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Background: ANDHI was done to assess the efficacy of benralizumab, including onset of effect and impact on health-related quality of life (HRQOL), exacerbation rate, lung function, and nasal polyposis symptoms., Methods: This phase 3b, randomised, double-blind, parallel-group, placebo-controlled ANDHI study was completed in adults (aged 18-75 years) with severe eosinophilic asthma with at least 2 exacerbations in the previous year, despite high-dose inhaled corticosteroid plus additional controllers, screening blood eosinophil counts of at least 150 cells per μL, and an Asthma Control Questionnaire 6 (ACQ-6) score of 1·5 or more. Patients who met eligibility criteria were randomly assigned (2:1; stratified by previous exacerbation count [two, or three or more], maintenance oral corticosteroid use, and region), using an integrated web-based response system, to receive benralizumab at 30 mg every 8 weeks (first three doses given 4 weeks apart) or matched placebo for 24 weeks. Primary efficacy measure was annualised asthma exacerbation rate, with rate ratio (RR) calculated over the approximate 24-week follow-up. Secondary efficacy measures included change from baseline to end of treatment (week 24) in St George's Respiratory Questionnaire (SGRQ) total score (key secondary endpoint), FEV 1 , peak expiratory flow (PEF), ACQ-6, Predominant Symptom and Impairment Assessment (PSIA), Clinician Global Impression of Change (CGI-C), Patient Global Impression of Change (PGI-C), and Sino-Nasal Outcome Test-22 (SNOT-22). All efficacy analyses, except for SNOT-22, were summarised and analysed using the full analysis set on an intention-to-treat population (all randomly assigned patients receiving investigational product, regardless of protocol adherence or continued participation in the study). SNOT-22 was summarised for the subgroup of patients with physician-diagnosed nasal polyposis with informed consent. This study is registered with ClinicalTrials.gov, NCT03170271., Findings: Between July 7, 2017, and Sept 25, 2019, 656 patients received benralizumab (n=427) or placebo (n=229). Baseline characteristics were consistent with severe eosinophilic asthma. Benralizumab significantly reduced exacerbation risk by 49% compared with placebo (RR estimate 0·51, 95% CI 0·39-0·65; p<0·0001) over the 24-week treatment period and provided clinically meaningful and statistically significant improvement from baseline to week 24 in SGRQ total score versus placebo (least squares mean change from baseline -8·11 (95% CI -11·41 to -4·82; p<0·0001), with similar differences at earlier timepoints. Benralizumab improved FEV 1 , PEF, ACQ-6, CGI-C, PGI-C, PSIA, and SNOT-22 at week 24 versus placebo, with differences observed early (within weeks 1 to 4). Adverse events were reported for 271 (63%) of 427 patients on benralizumab versus 143 (62%) of 229 patients on placebo. The most commonly reported adverse events for the 427 patients receiving benralizumab (frequency >5%) were nasopharyngitis (30 [7%]), headache (37 [9%]), sinusitis (28 [7%]), bronchitis (22 [5%]), and pyrexia (26 [6%]). Fewer serious adverse events were reported for benralizumab (23 [5%]) versus placebo (25 [11%]), and the only common serious adverse event (experienced by >1% of patients) was worsening of asthma, which was reported for nine (2%) patients in the benralizumab group and nine (4%) patients in the placebo group., Interpretation: Our results extend the efficacy profile of benralizumab for patients with severe eosinophilic asthma, showing early clinical benefits in patient-reported outcomes, HRQOL, lung function, and nasal polyposis symptoms., Funding: AstraZeneca., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Serine hydroxymethyltransferase (SHMT) is a pivotal enzyme in one-carbon metabolism that catalyses the reversible conversion of serine and tetrahydrofolate into glycine and methylenetetrahydrofolate. It exists in cytosolic (SHMT1) and mitochondrial (SHMT2) isoforms. Research on one-carbon metabolism in cancer cell lines has shown that SHMT1 preferentially catalyses serine synthesis, whereas in mitochondria SHMT2 is involved in serine breakdown. Recent research has focused on the identification of inhibitors that bind at the folate pocket. We have previously found that a representative derivative of the pyrazolopyran scaffold, namely 2.12, inhibits both SHMT isoforms, with a preference for SHMT1, causing apoptosis in lung cancer cell lines. Here we show that the affinity of 2.12 for SHMT depends on the identity of the amino acid substrate bound to the enzyme. The dissociation constant of 2.12 is 50-fold lower when it binds to SHMT1 enzyme-serine complex, as compared to the enzyme-glycine complex. Evidence is presented for a similar behaviour of compound 2.12 in the cellular environment. These findings suggest that the presence and identity of the amino acid substrate should be considered when designing SHMT inhibitors. Moreover, our data provide the proof-of-concept that SHMT inhibitors selectively targeting the directionality of one-carbon metabolism flux could be designed., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Arachidonic acid (ARA) metabolites maintain pregnancy and control parturition. We generated a network of 77 proteins involved in placental ARA metabolism to identify novel proteins in this pathway. We identified a long pathway within this network which showed that secretory and cytosolic phospholipase A2 proteins act in concert. The functions of all network proteins expressed in the placental decidua were determined by database searches. Thus ARA metabolism was linked to carbohydrate metabolism. One protein, transmembrane protein 62 (TMEM62), expressed in decidua was previously uncharacterized, and was identified as a putative lipoxygenase. TMEM62 may play a role in pregnancy and/or parturition., (Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.)

