Successful switch to cisplatin-based chemotherapy in a patient with lung cancer who developed a carboplatin-induced hypersensitivity reaction.

INTRODUCTION: Platinum-based chemotherapy is the mainstay of first-line therapy for advanced-stage non-small cell lung cancer (NSCLC). Although carboplatin-induced hypersensitivity reactions (HSRs) commonly occur following multiple cycles of therapy, they are rarely observed during the first cycle of the treatment. CASE REPORT: Here, we report the case of a 70-year-old man with advanced-stage NSCLC who developed HSR possibly caused by carboplatin during the first cycle of induction with platinum-doublet chemotherapy plus pembrolizumab. The patient presented with bronchial obstruction due to a centrally located tumor. No driver mutations were detected, and the programmed death-ligand 1 expression ranged from 1% to 24%. Consequently, the patient was treated with pembrolizumab combined with carboplatin and paclitaxel. However, immediately after the start of carboplatin, the blood pressure and oxygen levels of the patient dropped and he began exhibiting an altered level of consciousness. These findings indicated carboplatin-induced anaphylaxis. Hypotension and oxygen desaturation improved following carboplatin discontinuation and normal saline administration. MANAGEMENT AND OUTCOME: The basophil activation test for both carboplatin and cisplatin was negative. Thus, the risk of anaphylaxis owing to both drugs was ruled out, and carboplatin was believed to have induced grade 3 HSR. Subsequently, carboplatin-based chemotherapy was switched to cisplatin-based chemotherapy. HSR was not observed during the four treatment cycles with pembrolizumab, cisplatin, and pemetrexed, and best response was partial response. DISCUSSION: Cisplatin-based chemotherapy could be used as an alternate treatment in patients with NSCLC who develop severe carboplatin-induced HSR.

Risk factors indicating immune-related adverse events with combination chemotherapy with immune checkpoint inhibitors and platinum agents in patients with non-small cell lung cancer: a multicenter retrospective study.

PURPOSE: Immune checkpoint inhibitors (ICI) ushered in a new era for the treatment of non-small cell lung cancer (NSCLC). However, they carry the risk of immune-related adverse events (irAEs). Recently, various studies have been conducted on the predictive factors for irAEs, but there are no reports focusing only on ICI plus platinum agents. The present study aimed to identify the risk factors for irAEs due to ICI combined with platinum-based induction immunochemotherapy in NSCLC patients, focusing only on the period of combined therapy and excluding the period of ICI maintenance therapy. METHODS: This retrospective study included 315 NSCLC patients who started ICI combined with platinum-based chemotherapy treatment at 14 hospitals between December 2018 and March 2021. A logistic regression analysis was used to explore the predictive factors. RESULTS: Fifty patients (15.9%) experienced irAEs. A multivariate analysis revealed that squamous cell carcinoma (P = 0.021; odds ratio [OR]: 2.30; 95% confidence interval [Cl]: 1.14-4.65), anti-programmed death 1 antibody (anti-PD-1) plus anti-cytotoxic T-lymphocyte antigen-4 antibody (anti-CTLA-4) regimens (P < 0.01; OR: 22.10; 95% Cl: 5.60-87.20), and neutrophil-to-lymphocyte rate (NLR) < 3 (P < 0.01; OR: 2.91; 95% Cl: 1.35-6.27) were independent predictive factors for irAEs occurrence. CONCLUSION: Squamous cell carcinoma, anti-PD-1 plus anti-CTLA-4 regimens, and NLR < 3 may be predictive factors for the occurrence of irAEs due to induction immunochemotherapy in patients with NSCLC. By focusing on the potential risk of irAEs in patients with these factors, irAEs can be appropriately managed from an early stage.

Effects of refractive errors on visual evoked magnetic fields.

