1
|
Chintapally N, Nuwayhid M, Arroju V, Muddu VK, Gao P, Reddy BY, Sunkavalli C. State of cancer care in India and opportunities for innovation. Future Oncol 2023; 19:2593-2606. [PMID: 37675499 DOI: 10.2217/fon-2023-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
Abstract
Cancer is one of the leading causes of morbidity and mortality in India. Despite recent medical and technological advances, the cancer burden in India remains high and continues to rise. Moreover, substantial regional disparities in cancer incidence and access to essential medical resources exist throughout the country. While innovative and effective cancer therapies hold promise for improving patient outcomes, several barriers hinder their development and utilization in India. Here we provide an overview of these barriers, including challenges related to patient awareness, inadequate infrastructure, scarcity of trained oncology professionals, and the high cost of cancer care. Furthermore, we discuss the limited availability of cancer clinical trials in the country, along with an examination of potential avenues to enhance cancer care in India. By confronting these hurdles head-on and implementing innovative, pragmatic solutions, we take an indispensable step toward a future where every cancer patient in the country can access quality care.
Collapse
Affiliation(s)
- Neha Chintapally
- Pi Health USA, Cambridge, MA, USA
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | | | | | - Vamshi K Muddu
- Asian Institute of Gastroenterology (AIG) Hospitals, Hyderabad, Telangana, India
| | - Peng Gao
- Pi Health USA, Cambridge, MA, USA
| | | | | |
Collapse
|
2
|
Kumar R, Njauw CN, Reddy BY, Ji Z, Rajadurai A, Klebanov N, Tsao H. Growth suppression by dual BRAF(V600E) and NRAS(Q61) oncogene expression is mediated by SPRY4 in melanoma. Oncogene 2019; 38:3504-3520. [PMID: 30651601 PMCID: PMC6756020 DOI: 10.1038/s41388-018-0632-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/15/2018] [Accepted: 10/11/2018] [Indexed: 01/08/2023]
Abstract
The underlying forces that shape mutational patterns within any type of cancer have been poorly characterized. One of the best preserved exclusionary relationships is that between BRAF(V600E) and NRAS(Q61) in melanomas. To explore possible mechanisms which could explain this phenomenon, we overexpressed NRAS(Q61) in a set of BRAF(V600E) melanoma lines and vice versa. Controlled expression of a second activating oncogene led to growth arrest (“synthetic suppression”) in a subset of cells, which was accompanied by cell cycle arrest and senescence in several melanoma cell lines along with apoptosis. Through differential gene expression analysis, we identified SPRY4 as the potential mediator of this synthetic response to dual oncogene suppression. Ectopic introduction of SPRY4 recapitulated the growth arrest phenotype of dual BRAF(V600E)/NRAS(Q61) expression while SPRY4 depletion led to a partial rescue from oncogenic antagonism. This study thus defined SPRY4 as a potential mediator of synthetic suppression, which is likely to contribute to the observed exclusivity between BRAF(V600E) and NRAS(Q61R) mutations in melanoma. Further leverage of the SPRY4 pathway may also hold therapeutic promise for NRAS(Q61) melanomas.
Collapse
Affiliation(s)
- Raj Kumar
- Department of Dermatology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ching-Ni Njauw
- Department of Dermatology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Bobby Y Reddy
- Department of Dermatology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Zhenyu Ji
- Department of Dermatology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Edwards 211 50 Blossom Street, Boston, MA, USA
| | - Anpuchchelvi Rajadurai
- Department of Dermatology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nikolai Klebanov
- Department of Dermatology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hensin Tsao
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Edwards 211 50 Blossom Street, Boston, MA, USA.
