NF-kB Complex Activation and Association of αB-Crystallin and Vimentin with Poor Prognosis in Primary Breast Cancer

Background: Nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB) is a protein complex found in almost all animal cell types and is involved in cellular responses to stimuli such as stress, free radicals, cytokines et.c. NF-kB plays a key role in regulating the immune response and incorrect regulation of NF-kB has been linked to the development of cancer, several inflammatory and autoimmune diseases. The role of NF-kB, its subunits and pathways in breast cancer and in the surrounding stromal tissues remains uncertain. αB-crystallin is a heat shock protein, which function as stress-induced molecular chaperones to inhibit the aggregation of denatured proteins. Previous studies have identified αB-crystallin as a marker of poor prognosis for breast cancer and have suggested that it is an excellent marker for tumours of basal origin. The aim of this study is to examine, for the first time, NF-kB and αB-crystallin, vimentin and HSPs in the same set of breast cancers and stroma and relate this to clinical parameters including outcome.Methods: Tissue Micro Arrays of 0.6mm cores of 246 breast cancers were stained with antibodies to αB-crystallin, vimentin, HSP27 (antibody ERD5) and HSP27 82P and 12 subsequent antibodies for NF-kB (IKKa, Ser276, Ser32/36, 180/181, P52, 1kkygmma, P65, RELB, P100/P52, IkBa, cREL, and P50) and scored using the Quick Score Method.Results: Positive associations have been found between αB-crystallin and IKBA (P=0.001 Fishers exact test (FET)), RELB (P<0.001 (FET)) and SER32/36 (P=0.03 (FET)) whereas Vimentin was positively associated IKBA (P=0.003 (FET)), IKKA (P=0.001 (FET)), P50 (P=0.002 (FET)), RELB (P<0.001 (FET)) and SER32/36 (P=0.01 (FET)). Positive associations have also been found between HSP27 and P50 (P=0.002 (FET)), SER32/36 (P<0.001 (FET)). Antibodies such as 180/181 (P=0.04 Kaplan Meier Log Rank (KM), cREL (P=0.03 (KM)), IKBA (P=0.03 (KM)) and IKKA (P=0.01 (KM)) was associated with good survival and P50 (P=0.002 (KM)) and P65 (P=0.01 (KM)) to poor survival. Expression of αB-crystallin was associated with vimentin (P<0.001 (FET)). Its expression was linked to a low expression of the estrogen receptor. Vimentin expression was associated with estrogen receptor (ER) negative cancers and poor survival (P <0.001 (FET)), P=0.002 (KM Log Rank) respectively). In contrast to αB-crystallin, low expression of HSP27 was associated with low ER and progesterone receptor (PGR).Conclusions: Associations were found between various antibodies within the NF-kB pathway as well as the heat shock proteins αB-crystallin, vimentin and HSP27 with varying implications for overall survival. We aim to clarify the mechanisms to prevent the aggregation of stress-accumulated misfolded proteins and apoptosis resulting better survival.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2143.

Genetic epidemiology of the sudden oak death pathogen Phytophthora ramorum in California

A total of 669 isolates of Phytophthora ramorum, the pathogen responsible for Sudden Oak Death, were collected from 34 Californian forests and from the ornamental plant-trade. Seven microsatellite markers revealed 82 multilocus genotypes (MGs) of which only three were abundant (>10%). Iteratively collapsing based upon minimum Phi(ST), yielded five meta-samples and five singleton populations. Populations in the same meta-sample were geographically contiguous, with one exception, possibly explained by the trade of infected plants from the same source into different locations. Multidimensional scaling corroborated this clustering and identified nursery populations as genetically most distant from the most recent outbreaks. A minimum-spanning network illustrated the evolutionary relationships among MGs, with common genotypes at the centre and singletons at the extremities; consistent with colonization by a few common genotypes followed by local evolution. Coalescent migration analyses used the original data set and a data set in which local genotypes were collapsed into common ancestral genotypes. Both analyses suggested that meta-samples 1 (Santa Cruz County) and 3 (Sonoma and Marin Counties), act as sources for most of the other forests. The untransformed data set best explains the first phases of the invasion, when the role of novel genotypes may have been minimal, whereas the second analysis best explains migration patterns in later phases of the invasion, when prevalence of novel genotypes was likely to have become more significant. Using this combined approach, we discuss possible migration routes based on our analyses, and compare them to historical and field observations from several case studies.

