Detection of high-risk Human Papillomavirus in prostate cancer from a UK based population

Human papillomavirus (HPV) infection is one of the sexually transmitted diseases which have been implicated in the etiology of multiple cancers. To date, several studies have been conducted to evaluate the incidence of high-risk (HR) HPV in prostate cancer (PCa) which have generated widely conflicting data. Hence, this leaves a lack of awareness on the causal role of persistent HPV infection in the development of PCa. Although this has been investigated in a handful of countries, to the best of our knowledge, no prior studies have been conducted in the UK. In this study, polymerase chain reaction (PCR) and Sanger sequencing were implemented to analyze a total of 49 fresh prostate specimens (35 benign and 14 malignant specimens) for the presence of viral DNA of 12 HR-HPV types. Data obtained confirmed the presence of HR-HPV in 32.7% of analyzed benign and malignant prostate tissues with HPV 35 being identified as the most frequent type. Moreover, HR-HPV positivity rate was found to be higher in abnormal prostate tissues (adenocarcinoma and benign with prostatitis) compared those with normal prostate condition. Using immunohistochemistry, we have confirmed the expression of HPV E7 protein in prostate tissues positive for HPV DNA. This observation, the first reported from a UK population, suggests that the presence of HPV in prostate tissue is likely to be a related factor in the progression of certain cases of prostate cancer.

Abstract 350: Co-expression and predictive value of HER family members for the response to therapy with cetuximab in patients with metastatic colorectal cancer

Background: Overexpression of the EGFR is common in patients with a wide range of cancers and the EGFR is an important target for therapy with monoclonal antibodies (mAbs) based drugs. Of these, cetuximab and panitumumab have been approved for the treatment of patients with metastatic colorectal cancer (mCRC). However, therapeutic benefits are seen in a subset of such patients and the duration of response can also be short. Indeed, there is currently no reliable predictive biomarkers for the selection of patients who benefit from therapy with the anti-EGFR antibodies. While KRAS mutation is currently used as an important negative predictive biomarker for the response to therapy with anti-EGFR mAbs, not all patients with wild type KRAS gain benefit from therapy with anti-EGFR mAbs and objective responses have been reported in mCRC patients with KRAS mutations.

Aim: The aim of this study was to investigate the predictive value of EGFR and its dimerization partner (i.e. all other members of the HER family) for the response to treatment with cetuximab in patients with wild-type KRAS status mCRC.

Methods: Using immunohistochemistry (IHC) we investigated the co-expression and predictive value of all four members of the HER family, for the response to cetuximab in 144 mCRC patients and in 21 paired primary tumours and their metastatic sites.

Results: Co-expression of all four members of the HER family were found in 10% of the cases examined. The expression of wtEGFR was an indicator of poorer overall survival and the membranous expression of HER2 and HER3 3+ intensity was associated with a shorter progression free survival (PFS). In contrast, the cytoplasmic expression of HER2 was associated with better PFS. In 48% and 71% of the cases examined, there were discordance in the expression of EGFR or one or more HER family members in paired primary and related metastatic tumours, respectively.

Conclusion: Our results implicate the importance of large prospective investigation of the expression level and predictive value of not only the therapeutic target (i.e. EGFR protein) but also its dimerization partners for the response to therapy with anti-EGFR mAbs and other forms of HER inhibitors in both the primary tumours and metastatic sites in colorectal cancer.

Citation Format: Said A. Khelwatty, Soozana Puvanenthiran, Sharadah Essapen, Izhar Bagwan, Alan M. Seddon, Helmout Modjtahedi. Co-expression and predictive value of HER family members for the response to therapy with cetuximab in patients with metastatic colorectal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 350.

Synergistic activity of agents targeting growth factor receptors, CDKs and downstream signaling molecules in a panel of pancreatic cancer cell lines and the identification of antagonistic combinations: Implications for future clinical trials in pancreatic cancer

Pancreatic cancer is one of the most aggressive, heterogeneous and fatal type of human cancers for which more effective therapeutic agents are urgently needed. Here, we investigated the sensitivity of a panel of seven human pancreatic cancer cell lines (HPCCLs) to treatment with various tyrosine kinase inhibitors (TKIs), cyclin-dependent kinase (CDK) inhibitors, an inhibitor of STAT3 stattic, and a cytotoxic agent gemcitabine both as single agents and in combination. The membranous expression of various receptors and the effect of selected agents on cell cycle distribution, cell signaling pathways and migration was determined using flow cytometry, western blot analysis and scratch wound healing assays, respectively. While the expression of both HER-3 and HER-4 was low or negative, the expression of EGFR and HER2 was high or intermediate in all HPCCLs. Of all the agents examined, the CDK1/2/5/9 inhibitor, dinacicilib, was the most potent agent which inhibited the proliferation of all seven HPCCLs with IC₅₀ values of ≤10 nM, followed by SRC targeting TKI dasatinib (IC₅₀ of ≤258 nM), gemcitabine (IC₅₀ of ≤330 nM), stattic (IC₅₀ of ≤2 µM) and the irreversible pan-HER TKI afatinib (IC₅₀ of ≤2.95 µM). Treatment with afatinib and dasatinib inhibited the ligand-induced phosphorylation of EGFR and SRC respectively. Statistically significant associations were found between HER2 expression and response to treatment with the ALK/IGF-IR/InsR inhibitor ceritinib and fibroblast growth factor receptor (FGFR)1/2/3 inhibitor AZD4547, HER3 and IGF-IR expression and their response to treatment with TKIs targeting HER family members (erlotinib and afatinib), and c-MET and ALK7 expression and their response to treatment with stattic. Interestingly, treatment with a combination of afatinib with dasatinib and gemcitabine with dasatinib resulted in synergistic tumor growth inhibition in all HPCCLs examined. In contrast, the combination of afatinib with dinaciclib was found to be antagonistic. Finally, the treatment with afatinib, dasatinib and dinaciclib strongly inhibited the migration of all HPCCLs examined. In conclusion, the CDK1/2/5/9 inhibitor dinaciclib, irreversible pan-HER TKI afatinib and SRC targeting TKI dasatinib were most effective at inhibiting the proliferation and migration of HPCCLs and the combination of afatinib with dasatinib and gemcitabine with dasatinib led to synergistic tumor growth inhibition in all HPCCLs examined. Our results support further investigation on the therapeutic potential of these combinations in future clinical trials in pancreatic cancer.

