ZW800-PEG: A Renal Clearable Zwitterionic Near-Infrared Fluorophore for Potential Clinical Translation.

Near-infrared (NIR) fluorescence imaging has advanced medical imaging and image-guided interventions during the past three decades. Despite tremendous advances in imaging devices, surprisingly only a few dyes are currently available in the clinic. Previous fluorophores, ZW800-1A and ZW800-1C, significantly improved the poor performance of the FDA-approved indocyanine green. However, ZW800-1A is not stable in serum and ZW800-1C induces severe stacking in aqueous media. To solve such dilemmas, ZW800-PEG was designed by introducing a flexible yet stable thiol PEG linker. ZW800-PEG shows high solubility in both aqueous and organic solvents, thus improving renal clearance with minimal binding to serum proteins during systemic circulation. The sulfide group on the meso position of the heptamethine core improves serum stability and physicochemical properties including the maximum emission wavelength shift to 800 nm, enabling the use of ZW800-PEG for image-guided interventions and augmenting photothermal therapy.

Combination of fluvastatin with pegylated interferon/ribavirin therapy reduces viral relapse in chronic hepatitis C infected with HCV genotype 1b.

BACKGROUND AND AIM: Although the anti-hepatitis C virus (HCV) effect of statins in vitro and clinical efficacy of fluvastatin combined with Pegylated interferon (PEG-IFN)/ribavirin therapy for chronic hepatitis C (CHC) have been reported, the details of clinical presentation are largely unknown. We focused on viral relapse that influences treatment outcome, and performed a post-hoc analysis by using data from a randomized controlled trial. METHODS: Thirty-four patients in the fluvastatin group and 33 patients in the non-fluvastatin group who achieved virological response (complete early virological response [cEVR] or late virological response [LVR]) with PEG-IFN/ribavirin therapy were subjected to this analysis. Factors contributing to viral relapse were identified by using multiple logistic regression analysis. RESULTS: Relapse rate in patients with cEVR was significantly lower in the fluvastatin group (2 of 23, 8.7%) than in the non-fluvastatin group (9 of 26, 34.6%; P = 0.042). The use of fluvastatin decreased relapse rate in patients with LVR (27.3% vs 57.1%), though not significantly. Overall, relapse rate was significantly lower in the fluvastatin group (14.7%; 5 of 34) than in the non-fluvastatin group (39.4%; 13 of 33; P = 0.027). Multivariate analysis identified absence of fluvastatin (P = 0.027, odds ratio [OR] = 3.98, 95% confidence interval [CI] = 1.05-15.11) and low total ribavirin dose (P = 0.002, OR = 2.41, 95% CI = 1.38-4.19) as independent factors contributing to relapse. CONCLUSION: The concomitant addition of fluvastatin significantly suppressed viral relapse, resulting in the improvement of sustained virological response rate, in PEG-IFN/ribavirin therapy for CHC patients with HCV genotype 1b and high viral load.

Lead-in treatment with interferon-ß/ribavirin may modify the early hepatitis C virus dynamics in pegylated interferon alpha-2b/ribavirin combination for chronic hepatitis C patients with the IL28B minor genotype.

