A phase Ib/II dose expansion study of subcutaneous sasanlimab in patients with locally advanced or metastatic non-small-cell lung cancer and urothelial carcinoma.

BACKGROUND: Sasanlimab is an antibody to the programmed cell death protein 1 receptor. We report updated data of subcutaneous sasanlimab in non-small-cell lung cancer (NSCLC) and urothelial carcinoma dose expansion cohorts from a first-in-human phase Ib/II study. PATIENTS AND METHODS: Patients were ≥18 years of age with NSCLC or urothelial carcinoma, and no prior immunotherapies, who progressed on or were intolerant to systemic therapy, or for whom systemic therapy was refused or unavailable. Patients received subcutaneous sasanlimab at 300 mg every 4 weeks (q4w). Primary objectives were to evaluate safety, tolerability, and clinical efficacy by objective response rate (ORR). RESULTS: Sixty-eight and 38 patients with NSCLC and urothelial carcinoma, respectively, received subcutaneous sasanlimab. Overall, sasanlimab was well tolerated; 13.2% of patients experienced grade ≥3 treatment-related adverse events. Confirmed ORR was 16.4% and 18.4% in the NSCLC and urothelial carcinoma cohorts, respectively. ORR was generally higher in patients with high programmed death-ligand 1 (PD-L1) expression (≥25%) and high tumor mutational burden (TMB; >75%). In the NSCLC and urothelial carcinoma cohorts, median progression-free survival (PFS) was 3.7 and 2.9 months, respectively; corresponding median overall survival (OS) was 14.7 and 10.9 months. Overall, longer median PFS and OS correlated with high PD-L1 expression and high TMB. Longer median PFS and OS were also associated with T-cell inflamed gene signature in the urothelial carcinoma cohort. CONCLUSIONS: Subcutaneous sasanlimab at 300 mg q4w was well tolerated with promising clinical efficacy observed. Phase II and III clinical trials of sasanlimab are ongoing to validate clinical benefit. Subcutaneous sasanlimab may be a potential treatment option for patients with NSCLC or urothelial carcinoma.

YVO4:Nd3+ nanophosphors as NIR-to-NIR thermal sensors in wide temperature range.

We report on the potential application of NIR-to-NIR Nd3+-doped yttrium vanadate nanoparticles with both emission and excitation operating within biological windows as thermal sensors in 123-873 K temperature range. It was demonstrated that thermal sensing could be based on three temperature dependent luminescence parameters: the luminescence intensity ratio, the spectral line position and the line bandwidth. Advantages and limitations of each sensing parameter as well as thermal sensitivity and thermal uncertainty were calculated and discussed. The influence of Nd3+ doping concentration on the sensitivity of luminescent thermometers was also studied.

[Occlusion planning for dentures on implants depending on density coefficient of bone tissue].

Results of examination and prosthetics making in 32 patients aged 27-56 years with end defects of lower dentition are presented. Bridge like constructions with abutment on natural teeth and intraosseous implants were made and tested. Influence of density coefficient of bone tissue on its resorption in the implant region is described and discussed.

Solution structure of the catalytic domain of human stromelysin complexed with a hydrophobic inhibitor.

Stromelysin, a representative matrix metalloproteinase and target of drug development efforts, plays a prominent role in the pathological proteolysis associated with arthritis and secondarily in that of cancer metastasis and invasion. To provide a structural template to aid the development of therapeutic inhibitors, we have determined a medium-resolution structure of a 20-kDa complex of human stromelysin's catalytic domain with a hydrophobic peptidic inhibitor using multinuclear, multidimensional NMR spectroscopy. This domain of this zinc hydrolase contains a mixed beta-sheet comprising one antiparallel strand and four parallel strands, three helices, and a methionine-containing turn near the catalytic center. The ensemble of 20 structures was calculated using, on average, 8 interresidue NOE restraints per residue for the 166-residue protein fragment complexed with a 4-residue substrate analogue. The mean RMS deviation (RMSD) to the average structure for backbone heavy atoms is 0.91 A and for all heavy atoms is 1.42 A. The structure has good stereochemical properties, including its backbone torsion angles. The beta-sheet and alpha-helices of the catalytic domains of human stromelysin (NMR model) and human fibroblast collagenase (X-ray crystallographic model of Lovejoy B et al., 1994b, Biochemistry 33:8207-8217) superimpose well, having a pairwise RMSD for backbone heavy atoms of 2.28 A when three loop segments are disregarded. The hydroxamate-substituted inhibitor binds across the hydrophobic active site of stromelysin in an extended conformation. The first hydrophobic side chain is deeply buried in the principal S'1 subsite, the second hydrophobic side chain is located on the opposite side of the inhibitor backbone in the hydrophobic S'2 surface subsite, and a third hydrophobic side chain (P'3) lies at the surface.