Abstract 2973: Growth response of human liver cancer cell lines to treatment with various agents targeting different members of the HER family and CDKs

Liver cancer is one of the most lethal types of cancer in the world. The heterogeneous nature of liver cancer, together with primary and secondary resistance to existing drugs are some of the important contributing factors. In the past three decades, abnormal expression and activation of human epidermal growth factor receptor (HER) family members have been reported in a wide range of epithelial cancers and several monoclonal antibody (mAb)-based drugs and small molecule tyrosine kinase inhibitors (TKIs) targeting the HER family members have been approved for the treatment of patients with a wide range of cancers. However, none of the HER inhibitors have yet been approved for the treatment of patients with liver cancer. In some studies, the expression of other members of the HER family or other growth factor receptors has been associated with the resistance to therapy with the HER inhibitors. In this study, we investigated the relative expression of all HER family members, other growth factor receptors (e.g. IGF-IR, C-MET) and the putative cancer stem cell biomarker CD44 in a panel of human liver cancer cell lines (LCCLs). We also investigated the sensitivity of these LCCLs to treatment with various agents including different types of TKIs with specificity to one or more members of the HER family, C-MET or IGFI-IR, as well as inhibitors of CDK4/6 (palbocicilib) and CDK1/2/5/9 (dinacicilib) and compared our data to those obtained with the FDA approved agents sorafenib and regorafenib for the treatment of liver cancer. While the great majority of the LCCLs were positive for the HER family members, overexpression of the EGFR, HER-3, and HER-4 were only present in SNU475, PLC/PRF5 and PLC/PRF5 LCCLs with mean fluorescence intensity (MFI) values of 620, 130 and 84 respectively. In contrast, the expression levels of C-MET and IGF-IR were the highest in SNU449 and HEPG-2 with MFI values of 95 and 99 respectively. Four of the seven LCCLs had overexpression of CD44 with the MFI values ranging from 329 to 704. With the exception of PLC/PRF5 which was found to be more sensitive to treatment with the pan-HER TKI afatinib (IC50 = 86nM) than treatment with sorafenib (IC50= 370nM) and regorafenib (372 nM), most of the other LCCLs were insensitive to treatment with the other types of HER inhibitors. Moreover, out of all the targeted therapies, the CDK inhibitors Dinacicilib and Palbocicilib were the most effective treatment for inhibiting the growth in vitro of these LCCLs. However, using linear regression analysis, we did not find any significant association between the expression level of different growth factor receptors and the response to therapy with various agents. Taken together our results show the heterogeneous nature of human LCCLs and the need for further investigation on the therapeutic potential of afatinib in combination with other agents in liver cancer.

Citation Format: Ozlem H. Ozyamaci, Alan M. Seddon, Satvider Mudan, Helmout Modjtahedi. Growth response of human liver cancer cell lines to treatment with various agents targeting different members of the HER family and CDKs [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2973.

Co-expression and prognostic significance of putative CSC markers CD44, CD133, wild-type EGFR and EGFRvIII in metastatic colorectal cancer

The presence of colorectal cancer stem cells (CSCs) have been associated with tumour initiation and resistance to therapy. This study investigated the co-expression and prognostic significance of the CSCs biomarkers CD44 and CD133 with wild-type EGFR (wtEGFR) and EGFRvIII in colorectal cancer (CRC). The expression of these biomarkers were determined in tumours from 70 patients with metastatic CRC by immunohistochemistry, and in a panel of human CRC cell lines, and their variants with acquired-resistance to EGFR inhibitors, by flow cytometry. The expression of CD44, CD133, wtEGFR and EGFRvIII were present in 17%, 23%, 26% and 13% of cases and the co-expression of CD44/CD133 with wtEGFR and EGFRvIII were present in 9% and 3% of the cases respectively. Only co-expression of CSCs/EGFRvIII (P = 0.037), and amphiregulin (P = 0.017) were associated with worse overall survival. Interestingly, disease-free survival was improved in BTC expressing patients (P = 0.025). In vitro CD133 expression and its co-expression with CD44 were associated with primary-resistance to irinotecan and acquired-resistance to anti-EGFR inhibitors respectively. Our results suggest co-expression of CSCs and EGFRvIII could be potential biomarkers of worse overall survival and resistance to therapy in patients with mCRC and warrants further validation in a larger cohort.

Complex three-dimensional self-assembly in proxies for atmospheric aerosols

Aerosols are significant to the Earth’s climate, with nearly all atmospheric aerosols containing organic compounds that often contain both hydrophilic and hydrophobic parts. However, the nature of how these compounds are arranged within an aerosol droplet remains unknown. Here we demonstrate that fatty acids in proxies for atmospheric aerosols self-assemble into highly ordered three-dimensional nanostructures that may have implications for environmentally important processes. Acoustically trapped droplets of oleic acid/sodium oleate mixtures in sodium chloride solution are analysed by simultaneous synchrotron small-angle X-ray scattering and Raman spectroscopy in a controlled gas-phase environment. We demonstrate that the droplets contained crystal-like lyotropic phases including hexagonal and cubic close-packed arrangements of spherical and cylindrical micelles, and stacks of bilayers, whose structures responded to atmospherically relevant humidity changes and chemical reactions. Further experiments show that self-assembly reduces the rate of the reaction of the fatty acid with ozone, and that lyotropic-phase formation also occurs in more complex mixtures more closely resembling compositions of atmospheric aerosols. We suggest that lyotropic-phase formation likely occurs in the atmosphere, with potential implications for radiative forcing, residence times and other aerosol characteristics.

Nearly all atmospheric aerosols contain surface-active organic compounds; however, the nature of how they arrange remains poorly understood. Here, the authors show that fatty acids in atmospheric aerosol proxies self-assemble into highly ordered, viscous 3D nanostructures that undergo changes upon exposure to humidity and ozone.

Lactobacillus fermentum 3872 as a potential tool for combatting Campylobacter jejuni infections

Due to the global spread of multidrug resistant pathogenic bacteria, alternative approaches in combating infectious diseases are required. One such approach is the use of probiotics. Lactobacillus fermentum 3872 is a promising probiotic bacterium producing a range of antimicrobial compounds, such as hydrogen peroxide and lactic acid. In addition, previous studies involving genome sequencing and analysis of L. fermentum 3872 allowed the identification of a gene encoding a cell surface protein referred to as collagen binding protein (CBP) (not found in other strains of the species, according to the GenBank database), consisting of a C-terminal cell wall anchor domain (LPXT), multiple repeats of ‘B domains' that form stalks presenting an “A domain” required for adhesion. In this study, we found that the CBP of L. fermentum 3872 binds to collagen I present on the surface of the epithelial cells lining the gastrointestinal tract. Moreover, we found that this host receptor is also used for attachment by the major gastrointestinal pathogen, Campylobacter jejuni. Furthermore, we identified an adhesin involved in such interaction and demonstrated that both L. fermentum 3872 and its CBP can inhibit binding of this pathogen to collagen I. Combined with the observation that C. jejuni growth is affected in the acidic environment produced by L. fermentum 3872, the finding provides a good basis for further investigation of this strain as a potential tool for fighting Campylobacter infections.

