Assessing Nordihydroguaiaretic Acid Therapeutic Effect for Glioblastoma Multiforme.

In this study, we demonstrate that Raman microscopy combined with computational analysis is a useful approach to discriminating accurately between brain tumor bio-specimens and to identifying structural changes in glioblastoma (GBM) bio-signatures after nordihydroguaiaretic acid (NDGA) administration. NDGA phenolic lignan was selected as a potential therapeutic agent because of its reported beneficial effects in alleviating and inhibiting the formation of multi-organ malignant tumors. The current analysis of NDGA's impact on GBM human cells demonstrates a reduction in the quantity of altered protein content and of reactive oxygen species (ROS)-damaged phenylalanine; results that correlate with the ROS scavenger and anti-oxidant properties of NDGA. A novel outcome presented here is the use of phenylalanine as a biomarker for differentiating between samples and assessing drug efficacy. Treatment with a low NDGA dose shows a decline in abnormal lipid-protein metabolism, which is inferred by the formation of lipid droplets and a decrease in altered protein content. A very high dose results in cell structural and membrane damage that favors transformed protein overexpression. The information gained through this work is of substantial value for understanding NDGA's beneficial as well as detrimental bio-effects as a potential therapeutic drug for brain cancer.

Impact of CTLA-4 blockade in conjunction with metronomic chemotherapy on preclinical breast cancer growth.

BACKGROUND: Although there are reports that metronomic cyclophosphamide (CTX) can be immune stimulating, the impact of its combination with anti-CTLA-4 immunotherapy for the treatment of cancer remains to be evaluated. METHODS: Murine EMT-6/P breast cancer, or its cisplatin or CTX-resistant variants, or CT-26 colon, were implanted into Balb/c mice. Established tumours were monitored for relative growth following treatment with anti-CTLA-4 antibody alone or in combination with; (a) metronomic CTX (ldCTX; 20 mg kg-1 day-1), b) bolus (150 mg kg-1) plus ldCTX, or (c) sequential treatment with gemcitabine (160 mg kg-1 every 3 days). RESULTS: EMT-6/P tumours responded to anti-CTLA-4 therapy, but this response was less effective when combined with bolus plus ldCTX. Anti-CTLA-4 could be effectively combined with either ldCTX (without a bolus), or with regimens of either sequential or concomitant gemcitabine, including in orthotopic EMT-6 tumours, and independently of the schedule of drug administration. Tumour responses were confirmed with CT-26 tumours but were less pronounced in drug-resistant EMT-6/CTX or EMT-6/DDP tumour models than in the parent tumour. A number of tumour bearing mice developed spontaneous metastases under continuous therapy. The majority of cured mice rejected tumour re-challenges. CONCLUSIONS: Metronomic CTX can be combined with anti-CTLA-4 therapy, but this therapy is impaired by concomitant bolus CTX. Sequential therapy of anti-CTLA-4 followed by gemcitabine is effective in chemotherapy-naive tumours, although tumour relapses can occur, in some cases accompanied by the development of spontaneous metastases.

Pharmacodynamic biomarkers in metronomic chemotherapy: multiplex cytokine measurements in gastrointestinal cancer patients.

