL, interquartile range 0.1 to 0.8) compared with distant recurrence (median 5.5 mean tumor molecules/mL, interquartile range 0.8 to 33.3, p = 0.004). CONCLUSIONS: Peritoneal-only recurrence was associated with delayed ctDNA detection and low levels of ctDNA after optimal resection for mCRC. ctDNA testing may effectively characterize recurrence sites and may help guide subsequent treatments specific to the disease sites involved.

Activation of Endothelial Large Conductance Potassium Channels Protects against TNF-α-Induced Inflammation.

Elevated TNF-α levels in serum and broncho-alveolar lavage fluid of acute lung injury patients correlate with mortality rates. We hypothesized that pharmacological plasma membrane potential (Em) hyperpolarization protects against TNF-α-induced CCL-2 and IL-6 secretion from human pulmonary endothelial cells through inhibition of inflammatory Ca2+-dependent MAPK pathways. Since the role of Ca2+ influx in TNF-α-mediated inflammation remains poorly understood, we explored the role of L-type voltage-gated Ca2+ (CaV) channels in TNF-α-induced CCL-2 and IL-6 secretion from human pulmonary endothelial cells. The CaV channel blocker, Nifedipine, decreased both CCL-2 and IL-6 secretion, suggesting that a fraction of CaV channels is open at the significantly depolarized resting Em of human microvascular pulmonary endothelial cells (-6 ± 1.9 mV), as shown by whole-cell patch-clamp measurements. To further explore the role of CaV channels in cytokine secretion, we demonstrated that the beneficial effects of Nifedipine could also be achieved by Em hyperpolarization via the pharmacological activation of large conductance K+ (BK) channels with NS1619, which elicited a similar decrease in CCL-2 but not IL-6 secretion. Using functional gene enrichment analysis tools, we predicted and validated that known Ca2+-dependent kinases, JNK-1/2 and p38, are the most likely pathways to mediate the decrease in CCL-2 secretion.

BK Channels Regulate LPS-induced CCL-2 Release from Human Pulmonary Endothelial Cells.

We recently established a role for the stretch-activated two-pore-domain K+ (K2P) channel TREK-1 (K2P2.1) in inflammatory cytokine secretion using models of hyperoxia-, mechanical stretch-, and TNF-α-induced acute lung injury. We have now discovered the expression of large conductance, Ca2+-activated K+ (BK) channels in human pulmonary microvascular endothelial cells and primary human alveolar epithelial cells using semiquantitative real-time PCR, IP and Western blot, and investigated their role in inflammatory cytokine secretion using an LPS-induced acute lung injury model. As expected, LPS induced IL-6 and CCL-2 secretion from pulmonary endothelial and epithelial cells. BK activation with NS1619 decreased LPS-induced CCL-2 but not IL-6 secretion from endothelial cells and had no effect on epithelial cells, although fluorometric assays revealed that BK activation hyperpolarized the plasma membrane potential (Em) of both cell types. Interestingly, BK inhibition (Paxilline) did not alter cytokine secretion or the Em in either cell type. Furthermore, LPS treatment by itself did not affect the Em or intracellular Ca2+ concentrations. Therefore, we propose BK channel activation as a novel targeted approach to counteract LPS-induced CCL-2 secretion from endothelial cells. This protective effect appears to occur via Em hyperpolarization but independent of intracellular Ca2+ concentrations.

MPRAD: A Monte Carlo and ray-tracing code for the proton radiography in high-energy-density plasma experiments.

Proton radiography is used in various high-energy-density (HED) plasma experiments. In this paper, we describe a Monte Carlo and ray-tracing simulation tool called multimegaelectronvolt proton radiography (MPRAD) that can be used for modeling the deflection of proton beams in arbitrary three dimensional electromagnetic fields as well as the diffusion of the proton beams by Coulomb scattering and stopping power. The Coulomb scattering and stopping power models in cold matter and fully ionized plasma are combined using interpolation. We discuss the application of MPRAD in a few setups relevant to HED plasma experiments where the plasma density can play a role in diffusing the proton beams and affecting the prediction and interpretation of the proton images. It is shown how the diffusion due to plasma density can affect the resolution and dynamical range of the proton radiography.

The analysis of cardio-respiratory signals and cerebral autoregulation based on CO2 reactivity with healthy subjects and Parkinson's patients.

Current paper focus on Parkinson's patients with autonomic dysfunction and how their interactions between cerebral autoregulation and ventilatory control are affected. The experimental data of dynamic CA assessment from the ANS Laboratory of CCGH was accessed for further processing and analysis. The subjects were classified into the groups of healthy and with Parkinson's disease. Based on the accessed ventilation and CBF data, the percentage changes in ventilation and CBF responses to PETCO2 were examined. To minimize effects of changes in ABP on cerebral vasomotor reactivity (CVMR) estimation, cerebrovascular conductance index (CVCi) was calculated, and CBFV-PETCO2 and CVCi-PETCO2 relationships were quantified by nonlinear logistic regression. The interaction between ventilation responses and CBF autoregulation will be modeled and parameters will be validated.

The analysis of cardio-respiratory signals and cerebral autoregulation based on CO2 reactivity with healthy subjects and Parkinson's patients.

Current paper focus on Parkinson's patients with autonomic dysfunction and how their interactions between cerebral autoregulation and ventilatory control are affected. The experimental data of dynamic CA assessment from the ANS Laboratory of CCGH was accessed for further processing and analysis. The subjects were classified into the groups of healthy and with Parkinson's disease. Based on the accessed ventilation and CBF data, the percentage changes in ventilation and CBF responses to PETCO2 were examined. To minimize effects of changes in ABP on cerebral vasomotor reactivity (CVMR) estimation, cerebrovascular conductance index (CVCi) was calculated, and CBFV-PETCO2 and CVCi-PETCO2 relationships were quantified by nonlinear logistic regression. The interaction between ventilation responses and CBF autoregulation will be modeled and parameters will be validated.