Bax Inhibitor-1与Herp的相互作用

应用酵母双杂交技术筛选Herp的相互作用蛋白。构建编码Herp的基因HERPUD1真核表达载体HERPUD1plexA,应用MATCHMAKERLexA酵母双杂交系统筛选人胎脑cDNA文库,获得的阳性克隆的插入子为Herp的候选相互作用蛋白质,将Herp与筛选到的相互作用蛋白再一对一回复进行酵母双杂交实验,去除假阳性。对阳性克隆插入子的DNA序列测序,在GenBank中作匹配及生物信息学分析。结果得到其中1个阳性克隆的插入子序列与TEGT基因序列一致,编码蛋白为Baxinhibitor1。得出结论:Herp与Baxinhibitor1相互作用,Baxinhibitor1具有调节凋亡特性,提示Herp可能参与凋亡调节。

棉花Bax inhibitor-1影响内质网胁迫介导的细胞死亡的研究

Bax inhibitor-1(BI-1)是调控内质网胁迫(endoplasmic reticulum stress,ER stress)介导的细胞死亡的关键因子,在植物耐逆中具有重要作用。目前,棉花BI-1(GhBI-1)的耐逆功能及其调控细胞死亡的相关报道较少。在本研究中,采用ER stress专一性诱导毒素——衣霉素(tunicamycin,TM)对棉花幼苗进行胁迫处理,实时定量PCR结果表明,GhBI-1的TM诱导表达具有组织特异性,根GhBI-1对TM的响应更加强烈。通过TM抗性试验及细胞死亡的分析发现,GhBI-1的表达提高了拟南芥的TM抗性,减缓了ER stress介导的细胞死亡。此外,未折叠蛋白反应信号通路中的bZip60转录因子基因的表达受GhBI-1的调控。

靶向人Bax inhibitor-1的siRNA表达质粒的构建及鉴定

目的:构建靶向人Bax inhibitor-1的siRNA表达质粒。方法:借助siRNA设计工具,确定Bax inhibitor-1编码序列中4个可能的干扰位点,人工合成4对正反义脱氧寡核苷酸链(B1、B2、B3、B4),定向克隆至真核表达质粒pmU6,得质粒pmU6-B1、pmU6-B2、pmU6-B3、pmU6-B4。将重组质粒转染DH5α,PCR法筛选阳性克隆,DNA测序法检测插入序列的正确性。结果与结论:PCR和DNA测序结果证实各重组质粒的插入序列完全正确。靶向人Bax inhibitor-1的siRNA表达质粒构建成功。

Imbalance of matrix metalloproteinase-9 and matrix metalloproteinase tissue inhibitor-1 may contribute to hemorrhage in cerebellar arteriovenous malformations

In this study, we determined the expression levels of matrix metalloproteinase-2 and -9 and matrix metalloproteinase tissue inhibitor-1 and -2 in brain tissues and blood plasma of patients undergoing surgery for cerebellar arteriovenous malformations or primary epilepsy （control group）. Immunohistochemistry and enzyme-linked immunosorbent assay revealed that the expression of matrix metalloproteinase-9 and matrix metalloproteinase tissue inhibitor-1 was significantly higher in patients with cerebellar arteriovenous malformations than in patients with primary epilepsy. The ratio of matrix metalloproteinase-9 to matrix metalloproteinase tissue inhibitor-1 was significantly higher in patients with hemorrhagic cerebellar arteriovenous malformations compared with those with non-hemorrhagic malformations. Matrix metalloproteinase-2 and matrix metalloproteinase tissue inhibitor-2 levels were not significantly changed. These findings indicate that an imbalance of matrix metalloproteinase-9 and matrix metalloproteinase tissue inhibitor-I, resulting in a relative overabundance of matrix metalloproteinase-9, might be the underlying mechanism of hemorrhage of cerebellar arteriovenous malformations.

