The Impact of potential 'confounders' on the diagnostic sensitivity of circulating free DNA in management of FIT+ patients: a pilot study.

Cell-free DNA (cfDNA) has long been established as a useful diagnostic and prognostic tool in a variety of clinical settings, ranging from infectious to cardiovascular and neoplastic diseases. However, non-neoplastic diseases can act as confounders impacting on the amount of cfDNA shed in bloodstream and on technical feasibility of tumour derived free circulating nucleic acids selecting patients with cancer. Here, we investigated the potential impact of other pathological processes in the clinical stratification of 637 FIT+ patients. A single and multiple logistic regression yielded similar results. Crude sensitivity was 75.9% versus adjusted sensitivity of 74.1%, relative risk 0.9761 (0.8516 to 1.1188), risk difference 0.0181 (-0.0835 to 0.1199) and OR 0.9079 (0.5264 to 1.5658). Potential confounding effect from other source of cfDNA plays a pivotal role in the clinical stratification of FIT+ patients.

Non-Small Cell Lung Cancer Testing on Reference Specimens: An Italian Multicenter Experience.

INTRODUCTION: Biomarker testing is mandatory for the clinical management of patients with advanced non-small cell lung cancer (NSCLC). Myriads of technical platforms are now available for biomarker analysis with differences in terms of multiplexing capability, analytical sensitivity, and turnaround time (TAT). We evaluated the technical performance of the diagnostic workflows of 24 representative Italian institutions performing molecular tests on a series of artificial reference specimens built to mimic routine diagnostic samples. METHODS: Sample sets of eight slides from cell blocks of artificial reference specimens harboring exon 19 EGFR (epidermal growth factor receptor) p.E746_AT50del, exon 2 KRAS (Kirsten rat sarcoma viral oncogene homologue) p.G12C, ROS1 (c-ros oncogene 1)-unknown gene fusion, and MET (MET proto-oncogene, receptor tyrosine kinase) Δ exon 14 skipping were distributed to each participating institution. Two independent cell block specimens were validated by the University of Naples Federico II before shipment. Methodological and molecular data from reference specimens were annotated. RESULTS: Overall, a median DNA concentration of 3.3 ng/µL (range 0.1-10.0 ng/µL) and 13.4 ng/µL (range 2.0-45.8 ng/µL) were obtained with automated and manual technical procedures, respectively. RNA concentrations of 5.7 ng/µL (range 0.2-11.9 ng/µL) and 9.3 ng/µL (range 0.5-18.0 ng/µL) were also detected. KRAS exon 2 p.G12C, EGFR exon 19 p.E736_A750del hotspot mutations, and ROS1 aberrant transcripts were identified in all tested cases, whereas 15 out of 16 (93.7%) centers detected MET exon 14 skipping mutation. CONCLUSIONS: Optimized technical workflows are crucial in the decision-making strategy of patients with NSCLC. Artificial reference specimens enable optimization of diagnostic workflows for predictive molecular analysis in routine clinical practice.

Liquid biopsy: A promising tool for driving strategies and predicting failures in patients with classic Hodgkin lymphoma.

Classic Hodgkin lymphoma (cHL) consists of a heterogeneous group of haematological disorders that covers undifferentiated B cell neoplasms originating from germinal centre B cells. The HL molecular characterization still represents an ongoing challenge due to the low fraction of tumour Hodgkin and Reed-Sternberg cells mixed with a plethora of non-tumour haematological cells. In this scenario, next generation sequencing of liquid biopsy samples is emerging as a useful tool in HL patients' management. In this review, we aimed to overview the clinical and methodological topics regarding the implementation of molecular analysis in cHL, focusing on the role of liquid biopsy in diagnosis, follow-up, and response prediction.

Separation and quantification of Tartrazine (E102) and Brilliant Blue FCF (E133) in green colored foods and beverages.

