Design and synthesis of S-ribosylhomocysteine analogues

Bacteria are known to release a large variety of small molecules known as autoinducers (AI) which effect quorum sensing (QS) initiation. The interruption of QS effects bacterial communication, growth and virulence. ^ Three novel classes of S-ribosylhomocysteine (SRH) analogues as potential inhibitors of S-ribosylhomocysteinase (LuxS enzyme) and AI-2 modulators of QS were developed. The synthesis of 2-deoxy-2-bromo-SRH analogues was attempted by coupling of the corresponding 2-bromo-2-deoxypentafuranosyl precursors with the homocysteinate anion. The displacement of the bromide from C2 rather than the expected substitution of the mesylate from C5 was observed. The synthesis of 4-C-alkyl/aryl-S-ribosylhomocysteine analogues involved the following steps: (i) conversion of the D-ribose to the ribitol-4-ulose; (ii) diastereoselective addition of various alkyl or aryl or vinyl Grignard reagents to 4-ketone intermediate; (iii) oxidation of the primary hydroxyl group at C1 followed by the intramolecular ring closure to the corresponding 4-C-alkyl/aryl-substituted ribono-1,4-lactones; (iv) displacement of the activated 5-hydroxyl group with the protected homocysteinate. Treatment of the 4-C-alkyl/aryl-substituted SRH analogues with lithium triethylborohydride effected reduction of the ribonolactone to the ribose (hemiacetal) and subsequent global deprotection with trifluoroacetic acid provided 4-C-alkyl/aryl-SRHs. ^ The 4-[thia]-SRH were prepared from the 1-deoxy-4-thioribose through the coupling of the &agr;-fluoro thioethers (thioribosyl fluorides) with homocysteinate anion. The 4-[thia]-SRH analogues showed concentration dependent effect on the growth on las (50% inhibitory effect at 200 µg/mL). The most active was 1-deoxy-4-[thia]-SRH analogue with sufur atom in the ring oxidized to sulfoxide decreasing las gene activity to approximately 35% without affecting rhl gene. Neither of the tested compounds had effect on bioluminescence nor on total growth of V. harveyi, but had however slight inhibition of the QS.^

Dinâmica das configurações de formação e inibição das chuvas no Rio Grande do Norte: caracterização hidroclimática do estado

This study aimed to evaluate the influence of the main meteorological mechanisms trainers and inhibitors of precipitation, and the interactions between different scales of operation, the spatial and temporal variability of the annual cycle of precipitation in the Rio Grande do Norte. Além disso, considerando as circunstâncias locais e regionais, criando assim uma base científica para apoiar ações futuras na gestão da demanda de água no Estado. Database from monthly precipitation of 45 years, ranging between 1963 and 2007, data provided by EMPARN. The methodology used to achieve the results was initially composed of descriptive statistical analysis of historical data to prove the stability of the series, were applied after, geostatistics tool for plotting maps of the variables, within the geostatistical we opted for by Kriging interpolation method because it was the method that showed the best results and minor errors. Among the results, we highlight the annual cycle of rainfall the State which is influenced by meteorological mechanisms of different spatial and temporal scales, where the main mechanisms cycle modulators are the Conference Intertropical Zone (ITCZ) acting since midFebruary to mid May throughout the state, waves Leste (OL), Lines of instability (LI), breeze systems and orographic rainfall acting mainly in the Coastal strip between February and July. Along with vortice of high levels (VCANs), Complex Mesoscale Convective (CCMs) and orographic rain in any region of the state mainly in spring and summer. In terms of larger scale phenomena stood out El Niño and La Niña, ENSO in the tropical Pacific basin. In La Niña episodes usually occur normal or rainy years, as upon the occurrence of prolonged periods of drought are influenced by EL NIÑO. In the Atlantic Ocean the standard Dipole also affects the intensity of the rainfall cycle in State. The cycle of rains in Rio Grande do Norte is divided into two periods, one comprising the regions West, Central and the Western Portion of the Wasteland Potiguar mesoregions of west Chapada Borborema, causing rains from midFebruary to mid-May and a second period of cycle, between February-July, where rains occur in mesoregions East and of the Wasteland, located upwind of the Chapada Borborema, both interspersed with dry periods without occurrence of significant rainfall and transition periods of rainy - dry and dry-rainy where isolated rainfall occur. Approximately 82% of the rainfall stations of the state which corresponds to 83.4% of the total area of Rio Grande do Norte, do not record annual volumes above 900 mm. Because the water supply of the State be maintained by small reservoirs already are in an advanced state of eutrophication, when the rains occur, act to wash and replace the water in the reservoirs, improving the quality of these, reducing the eutrophication process. When rain they do not significantly occur or after long periods of shortages, the process of eutrophication and deterioration of water in dams increased significantly. Through knowledge of the behavior of the annual cycle of rainfall can have an intimate knowledge of how it may be the tendency of rainy or prone to shortages following period, mainly observing the trends of larger scale phenomena