转番茄Bax inhibitor-1基因烟草悬浮细胞系的建立

利用农杆菌侵染获得转番茄Bax inhibitor-1(LeBI-1)基因的抗性烟草植株,进行了PCR鉴定和共聚焦扫描显微镜检测;同时以MS为基本培养基研究植物生长调节剂的最佳配比和浓度对建立野生型和转基因烟草悬浮细胞素的影响。结果表明:PCR鉴定为阳性,并检测到绿色荧光蛋白,而且6-BA浓度在0.2 mg/L、NAA浓度为2.0 mg/L条件下,可建立野生型和转基因烟草稳定的悬浮细胞系。

Bax inhibitor-1基因研究进展

Bax inhibitor-1(简称BI-1)是1998年被克隆鉴定的新的凋亡抑制基因,其蛋白产物可以抑 制由 Bax 引起的凋亡。BI-1 最初以睾丸增强基因转录本而被克隆得到,位于12q12-q13,是一种高度保 守的单拷贝基因。BI-1 过表达与一些肿瘤发生及转移相关。

Association of plasminogen activator inhibitor-1 4G/5G promoter polymorphism with recurrent cerebral infarction in China’s North Jiangsu Province

BACKGROUND： Many international studies have shown that plasminogen activator inhibitor-1 （PAl-l） 4G/5G promoter polymorphism does not increase the risk for cerebral infarction. OBJECTIVE： Using PCR methodology and agarose electrophoresis to detect PAI-1 4G/5G promoter polymorphism in patients with recurrent cerebral infarction in the North Jiangsu Province of China, and to compare results with healthy subjects and patients with first-occurrence cerebral infarction in the same region. DESIGN, TIME AND SETTING： Non-randomized, concurrent, control trial. A total of 122 cerebral infarction patients were admitted to Xuzhou Medical College Hospital＇s Department of Neurology and Xuzhou Central Hospital＇s Department of Neurology between July 2003 and August 2006. PARTICIPANTS： The patients consisted of 63 males and 59 females, aged （62 ± 10） years. They were divided into first-occurrence （n = 58） and recurrence （n = 64） groups. In addition, 50 healthy subjects that underwent physical examination in the outpatient department, including 26 males and 24 females, aged （60 ±12） years, were selected as controls. METHODS AND MAIN OUTCOME MEASURES： PAl-1 4G/5G promoter polymorphism was detected and analyzed using PCR methodology and agarose electrophoresis. RESULTS： Significant differences were determined in terms of genotypic frequency and allele frequency of PAI-1 4G/5G promoter polymorphism, in patients with first-occurrence or recurrent cerebral infarction, when compared with healthy subjects （P 〈 0.05）. There was, however, no significant difference between the first-occurrence and recurrence groups （P 〉 0.05）. CONCLUSION： PAl- 1 4G/5G promoter polymorphism is genetic risk factor for cerebral infarction in China. However, it may be associated with recurrence of cerebral infarction in patients from the North Jiangsu Province of China.

Multikinase inhibitor-associated hand-foot skin reaction as a predictor of outcomes in patients with hepatocellular carcinoma treated with sorafenib

AIM To investigate the relationship between the onsets of multikinase inhibitor(MKI)-associated hand-foot skin reaction(HFSR) and prognosis under intervention by pharmacists after the introduction of sorafenib.METHODS We conducted a retrospective study involving 40 patients treated with sorafenib. Intervention by pharmacists began at the time of treatment introduction and continued until the appearance of symptomatic exacerbation or non-permissible adverse reactions. We examined the relationship between MKI-associated HFSR and overall survival(OS) after the initiation of treatment.RESULTS The median OS was 10.9 mo in the MKI-associated HFSR group and 3.4 mo in the no HFSR group, showing a significant difference in multivariate analysis. A multivariate analysis of the time to treatment failure indicated that the intervention by pharmacists and MKI-associated HFSR were significant factors. The median cumulative dose and the mean medication possession ratio were significantly higher in the intervention group than in the non-intervention group. A borderline significant difference was observed in terms of OS in this group.CONCLUSION Intervention by pharmacists increased drug adherence. Under increased adherence, MKI-associated HFSR was an advantageous surrogate marker. Intervention by healthcare providers needs to be performed for adequate sorafenib treatment.