| |
Collapse
|
3
|
Klebanov N, Gunasekera NS, Lin WM, Hawryluk EB, Miller DM, Reddy BY, Christman MP, Beaulieu D, Rajadurai S, Duncan LM, Sober AJ, Tsao H. Clinical spectrum of cutaneous melanoma morphology. J Am Acad Dermatol 2018; 80:178-188.e3. [PMID: 30165162 DOI: 10.1016/j.jaad.2018.08.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/10/2018] [Accepted: 08/18/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Melanoma can mimic other cutaneous lesions, but the full spectrum and prevalence of these morphologic variants remain largely unknown. OBJECTIVE To classify nonacral cutaneous melanomas into distinct morphologic clusters and characterize clusters' clinicopathologic features. METHODS All pathologic melanoma diagnoses (occurring during 2011-2016) were reviewed for routine prebiopsy digital photographs (n = 400). Six dermatologists independently assigned lesions into 1 of 14 diagnostic classes on the basis of morphology. Image consensus clusters were generated by K-means; clinicopathologic features were compared with analysis of variance and χ2. RESULTS Five morphologic clusters were identified: typical (n = 136), nevus-like (n = 81), amelanotic/nonmelanoma skin cancer (NMSC)-like (n = 70), seborrheic keratosis (SK)-like (n = 68), and lentigo/lentigo maligna (LM)-like (n = 45) melanomas. Nevus-like melanomas were found in younger patients. Nevus-like and lentigo/LM-like melanomas tended to be thinner and more likely identified on routine dermatologic examinations. NMSC-like melanomas were tender, thicker, more mitotically active, and associated with prior NMSC. Typical and SK-like melanomas had similar clinicopathologic features. LIMITATIONS Cluster subdivision yielded diminished sample sizes. Visual assignment was performed without clinical context. CONCLUSION When primary cutaneous melanomas were assigned into diagnostic groups and subjected to novel consensus clustering, recurrent morphologic patterns emerged. The spectrum of these morphologies was unexpectedly diverse, which might have implications for visual training and possibly clinical diagnosis.
Collapse
Affiliation(s)
- Nikolai Klebanov
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nicole S Gunasekera
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - William M Lin
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Elena B Hawryluk
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - David M Miller
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Division of Hematology and Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Bobby Y Reddy
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Mitalee P Christman
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Derek Beaulieu
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Suvithan Rajadurai
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lyn M Duncan
- Pathology Service, Massachusetts General Hospital, Boston, Massachusetts
| | - Arthur J Sober
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Hensin Tsao
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts.
| |
Collapse
|
4
|
Abstract
Pleomorphic dermal sarcoma (PDS) is a rare mesenchymal tissue tumor. Distinguishing PDS from similar conditions, such as atypical fibroxanthoma (AFX), its less aggressive tumor counterpart, is difficult, as they are clinically and histologically similar. We present a case of a 77-year-old man presenting with a large nodular scalp lesion of three weeks duration. Pathology revealed a 3.3 cm invasive pleomorphic dermal sarcoma. Surgical excision with 2 cm margins was performed with successful healing of the graft. This case highlights a rare case of a large pleomorphic dermal sarcoma and discusses the histological features and management of PDS.
