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Introduction Prostate cancer has the second highest cancer incidence worldwide. Diagnosis of clinically significant prostate cancer (CSPC), defined as Gleason ≥3+4 or ≥ISUP 2, is underpinned by Prostate Imaging-Report and Data System (PI-RADS) scoring on MRI and serum PSA, with confirmation with prostate biopsy. Positive predictive value of PI-RADS 3 for CSPC is 13%. A PSA-density threshold of 0.15-0.18 ng/mL/cc is commonly utilised to justify biopsy vs PSA monitoring for PI-RADS 3. Methods Retrospective analysis of MRI, PSA and pathology results for consecutive patients undergoing diagnostic investigations for prostate cancer between November 2021 and March 2022. Results Average age of 200 males was 66.4 (SEM 0.62). MRIs reported 6% ≤PI-RADS 2, 61.5% PI-RADS 3 and 32.5% ≥PI-RADS 4. Among the PI-RADS 3 (n=123), average prostate volume was 70.0cc (SEM 3.21) and PSA density was 0.12 (SEM 0.01). 17.9% PI-RADS 3 patients underwent prostate biopsy although just 8.9% had PSA-density >0.18 ng/mL/cc. 40.9% biopsies identified CSPC with average PSA-density 0.23 (SEM 0.06). Conversely, for the 59.1% biopsies with no cancer or non-CSPC, average PSA-density was 0.14 (SEM 0.03) (p 0.078). Conclusion Almost 3/5 prostate biopsies carried out in patients with PI-RADS 3 lesions revealed non-CSPC or no cancer. There was a notable difference in PSA-density among PI-RADS 3 patients with biopsy-proven CSPC vs. non-CSPC or benign histology. Based on our institutions experience, we would propose a 0.2 ng/mL/cc PSA-density threshold when recommending biopsy over PSA monitoring for MRI reported PI-RADS 3 to improve patient selection for biopsy to identify CSPC.

Innate immune responses, including the production of type I and III interferons, play a crucial role in the first line of defense against RSV infection. However, only a poor induction of type I IFNs is observed during RSV infection, suggesting that RSV has evolved mechanisms to prevent type I IFN expression by the infected host cell. Human respiratory syncytial virus (RSV) is the leading cause of severe acute lower respiratory tract infections in infants worldwide. Nonstructural protein NS1 of RSV modulates the host innate immune response by acting as an antagonist of type I and type III interferon (IFN) production and signaling in multiple ways. Likely, NS1 performs this function by interacting with different host proteins. In order to obtain a comprehensive overview of the NS1 interaction partners, we performed three complementary protein-protein interaction screens, i.e., BioID, MAPPIT, and KISS. To closely mimic a natural infection, the BioID proximity screen was performed using a recombinant RSV in which the NS1 protein is fused to a biotin ligase. Remarkably, MED25, a subunit of the Mediator complex, was identified in all three performed screening methods as a potential NS1-interacting protein. We confirmed the interaction between MED25 and RSV NS1 by coimmunoprecipitation, not only upon overexpression of NS1 but also with endogenous NS1 during RSV infection. We also demonstrate that the replication of RSV can be enhanced in MED25 knockout A549 cells, suggesting a potential antiviral role of MED25 during RSV infection. Mediator subunits function as transcriptional coactivators and are involved in transcriptional regulation of their target genes. Therefore, the interaction between RSV NS1 and cellular MED25 might be beneficial for RSV during infection by affecting host transcription and the host immune response to infection. IMPORTANCE Innate immune responses, including the production of type I and III interferons, play a crucial role in the first line of defense against RSV infection. However, only a poor induction of type I IFNs is observed during RSV infection, suggesting that RSV has evolved mechanisms to prevent type I IFN expression by the infected host cell. A unique RSV protein, NS1, is largely responsible for this effect, probably through interaction with multiple host proteins. A better understanding of the interactions that occur between RSV NS1 and host proteins may help to identify targets for an effective antiviral therapy. We addressed this question by performing three complementary protein-protein interaction screens and identified MED25 as an RSV NS1-interacting protein. We propose a role in innate anti-RSV defense for this Mediator complex subunit.