Low levels of Bax inhibitor-1 gene expression increase tunicamycin-induced apoptosis in human neuroblastoma SY5Y cells

A human SH-SY5Y neuroblastoma cell line with a low level of Bax inhibitor-1 expression was established by lentivirus-mediated RNA interference and fluorescence-activated cell sorting. In control SH-SY5Y cells, tunicamycin treatment induced endoplasmic reticulum stress-mediated apoptosis; however, after Bax inhibitor-1 gene knockdown, cell survival rates were significantly decreased and the degree of apoptosis was significantly increased following tunicamycin treatment In addition, chromatin condensation and apparent apoptotic phenomena, such as marginalization and cytoplasmic vesicles, were observed. Our findings indicate that Bax inhibitor-1 can delay apoptosis induced by endoplasmic reticulum stress.

Construction of Tobacco Bax Inhibitor-1 ihpRNA Gene Silencing Vector and Transformation into Agrobacterium tumefaciens EHA105

The plasmid pGSA1285 was first modified by substituting its GUS sequence with the Chalcone synthase intron fragment from vector pFGC5941 to get the plant silencing expression vector that contained Kanamycin resistance site and was named as pGSA2285. Using PCR-based amplification, two different restriction sites at both ends of tobacco Bax inhibitor-1 （NtBI-I） gene were created, respectively, which made the construction of ihpRNA gene silencing vector more efficiently. Then, NtBI-1 genes were inserted into Multiple Cloning Site （MCS） of pGSA2285 respectively to form Bax inhibitor-1 ihpRNA gene silencing vector, named as pGSA4285, containing sense and anti-sense BI-1 sequence which was spliced by chalcone synthase intron. Combined PCR identification and enzyme restriction analyses, the results showed that Bax inhibitor-1 ihpRNA gene silencing vector had been constructed and transferred into Agrobacterium tumefaciens EHA105 successfully, which laid a foundation for the further study on the function of BI-1 in plant PCD regulation.

Study on Effect of Different Dosages of Ligustrazine on Level of Plasminogen Activator Inhibitor-1 Activity in Type 2 Diabetes Mellitus Patients

Objective: To observe the effect of different dosages of ligustrazine (LG) on the level of plasminogen activator inhibitor-1 (PAI-1) activity in patients with type 2 diabetes mellitus. Methods: Ninety cases of type 2 diabetes mellitus inpatients were selected, and randomly divided into LG small dosage group (SDG), LG large dosage group (LDG) and control group. The 120 mg LG, 400 mg LG and normal saline 250 ml were given through intravenous dripping respectively, once daily, 20 days as one treatment course. Before and after treatment, all the patients had their fasting blood taken for PAI-1 and tissue plasminogen activator (t-PA) assessment test to perform the comparative study. Results:Seventy-three out of the 90 patients completed the observation course, the PAI-1 activity of three groups after treatment all lowered compared with that before treatment, and the difference between groups was also significant (all P<0. 01). After treatment the PAI-1 level of SDG and LDG of LG were all markedly lowered (all P<0. 01), the LDG's lowering was more evident than that of SDG, and comparison between these two groups of patients showed significant difference (P<0. 01). Although in the control group there was some difference between before and after treatment, it was not so significant like the above-mentioned two groups (P = 0. 0140). No adverse reaction occurred in the 3 groups during the observation period. Conclusion:LG could safely and effectively lower type 2 diabetes mellitus patient's plasma PAI-1 activity level, and LDG of LG proved to be particularly effective.