Collapse
Affiliation(s)
| | - Mai P Hoang
- Pathology, Massachusetts General Hospital/Harvard Medical School, Boston, USA
| | - Bobby Y Reddy
- Dermatology, Massachusetts General Hospital, Boston, USA
| |
Collapse
|
5
|
Artomov M, Stratigos AJ, Kim I, Kumar R, Lauss M, Reddy BY, Miao B, Daniela Robles-Espinoza C, Sankar A, Njauw CN, Shannon K, Gragoudas ES, Marie Lane A, Iyer V, Newton-Bishop JA, Timothy Bishop D, Holland EA, Mann GJ, Singh T, Daly MJ, Tsao H. Rare Variant, Gene-Based Association Study of Hereditary Melanoma Using Whole-Exome Sequencing. J Natl Cancer Inst 2017; 109:3861235. [PMID: 29522175 PMCID: PMC5939858 DOI: 10.1093/jnci/djx083] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 02/03/2017] [Accepted: 04/04/2017] [Indexed: 12/29/2022] Open
Abstract
Background Extraordinary progress has been made in our understanding of common variants in many diseases, including melanoma. Because the contribution of rare coding variants is not as well characterized, we performed an exome-wide, gene-based association study of familial cutaneous melanoma (CM) and ocular melanoma (OM). Methods Using 11 990 jointly processed individual DNA samples, whole-exome sequencing was performed, followed by large-scale joint variant calling using GATK (Genome Analysis ToolKit). PLINK/SEQ was used for statistical analysis of genetic variation. Four models were used to estimate the association among different types of variants. In vitro functional validation was performed using three human melanoma cell lines in 2D and 3D proliferation assays. In vivo tumor growth was assessed using xenografts of human melanoma A375 melanoma cells in nude mice (eight mice per group). All statistical tests were two-sided. Results Strong signals were detected for CDKN2A (Pmin = 6.16 × 10-8) in the CM cohort (n = 273) and BAP1 (Pmin = 3.83 × 10-6) in the OM (n = 99) cohort. Eleven genes that exhibited borderline association (P < 10-4) were independently validated using The Cancer Genome Atlas melanoma cohort (379 CM, 47 OM) and a matched set of 3563 European controls with CDKN2A (P = .009), BAP1 (P = .03), and EBF3 (P = 4.75 × 10-4), a candidate risk locus, all showing evidence of replication. EBF3 was then evaluated using germline data from a set of 132 familial melanoma cases and 4769 controls of UK origin (joint P = 1.37 × 10-5). Somatically, loss of EBF3 expression correlated with progression, poorer outcome, and high MITF tumors. Functionally, induction of EBF3 in melanoma cells reduced cell growth in vitro, retarded tumor formation in vivo, and reduced MITF levels. Conclusions The results of this large rare variant germline association study further define the mutational landscape of hereditary melanoma and implicate EBF3 as a possible CM predisposition gene.
Collapse
Affiliation(s)
- Mykyta Artomov
- MGH Analytic and Translational Genetics Unit, MGH and Broad Institute, Boston, MA
- Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA
| | - Alexander J Stratigos
- 1st Department of Dermatology, University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - Ivana Kim
- Retina Service, Massachusetts Eye and Ear Infirmary, Boston, MA
| | - Raj Kumar
- Department of Dermatology, Wellman Center for Photomedicine, MGH, Boston, MA
| | - Martin Lauss
- Retina Service, Massachusetts Eye and Ear Infirmary, Boston, MA
- Department of Oncology, Clinical Sciences, Lund University, Lund, Sweden
| | - Bobby Y Reddy
- Department of Dermatology, Wellman Center for Photomedicine, MGH, Boston, MA
| | - Benchun Miao
- Department of Dermatology, Wellman Center for Photomedicine, MGH, Boston, MA
| | - Carla Daniela Robles-Espinoza
- Experimental Cancer Genetics, Wellcome Trust Sanger Institute, Cambridge, UK
- Laboratorio Internacional de Investigación sobre el Genoma Humano, Universidad Nacional Autónoma de México, Santiago de Querétaro, Mexico
| | - Aravind Sankar
- Experimental Cancer Genetics, Wellcome Trust Sanger Institute, Cambridge, UK
| | - Ching-Ni Njauw
- Department of Dermatology, Wellman Center for Photomedicine, MGH, Boston, MA
| | - Kristen Shannon
- Melanoma Genetics Program, MGH Cancer Center, MGH, Boston, MA
| | | | - Anne Marie Lane
- Retina Service, Massachusetts Eye and Ear Infirmary, Boston, MA
| | - Vivek Iyer
- Experimental Cancer Genetics, Wellcome Trust Sanger Institute, Cambridge, UK
| | - Julia A Newton-Bishop
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - D Timothy Bishop
- Department of Dermatology, Wellman Center for Photomedicine, MGH, Boston, MA
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Elizabeth A Holland
- Centre for Cancer Research, Westmead Institute for Medical Research, University of Sydney, Westmead, Australia
| | - Graham J Mann
- Centre for Cancer Research, Westmead Institute for Medical Research, University of Sydney, Westmead, Australia
- Melanoma Institute Australia, University of Sydney, North Sydney, NSW, Australia
| | - Tarjinder Singh
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - Mark J Daly
- MGH Analytic and Translational Genetics Unit, MGH and Broad Institute, Boston, MA
