Favorable outcome of a histiocytic sarcoma patient treated with immune checkpoint inhibitor: a case report.

Introduction and Importance: Histiocytic sarcoma (HS) is an extremely rare malignancy in which there has been no standard treatment approach. Some preclinical studies have provided rationales for the application of immunotherapy in advanced HS. Case Presentation: The authors reported a case of a 61-year-old patient with metastatic HS who had a rapid progression on ifosfamide, carboplatin, and etoposide chemotherapy. The authors performed PD-L1 testing, which showed a strong positivity in 90% of tumor cells. The patient was then treated with pembrolizumab 200 mg every 3 weeks. He refused palliative radiotherapy. A dramatic response in all sites was recorded on the PET-CT scan after three cycles. He was maintained on pembrolizumab, reaching over 30 months without disease progression. Clinical Discussion: Recent molecular data suggests there could be a role of immunotherapy in HS. In our patient, the disease was refractory to chemotherapy and pembrolizumab has been given based on the strong PD-L1 expression. Response to immunotherapy has also been recorded in several cases with malignant histiocytic neoplasm. Conclusion: Immunotherapy might bring sustained disease remission in PD-L1 high expression HS and further studies evaluating the role of immune checkpoint inhibitor in this disease are warranted.

Molecular genotypes of gag sequences in HIV-1 infected children treated with antiretroviral therapy in Vietnam.

BACKGROUND: Gag protein of human immunodeficiency virus (HIV) has been reported to play a crucial role in establishing infection, viral replication, and disease progression; thus, gag might be related to treatment response. The objective of this study was to investigate molecular genotypes of the gag gene, particularly the important functional binding domains in relation to treatment outcomes. METHODS: HIV-infected children enrolled and treated at Vietnam National Children's Hospital were recruited in the study. A total of 25 gag sequences were generated and used to construct phylogenetic trees and aligned with a reference sequence comparing 17 functional domains. RESULTS: We found that all patients in a treatment failure (TF) group belonged to one cluster of the phylogenetic tree. In addition, the rate of mutations was significantly higher in TF compared with a treatment success (TS) group, specifically the PIP2 recognition motif, and the nucleocapsid basic and zinc motif 2 domains [median and (interquartile range (IQR): 12.5 (6.25-12.5) versus 50 (25-50), p < 0.01; 0 (0-0) versus 0 (0-21.43), p = 0.03 and 0 (0-7.14) versus 7.14 (7.14-7.14), p = 0.04, respectively]. When analyzing gag sequences at different time points in seven patients, we did not observe a consistent mutation pattern related to treatment response. CONCLUSION: Gag mutations in certain domains might be associated with increased viral load; therefore, studying the molecular genotype of the gag gene might be beneficial in monitoring treatment response in HIV-infected children.

Characterization of envelope sequence of HIV virus in children infected with HIV in Vietnam.

BACKGROUND: HIV is characterized by high levels of genetic variability, including increased numbers of heterogeneous sequences of the envelope region. Therefore, studying genetic variability of HIV in relation to viral replication might facilitate prognosis of disease progression. METHODS: The study was designed as cross-sectional; data and samples of participants collected and analyzed env genes were obtained from 23 children enrolled by Vietnam National Children's Hospital. RESULTS: Substantial mutations in the C2 region were found in patients with high levels of viral replication while changes in the C3 region were mostly found in patients with low viral load. In the V1 region, we found profound amino acid modifications in patients with low HIV viral loads in contrast to the V2 sequence, where we identified single point mutations in patients with increased HIV viral load. The V3 region was relatively homogeneous, while profound deletions in the V4 region were detected in patients with increased viral replication. CONCLUSION: Our results suggest that genetic variations in different regions of the HIV envelope sequence, including both conserved C2 and C3 and variable V1/V2 and V4 regions, might be involved in increased viral infectivity and replication capacity. Such knowledge might help improve prediction of HIV progress and treatment in patients.

Developing a Sufficient Protocol for the Enhancement of α-Glucosidase Inhibitory Activity by Urena lobata L. Aeroponic Hairy Roots Using Exogenous Factors, a Precursor, and an Elicitor.

Aeroponics is considered as a potential method for the culture of herbal plants due to the high growth rate, quantity and quality enhancement of secondary metabolites, and substantial environmental progress associated with this method. The aim of this study was to develop a sufficient protocol for successful Urena lobata hairy root induction by Agrobacterium rhizogenes ATCC 15834, using a precursor and elicitor to enhance α-glucosidase inhibitory activity (GIA) of aeroponic hairy roots (AHRs) in greenhouse conditions. In this study, we found that the optimized procedure (10 min, Woody plant medium (WPM), 1/25 salt strength) had an outstanding effect with a reduction in the rooting time (RT), promotion of the rooting rate (RR), and increase in the fresh weight (FW) and dry weight (DW) compared with the original procedure (30 min, Murashige and Skoog (MS) medium, 1/25 salt strength) after 30 days of culture. The highest DW, GIA, flavonoid (FLA) and phenolic (PHEL) contents were observed for individual addition of 10 mM phenylalanine (PA) or 50 mM chitosan (CS) in the late exponential phase (eighth week) with 15 days of elicitation compared to the control AHRs. However, individual treatment was less effective than the combination of the two. Positive correlations among the GIA, FLA and PHEL indicate that AHRs accumulated phenolic compounds, leading to an increase in the GIA by a synergistic effect. In conclusion, the culture of Urena lobata AHRs with PA and CS is an efficient procedure to produce GIA material in greenhouse conditions.

Impact and significance of alkaline-oxidant pretreatment on the enzymatic digestibility of Sphenoclea zeylanica for bioethanol production.

Gooseweed (Sphenoclea zeylanica Gaertn.) is a pest on the rice field that has a potential to be a promising substrate for bioethanol production. Dry powdered gooseweed was firstly pretreated with 1% NaOH, following 1% H2O2 at variety conditions. The hydrolysis process was set at 50°C for 24-72h with enzyme cellulase (ß-glucosidase) while the fermentation process was carried using Saccharomyces cerevisiae TISTR 5020 at 33°C for nine days. The ethanol concentration was recorded for three, five, seven, and nine days using an ebulliometer. The results showed that the treatment with only 1% NaOH for 24h has the highest sugar performance. In regard with hydrolysis, the optimum retention time was at 24h. Lastly, the highest ethanol concentration was achieved at 11.84g/L after five days and a rapid decreasing after seven to nine days was also observed.