Potential probiotic-associated traits revealed from completed high quality genome sequence of Lactobacillus fermentum 3872

The article provides an overview of the genomic features of Lactobacillus fermentum strain 3872. The genomic sequence reported here is one of three L. fermentum genome sequences completed to date. Comparative genomic analysis allowed the identification of genes that may be contributing to enhanced probiotic properties of this strain. In particular, the genes encoding putative mucus binding proteins, collagen-binding proteins, class III bacteriocin, as well as exopolysaccharide and prophage-related genes were identified. Genes related to bacterial aggregation and survival under harsh conditions in the gastrointestinal tract, along with the genes required for vitamin production were also found.

YPTB3816 of Yersinia pseudotuberculosis strain IP32953 is a virulence-related metallo-oligopeptidase

Background

Although bacterial peptidases are known to be produced by various microorganisms, including pathogenic bacteria, their role in bacterial physiology is not fully understood. In particular, oligopeptidases are thought to be mainly involved in degradation of short peptides e.g. leader peptides released during classical protein secretion pathways. The aim of this study was to investigate effects of inactivation of an oligopeptidase encoding gene opdA gene of Yersinia pseudotuberculosis on bacterial properties in vivo and in vitro, and to test dependence of the enzymatic activity of the respective purified enzyme on the presence of different divalent cations.

Results

In this study we found that oligopeptidase OpdA of Yersinia pseudotuberculosis is required for bacterial virulence, whilst knocking out the respective gene did not have any effect on bacterial viability or growth rate in vitro. In addition, we studied enzymatic properties of this enzyme after expression and purification from E. coli. Using an enzyme depleted of contaminant divalent cations and different types of fluorescently labelled substrates, we found strong dependence of its activity on the presence of particular cations. Unexpectedly, Zn2+ showed stimulatory activity only at low concentrations, but inhibited the enzyme at higher concentrations. In contrast, Co2+, Ca2+ and Mn2+ stimulated activity at all concentrations tested, whilst Mg2+ revealed no effect on the enzyme activity at all concentrations used.

Conclusions

The results of this study provide valuable contribution to the investigation of bacterial peptidases in general, and that of metallo-oligopeptidases in particular. This is the first study demonstrating that opdA in Yersinia pseudotuberculsosis is required for pathogenicity. The data reported are important for better understanding of the role of OpdA-like enzymes in pathogenesis in bacterial infections. Characterisation of this protein may serve as a basis for the development of novel antibacterials based on specific inhibition of this peptidase activity.

Electronic supplementary material

The online version of this article (doi:10.1186/s12866-016-0900-7) contains supplementary material, which is available to authorized users.

Impact of the putative cancer stem cell markers and growth factor receptor expression on the sensitivity of ovarian cancer cells to treatment with various forms of small molecule tyrosine kinase inhibitors and cytotoxic drugs

Increased expression and activation of human epidermal growth factor receptor (EGFR) and HER-2 have been reported in numerous cancers. The aim of this study was to determine the sensitivity of a large panel of human ovarian cancer cell lines (OCCLs) to treatment with various forms of small molecule tyrosine kinase inhibitors (TKIs) and cytotoxic drugs. The aim was to see if there was any association between the protein expression of various biomarkers including three putative ovarian cancer stem cell (CSC) markers (CD24, CD44, CD117/c-Kit), P-glycoprotein (P-gp), and HER family members and response to treatment with these agents. The sensitivity of 10 ovarian tumour cell lines to the treatment with various forms of HER TKIs (gefitinib, erlotinib, lapatinib, sapitinib, afatinib, canertinib, neratinib), as well as other TKIs (dasatinib, imatinib, NVP-AEW541, crizotinib) and cytotoxic agents (paclitaxel, cisplatin and doxorubicin), as single agents or in combination, was determined by SRB assay. The effect on these agents on the cell cycle distribution, and downstream signaling molecules and tumour migration were determined using flow cytometry, western blotting, and the IncuCyte Clear View cell migration assay respectively. Of the HER inhibitors, the irreversible pan-TKIs (canertinib, neratinib and afatinib) were the most effective TKIs for inhibiting the growth of all ovarian cancer cells, and for blocking the phosphorylation of EGFR, HER-2, AKT and MAPK in SKOV3 cells. Interestingly, while the majority of cancer cells were highly sensitive to treatment with dasatinib, they were relatively resistant to treatment with imatinib (i.e., IC50 >10 µM). Of the cytotoxic agents, paclitaxel was the most effective for inhibiting the growth of OCCLs, and of various combinations of these drugs, only treatment with a combination of NVP-AEW541 and paclitaxel produced a synergistic or additive anti-proliferative effect in all three cell lines examined (i.e., SKOV3, Caov3, ES2). Finally, of the TKIs, only treatment with afatinib, neratinib and dasatinib were able to reduce the migration of HER-2 overexpressing SKOV3 cells. We did not find any significant association between the expression of putative ovarian CSC marker, HER family members, c-MET, ALK, and IGF-IR and the response to the irreversible HER TKIs. Our results support the need for further investigations of the therapeutic potential of these irreversible HER family blockers in ovarian cancer, and the therapeutic potential of dasatinib when used in combination with the inhibitors of the HER family members in ovarian cancer.

Ultra-fast stem cell labelling using cationised magnetoferritin

Magnetic cell labelling with superparamagnetic iron oxide nanoparticles (SPIONs) facilitates many important biotechnological applications, such as cell imaging and remote manipulation. However, to achieve adequate cellular loading of SPIONs, long incubation times (24 hours and more) or laborious surface functionalisation are often employed, which can adversely affect cell function. Here, we demonstrate that chemical cationisation of magnetoferritin produces a highly membrane-active nanoparticle that can magnetise human mesenchymal stem cells (hMSCs) using incubation times as short as one minute. Magnetisation persisted for several weeks in culture and provided significant T2* contrast enhancement during magnetic resonance imaging. Exposure to cationised magnetoferritin did not adversely affect the membrane integrity, proliferation and multi-lineage differentiation capacity of hMSCs, which provides the first detailed evidence for the biocompatibility of magnetoferritin. The combination of synthetic ease and flexibility, the rapidity of labelling and absence of cytotoxicity make this novel nanoparticle system an easily accessible and versatile platform for a range of cell-based therapies in regenerative medicine.