BACKGROUND: The latency and amplitude of visual evoked cortical responses are known to be affected by refractive states, suggesting that they may be used as an objective index of refractive errors. In order to establish an easy and reliable method for this purpose, we herein examined the effects of refractive errors on visual evoked magnetic fields (VEFs). METHODS: Binocular VEFs following the presentation of a simple grating of 0.16 cd/m(2) in the lower visual field were recorded in 12 healthy volunteers and compared among four refractive states: 0D, +1D, +2D, and +4D, by using plus lenses. RESULTS: The low-luminance visual stimulus evoked a main MEG response at approximately 120 ms (M100) that reversed its polarity between the upper and lower visual field stimulations and originated from the occipital midline area. When refractive errors were induced by plus lenses, the latency of M100 increased, while its amplitude decreased with an increase in power of the lens. Differences from the control condition (+0D) were significant for all three lenses examined. The results of dipole analyses showed that evoked fields for the control (+0D) condition were explainable by one dipole in the primary visual cortex (V1), while other sources, presumably in V3 or V6, slightly contributed to shape M100 for the +2D or +4D condition. CONCLUSIONS: The present results showed that the latency and amplitude of M100 are both useful indicators for assessing refractive states. The contribution of neural sources other than V1 to M100 was modest under the 0D and +1D conditions. By considering the nature of the activity of M100 including its high sensitivity to a spatial frequency and lower visual field dominance, a simple low-luminance grating stimulus at an optimal spatial frequency in the lower visual field appears appropriate for obtaining data on high S/N ratios and reducing the load on subjects.

The Japanese Criminal Thinking Inventory: Development, Reliability, and Initial Validation of a New Scale for Assessing Criminal Thinking in a Japanese Offender Population.

Using a sample of 116 Japanese men who had been placed under parole/probationary supervision or released from prison, the present study examined standardization, reliability, and validation of the Japanese Criminal Thinking Inventory (JCTI) that was based on the short form of the Psychological Inventory of Criminal Thinking Styles (PICTS), a self-rating instrument designed to evaluate cognitive patterns specific to criminal conduct. An exploratory factor analysis revealed that four dimensions adequately captured the structure of the JCTI, and the resultant 17-item JCTI demonstrated high internal consistency. Compared with the Japanese version of the Buss-Perry Aggression Questionnaire (BAQ), the JCTI showed a favorable pattern of criterion-related validity. Prior criminal environment and drug abuse as the most recent offense also significantly correlated with the JCTI total score. Overall, the JCTI possesses an important implication for offender rehabilitation as it identifies relevant cognitive targets and assesses offender progress.

Effects of spatial frequency on visual evoked magnetic fields.

Psychophysical and visual evoked potential (VEP) studies have shown that spatial frequency of a visual stimulus affects contrast sensitivity and VEPs in humans. However, it is not clear whether and how the effect of spatial frequency varies among cortical areas. Considering that all visual inputs to the retina could be expressed as a sum of sinusoidal gratings of different spatial frequencies, the effect of spatial frequency must be clarified to separate the brain activity specific to each visual stimulus. In order to examine the effect of spatial frequency on different cortical areas, the present study compared cortical responses to sinusoidal gratings of seven different spatial frequencies using magnetoencephalography (MEG). MEG waveforms of twelve healthy adults in response to sinusoidal gratings of 0.3-18.1 cycles per degree were subjected to a multi-dipole analysis. As a result, the effect of spatial frequency was significant on the first peak latency and amplitude of the source activity around V1 and V2 but not on the source activity around V3 and V6, indicating that the effect of spatial frequency varies across different visual areas in the human brain. Our results also suggest that the responses in V1 and V2 that have a peak around 90 ms and that of V6 peaking around 120 ms should be separated to investigate the stimulus-specific cortical response, particularly when examining effects of spatial frequency on the response latency.

Jacalin regulates IgA production by peripheral blood mononuclear cells.