In the present study we investigated the capacities of a panel of 25 solid sorbents represented by layered structures, inorganic oxides and hydroxides, and phyllosilicates, to effectively remove in high yield Tartrazine (E102) and Brilliant Blue FCF (E133) from aqueous solutions, and more notable, green colored food matrices. Quantification of the title compounds have been achieved by HPLC-DAD analyses. Contents of E102 and E133 in real samples were in the range 1.3-36.5 µg/mL and 1.0-20.1 µg/mL, respectively. After a treatment of 1 min., in most cases a complete bleaching of solutions and deep coloring of the solid phase was recorded. The most effective solids to this aim were seen to be aluminium based ayered double hydroxides. In the case of magnesium oxide for E102, and magnesium aluminium D. benzensulfonate SDS 01 H8L and Florisil for E133, a selective adsorption (>99.9 %) of only one dye was observed. The adsorption recorded was strictly dependent on the loading of the sorbent. Related values were 300 mg for the separation of E102 by magnesium oxide from all the five food matrices under investigation, and in the range 200 mg-300 mg for magnesium aluminium D. benzensulfonate SDS 01 H8L and Florisil in the case of E133. The application of Langmuir and Freundlich models suggested that the adsorption may take place in the inner layers of the solids with a favourable thermodynamique outcome. Findings described herein offer the concrete possibility of quantifications of individual dyes in matrices containing more than one food colorant.

Novel insights into the biomolecular mechanism of action of 4'-geranyloxyferulic acid, a colon cancer chemopreventive agent.

In this manuscript the biomolecular mechanism of action of the natural colon cancer chemopreventive agent 4'-geranyloxyferulic acid in cultured Caco-2 cells has been investigated. It was first demonstrated how the application of this phytochemical led to a time- and dose-dependent decrease of cell viability and in parallel to a massive generation of reactive oxygen species and induction of caspases 3 and 9, finally providing apoptosis. This event is accompanied by deep modifications in key pro-apoptotic targets like CD95, DR4 and 5, cytochrome c, Apaf-1, Bcl-2, and Bax. Such effects can explain the large apoptosis recorded in Caco-2 cells treated with 4'-geranyloxyferulic acid.

Protection of Mitochondrial Potential and Activity by Oxyprenylated Phenylpropanoids.

A series of five naturally occurring oxyprenylated phenylpropanoids, namely, the coumarins auraptene (7-geranyloxycoumarin) 1 and 7-isopentenyloxycoumarin 2, and the coumaric acid and ferulic acid derivatives, 4'-isopentenyloxycoumaric acid 3, boropinic acid 4, and 4'-geranyloxyferulic acid 5 were tested for their effects on mitochondrial functionality using the organophosphate pesticides glyphosate and chlorpyrifos, and resveratrol, as the reference. While not showing an appreciable in vitro antioxidant activity, and virtually no or a little effect on the viability of non-cancer cell lines BEAS-2B and SHSY-5Y, all phytochemicals exhibited a marked protective effect on mitochondrial potential and activity, with values that were comparable to resveratrol. Auraptene 1 and 7-isopentenyloxycoumarin 2 were seen to be the most effective secondary metabolite to this concern, in particular in being able to completely abolish the decrease of mitochondrial potential induced by increasing concentration of both glyphosate and chlorpyrifos. All the compounds tested also exhibited a protective effect on mitochondrial activity. The potency displayed will shed more light on the molecular basis of the beneficial effects of auraptene, 7-isopentenyloxycoumarin, and structurally related oxyprenylated phenylpropanoids reported to date in the literature.

Solid-phase adsorption methodologies of naturally occurring anthraquinones: A review.