Lactobacillus fermentum 3872 genome sequencing reveals plasmid and chromosomal genes potentially involved in a probiotic activity

In this report we describe a Lactobacillus fermentum 3872 plasmid (pLF3872) not previously found in any other strain of this species. The analysis of the complete sequence of this plasmid revealed the presence of a gene encoding a large collagen-binding protein (CBP), as well as the genes responsible for plasmid maintenance and conjugation. Potential roles of CBP and a chromosomally encoded fibronectin-binding protein (FbpA) in probiotic activity are discussed.

Campylobacter-Acanthamoeba interactions

Campylobacter jejuni is a foodborne pathogen recognized as the major cause of human bacterial enteritis. Undercooked poultry products and contaminated water are considered as the most important sources of infection. Some studies suggest transmission and survival of this bacterial pathogen may be assisted by the free-living protozoa Acanthamoeba. The latter is known to play the role of a host for various pathogenic bacteria, protecting them from harsh environmental conditions. Importantly, there is a similarity between the mechanisms of bacterial survival within amoebae and macrophages, making the former a convenient tool for the investigation of the survival of pathogenic bacteria in the environment. However, the molecular mechanisms involved in the interaction between Campylobacter and Acanthamoeba are not well understood. Whilst some studies suggest the ability of C. jejuni to survive within the protozoa, the other reports support an extracellular mode of survival only. In this review, we focus on the studies investigating the interaction between Campylobacter and Acanthamoeba, address some reasons for the contradictory results, and discuss possible implications of these results for epidemiology. Additionally, as the molecular mechanisms involved remain unknown, we also suggest possible factors that may be involved in this process. Deciphering the molecular mechanisms of pathogen-protozoa interaction will assist in a better understanding of Campylobacter lifestyle and in the development of novel antibacterial drugs.

Abstract 4514: Studies on growth response of a panel of human ovarian tumor cell lines to treatment with afatinib, erlotinib, crizotinib and cytotoxic drugs

Ovarian cancer is one of the most aggressive and fatal types of gynaecological cancer. To reduce mortality, it is considered important to discover the underlying molecular mechanisms and various cell signalling pathways which are altered in ovarian cancer. This study investigated the sensitivity of a panel of human ovarian cancer cell lines (OVCAR3, SKOV3, CAOV3, COV318, ES2, PA1, SW626, A2780, A2780CIS and A2780ADR) to treatment with the irreversible ErbB family blocker afatinib, the reversible EGFR tyrosine kinase inhibitor (TKI) erlotinib, the c-MET and Anaplastic Lymphoma Kinase (ALK) TKI crizotinib, and various cytotoxic agents, using the SRB colorimetric assay in 2D cell culture. We also determined the expression of HER family members, ALK and c-MET in these cancer cell lines using FACS analysis and investigated whether there was any association between the expression level of these growth factor receptors and response to treatment with these agents. Of the 10 ovarian cancer cell lines studied, ES2, SKOV3, CAOV3, COV318 and SW626 were EGFR positive with mean fluorescence intensity (MFI) values of 10, 21, 45, 34 and 11 respectively. Four of the cell lines were also HER-2 positive, with MFI values of 368 (SKOV3), 12 (CAOV3), 13 (A2780) and 16 (A2780CIS) respectively. In contrast, all ovarian tumor cell lines expressed very low levels, or were negative for both HER-3 and HER-4. With the exceptions of COV318 and SW626, which were c-MET and ALK positive, and SKOV3 and CAOV3 cells, which were c-MET positive, all the remaining ovarian cancer cell lines were negative for both ALK and c-MET expression. Of the HER inhibitors, afatinib inhibited the growth of ovarian cancer cell lines with IC50 values ranging from 52nM (CAOV3) to 1.8μM (A2780ADR).

Erlotinib also inhibited the growth of these cancer cell lines with IC50 values ranging from 152nM (CAOV3) to 9.6μM (A2780ADR). The growth of ovarian cancer cell lines was also inhibited by crizotinib with IC50 values ranging from 162nM (PA1) to 2.7μM (A2780ADR). Of the three cytotoxic drugs used in this study, paclitaxel was most effective at inhibiting proliferation of ovarian cancer cell lines [IC50 range: 102pM (CaOv3) to 278nM (OVCAR3)], followed by doxorubicin. Interestingly, most ovarian cancer cells were relatively resistant to treatment with cisplatin and had an IC50 above 20μM. We did not find any significant association between the expression levels of individual members of the HER family, co-expression of HER family members, the expression of ALK or c-Met in ovarian cancer cells and response to treatment with the pan-HER inhibitor afatinib, erlotinib, critizinib, and cytotoxic drugs. Our results support the need for further in vitro and in vivo investigations on the therapeutic potential of co-targeting of the HER family of receptors and c-MET and ALK in ovarian cancer cells using a combination of these targeted agents and chemotherapy.

Citation Format: Soozana Pivanenthiran, Sharadah Essapen, Alan M. Seddon, Helmout Modjtahedi. Studies on growth response of a panel of human ovarian tumor cell lines to treatment with afatinib, erlotinib, crizotinib and cytotoxic drugs. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4514. doi:10.1158/1538-7445.AM2014-4514

A negative effect of Campylobacter capsule on bacterial interaction with an analogue of a host cell receptor

BACKGROUND

Campylobacter jejuni (C. jejuni) is the leading causative agent of bacterial gastrointestinal infections. The rise of antibiotic resistant forms of this pathogen necessitates the development of novel intervention strategies. One approach is the design of drugs preventing bacterial attachment to host cells. Although some putative C. jejuni adhesins have been identified, the molecular mechanisms of their interaction with host cells and their role in pathogenesis remain to be elucidated. C. jejuni adhesion may also be modulated by a bacterial capsule. However, the role of this structure in adhesion was not clear due to conflicting results published by different research groups. The aim of this study was to clarify the role of capsule in bacterial interaction with host cells by using an in vitro model of adhesion and an analogue of a host cell receptor.