AIMS: In IgA nephropathy, circulating immune complexes containing IgA1 are deposited on the glomerular mesangium, causing mesangial cell proliferation and acceleration of extracellular matrix production. The suppressive effect of jacalin, a galactose-binding lectin, on IgA production in vitro was determined. MATERIALS & METHODS: Normal human peripheral blood mononuclear cells were stimulated with plate-bound anti-CD3 and Th2 stimulation, with or without jacalin. Regulatory and effector cell subsets were determined by flow cytometry, and immunoglobulin production by ELISA. RESULTS: Jacalin increased the ratio of CD4(+)CD25(+)CD152(+) Tregs:effector T cells in peripheral blood mononuclear cell cultures 60-fold. This CD4(+)CD25(+)CD152(+) Treg increase may have inhibited Th2-stimulated IgA production by B cells. CONCLUSION: Immune tolerance induced by jacalin can suppress IgA production.

[A case of eosinophilic gastroenteritis with ring-like discoloration in the lower end of the esophagus].

We report the case of a 15-year-old Japanese boy with eosinophilic gastroenteritis. The patient complained of abdominal pain and watery diarrhea and had a history of allergic rhinitis. Laboratory data on admission showed leukocytosis with remarkable eosinophilia. Microscopic examination of the biopsied specimens taken from the esophagus, stomach, duodenum, lower ileum and colon showed eosinophilic infiltration. Especially in the lower esophagus, there was a ring-like discoloration with remarkable eosinophil infiltration. We diagnosed eosinophilic gastroenteritis and his clinical symptoms and eosinophilia improved following starting corticosteroid therapy. After 5 months therapy with prednisolone, discoloration of upper digestive tract disappeared. There have been no reports describing discoloration in the lower end of the esophagus seen by gastroscopy.

Improvements in seasonal allergic disease with Lactobacillus plantarum No. 14.

We conducted two randomized, placebo-controlled, double-blind studies of Lactobacillus plantarum No. 14 (LP14) in female students with seasonal allergic diseases. We also examined the mitogenic activity and cytokine inducibility of LP14 using Peyer's patch cells and mesenteric lymph node cells of swine. For subjects who took 8.7×10(8) of LP14, a significant improvement in ocular symptom-medication score was observed. In the placebo group, the T helper type 1 (Th1)/T helper type 2 (Th2) ratio tended to decrease after a 6-week intake period, while in the LP14 group, the percentage of Th1 cells significantly increased. Post-intake eosinophil counts significantly increased in comparison to those at intake cessation in the placebo group, but it appeared to be suppressed in the LP14 group. There were no changes in fecal microflora. LP14 strongly induced the gene expression of Th1-type cytokines. This study indicates the clinical effects of LP14 on seasonal allergic diseases.

Murine induced pluripotent stem cells can be derived from and differentiate into natural killer T cells.

NKT cells demonstrate antitumor activity when activated to produce Th1 cytokines by DCs loaded with alpha-galactosylceramide, the prototypic NKT cell-activating glycolipid antigen. However, most patients do not have sufficient numbers of NKT cells to induce an effective immune response in this context, indicating a need for a source of NKT cells that could be used to supplement the endogenous cell population. Induced pluripotent stem cells (iPSCs) hold tremendous potential for cell-replacement therapy, but whether it is possible to generate functionally competent NKT cells from iPSCs has not been rigorously assessed. In this study, we successfully derived iPSCs both from embryonic fibroblasts from mice harboring functional NKT cell-specific rearranged T cell receptor loci in the germline and from splenic NKT cells from WT adult mice. These iPSCs could be differentiated into NKT cells in vitro and secreted large amounts of the Th1 cytokine IFN-gamma. Importantly, iPSC-derived NKT cells recapitulated the known adjuvant effects of natural NKT cells and suppressed tumor growth in vivo. These studies demonstrate the feasibility of expanding functionally competent NKT cells via an iPSC phase, an approach that may be adapted for NKT cell-targeted therapy in humans.

Generation of functional NKT cells in vitro from embryonic stem cells bearing rearranged invariant Valpha14-Jalpha18 TCRalpha gene.