Metronomic chemotherapy has shown promising antitumor activity in a number of malignancies. We previously reported a phase II clinical trial of metronomic UFT (a 5-fluorouracil prodrug; 100 mg/twice per day p.o.) and cyclophosphamide (CTX; 500 mg/m2 i.v. bolus on day 1 and then 50 mg/day p.o.) plus celecoxib (200 mg/twice a day p.o.) in 38 patients with advanced refractory gastrointestinal tumors. The mechanisms of action of metronomic chemotherapy include inhibition of angiogenesis, direct cytotoxic effects on cancer cells, and, at least for drugs such as CTX, activation of the immune system. To further evaluate the latter, we carried out an immune system multiplex 14-cytokine profiling of plasma samples that were available (for day 0, day 28, and day 56) from 31 of the 38 patients in the above-noted clinical trial. Our results show that pre-treatment plasma-level cutoffs of interferon gamma (> 12.84 pg/ml), sCD40L (< 2168 pg/ml), interferon alpha 2 (> 55.11 pg/ml), and IL-17a (< 15.1 pg/ml) were predictive markers for those patients with better progression-free survival (p < .05 for each cytokine). After 28 days of metronomic therapy, the plasma levels of sCD40L, IL-17a, and IL-6 (< 130 pg/ml) could serve as predictors of improved progression-free survival, as could levels interferon gamma and sCD40L after 56 days of therapy. We observed minimal changes in cytokine profiles, from baseline, as a consequence of the metronomic therapy, with the exception of an elevation of IL-6 and IL-8 levels 28 days (and 56 days) after treatment started (p < 0.05). Our results indicate that a selective cytokine elevation involves IL-6 and IL-8, following metronomic chemotherapy administration. In addition, interferon gamma and sCD40L may be potential biomarkers for gastrointestinal cancer patients that are likely to benefit from metronomic chemotherapy. Our study contributes to our understanding of the mechanisms of action of metronomic chemotherapy, and the cytokine profiling we describe may guide future selection of gastrointestinal cancer patients for UFT/CTX/celecoxib combination metronomic chemotherapy.

Assessment of Renal Osteodystrophy via Computational Analysis of Label-free Raman Detection of Multiple Biomarkers.

Accurate clinical evaluation of renal osteodystrophy (ROD) is currently accomplished using invasive in vivo transiliac bone biopsy, followed by in vitro histomorphometry. In this study, we demonstrate that an alternative method for ROD assessment is through a fast, label-free Raman recording of multiple biomarkers combined with computational analysis for predicting the minimally required number of spectra for sample classification at defined accuracies. Four clinically relevant biomarkers: the mineral-to-matrix ratio, the carbonate-to-matrix ratio, phenylalanine, and calcium contents were experimentally determined and simultaneously considered as input to a linear discriminant analysis (LDA). Additionally, sample evaluation was performed with a linear support vector machine (LSVM) algorithm, with a 300 variable input. The computed probabilities based on a single spectrum were only marginally different (~80% from LDA and ~87% from LSVM), both providing an unacceptable classification power for a correct sample assignment. However, the Type I and Type II assignment errors confirm that a relatively small number of independent spectra (7 spectra for Type I and 5 spectra for Type II) is necessary for a p < 0.05 error probability. This low number of spectra supports the practicality of future in vivo Raman translation for a fast and accurate ROD detection in clinical settings.

Robust megavoltage x-ray spectra estimation from transmission measurements.

Megavoltage X-ray sources are commonly used for therapy planning, and knowledge of their spectral distribution is important for accurate dose calculations. There are many methods that could provide reasonable estimations of Megavoltage X-ray spectra, when very accurate attenuation data or at least very good set of initial guesses of the spectra are available. We present here a novel method, which can be used for accurate Megavoltage spectral reconstruction without any prior knowledge of spectral distribution; the method performs well even when the available transmission data are affected by noise. The method is based on a search for a smooth function that minimizes the differences between measured and calculated attenuation data. The algorithm is compared with well-known existing algorithms, using computer simulated data, both error-free and containing added random Gaussian noise. The reconstructed spectra are subsequently used to calculate the transmission through 50 cm of bone, muscle or fat tissue. It is shown that the relative errors in dose calculations, using the spectra reconstructed via this method, are significantly smaller than those obtained via well-established reconstruction algorithms--Truncated Singular Value Decomposition (TSVD) and Expectation Maximization (EM). These results suggest that the novel algorithm might be practical for routine Megavoltage therapy X-ray source calibration.

Optimization of biomarkers-based classification scores as progression-free survival predictors: an intuitive graphical representation.

Aim: To construct classification scores based on a combination of cancer patient plasma biomarker levels, for predicting progression-free survival. Methods: The approach is based on the optimization of the biomarker cut-off values, which maximize the statistical differences between the groups with values lower or larger than the cut-offs, respectively. An intuitive visualization of the quality of the classification score is also proposed. Results: Even if there are only weak correlations between individual biomarker levels and progression-free survival, scores based on suitably chosen combination of three biomarkers have classification power comparable with the Response Evaluation Criteria in Solid Tumors criteria classification of response to treatments in solid tumors. Conclusion: Our approach has the potential to improve the selection of the patients who will benefit from a given anticancer treatment.