Studies of the structure of bacteriophage lambda cro protein in solution. Analysis of the circular dichroism data.

The secondary and tertiary structures of bacteriophage cro protein were studied by circular dichroism. The pH dependence of this structure was investigated: cro protein is stable over pH 4.5-10.5. At these pH-values cro protein contains approximately 35% alpha-helix, approximately 20% antiparallel beta-structure and approximately 15% beta-turn, while the remaining part of the protein molecule is in the irregular state. The secondary and tertiary structures of the protein are modified abruptly at more acid and more alkaline pH-values. The curves characterizing the secondary and tertiary structures of the protein are symbatic. The effect of Gu-HCl on the secondary and tertiary structures of cro protein at 22 degrees C and pH 7.2 was studied also. The conformational transition occurs within 0.6-1.9 M Gu-HCl. The changes in the secondary and tertiary structures of the protein have a symbatic character. Thermal denaturation of cro protein was examined. A possible mechanism of the protein denaturation is discussed.

Interactions between cro repressor and the model specific binding site.

Binding of lambda phage cro repressor to the synthetic half of OR3, the most conservative half of the specific binding sites, was investigated by proton nuclear magnetic resonance spectroscopy. It was found that the alpha-helical segment (27-36) of the protein was involved in specific interactions with the model binding site. The 3-dimensional structure of cro repressor does not change noticeably upon complex formation. Intercalation can be excluded as a possible means of interaction.

Two-stage thermal unfolding of [Cys55]-substituted Cro repressor of bacteriophage lambda.

It has been shown by scanning calorimetry and 1H NMR spectroscopy that thermal denaturation of mutant lambda phage cro repressor in which Val55 was substituted for Cys, proceeds in 2 stages in contrast to the wild type protein. At neutral pH values, an additional cooperative transition has been observed at about 100 degrees C. Calorimetric measurements on the mutant and its tryptic fragment lead to the conclusion that the two-stage character of thermal unfolding of the mutant is due to a disruption of an additional cooperative domain in the dimer molecule which is stabilized by the S-S crosslink.

An iterative fitting procedure for the determination of longitudinal NMR cross-correlation rates.

We present a method to measure (15)N-(1)H dipolar/(15)N CSA longitudinal cross-correlation rates in protonated proteins. The method depends on the measurement of four observables: the cumulative proton-proton cross relaxation rates, the (15)N R(1) relaxation rate, the multiexponential decay of 2N(Z)H(N)(Z) spin-order, and multiexponential buildup of 2N(Z)H(N)(Z) spin-order. The (15)N-(1)H dipolar/(15)N CSA longitudinal cross-correlation rate is extracted from these measurements by an iterative fitting procedure to the solution of differential equations describing the coupled relaxation dynamics of the z-magnetization of the (15)N nucleus, the two-spin-order 2N(Z)H(N)(Z), and a two-spin-order term 2N(Z)H(Q)(Z) describing the interaction with remote protons. The method is applied to the microbial ribonuclease binase. The method can also extract longitudinal cross-correlation rates for those amide protons that are involved in rapid solvent exchange. The experiment that serves for extracting proton-proton cross-relaxation rates is a modification of 3D (15)N-resolved NOESY-HSQC. The experiment restores the solvent magnetization to its equilibrium state during data detection for all phase cycling steps and all values of NOE mixing times and is recommended for use in standard applications as well.

Interaction of lambda cro repressor with synthetic operator OR3 studied by competition binding with minor groove binders.

