HER2 in Colorectal Cancer: The Long and Winding Road From Negative Predictive Factor to Positive Actionable Target.

Human epidermal growth factor receptor 2 (HER2) is a well-known oncogenic driver in different tumors and an approved therapeutic target in breast and gastroesophageal cancer. In metastatic colorectal cancer, only 3% to 5% of patients present with HER2 alterations: somatic mutations and amplifications. HER2 was first assessed as a biomarker of resistance to anti-EGFR therapy; however, in more recent years, its role as a potential actionable target has emerged. In this article, we discuss the predictive and prognostic value of HER2 in metastatic colorectal cancer, its emerging role as an actionable therapeutic target, and its possible future developments.

Simultaneous CRISPR/Cas9 Editing of Three PPO Genes Reduces Fruit Flesh Browning in Solanum melongena L.

Polyphenol oxidases (PPOs) catalyze the oxidization of polyphenols, which in turn causes the browning of the eggplant berry flesh after cutting. This has a negative impact on fruit quality for both industrial transformation and fresh consumption. Ten PPO genes (named SmelPPO1-10) were identified in eggplant thanks to the recent availability of a high-quality genome sequence. A CRISPR/Cas9-based mutagenesis approach was applied to knock-out three target PPO genes (SmelPPO4, SmelPPO5, and SmelPPO6), which showed high transcript levels in the fruit after cutting. An optimized transformation protocol for eggplant cotyledons was used to obtain plants in which Cas9 is directed to a conserved region shared by the three PPO genes. The successful editing of the SmelPPO4, SmelPPO5, and SmelPPO6 loci of in vitro regenerated plantlets was confirmed by Illumina deep sequencing of amplicons of the target sites. Besides, deep sequencing of amplicons of the potential off-target loci identified in silico proved the absence of detectable non-specific mutations. The induced mutations were stably inherited in the T1 and T2 progeny and were associated with a reduced PPO activity and browning of the berry flesh after cutting. Our results provide the first example of the use of the CRISPR/Cas9 system in eggplant for biotechnological applications and open the way to the development of eggplant genotypes with low flesh browning which maintain a high polyphenol content in the berries.

Identification of a new R3 MYB type repressor and functional characterization of the members of the MBW transcriptional complex involved in anthocyanin biosynthesis in eggplant (S. melongena L.).

Here we focus on the highly conserved MYB-bHLH-WD repeat (MBW) transcriptional complex model in eggplant, which is pivotal in the transcriptional regulation of the anthocyanin biosynthetic pathway. Through a genome-wide approach performed on the recently released Eggplant Genome (cv. 67/3) previously identified, and reconfirmed by us, members belonging to the MBW complex (SmelANT1, SmelAN2, SmelJAF13, SmelAN1) were functionally characterized. Furthermore, a regulatory R3 MYB type repressor (SmelMYBL1), never reported before, was identified and characterized as well. Through a qPCR approach, we revealed specific transcriptional patterns of candidate genes in different plant tissue/organs at two stages of fruit development. Two strategies were adopted for investigating the interactions of bHLH partners (SmelAN1, SmelJAF13) with MYB counterparts (SmelANT1, SmelAN2 and SmelMYBL1): Yeast Two Hybrid (Y2H) and Bimolecular Fluorescent Complementation (BiFC) in A. thaliana mesophylls protoplast. Agro-infiltration experiments highlighted that N. benthamiana leaves transiently expressing SmelANT1 and SmelAN2 showed an anthocyanin-pigmented phenotype, while their co-expression with SmelMYBL1 prevented anthocyanin accumulation. Our results suggest that SmelMYBL1 may inhibits the MBW complex via the competition with MYB activators for bHLH binding site, although this hypothesis requires further elucidation.