INTRODUCTION: Solid-phase extraction applied to plant matrices is nowadays a well-validated technique allowing to concentrate and purify different secondary metabolites. Several classes of phytochemicals have been selectively extracted by this methodology. During the last decade attention has been focused on biologically active anthraquinones from numerous sources like edible, healthy, and medicinal plants. OBJECTIVES: The aim of this review is to provide a detailed literature survey of the solid-phase adsorption methodologies for the extraction of natural anthraquinones reported so far and to discuss and propose future directions in this field of research. MATERIALS AND METHODS: Substructure search was performed in the SciFinder Scholar, PubMed, Medline, and Scopus databases. RESULTS: The first report about application of solid-phase adsorption for the purification of anthraquinones appeared in the literature in 2002. From this date, and in particular during recent years, the most notable examples included the use of chitin- and chitosan-based polymers, of molecularly imprinted polymers, of coated magnetic nanoparticles, of miniaturized matrix solid-phase dispersion, of functionalized resins, of differently structured lamellar solids, and finally of vortex-synchronized matrix solid-phase dispersion. CONCLUSIONS: The herein detailed solid-phase adsorption methodologies are powerful tools to selectively extract natural anthraquinones and/or provide anthraquinone-enriched phytopreparations. Nevertheless, many other important methods have been applied to synthetic anthraquinones (e.g., azo dyes). These could be conveniently employed also for natural anthranoids. Studies in this field are discussed in this review article.

Microsatellite instability evaluation of patients with solid tumour: routine practice insight from a large series of Italian referral centre.

DNA mismatch repair complex is involved in the maintenance of DNA stability. In the recent years, a plethora of technical approaches for microsatellite instability (MSI) analysis emerged. Here, we review the results of our MSI status evaluation by adopting a customised workflow on microfluidic system obtained in 4 years of diagnostic routine practice. Data from MSI status were retrieved from our institutional archive covering the period from January 2017 to December 2021. Microfluidic analysis was carried out on microfluidic platform. Results were inspected with a proprietary software. Overall, microsatellite stability (MSS) and MSI-high (MSI-H) profile was detected in n=423/458 (92.36%) and n=35/458 (7.64%) patients with metastatic CRC (mCRC), respectively. In addition, n=78/86 (90.70%) and n=8/86 (9.30%) patients without CRC showed an MSS and MSI-H profile. This review highlights the suitability of microfluidic approach in patients with cancer for MSI testing.

Cognitive and biological effects of citrus phytochemicals in subjective cognitive decline: a 36-week, randomized, placebo-controlled trial.

BACKGROUND: Auraptene (AUR) and naringenin (NAR) are citrus-derived phytochemicals that influence several biological mechanisms associated with cognitive decline, including neuronal damage, oxidative stress and inflammation. Clinical evidence of the efficacy of a nutraceutical with the potential to enhance cognitive function in cohorts at risk of cognitive decline would be of great value from a preventive perspective. The primary aim of this study is to determine the cognitive effects of a 36-week treatment with citrus peel extract standardized in levels of AUR and NAR in older adults experiencing subjective cognitive decline (SCD). The secondary aim is to determine the effects of these phytochemicals on blood-based biomarkers indicative of neuronal damage, oxidative stress, and inflammation. METHODS: Eighty older persons with SCD will be recruited and randomly assigned to receive the active treatment (400 mg of citrus peel extract containing 0.1 mg of AUR and 3 mg of NAR) or the placebo at a 1:1 ratio for 36 weeks. The primary endpoint is a change in the Repeatable Battery for the Assessment of Neuropsychological Status score from baseline to weeks 18 and 36. Other cognitive outcomes will include changes in verbal and nonverbal memory, attention, executive and visuospatial functions. Blood samples will be collected from a consecutive subsample of 60 participants. The secondary endpoint is a change in interleukin-8 levels over the 36-week period. Other biological outcomes include changes in markers of neuronal damage, oxidative stress, and pro- and anti-inflammatory cytokines. CONCLUSION: This study will evaluate whether an intervention with citrus peel extract standardized in levels of AUR and NAR has cognitive and biological effects in older adults with SCD, facilitating the establishment of nutrition intervention in people at risk of cognitive decline. TRIAL REGISTRATION: The trial is registered with the United States National Library of Medicine at the National Institutes of Health Registry of Clinical Trials under the code NCT04744922 on February 9th, 2021 ( https://www. CLINICALTRIALS: gov/ct2/show/NCT04744922 ).