Desenvolvimento teórico e experimental de FSS com elementos fractais de Gosper em estruturas de multicamadas

The fractal self-similarity property is studied to develop frequency selective surfaces (FSS) with several rejection bands. Particularly, Gosper fractal curves are used to define the shapes of the FSS elements. Due to the difficulty of making the FSS element details, the analysis is developed for elements with up to three fractal levels. The simulation was carried out using Ansoft Designer software. For results validation, several FSS prototypes with fractal elements were fabricated. In the fabrication process, fractals elements were designed using computer aided design (CAD) tools. The prototypes were measured using a network analyzer (N3250A model, Agilent Technologies). Matlab software was used to generate compare measured and simulated results. The use of fractal elements in the FSS structures showed that the use of high fractal levels can reduce the size of the elements, at the same time as decreases the bandwidth. We also investigated the effect produced by cascading FSS structures. The considered cascaded structures are composed of two FSSs separated by a dielectric layer, which distance is varied to determine the effect produced on the bandwidth of the coupled geometry. Particularly, two FSS structures were coupled through dielectric layers of air and fiberglass. For comparison of results, we designed, fabricated and measured several prototypes of FSS on isolated and coupled structures. Agreement was observed between simulated and measured results. It was also observed that the use of cascaded FSS structures increases the FSSs bandwidths and, in particular cases, the number of resonant frequencies, in the considered frequency range. In future works, we will investigate the effects of using different types of fractal elements, in isolated, multilayer and coupled FSS structures for applications on planar filters, high-gain microstrip antennas and microwave absorbers

Projeto de absorvedores de micro-ondas integrados com superfícies seletivas em frequência

Considering the fact that, the use of wireless communication systems has grown too fast, investigations concerning absorbers of electromagnetic waves has called closer attention of researchers. It is applicable from indoor systems to military applications. Paralleling with this growth, some extremely relevant investigations through Frequency Selective Surfaces (FSS) allows its filter property to be applicable in several systems, for example: reflector antennas, band-pass radomes, and absorbers, which are the main objective of this work. Therefore, the main goal of this work concerns to design micro-waves absorbers through FSS. Thus, the methodology consists basically in two steps: the first step concerns a theoretical and numerical analysis of the structures involved in the process of absorption, the second step, the analysis of the cascaded structures. In order to carry out the analysis, the Equivalent Circuit Method will be used. This method provides characteristics of transmission from the structure, for a plane wave incidence and it requires an extremely limited computing resource in relation if compared to full wave analyses method. Hence, it is useful to allow fast predictions of the development of the structures. Furthermore, a spreading matrix will be used in order to cascade the conductive FSS and the resistive FSS achieving absorption characteristics in the designed band. The experimental results used for the analysis are found in the literature due to the difficulty of building soon, given that it is not a simple construction technique. To conclude, a mathematical development through the Equivalent Circuit Method of a FSS modeling with cross-dipole geometry and a resistive FSS will be presented, as well as the cascading involving the two structures. The same setting is used with a square loop geometry. Besides it, the next steps will be discussed in the conclusion.

