Differential Protein Expression between Type 1 Diabetic Cataract and Age-Related Cataract Patients

Diabetes has become one of the major diseases affecting human health. Diabetic cataracts (DCs) are considered a common complication in diabetic patients. The present study investigated differences in lens proteomic profiles between DCs and age-related cataracts (ACs) to determine the mechanism underlying the formation of DCs. Intrasurgical samples were collected from eight DC patients and 12 AC patients, and lens proteins were extracted by lysis and separated using two-dimensional gel electrophoresis (2-DE). The electrophoretic bands were analysed using PD-Quest software 8.0.1. Differentially expressed proteins were identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS) and peptide mass fingerprinting combined with protein database searching. In the 2-DE maps, the DC and AC lens proteins migrated in the region of pH 5-9 with a relative molecular weight (RMW) of 14-97 kDa, whereas the RMW of more abundant crystallin was 20-31 kDa. Approximately three protein spots with differential intensity were detected. Two crystallin proteins (αB and βB1) were identified using MALDI-TOF-MS. Proteomic analysis of the crystalline humour is feasible, and the proteins can be well separated; moreover, differentially expressed lens proteins can be analysed using 2-DE and mass spectrometry to compare DC and AC. The present results indicate that the αB and βB1 crystallins may accelerate the development of DCs. These techniques offer new avenues for mechanistic evaluation and future prevention or therapy of DCs.

Extracellular superoxide dismutase impairs neutrophil function and clearance of Listeria monocytogenes (118.4)

It is well established that reactive oxygen species (ROS) play a critical role during immune responses against pathogens. Extracellular superoxide dismutase (ecSOD) regulates extracellular concentrations of ROS and protects tissues during non-infectious inflammatory insults. However, how ecSOD activity impacts immune responses directed against pathogenic microorganisms has not been thoroughly investigated. We utilized mice with varying levels of ecSOD activity to investigate the involvement of this enzyme in innate immune responses against Listeria monocytogenes. Our data demonstrate that ecSOD activity negatively impacted host survival and bacterial clearance from the spleen and liver. Paradoxically, ecSOD activity was associated with increased percentages of neutrophils in the livers of mice prior to, and during infection. Neutrophils from livers of mice with high ecSOD activity were altered in their ability to produce various molecules important for bacterial clearance. Additionally, ecSOD activity was associated with a higher percentage of neutrophils that phenotypically resembled myeloid-derived suppressor cells. Neutrophil depletion studies revealed that high ecSOD activity resulted in neutrophils with no protective capacity, whereas neutrophils from mice lacking ecSOD provided superior protection compared to neutrophils from wild-type mice. Collectively, our data demonstrate that ecSOD activity inhibits innate immune responses, thus impairing bacterial clearance.

Foam consolidation and drainage

A theoretical model of foam as a consolidating continuum is proposed. The general model is applied to foam in a gravity settler. It is predicted that liquid drainage from foam in a gravity settler begins with a slow drainage stage. Next, a stage with faster drainage occurs where the drainage rate doubles compared to the initial stage. The experiments conducted within the framework of this work confirmed the theoretical predictions and allowed measurements of foam characteristics. Foams of three different concentrations of Pantene Pro-V Classic Care Solutions shampoo were studied, as well as the addition of polyethylene oxide (PEO) in one case. The shampoo's main foaming components are sodium lauryl sulfate and sodium laureth sulfate. It is shown to what extent foam drainage is slowed down by using higher shampoo concentrations and how it is further decreased by adding polymer (PEO).

Extracellular superoxide dismutase inhibits innate immune responses and clearance of an intracellular bacterial infection

Reactive oxygen species and reactive nitrogen species play important roles during immune responses to bacterial pathogens. Extracellular superoxide dismutase (ecSOD) regulates extracellular concentrations of reactive oxygen species and reactive nitrogen species and contributes to tissue protection during inflammatory insults. The participation of ecSOD in immune responses seems therefore intuitive, yet is poorly understood. In the current study, we used mice with varying levels of ecSOD activity to investigate the involvement of this enzyme in immune responses against Listeria monocytogenes. Surprisingly, our data demonstrate that despite enhanced neutrophil recruitment to the liver, ecSOD activity negatively affected host survival and bacterial clearance. Increased ecSOD activity was accompanied by decreased colocalization of neutrophils with bacteria, as well as increased neutrophil apoptosis, which reduced overall and neutrophil-specific TNF-α production. Liver leukocytes from mice lacking ecSOD produced equivalent NO· compared with liver leukocytes from mice expressing ecSOD. However, during infection, there were higher levels of peroxynitrite (NO(3)·(-)) in livers from mice lacking ecSOD compared with livers from mice expressing ecSOD. Neutrophil depletion studies revealed that high levels of ecSOD activity resulted in neutrophils with limited protective capacity, whereas neutrophils from mice lacking ecSOD provided superior protection compared with neutrophils from wild-type mice. Taken together, our data demonstrate that ecSOD activity reduces innate immune responses during bacterial infection and provides a potential target for therapeutic intervention.