Establishment of a system with efficient generation of natural killer T (NKT) cells from embryonic stem (ES) cells would enable us to identify the cells with NKT-cell potential and obtain NKT cells with desired function. Here, using cloned ES (NKT-ES) cells generated by the transfer of nuclei from mature NKT cells, we have established a culture system that preferentially developed functional NKT cells and also identified early NKT progenitors, which first appeared on day 11 as a c-kit(+) population in the cocultures on OP9 cells with expression of Notch ligand, delta-like1 (OP9/Dll-1) and became c-kit(lo/-) on day 14. Interestingly, in the presence of Notch signals, NKT-ES cells differentiated only to thymic CD44(lo) CD24(hi) NKT cells producing mainly interleukin-4 (IL-4), whereas NKT cells resembling CD44(hi) CD24(lo) liver NKT cells producing mainly interferon gamma (IFN-gamma) and exhibiting strong adjuvant activity in vivo were developed in the switch culture starting at day 14 in the absence of Notch. The cloned ES culture system offers a new opportunity for the elucidation of the molecular events on NKT-cell development and for the establishment of NKT-cell therapy.

The gastrointestinal transit tolerance of Lactobacillus plantarum strain No. 14 depended on the carbon source.

This study aimed to assess variations in the human gastrointestinal transit tolerance of Lactobacillus plantarum strain No. 14 after culture with glucose and with fructose. Transit tolerance was determined at 37 degrees C against simulated gastric juices at pH values of 2.5, 3.0, and 3.5, and against simulated small intestinal juices containing 0%, 0.2%, or 0.4% oxgall. The simulated gastrointestinal transit tolerance of Lactobacillus plantarum strain No. 14 varied with the carbon source. Hence we compared the amounts of exopolysaccharide from Lactobacillus plantarum strain No. 14 cultured in various carbon sources. The exopolysaccharide levels were 146.5+/-8.1 mg/l (culture) with glucose, and 20.1+/-17.0 mg/l (culture) with fructose. When exopolysaccharide was removed by centrifugation, the simulated gastric tolerance of Lactobacillus plantarum strain No. 14 cultured with glucose decreased markedly, but that with fructose did not decrease. These results suggest that the gastrointestinal transit tolerance of Lactobacillus plantarum strain No. 14 is related to exopolysaccharide contents.

[Bacillus cereus bacteremia in Crohn's disease with multiple ileal stricture on maintenance azathioprine therapy].

We describe a case of 36-year-old Japanese man with Crohn's disease, complicated by Bacillus cereus bacteremia on maintenance azathioprine therapy. Although anti-microbial agents were ineffective, the patient became well immediately after a partial resection of the ileum with multiple severe stenosis.

[Case of gastric cancer with isolated brain metastasis successfully managed by gamma knife radiotherapy and chemotherapy].

We describe a 51-year-old man case of a huge gastric cancer with an initial presentation of isolated brain metastasis. The patient was successfully managed by gamma knife radiotherapy, followed by chemotherapy using 5-fluorouracil and cisplatin. He has continued oral administration of TS-1 on an outpatient basis with disease free survival for more than one year.

Differential role of thymic stromal lymphopoietin in the induction of airway hyperreactivity and Th2 immune response in antigen-induced asthma with respect to natural killer T cell function.

Asthma is an inflammatory lung disease, in which CD1d-restricted natural killer T (NKT) cells play an important pathogenic role. Also, recent reports indicated that a cytokine, thymic stromal lymphopoietin (TSLP), is essential for the development of antigen-induced asthma. Here we examined the relationship between NKT cells and TSLP in a mouse model of asthma. NKT cells express TSLP receptor as well as IL-7 receptor alpha-chain. TSLP acts on NKT cells to preferentially increase their IL-13 production but not IFN-gamma and IL-4. In an allergen-induced asthma model, the development of airway hyperreactivity, a cardinal feature of asthma, was increased in TSLP transgenic mice, whereas this effect was not observed in TSLP transgenic mice lacking NKT cells. Interestingly, in the NKT cell-lacking TSLP transgenic mice, pulmonary eosinophilia and increase in IgE did not improve. Pulmonary lymphocytes from the NKT cell-lacking TSLP transgenic mice produced much less IL-13 upon CD3 stimulation than those from NKT cell-competent TSLP transgenic mice. These resultssuggest that, in allergen-induced asthma, TSLP acts on NKT cells to enhance airway hyperreactivity by upregulating their IL-13 production, whereas eosinophilia and IgE production are not influenced.

