RESUMEN

Background: Fragmented cytokeratin 18 (fCK18) is released from damaged hepatocytes undergoing apoptosis and is recognized as a liver condition biomarker. We have developed a highly sensitive serum fCK18 CLEIA and reported that serum levels of this caspase-derived protein were significantly associated with hepatocyte ballooning, thus assisting in the accurate diagnosis of nonalcoholic steatohepatitis (NASH). We aim to investigate serum fCK18 levels in a variety of chronic liver diseases and to explore its potential as a prognostic marker of survival in hepatocellular carcinoma (HCC) patients. Methods: Serum fCK18 levels were measured using a highly sensitive CLEIA in 497 chronic liver disease patients (297 outpatients and 200 hospitalized with HCC). Results: In 497 chronic liver disease patients, serum fCK18 levels were significantly correlated with overall liver condition, including ALT, FIB-4 index and albumin-bilirubin (ALBI) score and were significantly increased in patients with HCC. In 200 HCC patients, serum fCK18 levels were significantly correlated with alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP), and were significantly associated with HCC stage, whereas FIB-4 index and ALBI score were not changed based on HCC stage. The Survival group had significantly lower levels of serum fCK18, AFP, DCP, FIB-4 index and ALBI score. A ROC analysis yield area under the curve (AUC) value of 0.728 for serum fCK18 is a significantly high value when compared to AUC measurements for other factors. Notably, AUROC values for serum fCK18 levels were constant in the short- and long-term by time-dependent ROC analysis for the prediction of HCC patient survival. HCC patients with serum fCK18 measured at < 1.15 ng/mL, AFP < 7.7 ng/mL, DCP < 133 mAU/mL, ALBI score < -2.97 or FIB-4 index < 6.4 had significantly longer rates of survival when compared to patients with values exceeding these thresholds. Serum fCK18 (HR, 3.5; P < 0.0001), DCP (HR, 3.2; P < 0.0001) and Barcelona Clinic Liver Cancer (BCLC) (HR, 2.4; P = 0.001) values were independent predictors of patient survival. [Conclusion] Serum fCK18 levels reflect overall liver function, the level of liver fibrosis and the progression of HCC, and are a potential predictor of survival in HCC patients.

RESUMEN

Caspase-generated fragmented cytokeratin 18 (fCK18) is recognized as a useful noninvasive biomarker in the diagnosis of nonalcoholic fatty liver disease (NAFLD), particularly nonalcoholic steatohepatitis (NASH). However, fCK18 measurement is not applied clinically due to widely variable cut-off values under the current enzyme-linked immunosorbent assay platform. Therefore, we developed a highly sensitive chemiluminescent enzyme immunoassay using newly developed monoclonal antibodies against fCK18 and investigated its relevance in NASH diagnosis. Serum fCK18 levels were measured in the derivation and validation cohort. The correlation between serum fCK18 levels and NAFLD activity score (NAS), fibrosis stage, and liver function was examined. Serum fCK18 levels were significantly correlated with alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase. Serum fCK18 levels were significantly associated with NAS, Brunt's grade/stage, Matteoni's classification, portal inflammation, and fat accumulation in the liver. Notably, hepatocyte ballooning was the only independent variable significantly associated with serum fCK18 in the multivariate linear regression analysis. Serum fCK18 levels were significantly elevated in patients with NAFLD and nonalcoholic fatty liver (NAFL) compared to healthy individuals. They were also significantly elevated in patients with NAFL compared to NASH defined by NAS or Matteoni's classification, with area under the curve values being 0.961 (NAFLD vs. healthy), 0.913 (NAFL vs. healthy), 0.763 (NASH vs. NAFL), and 0.796 (NASH type 3-4 vs. NAFL type 1-2). These results were confirmed by a validation cohort. Notably, changes over time in serum fCK18 levels were significantly correlated with changes in ALT, AST, and the fibrosis-4 index in 25 patients who underwent lifestyle modification. Serum fCK18 levels were significantly correlated with liver damage associated with NASH pathology. Serum fCK18 levels are accurate in distinguishing patients with NAFL or NASH from healthy individuals and may be useful to monitor NASH over time.

Asunto(s)

Queratina-18 , Enfermedad del Hígado Graso no Alcohólico , Alanina Transaminasa , Biomarcadores/sangre , Fibrosis , Humanos , Queratina-18/sangre , Enfermedad del Hígado Graso no Alcohólico/diagnóstico

RESUMEN

Thermoresponsive water-soluble polymers, aqueous solutions of which undergo lower critical solution temperature (LCST)-type phase separation, have been investigated in detail for several decades. To develop LCST-type thermoresponsive polymers with new polymer backbone, 4-azido-5-hexynamide (AHA) derivatives were designed as monomers for copper(I)-catalyzed azide-alkyne cycloaddition (CuAAC) polymerization. AHA derivatives carrying secondary amide side chains, that is, 4-azido-N-methyl-5-hexynamide (M), 4-azido-N-ethyl-5-hexynamide (E), and 4-azido-N-isopropyl-5-hexynamide (iP), were first synthesized and polymerized by CuAAC to obtain polymers (poly(M), poly(E), and poly(iP)). Contrary to our expectation, poly(M), poly(E), and poly(iP) were insoluble in water and many organic solvents presumably because of the formation of hydrogen bonding between the amide side chains or between the amide side chains and triazole residues in the backbone. Thus, AHA derivatives carrying tertiary amide side chains, that is, 4-azido-N,N-dimethyl-5-hexynamide (MM), 4-azido-N-ethyl-N-methyl-5-hexynamide (ME), 4-azido-N-isopropyl-N-methyl-5-hexynamide (MiP), and 4-azido-N,N-diethyl-5-hexynamide (EE), were also synthesized and polymerized to yield polymers (poly(MM), poly(ME), poly(MiP), and poly(EE)). These polymers were soluble in a number of common organic solvents. It is noteworthy that poly(MM) and poly(ME) were also soluble in water. The phase separation behavior of 1.0 wt % aqueous solutions of poly(MM) and poly(ME) was then investigated by transmittance measurements. These data indicated that poly(ME) was an LCST-type thermoresponsive polymer, whereas poly(MM) was not. A large hysteresis was observed in the transmittance measurements for the poly(ME) aqueous solution because of slow rehydration after phase separation. The phase separation behavior was investigated preliminarily by differential scanning calorimetry and 1H NMR.