Caracterização de superfícies seletivas de frequência de periódicas e não-periódicas

The past years have seen a great interest in the use of frequency selective surfaces (FSS), as spatial filters, in many microwave applications. Among these, we highlight applications in telecommunication systems (such as satellite communications and radar), high gain antennas (combined with planar antennas) and (home and industrial) microwave ovens. The FSS is usually composed of two-dimensional periodic arrays, with equally spaced elements, which may be metallic patches (printed on dielectric substrates) or aperture (holes in thin metal surfaces). Using periodic arrays, the FSS have been able to meet the demands of the telecommunications industry. However, new demands are finding technological limitations. In this context, adverse filtering requirements have forced designers to use FSS optimization methods to find specific formats of FSS elements. Another alternative that has been used to increase the selectivity of the FSS is the cascaded FSS, a simple technique that has as main drawback the increased dimensions of the structure, as well as its weight. This work proposes the development of a new class of selective surfaces frequency (FSS) composed of quasi-periodic (or non-periodic) arrangements. The proposed FSS have no array periodicity, in relation with the spatial position of their elements. The frequency responses of these structures were simulated using commercial softwares that implement full-wave methods. For the purpose of validation of this study, FSS prototypes were built and measured, being possible to observe a good agreement between simulated and measured results. The main conclusions of this work are presented, as well as suggestions for future works.

Estudo da variação da periodicidade e do acoplamento entre superfícies seletivas de frequência com elementos fractais e helicoidais em estruturas de multicamadas

This work aims to investigate the behavior of fractal and helical elements structures in planar microstrip. In particular, the frequency selective surfaces (FSSs) had changed its conventional elements to fractal and helical formats. The dielectric substrate used was fiberglass (FR-4) and has a thickness of 1.5 mm, a relative permittivity 4.4 and tangent loss equal to 0.02. For FSSs, was adopting the Dürer’s fractal geometry and helical geometry. To make the measurements, we used two antennas horns in direct line of sight, connected by coaxial cable to the vector network analyzer. Some prototypes were select for built and measured. From preliminary results, it was aimed to find practical applications for structures from the cascading between them. For FSSs with Dürer’s fractal elements was observed behavior provided by the multiband fractal geometry, while the bandwidth has become narrow as the level of iteration fractal increased, making it a more selective frequency with a higher quality factor. A parametric analysis allowed the analysis of the variation of the air layer between them. The cascading between fractal elements structure were considered, presented a tri-band behavior for certain values of the layer of air between them, and find applications in the licensed 2.5GHz band (2.3-2.7) and 3.5GHz band (3.3-3.8). For FSSs with helical elements, six structures were considered, namely H0, H1, H2, H3, H4 and H5. The electromagnetic behavior of them was analyzed separately and cascaded. From preliminary results obtained from the separate analysis of structures, including the cascade, the higher the bandwidth, in that the thickness of the air layer increases. In order to find practical applications for helical structures cascaded, the helical elements structure has been cascaded find applications in the X-band (8.0-12.0) and unlicensed band (5.25-5.85). For numerical and experimental characterization of the structures discussed was used, respectively, the commercial software Ansoft Designer and a vector network analyzer, Agilent N5230A model.

A Review of ENSO Influence on the North Atlantic. A Non-Stationary Signal

The atmospheric seasonal cycle of the North Atlantic region is dominated by meridional movements of the circulation systems: from the tropics, where the West African Monsoon and extreme tropical weather events take place, to the extratropics, where the circulation is dominated by seasonal changes in the jetstream and extratropical cyclones. Climate variability over the North Atlantic is controlled by various mechanisms. Atmospheric internal variability plays a crucial role in the mid-latitudes. However, El Niño-Southern Oscillation (ENSO) is still the main source of predictability in this region situated far away from the Pacific. Although the ENSO influence over tropical and extra-tropical areas is related to different physical mechanisms, in both regions this teleconnection seems to be non-stationary in time and modulated by multidecadal changes of the mean flow. Nowadays, long observational records (greater than 100 years) and modeling projects (e.g., CMIP) permit detecting non-stationarities in the influence of ENSO over the Atlantic basin, and further analyzing its potential mechanisms. The present article reviews the ENSO influence over the Atlantic region, paying special attention to the stability of this teleconnection over time and the possible modulators. Evidence is given that the ENSO–Atlantic teleconnection is weak over the North Atlantic. In this regard, the multidecadal ocean variability seems to modulate the presence of teleconnections, which can lead to important impacts of ENSO and to open windows of opportunity for seasonal predictability.