Leaves of Yellow Gentian (Gentiana lutea) as an Alternative Source of Bitter Secoiridoid Glycosides.

In a search for methods of manufacturing bitter principles from Gentiana lutea, mainly represented by gentiopicroside (1) and amarogentin (2), as an alternative to extraction from the roots of this plant, in this short communication it is shown that the leaves of this plant can be regarded as an additional source of such phytochemicals. Extraction of G. lutea leaves was coupled to solid-phase adsorption by differently structured solids as a separation technology step, providing a selective isolation of both these secondary metabolites in good to excellent yields. Thus, the extraction of bitter secoiridoids can be achieved in an equivalent or improved way rather than processing the roots of G. lutea while preserving the biodiversity of the species.

A novel and efficient concentration of pomegranate juice with enhanced antioxidant activity.

In the present study we investigated the performance of a panel of 13 solid sorbents comprising layered double hydroxides, zirconium phosphate-based materials, and phyllosilicates as heterogeneous supports for the concentration of pomegranate (Punica granatum L.) juice. Mg-containing clays exhibited an almost complete bleaching capacityof pomegranate juice and more interestingly provided blends with an increased antioxidant capacity (around 1.5-fold) respect to the parent juice when assayed for the Trolox equivalent antioxidant capacity (TEAC) coupled to ABTS decolorization test. Such an activity remained practically unaltered after 4 days during which the pomegranate concentrated preparations remained supported on clays. The approach investigated herein and used for the concentration of pomegranate juice and the discovery of the preservation for long periods of the antioxidant activities of pomegranate extracts when supported on solid sorbents have been reported herein for the first time in the literature to the best of our knowledge.

A revised version of the Iwaoka's assay: Application of hyphenated techniques.

Assessing the effects of glutathione peroxidase (GPx)-like catalytic activities of natural, semi-synthetic, and synthetic compounds is nowadays well recognized of importance for the preliminary screening of potential anti-inflammatory, neuroprotective, and anti-cancer agents. To this aim the Iwaoka's assay, relying on 1H NMR data recording, has been the most exploited test. In this short communication we propose an efficient and easy to perform methodology to accomplish the same process based on the application of hyphenated techniques like gas-chromatography coupled to mass spectrometry (GC-MS) and high-performance liquid chromatography with diode array detection (HPLC-DAD). The assay consisted in monitoring and quantifying the oxidation at different times of 1,4-dithiothreitol to 4,5-dihydroxy-1,2-dithiane in the presence of H2O2 and 2-phenyl-1,2-benzoselenazol-3(2H)-one (Ebselen) as the catalyst in EtOAc or MeOH as the solvents. The results we recorded by the application of both GC-MS and HPLC-DAD, showed that the GPx-like activity of Ebselen, used as the reference compound, can be effectively monitored in a time-course manner, and compare favorably to the NMR-based test.

An easy way for the hydrolysis, pre-concentration, and chemical stabilization of crocetin from saffron powder.

To date there are no methods in the literature leading to crocetin selective concentration from saffron powder aqueous solutions. To this aim, we decided to test the performance of its heterogeneous extraction by means of a panel of 21 synthetic clays, 4 of which demonstrated to selectively retain crocetin in the solid phase after hydrolysis of its digentiobyosil ester (crocin) (and its isomers) and to its chemical stabilization (e.g., oxidation) over time. The best adsorption yield was obtained with zinc hydroxy chloride (66.18 ± 0.06 µg/g dry powder). This phenomenon was assessed by HPLC-DAD analyses after desorption of crocetin from the respective support and assessing its degradation along a period of 30 days. The method we established could represent a good mean to provide pure crocetin from saffron powder, preserving in the meantime its chemical properties for a concrete future exploitation for food pharmaceutical, and cosmetic purposes.

Oxyprenylated Secondary Metabolites as Modulators of Lipid and Sugar Metabolism.