Raman Spectroscopic and Microscopic Analysis for Monitoring Renal Osteodystrophy Signatures.

Defining the pathogenesis of renal osteodystrophy (ROD) and its treatment efficacy are difficult, since many factors potentially affect bone quality. In this study, confocal Raman microscopy and parallel statistical analysis were used to identify differences in bone composition between healthy and ROD bone tissues through direct visualization of three main compositional parametric ratios, namely, calcium content, mineral-to-matrix, and carbonate-to-matrix. Besides the substantially lower values found in ROD specimens for these representative ratios, an obvious accumulation of phenylalanine is Raman spectroscopically observed for the first time in ROD samples and reported here. Thus, elevated phenylalanine could also be considered as an indicator of the disease. Since the image results are based on tens of thousands of spectra per sample, not only are the average ratios statistically significantly different for normal and ROD bone, but the method is clearly powerful in distinguishing between the two types of samples. Furthermore, the statistical outcomes demonstrate that only a relatively small number of spectra need to be recorded in order to classify the samples. This work thus opens the possibility of future development of in vivo Raman sensors for assessment of bone structure, remodeling, and mineralization, where different biomarkers are simultaneously detected with unprecedented accuracy.

Simultaneous Detection of Dopamine and Serotonin-A Comparative Experimental and Theoretical Study of Neurotransmitter Interactions.

With the goal of accurately detecting and quantifying the amounts of dopamine (DA) and serotonin (5-HT) in mixtures of these neurotransmitters without using any labelling, we present a detailed, comparative computational and Raman experimental study. Although discrimination between these two analytes is achievable in such mixtures for concentrations in the millimolar range, their accurate quantification remains unattainable. As shown for the first time in this work, the formation of a new composite resulting from their interactions with each other is the main reason for this lack of quantification. While this new hydrogen-bonded complex further complicates potential analyte discrimination and quantification at concentrations characteristic of physiological levels (i.e., nanomolar concentrations), it can also open new avenues for its use in drug delivery and pharmaceutical research. This remark is based not only on chemical interactions analyzed here from both theoretical and experimental approaches, but also on biological relationship, with consideration of both functional and neural proximity perspectives. Thus, this research constitutes an important contribution toward better understanding of neural processes, as well as toward possible future development of label-free biosensors.

On possible microscopic origins of the swelling of neutral lipid bilayers induced by simple salts.

It was recently suggested that the swelling of neutral multilipid bilayers upon addition of a salt can be simply explained only by the electrolyte screening of the van der Waals attractions, while assuming that the hydration force and the repulsion due to thermal undulations of membranes are unaffected by the salt. While we agree that the screening of the van der Waals interactions plays a role, we suggest that the increase in the hydration force upon addition of a salt has also to be taken into account. In a statistical model, which accounts for the membrane undulations, parameters could be found to explain the multibilayer swelling even when the van der Waals attraction is considered unaffected by the electrolyte screening. These results point out that the decrease by a factor of three of the Hamaker constant upon addition of a salt, suggested recently to be responsible for the swelling of neutral multilipid bilayers, is perhaps too large, and a smaller decrease in Hamaker constant, coupled with the above mentioned effects might explain the swelling.

On the surface tension and Zeta potential of electrolyte solutions.

The distribution of ions in the vicinity of the air/water interface is still a matter of strong debate, with numerous calculations and experiments providing contradictory results, even regarding the preference of simple ions (such as H+ and OH-) for interfacial or bulk water. When short range interactions between ions and the interface are assumed independent of bulk concentrations, if they are compatible with the surface tension data, they underpredict the experimental Zeta potentials by orders of magnitude. If they are compatible with Zeta potential data, they are in strong disagreement with surface tension experiments. It is suggested that these observations might be a result of the relatively low number of interfacial water molecules available to hydrate the ions and the competition between various ions for adsorption sites. Therefore, whereas at low bulk concentrations, the Structure-Breaking ions prefer the interface, at sufficiently large bulk concentrations the surface adsorptions of these ions become saturated, and their interfacial concentrations may become lower than in the bulk. Consequently, the total interactions of ions with the interface can be strongly attractive at low bulk concentrations, and less attractive (or even repulsive), at high concentrations. To model this effect, the interactions between ions and interface are taken into account via modified Langmuir adsorption expressions for OH- and Cl-, while the H+ ions are considered to be attached to any interfacial water molecule, even if the latter participate in the hydration of anions. The simple model of adsorption employed here is in agreement with both experiments on Zeta potential and on surface tension, and might reveal the conditions under which a given ion exhibits propensity for either the air/water interface, or for bulk water.

