Intergenic risk variant rs56258221 skews the fate of naive CD4+ T cells via miR4464-BACH2 interplay in primary sclerosing cholangitis.

Primary sclerosing cholangitis (PSC) is an immune-mediated liver disease of unknown pathogenesis, with a high risk to develop cirrhosis and malignancies. Functional dysregulation of T cells and association with genetic polymorphisms in T cell-related genes were previously reported for PSC. Here, we genotyped a representative PSC cohort for several disease-associated risk loci and identified rs56258221 (BACH2/MIR4464) to correlate with not only the peripheral blood T cell immunophenotype but also the functional capacities of naive CD4+ T (CD4+ TN) cells in people with PSC. Mechanistically, rs56258221 leads to an increased expression of miR4464, in turn causing attenuated translation of BACH2, a major gatekeeper of T cell quiescence. Thereby, the fate of CD4+ TN is skewed toward polarization into pro-inflammatory subsets. Clinically, people with PSC carrying rs56258221 show signs of accelerated disease progression. The data presented here highlight the importance of assigning functional outcomes to disease-associated genetic polymorphisms as potential drivers of diseases.

Adjuvant Therapy for Elderly Breast Cancer Patients after Breast-Conserving Surgery: Outcomes in Real World Practice.

We aimed to evaluate the standard of care of adjuvant radiotherapy (RT) after breast-conserving surgery (BCS) in elderly female patients (≥65 years) treated outside of clinical trials and to identify potential factors related to the omission of RT and the interaction with endocrine therapy (ET). All women treated with BCS at two major breast centers between 1998 and 2014 were evaluated. Data were provided by the Tumor Registry Munich. Survival analyses were conducted using the Kaplan-Meier method. Prognostic factors were identified using multivariate Cox regression analysis. The median follow-up was 88.4 months. Adjuvant RT was performed in 82% (2599/3171) of patients. Irradiated patients were younger (70.9 vs. 76.5 years, p < 0.001) and were more likely to receive additional chemotherapy (p < 0.001) and ET (p = 0.014). Non-irradiated patients more often had non-invasive DCIS tumors (pTis: 20.3% vs. 6.8%, p < 0.001) and did not undergo axillary surgery (no axillary surgery: 50.5% vs. 9.5%, p < 0.001). Adjuvant RT was associated with improved locoregional tumor control after BCS in invasive tumors (10-year local recurrence-free survival (LRFS): 94.0% vs. 75.1%, p < 0.001, 10-year lymph node recurrence-free survival (LNRFS): 98.1% vs. 93.1%, p < 0.001). Multivariate analysis confirmed significant benefits for local control with postoperative RT. Furthermore, RT led to increased locoregional control even in patients who received ET (10-year LRFS 94.8% with ET + RT vs. 78.1% with ET alone, p < 0.001 and 10-year LNRFS: 98.2% vs. 95.0%, p = 0.003). Similarly, RT alone had significantly better locoregional control rates compared to ET alone (10-year LRFS 92.6% with RT alone vs. 78.1% with ET alone, p < 0.001 and 10-year LNRFS: 98.0% vs. 95.0%, p = 0.014). The present work confirms the efficacy of postoperative RT for breast carcinoma in elderly patients (≥65 years) treated in a modern clinical setting outside of clinical trials, even in patients who receive ET.

The Bioactive Phenolic Agents Diaryl Ether CVB2-61 and Diarylheptanoid CVB4-57 as Connexin Hemichannel Blockers.

Inflammation mediators enhance the activity of connexin (Cx) hemichannels, especially in the epithelial and endothelial tissues. As potential release routes for injury signals, such as (oligo)nucleotides, Cx hemichannels may contribute to long-lasting inflammation. Specific inhibition of Cx hemichannels may therefore be a mode of prevention and treatment of long-lasting, chronic sterile inflammation. The activity of Cx hemichannels was analysed in N2A and HeLa cells transfected with human Cx26 and Cx46 as well as in Calu-3 cells, using dye uptake as functional assay. Moreover, the possible impacts of the bioactive phenolic agents CVB2-61 and CVB4-57 on the barrier function of epithelial cells was analysed using Calu-3 cells. Both agents inhibited the dye uptake in N2A cells expressing Cx26 (>5 µM) and Cx46 (>20 µM). In Calu-3 cells, CVB2-61 and CVB4-57 reversibly inhibited the dye uptake at concentrations as low as 5 µM, without affecting the gap junction communication and barrier function, even at concentrations of 20 µM. While CVB2-61 or CVB4-57 maintained a reduced dye uptake in Calu-3 cells, an enhancement of the dye uptake in response to the stimulation of adenosine signalling was still observed after removal of the agents. The report shows that CVB2-61 and CVB4-57 reversibly block Cx hemichannels. Deciphering the mechanisms of the interactions of these agents with Cx hemichannels could allow further development of phenolic compounds to target Cx hemichannels for better and safer treatment of pathologies that involve Cx hemichannels.