O-Prenylcoumarins (3,3-dimethylallyl, geranyl-, farnesyl- and related biosynthetic derivatives) represent a class of rarely occurring natural compounds. Most of these secondary metabolites have been obtained from plant species belonging to the Rutaceae, Apiaceae, and Fabaceae families, and from fungi, and bacteria. In the last two decades, prenyloxycoumarins have been found to possess great potential in terms of pharmacological activities. The aim of this comprehensive review is to make a survey of the so far reported literature citations about these valuable phytochemicals and structurally related compounds about their modulatory properties of lipid and sugar metabolism. Literature data have been acquired from the main Internet database. Several oxyprenylated secondary metabolites have been surveyed. Among these, prenyloxycoumarins represented the main group displaying valuable effects as modulators of lipid and sugar metabolism. The title phytochemicals have been found in common fruits and vegetables already known to have beneficial effects, thus enforcing the nutraceutical role of these food plants. All compounds outlined in the present review article have a great potential in future for the prevention and management of acute and chronic metabolic disorders.

A Novel Auraptene-Enriched Citrus Peels-Based Blend with Enhanced Antioxidant Activity.

The aim of this study was to establish a convenient process to get auraptene-enriched blends from Citrus limon L. Osbeck (Rutaceae) peels powder with functional food and nutraceutical potential and antioxidant properties. The process consisted in the selective adsorption of auraptene by bentonite followed by desorption and evaporation of solvents to get the final product. HPLC analyses revealed an adsorption > 99% from lemon fruit peel powder and a 13.7-fold enrichment of the obtained composition respect to the parent food-derived sample. The antioxidant and radical scavenger activities of the Citrus peels based preparation were assayed by the DPPH and ABTS tests and reveal deffects higher than ascorbic acid and Trolox® used as the references. To the best of our knowledge, the findings described herein is the first example reported in the literature of solid phase adsorption experiments carried out on auraptene as a component of edible fruits.

An improved method for the isolation of amarogentin, the bitter principle of yellow gentian roots.

Amarogentin is well known to be among the most bitter naturally occurring compound. Either as an individual one or extracts, amarogentin is used as a food additive and as a dietary supplement. The aim of the present investigation is to set-up a convenient process to selectively isolate amarogentin from the ethanolic roots extract of Gentiana lutea. The process consisted in the treatment of an aqueous suspension of such an extract with a panel of 21 solid inorganic / organic sorbents followed by filtration, desorption, and high performance liquid chromatography (HPLC) analyses. Among the solid materials tested, those containing Mg+2 in the frame of a lamellar structure provided very good adsorption yields in the range 86.4% - 99.9% (p < 0.05 at Student's t-test). The method we set up could be in principle useful to obtain a pure nature-derived food additive to provide bitter taste to foods and beverages.

7-Isopentenyloxycoumarin: What Is New across the Last Decade.

7-Isopentenyloxycoumarin is among the most widespread naturally occurring prenyloxy umbelliferone derivatives. This secondary metabolite of mixed biosynthetic origin has been typically isolated from plants belonging to several genera of the Rutaceae and Apiaceae families, comprising widely used medicinal plants and in general plants with beneficial effects on human welfare, as well as edible fruits and vegetables. Although known for quite a long time (more than 50 years), only in the last two decades has this natural compound been revealed to exert powerful and promising pharmacological properties, such as active cancer chemopreventive, antibacterial, antiprotozoal, antifungal, anti-inflammatory, neuroprotective, and antioxidant properties, among the activities best outlined in the recent literature. The aim of this comprehensive miniature review article is to detail the novel natural sources and the effects described during the last decade for 7-isopentenyloxycoumarin and what has been reported on the mechanisms of action underlying the observed biological activities of this oxyprenylated secondary metabolite. In view of the herein described data, suggestions on how to address future research on the abovementioned natural product and structurally related derivatives in the best ways according to the authors will be also provided.

Solid phase adsorption of anthraquinones from plant extracts by lamellar solids.