In the present work, we employ a combination of CD spectroscopy and gel retardation technique to characterize thermodynamically the binding of lambda phage cro repressor to a 17 base pair operator OR3. We have found that three minor groove-binding antibiotics, distamycin A, netropsin and sibiromycin, compete effectively with the cro for binding to the operator OR3. Among these antibiotics, sibiromycin binds covalently to DNA in the minor groove at the NH2 of guanine, whereas distamycin A and netropsin interact preferentially with runs of AT base pairs and avoid DNA regions containing guanine bases in the two polynucleotide strands. Only subtle DNA conformation changes are known to take place upon binding of these antibiotics. Both the CD spectral profiles and the results of the gel retardation experiments indicate that distamycin A and netropsin can displace cro repressor from the operator OR3. The binding of cro repressor to the OR3 is accompanied by considerable changes in CD in the far-UV region which appear to be attributed to a DNA-dependent structural transition in the protein. Spectral changes are also induced in the wavelength region of 270-290 nm. The CD spectral profile of the cro-OR3 mixture in the presence of distamycin A can be represented as a sum of the CD spectrum of the repressor-operator complex and spectrum of distamycin-DNA complex at the appropriate molar ratio of the bound antibiotic to the operator DNA (r). When r tends to the saturation level of binding the CD spectrum in the region of 270-360 nm approaches a CD pattern typical of complexes of the antibiotic with the free DNA oligomer. This suggests that simultaneous binding of cro repressor and distamycin A to the same DNA oligomer is not possible and that distamycin A and netropsin can be used to determine the equilibrium affinity constant of cro repressor to the synthetic operator from competition-type experiments. The binding constant of cro repressor to the OR3 is found to be (6 +/- 1).10(6)M-1 at 20 degrees C in 10 mM sodium cacodylate buffer (pH 7.0) in the presence of 0.1 M NH4F.

[Spatial structure of cro-repressor in a solution. II. Effect of ionized groups]. / Prostranstvennaia struktura cro-repressora v rastvore. II. Vliianie ioniziruemykh grupp.

The technique of 1H NMR spectroscopy and absorption UV spectroscopy were used to study the ionization of the tyrosine phenol cycles and the effect of ionizable groups on the chemical shifts of signals from protons in the side chains of several amino acid residues. The microenvironment of these residues was established by analysing the titration curves. The mutual orientation of two functionally important adjacent alpha-helical protein regions was determined in solution. The signals from methionine residues belonging to different regions of the secondary structure were assigned in the NMR spectrum. The results indicate that the spatial structure of the repressor is similar in solution an in the crystal. They confirm the model proposed for the cro repressor interaction with DNA and based on the data of X-ray diffraction analysis.

[1H-NMR study of the OR1 operon in bacteriophage lambda. I. Assignment of signals from imino protons and adenine C2 protons]. / Izuchenie metodom 1H-IaMR operatora OR1 bakteriofaga lambda. I. Otnesenie signalov iminoprotonov i C2-protonov adenina.

An oligodeoxyribonucleotide composed of 17 residues, d(TATCACCGCCAGAGGTA), and a complementary chain were synthesized. Their duplex was identical with the operator OR1, the binding site for bacteriophage lambda cro and c1 repressors. The 1H NMR spectra (500 MHz) of the duplex imino and aromatic protons were studied at 10, 20 and 25 degrees C. Signals from the imino protons of complementary base pairs and from the C2 protons of adenine (with the exception of the duplex terminal nucleotides) were assigned using the NOE technique and the known characteristics of short DNA fragment melting. No signals from the imino protons of the terminal base pairs were detected even at 10 degrees C due to fraying which increased as the temperature was raised. The assignment of signals can be used to identify centers of interaction between the operator OR1 and repressors, as well as to study possible local changes in DNA geometry.

[Spatial structure of the cro-repressor in a solution. I. Identification of interaction in a hydrophobic cluster using the nuclear Overhauser effect]. / Prostranstvennaia struktura cro-repressora v rastvore. I. Identifikatsiia vzaimodeistviia v gidrofobnom klastere s pomoshch'iu iadernogo éffekta Overkhauzera.