Effect of postoperative radiotherapy on autologous deep inferior epigastric perforator flap volume after immediate breast reconstruction

Background

The effect of postoperative radiotherapy following autologous flap breast reconstruction is controversial. The aim of this study was to measure whether adjuvant radiotherapy following immediate deep inferior epigastric perforator (DIEP) free flap breast reconstruction affected flap volume.

Methods

Sixty-eight women underwent immediate autologous DIEP flap reconstruction following mastectomy for breast cancer. Twenty-two of the 68 received postoperative radiotherapy (45Gy in 20 fractions over 4 weeks). Intraoperative flap volume data were collected prospectively. Volumetric assessment was carried out a minimum of 1 year after surgery. Patients who had volume adjustment surgery after initial reconstruction were analysed separately.

Results

The mean age of the women was 52 (range 37–69) years and median follow-up was 3·5 (range 1–10) years. There was no statistically significant difference in volume change between patients who had and those who did not have postreconstruction radiotherapy for the whole cohort (median reduction 65 versus 0 ml) or when women who had undergone further volume adjustment surgery were excluded.

Conclusion

In this study postoperative radiotherapy did not significantly affect breast volume after DIEP flap reconstruction. The potential need for postoperative radiotherapy should not deter women from undergoing immediate DIEP flap breast reconstruction.

Oestrous synchronization, ovarian superovulation and intraspecific transfers from a closed breeding colony of inbred SLA miniature pigs

The inbred SLA miniature pig is a unique animal model developed for organ transplantation studies and pre-clinical experimental purposes. Reported oestrous synchronization and superovulation treatments were examined in two SLA haplotypes (AA and DD) to allow collection of embryos for both practical embryo transfer and experimental technologies from a closed breeding colony. Pre-puberal miniature pigs were poor responders to oestrous synchronization treatments, while post-puberal sows were equivalent to commercial sows. Following superovulation, the ovulation number (corpora .hemorrhagica) was higher (p < 0.05) in the cycling sows when compared with non-cycling sows. Ovulations were equivalent to commercial pre-puberal gilts and non-cycling sows (p > 0.05). No difference in ovulation number between haplotypes was observed, which differs from the previous report (DD>AA). Collection of zygotes for pronuclear injection was the highest in the non-cycling post-puberal miniature pig group (p < 0.05), although significantly lower when compared with the commercial pig treatment groups (p < 0.05). The incidence of cystic endometrial hyperplasia in our colony was equivalent to rates observed in commercial pigs. Pronuclear visualization following centrifugation was the highest in the non-cycling miniature sow group and approximates to about 25% of ovulations and about half the rate observed in the commercial pigs (50%). Miniature pig embryos transferred between SLA haplotypes and transfer of DD embryos to commercial pigs resulted in live births at a higher efficiency than previously reported. This study demonstrates the feasibility of undertaking assisted reproductive technologies in a closed breeding colony of inbred SLA miniature pigs without compromise to the breeding programmes.

αB-crystallin, vimentin and increased p53 expression levels in breast cancer is associated with poor prognosis

Abstract #5070

Background: Previous studies have identified αB-crystallin as a marker of poor prognosis for breast cancer and have suggested that it is an excellent marker for tumours of basal origin. Increased expression of αB-crystallin has been associated with anchorage-independent growth and metastasis leading to the suggestion that αB-crystallin is an oncoprotein. We have considered whether the αB-crystallin binding proteins, vimentin and HSP27 also show a similar association with poor prognosis. We also investigated whether either HSP27 phosphorylation HSP27 or p53 expression could be associated with αB-crystallin expression.&#x2028; Methods: Tissue Micro Arrays of 0.6x0.6mm cores of 205 breast cancers were stained with antibodies to αB-crystallin, vimentin, p53 (antibodies DO1, FP3), HSP27 (antibody ERD5) and HSP27 82P. The levels of protein expressions were then compared with clinical and pathological parameters.&#x2028; Results: The expression of αB-crystallin was positively associated with vimentin (P&lt;0.001 Fisher's exact test (FET)). We have confirmed that αB-crystallin expression is linked to a low expression of the estrogen receptor and reduced survival (P&lt;0.001 (FET), P=0.002 Kaplan Meier Log Rank (KM) respectively). Vimentin expression was similarly associated with estrogen receptor (ER) negative cancers and poor survival (P &lt;0.001 (FET), P= 0.002 (KM Log Rank) respectively). Low expression of HSP27 resulted in poor three-year survival (P=0.007 (KM Log Rank)), but longer-term survival was unaffected (P=0.09 (KM Log Rank)). In contrast to αB-crystallin, low expression of HSP27 was associated with ER and progesterone receptor (PGR) negativity (P&lt;0.001 (FET), P=0.001 (FET)). HSP27 82P similarly resulted in poor three-year survival (P=0.01 (KM Log Rank)) compared with longer-term survival (P=0.05 (KM Log Rank)). In samples positive for either αB-crystallin or vimentin, a strong association with increased p53 expression (p53 antibodies: DO1(P&lt;0.001 (FET)) and FP3(P&lt;0.001 (FET))) was found.&#x2028; Conclusions: The increased expression of the protein chaperone, αB-crystallin was linked with reduced survival as well as it's binding partner, vimentin. We found that within this patient subgroup, there was an increased level of p53. The potential functional significance of this interaction for metastasis will be discussed in the context of other predictive markers for breast cancer. A similar association was not found for HSP27 expression.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5070.