BACKGROUND AND AIM: The most important factor influencing the effect of pegylated interferon (PEG-IFN)/ribavirin therapy (PEG) for chronic hepatitis C genotype 1b with high viral load is the interleukin 28B (IL28B) genotype. We investigated the usefulness of lead-in twice-daily interferon (IFN)-ß/ribavirin therapy (IFN-ß), and the early hepatitis C virus RNA (HCV-RNA) dynamics was compared between PEG and IFN-ß groups according to the IL28B genotype. METHODS: Forty-six patients were randomly allocated to PEG and IFN-ß groups, and HCV-RNA dynamics in an early phase of treatment were analyzed. RESULTS: The patients with minor IL28B genotype was 6/23 and 8/23 in IFN-ß and PEG groups, respectively. In the patients with IL28B major genotype, viral load reduction was marginally greater in IFN-ß group than in PEG group. In contrast, in the patients with the IL28B minor genotype, viral load reduction was significantly and numerically greater in IFN-ß group than in PEG group at 1 week (2.07 vs. 0.76 log IU/mL, P = 0.038), 2 weeks (2.73 vs. 1.01, P = 0.009), 4 weeks (2.72 vs. 1.55, P = 0.059), and 12 weeks (4.56 vs. 3.24, P = 0.104). The sustained virological response rates in the IL28B major genotype were similar between IFN-ß group (47.1%, 8/17) and PEG group (53.3%, 8/15). In contrast, the sustained virological response rates in the IL28B minor genotype were numerically higher in IFN-ß group (50.0%, 3/6) than in PEG group (12.5%, 1/8), although not statistically significant. CONCLUSION: It was suggested that lead-in twice-daily IFN-ß/ribavirin treatment followed by PEG-IFN/ribavirin combination therapy may modify the HCV-RNA dynamics compared with that by PEG-IFN/ribavirin therapy, and it is particularly useful for the IL28B minor genotype.

Enhancement of cellulase activity by clones selected from the combinatorial library of the cellulose-binding domain by cell surface engineering.

To improve the cellulolytic activity of a yeast strain displaying endoglucanase IotaIota (EG II) from Trichoderma reesei, a combinatorial library of the cellulose-binding domain (CBD) of EG II was constructed by using cell surface engineering. When EG II degrades celluloses, CBD binds to cellulose, and its catalytic domain cleaves the glycosidic bonds of cellulose. CBD had a flat face, composed of five amino acids for binding. It was supposed that the three hydrophobic amino acid residues of the five amino acid residues were essential for binding to cellulose. Therefore, by improving the two remaining amino acid residues, construction of mutants with a combinatorial library of the two amino acids in CBD was carried out and binding ability and hydrolysis activity were measured. In the first screening by halo assay using the Congo Red staining method, about 200 of the 2000 colonies formed clear halos, and then five colonies with the clearest halos were finally selected. In the second screening, the binding ability of the five mutants to phosphoric acid-swollen Avicel was measured. In addition, the measurement of hydrolysis activity toward carboxymethylcellulose (CMC) using the screened mutants was carried out. As a result, the mutated EG II exhibiting higher binding ability (1.5-fold) had higher hydrolysis activity (1.3-fold) compared to the parent EG II-displaying yeast cell, demonstrating that CBD has confirmatively some effect on the cellulase activity through its binding ability of the enzyme to cellulose.

Safety and efficacy of partial splenic embolization in telaprevir-based triple therapy for chronic hepatitis C.

OBJECTIVE: Pegylated-interferon/ribavirin (peg-IFN/RBV) therapy with a protease inhibitor is the standard therapy for genotype 1b chronic hepatitis C. Despite improving treatment outcomes, patients with thrombocytopenia are often difficult to treat because interferon commonly exacerbates thrombocytopenia. In this study, partial splenic embolization (PSE) was performed in patients with hypersplenism-induced thrombocytopenia to determine the effectiveness of this method as a potential treatment. METHODS: Patients were pretreated with PSE and then received triple combination therapy. The safety and efficacy of PSE was evaluated. RESULTS: Eighteen patients were analyzed, including 12 patients with the interleukin 28B (IL28B) major genotype and 12 patients with the inosine triphosphatase (ITPA) major genotype. The median embolization rate with PSE was 70% (range: 40-85%). PSE increased the patients' platelet counts from 71.5×10(3) /µL (53-99×10(3) /µL) to 121.5×10(3) /µL (70-194×10(3) /µL; p=0.0002). The patients' platelet counts fluctuated above 50×10(3) /µL during the treatment. Specifically, the increase in the platelet count was significantly associated with the ITPA major genotype compared with the minor genotype (p=0.0057 at 2 weeks, p=0.0031 at 3 weeks, and p=0.0148 at 4 weeks). Adherence to peg-IFN-α2b was sufficient (1.38 µg/kg/week). The rapid viral response rate was 72.2% (13/18), the end of treatment response rate was 88.9% (16/18), and the sustained virological response (SVR) rate was 66.7% (12/18). The SVR rate for patients with the IL28B major genotype was 83.3% (10/12). No adverse effect due to PSE pretreatment was found in any patients. Furthermore, no patient discontinued treatment due to thrombocytopenia. CONCLUSION: PSE, in conjunction with triple combination therapy, is a useful and safe method to treat genotype 1b chronic hepatitis C patients with hypersplenism-induced thrombocytopenia.