RESULTS

In this study, we developed an in vitro bacterial adhesion assay, which was validated using various tests, including competitive inhibition studies, exoglycosydase treatment and site-directed mutagenesis. We demonstrate that PEB3 is one of the cell surface glycoproteins required for bacterial interaction with an analogue of a host cell receptor. In contrast, JlpA glycoprotein adhesin is not required for such interaction. We demonstrate that the production of capsule reduces bacterial attachment, and that the genes involved in capsule and PEB3 adhesin biosynthesis are differentially regulated.

CONCLUSIONS

In this study we report an in vitro model for the investigation of bacterial interaction with analogs of host cell receptors. The results suggest an interfering effect of capsule on bacterial attachment. In addition, using a liquid culture, we demonstrate differential expression of a gene involved in capsule production (kpsM) and a gene encoding a glycoprotein adhesin (peb3). Further studies are required in order to establish if these genes are also differentially regulated during the infection process. The results will assist in better understanding of the mechanism of pathogenesis of C. jejuni in general and the role of capsule in the process in particular.

Treatment with a combination of the ErbB (HER) family blocker afatinib and the IGF-IR inhibitor, NVP-AEW541 induces synergistic growth inhibition of human pancreatic cancer cells

Background

Aberrant expression and activation of the IGF-IR have been reported in a variety of human cancers and have been associated with resistance to HER targeted therapy. In this study, we investigated the effect of simultaneous targeting of IGF-IR and HER (erbB) family, with NVP-AEW541 and afatinib, on proliferation of pancreatic cancer cells.

Methods

The sensitivity of a panel of human pancreatic cancer cell lines to treatment with NVP-AEW541 used alone or in combination with afatinib, anti-EGFR antibody ICR62, and cytotoxic agents was determined using the Sulforhodamine B colorimetric assay. Growth factor receptor expression, cell-cycle distribution and cell signalling were determined using flow cytometry and western blot analysis.

Results

All pancreatic cancer cell lines were found to be IGF-IR positive and NVP-AEW541 treatment inhibited the growth of the pancreatic cancer cell lines with IC50 values ranging from 342 nM (FA6) to 2.73 μM (PT45). Interestingly, of the various combinations examined, treatment with a combination of NVP-AEW541 and afatinib was superior in inducing synergistic growth inhibition of the majority of pancreatic cancer cells.

Conclusion

Our results indicate that co-targeting of the erbB (HER) family and IGF-IR, with a combination of afatinib and NVP-AEW541, is superior to treatment with a single agent and encourages further investigation in vivo on their therapeutic potential in IGF-IR and HER positive pancreatic cancers.

Expression pattern and targeting of HER family members and IGF-IR in pancreatic cancer

Pancreatic cancer is still one of the most aggressive and fatal types of human cancer . Survival rates for patients with pancreatic cancer are extremely poor and one major contributing factor is the lack of specific marker(s) for the early detection of pancreatic cancer. Indeed, the great majority of pancreatic cancer cases are diagnosed at an advanced stage of the disease and these patients often have a poor response to treatment with conventional forms of therapy. In this article, we conduct a comprehensive review of the literature on the expression pattern, prognostic significance and predictive value of EGFR family members, IGF-IR and their ligands in pancreatic cancer. We also discuss recent advances in pancreatic cancer treatments and highlight the remaining challenges as well as future opportunities for more effective targeting of such receptors using a combination of growth factor receptor specific monoclonal antibodies, small molecule tyrosine kinase inhibitors and other therapeutic strategies. Such strategies could ultimately help to overcome the development of drug resistance and improve the overall survival rates for patients with pancreatic cancer.

Immunohistochemical discrimination of wild-type EGFR from EGFRvIII in fixed tumour specimens using anti-EGFR mAbs ICR9 and ICR10

Background:

The human epidermal growth factor receptor (EGFR) is an important therapeutic target in oncology, and three different types of EGFR inhibitors have been approved for the treatment of cancer patients. However, there has been no clear association between the expression levels of EGFR protein in the tumours determined by the FDA-approved EGFR PharmDx kit (Dako) or other standard anti-EGFR antibodies and the response to the EGFR inhibitors.

Method:

In this study, we investigated the potential of our anti-EGFR monoclonal antibodies (mAbs; ICR9, ICR10, ICR16) for immunohistochemical diagnosis of wild-type EGFR and/or the type-III deletion mutant form of EGFR (EGFRvIII) in formalin-fixed, paraffin-embedded human tumour specimens.

Results:

We found that the anti-EGFR mAb in the EGFR PharmDx kit stained both wild-type and EGFRvIII-expressing cells in formalin-fixed, paraffin-embedded sections. This pattern of EGFR immunostaining was also found with our anti-EGFR mAb ICR16. In contrast, mAbs ICR10 and ICR9 were specific for the wild-type EGFR.

Conclusion:

We conclude that mAbs ICR9 and ICR10 are ideal tools for investigating the expression patterns of wild-type EGFR protein in tumour specimens using immunohistochemistry, and to determine their prognostic significance, as well as predictive value for response to therapy with EGFR antibodies.

Three-dimensional visualisation of developmental stages of an apicomplexan fish blood parasite in its invertebrate host

Background

Although widely used in medicine, the application of three-dimensional (3D) imaging to parasitology appears limited to date. In this study, developmental stages of a marine fish haemogregarine, Haemogregarina curvata (Apicomplexa: Adeleorina), were investigated in their leech vector, Zeylanicobdella arugamensis; this involved 3D visualisation of brightfield and confocal microscopy images of histological sections through infected leech salivary gland cells.

Findings

3D assessment demonstrated the morphology of the haemogregarine stages, their spatial layout, and their relationship with enlarged host cells showing reduced cellular content. Haemogregarine meronts, located marginally within leech salivary gland cells, had small tail-like connections to the host cell limiting membrane; this parasite-host cell interface was not visible in two-dimensional (2D) light micrographs and no records of a similar connection in apicomplexan development have been traced.

Conclusions

This is likely the first account of the use of 3D visualisation to study developmental stages of an apicomplexan parasite in its invertebrate vector. Elucidation of the extent of development of the haemogregarine within the leech salivary cells, together with the unusual connections between meronts and the host cell membrane, illustrates the future potential of 3D visualisation in parasite-vector biology.

Anti-tumour activity of afatinib, an irreversible ErbB family blocker, in human pancreatic tumour cells

BACKGROUND

The combination of the reversible epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) erlotinib with gemcitabine obtained FDA approval for treating patients with pancreatic cancer. However, duration of response is often limited and there is currently no reliable predictive marker.