Latex allergy: two educational cases

Natural rubber latex (NRL) allergy is a significant problem both for health care workers and for children with complex medical and surgical conditions that require multiple surgical interventions. Primary and secondary prophylaxis are effective measures in identified high risk groups, such as spina bifida (SB). It is therefore likely that with proper attention to prevention and secondary prophylaxis in the highest risk groups that the numbers of paediatric SB patients with NRL allergy will continue to decrease. In contrast medical awareness of established latex allergy needs to be maintained. The issue of latex sensitisation via fruit and food allergy will also remain, so some of the attention that SB patients have received in the past may need to be refocussed onto other emerging high risk groups. Innovative immunomodulatory approaches may soon translate to the clinic for latex sensitised or allergic subjects.

Hierarchical Bayesian scaling of soil properties across urban, agricultural, and desert ecosystems

Ecologists increasingly use plot-scale data to inform research and policy related to regional and global environmental change. For soil chemistry research, scaling from the plot to the region is especially difficult due to high spatial variability at all scales. We used a hierarchical Bayesian model of plot-scale soil nutrient pools to predict storage of soil organic carbon (oC), inorganic carbon (iC), total nitrogen (N), and available phosphorus (avP) in a 7962-km2 area including the Phoenix, Arizona, USA, metropolitan area and its desert and agricultural surroundings. The Bayesian approach was compared to a traditional approach that multiplied mean values for urban mesic residential, urban xeric residential, nonresidential urban, agricultural, and desert areas by the aerial coverage of each land-use type. Both approaches suggest that oC, N, and avP are correlated with each other and are higher (in g/m2) in mesic residential and agricultural areas than in deserts or xeric residential areas. In addition to traditional biophysical variables, cultural variables related to impervious surface cover, tree cover, and turfgrass cover were significant in regression models predicting the regional distribution of soil properties. We estimate that 1140 Gg of oC have accumulated in human-dominated soils of this region, but a significant portion of this new C has a very short mean residence time in mesic yards and agricultural soils. For N, we estimate that 130 Gg have accumulated in soils, which explains a significant portion of "missing N" observed in the regional N budget. Predictions for iC differed between the approaches because the Bayesian approach predicted iC as a function of elevation while the traditional approach employed only land use. We suggest that Bayesian scaling enables models that are flexible enough to accommodate the diverse factors controlling soil chemistry in desert, urban, and agricultural ecosystems and, thus, may represent an important tool for ecological scaling that spans land-use types. Urban planners and city managers attempting to reduce C emissions and N pollution should consider ways that landscape choices and impervious surface cover affect city-wide soil C, N, and P storage.

Effect of corridors on the movement behavior of the jumping spider Phidippus princeps (Araneae, Salticidae)

Corridors are a common conservation strategy intended to increase the spatial connectivity among isolated habitat patches. Corridors, however, are not always effective. This study demonstrates that corridors increase movement to new patches for the jumping spider Phidippus princeps (Peckham and Peckham, 1883) (Araneae, Salticidae), a visually oriented predator. I assigned spiders to one of three microlandscape treatments, created in an old field dominated by alsike clover ( Trifolium hybridum L.) and alfalfa ( Medicago sativa L.), in which patches were connected to (i) vegetated corridors and bare pathways, (ii) only vegetated corridors, and (iii) only bare pathways. The movement of P. princeps was effectively directed by corridors. When given a choice of paths, spiders invariably chose vegetated corridors over bare pathways to emigrate from and to immigrate to new patches. Spiders rarely moved between patches when only bare pathways were available. In the absence of corridors, P. princeps did not risk open ground to move to new habitat even though conspecific density was high. The corridors facilitated the interpatch movement of P. princeps, suggesting that P. princeps is restricted in its habitat use. Thus, a higher degree of spatial connectivity is likely to increase the exchange of individuals for species that are restricted in their movements by unsuitable habitat.