| | - Hensin Tsao
- Melanoma Genetics Program, MGH Cancer Center, MGH, Boston, MA
| |
Collapse
|
6
|
MESH Headings
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antineoplastic Agents, Immunological/adverse effects
- Antineoplastic Agents, Immunological/therapeutic use
- Clinical Trials, Phase III as Topic
- Disease-Free Survival
- Drug Therapy, Combination
- Female
- Humans
- Immunotherapy/economics
- Immunotherapy/methods
- Ipilimumab/therapeutic use
- Melanoma/drug therapy
- Melanoma/pathology
- Melanoma/secondary
- Melanoma/surgery
- Middle Aged
- Molecular Targeted Therapy/economics
- Molecular Targeted Therapy/methods
- Nivolumab
- Proto-Oncogene Proteins B-raf/antagonists & inhibitors
- Proto-Oncogene Proteins B-raf/drug effects
- Proto-Oncogene Proteins B-raf/genetics
- Randomized Controlled Trials as Topic
- Skin Neoplasms/drug therapy
- Skin Neoplasms/immunology
- Skin Neoplasms/pathology
- Skin Neoplasms/secondary
Collapse
Affiliation(s)
- Chante Karimkhani
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Bobby Y Reddy
- Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Robert P Dellavalle
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Dermatology Service, Eastern Colorado Health Care System, US Department of Veteran Affairs, Denver, CO, USA
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Srinath Sundararajan
- Division of Hematology and Oncology, Department of Medicine, University of Arizona, Tucson, AZ, USA
| |
Collapse
|
7
|
Abstract
Melanoma has one of the highest somatic mutational burdens among solid malignancies. Although the rapid progress in genomic research has contributed immensely to our understanding of the pathogenesis of melanoma, the clinical significance of the vast array of genomic alterations discovered by next-generation sequencing is far from being fully characterized. Most mutations prevalent in melanoma are simply neutral "passengers," which accompany functionally significant "drivers" under transforming conditions. The delineation of driver mutations from passenger mutations is critical to the development of targeted therapies. Novel advances in genomic data analysis have aided in distinguishing true driver mutations involved in tumor progression. Here, the authors review the current literature on important somatic driver mutations in melanoma, along with the implications for treatment. Cancer 2017;123:2104-17. © 2017 American Cancer Society.
Collapse
Affiliation(s)
- Bobby Y Reddy
- Department of Dermatology, Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - David M Miller
- Department of Dermatology, Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Division of Hematology/Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Hensin Tsao
- Department of Dermatology, Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
8
|
Affiliation(s)
- Hannah M Singer
- Department of Dermatology, Columbia University, New York, New York
| | - Bobby Y Reddy
- Department of Dermatology, Massachusetts General Hospital, Harvard University, Boston, Massachusetts
| | - Marc E Grossman
- Medical and Cosmetic Dermatology, White Plains, Massachusetts
| |
Collapse
|
9
|
Yamany T, Reddy BY, Husain S, Grossman ME. Recurrent Richter's Transformation Presenting With a Penile Ulcer. JAMA Dermatol 2016; 152:586-7. [PMID: 26843375 DOI: 10.1001/jamadermatol.2015.5708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Tarek Yamany
- Consultation Service, Department of Dermatology, Columbia University, New York, New York
| | - Bobby Y Reddy
- Consultation Service, Department of Dermatology, Columbia University, New York, New York
| | - Sameera Husain
- Dermatopathology, Department of Dermatology, Columbia University, New York, New York
| | - Marc E Grossman
- Consultation Service, Department of Dermatology, Columbia University, New York, New York
| |
Collapse
|
10
|
Abstract
Fixed drug eruption (FDE) is a localized type IV sensitivity reaction to a systemically introduced allergen. It usually occurs as a result of new medication, making identification and avoidance of the trigger medication straightforward; however, in a rare subset of cases no pharmacological source is identified. In such cases, the causative agent is often a food or food additive. In this report we describe a case of a FDE in a 12-year-old girl recently immigrated to the United States from Ecuador who had no medication exposure over the course of her illness. Through an exhaustive patient history and literature review, we were able to hypothesize that her presentation was caused by a dietary change of the natural achiote dye used in the preparation of yellow rice to a locally available commercial dye mix containing tartrazine, or Yellow 5, which has previously been implicated in both systemic hypersensitivity reactions and specifically in FDE. This report adds to the small body of available literature on non-pharmacological fixed hypersensitivity eruptions and illustrates an effective approach to the management of such a presentation when history is not immediately revealing.