Allele-specific effects of ecSOD on asbestos-induced fibroproliferative lung disease in mice

Previous work by others suggests that there is a strain-dependent variation in the susceptibility to inflammatory lung injury in mice. Specifically, the 129/J mice appear to be more resistant to asbestos-induced pulmonary fibrosis than the C57BL/6 strain. A separate line of evidence suggests that extracellular superoxide dismutase (ecSOD) may play an important role in protecting the lung from such injuries. We have recently reported that the 129/J strain of mice has an ecSOD genotype and phenotype distinctly different from those of the C57BL/6 mice. In order to identify ecSOD as a potential "asbestos-injury resistance" gene, we bred congenic mice, on the C57BL/6 background, carrying the wild type (sod3wt) or the 129/J (sod3129) allele for ecSOD. This allowed us to examine the role of ecSOD polymorphism in susceptibility to lung injury in an otherwise identical genetic background. Interestingly, asbestos treatment induces a significant (~40%) increase in plasma ecSOD activity in the sod3129 mice, but not in the sod3wt mice. Asbestos administration results in a loss of ecSOD activity and protein from lung tissue of both congenic strains, but the lung ecSOD activity remains significantly higher in sod3129 mice. As expected, asbestos treatment results in a significant recovery of ecSOD protein in bronchoalveolar lavage fluid (BALF). The BALF of sod3129 mice also have significantly lower levels of proteins and inflammatory cells, especially neutrophils, accompanied by a significantly lower extent of lung injury, as measured by a pathology index score or hydroxyproline content. Immunohistochemistry reveals a significant loss of ecSOD from the tips of the respiratory epithelial cells in response to asbestos treatment and that the loss of immunodetectable ecSOD is compensated for by enzyme expression by infiltrating cells, especially in the sod3wt mice. Our studies thus identify ecSOD as an important anti-inflammatory gene, responsible for most, if not all of the resistance to asbestos-induced lung injury reported for the 129/J strain of mice. The data further suggest allele-specific differences in the regulation of ecSOD expression. These congenic mice therefore represent a very useful model to study the role of this enzyme in all inflammatory diseases. Polymorphisms in human ecSOD have also been reported and it appears logical to assume that such variations may have a profound effect on disease susceptibility.

Extracellular superoxide dismutase polymorphism in mice: Allele-specific effects on phenotype

Extracellular superoxide dismutase (ecSOD) protects the extracellular matrix from oxidative stress. We previously reported a new allele for ecSOD, expressed in 129P3/J mice (129), which differs from the wild type (wt), expressed in C57BL/6J and other strains, by two amino acid substitutions and a 10-bp deletion in the 3' UTR of the mRNA (A. Pierce et al., 2003, Arterioscler. Thromb. Vasc. Biol.23:1820-1825). The newly discovered allele is associated with a phenotype of significantly increased circulating and heparin-releasable enzyme activities and levels. To examine the properties of the two forms of ecSOD in an identical environment we generated, by extensive backcrossing of ecSOD heterozygous progeny to C57BL/6J females, a congenic C57 strain with the 129 (or wt) allele of ecSOD. These mice are homozygous for nearly 5000 SNPs across all chromosomes, as determined by the Affymetrix Parallele Mouse 5K SNP panel. This study describes the generation of the congenic mice (genetically >99.8% identical) and their ecSOD phenotype. The congenic mouse plasma ecSOD activity before and after heparin administration recapitulates the differences reported in the founder mice. Tissue enzyme distribution is similar in both congenic groups, although the 129 allele is associated with higher levels of enzyme expression despite lower levels of enzyme mRNA. In these characteristics the phenotype is allele driven, with little impact from the rest of the genome. The congenic mice carrying the 129 allele have mRNA levels that are in between those in the founder 129P3/J and C57BL/6J strains. We conclude that the ecSOD phenotype in most aspects of enzyme expression is allele driven, with the exception of tissue mRNA levels, for which a significant contribution by the surrounding (host) genome is observed. These results also suggest potential allele-specific differences in the regulation of ecSOD synthesis and intracellular processing/secretion of ecSOD, independent of the genotype context. Most importantly, the congenic mice offer an excellent model to examine the regulatory mechanisms of ecSOD expression and the role of ecSOD in various diseases involving oxidative stress.