Detection of Biased Rating of Medical Students by Standardized Patients: Opportunity for Improvement.

OBJECTIVES: To assess the inter-rater reliability of standardized patients (SPs) as they assess the clinical skills of medical students and to detect possible rating bias in SPs. METHODS: The ratings received by 6 students examined in 4 clinical stations by 13 SPs were examined. Each SP contributed at least 3 and at most 10 pairwise ratings, with an average of approximately 5 ratings per SP. The standard Cohen' kappa statistic was calculated and the distribution of scores among SPs was compared via both ANOVA the Kruskal-Wallis H test (one-way ANOVA by ranks). Furthermore, the number of discrepancies between pairwise raters (showing either "positive" or "negative" bias in the rating) were analyzed using ANOVA and a χ2 goodness-of-fit test. RESULTS: The conventional method, which compared the statistics of kappa scores of the raters (including the prevalence-adjusted-bias adjusted kappa scores) did not reject the null hypothesis, that the raters (SPs) are similar. However, the analysis of the distribution of the discrepancies among the raters revealed that the differences between raters cannot be attributed to chance, particularly when a distinction was made between their overall "positive" and "negative" bias. A strong (p<0.001) "negative" bias was detected, and the SPs responsible for this bias have been identified. CONCLUSIONS: The statistical method suggested here, which takes into account explicitly the "positive" and the "negative" bias of the raters, is more sensitive than the conventional method (Cohens' kappa). Since the outliers (the biased SPs) affect the fairness of the grading of the medical students, it is important to detect any statistically-significant bias in the rating and to adjust correspondingly the SP's assessment.

Label-Free Raman Imaging to Monitor Breast Tumor Signatures.

Although not yet ready for clinical application, methods based on Raman spectroscopy have shown significant potential in identifying, characterizing, and discriminating between noncancerous and cancerous specimens. Real-time and accurate medical diagnosis achievable through this vibrational optical method largely benefits from improvements in current technological and software capabilities. Not only is the acquisition of spectral information now possible in milliseconds and analysis of hundreds of thousands of data points achieved in minutes, but Raman spectroscopy also allows simultaneous detection and monitoring of several biological components. Besides demonstrating a significant Raman signature distinction between nontumorigenic (MCF-10A) and tumorigenic (MCF-7) breast epithelial cells, our study demonstrates that Raman can be used as a label-free method to evaluate epidermal growth factor activity in tumor cells. Comparative Raman profiles and images of specimens in the presence or absence of epidermal growth factor show important differences in regions attributed to lipid, protein, and nucleic acid vibrations. The occurrence, which is dependent on the presence of epidermal growth factor, of new Raman features associated with the appearance of phosphothreonine and phosphoserine residues reflects a signal transduction from the membrane to the nucleus, with concomitant modification of DNA/RNA structural characteristics. Parallel Western blotting analysis reveals an epidermal growth factor induction of phosphorylated Akt protein, corroborating the Raman results. The analysis presented in this work is an important step toward Raman-based evaluation of biological activity of epidermal growth factor receptors on the surfaces of breast cancer cells. With the ultimate future goal of clinically implementing Raman-guided techniques for the diagnosis of breast tumors (e.g., with regard to specific receptor activity), the current results just lay the foundation for further label-free optical tools to diagnose the disease.

Polarization model for poorly-organized interfacial water: hydration forces between silica surfaces.