Collapse
Affiliation(s)
- Ian Tattersall
- Department of Dermatology, Columbia University, New York, N.Y., USA
| | - Bobby Y Reddy
- Department of Dermatology, Columbia University, New York, N.Y., USA
| |
Collapse
|
11
|
Reddy BY, Shaigany S, Schulman L, Grossman ME. Resident Rounds Part III: Case Report: Fatal Cryptococcal Panniculitis in a Lung Transplant Recipient. J Drugs Dermatol 2015; 14:519-522. [PMID: 25942673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Cryptococcal panniculitis is a rare entity previously reported in only 13 solid organ transplant (SOT) recipients. Cutaneous cryptococcosis in SOT recipients warrants extensive systemic workup and treatment as if central nervous system (CNS) disease is present. It should be included in the differential diagnosis of panniculitis in the immunocompromised host, as early diagnosis and treatment are critical. We report a fatal case of cryptococcal panniculitis in a 44-year-old lung transplant recipient.
Collapse
|
12
|
Schwartz RA, Husain Z, Reddy BY. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome and dysphagia: A noteworthy association. J Am Acad Dermatol 2013; 69:1058. [DOI: 10.1016/j.jaad.2013.09.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 09/14/2013] [Indexed: 10/26/2022]
|
13
|
Husain Z, Reddy BY, Schwartz RA. DRESS syndrome. J Am Acad Dermatol 2013; 68:693.e1-14; quiz 706-8. [DOI: 10.1016/j.jaad.2013.01.033] [Citation(s) in RCA: 252] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 01/21/2013] [Accepted: 01/26/2013] [Indexed: 11/28/2022]
|
14
|
Affiliation(s)
- Bobby Y. Reddy
- Department of Dermatology; New Jersey Medical School; Newark; NJ; USA
| | - Tiffany Jow
- Department of Dermatology; New Jersey Medical School; Newark; NJ; USA
| | | |
Collapse
|
15
|
Patel N, Klassert TE, Greco SJ, Patel SA, Munoz JL, Reddy BY, Bryan M, Campbell N, Kokorina N, Sabaawy HE, Rameshwar P. Developmental regulation of TAC1 in peptidergic-induced human mesenchymal stem cells: implication for spinal cord injury in zebrafish. Stem Cells Dev 2012; 21:308-20. [PMID: 21671725 PMCID: PMC3258436 DOI: 10.1089/scd.2011.0179] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2011] [Accepted: 06/10/2011] [Indexed: 02/06/2023] Open
Abstract
Human mesenchymal stem cells (MSCs) are easy to expand, are relatively safe, and can be transplanted in allogeneic recipients as off-the-shelf cells. MSCs can be induced to form functional peptidergic neurons and express the neurotransmitter gene, TAC1. Expression of TAC1 requires that the repressor gene, RE-1 silencing transcription factor (REST), is decreased. This study investigated the molecular pathway in TAC1 induction as MSCs differentiated into neurons and then applied the findings in a model of spinal cord injury (SCI) in zebrafish. We studied the developmental roles of the 2 cAMP response element (CRE) sites: CRE1 and CRE2. Activator protein-1 (AP-1) binding site overlaps with CRE2 (CRE2/AP-1). Reporter gene studies with the 5' regulatory region of TAC1 containing wild-type or mutant CRE sites and, parallel studies with ectopically expressed inhibitor of cAMP proteins (inducible cAMP early repressor) indicated that CRE1 and CRE2/AP-1 are activated at days 6 and 12, respectively. Studies with protein kinase-A (PKA) and Jun N-terminal kinase (JNK) inhibitors in the reporter gene studies, chromatin immunoprecipation assay, and ectopic expression of REST indicated the following pathways: Decrease of REST activated upstream c-Jun N-terminal kinase (JNK). In turn, JNK activated ATF-2 and AP-1 for interaction with CRE1 and CRE2/AP-1, respectively. To apply the finding to SCI, we transplanted 6-day-induced MSCs in transgenic HB9-GFP zebrafish larvae with SCI, in the presence or absence of JNK inhibitors. Imaging and functional studies showed significant improvement in the fish. The repair mechanism involved the activation of JNK. The findings have long-term implications for SCI repair with MSCs.
