Thrombin is present in the lungs of patients with primary extremity osteosarcoma and pulmonary metastases

Efficacy of Recombinant Human Endostatin plus Neoadjuvant Chemotherapy for Osteosarcoma and Its Influence on Serum VEGF and MMP-9 Levels

Objective

To investigate the efficacy of recombinant human endostatin (rh-Endo) plus neoadjuvant chemotherapy (NACT) for osteosarcoma (OSA) and its influence on serum vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9).

Methods

The case data of 141 OSA patients presented to the North District, Xiangyang Central Hospital Affiliated to Hubei University of Arts and Sciences from January 2018 to June 2019, were analyzed retrospectively. Patients receiving NACT (methotrexate + ifosfamide + adriamycin) were assigned into the control group (CNG; n = 65), while those treated with rh-Endo plus NACT were included in the combination group (CMG; n = 76). The following aspects were compared: clinical efficacy, serum tumor markers, serum VEGF and MMP-9 contents, inflammatory factors, incidence of adverse reactions, limb function scores at 6 months of follow-up, and prognostic quality of life (QOL).

Results

A statistically higher overall response rate (ORR) was determined in CMG versus CNG (84.2% vs. 64.6%, P < 0.05). The pretreatment serum bone alkaline phosphatase (BALP), insulin-like growth factor (IGF)-1, serum amyloid A (SAA), VEGF, MMP-9, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, and interleukin (IL)-10 levels differed insignificantly between the two cohorts (P > 0.05); while except IL-10 that showed increased expression in both cohorts and was comparatively higher in CMG, the other 8 parameters reduced in both cohorts after 2 weeks of drug withdrawal, and the reduction of each parameter was more significant in CMG (P < 0.05). The total adverse reaction rate was 30.2% in CMG, which was higher than that of 36.9% in CNG, albeit without a statistical difference (P > 0.05). An evidently higher 2-year survival rate was determined in CMG (P < 0.05).

Conclusions

rh-Endo plus NACT is more effective than NACT alone in the treatment of osteosarcoma, which can validly restore the balance of vascular endothelial cells, reduce inflammation, and is worth promoting in clinic.

Understanding and Modeling Metastasis Biology to Improve Therapeutic Strategies for Combating Osteosarcoma Progression

Osteosarcoma is a malignant primary tumor of bone, arising from transformed progenitor cells with osteoblastic differentiation and osteoid production. While categorized as a rare tumor, most patients diagnosed with osteosarcoma are adolescents in their second decade of life and underscores the potential for life changing consequences in this vulnerable population. In the setting of localized disease, conventional treatment for osteosarcoma affords a cure rate approaching 70%; however, survival for patients suffering from metastatic disease remain disappointing with only 20% of individuals being alive past 5 years post-diagnosis. In patients with incurable disease, pulmonary metastases remain the leading cause for osteosarcoma-associated mortality; yet identifying new strategies for combating metastatic progression remains at a scientific and clinical impasse, with no significant advancements for the past four decades. While there is resonating clinical urgency for newer and more effective treatment options for managing osteosarcoma metastases, the discovery of druggable targets and development of innovative therapies for inhibiting metastatic progression will require a deeper and more detailed understanding of osteosarcoma metastasis biology. Toward the goal of illuminating the processes involved in cancer metastasis, a convergent science approach inclusive of diverse disciplines spanning the biology and physical science domains can offer novel and synergistic perspectives, inventive, and sophisticated model systems, and disruptive experimental approaches that can accelerate the discovery and characterization of key processes operative during metastatic progression. Through the lens of trans-disciplinary research, the field of comparative oncology is uniquely positioned to advance new discoveries in metastasis biology toward impactful clinical translation through the inclusion of pet dogs diagnosed with metastatic osteosarcoma. Given the spontaneous course of osteosarcoma development in the context of real-time tumor microenvironmental cues and immune mechanisms, pet dogs are distinctively valuable in translational modeling given their faithful recapitulation of metastatic disease progression as occurs in humans. Pet dogs can be leveraged for the exploration of novel therapies that exploit tumor cell vulnerabilities, perturb local microenvironmental cues, and amplify immunologic recognition. In this capacity, pet dogs can serve as valuable corroborative models for realizing the science and best clinical practices necessary for understanding and combating osteosarcoma metastases.