The mammalian FA-binding proteins (FABPs) bind long-chain FA with high affinity. The large number of FABP types is suggestive of distinct functions in specific tissues. Multiple experimental approaches have shown that individual FABPs possess both unique and overlapping functions, some of which are based on specific elements in the protein structure. Although FA binding affinities for all FABPs tend to correlate directly with FA hydrophobicity, structure-function studies indicate that subtle three-dimensional changes that occur upon ligand binding may promote specific protein-protein or protein-membrane interactions that ultimately determine the function of each FABP. The conformational changes are focused in the FABP helical/portal domain, a region that was identified by in vitro studies to be vital for the FA transport properties of the FABPs. Thus, the FABPs modulate intracellular lipid homeostasis by regulating FA transport in the nuclear and extra-nuclear compartments of the cell; in so doing, they also impact systemic energy homeostasis.

Recent research shows that Cancer stem cells (CSCs) are relatively resistant to apoptosis induction. We studied the effect of the immunological apoptogen TRAIL on Jurkat cells enriched in the CD133-positive population. CD133(high) Jurkat cells were more resistant to apoptosis than their CD133(low) counterparts, and showed higher level of expression of FLIP, an inhibitor of death receptor-mediated apoptosis. Breast cancer MCF7 cells showed high level of expression CD133 in the unseparated culture, with accompanying high level of FLIP. Down-regulation of FLIP by siRNA resulted in sensitisation of the cells to TRAIL, as documented by more robust apoptosis. We conclude that high expression of FLIP is at least one of the reasons for resistance of CSCs to apoptosis induced by the death ligand TRAIL.

Objectives: To review the effectiveness of social marketing interventions designed to improve diet, increase physical activity, and tackle substance misuse., Study Design and Methods: This article describes three reviews of systematic reviews and primary studies that evaluate social marketing effectiveness. All three reviews used pre-defined search and inclusion criteria and defined social marketing interventions as those which adopted six key social marketing principles., Results: The reviews provide evidence that social marketing interventions can be effective in improving diet, increasing exercise, and tackling the misuse of substances like alcohol, tobacco, and illicit drugs. There is evidence that social marketing interventions can work with a range of target groups, in different settings, and can work upstream as well as with individuals., Conclusions: Social marketing provides a very promising framework for improving health both at the individual level and at wider environmental and policy-levels. Problems with research design, lack of conceptual understanding or implementation are valid research concerns.

