The role of histamine and its receptors in breast cancer: from pathology to therapeutic targets

Involvement of Pruritus, Gut Dysbiosis and Histamine-Producing Bacteria in Paraneoplastic Syndromes

Background/Objectives: Paraneoplastic syndromes (PNS), characterized by a large diversity of symptoms, may sometimes be the first clinical feature of a severe underlying disorder such as cancer. Methods: We report the case of a middle-aged male patient with no significant previous medical history, a nonsmoker or alcohol heavy drinker, complaining about generalized, recently onset itch. Given no reasonable explanation of pruritus after dermatological consultation and the unsatisfactory response to treatment, the patient was referred to gastroenterology with the suspicion of a cholestatic liver disease. Results: The abdominal ultrasound examination revealed gallstones and no dilation of the biliary tree. Numerous tests were run and came out negative, except for the slight elevation of C-reactive protein, mild dyslipidemia, and positivity for H. pylori antigen. The gut microbiota displayed important dysbiosis with a significant increase in the histamine-producing bacteria. Given this chronic pruritus became suspicious, thorax and abdominal CT were recommended and performed soon after. A large right mid-thoracic tumor image was found. Bronchoscopy came out negative for a tumor. After the CT-guided biopsy, the tumor turned out not to be a lymphoma, but a non-small cell lung carcinoma (NSCLC). Conclusions: Chronic pruritus was not associated with cholestasis in a patient with gallstone disease, but rather with a PNS, as the first clinical manifestation of NSCLC, triggering many diagnostic and therapeutic challenges.

Machine learning model reveals the risk, prognosis, and drug response of histamine-related signatures in pancreatic cancer

BACKGROUND

Histamine, a critical inflammatory mediator, is generated by both mast cells and specific tumor cells, and it plays a fundamental role in inflammatory and immune responses. In the current scientific landscape, histamine-related genes (HRGs) and their associated pathways have been validated to be implicated in the development and advancement of cancer. However, the precise role of HRGs in gauging the risk and predicting the prognosis of pancreatic adenocarcinoma (PAAD) remains nebulous.

METHODS

We carried out an elaborate data collection endeavor. Transcriptome data along with pertinent clinical information were obtained from the GSE28735, GSE62452, and TCGA-PAAD cohorts. GWAS data were retrieved from the FinnGen Release 11 and eQTLGen databases. For the drug-target Mendelian randomization (MR) analysis, the "TwoSampleMR" (version 0.5.6) R package was employed. The random survival forest (RSF) model was analyzed using the "randomForestSRC (rfsrc)" R package and further elucidated with the help of the "mlr3" package. Somatic mutation analysis and immune infiltration investigations were conducted by means of the "maftools" (v. 2.12.0) R package and "pRRophetic" R software package, respectively. Targeted drug sensitivity analysis was executed using the "oncopredict" and "parallel" packages.

RESULTS

Through a meticulous drug-targeted MR analysis and an exhaustive exploration of transcriptome databases (including 2 GSE combat and TCGA cohort), 20 upregulated differentially expressed genes (DEGs) were identified. The RSF model emerged as the optimal choice, and a 9-HRGs signature was selected to construct a prognostic model that boasted an average C-index of 0.777. In the training and validation cohorts, the model exhibited remarkable predictive prowess, with 1-, 2-, and 3-year prediction accuracies of 0.898, 0.932, and 0.922 in the training set, and 0.909, 0.974, and 0.962 in the validation set, respectively. A higher HRG score was found to correlate with adverse events and the N1 stage. Additionally, it was associated with an increase in M0 macrophages and a decline in CD8 + T cell function. For patients with a low HRG score, several commonly used chemotherapeutic agents, namely Gemcitabine, Carboplatin, Sorafenib, and Oxaliplatin, were more efficacious.

CONCLUSION

The HRG signature holds the potential to serve as effective biomarkers for diagnosing, predicting the prognosis, and assessing the sensitivity to chemotherapy in PAAD.