Introduction Delivering timely cancer care during the COVID-19 pandemic was a major challenge. We analysed our success in addressing this. Method A key factor was the proximity of a private hospital (GN) to the primary trust. GN acted as a ‘clean site’. From 6th April 2020, two robots and dedicated staff were relocated to day surgery theatres with direct access to GN. Procedures and post-operative recovery happened in GN. National surgical guidelines were followed related to Covid-19. All theatre staff were swabbed weekly. Patients were risk stratified prior to admittance. Results We reviewed operations performed and cancer pathway data from March to June 2020 and compared it to data collected from August to November 2019. From March until June 2020 we performed 369 cancer operations; 120 robotic, 138 endoscopic and 7 open cases. From August to November 2019 we performed 407 cancer operations; 116 robotic, 175 endoscopic and 7 open cases. No elective patient developed symptomatic COVID-19 secondary to admission. Conclusions This study demonstrates that with rapid development of separate ‘clean’ and ‘COVID’ sites, we successfully delivered a comparable, safe and effective cancer service. As we potentially face a second wave we share our success to see if these changes can be replicated elsewhere.

A feeding trial involving growing piglets was undertaken to establish whether feed supplemented with whey protein concentrate (WPC), exhibiting antioxidant properties, had any effects on welfare and meat quality. For that purpose, 48 weaned piglets (20-days-old) were assigned to two experimental groups receiving standard or experimental diet for 30 days. Blood and tissue collection were performed at various time-points. The following oxidative stress markers were assessed: reduced glutathione (GSH), catalase activity, total antioxidant capacity (TAC), thiobarbituric acid reactive substances (TBARS), protein carbonyls (CARB) and hydrogen peroxide (H2O2) decomposition activity. The effects on bacterial growth and the fatty acid profile of meat were also assessed. Results showed that piglets fed with the WPC-supplemented diet had significantly increased antioxidant mechanisms in almost all tissues tested, as indicated by increases in GSH, H2O2 decomposition activity and TAC compared with the control group. Piglets fed with the experimental diet exhibited decreased oxidative stress-induced damage to lipids and proteins, as shown by decreases in TBARS and CARB in the WPC group compared with the control group. In addition, the experimental diet enhanced growth of facultative probiotic bacteria and lactic acid bacteria and inhibited growth of pathogen populations. In addition, WPC inclusion in piglets' diet increased n-3 fatty acids significantly and decreased n-6/n-3 ratio significantly compared with the control group. The current study showed that WPC inclusion in the diet had a significant effect on welfare and meat quality of growing piglets.

We have identified camelid single-domain antibodies (VHHs) that cross-neutralize SARS-CoV-1 and −2, such as VHH72, which binds to a unique highly conserved epitope in the viral receptor-binding domain (RBD) that is difficult to access for human antibodies. Here, we establish a protein engineering path for how a stable, long-acting drug candidate can be generated out of such a VHH building block. When fused to human IgG1-Fc, the prototype VHH72 molecule prophylactically protects hamsters from SARS-CoV-2. In addition, we demonstrate that both systemic and intranasal application protects hACE-2-transgenic mice from SARS-CoV-2 induced lethal disease progression. To boost potency of the lead, we used structure-guided molecular modeling combined with rapid yeast-based Fc-fusion prototyping, resulting in the affinity-matured VHH72_S56A-Fc, with subnanomolar SARS-CoV-1 and −2 neutralizing potency. Upon humanization, VHH72_S56A was fused to a human IgG1 Fc with optimized manufacturing homogeneity and silenced effector functions for enhanced safety, and its stability as well as lack of off-target binding was extensively characterized. Therapeutic systemic administration of a low dose of VHH72_S56A-Fc antibodies strongly restricted replication of both original and D614G mutant variants of SARS-CoV-2 virus in hamsters, and minimized the development of lung damage. This work led to the selection of XVR011 for clinical development, a highly stable anti-COVID-19 biologic with excellent manufacturability. Additionally, we show that XVR011 is unaffected in its neutralizing capacity of currently rapidly spreading SARS-CoV-2 variants, and demonstrate its unique, wide scope of binding across the Sarbecovirus clades.

In this report a strand specific RT-PCR was established for the detection of the replicative negative RNA strand of poliovirus sabin 1 (Sabin1) and Echovirus 19 (E19) strains. The key for the successful conduction of the assay was the use of a specific reverse transcription primer targeting the 5’-UTR of enteroviruses that consisted of a stem-loop structure at the 5’-end and an enteroviral-specific sequence at the 3’-end. The stem loop RT–PCR was found to be an accurate and sensitive method, detecting even 10-2 CCID50 of poliovirus sabin 1 (Sabin1) and E19 strains 6h post infection (p.i.), while CPE appeared three days later. This assay was also validated in SiHa and Caski cell lines that are not used for the detection of enteroviruses. The negative RNA strand was detected 6h and 12h p.i. in SiHa and Caski cells, when these cell lines were inoculated with 105 and 1 CCID50 respectively, whereas CPE was observed 5 days p.i for SiHa cells and 8 days p.i for Caski cells and that only at 105 CCID50. The results show that this approach may be used for replacing the time-consuming cell cultures in order to detect the active replication of enteroviruses. This article is protected by copyright. All rights reserved.