The clinical relevance of p53 isoforms modifying the effects of p53 mutation on survival from breast cancer

10505

Background: p53 is a key gene in the development of breast cancer and response to therapy. Nine splice variants of p53 in breast cancer have been identified, with full length p53, p53beta and p53gamma (both 46kD, C terminal truncated proteins) commonly expressed. This study examined the clinical relevance of splice variants in breast cancer. Methods: Tumors from 248 patients with primary breast cancer were examined for mutation with the Roche p53 mutation chip and p53 isoform expression detected by RT-PCR followed by nested PCR; full clinical and pathological data included median follow up of 6.4 years. Results: p53 mutation, identified in 65/248 (26%) cancers, was significantly associated by Chi square test with shorter survival (p=0.001), histological grade 3 (p<0.001) and estrogen receptor (ER) negative cancers (p<0.001), as expected. Expression of p53 beta or p53 gamma mRNA was associated with p53 mutation (p=0.002, Fisher's exact test). Intriguingly, the patient groups with a mutant p53 cancer but expressing p53 gamma or p53 beta or both isoforms had survival curves comparable to patients with cancer containing wild type p53. Similarly, p53 gamma or p53 beta was associated with ER negative cancers (Chi square; p<0.001), but the group of ER negative tumors expressing p53 gamma or p53 beta had improved survival similar to ER positive cancers. Patients with p53 mutant, p53 beta negative and ER negative cancers comprised half of those who died within 3 years of diagnosis. Conclusions: p53 beta or p53 gamma isoform expression in breast cancer is associated with better prognosis and may moderate disease behaviour even in mutant p53 and ER negative cancers. Manipulation of p53 isoforms in breast cancer may thus offer therapeutic potential.

No significant financial relationships to disclose.

Biomechanical couplings between elbow and forearm movements

Control of reaching task requires a strategy that takes into account biomechanical couplings in the musculoskeletal system. In a kinematic study, normal subjects were asked to reach to, grasp a cup, and bring it back. It was found that forearm rotation was coordinated in a particular manner with elbow motion in order to keep the cup in a leveled orientation. This coordination pattern may be due to the multi-axial actions of biceps muscles. A realistic model of human arm was used to examine the biomechanical constraints arising from musculature couplings in the coordination of elbow and forearm movements. Moment arm analysis indicated that biceps and brachioradialis have significant moment arms in forearm supination and pronation (S/P), which displays equilibrium point like neutral positions that vary with elbow angles. The dependency of S/P neutral positions with elbow angles in biceps is consistent with the coordination pattern observed between elbow and forearm movements during the reach and grasp in normal subjects.

Ischaemic stroke in children secondary to post varicella angiopathy

Varicella in childhood is a self-limiting disease, which usually follows a benign course. However, complications, although rare, may have serious consequences. Ischaemic stroke secondary to post varicella angiopathy is a well-described complication and is estimated to account for up to a third of all strokes in infants. We present three previously healthy children who presented to our centre with ischaemic cerebrovascular infarction due to varicella angiopathy. All three children first presented within six weeks after onset of varicella infection and had MRI changes characteristic of ischaemic stroke secondary to post varicella angiopathy. While one child made an excellent recovery being left with only a minor deficit, the remaining two children were left with considerable morbidity severely affecting quality of life. The varicella vaccine has been proven to be well tolerated, safe and effective. We conclude that varicella vaccination should be considered for inclusion in the vaccination schedule to prevent serious complications which while rare may have devastating consequences.