Synthetic protease inhibitor-induced inclusions in PC12 cells Potential proteomic characterization of six subunits in the 26S proteasome

Proteasome dysfunction during dopaminergic degeneration induces proteolytic stress, and is a contributing factor for the onset and formation of Lewy bodies. Results from our previous studies showed that synthetic proteasome inhibitor-induced inclusions in PC12 cells contained six subunits in the 26S proteasome. In the present study, mass spectrometry analysis of single protein spots resolved by two-dimensional gel electrophoresis and identified by bioinformatic analysis of peptide mass fingerprint （PMF） data were performed to comprehensively characterize the proteomic profile of the proteasome subunits. Results showed that six subunits in the 26S proteasome were characterized through accurate assignment by PMF data-specific protein identification in protein databases. Additionally, identification of one of the proteasome subunits was further confirmed using a subunit-specific antibody against non-adenosine triphosphatase subunit 11 of the 19S regulatory particle. Results suggest that the potential proteomic profile of six subunits in the 26S proteasome could be established from proteasome inhibitor-induced inclusions in PC12 cells.

Research on the correlation of serum plasminogen activator inhibitor-1 level to vascular complications in type 2 diabetes mellitus patients with overweight or obesity

Objective:To explore the relationship between serum plasminogen activator inhibitor(PAI-1)level and Type 2 Diabetes Mellitus(T2DM)accompanied by overweight or obesity by observing not only the changes of PAI-1 level in T2DM patients with overweight or obesity,but also glucose and lipid metabolism related indicators,the changes of the inflammatory cytokines secreted by adipocytes,and then making an analysis on the correlation to PAI-1.Methods:36 cases of healthy examinees were selected as normal control group(NC group),and the experimental group can be divided into T2DM group(54 cases),Overweight/Obesity group(35 cases)and T2DM+Overweight/Obesity group(48 cases).Glucose and lipid metabolism related indicators such as fasting blood glucose(FBG),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),glycated hemoglobin(HbA1c),fasting insulin(FINS),insulin resistance index(IR),body weight index(BMI)and inflammatory cytokines interleukin-6(IL-6),tumor necrosis factor(TNF-α)and PAI-1 were observed and compared between groups,and then made an analysis to explore the correlation of these factors to PAI-1.Results:(1)Compared with NC group,the levels of FBG,HbA1c,FINS and IR were increased in T2DM group,and the difference was of statistical significance.However,there was no statistically significant difference in TG,TC,LDL-C and BMI between NC group and T2DM group;the levels of FINS,IR,TG,LDL-C,TC and BMI were elevated in Overweight/Obesity group,and the difference was of statistical significance.However,there was no statistically significant difference in FBG and HbA1c;the levels of FBG,HbA1c,FINS,IR,TG,LDL-C,TC and BMI were up-regulated in T2DM+Overweight/Obesity group,and the difference was of statistical significance.Compared with T2DM group,the levels of TG,TC,LDL-C and BMI were increased in Overweight/Obesity group,and the difference was of statistical significance,however,the levels of FBG,HbA1c,FINS and IR were decreased,and the difference was statistically significant;The levels of FINS,IR,TG,TC,LDL-C and BMI were elevated in T2DM+Overweight/Obesity group,and the difference was of statistical significance,however,there was no statistically significant difference in FBG and HbA1c.Compared with Overweight/Obesity group,the levels of FBG,FINS,IR,HbA1c and LDL-C were increased in T2DM+Overweight/Obesity group,and the difference was of statistical significance.However,the difference in TG,TC and BMI was not statistically significant.(2)Compared with NC group,the levels of IL-6,TNF-αand PAI-1 were increased in T2DM group,Overweight/Obesity group and T2DM+Overweight/Obesity group,and the difference was statistically significant.Compared with T2DM group,the levels of IL-6 and TNF-αwere elevated in Overweight/Obesity group,and the difference was of statistical significance,but there was no statistically significant difference in PAI-1;the levels of IL-6,TNF-αand PAI-1 were up-regulated in T2DM+Overweight/Obesity group,and the difference was statistically significant.Compared with Overweight/Obesity group,there was no statistically significant difference in IL-6 and TNF-αbetween T2DM+Overweight/Obesity group and Overweight/Obesity group,but the level of PAI-1 was increased in T2DM+Overweight/Obesity group,and the difference was of statistical significance.(3)Multivariate Logistic Regression Analysis showed that HbA1c,IR,TG,BMI,IL-6 and TNF-αwere independently associated with the level of PAI-1(all p<.05).Conclusions:(1)The level of PAI-1 is higher in type 2 diabetes mellitus patients with overweight or obesity than that in patients only with type 2 diabetes mellitus,and it is one of causes that result in vascular complications.(2)The increase in the level of PAI-1 is considered to be associated with IL-6 and TNF-αsecreted by adipocytes.