Collapse
Affiliation(s)
- Nitixa Patel
- UMDNJ–New Jersey Medical School, Newark, New Jersey
| | - Tilman E. Klassert
- Instituto de Enfermedades Tropicales y Salud Pública, Universito of La Laguna, Canary Islands, Spain
| | | | | | | | | | | | - Neil Campbell
- UMDNJ–Robert Wood Johnson Medical School and Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Natalia Kokorina
- UMDNJ–Robert Wood Johnson Medical School and Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Hatem E. Sabaawy
- UMDNJ–Robert Wood Johnson Medical School and Cancer Institute of New Jersey, New Brunswick, New Jersey
| | | |
Collapse
|
16
|
Reddy BY, Xu DS, Hantash BM. Mesenchymal stem cells as immunomodulator therapies for immune-mediated systemic dermatoses. Stem Cells Dev 2011; 21:352-62. [PMID: 21864110 DOI: 10.1089/scd.2011.0404] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Mesenchymal stems cells (MSCs) are a population of multipotent cells residing in several readily available adult tissue compartments, thus allowing for their ex vivo expansion. To date, therapeutic applications of MSCs have focused on their ability to hone to and support the repair of damaged tissues. More recent evidence suggests that MSCs possess low immunogenicity and a diverse array of immunosuppressive properties. In thisarticle, we will review the basic biology of bone marrow-derived MSCs including their immunoregulatory effects and the putative mechanisms underlying them. We will then present some of the recent clinical applications of MSCs that have leveraged these effects for the treatment of immune-mediated dermatoses such as graft-versus-host disease and systemic lupus erythematosus. Although MSCs offer great therapeutic promise, we will also highlight a number of pertinent challenges that should be overcome before their successful clinical translation.
Collapse
Affiliation(s)
- Bobby Y Reddy
- Department of Dermatology, UMDNJ-New Jersey Medical School, Newark, New Jersey, USA
| | | | | |
Collapse
|
17
|
|
18
|
Heinrich AC, Patel SA, Reddy BY, Milton R, Rameshwar P. Multi- and inter-disciplinary science in personalized delivery of stem cells for tissue repair. Curr Stem Cell Res Ther 2009; 4:16-22. [PMID: 19149626 DOI: 10.2174/157488809787169075] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Stem cell therapy has a place for future application in the treatment of degenerative diseases. Regardless of the origin of the stem cell, when placed within a milieu of inflammatory mediator, they will show varied functions. This review focuses on human mesenchymal stem cells (MSCs) and discusses neuronal replacement using multi- and inter-disciplinary approaches. We caution the enthusiasm of scientists since there is always the potential for tumor formation, even for adult stem cells. The review places RE-1 silencing transcription factor (REST) gene as central to the understanding of stem cell behavior in the microenvironment of tissue injury. REST is relevant in the development of dopaminergic and peptidergic neurons from MSCs. Premature downregulation of REST by the pro-inflammatory mediator, IL-1alpha, can prematurely lead to the expression of neurotransmitters, which in turn, could develop rapid crosstalk with immune cells. In-depth inter- and multi-disciplinary research will lead to rapid and safe translation of MSCs to patients. An understanding of the changes induced in MSCs by cytokines and other mediators will establish future application of MSCs and other stem cells for safe and effective treatments. This study also alludes to the potential of personalized medicine through engineering and mathematics.