METHODS

We determined the sensitivity of a panel of human pancreatic tumour cell lines to treatment with afatinib, erlotinib, monoclonal antibody (mAb) ICR62, and gemcitabine, using the Sulforhodamine B colorimetric assay. The effect of these agents on cell signalling and cell-cycle distribution was determined by western blot and flow cytometry, respectively.

RESULTS

At 200 nM, ICR62 had no effect on growth of these tumour cells with the exception of BxPC-3 cells. BxPC-3 cells were also sensitive to treatment with afatinib and erlotinib with respective IC(50) values of 11 and 1200 nM. Compared with erlotinib, afatinib was also more effective in inhibiting the growth of the other human pancreatic tumour cell lines and in blocking the EGF-induced phosphorylation of tyrosine, EGFR, MAPK, and AKT. When tested in BxPC-3 xenografts, afatinib induced significant delay in tumour growth.

CONCLUSION

The superiority of afatinib in this study encourages further investigation on the therapeutic potential of afatinib as a single agent or in combination with gemcitabine in pancreatic cancer.

Growth response of human colorectal tumour cell lines to treatment with afatinib (BIBW2992), an irreversible erbB family blocker, and its association with expression of HER family members

Despite the approval of the anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (mAbs), cetuximab and panitumumab, for the treatment of colorectal cancer patients, there is currently no reliable predictive marker for response to therapy. In addition, the duration of response is often limited. Therefore, this study aimed to investigate the effect of afatinib, an irreversible erbB family blocker, as a single agent or in combination with cytotoxic drugs (5-fluorouracil, irinotecan and oxaliplatin) or mAb ICR62 on the proliferation of a panel of human colorectal tumour cell lines and the association between the expression levels of the EGFR family members and response to treatment. Of the cells examined, EGFR-overexpressing DiFi cells were the most sensitive to treatment with both afatinib (IC50=45 nM) and ICR62 (IC50=4.33 nM). Afatinib also inhibited the growth of other tumour cell lines with IC50 values which ranged from 0.33 µM (CCL-221) to 1.62 µM (HCT-116). A significant association was found between the co-expression of EGFR, human epidermal growth factor receptor (HER)-2 and HER-3 and response to treatment with afatinib (R=0.915, P=0.021). Treat-ment with afatinib and cytotoxic drugs was accompanied by an increase in the proportion of these cells in the sub-G0/G1 and in the S and G2/M phase of the cell cycle, respectively. We conclude that afatinib as monotherapy or in combination with other drugs shows activity in colorectal tumour cells and that determination of the co-expression of HER family members should be conducted in clinical trials using drugs targeting erbB signaling. This approach could lead to the identification of a specific subpopulation of cancer patients more likely to benefit from erbB-directed therapy.

Abstract 630: Responses of human pancreatic cancer cells to treatment with insulin-like growth factor receptor (IGF-IR) tyrosine kinase inhibitor NVP-AEW541 alone and in combination with anti-EGFR mAb ICR62 or cytotoxic drugs

Aberrant expression and activation of growth factor receptor signalling pathways including epidermal growth factor receptor (EGFR) and the insulin-like growth factor receptor (IGF-IR) have been reported in a wide range of epithelial cancers and have been associated with increased cell proliferation, reduced apoptosis, invasion and metastasis. Of the growth factor receptor inhibitors, the EGFR inhibitor erlotinib has been approved for the treatment of pancreatic cancer. However, its overall therapeutic efficacy can be of short duration. In some studies, signalling with the IGF-IR has been associated with resistance to therapy with the EGFR inhibitors. In this study, using the Sulforhodamine B colorimetric assay, we investigated the sensitivity of a panel of human pancreatic cancer cell lines (PT-45, AsPC1, PANC1, MiaPaca2, BxPC3, Capan1 and FA6) to treatment with IGF-IR tyrosine kinase inhibitor NVP-AEW541 alone or in combination with anti-EGFR monoclonal antibody (mAb) ICR62 and cytotoxic agents (i.e. 5-FU, doxycycline and gemcitabine). We also investigated the association between the expression levels of IGF-IR and EGFR in these tumour cells, determined by flow cytometry, and their responses to treatment with NVP-AEW541 and/or ICR62. At concentrations above 5μM, NVP-AEW541 inhibited completely the growth of most of the pancreatic cancer cell lines with IC50 values ranging from 342nM (FA6) to 2.73μM (PT45). At maximum concentration of 150nM used in this study, ICR62 did not have any effect on the growth of human pancreatic tumour cell lines. In addition, treatment with a combination of ICR62 and NVP-AEW541 did not enhance the inhibitory effect of the single agent in pancreatic cancer cells. Interestingly, treatment with a combination of NVP-AEW541 and gemcitabine was found to be synergistic for AsPC1 and PANC1 cells, additive for BxPC3, MiaPaca2 and PT-45 cells, but antagonistic for FA6 and CAPAN1 cells. We also examined the cell cycle distribution of BxPC3 cells following treatment with NVP-AEW541 and found an increase in the population of cells in sub-G1 and G0/G1 phases. In contrast, gemcitabine treatment of BxPC3 cells was accompanied by an increase in the populations of cells in both the sub-G1 and S phases of the cell cycle. Taken together, our results suggest that dual targeting of the EGFR and IGF-IR in pancreatic cancer cells by a combination of ICR62 and NVP-AEW541 is not superior to treatment with the single agent in vitro. Further investigations in vivo on the anti-tumour activity of the NVP-AEW541 in combination with ICR62 and cytotoxic drugs in pancreatic cancer are warranted.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 630. doi:10.1158/1538-7445.AM2011-630

A new fish haemogregarine from South Africa and its suspected dual transmission with trypanosomes by a marine leech

Twenty two percent (22/98) of intertidal fishes of 10 species captured in South Africa at Koppie Alleen, De Hoop Nature Reserve (south coast) and Mouille Point, Cape Town (west coast), harboured single or combined infections of haemogregarines, trypanosomes and an intraerythrocytic parasite resembling a Haemohormidium sp. The haemogregarines included the known species Haemogregarina (sensu lato) bigemina (Laveran et Mesnil, 1901) Siddall, 1995 and Haemogregarina (sensu lato) koppiensis Smit et Davies, 2001, while Haemogregarina (sensu lato) curvata sp. n. was observed in Clinus cottoides Valenciennes and Parablennius cornutus (L.) at Koppie Alleen. This last haemogregarine is characterised particularly by its distinctly curved gamonts. Also at Koppie Alleen, squash and histological preparations of 9/10 leeches, Zeylanicobdella arugamensis De Silva, 1963, taken from infected C. cottoides and P. cornutus contained developmental stages of H. curvata and/or trypanosomes, but these were absent from haematophagous gnathiid isopods (Gnathia africana Barnard, 1914) taken from infected fishes. It is suspected that Z. arugamensis transmits the haemogregarine and trypanosomes simultaneously between fishes, a double event unreported previously from the marine environment.