RESUMEN

The morphology and crystalline quality of p-GaN shells on coaxial GaInN/GaN multiple quantum shell (MQS) nanowires (NWs) were investigated using metal-organic chemical vapor deposition. By varying the trimethylgallium (TMG) flow rate, Mg doping, and growth temperature, it was verified that the TMG supply and growth temperature were the dominant parameters in the control of the p-GaN shape on NWs. Specifically, a sufficiently high TMG supply enabled the formation of a pyramid-shaped NW structure with a uniform p-GaN shell. The ratio of the growth rate between the c- and m-planes on the NWs was calculated to be approximately 0.4545. High-angle annular dark-field scanning transmission electron microscopy characterization confirmed that no clear extended defects were present in the n-GaN core and MQS/p-GaN shells on the sidewall. Regarding the p-GaN shell above the c-plane MQS region, only a few screw dislocations and Frank-type partial dislocations appeared at the interface between the serpentine c-plane MQS and the p-GaN shell near the tips. This suggested that the crystalline quality of the MQS structure can trigger the formation of screw dislocations and Frank-type partial dislocations during the p-GaN growth. The growth mechanism of the p-GaN shell on NWs was also discussed. To inspect the electronic properties, a prototype of a micro light-emitting diode (LED) with a chip size of 50 × 50 µm2 was demonstrated in the NWs with optimal growth. By correlating the light output curve with the electroluminescence spectra, three different emission peaks (450, 470, and 510 nm) were assignable to the emission from the m-, r-, and c-planes, respectively.

RESUMEN

Fragmented cytokeratin 18 (fCK18) released from epithelial cells undergoing apoptosis is widely studied in various diseases. However, fCK18 measurement is not utilized in clinical practice due to imprecise disease-state cutoff values. Therefore, we set out to generate new monoclonal antibodies (mAbs) and a recombinant fCK18 (rfCK18) calibrator in an effort to develop a highly sensitive chemiluminescent enzyme immunoassay (CLEIA). New capture mAb (K18-624) had a high binding ability compared to the current commercial antibody. New detection mAb (K18-328) recognized 323S-340G of CK18. A rfCK18 was expressed in the soluble fraction of E. coli when the N-terminal region (260 amino acid residues) of CK18 was truncated. Analysis of performance and measurement of human fCK18 were evaluated using K18-624 and K18-328 in a highly sensitive CLEIA. The coefficients of variation (CV) for within-run and between-day repeatability were below 10% and the recoveries were in the range of 15%. The detection sensitivity was 0.056 ng/mL. Serum fCK18 levels were significantly increased in non-alcoholic steatohepatitis (NASH) patients when compared to healthy individuals. Our new fCK18 mAbs showed high affinity and sensitivity. CLEIA using our new antibodies will be useful in measuring fCK18 in human blood thereby generating accurate clinical diagnoses of human liver diseases.

Asunto(s)

Anticuerpos Monoclonales/inmunología , Queratina-18/sangre , Técnicas de Diagnóstico Molecular/métodos , Enfermedad del Hígado Graso no Alcohólico/sangre , Biomarcadores/sangre , Humanos , Técnicas para Inmunoenzimas/métodos , Técnicas para Inmunoenzimas/normas , Queratina-18/inmunología , Técnicas de Diagnóstico Molecular/normas , Sensibilidad y Especificidad

RESUMEN

Here, we systematically investigated the growth conditions of an n-GaN cap layer for nanowire-based light emitters with a tunnel junction. Selective-area growth of multiple quantum shell (MQS)/nanowire core-shell structures on a patterned n-GaN/sapphire substrate was performed by metal-organic vapor phase epitaxy, followed by the growth of a p-GaN, an n++/ p++-GaN tunnel junction, and an n-GaN cap layer. Specifically, two-step growth of the n-GaN cap layer was carried out under various growth conditions to determine the optimal conditions for a flat n-GaN cap layer. Scanning transmission electron microscopy characterization revealed that n++-GaN can be uniformly grown on the m-plane sidewall of MQS nanowires. A clear tunnel junction, involving 10-nm-thick p++-GaN and 3-nm-thick n++-GaN, was confirmed on the nonpolar m-planes of the nanowires. The Mg doping concentration and distribution profile of the p++-GaN shell were inspected using three-dimensional atom probe tomography. Afterward, the reconstructed isoconcentration mapping was applied to identify Mg-rich clusters. The density and average size of the Mg clusters were estimated to be approximately 4.3 × 1017 cm-3 and 5 nm, respectively. Excluding the Mg atoms contained in the clusters, the remaining Mg doping concentration in the p++-GaN region was calculated to be 1.1 × 1020 cm-3. Despite the lack of effective activation, a reasonably low operating voltage and distinct light emissions were preliminarily observed in MQS nanowire-based LEDs under the optimal n-GaN cap growth conditions. In the fabricated MQS-nanowire devices, carriers were injected into both the r-plane and m-plane of the nanowires without a clear quantum confinement Stark effect.