IL-21-induced Bepsilon cell apoptosis mediated by natural killer T cells suppresses IgE responses.

Epidemiological studies have suggested that the recent increase in the incidence and severity of immunoglobulin (Ig)E-mediated allergic disorders is inversely correlated with Mycobacterium bovis bacillus Calmette Guerin (BCG) vaccination; however, the underlying mechanisms remain uncertain. Here, we demonstrate that natural killer T (NKT) cells in mice and humans play a crucial role in the BCG-induced suppression of IgE responses. BCG-activated murine Valpha14 NKT cells, but not conventional CD4 T cells, selectively express high levels of interleukin (IL)-21, which preferentially induces apoptosis in Bepsilon cells. Signaling from the IL-21 receptor increases the formation of a complex between Bcl-2 and the proapoptotic molecule Bcl-2-modifying factor, resulting in Bepsilon cell apoptosis. Similarly, BCG vaccination induces IL-21 expression by human peripheral blood mononuclear cells (PBMCs) in a partially NKT cell-dependent fashion. BCG-activated PBMCs significantly reduce IgE production by human B cells. These findings provide new insight into the therapeutic effect of BCG in allergic diseases.

Transcriptomic analysis indicates putative metabolic changes caused by manipulation of phosphorus availability in rice leaves.

Plants have developed several strategies for coping with phosphorus (P) deficiency. However, the details of the regulation of gene expression of adaptations to low P are still unclear. Using a cDNA microarray, transcriptomic analyses were carried out of the rice genes regulated by P deficiency and P re-supply to P-deficient plants. The OsPI1 gene, which was isolated as the most significant up-regulated gene under -P conditions, was also the most significant down-regulated gene following P re-supply. Many starch metabolism-related genes, as well as several genes for P(i)-liberating enzymes, were up-regulated by -P treatment, suggesting a homeostatic contribution to the P(i) concentration in leaf tissues. mRNAs for glucanases were also induced by P re-supply: these are suspected to play a role in loosening the cell wall compounds. Most of the genes up-regulated by -P treatment were down-regulated by P re-supply, suggesting that their responses were specific to -P conditions. Conversely, the number of genes up-regulated by P re-supply was also larger following P re-supply than in the -P condition. It is proposed that the genes up-regulated by P re-supply play an important role in P acquisition by P-deficient plants.

Seminal plasma inhibin-B level is a useful predictor of the success of conventional testicular sperm extraction in patients with non-obstructive azoospermia.

AIM: The value of serum inhibin-B as a predictor of the presence of testicular spermatozoa is still controversial. The purpose of this study is to evaluate the predictive value of the seminal plasma inhibin-B level, which might more directly reflect the secretion by Sertoli cells, and to discriminate between successful and failed testicular sperm extraction (TESE) in non-obstructive azoospermia. METHODS: Sixty-two patients with non-obstructive azoospermia were examined at the Department of Obstetrics and Gynecology at Niigata University Hospital, Niigata, Japan. The level of inhibin-B was measured using a two-site enzyme-linked immunoassay. RESULTS: Testicular sperm were successfully retrieved in 17 of 62 patients (27.4%). The serum levels of follicle-stimulating hormone (FSH) were significantly lower and the serum and seminal inhibin-B concentrations were significantly higher in the successful TESE group compared with the failed TESE group. According to the receiver operating characteristics (ROC) curve analysis, the best discriminating seminal plasma inhibin-B level was 27.0 pg/mL (sensitivity 88.2%, specificity 93.3%). The best discriminating serum inhibin-B level was 34.0 pg/mL (sensitivity 70.6%, specificity 95.6%). The area under the ROC curve for seminal plasma inhibin-B was significantly larger than that for FSH and testicular volume. Using multivariate logistic regression analysis, only seminal plasma inhibin-B was an independent predictor of the presence of spermatozoa on TESE. CONCLUSION: Seminal plasma inhibin-B level is a useful predictor of the presence of testicular sperm in men with non-obstructive azoospermia.