Large Animal Model of Osteoporotic Defect Healing: An Alternative to Metaphyseal Defect Model.

Osteoporosis is a common metabolic disorder diagnosed by lower bone density and higher risk of fracture. Fragility fractures because of osteoporosis are associated with high mortality rate. Deep understanding of fracture healing in osteoporosis is important for successful treatment. Therefore, the FDA approved the use of small and large animal models for preclinical testing. This study investigated the clinical relevance of a fracture defect model in the iliac crest of the osteoporotic sheep model and its several advantages over other models. The osteoporosis was achieved using ovariectomy (OVX) in combination with diet deficiency (OVXD) and steroid administration (OVXDS). Fluorochrome was injected to examine the rate of bone remodelling and bone mineralization. The defect areas were collected and embedded in paraffin and polymethyl metha acrylate (PMMA) for histological staining. OVXDS showed significantly lower bone mineral density (BMD) and bone mineral content (BMC) at all time points. Furthermore, variations in healing patterns were noticed, while the control, OVX and OVXD showed complete healing after 8 months. Bone quality was affected mostly in the OVXDS group showing irregular trabecular network, lower cortical bone thickness and higher cartilaginous tissue at 8 months. The mineral deposition rate showed a declining pattern in the control, OVX, and OVXD from 5 months to 8 months. One the contrary, the OVXDS group showed an incremental pattern from 5 months to 8 months. The defect zone in osteoporotic animals showed impaired healing and the control showed complete healing after 8 months. This unique established model serves as a dual-purpose model and has several advantages: no intraoperative and postoperative complications, no need for fixation methods for biomaterial testing, and reduction in animal numbers, which comply with 3R principles by using the same animal at two different time points.

Impact of surface-guided positioning on the use of portal imaging and initial set-up duration in breast cancer patients.

OBJECTIVE: The impact of optical surface guidance on the use of portal imaging and the initial set-up duration in patients receiving postoperative radiotherapy of the breast or chest wall was investigated. MATERIAL AND METHODS: A retrospective analysis was performed including breast cancer patients who received postoperative radiotherapy between January 2016 and December 2016. One group of patients received treatment before the optical surface scanner was installed (no-OSS) and the other group was positioned using the additional information derived by the optical surface scanner (OSS). The duration of the initial set-up was recorded for each patient and a comparison of both groups was performed. Accordingly, the differences between planned and actually acquired portal images during the course of radiotherapy were compared between both groups. RESULTS: A total of 180 breast cancer patients were included (90 no-OSS, 90 OSS) in this analysis. Of these, 30 patients with left-sided breast cancer received radiotherapy in deep inspiration breath hold (DIBH). The mean set-up time was 10 min and 18 s and no significant difference between the two groups of patients was found (p = 0.931). The mean set-up time in patients treated without DIBH was 9 min and 45 s compared to 13 min with DIBH (p < 0.001), as portal imaging was performed in DIBH. No significant difference was found in the number of acquired to the planned number of portal images during the entire radiotherapy treatment for both groups (p = 0.287). CONCLUSION: Optical surface imaging is a valuable addition for primary patient set-up. The findings confirm that the addition of surface-based imaging did not prolong the clinical workflow and had no significant impact on the number of portal verification images carried out during the course of radiotherapy.

Preparation of a silanone through oxygen atom transfer to a stable cyclic silylene.

We report the evaporation of a stable cyclic silylene and its oxidation (with ozone or N2 O) through oxygen atom transfer to form the corresponding silanone under matrix isolation conditions. As uncomplexed silanones are rare owing to their very high reactivity, this method provides an alternative route to these sought-after molecules. The silanone, as well as a novel bicyclic silane with a bridgehead silicon atom derived from an intramolecular silylene CH bond insertion, were characterized by comparison of high-resolution infrared spectra with density functional theory (DFT) computations at the M06-2X/cc-pVDZ level of theory.

Dihydrogen activation by a silylium silylene frustrated Lewis pair and the unexpected isomerization reaction of a protonated silylene.

The isolable silylene 1 forms a frustrated Lewis pair with silylium ion 2 that is able to split hydrogen under ambient conditions. The protonated silylene 3 obtained in this reaction isomerizes to yield the hydrogen-bridged disilyl cation 4. Cation 4 is fully characterized by NMR spectroscopy and by XRD analysis. Its formation via the protonated silylene 3 is indicated by independent synthesis of cation 3 by hydride abstraction from the corresponding dihydridosilane 11 and is further supported by the results of density functional calculations.

A new synthesis of triarylsilylium ions and their application in dihydrogen activation.