Pharmacotherapeutic problems and pharmaceutical interventions in critical hospitalized patients / Problemas farmacoterapêuticos e intervenções farmacêuticasa em pacientes críticos hospitalizados

A critical patient is one who is seriously ill and needs a multi-professional team dedicated to their intensive care. Because ample prescription medication is involved, such patients are more susceptible to pharmacotherapeutic problems. The purpose of the study was to evaluate the profile of pharmacotherapeutic problems (PP) and pharmaceutical interventions (PI) performed by residents of a Multi-professional Residency Program in Critical Patient Care. This was a descriptive and quantitative study carried out by evaluating pharmaceutical care records completed by residents caring for critical patients who were hospitalized at a teaching hospital in Campo Grande, MS, from March to August 2016. The study was approved by the Ethics Committee of the Federal University of Mato Grosso do Sul, opinion No. 1,371,325. The drug prescriptions of 60 patients with an average age of 60.2 (± 16.6) years were evaluated. A total of 218 PP were identified, with an average of 3.6 (± 1.4) PP per participant. Twenty-six patients (43.3%) had 4 or more PP. The most frequent were: medication not available due to lack of stock (n=48; 22%), existence of a more adequate/available therapeutic alternative (n=37; 17%), and need for laboratory monitoring (n=22; 10.1%). A total of 154 PI, 2.56 (± 0.7) per participant, were performed. The most frequent were: indication of a more adequate/available therapeutic alternative (n=37; 24%), orientation on drug-drug incompatibility (n=16, 10.4%), and orientation on drugdrug interaction (n=12; 7.8%). Most PI (n=133; 86.4%) were directed to physicians and were accepted without change (n=96; 62%). The results showed a high incidence of PP and PI in critical patients

Paciente crítico é aquele que se encontra gravemente doente e necessita de equipe multiprofissional dedicada ao seu cuidado intensivo. Por apresentar ampla prescrição medicamentosa, é mais susceptível a problemas farmacoterapêuticos (PF). O estudo teve como propósito avaliar o perfil dos PF e das intervenções farmacêuticas (IF) realizadas pelos residentes de um Programa de Residência Multiprofissional em Atenção ao Paciente Crítico. Tratou-se de um estudo descritivo e quantitativo, realizado através da avaliação das fichas de cuidado farmacêutico preenchidas pelos residentes durante o cuidado a pacientes críticos internados em um hospital de ensino de Campo Grande/MS, de março a agosto de 2016. O estudo foi aprovado pelo Comitê de Ética da Universidade Federal de Mato Grosso do Sul, sob o parecer nº 1.371.325. As prescrições medicamentosas de 60 pacientes com idade média de 60,2 (±16,6) anos foram avaliadas. Identificou-se um total de 218 PF, sendo a média por participante igual a 3,6 (±1,4). Vinte e seis pacientes (43,3%) apresentaram 4 ou mais PF. Os mais frequentes foram: medicamento não dispensado por falta de estoque (n=48; 22%), alternativa terapêutica mais adequada/disponível (n=37; 17%) e necessidade de monitoramento laboratorial (n=22; 10,1%). Foram realizadas 154 IF, 2,56 (±0,7) por participante. As mais frequentes foram: indicação de alternativa terapêutica mais adequada/ disponível (n=37; 24%), orientação sobre incompatibilidade fármaco-fármaco (n=16; 10,4%) e orientação sobre interação fármaco-fármaco (n=12; 7,8%). A maioria das IF (n=133; 86,4%) foram direcionadas aos médicos e foram aceitas sem alteração (n=96; 62%). Os resultados evidenciaram alta incidência de PF e IF em pacientes críticos

Therapeutic effect of human adipose-derived stem cells and their secretome in experimental diabetic pain.

Painful neuropathy is one of the complications of diabetes mellitus that adversely affects patients'quality of life. Pharmacological treatments are not fully satisfactory, and novel approaches needed. In a preclinical mouse model of diabetes the effect of both human mesenchymal stromal cells from adipose tissue (hASC) and their conditioned medium (hASC-CM) was evaluated. Diabetes was induced by streptozotocin. After neuropathic hypersensitivity was established, mice were intravenously injected with either 1 × 106 hASC or with CM derived from 2 × 106 hASC. Both hASC and CM (secretome) reversed mechanical, thermal allodynia and thermal hyperalgesia, with a rapid and long lasting effect, maintained up to 12 weeks after treatments. In nerves, dorsal root ganglia and spinal cord of neuropathic mice we determined high IL-1ß, IL-6 and TNF-α and low IL-10 levels. Both treatments restored a correct pro/antinflammatory cytokine balance and prevented skin innervation loss. In spleens of streptozotocin-mice, both hASC and hASC-CM re-established Th1/Th2 balance that was shifted to Th1 during diabetes. Blood glucose levels were unaffected although diabetic animals regained weight, and kidney morphology was recovered by treatments. Our data show that hASC and hASC-CM treatments may be promising approaches for diabetic neuropathic pain, and suggest that cell effect is likely mediated by their secretome.