The main goal of this paper is to review the theoretical models which can be used to describe the interactions between silica surfaces and to show that a model proposed earlier by the authors (the polarization model), which accounts concomitantly for double layer and hydration forces, can be adapted to explain recent experiments in this direction. When the water molecules near the interface were considered to have an ice-like structure, a strong coupling between the double layer and hydration forces (described by the correlation length between neighboring dipoles, lambda(m)) generates long range interactions, larger than the experimentally determined interactions between silica surfaces. Arguments are brought that a gel layer is likely to be formed on the surface of silica, which, by generating disorder in the interfacial water layers, can decrease strongly the value of lambda(m). Since the prediction of lambda(m) involves a choice for the microscopic structure of water, which is often unknown, the polarization model is also presented here as a phenomenological theory, in which lambda(m) is used as a fitting parameter. Two extreme cases are considered. In one of them, the water molecules near the interface are considered to have an ice-like structure, whereas in the other they are considered randomly distributed. In the first case, the dipole correlation length lambda(m)=14.9 Angstrom. In the second limiting case, lambda(m) can be of the order of 1 Angstrom. It is shown that, for lambda(m)=4 Angstrom, a more than qualitative agreement with the experiment could be obtained, for reasonable values of the parameters involved (e.g. surface dipole strength and density, dipole location, surface charge).

Ions at the air/water interface.

In a recent review of this topic [B.C. Garett, Science 303 (2004) 1146] the emphasis was on some recent experiments, in which it was found that some anions accumulate at the air/water interface and not in the bulk, as usually happens to the cations, and on some simulations which explained those positive surface adsorption excesses. Because a large number of these experiments could be explained on the basis of some simple physical models proposed by the authors for the interaction between the ions and the air/water interface [M. Manciu, E. Ruckenstein, Adv. Colloid Interface Sci. 105 (2003) 63; Adv. Colloid Interface Sci. 112 (2004) 109; Langmuir 21 (2005) 11312], those models are reviewed in the present note, the goal being to draw attention to them.

Polarization of water near dipolar surfaces: a simple model for anomalous dielectric behavior.

A model for the electrostatic interactions in water in the vicinity of a surface is suggested, which accounts, within the Poisson-Boltzmann mean field approach, for the screening of the charges and for the coupling interactions between neighboring dipoles. When the water molecules near a solid surface are assumed to be organized in icelike layers, the polarization is not a continuous function but exists only at the discrete positions of the water molecules. The particular positions of the water molecules in the icelike structure govern the manner in which the average water dipoles align with each other. On the basis of this model, one could explain the nonmonotonic behavior of the polarization and the electrical potential as well as the anomalous dielectric response of water (the nonproportionality of the polarization and the macroscopic electric field), which were obtained recently via molecular dynamics simulations.

The polarization model for hydration/double layer interactions: the role of the electrolyte ions.

The interactions between hydrophilic surfaces in water cannot be always explained on the basis of the traditional Derjaguin-Landau-Verwey-Overbeek (DLVO) theory, and an additional repulsion, the "hydration force" is required to accommodate the experimental data. While this force is in general associated with the organization of water in the vicinity of the surface, different models for the hydration were typically required to explain different experiments. In this article, it is shown that the polarization-model for the double layer/hydration proposed by the authors can explain both (i) the repulsion between neutral lipid bilayers, with a short decay length ( approximately 2 A), which is almost independent of the electrolyte concentration, and, at the same time, (ii) the repulsion between weakly charged mica surfaces, with a longer decay length ( approximately 10 A), exhibiting not only a dependence on the ionic strength, but also strong ion-specific effects. The model, which was previously employed to explain the restabilization of protein-covered latex particles at high ionic strengths and the existence of a long-range repulsion between the apoferritin molecules at moderate ionic strengths, is extended to account for the additional interactions between ions and surfaces, not included in the mean field electrical potential. The effect of the disorder in the water structure on the dipole correlation length is examined and the conditions under which the results of the polarization model are qualitatively similar to those obtained by the traditional theory via parameter fitting are emphasized. However, there are conditions under which the polarization model predicts results that cannot be recovered by the traditional theory via parameter fitting.

Specific ion effects via ion hydration: I. Surface tension.