Well-shuffled: An unexpected substituent distribution reaction via alkyldiarylsilylium ions leads to a distribution of substituents. Starting from alkyldiaryl silanes, this reaction provides a facile synthetic approach to sterically highly hindered triarylsilylium ions. These silylium ions can be applied in dihydrogen activation reactions.

Stannylium ions, a tin(II) arene complex, and a tin dication stabilized by weakly coordinating anions.

The reactivity of aryl-substituted stannylenes, Ar(2)Sn (4), towards silylarenium borates, [R(3)SiArH][B(C(6)F(5))(4)] (3), was investigated. The reaction with 2,3,4-trimethyl-6-tert-butylphenyl (mebp)-substituted stannylene gave silyl-substituted stannylium ions 2a,b, which were characterized by NMR spectroscopy supported by the results of quantum-mechanical computations of molecular structures and magnetic properties. The tri-iso-propylphenyl-substituted stannylium ions 2c,d undergo a decomposition reaction in toluene to give the dicationic tin-arene complex [Sn(C(7)H(8))(3)](2+) (5) in the form of the [B(C(6)F(5))(4)] salt in high yields. The 5[B(C(6)F(5))(4)](2) salt was identified by single crystal X-ray diffraction analysis and by Mössbauer spectroscopy. The bonding situation was investigated by using natural bond orbital (NBO) and quantum theory of atoms in molecules (QTAIM) calculations. The substitution of the weakly coordinating borate anion by the carboranate [CB(11)H(6)Br(6)](-) results in replacement of the toluene ligands and formation of tin(II) carboranate with only weak Sn(2+)-anion interactions as suggested by the solid-state structure of the isolated salt.

Persistent dialkyl(silyl)stannylium ions.

The synthesis of dialkyl(silyl)stannylium borates 2[B(C(6)F(5))(4)] by reaction of a stable ß-silyl-substituted stannylene 3 with silylarenium borates 4[B(C(6)F(5))(4)] is reported. The stannylium borates 2[B(C(6)F(5))(4)] are characterized by NMR spectroscopy and single-crystal X-ray diffraction, supported by the results of quantum mechanical calculations. The accumulated experimental and theoretical data indicate that the stannylium ions 2 are not stabilized by ß-silyl hyperconjugation and that intramolecular C-H/Sn(+) interactions are not important.

Silaimidazolium and silaimidazolidinium ions.

2-Silaimidazolium ions and 2-silaimidazolidinium ions were synthesized by Lewis acid-base adduct formation between N-heterocyclic silylenes and silyl arenium ions. They were isolated in high yields as their [B(C(6)F(5))(4)](-) salts. These salts are stable at room temperature and were characterized by NMR spectroscopy supported by the results of density functional computations of molecular structures and NMR chemical shifts. NICS calculations suggest for the imidazolium ions only a modest degree of aromaticity. Despite the bulkiness of the used substituents R(1) and R(2), silylium ions and behave as classical Lewis pairs and show no unexpected reactivity.

Electrochemical properties of a disilene, a tetrasila-1,3-butadiene, and their germanium analogues.

The redox properties of aryl-substituted disilene (1), tetrasila-1,3-butadiene (2), digermene (3), and tetragerma-1,3-butadiene (4) (in which the aryl group is 2,4,6-triisopropylphenyl) have been studied by cyclic voltammetry (CV) in two different solvents. In o-dichlorobenzene, disilene 1 exhibited reversible redox couples in both oxidation and reduction processes, whereas tetrasilabutadiene 2 showed a reversible behavior only in its oxidation and an irreversible wave in its reduction. Tetragermabutadiene 4 afforded a reversible couple in its reduction and an irreversible wave in its oxidation, whereas digermene 3 showed only an irreversible oxidation wave but no reduction one. In comparison, all observed oxidation and reduction waves in THF were irreversible. In both solvents, the same trend of decreasing ease of oxidation has been observed: 2>4>3>1. The calculated vertical ionization energies (E(i)) for the 2,6-dimethylphenyl-substituted model compounds 9-12 afforded a trend of ease of oxidation that decreases in the series tetrasilabutadiene 10>tetragermabutadiene 12>disilene 9>digermene 11. This predicted trend parallels the measured oxidation potentials in the sense that the heavy butadienes are easier to oxidize than the heavy alkenes. The trend in the reduction direction has been found to be different in the two solvents studied. The computed electron affinities (E(ea)) for compounds 9-12 indicated that the ease of reduction decreased in the sequence tetragermabutadiene 12>tetrasilabutadiene 10>digermene 11>disilene 9. However, no straightforward relation between the computed electron affinities and the experimentally measured reduction potentials has been found.

A germanium(II) cation with [1+1] coordination.

Breaking the molecular symmetry by protonation of germylene 1 is the key step in the synthesis of the germyliumylidene 2, which is stabilized by an intramolecular interaction with a distant imido group.