Genome-Wide Identification of BAHD Acyltransferases and In vivo Characterization of HQT-like Enzymes Involved in Caffeoylquinic Acid Synthesis in Globe Artichoke.

Globe artichoke (Cynara cardunculus L. var. scolymus) is a rich source of compounds promoting human health (phytonutrients), among them caffeoylquinic acids (CQAs), mainly represented by chlorogenic acid (CGA), and dicaffeoylquinic acids (diCQAs). The enzymes involved in their biosynthesis belong to the large family of BAHD acyltransferases. Following a survey of the globe artichoke genome, we identified 69 BAHD proteins carrying the catalytic site (HXXXD). Their phylogenetic analysis together with another 43 proteins, from 21 species, representative of the BAHD family, highlighted their grouping in seven major clades. Nine globe artichoke acyltransferases clustered in a sub-group of Clade V, with 3 belonging to hydroxycinnamoyl-CoA:quinate hydroxycinnamoyl transferase (HQT) and 2 to hydroxycinnamoyl-CoA:shikimate/quinate hydroxycinnamoyl transferase (HCT) like proteins. We focused our attention on the former, HQT1, HQT2, and HQT3, as they are known to play a key role in CGA biosynthesis. The expression of genes coding for the three HQTs and correlation of expression with the CQA content is reported for different globe artichoke tissues. For the first time in the globe artichoke, we developed and applied the virus-induced gene silencing approach with the goal of assessing in vivo the effect of HQT1 silencing, which resulted in a marked reduction of both CGA and diCQAs. On the other hand, when the role of the three HQTs was assessed in leaves of Nicotiana benthamiana through their transient overexpression, significant increases in mono- and diCQAs content were observed. Using transient GFP fusion proteins expressed in N. benthamiana leaves we also established the sub-cellular localization of these three enzymes.

17ß-estradiol differently affects osteogenic differentiation of mesenchymal stem/stromal cells from adipose tissue and bone marrow.

Adipose-derived and bone marrow stem/stromal cells (ASCs and BMSCs) have been often compared for their application in regenerative medicine, and several factors sustaining their differentiation and efficacy have been investigated. 17 ß-estradiol (E2) has been reported to influence some functions of progenitor cells. Here we studied the effects of 10 and 100nM E2 on ASC and BMSC vitality, proliferation and differentiation towards osteogenic and adipogenic lineages. E2 did not modulate ASC and BMSC vitality and growth rate, while the hormone produced a pro-adipogenic effect on both mesenchymal stem/stromal cells (MSCs). In particular, the synergy between 7-day pre-treatment and 100nM E2 led to the most evident result, increasing lipid vacuoles formation in ASCs and BMSCs of +44% and +82%, respectively. Despite the fact that E2 did not alter collagen deposition of osteo-induced MSCs, we observed a different modulation of ASC and BMSC alkaline phosphatase (ALP) activity. Indeed, this osteogenic marker was always enhanced by 17 ß-estradiol in BMSCs, and 7-day pre-treatment with 100nM E2 increased it of about 70%. In contrast, E2 weakened ASC osteogenic potential, reducing their ALP activity of about 20%, with the most evident effect on ASCs isolated from pre-menopausal women (-30%). Finally, we identified an estrogen receptor α (ERα) variant of about 37kDa expressed in both MSCs. Interestingly, adipogenic stimuli drastically reduced its expression, while osteogenic ones mildly increased this isoform in BMSCs only. In conclusion, E2 positively affected the adipogenic process of both MSCs while it favored osteogenic induction in BMSCs only, and both mesenchymal progenitors expressed a novel 37kDa ER-α variant whose expression was modulated during differentiation.