Collapse
Affiliation(s)
- Andrew C Heinrich
- UMDNJ-New Jersey Medical School, 185 South Orange Ave., Newark, NJ 07103, USA
| | | | | | | | | |
Collapse
|
19
|
Abstract
Connective tissue diseases (CTDs) are a group of clinical disorders that have an underlying autoimmune pathogenesis. These include a diverse set of diseases such as relapsing polychondritis, rheumatoid arthritis, and eosinophilic fasciitis, along with more common entities like Sjogren's syndrome, dermatomyositis, scleroderma, and lupus erythematosus. The latter three will be the focus of this review, as they constitute the most significant and common CTD with cutaneous manifestations. The cutaneous signs often represent the preliminary stages of disease and the presenting clinical symptoms. Therefore, comprehensive knowledge of CTD manifestations is essential for accurate diagnosis, better assessment of prognosis, and effective management. Although the precise etiologies of CTDs remain obscure, recent advances have allowed for further understanding of their pathogenesis and improved disease classifications. In addition, there have been developments in therapeutic options for CTDs. This review provides an overview of the epidemiology, clinical presentations, and current treatment options of cutaneous lupus erythematous, dermatomyositis and scleroderma.
Collapse
|
20
|
Abstract
Inflammation encompasses diverse molecular pathways, and it is intertwined with a wide array of biological processes. Recently, there has been an upsurge of interest in the interactions between mediators of inflammation and other cells such as stem cells and cancer cells. Since tissue injuries are associated with the release of inflammatory mediators, it would be difficult to address this subject without considering the implications of their systemic effects. In this review, we discuss the effects of inflammatory reactions on stem cells and extrapolate on information pertaining to cancer biology. The discussion focuses on integrins and cytokines, and identifies the transcription factor, nuclear factor-kappa B (NFκB) as central to the inflammatory response. Since stem cell therapy has been proposed for type II diabetes mellitus, metabolic syndrome, pulmonary edema, these disorders are used as examples to discuss the roles of inflammatory mediators. We propose prospects for future research on targeting the NFκB signaling pathway. Finally, we explore the bridge between inflammation and stem cells, including neural stem cells and adult stem cells from the bone marrow. The implications of mesenchymal stem cells in regenerative medicine as pertaining to inflammation are vast based on their anti-inflammatory and immunosuppressive effects. Such features of stem cells offer great potential for therapy in graft-versus-host disease, conditions with a significant inflammatory component, and tissue regeneration.
Collapse
Affiliation(s)
- Shyam A Patel
- Graduate School of Biomedical Sciences, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA
| | | | | | | |
Collapse
|
21
|
Trzaska KA, Reddy BY, Munoz JL, Li KY, Ye JH, Rameshwar P. Loss of RE-1 silencing factor in mesenchymal stem cell-derived dopamine progenitors induces functional maturity. Mol Cell Neurosci 2008; 39:285-90. [DOI: 10.1016/j.mcn.2008.07.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Revised: 06/30/2008] [Accepted: 07/09/2008] [Indexed: 02/08/2023] Open
|
22
|
Abstract
Despite recent advances in the diagnoses and treatment of breast cancer, this disease continues to be a major cause of death. One of the biggest challenges in breast cancer treatment is bone metastasis. Breast cancer cells (BCCs) are capable of migrating to the bone marrow and utilizing the marrow microenvironment to remain quiescent. While exhibiting quiescence in the marrow, BCCs can evade the effects of conventional cancer treatments such as chemotherapy. Therefore, scientists must find a new paradigm to target these quiescent BCCs. The development of potential targets may require a more comprehensive understanding of the marrow microenvironment and its regulators. The preprotachykinin-1 (PPT-I) gene encodes for the tachykinin peptides, which interact with neurokinin (NK) receptors. Studies have correlated this interaction with BCC integration into the bone marrow and breast cancer progression. In this review, we discuss the roles that different factors of the marrow microenvironment play in breast cancer and targets of NK receptors as potential treatment options.
