Institutional Review Board Ethics Committee Research Articles

Endoscopic-Assisted Microsurgical Removal of a Tectal Plate Pilocytic Astrocytoma Through the Occipital Inter Hemispheric Transtentorial Approach: 2-Dimensional Operative Video

Pilocytic astrocytomas are challenging benign midline lesions which occur rarely in adults where they represent 2.3% of the tumours. 1,2 Posterior fossa location is the most frequent, but they also can be seen in the brainstem, tectal plate, and optochiasmatic region. 1,2 Tectal plate location is very challenging and can be reached through a infraoccipital supracerebellar approach 1,2 or the occipital inter hemispheric transtentorial approach. We present the case of a 32-years-old patient who presented with acute hydrocephalus 2 years previously and was treated by third ventriculostomy in an outside institution. Follow-up showed slight increase of the tumor while the patient remained asymptomatic. Microsurgical treatment was offered to the patient given the size of the lesion, the progression of the tumor, and her young age. We present the main surgical steps of the surgery through an occipital interhemispheric approach with section of the tentorium. The lesion was removed piecemeal through the intercollicular sulcus. The postoperative course was favorable; at 3 months of follow-up, the patient showed no neurological deficit. Brain MRI showed a complete resection of the astrocytoma and no postoperative complications. We present the surgical technique for endoscopic-assisted microsurgical removal of a tectal plate pilocytic astrocytoma through the occipital inter hemispheric transtentorial approach. We discuss the prognostic survival factors reported in the literature. 2 The patient consented to the procedure and to the publication of the images. Our institutional review board ethics committee do not require an approval for this type of publication.

MtDNA-STING Pathway Promotes Necroptosis-Dependent Enterocyte Injury in Intestinal Ischemia Reperfusion

Background: Intestinal ischemia reperfusion (I/R) injury is the important pathogenesis for acute intestinal barrier disruption. The STING signaling is associated with gut homeostasis and barrier integrity. However, the biological function and regulation of STING signaling in intestinal I/R injury are not yet fully understood. As the ligand of STING signaling, the mitochondrial DNA (mtDNA) has been found to be associated with necroptosis. It still remains unknown whether mtDNA-STING signaling triggers intestinal necroptosis in intestinal I/R injury. Methods: The levels of circulating receptor interacting protein kinase 3 (RIPK3) were first collected to explore the role of necroptosis in critically ill patients with intestinal injury. Furthermore, the relationship between mtDNA-STING signaling and necroptosis was explored through establishing a murine model of intestinal I/R injury in wild-type mice and STING knockout mice. Primary intestinal epithelial cells (IECs) were isolated to investigate downstream signaling of STING leading to intestinal necroptosis. Findings: In critically ill patients with intestinal injury, circulating RIPK3 was significantly increased and had a positive correlation with markers of enterocyte injury. Moreover, the levels of circulating mtDNA were also associated with the levels of circulating RIPK3. After the intraperitoneal injection of mtDNA in mice, necroptosis signaling was remarkably activated and the inhibition of necroptosis alleviated mtDNA-induced intestinal injury. Furthermore, STING knockout mice showed an alleviated necroptosis. In intestinal I/R injury, mtDNA released from IECs was released and necroptosis was also triggered, companied with a significant decrease of RIPK3 in the intestine. STING knockout mice markedly attenuated intestinal necroptosis and intestinal I/R injury. Finally, we found that mtDNA-mediated STING signaling triggered necroptosis through synergistic IFN and TNF-α signaling in primary IECs. Interpretation: Our results indicated that mtDNA-STING signaling can contribute to intestinal I/R injury by promoting IEC neroptosis. STING-mediated both IFN and TNF-α signaling can trigger intestinal nercroptosis. Funding Statement: This work was supported by the National Natural Science Foundation of China (81801971, 81772052), Distinguished Scholars Foundation of Jiangsu Province (JCRCB2016006). Declaration of Interests: The authors declare no conflict of interest. Ethics Approval Statement: The collection of human blood samples was approved by the Institutional Review Board Ethics Committee at Jinling Hospital. Before collecting blood samples, all patients and healthy adult volunteers provided written informed consent. The care and use of the animals were approved by Jinling Hospital Animal Care Committee.

Global Requirements for DNA Sample Collections: Results of a Survey of 204 Ethics Committees in 40 Countries

The Industry Pharmacogenomics Working Group has an interest in attaining a better understanding of global requirements for sample collections intended for pharmacogenetics research. To have adequately powered pharmacogenetics studies representative of the clinical trial population, it is important to collect DNA samples from a majority of consenting study participants under many institutional review board/ethics committee (IRB/EC) jurisdictions. A survey was distributed to gather information from local and central IRBs/ECs. The survey included questions related to the approval of pharmacogenetics studies, collection and banking of samples, and return of data to subjects. A total of 204 responses were received from global IRBs/ECs with pharmacogenetic experience. The data show that requirements for approval of pharmacogenetic research differ between IRBs/ECs within and between countries but not between regions of the United States. A better understanding of differing requirements should facilitate global sample collection of DNA for pharmacogenetics research and may provide the basis for harmonized regulations for collection of genetic samples in the future.