microRNA Regulation of Cellular Immunity

Immunity is broadly defined as a mechanism of protection against non-self entities, a process which must be sufficiently robust to both eliminate the initial foreign body and then be maintained over the life of the host. Life-long immunity is impossible without the development of immunological memory, of which a central component is the cellular immune system, or T cells. Cellular immunity hinges upon a naïve T cell pool of sufficient size and breadth to enable Darwinian selection of clones responsive to foreign antigens during an initial encounter. Further, the generation and maintenance of memory T cells is required for rapid clearance responses against repeated insult, and so this small memory pool must be actively maintained by pro-survival cytokine signals over the life of the host.

T cell development, function, and maintenance are regulated on a number of molecular levels through complex regulatory networks. Recently, small non-coding RNAs, miRNAs, have been observed to have profound impacts on diverse aspects of T cell biology by impeding the translation of RNA transcripts to protein. While many miRNAs have been described that alter T cell development or functional differentiation, little is known regarding the role that miRNAs have in T cell maintenance in the periphery at homeostasis.

In Chapter 3 of this dissertation, tools to study miRNA biology and function were developed. First, to understand the effect that miRNA overexpression had on T cell responses, a novel overexpression system was developed to enhance the processing efficiency and ultimate expression of a given miRNA by placing it within an alternative miRNA backbone. Next, a conditional knockout mouse system was devised to specifically delete miR-191 in a cell population expressing recombinase. This strategy was expanded to permit the selective deletion of single miRNAs from within a cluster to discern the effects of specific miRNAs that were previously inaccessible in isolation. Last, to enable the identification of potentially therapeutically viable miRNA function and/or expression modulators, a high-throughput flow cytometry-based screening system utilizing miRNA activity reporters was tested and validated. Thus, several novel and useful tools were developed to assist in the studies described in Chapter 4 and in future miRNA studies.

In Chapter 4 of this dissertation, the role of miR-191 in T cell biology was evaluated. Using tools developed in Chapter 3, miR-191 was observed to be critical for T cell survival following activation-induced cell death, while proliferation was unaffected by alterations in miR-191 expression. Loss of miR-191 led to significant decreases in the numbers of CD4+ and CD8+ T cells in the periphery lymph nodes, but this loss had no impact on the homeostatic activation of either CD4+ or CD8+ cells. These peripheral changes were not caused by gross defects in thymic development, but rather impaired STAT5 phosphorylation downstream of pro-survival cytokine signals. miR-191 does not specifically inhibit STAT5, but rather directly targets the scaffolding protein, IRS1, which in turn alters cytokine-dependent signaling. The defect in peripheral T cell maintenance was exacerbated by the presence of a Bcl-2YFP transgene, which led to even greater peripheral T cell losses in addition to developmental defects. These studies collectively demonstrate that miR-191 controls peripheral T cell maintenance by modulating homeostatic cytokine signaling through the regulation of IRS1 expression and downstream STAT5 phosphorylation.

The studies described in this dissertation collectively demonstrate that miR-191 has a profound role in the maintenance of T cells at homeostasis in the periphery. Importantly, the manipulation of miR-191 altered immune homeostasis without leading to severe immunodeficiency or autoimmunity. As much data exists on the causative agents disrupting active immune responses and the formation of immunological memory, the basic processes underlying the continued maintenance of a functioning immune system must be fully characterized to facilitate the development of methods for promoting healthy immune function throughout the life of the individual. These findings also have powerful implications for the ability of patients with modest perturbations in T cell homeostasis to effectively fight disease and respond to vaccination and may provide valuable targets for therapeutic intervention.

