Immune checkpoint markers and tumour mutation burden in Wilms tumour: a study of 59 cases.

Wilms tumour (WT) is the most common renal tumour in children, and studies of immune checkpoint inhibitors (ICIs) treatment and markers are limited in number. In this study we investigated the ICIs' related immune landscape by examining the expression of PD-L1, PD-1, CD8 and DNA mismatch repair (MMR) proteins by immunohistochemistry (IHC), tumour mutation burden (TMB), and correlations with histology and clinical outcome. Positive PD-L1 (SP263) expression was defined as modified combined positive score (CPS) ≥1. A total of 59 WTs (from 2000 to 2017), including eight (14.0%) with anaplasia, from 46 patients were analysed (45 primary and 14 metastatic). Thirteen WTs (13/59, 22%) were positive for PD-L1 (8 primary, 5 metastatic; CPS 1.11-3.42). Positive PD-L1 expression was associated with diffuse anaplasia (p<0.05) and significantly shorter progression-free survival (p<0.05) among WTs with favourable histology (n=39). CD8+ lymphocytes were present in all analysed WTs. A subset of CD8+ cells co-expressed PD-1, which was associated with favourable histology and treatment. MMR IHC stains identified two (2/18, 11%) WTs with isolated PMS2 loss. All six WTs analysed for TMB showed low mutation burden. We found CD8+ lymphocytes in all analysed WTs and identified a fraction of WT (17.8% of primary and 35.8% of metastatic) with positive PD-L1 CPS, suggesting potential response to ICIs in some patients.

Interleukin 6 Receptor Blockade to Treat Chronic Active Antibody-Mediated Rejection in Kidney Transplant: A Case Report With Review of Relevant Literature.

A 40-year-old male patient with a pretransplant calculated panel reactive antibody of 0 and no prior sensitizing events developed mixed active antibody-mediated rejection and acute cellular rejection (Banff grade 1A) 1.5 years posttransplant. Testing for donor-specific antibody or non-human leukocyte antigen antibody (major histocompatibility complex class I chain-related antigen A/angiotensin II type I receptor) was negative. Biopsy demonstrated diffuse C4d staining in peritubular capillaries. The patient was treated with standard of care, including plasma-pheresis and intravenous immunoglobulin along with steroids, with return of renal function to baseline. However, 1 year after treatment, he developed chronic active antibody-mediated rejection without any donor-specific antibodies. We believe he did have smoldering antibody-mediated rejection that had progressed to a more chronic state over time. He was then treated with tocilizumab and had a successful return of serum creatinine to baseline. One year after treatment, he still has stable renal function, suggesting a role of tocilizumab in stabilizing renal function in patients with chronic active antibody-mediated rejection for which there is no Food and Drug Administration-approved treatment.

Cervical clear cell adenocarcinoma with an exceptionally low proliferation index: Report of a case.

•A histologically low-grade cervical clear cell lesion was observed.•Proliferating cells were seen only at the periphery of this lesion.•Due to its low proliferation index, this may represent a precursor of clear cell carcinoma.•Further definition of such lesions may allow for more minimal management.

Tuning cofactor redox potentials: the 2-methoxy dihedral angle generates a redox potential difference of >160 mV between the primary (Q(A)) and secondary (Q(B)) quinones of the bacterial photosynthetic reaction center.

Only quinones with a 2-methoxy group can act simultaneously as the primary (QA) and secondary (QB) electron acceptors in photosynthetic reaction centers from Rhodobacter sphaeroides. (13)C hyperfine sublevel correlation measurements of the 2-methoxy in the semiquinone states, SQA and SQB, were compared with quantum mechanics calculations of the (13)C couplings as a function of the dihedral angle. X-ray structures support dihedral angle assignments corresponding to a redox potential gap (ΔEm) between QA and QB of ~180 mV. This is consistent with the failure of a ubiquinone analogue lacking the 2-methoxy to function as QB in mutant reaction centers with a ΔEm of ≈160-195 mV.

Photoelectrochemical complexes for solar energy conversion that chemically and autonomously regenerate.

Naturally occurring photosynthetic systems use elaborate pathways of self-repair to limit the impact of photo-damage. Here, we demonstrate a complex consisting of two recombinant proteins, phospholipids and a carbon nanotube that mimics this process. The components self-assemble into a configuration in which an array of lipid bilayers aggregate on the surface of the carbon nanotube, creating a platform for the attachment of light-converting proteins. The system can disassemble upon the addition of a surfactant and reassemble upon its removal over an indefinite number of cycles. The assembly is thermodynamically metastable and can only transition reversibly if the rate of surfactant removal exceeds a threshold value. Only in the assembled state do the complexes exhibit photoelectrochemical activity. We demonstrate a regeneration cycle that uses surfactant to switch between assembled and disassembled states, resulting in an increased photoconversion efficiency of more than 300% over 168 hours and an indefinite extension of the system lifetime.

The 2-methoxy group of ubiquinone is essential for function of the acceptor quinones in reaction centers from Rba. sphaeroides.

The orientation of a methoxy substituent is known to substantially influence the electron affinity and vibrational spectroscopy of benzoquinones, and has been suggested to be important in determining the function of ubiquinone as a redox cofactor in bioenergetics. Ubiquinone functions as both the primary (Q(A)) and secondary (Q(B)) quinone in the reaction centers of many purple photosynthetic bacteria, and is almost unique in its ability to establish the necessary redox free energy gap for 1-electron transfer between them. The role of the methoxy substitution in this requirement was examined using monomethoxy analogues of ubiquinone-4 - 2-methoxy-3,5-dimethyl-6-isoprenyl-1,4-benzoquinone (2-MeO-Q) and 3-methoxy-2,5-dimethyl-6-isoprenyl-1,4-benzoquinone (3-MeO-Q). Only 2-MeO-Q was able to simultaneously act as Q(A) and Q(B) and the necessary redox potential tuning was shown to occur in the Q(B) site. In the absence of active Q(B), the IR spectrum of the monomethoxy quinones was examined in vitro and in the Q(A) site, and a novel distinction between the two methoxy groups was tentatively identified, consistent with the unique role of the 2-methoxy group in distinguishing Q(A) and Q(B) functionality.