SummaryBackgroundChloroquine was used for malaria treatment until resistant Plasmodium falciparum was identified. Because 4-aminoquinolines with modified side chains, such as AQ-13, are active against resistant parasites, we compared AQ-13 against artemether plus lumefantrine for treatment of uncomplicated P falciparum malaria.MethodsWe did a randomised, non-inferiority trial. We screened men (≥18 years) with uncomplicated malaria in Missira (northeast Mali) and Bamako (capital of Mali) for eligibility (≥2000 asexual P falciparum parasites per μL of blood). Eligible participants were randomly assigned to either the artemether plus lumefantrine group or AQ-13 group by permuting blocks of four with a random number generator. Physicians and others caring for the participants were masked, except for participants who received treatment and the research pharmacist who implemented the randomisation and provided treatment. Participants received either 80 mg of oral artemether and 480 mg of oral lumefantrine twice daily for 3 days or 638·50 mg of AQ-13 base (two oral capsules) on days 1 and 2, and 319·25 mg base (one oral capsule) on day 3. Participants were monitored for parasite clearance (50 μL blood samples twice daily at 12 h intervals until two consecutive negative samples were obtained) and interviewed for adverse events (once every day) as inpatients during week 1. During the 5-week outpatient follow-up, participants were examined for adverse events and recurrent infection twice per week. All participants were included in the intention-to-treat analysis and per-protocol analysis, except for those who dropped out in the per-protocol analysis. The composite primary outcome was clearance of asexual parasites and fever by day 7, and absence of recrudescent infection by parasites with the same molecular markers from days 8 to 42 (defined as cure). Non-inferiority was considered established if the proportion of patients who were cured was higher for artemether plus lumefantrine than for AQ-13 and the upper limit of the 95% CI was less than the non-inferiority margin of 15%. This trial is registered at ClinicalTrials.gov, number NCT01614964.FindingsBetween Aug 6 and Nov 18, 2013, and between Sept 18 and Nov 20, 2015, 66 Malian men with uncomplicated malaria were enrolled. 33 participants were randomly assigned to each group. There were no serious adverse events (grade 2–4) and asexual parasites were cleared by day 7 in both groups. 453 less-severe adverse events (≤grade 1) were reported: 214 in the combination group and 239 in the AQ-13 group. Two participants withdrew from the AQ-13 group after parasite clearance and three were lost to follow-up. In the artemether plus lumefantrine group, two participants had late treatment failures (same markers as original isolates). On the basis of the per-protocol analysis, the AQ-13 and artemether plus lumefantrine groups had similar proportions cured (28 [100%] of 28 vs 31 [93·9%] of 33; p=0·50) and AQ-13 was not inferior to artemether plus lumefantrine (difference −6·1%, 95% CI −...
Patients with psoriasis tend to develop skin cancer, and the hyperproliferation of the epidermis is a histopathological hallmark of both psoriasis and cutaneous squamous cell carcinoma (SCC), indicating that they may share pathogenic mechanisms. Interleukin-17 (IL17) stimulates the proliferation of the epidermis, leading to psoriasis. Overexpression of Polo-like kinase 4 (PLK4), which controls centriole duplication, has been identified in SCC, which also shows the hyperproliferation of keratinocytes. To investigate the cooperation between IL17 signaling and centriole duplication in epidermal proliferation, we established psoriasis and skin papilloma models in wild type (WT), IL17 receptor A (T779A) knockin (Il17ra(T779A)-KI), and IL17 receptor C knockout (Il17rc-KO) mouse strains. Bioinformatics, Western blot, immunohistochemical staining, colony formation, and real-time PCR were used to determine the effect of IL17 signaling and centrinone on epithelial proliferation. In the psoriasis model, compared to WT and Il17ra(T779A)-KI, Il17rc-KO dramatically suppressed epidermal thickening. The proliferation of keratinocytes significantly decreased in this order from WT to Il17ra(T779A)-KI and Il17rc-KO mice. In the skin papilloma model, Il17ra(T779A)-KI significantly decreased tumor burden compared to the WT, while Il17rc-KO abolished papilloma development. However, centrinone, a selective inhibitor of PLK4, did not affect skin lesion formation in either model. Our data demonstrated that Il17ra(T779A)-KI and Il17rc-KO prevent the development of psoriasis and tumorigenesis in the skin, while the topical administration of centrinone does not have any effect.
Introduction: Hyperproliferation of epidermis is a histopathological hallmark of skin disorders, such as skin cancers and psoriasis. Polo-like kinase 4 (PLK4) is a master regulator of centriole replication and its overexpression has been identified in non-melanoma skin cancers. The aberrant proliferation of epidermal keratinocytes provoked by interleukin-17 (IL-17) leads to psoriasis. Thus, targeting centriole replication and IL-17 signaling simultaneously has been speculated as a potential therapeutic strategy. We hypothesized that inhibition of centriole duplication might enhance the blockade of epidermal proliferation through Il-17rc knockout. Methods: To investigate cooperation between IL-17 signaling and centriole duplication in the proliferation of epidermis, we used 37 mice to establish a two-stage model of skin carcinogenesis and 69 mice to establish imiquimod-induced psoriasis model in wild-type (WT), IL-17 receptor A (T779A) knock-in (Il-17ra(T779A)-KI) and IL-17 receptor C knock-out (Il-17rc-KO) C57BL/6J mouse strains. Results: During our 13-week monitor of the two-stage skin carcinogenesis model, we found that Il-17ra(T779A)-KI mice showed significantly decreased tumor incidence, tumor multiplicity, and tumor volume, compared to the wild-type mice. Il-17rc-KO mice didn’t develop any skin papilloma. The skin papilloma formed never progressed into squamous carcinoma based on our immunohistochemical (IHC) staining of laminin and cytokeratin 8. However, centrinone, a selective inhibitor of PLK4, didn’t affect skin papilloma formation or epidermal thickening. In our psoriasis model, we found that the thickness of the epidermis of Il-17rc-KO mice was dramatically decreased, compared to WT and Il-17ra(T779A)-KI mice. There was no significant difference between WT and Il-17ra(T779A)-KI mice, in terms of psoriasis formation and the thickness of the epidermis. Centrinone didn’t stall the thickening of the epidermis in the psoriasis model. IHC staining showed significantly increased Ki-67+ basal keratinocytes in the untreated skin of Il-17ra(T779A)-KI male mice, but not in female mice, compared to WT mice. In imiquimod-treated skin, the percentage of Ki-67+ basal keratinocytes significantly decreased in Il-17ra(T779A)-KI mice, compared to WT mice. The percentage of Ki-67+ basal keratinocytes was also dramatically decreased in Il-17rc-KO mice, compared to WT and Il-17ra(T779A)-KI mice. Conclusion: Our findings suggest that the proliferation of keratinocytes is not stalled by PLK4 inhibitor centrinone but is inhibited by Il-17rc-KO. Il-17ra(T779A)-KI significantly inhibits skin papilloma formation, but only slightly decreases epidermal thickening in the psoriasis model. However, in the untreated normal skin, Il-17ra(T779A)-KI increases keratinocyte proliferation based on Ki-67 staining. Citation Format: Ben Jin, Yongfeng Zhang, Haiyan D. Miller, Ling He, Zongbing You. IL-17RC, but not PLK4 inhibitor centrinone, plays a critical role in the development of skin papilloma and psoriasis in mouse models [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1313.
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