Objective: To examine changes in smoking behaviour among young women over four life stages: leaving home; employment or attending college or university; marriage; and parenthood., Methods: Young women participating in the Australian Longitudinal Study on Women's Health completed postal questionnaires in 1996 and 2000., Results: Unmarried women who moved out of their parents' home between 1996 and 2000 had higher odds of adopting smoking than those who had not lived with their parents at either time (OR 1.8, 95% CI 1.2-2.6). Married women had lower odds of resuming smoking after quitting (OR 0.4, 95% CI 0.2-0.7) than unmarried women. Women who were pregnant in 2000 had higher odds of quitting smoking (OR 3.8, 95% CI 2.5-5.6) and women who were pregnant in 1996 and not in 2000 had higher odds of starting to smoke again (OR 3.2, 95% CI 1.6-6.2) than women who were not pregnant. The odds of being a current smoker or adopting smoking were significantly greater for women who binge drank alcohol or used cannabis and other illicit drugs., Conclusions: Adoption, maintenance and cessation of smoking among young women is strongly related to major life stage transitions, illicit drug use and alcohol consumption., Implications: Life changes such as marriage and actual or contemplated pregnancy provide opportunities for targeted interventions to help women quit smoking and not relapse after having a baby. Legislation to control smoking on licensed premises would reduce the social pressure on women to smoke.

A retractable wire knife was used to transect medial or lateral components of the MFB or its lateral projections to the striatum and amygdaloid complex. All cuts produced significant depletions of NE, DA, and 5-HT from telencephalon and striatum but little or no effect on hypothalamic NE or 5-HT. Two of our cuts resulted in aphagia and adipsia, the third in hyperphagia and obesity. A detailed correlational analysis of the magnitude and direction of the behavioral and biochemical consequences of our cuts indicated that the ingestive behavior of all of our experimental animals (including animals which had been aphagic and adipsic after surgery as well as animals which were hyperphagic and obese) was positively correlated with the concentration of DA in striatum and telencephalon and negatively correlated with telencephalic 5-HT. Less consistent evidence for facilitatory noradrenergic influences on food intake was also obtained. Our results suggest that the regulation of food intake may be the result of an interaction between telencephalic serotonergic mechanisms and dopaminergic pathways which exert opposite effects on ingestive behavior.

The effects of intrahippocampal or intrahypothalamic injections of anticholinergic compounds on operant responding were observed in a multiple schedule paradigm consisting of reinforced, punished, and nonreinforced components and on a punished ingestive passive avoidance task. The pattern of results suggests that cholinergic components of the hippocampus and hypothalamus mediate responding suppressed by nonreinforcement but not by punishment. The data are discussed with reference to Carlton's proposed central cholinergic inhibitory mechanisms.

Previous studies reveal a dose-dependent increase in locomotor activity of the C57B1/6J mouse after administration of morphine or amphetamine. Concurrent partial lesions of both the dorsomedial caudate and lateral septal nuclei resulted in a significant decrease in morphine-induced, but not amphetamine-induced, hyperactivity. Concurrent partial lesions of the nucleus accumbens and stria terminalis produced only a nonsignificant decrease in the morphine-induced hyperactivity. Lesions of the individual brain structures did not significantly affect the morphine-induced locomotor hyperactivity. Microinjections of the opiate antagonist naloxone into discrete portions of the caudate and septal nuclei produced suppression of the morphine-induced hyperactivity response without affecting the hyperactivity caused by amphetamine injections. Only a slight suppression of morphine-induced locomotion was produced when naloxone was injected into the nucleus accumbens and stria terminalis. These data suggest that portions of the caudate and septum may be involved in the mediation of morphine-induced hyperactivity in the C57B1/6J mouse.

Knife cuts were made that preferentially interrupted (a) the nigrostriatal pathway; (b) pallidofugal projections to the lower brainstem; (c) caudate-pallidal interconnections; and (d) fibers entering or leaving the striatum ventrally. The effects of these cuts on conditioned (shuttle box) avoidance, passive avoidance, swimming escape, sucrose-rewarded alley running, locomotor activity, and various measures of sensory-motor function were examined. The norepinephrine, dopamine and serotonin content of the striatum, residual forebrain and hypothalamus were determined following the completion of behavioral testing. The pattern of results suggests that striatal functions which are significantly influenced by several afferent and efferent connections are essential for the acquisition and, perhaps, execution of complex behavior in appetitive as well as aversive test paradigms. A special role for the dopaminergic afferents to the striatum was not established in these tests.