Bile acids destabilise HIF-1α and promote anti-tumour phenotypes in cancer cell models

BACKGROUND: The role of the microbiome has become synonymous with human health and disease. Bile acids, as essential components of the microbiome, have gained sustained credibility as potential modulators of cancer progression in several disease models. At physiological concentrations, bile acids appear to influence cancer phenotypes, although conflicting data surrounds their precise physiological mechanism of action. Previously, we demonstrated bile acids destabilised the HIF-1α subunit of the Hypoxic-Inducible Factor-1 (HIF-1) transcription factor. HIF-1 overexpression is an early biomarker of tumour metastasis and is associated with tumour resistance to conventional therapies, and poor prognosis in a range of different cancers. METHODS: Here we investigated the effects of bile acids on the cancer growth and migratory potential of cell lines where HIF-1α is known to be active under hypoxic conditions. HIF-1α status was investigated in A-549 lung, DU-145 prostate and MCF-7 breast cancer cell lines exposed to bile acids (CDCA and DCA). Cell adhesion, invasion, migration was assessed in DU-145 cells while clonogenic growth was assessed in all cell lines. RESULTS: Intracellular HIF-1α was destabilised in the presence of bile acids in all cell lines tested. Bile acids were not cytotoxic but exhibited greatly reduced clonogenic potential in two out of three cell lines. In the migratory prostate cancer cell line DU-145, bile acids impaired cell adhesion, migration and invasion. CDCA and DCA destabilised HIF-1α in all cells and significantly suppressed key cancer progression associated phenotypes; clonogenic growth, invasion and migration in DU-145 cells. CONCLUSIONS: These findings suggest previously unobserved roles for bile acids as physiologically relevant molecules targeting hypoxic tumour progression.

Ultra Compact Inline E-Plane Waveguide Bandpass Filters Using Cross Coupling

This paper presents novel ultra-compact waveguide bandpass filters that exhibit pseudo elliptic responses with ability to place transmission zeros on both sides of the passband to form sharp roll offs. The filters contain E plane extracted pole sections cascaded with cross-coupled filtering blocks. Compactness is achieved by the use of evanescent mode sections and closer arranged resonators modified to shrink in size. The filters containing non-resonating nodes are designed by means of the generalized coupling coefficients (GCC) extraction procedure for the cross-coupled filtering blocks and extracted pole sections. We illustrate the performance of the proposed structures through the design examples of a third and a fourth order filters with center frequencies of 9.2 GHz and 10 GHz respectively. The sizes of the proposed structures suitable for fabricating using the low cost E plane waveguide technology are 38% smaller than ones of the E plane extracted pole filter of the same order.

Design, analysis and evaluation of sigma-delta based beamformers for medical ultrasound imaging applications

The inherent analogue nature of medical ultrasound signals in conjunction with the abundant merits provided by digital image acquisition, together with the increasing use of relatively simple front-end circuitries, have created considerable demand for single-bit  beamformers in digital ultrasound imaging systems. Furthermore, the increasing need to design lightweight ultrasound systems with low power consumption and low noise, provide ample justification for development and innovation in the use of single-bit  beamformers in ultrasound imaging systems. The overall aim of this research program is to investigate, establish, develop and confirm through a combination of theoretical analysis and detailed simulations, that utilize raw phantom data sets, suitable techniques for the design of simple-to-implement hardware efficient  digital ultrasound beamformers to address the requirements for 3D scanners with large channel counts, as well as portable and lightweight ultrasound scanners for point-of-care applications and intravascular imaging systems. In addition, the stability boundaries of higher-order High-Pass (HP) and Band-Pass (BP) Σ−Δ modulators for single- and dual- sinusoidal inputs are determined using quasi-linear modeling together with the describing-function method, to more accurately model the  modulator quantizer. The theoretical results are shown to be in good agreement with the simulation results for a variety of input amplitudes, bandwidths, and modulator orders. The proposed mathematical models of the quantizer will immensely help speed up the design of higher order HP and BP Σ−Δ modulators to be applicable for digital ultrasound beamformers. Finally, a user friendly design and performance evaluation tool for LP, BP and HP  modulators is developed. This toolbox, which uses various design methodologies and covers an assortment of  modulators topologies, is intended to accelerate the design process and evaluation of  modulators. This design tool is further developed to enable the design, analysis and evaluation of  beamformer structures including the noise analyses of the final B-scan images. Thus, this tool will allow researchers and practitioners to design and verify different reconstruction filters and analyze the results directly on the B-scan ultrasound images thereby saving considerable time and effort.

