Vinblastine 10mg/10ml solution for injection vials

Hodgkin lymphoma during pregnancy is rare and may present diagnostic and therapeutic challenges, particularly when complicated by superior vena cava syndrome, a life-threatening condition. We report a 41-year-old pregnant patient at 30 weeks of gestation who presented with rapidly progressive dyspnea, cervical venous congestion, and facial edema. Imaging revealed a bulky mediastinal mass compressing the superior vena cava. Due to acute maternal risk, an emergency multidisciplinary decision was made to perform cesarean delivery followed by immediate uniportal video-assisted thoracoscopic biopsy. Histopathology confirmed classical Hodgkin lymphoma, nodular sclerosis subtype. Postpartum positron emission tomography/computed tomography demonstrated extensive supradiaphragmatic disease, and chemotherapy with doxorubicin, bleomycin, vinblastine, and dacarbazine was promptly initiated. The patient showed a favorable clinical and metabolic response, and the neonate demonstrated normal early postnatal development. This case highlights the importance of early recognition and multidisciplinary management of superior vena cava syndrome in pregnancy and raises the hypothesis that pregnancy-associated immunologic changes, including interleukin-6-mediated pathways, may contribute to accelerated disease progression.

Abstract licence: CC BY

Multisystem Langerhans cell histiocytosis (MS-LCH) is exceedingly rare in very young children and can present with predominant lung involvement. We report a 2-year-old boy who presented with prolonged fever, cough, and acute respiratory distress. Chest imaging revealed recurrent bilateral pneumothoraces requiring multiple chest drains; high-resolution computed tomography showed diffuse bilateral thin-walled lung cysts. Thoracoscopic lung biopsy with immunohistochemistry (CD1a+, CD45+, S100+) confirmed Langerhans cell histiocytosis. Given the strong association between pediatric pulmonary LCH and multisystem disease, a whole-body FDG-PET/CT was performed, revealing hepatic and splenic involvement and confirming a diagnosis of MS-LCH. Systemic chemotherapy with vinblastine and corticosteroids led to clinical improvement. We also review nine similar pediatric cases reported in the literature, highlighting the importance of recognizing pulmonary findings as a gateway to diagnosing underlying multisystem LCH.

Abstract licence: CC BY

Terpenoid natural products and their derivatives exhibit bioactivity that is utilized in FDA-approved drugs and candidates for future drugs; however, the widespread utilization of terpenoids has been limited by complex, low-yielding native biosyntheses and chemical syntheses. Microbial total/semi-biosynthesis of natural and new-to-nature terpenoids from sustainable feedstocks is scalable and can achieve economically viable cost targets. Herein, this review describes foundational advances in synthetic biology and metabolic engineering as exemplified by efforts to biosynthesize prominent terpenoids (i.e. artemisinin, taxol, vinblastine, QS-21, and cyclopamine) in engineered microorganisms (e.g. Escherichia coli and Saccharomyces cerevisiae). Emerging methods that accelerate microbial biosynthesis campaigns (i.e. automation, machine learning, artificial intelligence, and combinatorial screening) are then discussed.

Abstract licence: CC BY

The leaves of the medicinal-ornamental plant Catharanthus roseus serve as the exclusive source of the anticancer alkaloids vinblastine and vincristine. The limited synthesis of these alkaloids, alongside efforts to enhance their production, has consistently been a focal point of research. Water scarcity, recognized as one of the most significant constraints in agriculture, has prompted this study to examine the effects of the amino acid elicitor tryptophan and drought stress on the alterations in secondary metabolites of C. roseus and the genes implicated in their biosynthetic pathways. This investigation was factorial experiment conducted within a completely randomized design (CRD) with three replications. The first factor involved drought stress (40% and 100% field capacity), the second factor pertained to tryptophan concentrations (0 and 250 ppm), and the third factor encompassed duration (24, 48, 72, and 168 hours). Key genes associated with four metabolic pathways, phenolic/flavonoid, indole, terpenoid, and alkaloid pathways, were analyzed using quantitative polymerase chain reaction (qRT- PCR). Notably, the Cm gene (phenolic/flavonoid pathway) exhibited increased expression across all treatments, with the highest expression level recorded at 168 hours under the combined conditions of tryptophan and drought. Genes associated with the indole alkaloid pathway (As and Tdc) demonstrated similar temporal variations, with peak expression levels observed at 24 hours, particularly under drought stress. Genes within the terpenoid pathway (Sls) and alkaloid pathway (Str, Dat, Prx) displayed an initial increase in expression at 24 hours, followed by a decline at 48 and 72 hours, and a subsequent increase at 168 hours post-treatment in comparison to the control. Additionally, alkaloid accumulation (vincristine, vinblastine) significantly increased, especially under severe drought stress, correlating with the observed gene expression patterns. Non-enzymatic antioxidants, including phenols and flavonoids, also exhibited elevated levels in response to stress and tryptophan treatment. Furthermore, tryptophan application resulted in a doubling of plant biomass compared to the control. Collectively, the findings of this study suggest that the combination of drought stress and tryptophan application modulates gene expression and metabolite production in C. roseus, which may be crucial for optimizing alkaloid biosynthesis under drought stress conditions.

Abstract licence: CC BY