The structure of a bacteriophage lambda cro repressor hydrophobic globule was studied by the technique of 1H NMR spectroscopy at 500 MHz. The analysis of NOE difference spectra and building of the molecular models for the most probable fragments of the secondary structure allowed us to assign many signals in the protein spectrum and to identify the intramolecular interactions which stabilized the hydrophobic globule and the tertiary structure of the molecule. The results suggest that the structure of the cro repressor hydrophobic globule in solution coincides with the crystal one, although there are some differences in the mutual arrangement of the alpha 1 helix and the three-fold beta-sheet. Resonance assignment has made it possible to study conformational changes and specific interactions of the cro repressor by using suitable reporter groups.

[Study of the structure of phage lambda operator OR1 using two-dimensional 1H-NMR-spectroscopy]. / Izuchenie struktury operatora OR1 bakteriofaga lambda metodom dvumernoi 1H-IaMR-spektroskopii.

NOESY spectroscopy at 500 HMz was employed to assign resonances of nonexchangeable protons in the 1H NMR spectrum of the synthesized 17 base pair duplex of deoxyribonucleotides comprising the OR1 operator, one of the specific binding sites for the bacteriophage lambda cro repressor. A pure absorption spectrum that was obtained by the phase sensitive detection technique allowed to perform a resonance assignment of base and deoxyribose protons, excepting H-5'- and H-5"-protons, on the basis of a single NOESY experiment, mixing time 200 ms. The sequential assignment strategy for 2D NMR spectra of oligonucleotides was used for this purpose. The data obtained and the previous results on OR3 are discussed in the view of the conformation of operators in solution. It is shown that both duplexes exist in the DNA B-form with its intrinsic anti conformation of the nucleotides. Conformation of DNA segments with identical primary structures are similar, and local deviations from the classical B-form are determined by a nucleotide sequence.

[Model substates and inhibitors of the peptidyltransferase center of ribosomes. Conformational possibilities in aqueous solution]. / Model'nye substraty i ingibitory peptidiltransferaznogo tsentra ribosom. Konformatsionnye vozmozhnosti v vodnum rastvore.

The constants of sin-anti-equilibrium in aqueous solution of model inhibitors of peptidyltransferase center of ribosomes: 3'-amino-3'-deoxadenosine-5'-phosphate, 3'-N-glycinamido-3'-deoxyadenosine, 3'-(N-formyl-L-methionynamido)-3'-deoxyadenosine-5'-phosphate and 3'-(n-formylglycinamido)-3'-deoxyadenosine-5'-phosphate were determined using the measurements of spin-lattice relaxation times. All compounds have similar conformation possibilities of the nucleotide component. The possibilities of correlation between the biological activity of these compounds and their conformation in aqueous solution are discussed.

[Complete assignment of signals in 1D and 2D H-NMR spectra of a 17-member oligonucleotide, a model symmetrical analog of lambda operators]. / Polnoe otnesenie signalov v 1D i 2D H-IaMR-spektrakh 17-chlennogo oligonukleotida - model'nogo simmetrichnogo analoga lambda-operatorov.

A synthetic analog of lambda phage operators, a symmetric duplex of oligonucleotides, was studied by 1H NMR at 400 MHz. Signals in the spectrum of imino protons of the duplex in H2O were assigned based on the results of NOE experiments and temperature dependences. Resonance assignment of the non-exchangeable protons of bases and deoxyribose was performed by analysing the NOESY spectrum obtained in the single experiment. The results indicate that the major part of the duplex has a conformation similar to the B-form of DNA, and the region of the central non-complementary base pair exhibits deviations from the regular structure.

[Concentrations of phosphatidylinositols in patients different variants of neurocirculatory asthenia]. / Soderzhanie fosfatidilinozitov u bol'nykh s razlichnymi variantami neirotsirkuliatornoi distonii.

Levels of phosphatidylinosites (PI) in blood lymphocytes were measured in 59 children and adolescents (mean age 11 +/- 3.8 years) with neurocirculatory dystonia (NCD). Sex-specific minimal PI differences were determined. Contrary to childhood, in adolescence PI levels are elevated both in healthy and NCD subjects (p < 0.01). PI in controls and NCD patients differed more in arrhythmogenic, cardialgic and hypotonic NCD, less--in hypertensive variant. PI values closely correlated both with clinical course of NCD and type of neurodynamic regulation of autonomic nervous system.

[Intraoperative ultrasonographic examination in surgery of the biliary tract]. / Intraoperatsionnoe ul'trazvukovoe issledovanie v khirurgii zhelchnykh putei.