Pb2+ reduces PKCs and NF-κB in vitro

The mechanism of lead (Pb(2+))-induced neurotoxicity has not yet been fully elucidated. The purpose of this study was to examine the effects of Pb(2+) on several protein kinase C (PKC) isoforms and the nuclear factor-kappaB (NF-kappaB)-I-kappaB kinase-alpha (IKK-alpha) axis in cultured neuronal cells. Neurons were isolated from rat fetal brain at the 18th day of gestation of pregnant Sprague Dawley rats and cultured for 10 days before use. Neurons were exposed to Pb(2+) at concentrations of 10(-10), 10(-9), 10(-8), and 10(-7) mol/L for 14 h and antigens of typical PKC-alpha,beta,gamma; novel PKC (epsilon, delta), atypical PKC (lambda), NF-kappaB (p50), and IKK-alpha were enriched by immunoprecipitation and determined by western blotting. Total, calcium-dependent and independent PKC activities were also determined by counting the transferred gamma-(32) P in the substrate-histone. The results indicated that inorganic Pb(2+) significantly reduced all PKC isoforms (alpha,beta,gamma, epsilon, lambda) except delta, inhibiting the total, calcium-dependent and calcium-independent PKC activities in a dose-dependent manner. Additionally, Pb(2+) gradually reduced NF-kappaB (p50) and IKK-alpha protein levels. This suggests that Pb(2+) exhibits varying preference for individual PKC isoforms but reduces the NF-kappaB-IKK-alpha axis to a similar extent.

The effect of passing an "anti-immigrant" ballot proposition on the use of prenatal care by foreign-born mothers in California

This study examines whether the passage of California's Proposition 187, a proposition designed to restrict undocumented immigrants from using public services, had a negative effect on the use of prenatal care and birth outcomes. Comparisons of prenatal care use and birth outcomes before and after the passage of the proposition are made between low-education foreign-born and U.S.-born mothers using California's Birth Public Use files. Multivariate linear and logistic regressions were used to control for regional and maternal characteristics. We find a significant but small decline in the use of prenatal care by low-education foreign-born women after Proposition 187 passed; however, there was no detectable deterioration of birth outcomes. Whether future reductions in the availability of prenatal care would damage the health of children is unclear.

Electrical and neurotransmitter activity of mature neurons derived from mouse embryonic stem cells by Sox-1 lineage selection and directed differentiation

Sx1TV2/16C is a mouse embryonic stem (ES) cell line in which one copy of the Sox1 gene, an early neuroectodermal marker, has been targeted with a neomycin (G418) selection cassette. A combination of directed differentiation with retinoic acid and G418 selection results in an enriched neural stem cell population that can be further differentiated into neurons. After 6-7 days post-plating (D6-7PP) most neurons readily fired tetrodotoxin (TTX)-sensitive action potentials due to the expression of TTX-sensitive Na(+) and tetraethylammonium (TEA)-sensitive K(+) channels. Neurons reached their maximal cell capacitance after D6-7PP; however, ion channel expression continued until at least D21PP. The percentage of cells receiving spontaneous synaptic currents (s.s.c.) increased with days in culture until 100% of cells received a synaptic input by D20PP. Spontaneous synaptic currents were reduced in amplitude and frequency by TTX, or upon exposure to a Ca(2+)-free, 2.5 mm Mg(2+) saline. S.s.c. of rapid decay time constants were preferentially blocked by the nonNMDA glutamatergic receptor antagonists CNQX or NBQX. Ca(2+) levels within ES cell-derived neurons increased in response to glutamate receptor agonists l-glutamate, AMPA, N-methyl-d-aspartate (NMDA) and kainic acid and to acetylcholine, ATP and dopamine. ES cell-derived neurons also generated cationic and Cl(-)-selective currents in response to NMDA and glycine or GABA, respectively. It was concluded that ES-derived neurons fire action potentials, receive excitatory and inhibitory synaptic input and respond to various neurotransmitters in a manner akin to primary central neurons.

Bimedial hang-back recession— outcomes and surgical response

AIM

To report outcomes and identify factors affecting surgical response for constant esotropia using 'hang-back' bimedial rectus recession.

STUDY TYPE

Retrospective case series analysis.

METHODS

Patients managed by a single surgeon over a 4-year study period were categorized into esotropia types: infantile, partially accommodative, nonaccommodative and secondary esotropia. Postoperative alignment was compared between types, and regression modelling used to examine factors predicting surgical response.

RESULTS

In all, 95% (18/19) of children with partially accommodative esotropia achieved postoperative deviation <15 prism dioptres from orthotropia, compared to 56% (15/27) of children with infantile esotropia, 69% (11/16) of children with non-accommodative esotropia and all (2/2) of those with secondary esotropia. Surgical response (Delta/mm recession performed) increased with the magnitude of both preoperative deviation (P<0.001) and anisometropia (P<0.001); the effect of deviation on surgical response was reduced by amblyopia (P=0.02). Age at surgery was statistically associated (P=0.002) but had negligible clinical effect on response.

CONCLUSIONS

Surgical response to hang-back recession may be partially predicted by preoperative factors.