MALT1 is a critical mediator of PAR1-driven NF-κB activation and metastasis in multiple tumor types

Protease-activated receptor 1 (PAR1), a thrombin-responsive G protein-coupled receptor (GPCR), is implicated in promoting metastasis in multiple tumor types, including both sarcomas and carcinomas, but the molecular mechanisms responsible remain largely unknown. We previously discovered that PAR1 stimulation in endothelial cells leads to activation of NF-κB, mediated by a protein complex comprised of CARMA3, Bcl10, and the MALT1 effector protein (CBM complex). Given the strong association between NF-κB and metastasis, we hypothesized that this CBM complex could play a critical role in the PAR1-driven metastatic progression of specific solid tumors. In support of our hypothesis, we demonstrate that PAR1 stimulation results in NF-κB activation in both osteosarcoma and breast cancer, which is suppressed by siRNA-mediated MALT1 knockdown, suggesting that an intact CBM complex is required for the response in both tumor cell types. We identify several metastasis-associated genes that are upregulated in a MALT1-dependent manner after PAR1 stimulation in cancer cells, including those encoding the matrix remodeling protein, MMP9, and the cytokines, IL-1β and IL-8. Further, exogenous expression of PAR1 in MCF7 breast cancer cells confers highly invasive and metastatic behavior which can be blocked by CRISPR/Cas9-mediated MALT1 knockout. Importantly, we find that PAR1 stimulation induces MALT1 protease activity in both osteosarcoma and breast cancer cells, an activity that is mechanistically linked to NF-κB activation and potentially other responses associated with aggressive phenotype. Several small molecule MALT1 protease inhibitors have recently been described that could therefore represent promising new therapeutics for the prevention and/or treatment of PAR1-driven tumor metastasis.

Proximity ligation assay induced and DNAzyme powered DNA motor for fluorescent detection of thrombin

A novel DNA motor for thrombin detection was described here based on proximity ligation assay (PLA) induced DNAzyme recycling cleavage. Fluorophore labeled DNA is modified on gold nanoparticles (AuNPs) and the fluorescent signal is quenched by AuNPs. The PLA between target thrombin and two aptamers induces the forming of Mg²⁺-dependent DNAzyme. The fluorophore labeled DNA is cleaved circularly by the DNAzyme, releasing the fluorescent fragment from AuNPs surface. The cleavage and rebinding process create a processive walking along AuNPs surface track. As a result, the fluorescent intensity recovers significantly. A good linear relationship is obtained between the ratio of fluorescence intensity and thrombin concentration in the range from 10 pM to 10 nM. The limit of detection is calculated to be 4 pM. These results are comparable or even better than other amplification based methods.

Coagulation Factor Levels in Non-Metastatic Colorectal Cancer Patients

There is evidence that high plasma levels of factor (F) VIII, FIX, FXI and fibrinogen are independent risk factors for venous thromboembolism.

Aim

To determine the plasma concentrations of several coagulation factors and C4b-binding protein (C4BP) in a group of patients with non-metastatic colorectal cancer in order to investigate some aspects of cancer-acquired thrombophilia. Methods: Plasma fibrinogen, FII, FV, FVII, FVIII, FIX, FX, FXI and FXII activity levels and C4BP concentrations were determined in 73 patients with non-metastatic colorectal cancer (48 colon and 25 rectum) and in 67 matched control subjects. No one in either group had had previous thrombotic events.

Results

Mean plasma concentrations of fibrinogen (functional and antigen), FVIII, FIX, FV and C4BP were significantly higher in colorectal cancer patients than in control subjects, while FVII and FXII levels were significantly decreased. Several correlations were found between the increased coagulation factors and C4BP concentrations, while FVII was highly correlated with FXII.

Conclusions

In colorectal cancer patients high plasma fibrinogen, FVIII and FIX levels might represent further risk factors for venous thrombotic complications in the immediate post-surgery period, while decreased FVII and FXII concentrations may be an index of intravascular coagulation activation, still in a subclinical phase.