Solid phase extraction is nowadays a well validated and powerful technique applicable to complex matrices like plant extracts and phytocomplexes. This process provides concentration and/or purification of selected secondary metabolites from these matrices for subsequent analysis and isolation. In this research article sixteen lamellar solids, comprising layered structures (hydrotalcites, zirconium phosphates, magnesium hydroxide), magnesium oxide, and the phyllosilicates talc and bentonite were investigated for their capacity and performance to selectively adsorb five naturally occurring and widespread anthraquinones (aloe, aloe-emodin, rhein, chrysophanol, and physcion) contained in three ethanolic extracts of well known plants with purgative effects (frangula, senna, and rhubarb). Ethanolic solutions of extracts from these species were vigorously magnetically stirred with fixed quantities of each solid support at room temperature for 1 h. Subsequent HPLC analysis, coupled to photodiode array detection, revealed that, among the solids tested, the hydrotalcite zinc aluminum oleate and magnesium aluminum azelate and magnesium oxide were largely the most effective to this concern allowing to recover anthraquinones (all or some) in good to excellent percentages. Another interesting result was the selective and total removal of rhein by some sorbents from senna and rhubarb extracts. Sorbents were also recyclable and could be re-used to accomplish additional steps without appreciable loss of adsorption capacity. The application of the title solid inorganic and mixed inorganic/organic supports for the selective adsorption and concentration in the solid phase of anthraquinones from commonly used laxative plant species is reported herein for the first time.

Solid phase adsorption of emodin on hydrotalcites and inorganic oxides: A preliminary study.

Solid phase extraction applied to plant matrices is nowadays a well validated technique allowing the concentration and purification of selected secondary metabolites for subsequent analysis. In this short communication we screened the efficiency of 16 selected solid supports including layered structures (hydrotalcites and zirconium phosphate), magnesium oxide and hydroxide, and finally the phyllosilicates talc and bentonite for the selective concentration of the anthraquinone emodin from raw solid extracts of Polygonum cuspidatum Siebold & Zucc. (sin. Reynoutria japonica Houtt.) (Polygonaceae), commonly known as "Japanese knotweed". An ethanolic solution of sample extract from this plant was vigorously mixed with fixed quantities of each solid support. Subsequent HPLC analysis, coupled to photodiode array detection, revealed that, among the solid supports assayed, the hydrotalcite zinc aluminum oleate and magnesium oxide were largely the most effective to this concern. Both were able to extract emodin from the raw extract in percentages of 81.5 % and 92.4 %, respectively. The application of the title supports for the extraction and concentration in the solid phase of anthraquinones from raw plant extracts have been reported herein for the first time.

Umbelliprenin as a novel component of the phytochemical pool from Artemisia spp.

Plants belonging to Artemisia spp. are known to biosynthesize a wide panel of 3,3-dimethylallyl- and sesquiterpenyl- substituted coumarins. In this short communication we applied a novel extraction methodology based on the use of subcritical butane under a counter-current mode to further characterize the presence of selected biologically active oxyprenylated phenylpropanoids, namely coumarins and ferulic acid derivatives, in extracts deriving from aerial parts of Artemisia vulgaris L. (commonly known as "common mugwort") (Asteraceae). In the mean time, we assessed the efficiency of the above mentioned extractive methodology with other routes like maceration and ultrasounds and microwaves-based methods using absolute EtOH as the solvents. UHPLC analysis coupled to UV/Vis detection revealed that, among the 5 pure chemical standard assayed, only umbelliprenin (7-farnesyloxycoumarin) was recorded, while boropinic acid, 4'-geranyloxyferulic acid, 7-isopentenyloxycoumarin, and auraptene were not detected. The best extractive yield (0.18 %) was obtained after extaction with subcritical butane. The presence of umbelliprenin in Artemisia plant species has been reported herein for the first time. This coumarin may represent the biosynthetic precursors of sesquiterpenyloxycoumarins with more complex structures typically found in this genus.