A simple modality is suggested to include, in the framework of a modified Poisson-Boltzmann approach, specific ion effects via the change in the ion hydration between the bulk and the vicinity of the surface. This approach can account for both the depletion of the interfacial region of structure-making ions as well as for the accumulation of structure-breaking ions near the interface. Expressions for the change in interfacial tension as a function of electrolyte concentrations are derived. On the basis of this theory, one explains the dependence of the surface potential on pH and electrolyte concentration, the existence of a minimum in the surface tension at low electrolyte concentrations and the linear dependence, with a positive or sometimes negative slope, of the surface tension on the electrolyte concentration at sufficiently high ionic strengths.

Specific ion effects via ion hydration: II. Double layer interaction.

A simple modified Poisson-Boltzmann formalism, which accounts also for those interactions between electrolyte ions and colloidal particles not included in the mean potential, is used to calculate the force between two parallel plates. It is shown that the short-range interactions between ions and plates, such as those due to the change in the hydration free energy of a structure-making/breaking ion that approaches the interface, affect the double layer interaction at large separations through the modification of the surface potential and surface charge density. While at short separations (below the range of the short-range ion-hydration forces) the interaction can be attractive, at larger separations the interaction is always repulsive, as in the traditional theory. When the long-range van der Waals interactions between the ions and the system (ion-dispersion interactions) are accounted for in the modified Poisson-Boltzmann approach, an attractive force between plates can be generated. At sufficiently large separations, this attraction can become even stronger than the traditional van der Waals attraction between plates of finite thickness, thus generating a dominant long-range 'double layer attraction'. At small plate separations, the attraction generated by the ion-dispersion forces combined with the electrostatic repulsion due to the double layers overlap can lead to a variety of interactions, from a weak attraction (which is typically by at least one order of magnitude smaller than the traditional van der Waals attraction between plates) to a strong double layer repulsion (for sufficiently large surface charges). Both types of ion interactions (long-range van der Waals or short-range ionic hydration) strongly affect the magnitude of the double layer interaction, and can account for the specific ion effects observed experimentally. However, they do not affect qualitatively the traditional theory of the colloid stability, which predicts that the colloid is stable when there is a sufficiently large charge on the surface, and coagulates when the van der Waals interactions between two colloidal particles dominate. The only qualitative difference found when the ion-dispersion interactions were incorporated into the traditional double layer theory was the emergence of a 'double layer attraction' at very large separations, which, however, does not affect much the stability of colloids.

The effect of surface dipoles and of the field generated by a polarization gradient on the repulsive force.

Double-layer and hydration interactions have been coupled into a single set of equations because both are dependent on the polarization of the water molecules. The coupled equations involve the electric fields generated by the surface charge and surface dipoles, as well as the field due to the neighboring dipoles in water. The dipoles on the surface are generated through the counterions' binding to sites of opposite charge. The equations obtained were employed to explain the restabilization observed experimentally at large ionic strengths for colloidal particles on which protein molecules were adsorbed. Polar molecules adsorbed on a charged surface of colloidal particle can generate a field either in the same direction as that generated by the charge or in the opposite direction. The effect of the sign of the dipole of the adsorbed polar molecules on the interaction between surfaces was also examined.

Dynamics of a gravitationally loaded chain of elastic beads.

Elastic beads repel in a highly nonlinear fashion, as described by Hertz law, when they are compressed against one another. Vertical stacking results in significant compressions of beads at finite distances from the surface of the stack due to gravity. Analytic studies that have been reported in the literature assume acoustic excitations upon weak perturbation [J. Hong et al., Phys. Rev. Lett. 82, 3058 (1999)] and soliton-like excitations upon strong perturbation [V. Nesterenko, J. Appl. Mech. Tech. Phys. 5, 733 (1983); S. Sen and M. Manciu, Physica A 268, 644 (1999)]. The present study probes the position, velocity and acceleration and selected two-point temporal correlations and their power spectra for individual beads for cases in which the system has been (i) weakly, (ii) strongly, and (iii) moderately perturbed at the surface in the sense specified in the text. Our studies reveal the existence of distinctly different dynamical behavior of the tagged beads, in contrast to conventional acoustic response, as the strength of the perturbation is varied at fixed gravitational loading. We also comment on the effects of polydispersity on system dynamics and probe the relaxation of isolated light and heavy beads in the chain. (c) 2000 American Institute of Physics.