烟草Bax inhibitor-1基因植物沉默表达载体的构建及对农杆菌的转化

试验首先对质粒pGSA1285进行改造,将pFGC5941质粒的查尔酮合酶的Intron片段取代pGSA1285的GUS片段,构建含有内含子并具有卡那抗性的pGSA2285植物沉默表达载体。同时设计引物、PCR扩增、在BI-1基因两端各加上两个酶切位点,将BI-1基因分别反向、正向插入改造后的质粒pGSA2285Intron片段两端的多克隆位点中,构建得到烟草BI-1基因沉默载体pGSA4285。此沉默质粒经PCR鉴定、限制性酶切分析以及回复动员试验证明已正确构建并成功转入农杆菌,为获得含有BI-1基因沉默烟草植株及其在植物程序性死亡中调控作用的研究奠定试验基础。

Chinese consensus on management of tyrosine kinase inhibitor-associated side effects in gastrointestinal stromal tumors

Tyrosine kinase inhibitors(TKIs) have improved the overall survival of patients with gastrointestinal stromal tumors(GISTs), but their side effects can impact dose intensity and, consequently, the clinical benefit. To date, no guideline or consensus has been published on the TKI-associated adverse reactions. Therefore, the Chinese Society of Surgeons for Gastrointestinal Stromal Tumor of the Chinese Medical Doctor Association organized an expert panel discussion involving representatives from gastrointestinal surgery, medical oncology, cardiology, dermatology, nephrology, endocrinology, and ophthalmology to consider the systemic clinical symptoms, molecular and cellular mechanisms, and treatment recommendations of GISTs. Here, we present the resultant evidence-and experience-based consensus to guide the management of TKI-associated side events in clinical practice.

Microproteinuria for detecting calcineurin inhibitor-related nephrotoxicity after liver transplantation

AIM: To investigate whether microproteinuria could be used as an early and sensitive indicator to detect calcineurin inhibitor (CNI)-related nephrotoxicity after liver transplantation. METHODS: All liver transplant recipients with normal serum creatinine (SCr) and detectable microproteinuria at baseline were included in this study. The renal function was monitored by the blood clearance of 99mTc-diethylenetriaminepentaacetic acid every 6 mo. Microproteinuria, SCr and blood urea nitrogen (BUN) were measured at entry and at subsequent follow-up visits. The patients were divided into different groups according to the mean values of glomerular filtration rate (GFR) at the follow-up time points: Group 1, GFR decreased from baseline by 0%-10%; Group 2, GFR decreased from baseline by 11%-20%; Group 3, GFR decreased from baseline by 21%-40%; Group 4, GFR decreased from baseline by > 40% and/or SCr was increasing. RESULTS: A total of 143 patients were enrolled into this study (23 females and 120 males). The mean follow-up was 32 mo (range 16-36 mo). Downward trends in renal function over time were observed in the study groups. SCr and BUN increased significantly only in Group 4 patients (P < 0.001). β2-microglobulin (β2m) and α1-microglobulin (α1m) significantly increased with the subtle change of renal function in recipients who were exposed to CNI-based immunosuppression regimens. The reductions in GFR were closely correlated with elevated α1m (r2 = -0.728, P < 0.001) and β2m (r2 = -0.787, P < 0.001). CONCLUSION: β2m and α1m could be useful as early and sensitive indicators of CNI-induced nephrotoxicity.