Transcriptional profiling of genes responsive to abscisic acid and gibberellin in rice: phenotyping and comparative analysis between rice and Arabidopsis.

We collected and completely sequenced 32,127 full-length complementary DNA clones from Oryza sativa L. ssp. japonica cv. "Nipponbare." Mapping of these clones to genomic DNA revealed approximately 20,500 transcriptional units (TUs) in the rice genome. For each TU, we selected 60-mers using an algorithm that took into account some DNA conditions such as base composition and sequence complexity. Using in situ synthesis technology, we constructed oligonucleotide arrays with these TUs on glass slides. We targeted RNAs prepared from normally grown rice callus and from callus treated with abscisic acid (ABA) or gibberellin (GA). We identified 200 ABA-responsive and 301 GA-responsive genes, many of which had never before been annotated as ABA or GA responsive in other expression analysis. Comparison of these genes revealed antagonistic regulation of almost all by both hormones; these had previously been annotated as being responsible for protein storage and defense against pathogens. Comparison of the cis-elements of genes responsive to one or antagonistic to both hormones revealed that the antagonistic genes had cis-elements related to ABA and GA responses. The genes responsive to only one hormone were rich in cis-elements that supported ABA and GA responses. In a search for the phenotypes of mutants in which a retrotransposon was inserted in these hormone-responsive genes, we identified phenotypes related to seed formation or plant height, including sterility, vivipary, and dwarfism. In comparison of cis-elements for hormone response genes between rice and Arabidopsis thaliana, we identified cis-elements for dehydration-stress response as Arabidopsis specific and for protein storage as rice specific.

Optimization of a fermentation medium using neural networks and genetic algorithms.

Artificial neural networks and genetic algorithms are used to model and optimize a fermentation medium for the production of the enzyme hydantoinase by Agrobacterium radiobacter. Experimental data reported in the literature were used to build two neural network models. The concentrations of four medium components served as inputs to the neural network models, and hydantoinase or cell concentration served as a single output of each model. Genetic algorithms were used to optimize the input space of the neural network models to find the optimum settings for maximum enzyme and cell production. Using this procedure, two artificial intelligence techniques have been effectively integrated to create a powerful tool for process modeling and optimization.

Genomics approach to abscisic acid- and gibberellin-responsive genes in rice.

We used an 8987-EST collection to construct a cDNA microarray system with various genomics information (full-length cDNA, expression profile, high accuracy genome sequence, phenotype, genetic map, and physical map) in rice. This array was used as a probe to hybridize target RNAs prepared from normally grown callus of rice and from callus treated for 6 hr or 3 days with the hormones abscisic acid (ABA) or gibberellin (GA). We identified 509 clones, including many clones that had never been annotated as ABA-or GA-responsive. These genes included not only ABA- or GA-responsive genes but also genes responsive to other physiological conditions such as pathogen infection, heat shock, and metal ion stress. Comparison of ABA- and GA-responsive genes revealed antagonistic regulation for these genes by both hormones except for one defense-related gene, thionin. The gene for thionin was up-regulated by both hormone treatments for 3 days. The upstream regions of all the genes that were regulated by both hormones had cis-elements for ABA and GA response. We performed a clustering analysis of genes regulated by both hormones and various expression profiles that showed three notable clusters (seed tissues, low temperature and sugar starvation, and thionin-gene related). A comparison of the cis-elements for hormone response genes between rice and Arabidopsis thaliana, we identified cis-elements for dehydration-stress response or for expression of amylase gene as Arabidopsis gene-specific or rice gene-specific, respectively.