Phase I clinical study of oral olaparib in pediatric patients with refractory solid tumors: study protocol.

BACKGROUND: There is no established standard chemotherapy for recurrent pediatric solid tumors such as neuroblastoma and sarcoma. Since some of these tumor cells show dysfunctions in homologous recombination repair, the goal is to conduct a phase I study of olaparib, a poly(ADP-ribose) polymerase inhibitor. In this clinical trial, the aims are to evaluate the safety, tolerability, and efficacy of olaparib in pediatric patients with refractory solid tumors and to recommend a dose for phase II trials. METHODS: In this open-label, multicenter study, olaparib tablets (62.5, 125, and 187.5 mg/m2 b.i.d.) will be administered orally in a standard 3 + 3 dose escalation design. Patients aged 3 to 18 years with recurrent pediatric solid tumors are eligible. Pharmacokinetic and pharmacodynamic analyses will also be performed. DISCUSSION: This study aims to extend the indications for olaparib by assessing its safety and efficacy in pediatric refractory solid tumor patients. TRIAL REGISTRATION: UMIN-CTR ( UMIN000025521 ); Registered on January 4, 2017.

Propionibacterium acnes catalase induces increased Th1 immune response in sarcoidosis patients.

BACKGROUND: Propionibacterium acnes is one of the most commonly implicated etiologic agents of sarcoidosis. We screened antigenic proteins from this indigenous bacterium that increase Th1 responses in sarcoidosis patients. METHODS: Antigenic bacterial proteins were screened by probing western blots of P. acnes whole cell lysates with blood plasma samples from 52 sarcoidosis patients and 34 healthy volunteers. Soluble protein antigens from the bands most frequently detected on blotting membranes were analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/MS). Recombinant proteins were prepared from DNA sequences of the proteins identified by MALDI-TOF/MS and analyzed by immunologic assays. RESULTS: MALDI-TOF/MS analysis identified propionyl-CoA carboxylase subunit beta, arginine deiminase (ADI), catalase (KAT), and UDP-N-acetylglucosamine pyrophosphorylase (UAP). Successfully prepared recombinant proteins from ADI, KAT, and UAP provoked humoral and cellular immune responses in mice immunized with P. acnes when measured by enzyme-linked immunosorbent assay for serum antibodies and enzyme-linked immunospot assay for interferon (IFN)-γ-secreting cells (ELISPOT IFN-γ assay) with lymph node cells. Plasma IgG and IgA titers to KAT and UAP were significantly higher in sarcoidosis patients than in healthy volunteers. When Th1 immune responses to ADI, KAT, and UAP were measured by ELISPOT IFN-γ assay with peripheral blood mononuclear cells from 12 sarcoidosis patients, 13 other pneumonitis patients, and 11 healthy volunteers, only the KAT protein provoked a significantly higher response in sarcoidosis patients (p=0.0032). CONCLUSION: These results suggest that P. acnes KAT is an antigen that provokes allergic Th1 immune responses in sarcoidosis patients.

Stage-specific embryonic antigen 4 in Wharton's jelly-derived mesenchymal stem cells is not a marker for proliferation and multipotency.

BACKGROUND: Umbilical cord Wharton's jelly (WJ) is a rich source of mesenchymal stem cells (MSCs) similar to bone marrow (BM) and adipose tissues. Stage-specific embryonic antigen (SSEA)4 has been reported as a stem cell marker in BM-derived MSCs, but whether SSEA4(+) cells have growth and differentiation advantages over SSEA4(-) cells remains controversial. To gain insight into the role of SSEA4, we studied SSEA4(+) cells in WJ-derived MSCs (WJ-MSCs). METHODS: WJ-MSCs were collected by the explant (WJe-MSCs) or collagenase methods (WJc-MSCs) and analyzed by flow cytometry and reverse-transcription polymerase chain reaction (RT-PCR). To evaluate whether culture conditions influenced the SSEA4 expression, WJe-MSCs were cultured in the medium supplemented with different fetal bovine serum (FBS) concentrations. RESULTS: SSEA4 was expressed for a long-term culture. In contrast, SSEA3(+) disappeared rapidly in early passages of the culture. The incidence of SSEA4(+) and SSEA3(+) cells was similar between WJe-MSCs and WJc-MSCs at passages P0-P9, except for transient depletion of SSEA4 expression in early passages of WJe-MSCs. These were CD73(+)CD105(+) cells that express embryonic stem cell markers detected by RT-PCR. No differences in growth and differentiation ability of osteocytes and adipocytes were observed between the sorted SSEA4(+) cells and SSEA4(-) cells. Further, SSEA4 expression in WJe-MSCs was significantly correlated with FBS concentration in the culture medium. DISCUSSION: SSEA4, which may display altered expression profiles in response to culture conditions, may not be an essential marker of WJ-MSC multipotency.