Programmed cell death-1 inhibitor-related sclerosing cholangitis:A systematic review

BACKGROUND Programmed cell death-1(PD-1)inhibitor has been indicated for many types of malignancies.However,these inhibitors also cause immune-related adverse events.Hepatobiliary disorder is a phenotype of immune-related adverse event affecting 0%–4.5%of patients treated with PD-1 inhibitors.Recent studies have reported PD-1 inhibitor-related sclerosing cholangitis(SC);however,the associated clinical and pathological features are unclear.AIM To evaluate the clinical and pathological features of PD-1 inhibitor-related SC through a systematic review of the literature.METHODS The review,conducted using electronic databases in PubMed,was restricted to the period from January 2014 to September 2019 and focused on case reports/series on PD-1 inhibitor-related SC published in English.We scanned the references of the selected literature to identify any further relevant studies.Six cases previously studied by us,including three that have not yet been published,were included in this review.RESULTS Thirty-one PD-1 inhibitor-related SC cases were evaluated.Median age of patients was 67 years(range,43–89),with a male to female ratio of 21:10.The main disease requiring PD-1 inhibitor treatment was non-small cell lung cancer.Agents that caused PD-1 inhibitor-related SC were nivolumab(19 cases),pembrolizumab(10 cases),avelumab(1 case),and durvalumab(1 case).The median number of cycles until PD-1 inhibitor-related SC onset was 5.5(range,1–27).Abdominal pain or discomfort(35.5%,11/31)was the most frequent symptom.Blood serum tests identified liver dysfunction with a notable increase in biliary tract enzymes relative to hepatic enzymes,and a normal level of serum immunoglobulin G4.Biliary dilation without obstruction(76.9%,20/26),diffuse hypertrophy of the extrahepatic biliary tract(90.5%,19/21),and multiple strictures of the intrahepatic biliary tract(30.4%,7/23)were noted.In 11/23(47.8%)cases,pathological examination indicated that CD8+T cells were the dominant inflammatory cells in the bile duct or peribiliary tract.Although corticosteroids were mainly used for PD inhibitor-related SC treatment,the response rate was 11.5%(3/26).CONCLUSION Some clinical and pathological features of PD-1 inhibitor-related SC were revealed.To establish diagnostic criteria for PD-1 inhibitor-related SC,more cases need to be evaluated.

Efficacy of endoluminal gastroplication in Japanese patients with proton pump inhibitor-resistant,non-erosive esophagitis