Crystal and microparticle effects on MDCK cell superoxide production: oxalate-specific mitochondrial membrane potential changes

We have previously shown that crystals of calcium oxalate (COM) elicit a superoxide (O2-) response from mitochondria. We have now investigated: (i) if other microparticles can elicit the same response, (ii) if processing of crystals is involved, and (iii) at what level of mitochondrial function oxalate acts. O2- was measured in digitonin-permeabilized MDCK cells by lucigenin (10 microM) chemiluminescence. [(14)C]-COM dissociation was examined with or without EDTA and employing alternative chelators. Whereas mitochondrial O2- in COM-treated cells was three- to fourfold enhanced compared to controls, other particulates (uric acid, zymosan, and latex beads) either did not increase O2- or were much less effective (hydroxyapatite +50%, p < 0.01), with all at 28 microg/cm(2). Free oxalate (750 microM), at the level released from COM with EDTA (1 mM), increased O2- (+50%, p < 0.01). Omitting EDTA abrogated this signal, which was restored completely by EGTA and partially by ascorbate, but not by desferrioxamine or citrate. Omission of phosphate abrogated O2-, implicating phosphate-dependent mitochondrial dicarboxylate transport. COM caused a time-related increase in the mitochondrial membrane potential (deltapsi(m)) measured using TMRM fluorescence and confocal microscopy. Application of COM to Fura 2-loaded cells induced rapid, large-amplitude cytosolic Ca(2+) transients, which were inhibited by thapsigargin, indicating that COM induces release of Ca(2+) from internal stores. Thus, COM-induced mitochondrial O2- requires the release of free oxalate and contributes to a synergistic response. Intracellular dissociation of COM and the mitochondrial dicarboxylate transporter are important in O2- production, which is probably regulated by deltapsi(m).

Haemogregarina bigemina (Protozoa: Apicomplexa: Adeleorina) - past, present and future

This paper reviews past, current and likely future research on the fish haemogregarine, Haemogregarina bigemina Laveran et Mesnil, 1901. Recorded from 96 species of fishes, across 70 genera and 34 families, this broad distribution for H. bigemina is questioned. In its type hosts and other fishes, the parasite undergoes intraerythrocytic binary fission, finally forming mature paired gamonts. An intraleukocytic phase is also reported, but not from the type hosts. This paper asks whether stages from the white cell series are truly H. bigemina. A future aim should be to compare the molecular constitution of so-called H. bigemina from a number of locations to determine whether all represent the same species. The transmission of H. bigemina between fishes is also considered. Past studies show that young fish acquire the haemogregarine when close to metamorphosis, but vertical and faecal-oral transmission seem unlikely. Some fish haemogregarines are leech-transmitted, but where fish populations with H. bigemina have been studied, these annelids are largely absent. However, haematophagous larval gnathiid isopods occur on such fishes and may be readily eaten by them. Sequential squashes of gnathiids from fishes with H. bigemina have demonstrated development of the haemogregarine in these isopods. Examination of histological sections through gnathiids is now underway to determine the precise development sites of the haemogregarine, particularly whether merozoites finally invade the salivary glands. To assist in this procedure and to clarify the internal anatomy of gnathiids, 3D visualisation of stacked, serial histological sections is being undertaken. Biological transmission experiments should follow these processes.

A family of polynuclear cobalt and nickel complexes stabilised by 2-pyridonate and carboxylate ligands

The synthesis and structural characterisation of a series of cobalt and nickel cages are reported. Eight of these structures contain a [M10(mu3-OH)6(eta2, mu3-xhp),(eta2, mu2-O2CR)6]2+ core (where M = Co or Ni; xhp = 6-chloro- or 6-methyl-2-pyridonate: R = Me, Ph, CHMe2, CH2Cl, CHPh2 or CMe3), where the ten metal atoms describe a centred-tricapped-trigonal prism (ttp). The cage contains six hydroxide ligands around the central metal, and the exterior is coated with pyridonate and carboxylate ligands. For four of the cages additional metal centres are found attached to the upper and/or lower triangular faces of the trigonal prism, generating dodeca- and undecanuclear cages. Three further cages are reported that contain a metal core based on an incomplete centred-tetraicosahedron. These cages involve trimethylacetate as a ligand in company with either 6-methyl-2-pyridonate or 6-chloro-2-pyridonate. Comparison of these latter structures with the trigonal prisms reveal that they can be described as a pentacapped-trigonal prism missing one edge. Magnetic studies of three of the nickel cages with trigonal prismatic cores show spin ground states of S = 8, 4 and 2 for Ni12, Ni11 and Ni10 cages, respectively.

The effect of platelet inhibitory therapy on graft thromboresistance

Greyhounds (n = 38) were randomized to aspirin and dipyridamole (ASA + DPM), the thromboxane synthetase inhibitor (TSI) CGS12970 (CIBA-GEIGY) or placebo twice daily for 48 hours prior to bilateral implantation of femoral artery Dacron grafts. In-vivo 111In-platelet deposition on grafts was measured at 5 days and 2 months. Grafts were removed at 2 months when ex-vivo graft and arterial release of 6-ketoprostaglandin F1a (6-keto PGF1a) was measured by radioimmunoassay. Graft 6-keto-PGF1a was significantly increased by CGS12970 but ASA + DPM had no significant effect. ASA + DPM significantly reduced arterial 6-keto-PGF1a although this was marginally increased by CGS12970. Neither active treatment reduced in-vivo 111In-platelet deposition. Preservation of vascular or graft prostacyclin by thromboxane synthetase inhibitors may represent an alternative strategy in preventing prosthetic graft thrombosis.

Popliteal artery aneurysm. Prompt intervention prevents tragic consequences

Popliteal artery aneurysm is an important, if uncommon, cause of lower extremity ischemia. About half of cases are asymptomatic. Untreated aneurysms may lead to embolization, rupture, thrombosis, and amputation. Diagnosis involves careful physical examination and use of ultrasound and arteriography. Prompt surgical intervention is essential.