Purpose. The tumour suppressor protein RB plays a decisive role in negative control of the cell cycle, inhibiting tumour development. The present analysis investigated the prevalence of the nucleotide polymorphism A153104G, which is located at intron 18 of the RB1 gene, and investigated the impact of the polymorphic variability in the exon 19 and its flanking intronic sequences on the severity of cervical disease in HPV16-positive Greek women. Methodology. The nucleotide polymorphism A153104G was detected by PCR-RFLP assay, while the amplicons were further subjected to cloning and sequencing. Moreover, molecular evolutionary analysis was performed using the maximum-likelihood (ML) and empirical Bayesian (EB) methods in order to evaluate the selective pressure acting on exon 19 of the RB1 gene. Results/Key findings. The A153104G nucleotide polymorphism was only detected in one control case. Moreover, sequence analysis of the amplicons revealed that the polymorphic variability in the RB1 gene increased with the severity of the cervical dysplasia. The link between the observed polymorphic variability and the progress of cervical disease was reflected in the molecular evolutionary analysis that was performed on the exon 19 of the RB1 gene, since negative selective pressure was acting upon exon 19 in the control and low-grade squamous intraepithelial lesion (LSIL) cervical samples, while positive selective pressure was acting upon exon 19 in the high-grade squamous intraepithelial lesion (HSIL) specimens. Conclusions. The A153104G nucleotide polymorphism did not emerge as a potential biomarker for the development of precancerous lesions in the Greek patients, while the accumulation of sequence variations in RB1 gene might influence patients’ susceptibility towards the progression of cervical neoplasia.

The tumor suppressor protein p16 plays a fundamental role in cell cycle regulation and exerts a protective effect against tumor growth. Two different polymorphisms at positions 540 and 580 at the 3'UTR of exon 3 of p16 gene are implicated in several types of cancer, while their role in cervical cancer development remains rather vague. In the present study, we investigated for the impact of p16 genotypes/haplotypes on patients' vulnerability to cervical disease and examined whether these factors can be used as progression markers in the Greek population. A total of 96 HPV16 positive samples and histologically confirmed as LSIL (42 samples), HSIL (44 samples), and cervical cancer cases (10 samples) along with 50 control cases were tested. The identification of p16 polymorphisms was performed by PCR-RFLP methodology. The present analysis revealed that women with p16 540 CG/GG genotype are at a 2.7-fold higher risk of developing HPV16-associated HSIL (OR = 2.7, 95%CI: 1.01-6.6, P = 0.028). The G allele can be regarded as a risk factor of developing HSIL in the Greek population (OR = 2.7, 95%CI: 1.2-5.9, P = 0.012). Moreover, p16 polymorphism C580T is not associated with the growth of cervical lesion in Greek patients, while 540G/580C haplotype can be regarded as a risk haplotype of developing HSIL (OR = 3.67, 95%CI: 1.56-8.6, P = 0.0019). Our results demonstrated that p16 C540G polymorphism influence patients' susceptibility to more severe dysplasia and consequently this polymorphism could potentially emerge as a valuable biomarker for HSIL development in the Greek population.

Purpose. Polymorphic variability in the tumour-suppressor protein p53 at codon 72 has a considerable impact on cervical cancer development. The present study clarified the association between p53 codon 72 genotypes and the risk of cervical disease in Greek patients. We also examined whether the presence of specific p53 genotypes in combination with HPV16 variants or E6 T350G sequence variation can modify an individual's susceptibility to cervical disease. Methodology. The analysis of p53 genotypes was performed through PCR-RFLP. Sequence and phylogenetic tree analyses of the HPV16 E6 gene were also performed in order to identify HPV16 variants and T350G sequence variation. Results/Key findings. The outcomes of the present analysis revealed that women who are homozygous for the arg genotype are at a 4.17-fold higher risk of developing HPV16-associated HSIL+ (OR=4.17, 95 % CI:1.48–4.9, P=0.0049). Moreover, p53 arg/arg patients infected by an HPV16 prototype strain were associated with an increased risk of more severe lesions, while a significant relationship between the p53 arg/arg genotype in patients with T350G sequence variation and the risk of high-grade squamous intraepithelial lesions (HSILs) was revealed. Conclusion. The oncogenic potential of the virus is increased by the presence of the p53 arg/arg genotype in the Greek population in such a way that the specific protein interaction E6 (L83V)–p53 (Arg-72) can modify an individual's susceptibility to cervical disease.