Effect of denosumab on bone mineral density (BMD) in women with breast cancer (BC) and men with prostate cancer (PC) undergoing hormone ablation therapy

9520

Background: Hormone ablation therapies, including adjuvant aromatase inhibitor (AI) therapy and androgen deprivation therapy (ADT), improve recurrence-free survival in patients (pts) with BC and PC, respectively. However, these treatments increase bone resorption, leading to bone loss and fractures. RANKL is a key mediator of osteoclast-mediated bone resorption. In this 24 month (mo) comparison, we investigated the effects of denosumab, a fully human monoclonal antibody against RANKL, on preserving BMD across both populations. Methods: Two trials were conducted: a 24-mo BC study and a 36-mo PC study. Postmenopausal women with low BMD receiving AI therapy for nonmetastatic BC and men receiving ADT for nonmetastatic PC (with low BMD or history of osteoporotic fracture if < 70 yrs) were randomized to receive placebo or denosumab 60mg subcutaneously every 6 mos. All pts in both studies were prescribed calcium and vitamin D supplements. The primary endpoint was % change from baseline in lumbar spine (LS) BMD at 12 mos for the BC study and at 24 mos for the PC study. Herein, we present changes in BMD at 24 mos at LS, total hip (TH), and 1/3 radius from both studies. Power calculations were based on enrollment of at least 208 patients in the BC study (for primary endpoint only) and 1226 in the PC study (for primary and key secondary endpoints). The actual numbers randomized were 252 and 1468, respectively. Results: Denosumab increased BMD of the LS, TH, and 1/3 radius compared with placebo at 24 mos in both pt populations ( Table ). In both studies, differences between denosumab and placebo at each skeletal site were consistent, and the effects of denosumab were statistically significantly different from placebo as early as 1 month at the LS in both studies. The overall safety profile was similar to placebo in each study. Conclusions: Denosumab consistently increased BMD at all 3 skeletal sites compared with placebo in both women with BC undergoing AI therapy and in men with PC undergoing ADT.

[Table: see text]

[Table: see text]

RIPK1 gene polymorphism as a prognostic marker for survival in patients with colorectal cancer

e15078

Background: Since apoptosis plays a key role in cancer progression, we hypothesized that single nucleotide polymorphisms (SNPs) of apoptosis-related gene can affect survival after curative resection in patients with colorectal cancer. Patients and Methods: Three hundred and ninety seven patients with colorectal cancer who underwent surgery with curative intent were enrolled in the present study. The genomic DNA was extracted from fresh colorectal mucosal tissue, and the 19 SNPs of 15 apoptosis-related genes (CASP3, CASP6–10, FAS, FAS ligand [FASLG], TNSFR1A, TNSFR10B, RIPK1, BCL2, BCL2 ligand [BCL2L], TP53, and PTGS2) were determined using a PCR-RFLP assay. Results: The median age of the patients was 63 years (range, 21–85), and 218 (54.9%) patients had colon cancer and 179 (45.1%) patients rectal cancer. Pathologic stages after surgery were as follows: stage 0/I (n=86, 21.7%), stage II (n=146, 36.8%), stage III (n=145, 36.5%), and stage IV (n=20, 5.0%). Multivariate survival analysis including pathologic stage, differentiation, age, and CEA level showed that relapse-free survival for the patients with the GA+AA genotype of RIPK1 (Receptor interacting serine/threonine kinase 1) +83G>A (rs2272990) was worse than for the patients with the GG genotype (hazard ratio [HR]=1.66, 95% confidence interval [CI]=1.03–2.68, p=0.038). However, no associations were observed between the polymorphisms and overall survival (OS) in a multivariate analysis. Conclusions: RIPK1 gene polymorphism can be considered as a possible prognostic marker for survival after curative resection in patient with colorectal cancer.

No significant financial relationships to disclose.

Denosumab for the treatment of giant cell tumor (GCT) of bone: Final results from a proof-of-concept, phase II study

10510

Background: GCT of bone is a primary osteolytic bone tumor with low metastatic potential that is associated with significant skeletal morbidity. GCT is rich in stromal cells that express RANKL, a key mediator of osteoclast activation. In this open-label, study, we investigated whether denosumab, a fully human monoclonal antibody against RANKL, could have a potential therapeutic effect on giant cell histology for patients with GCT. Methods: In this single-arm study, 37 patients with measurable or unresectable GCT received denosumab 120 mg subcutaneously once monthly with loading doses on days 8 and 15 of month 1. The primary endpoint was the proportion of patients with a tumor response (≥90% elimination of giant cells or no radiographic progression of the target lesion) at week 25 as assessed by histology and CT or MRI. A sample size of 35 patients was planned. All 37 enrolled patients were evaluated for safety; 35 were eligible for efficacy evaluation (2 had insufficient histology or radiology data). Results: Thirty of 35 patients (86%; 95% CI 70%-95%) had a tumor response: 20 of 20 by histology and 10 of 15 by radiology. Of 31 patients with data for assessments of clinical benefit, 26 (84%%; 95% CI 66%-95%) reported reduced pain or improvement in functional status. Bone repair was reported in 9 patients (29%; 95% CI 14%-48%). Suppression of the bone turnover markers urinary N-telopeptide and serum C-telopeptide was seen as early as 28 days after the first dose and sustained for the duration of the study. Adverse events (AEs) were reported in 33 patients (89%). One death due to surgical complications (not treatment-related) occurred on-study. No patient experienced treatment-related serious AEs or developed anti-denosumab antibodies. Conclusions: In this study, 86% of patients with measurable or unresectable GCT experienced a tumor response with denosumab. Further clinical trials of denosumab as a new therapy for GCT are warranted.