The diagnostic value of intraoperative ultrasonic examination (IUSE) in surgery on the biliary tract was shown from analysis of the literature and the authors' experience. IUSE in more than 300 patients demonstrated a high resolving power in the diagnosis of choledocholithiasis and the absence of radiation load, allergic reactions and complications. In comparison of IUSE with intraoperative cholangiography in the diagnosis of stones in the gallbladder the total efficacy of the methods was 98.2% and 92.6%, respectively. IUSE has no side effects, is a simpler and cheaper method of examination, and allows goal-oriented removal of stones from the biliary tract. It is shown that with accumulation of experience in IUSE the performance of intraoperative cholangiography can be brought to the minimum.

[Surgical treatment of children with generalized myasthenia]. / Khirurgicheskoe lechenie detei, bol'nykh generalizovannoi miasteniei.

The rich experience in the country in surgical treatment of children with generalized myasthenia has been analysed. The comparative analysis of various means of preoperative preparation is done. Stabilisation of myasthenical status is very important in the preoperative preparation, the use of steroid hormones is advocated for this purpose. The indications, contraindications, as well as the scope and optimal timing of surgery are formulated. Two types of clinical and immunomorphological changes are depicted in children with generalized myasthenia that are of certain prognostic value. The rating of risk factors, useful for prognosis of unfavorable results of surgery is proposed.

[Diagnosis and surgical treatment of myasthenia gravis in childhood]. / Diagnostika i khirurgicheskoe lechenie miastenii v detskom vozraste.

Thirty-year experience in surgical treatment of myasthenia in children and adolescents (175 patients) is generalized. It provides evidence of delayed recognition of this disease in many patients and of prolonged, often ineffective nonoperative treatment. Operation for thymectomy should be one of the main methods for the management of myasthenia in children. Operative treatment is indicated in a disease of moderate severity or in a severe course of myasthenia, particularly in patients with the first type of immunomorphological changes. It is important to amend the myasthenic disorders before the operation by means of maximally possible doses of anticholinesterases with addition of corticosteroids, whenever necessary. Whatever the method of treatment chosen, the patients must be kept under skilled dynamic control. Excellent and good late-term results were produced in 84.6% of cases.

[Diagnosis, surgical treatment and prognosis in patients with generalized myasthenia]. / Diagnostika, khirurgicheskoe lechenie i ego prognoz u bolnykh generalizovannoi miasteniei.

The work deals with the clinical analysis of the richest experience in the surgical treatment of patients with generalized myasthenia in the country. The efficacy of various methods for the diagnosis of affection of the thymus is studied comparatively. It is shown that for more effective diagnosis of neoplastic lesions of the thymus wider use of computerized and magneto-resonance tomography is expedient and that they must replace the insufficiently informative and invasive examination methods used today (pneumonodiastinography, phlebography, scintigraphy, etc.) which still form the basis for the system of diagnostic research in patients with myasthenia. The authors determined the indications and contraindications for, the optimum terms for undertaking the surgical intervention and its volume in neoplastic and nonneoplastic diseases of the thymus in adults and children. Comparative evaluation of various means of preoperative management was conducted. It is shown that to improve the patient's condition and stabilize the myasthenic status on the possibly minimal doses of anticholesteremic agents glucocorticoid hormones should be included in the complex of preoperative management. The indications for hormonotherapy were determined. The efficacy of plasmapheresis, radiotherapy, and glomectomy with denervation of the sinocarotid zone was evaluated and their place in the complex treatment of patients was determined. From study of the late-term results of treatment of a large group of patients (children, adults with a thymus) the main causes of unsuccessful surgical treatment of generalized myasthenia were identified and the concrete means of improving the results of treatment were planned. Two types of changes in the clinico-immuno-morphological values were revealed in patients with generalized myasthenia, differing evidently in pathogenesis. New clinico-immuno-morphological correlations and prognostic factors were discovered, and a method for prognosticating the effect of thymectomy was suggested. It is shown that splenectomy has a favorable effect in the most severe category of patients in unsuccessful operative and nonoperative treatment. The tactics of management of patients accepted in the clinic led to a uncomplicated course of the postoperative period in the majority of patients in the last years.