AIM:To evaluate the efficacy,safety,and long-term outcomes of endoluminal gastroplication(ELGP) in patients with proton pump inhibitor(PPI)-resistant,nonerosive reflux disease(NERD).METHODS:The subjects were NERD patients,diagnosed by upper endoscopy before PPI use,who had symptoms such as heartburn or reflux sensations two or more times a week even after 8 wk of full-dose PPI treatment.Prior to ELGP,while continuing full-dose PPI medication,patients' symptoms and quality of life(QOL) were assessed using the questionnaire for the diagnosis of reflux disease,the frequency scale for symptoms of gastro-esophageal reflux disease(FSSG),gastrointestinal symptoms rating scale,a 36-item short-form.In addition,24-h esophageal pH monitoring or 24-h intraesophageal pH/impedance(MII-pH) monitoring was performed.The Bard EndoCinch TM was used for ELGP,and 2 or 3 plications were made.After ELGP,all acid reducers were temporarily discontinued,and medication was resumed depending on the development and severity of symptoms.Three mo after ELGP,symptoms,QOL,pH or MII-pH monitoring,number of plications,and PPI medication were evaluated.Further,symptoms,number of plications,and PPI medication were evaluated 12 mo after ELGP to investigate long-term effects.RESULTS:The mean FSSG score decreased significantly from before ELGP to 3 and 12 mo after ELGP(19.1 ± 10.5 to 10.3 ± 7.4 and 9.3 ± 9.9,P < 0.05,respectively).The total number of plications decreased gradually at 3 and 12 mo after ELGP(2.4 ± 0.8 to 1.2 ± 0.8 and 0.8 ± 1.0,P < 0.05,respectively).The FSSG scores in cases with no remaining plications and in cases with one or more remaining plications were 4.4 and 2.7,respectively,after 3 mo,and 2.0 and 2.8,respectively,after 12 mo,showing no correlation to plication loss.On pH monitoring,there was no difference in the percent time pH < 4 from before ELGP to 3 mo after.Impedance monitoring revealed no changes in the number of reflux episodes or the symptom index for reflux events from before ELGP to 3 mo after,but the symptom sensitivity index decreased significantly 3 mo after ELGP(16.1 ± 12.9 to 3.9 ± 8.3,P < 0.01).At 3 mo after ELGP,6 patients(31.6%) had reduced their PPI medication by 50% or more,and 11 patients(57.9%) were able to discontinue PPI medication altogether.After 12 mo,3 patients(16.7%) were able to reduce the amount of PPI medication by 50% or more,and 12 patients(66.7%) were able to discontinue PPI medication altogether.A high percentage of cases with remaining plications had discontinued PPIs medication after 3 mo,but there was no difference after 12 mo.No serious complications were observed in this study.CONCLUSION:ELGP was safe,resulted in significant improvement in subjective symptoms,and allowed less medication to be used over the long term in patients with PPI-refractory NERD.

Hepatitis C virus protease inhibitor-resistance mutations: Our experience and review

Direct-acting antiviral agents(DAAs)for hepatitis C virus(HCV)infection are one of the major advances in its medical treatment.The HCV protease inhibitors boceprevir and telaprevir were the first approved DAAs in the United States,Europe,and Japan.When combined with peginterferon plus ribavirin,these agents increase sustained virologic response rates to70%-80%in treatment-na?ve patients and previoustreatment relapsers with chronic HCV genotype 1 infection.Without peginterferon plus ribavirin,DAA monotherapies increased DAA-resistance mutations.Several new DAAs for HCV are now in clinical development and are likely to be approved in the near future.However,it has been reported that the use of these drugs also led to the emergence of DAA-resistance mutations in certain cases.Furthermore,these mutations exhibit cross-resistance to multiple drugs.The prevalence of DAA-resistance mutations in HCV-infected patients who were not treated with DAAs is unknown,and it is as yet uncertain whether such variants are sensitive to DAAs.We performed a population sequence analysis to assess the frequency of such variants in the sera of HCV genotype 1-infected patients not treated with HCV protease inhibitors.Here,we reviewed the literature on resistance variants of HCV protease inhibitors in treatment na?ve patients with chronic HCV genotype 1,as well as our experience.

Immune checkpoint inhibitor-induced diarrhea/colitis: Endoscopic and pathologic findings

The indications of immune checkpoint inhibitors(ICPIs)for cancer treatment have rapidly expanded,and their use is increasing in clinical settings worldwide.Despite the considerable clinical benefits of ICPIs,frequent immune-related adverse events(ir AEs)have become nonnegligible concerns.Among ir AEs,ICPIinduced colitis/diarrhea is frequent and recognized not only by oncologists but also by gastroenterologists or endoscopists.The endoscopic findings show similarity to those of inflammatory bowel disease to a certain extent,particularly ulcerative colitis,but do not seem to be identical.The pathological findings of ICPI-induced colitis may vary among drug classes.They show acute or chronic inflammation,but it may depend on the time of colitis suggested by colonoscopy,including biopsy or treatment intervention.In the case of chronic inflammation determined by biopsy,the endoscopy findings may overlap with those of inflammatory bowel disease.Here,we provide a comprehensive review of ICPIinduced colitis based on clinical,endoscopic and pathologic findings.