[Table: see text]

Effects of denosumab treatment in breast cancer patients with bone metastases and elevated bone resorption levels after therapy with intravenous bisphosphonates: results of a phase 2 randomized trial

Abstract #1155

Background: Patients with breast cancer-induced bone disease and elevated urine-N-telopeptide (uNTx), a marker of bone resorption, are at increased risk for skeletal complications, disease progression, and death. Receptor activator of NF-kB ligand (RANKL) mediates osteoclastic bone resorption. Denosumab, a fully human monoclonal antibody, inhibits bone destruction by binding and neutralizing RANKL. Denosumab efficacy and safety were assessed in a phase 2, randomized, open-label, active-controlled trial in patients with bone metastases and elevated levels of uNTx after at least 8 weeks of intravenous (IV) bisphosphonate (BP) therapy. We report results in a subset of patients with breast cancer.&#x2028; Methods: Cancer patients with bone metastases and uNTx &gt;50 nM/mM creatinine [Cr] following at least 8 weeks of IV BP therapy were randomized to continue IV BP therapy every 4 weeks (Q4W) or switch to subcutaneous (SC) denosumab injection (180 mg) Q4W or every 12 weeks (Q12W). The primary endpoint was the proportion of patients who achieved uNTx &lt;50 nM/mM at week 13. Safety was also assessed.&#x2028; Results: The study population (N = 111) included 46 patients (41%) with breast cancer; the median time since diagnosis of bone metastases was approximately 1 year in both groups. At week 13, 76% of denosumab-treated patients and 33% of IV BP-treated patients had uNTx &lt; 50 nM/mM. Denosumab-induced suppression of uNTx was rapid (as early as 2 weeks after initial treatment), sustained through week 25, and unaffected by baseline uNTx (Table). In the total study population, adverse events of grade 3, 4, or 5 were reported in 25 (71%) IV BP-treated patients and 40 (55%) denosumab-treated patients.&#x2028; &#x2028; Discussion: Denosumab reduced bone turnover in breast cancer patients with bone metastases and elevated uNTx despite prior IV BP therapy. Phase 3 trials of denosumab in cancer patients with bone metastases are in progress.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1155.

Burden of hospitalizations associated with skeletal related events in patients with breast cancer or lung cancer and bone metastases or multiple myeloma

17083

Background: Patients with bone metastases secondary to cancer often experience skeletal related events (SREs) including pathological fracture, spinal cord compression, hypercalcemia, bone surgery or radiotherapy, or initiation of opioid analgesic use. These SREs result in major morbidity and reduced quality of life. This research examines hospitalizations associated with SREs. Methods: Data for this study were obtained from i3 LabRx Database (05/01/2000 to 03/31/2005). Individuals were included in the analyses if they had at least two diagnoses of breast cancer (based upon an ICD-9 code of 174.xx), lung cancer (162.xx), or multiple myeloma (203.0x) and had at least two diagnoses of bone metastases (198.5x) after the first diagnosis of cancer. In addition, individuals were required to have at least one SRE (based upon a previously published algorithm) on or after their initial diagnosis of bone metastases (their index date). Individuals were required to be continuously insured for at least 6 months prior to, and at least one month post their index date. Data were analyzed until 03/31/2005 or until the end of their continuous coverage, whichever occurred first. Descriptive statistics for each of these cohorts are provided. Results: A total of 1,204 individuals with breast cancer, 1,094 with lung cancer, and 258 with multiple myeloma were included in the study. The vast majority of individuals with breast cancer (96.5%), lung cancer (95.9%), or multiple myeloma (96.8%) were hospitalized. All three patient groups were likely to have SRE-related hospitalizations; multiple myeloma 43.4%, breast cancer 36.2% and lung cancer 35.6%. The average number of days per patient year that patients were hospitalized related to a diagnosis or procedure for a SRE was 6.75 days for patients with lung cancer, 6.56 days for patients with multiple myeloma, and 3.75 days for patients with breast cancer. Conclusion: Hospitalizations related to SREs are common and the number of days per year is substantial.

No significant financial relationships to disclose.