Relationship between HCV dynamics and sustained virological responses in chronic hepatitis C genotype 1b patients treated with telaprevir-based triple therapy.

OBJECTIVES: This study investigated the relationship between hepatitis C virus (HCV) dynamics and sustained virological response (SVR), as well as the efficacy of an extended treatment with telaprevir-based triple therapy among patients with chronic hepatitis C genotype 1b. METHODS: Among 220 patients receiving triple therapy for 24 weeks, the SVR rate was analyzed at each time point at which HCV RNA became undetectable. The SVR rates in the patients who did not achieve a rapid virological response (RVR) were compared with those in 27 patients who received triple therapy for 48 weeks. RESULTS: The SVR rates of interleukin 28B (IL28B) TT and non-TT patients were 100 versus 66.7% after 1 week, 97.6 versus 72.2% after 2 weeks, 95.2 versus 84.2% after 3 weeks, 93.1 versus 72.2% after 4 weeks, 76.9% versus 11.1% after 6 weeks, and 88.9 versus 14.3% after 8 weeks, respectively. All of the IL28B TT patients who showed undetectable HCV RNA levels until week 8 achieved an SVR. In contrast, the SVR rates in the IL28B non-TT patients who did not achieve RVR with 24 and 48 weeks of treatment were 11.8 and 62.5%, respectively (P=0.017). CONCLUSION: These results suggest that an SVR can frequently be achieved by IL28B TT patients, even with 24 weeks of treatment, when HCV RNA remains undetectable until week 8, and also that IL28B non-TT patients should have RVR values to achieve an SVR with 24 weeks of treatment. The SVR rate was low in IL28B non-TT patients treated for 24 weeks who did not achieve an RVR; however, it could increase when the treatment duration was extended to 48 weeks.

Clinical application of cone beam computed tomography for ideal absorbable membrane placement in interproximal bone defects.

When a guided tissue regeneration (GTR) membrane is placed in an interproximal area, adjustment of the membrane is difficult because of the complex anatomy of the root surface and presence of bone defects, thus prolonging the surgery. This report describes the clinical application of cone beam computed tomography (CT) images to aid insertion of a barrier membrane in the treatment of interproximal bone defects. Using CT images, the membrane can be pre-cut into the optimal shape to cover the bone defect and fit the roots tightly, thus shortening the time required to adjust the GTR membrane, and providing excellent clinical outcomes.

Improvement in enzymatic desizing of starched cotton cloth using yeast codisplaying glucoamylase and cellulose-binding domain.

To utilize glucoamylase-displaying yeast cells for enzymatic desizing of starched cotton cloth, we constructed yeast strains that codisplayed Rhizopus oryzae glucoamylase and two kinds of Trichoderma reesei cellulose-binding domains (CBD1, CBD of cellobiohydrolase I (CBHI); and CBD2, CBD of cellobiohydrolase II (CBHII)). In this study, we aimed to obtain a high efficiency of enzymatic desizing of starched cotton cloth. Yeast cells that codisplayed glucoamylase and CBD had higher activity on starched cotton cloth than yeast cells that displayed only glucoamylase. Glucoamylase and double CBDs (CBD1 and CBD2) codisplaying yeast cells exhibited the highest activity ratio (4.36-fold), and glucoamylase and single CBD (CBD1 or CBD2) codisplaying yeast cells had higher relative activity ratios (2.78- and 2.99-fold, respectively) than glucoamylase single-displaying cells. These results indicate that the glucoamylase activity of glucoamylase-displaying cells would be affected by the binding ability of CBD codisplayed on the cell surface to starched cotton cloth. These novel strains might play useful roles in the enzymatic desizing of starched cotton cloth in the textile industry.