Lack of association between platelet indices and disease stage in osteosarcoma at diagnosis

Purpose

The purpose of this study was to investigate the relationship between platelet indices [mean platelet volume (MPV), platelet count (PLT), platelet distribution width (PDW) and plateletcrit (PCT)] at diagnosis in osteosarcoma.

Methods

The information of 233 patients with osteosarcoma at diagnosis between 2007 and 2015 was retrospectively reviewed. Clinical parameters such as gender, age, size and site of tumor, and tumor necrosis rate after neoadjuvant chemotherapy were analyzed.

Results

No significant difference was noted in the mean values of MPV, PLT, PDW and PCT among stage I, II and III patients. In localized patients, the median disease-free survival (DFS) values were 42 and 22 months in the PLT<300×10⁹/L and ≥300×10⁹/L groups, respectively, but the difference was not statistically significant (P = 0.2611). No difference in the DFS among the three different levels of MPV was observed.

Conclusion

No significantly different platelet indices were noted among the different stages. Although a shorter median DFS was found in localized patients with PLT≥300×10⁹/L, there was still a lack of strong evidence to demonstrate the association between platelet indices and osteosarcoma.

Cooperation of protease-activated receptor 1 and integrin ανβ5 in thrombin-mediated lung cancer cell invasion

Protease-activated receptor 1 (PAR1) and integrins play an important role in thrombin-mediated tumor cell invasion. However, the role of PAR1 and integrin ανβ5 and the relationship between the two receptors in thrombin-induced lung cancer invasion remains unknown. Moreover, the mechanisms through which immobilized thrombin facilitates tumor invasion are poorly understood. In this study, both native and immobilized thrombin promoted lung cancer cell adhesion, migration and extracellular signal-regulated kinase phosphorylation. Integrin ανβ5 is involved in both native and immobilized thrombin-mediated tumor cell invasion; PAR1 had no effect on immobilized thrombin-mediated cell invasion. PAR1 and integrin ανβ5 colocalized on the surface of native thrombin-treated cells. This study suggests that targeting of integrin ανβ5 or the PAR1-integrin ανβ5 complex may present an important therapeutic opportunity to prevent lung cancer invasion.

Thrombin induces tumor invasion through the induction and association of matrix metalloproteinase-9 and beta1-integrin on the cell surface

The procoagulatory serine protease, thrombin, is known to induce invasion and metastasis in various cancers, but the mechanisms by which it promotes tumorigenesis are poorly understood. Because the 92-kDa gelatinase (MMP-9) is a known mediator of tumor cell invasion, we sought to determine whether and how thrombin regulates MMP-9. The thrombin receptor, PAR-1, and MMP-9 are expressed in osteosarcomas, as determined by immunohistochemistry. Stimulation of U2-OS osteosarcoma cells with thrombin and a thrombin receptor-activating peptide induced pro-MMP-9 secretion as well as cell surface-associated pro-MMP-9 expression and proteolytic activity. This was paralleled by an increase in MMP-9 mRNA and MMP-9 promoter activity. Thrombin-induced invasion of U2-OS cells through Matrigel was mediated by the phosphatidylinositol 3-kinase signaling pathway and could be inhibited with an MMP-9 antibody. The stimulation of MMP-9 by thrombin was paralleled by an increase in beta1-integrin mRNA and beta1-integrin expression on the cell surface, which was also mediated by phosphatidylinositol 3-kinase and was required for invasion. Thrombin activation induced and co-localized both beta1-integrin and pro-MMP-9 on the cell membrane, as evidenced by co-immunoprecipitation, confocal microscopy, and a protein binding assay. The thrombin-mediated association of these two proteins, as well as thrombin-mediated invasion of U2-OS cells, could be blocked with a cyclic peptide and with an antibody preventing binding of the MMP-9 hemopexin domain to beta1-integrin. These results suggest that thrombin induces expression and association of beta1-integrin with MMP-9 and that the cell surface localization of the protease by the integrin promotes tumor cell invasion.