Collapse
Affiliation(s)
- Bobby Y Reddy
- UMDNJ-New Jersey Medical School, MSB, Room E-579, 185 South Orange Avenue, Newark, NJ 07103, USA
| | | | | | | | | |
Collapse
|
23
|
Murthy RG, Reddy BY, Ruggiero JE, Rameshwar P. Tachykinins and hematopoietic stem cell functions: implications in clinical disorders and tissue regeneration. FRONT BIOSCI-LANDMRK 2007; 12:4779-87. [PMID: 17485413 DOI: 10.2741/2426] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hematopoiesis is the process by which a limited number of hematopoietic stem cells (HSCs) maintain a functioning blood and immune system. In adults, hematopoiesis occurs in bone marrow and is supported by the microenvironment. The tachykinin family of peptides regulates hematopoiesis. Tachykinins can be released in bone marrow as neurotransmitters from innervating fibers, and from resident bone marrow cells. The hematopoietic effects by tachykinins involve four tachykinin genes, Tac1-Tac4. The latter is the most recently discovered member and encodes hemokinin-1, endokinin A, endokinin B, and two orphan peptides, endokinin C, and endokinin D. The alteration of normal hematopoietic functions by the tachykinins may result in the development of various pathologies. For example, Tac1 is involved in myelofibrosis and in leukemia, both of which are dysfunction of hematopoietic stem cells. A comprehensive understanding of dysfunctions caused by the tachykinins requires further research since other cells, such as stromal cells and factors including cytokines, chemokines, and endopeptidases, are involved in a network in which the tachykinins have critical roles. Studies into the properties and functions of tachykinins, the biology of their receptors, and related molecules would provide insights into the development of aging disorders, hematopoiesis, other dysfunction, and may also lead to the discovery of novel and effective clinical therapies. Controversies on applications for hematopoietic stem cells in regenerative medicine are discussed. Despite these controversies, a detailed understanding on how the bone marrow microenvironment maintains pluripotency of hematopoietic stem cells would be useful to manipulate the system to acquire specialized cells for tissue repair.
Collapse
Affiliation(s)
- Raghav G Murthy
- Graduate School of Biomedical Sciences-UMDNJ, Newark, NJ 07103, USA
| | | | | | | |
Collapse
|
24
|
Lohray BB, Baskaran S, Rao BS, Mallesham B, Bharath KS, Reddy BY, Venkateswarlu S, Sadhukhan AK, Kumar MS, Sarnaik HM. Novel quinolone derivatives as potent antibacterials. Bioorg Med Chem Lett 1998; 8:525-8. [PMID: 9871611 DOI: 10.1016/s0960-894x(98)00063-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Several 7-(3R,4R-N,N'-dialkyl diaminopyrrolidinyl)-substituted quinolones were synthesized and evaluated for antibacterial activities. 5-Amino-7-(3R,4R-N,N'-dimethyldiamino-6,8-difluoro-1,4-dihydro-1-c yclopropyl -4-oxoquinoline-3-carboxylic acid was found to have potent antibacterial activity against gram +ve organisms.
Collapse
Affiliation(s)
- B B Lohray
- Department of Medicinal Chemistry and Drug Discovery, Dr. Reddy's Research Foundation, Hyderabad, India
| | | | | | | | | | | | | | | | | | | |
Collapse
|