Clinical potential of oligonucleotide-based therapeutics in the respiratory system

The discovery of an ever-expanding plethora of coding and non-coding RNAs with nodal and causal roles in the regulation of lung physiology and disease is reinvigorating interest in the clinical utility of the oligonucleotide therapeutic class. This is strongly supported through recent advances in nucleic acids chemistry, synthetic oligonucleotide delivery and viral gene therapy that have succeeded in bringing to market at least three nucleic acid-based drugs. As a consequence, multiple new candidates such as RNA interference modulators, antisense, and splice switching compounds are now progressing through clinical evaluation. Here, manipulation of RNA for the treatment of lung disease is explored, with emphasis on robust pharmacological evidence aligned to the five pillars of drug development: exposure to the appropriate tissue, binding to the desired molecular target, evidence of the expected mode of action, activity in the relevant patient population and commercially viable value proposition.

Survival or death: a dual role of autophagy in stress-induced pericyte loss in diabetic retinopathy

Aims/hypothesis
Intra-retinal extravasation and modification of LDL have been implicated in diabetic retinopathy: autophagy may mediate these effects.
Methods
Immunohistochemistry was used to detect autophagy marker LC3B in human and murine diabetic and non-diabetic retinas. Cultured human retinal capillary pericytes (HRCPs) were treated with in vitro-modified heavily-oxidised glycated LDL (HOG-LDL) vs native LDL (N-LDL) with or without autophagy modulators: green fluorescent protein–LC3 transfection; small interfering RNAs against Beclin-1, c-Jun NH(2)-terminal kinase (JNK) and C/EBP-homologous protein (CHOP); autophagy inhibitor 3-MA (5 mmol/l) and/or caspase inhibitor Z-VAD-fmk (100 μmol/l). Autophagy, cell viability, oxidative stress, endoplasmic reticulum stress, JNK activation, apoptosis and CHOP expression were assessed by western blots, CCK-8 assay and TUNEL assay. Finally, HOG-LDL vs N-LDL were injected intravitreally to STZ-induced diabetic vs control rats (yielding 50 and 200 mg protein/l intravitreal concentration) and, after 7 days, retinas were analysed for ER stress, autophagy and apoptosis.
Results
Intra-retinal autophagy (LC3B staining) was increased in diabetic vs non-diabetic humans and mice. In HRCPs, 50 mg/l HOG-LDL elicited autophagy without altering cell viability, and inhibition of autophagy decreased survival. At 100–200 mg/l, HOG-LDL caused significant cell death, and inhibition of either autophagy or apoptosis improved survival. Further, 25–200 mg/l HOG-LDL dose-dependently induced oxidative and ER stress. JNK activation was implicated in autophagy but not in apoptosis. In diabetic rat retina, 50 mg/l intravitreal HOG-LDL elicited autophagy and ER stress but not apoptosis; 200 mg/l elicited greater ER stress and apoptosis.
Conclusions
Autophagy has a dual role in diabetic retinopathy: under mild stress (50 mg/l HOG-LDL) it is protective; under more severe stress (200 mg/l HOG-LDL) it promotes cell death.

Natural history of markers of collagen turnover in patients with early diastolic dysfunction and impact of eplerenone

OBJECTIVES: This study was designed to evaluate the impact of eplerenone on collagen turnover in preserved systolic function heart failure (HFPSF).