Mesothelial seeding of knitted Dacron

Bilateral superficial femoral artery replacement using knitted Dacron was performed in 38 dogs. One side was seeded with omental mesothelium and the other acted as an unseeded control. 111In-labelled platelet accumulation on grafts was measured at 5 days and 2 months and the thrombogenicity index of seeded and unseeded grafts calculated. Patency was monitored for 2 months, at which time grafts were removed and luminal thrombus, ultrastructural cell cover and prostacyclin release were measured. Cell seeding did not influence the mean(s.e.m.) thrombogenicity index of 0.95(0.25) and 0.88(0.24) at 5 days in control and seeded grafts respectively; nor was there any difference between the groups at 2 months. Occlusion occurred in six control and four seeded grafts. Seeding did not significantly improve the percentage thrombus-free area or luminal cell cover. Neither did it enhance mean(s.e.m.) luminal 6-keto-prostaglandin F1 alpha release of 2.58(0.80) pg cm-2 in controls and 2.63(0.78) pg cm-2 in seeded grafts. Further studies demonstrated that only a mean(s.e.m.) of 4.4(1.9) per cent of the seeded inoculum was present on grafts 48 h after implantation, providing too few cells to achieve confluent cover. Mesothelial cell seeding might be useful in promoting a healed graft surface but critical levels of seeding density must be achieved before the technique can be properly evaluated.

The effect of platelet inhibitory therapy on prosthetic graft maturation

Thirty-eight dogs were randomized to the thromboxane synthetase inhibitor CGS12790 (3 mg/kg), aspirin 150 mg and dipyridamole 50 mg (ASA + DPM) or placebo (PLA), all twice daily. Two days later, animals underwent bilateral superficial femoral artery replacement with knitted Dacron. Grafts were removed at two months and subjected to macroscopic and histological examination. Thirty dogs survived to two months. Percentage thrombus free area (TFA) was increased from 15.1 +/- 2.2 with PLA to 46.6 +/- 5.2 with CGS12970 (P < 0.001) and to 32.9 +/- 5.0 with ASA + DPM (P < 0.01). At the anastomoses, only CGS12970 significantly reduced neointimal thickness, promoted pannus ingrowth and improved endothelialization. Percentage luminal occlusion at the midgraft was reduced from 48.2 +/- 5.9 with PLA to 33.9 +/- 2.7 with CGS12970 (P < 0.05). These results provide further evidence that platelet inhibitory therapy reduces thrombosis but also that the platelet is involved in anastomotic maturation. Therapy directed against thromboxane synthesis has potential that may be useful in clinical practice.

An immunohistochemical study of mesothelial cell seeding for knitted Dacron

Six greyhounds underwent bilateral femoral artery replacement with knitted Dacron, one side seeded with omental digest at graft preclotting, the other acting as an unseeded control. Grafts were removed at 24 hours and two months. Tissue was examined using a monoclonal antibody (MNF116) directed against a broad range of human cytokeratins to differentiate mesothelial cells (MC) from microvascular endothelial cells (MEC), which stained only with a polyclonal antibody directed against von Willebrand Factor (anti-vWF). Cells released from omentum by collagenase stained with MNF116 and reacted poorly with anti-vWF. Identical cells were observed to be within the interstices of seeded but not control knitted Dacron. Few remained in seeded grafts (n = 2) removed at 24 hours and none at two months (n = 4).

Primary prevention of atherosclerosis by lovastatin in a genetically hyperlipidaemic rabbit strain

Lovastatin, a lipid-lowering drug which inhibits cholesterol synthesis, was administered to genetically hyperlipidaemic rabbits from the age of 2 months. Twenty rabbits were selected with similar plasma cholesterol levels and divided into matched treatment and control groups. The treated animals showed a 60% decrease in plasma cholesterol due to reduced levels of low density lipoprotein (LDL) and intermediate density lipoprotein (IDL). Levels of other lipoproteins remained unchanged. In untreated animals cholesterol levels in plasma, LDL and IDL increased with age. The area of aortic atherosclerosis-like lesions was quantified after 2-10.5 months of treatment. At each time point the extent of arterial disease was profoundly less in treated than in untreated animals. The findings demonstrate that primary prevention of arterial lesions resembling human atherosclerosis (increased amounts of fibrous tissue, smooth muscle cell proliferation, foam cell formation and necrosis at the base of the plaques) results from early effective reduction of elevated plasma lipids by lovastatin in this rabbit strain.

A new treatment for urethral strictures

A urethral stent, originally developed for endovascular use, was implanted into eight patients with urethral strictures after experimental studies in the canine urethra. The stent is woven in the form of a tubular mesh from surgical grade stainless steel wire and is self-expanding when released from its small-diameter delivery catheter. At follow-up 6 months to 1 year postoperatively (mean 8 months) all had a good calibre urethra. Urethroscopy showed complete epithelial covering of the implant at 4-6 months.

Biliary stent blockage with bacterial biofilm. A light and electron microscopy study

Clogging of endoscopic stents necessitates their replacement in many patients with malignant obstructive jaundice and limits their use in benign strictures. We studied the basic mechanism of clogging to find ways to prevent it. We did light and electron microscopy studies of blocked and functioning stents, which were prepared so that organic structures would be preserved. The material blocking the lumina was composed of a matrix of bacterial cells and their fibrillar anionic extracellular products. Crystals of calcium bilirubinate, calcium palmitate, and cholesterol were embedded within this matrix. Bacterial cells were attached to the stent surface by a fibrillar matrix, suggesting that the initial event in stent clogging is the development of an adherent bacterial biofilm. Bacterial enzyme activity (beta-glucuronidase and phospholipase) leads to the deposition of crystals. The use of antibacterial plastics in the manufacture of stents may reduce bacterial adhesion and stent clogging.

Hereditary hyperlipidemia and atherosclerosis in the rabbit due to overproduction of lipoproteins. II. Preliminary report of arterial pathology

A genetically determined hyperlipidemic strain of New Zealand White rabbit that has features in common with combined familial hyperlipidemia in humans has been identified. The morphologic findings in a few animals fed a normal chow diet are reported. These consisted of macroscopically visible aortic intimal elevations found in the greatest number in the descending thoracic aorta. The plaques showed the presence of a cell population consisting of modified smooth muscle cells and lipid-laden macrophages. The lesion bases were necrotic and acellular, and some showed the presence of dystrophic calcification. Scanning electron microscopy revealed numerous monocytes attached to the endothelium. Endothelial defects were common, and these were filled with swollen and "ruffled" macrophages. Transmission electron microscopy confirmed the presence of lipid-laden cells penetrating between adjacent endothelial cells. These findings resemble those reported in a number of different animal species after dietary induction of hyperlipidemia. This strain is a useful new model for the study of atherogenesis.