Lesions in the rostral zona incerta (ZI) of male albino rats severely impaired feeding responses to 2-deoxy-D-glucose (2DG) and drinking responses to hypertonic saline during the first month after surgery. There was evidence of recovery 6 months after surgery but the magnitude of the improvement was small and severe impairments persisted in most subjects. A small but significant deficit in the feeding response to insulin persisted unabated after the 6-month recovery period. Caffeine or amphetamine pretreatment, but not apomorphine, increased ad lib feeding as well as the response to low doses of 2DG in rats with ZI lesions as well as in controls. The increased feeding response to 2DG after caffeine or amphetamine was larger than the sum of the effects of 2DG alone plus the effect of caffeine or amphetamine alone.

Knife cuts ventral or medial to the striatum were used to interrupt some of the principal connections of this structure. All of the cuts depleted striatal dopamine and produced aphagia and adipsia but there was no indication that the two classes of effects were always correlated. Cuts medial to the striatum produced the most severe DA depletions, persistent aphagia and adipsia, and the full complement of deficits in responding to glucoprivic and hydrational challenges that characterize rats that have recovered from lateral hypothalamic lesions. Cuts ventral to posterior portions of the striatum produced comparable periods of aphagia and adipsia (but few of the persisting impairments in responsiveness to regulatory challenges) even though their effect on striatal DA was relatively small (the average depletion was 51% compared to 89% for rats with cuts medial to the striatum). A second group of rats with cuts below more anterior aspects of the striatum sustained severe DA depletions (70%) but only very brief periods of aphagia and adipsia and only slight deficits in responding to osmotic challenges. The effects of the DA depleting cuts were compared with the behavioral consequences of coronal cuts in the midbrain tegmentum which selectively depleted hypothalamic norepinephrine. These cuts did not produce reliable effects on either food or water intake but abolished the normal feeding response to 2-deoxy-d-glucose without affecting the response to insulin. A correlational analysis of the biochemical and behavioral results of our cuts indicated a significant positive relationship between drinking in response to cellular thirst stimuli and hypothalamic NE as well as striatal DA. The postoperative body weights of our experimental animals were positively correlated with striatal dopamine and negatively related to hypothalamic norepinephrine.

Aphagia and adipsia of equivalent duration were produced by knife cuts along the lateral border of the hypothalamus (PH cuts), or the medial surface of the globus pallidus (MP cuts) in male albino rats. Striatal dopamine (DA) was reduced by 75% in animals with PH cuts but only 50% by MP cuts. Hypothalamic norepinephrine was reduced 25% by PH cuts and was unaffected by MP cuts. Aphagia and adipsia were positively correlated with DA depletions only in rats with PH cuts. Presurgical catecholamine depletions produced by chronic injections of alpha-methyl-p-tyrosine did not alter the duration of aphagia or adipsia resulting from these knife cuts. However, following recovery of ingestive behavior, rats with PH and MP cuts were supersensitive to the anorexic effects of the dopamine-beta-hydroxylase inhibitor, diethyldithiocarbamate. Exaggerated anorexia was also observed after DA blockade by haloperidol or alpha-adrenergic blockade by phenoxybenzamine. The most pronounced effects of catecholamine blockade were observed in rats with PH cuts.

Parasagittal knife cuts along the lateral border of the diencephalon (PS), coronal cuts across the lateral (LMFB) or medial (MMFB) components of the medial forebrain bundle reproduce most of the persisting deficits in responding to glucoprivic and hydrational challenges that characterize rats with lateral hypothalamic lesions or intracranial injections of 6-hydroxydopamine (60HDA). Each of these cuts produced a differnet pattern of regulatory deficits, suggesting that individual components of the LH syndrome may be mediated by different neural substrates. This interpretation is supported by the results of our correlational analysis of the relationships between specific behavioral and biochemical effects of our cuts. For example, feeding responses to insulin were reliably correlated with striatal DA concentrations but feeding responses to 2-deoxy-d-glucose (2DG) were not. Water intake during periods of food deprivation was reliably correlated with striatal DA but water intake after an experimental osmotic challenge was not. Only one of the common persisting deficits (impaired feeding response to peripheral injections of insulin) was positively correlated with the duration of aphagia and adipsia.