BACKGROUND: Despite growing interest in abnormal collagen metabolism as a feature of HFPSF with diastolic dysfunction, the natural history of markers of collagen turnover and the impact of selective aldosterone antagonism on this natural history remains unknown.

METHODS: We evaluated 44 patients with HFPSF, randomly assigned to control (n = 20) or eplerenone 25 mg daily (n = 24) for 6 months, increased to 50 mg daily from 6 to 12 months. Serum markers of collagen turnover and inflammation were analyzed at baseline and at 6 and 12 months and included pro-collagen type-I and -III aminoterminal peptides, matrix metalloproteinase type-2, interleukin-6 and -8, and tumor necrosis factor-alpha. Doppler-echocardiographic assessment of diastolic filling indexes and tissue Doppler analyses were also obtained.

RESULTS: The mean age of the patients was 80 +/- 7.8 years; 46% were male; 64% were receiving an angiotensin-converting enzyme inhibitor, 34% an angiotensin-II receptor blocker, and 68% were receiving beta-blocker therapy. Pro-collagen type-III and -I aminoterminal peptides, matrix metalloproteinase type-2, interleukin-6 and -8, and tumor necrosis factor-alpha increased with time in the control group. Eplerenone treatment had no significant impact on any biomarker at 6 months but attenuated the increase in pro-collagen type-III aminoterminal peptide at 12 months (p = 0.006). Eplerenone therapy was associated with modest effects on diastolic function without any impact on clinical variables or brain natriuretic peptide.

CONCLUSIONS: This study demonstrates progressive increases in markers of collagen turnover and inflammation in HFPSF with diastolic dysfunction. Despite high background utilization of renin-angiotensin-aldosterone modulators, eplerenone therapy prevents a progressive increase in pro-collagen type-III aminoterminal peptide and may have a role in management of this disease. (The Effect of Eplerenone and Atorvastatin on Markers of Collagen Turnover in Diastolic Heart Failure; NCT00505336).

Chemoprevention in BRCA1 Mutation Carriers—A Proof-of-Concept Study

Background: Women with germline BRCA1 mutations have a high lifetime risk of breast cancer, with the only available risk-reduction strategies being risk-reducing surgery or chemoprevention. These women predominantly develop triple-negative breast cancers; hence, it is unlikely that selective estrogen receptor modulators (serms) will reduce the risk of developing cancer, as these have not been shown to reduce the incidence of estrogen receptor–negative breast cancers. Preclinical data from our laboratory suggest that exposure to estrogen and its metabolites is capable of causing dna double-strand breaks (dsbs) and thus driving genomic instability, an early hallmark of BRCA1-related breast cancer. Therefore, an approach that lowers circulating estrogen levels and reduces estrogen metabolite exposure may prove a successful chemopreventive strategy.

Aims: To provide proof of concept of the hypothesis that the combination of luteinizing-hormone releasing-hormone agonists (lhrha) and aromatase inhibitors (ais) can suppress circulating levels of estrogen and its metabolites in BRCA1 mutation carriers, thus reducing estrogen metabolite levels in breast cells, reducing dna dsbs, and potentially reducing the incidence of breast cancer.

Methods: 12 Premenopausal BRCA1 mutation carriers will undergo baseline ultrasound-guided breast core biopsy and plasma and urine sampling. Half the women will be treated for 3 months with combination goserelin (lhrha) plus anastrazole (ai), and the remainder with tamoxifen (serm) before repeat tissue, plasma, and urine sampling. After a 1-month washout period, groups will cross over for a further 3 months treatment before final biologic sample collection. Tissue, plasma, and urine samples will be examined using a combination of immunohistochemistry, comet assays, and ultrahigh performance liquid chromatography tandem mass spectrometry to assess the impact of lhrha plus ai compared with serm on levels of dna damage, estrogens, and genotoxic estrogen metabolites. Quality of life will also be assessed during the study.

Results: This trial is currently ongoing.