LP07 and LLC preclinical models of lung cancer induce divergent anabolic deficits and expression of pro-inflammatory effectors of muscle wasting

Preclinical models have been instrumental to elucidate the mechanisms underlying muscle wasting in lung cancer (LC). We investigated anabolic deficits and the expression of proinflammatory effectors of muscle wasting in the LP07 and Lewis lung carcinoma (LLC) tumor models. Tumor growth resulted in significant weakness in LP07 but not in LLC mice despite similar reductions in gastrocnemius muscle mass in both models. The LP07 tumors caused a reduction in ribosomal (r)RNA and a decrease in rRNA gene (rDNA) transcription elongation, whereas no changes in ribosomal capacity were evident in LLC tumor-bearing mice. Expression of RNA Polymerase I (Pol I) elongation-associated subunits Polr2f, PAF53, and Znrd1 mRNAs was significantly elevated in the LP07 model, whereas Pol I elongation-related factors FACT and Spt4/5 mRNAs were elevated in the LLC mice. Reductions in RPS6 and 4E-BP1 phosphorylation were similar in both models but were independent of mTOR phosphorylation in LP07 mice. Muscle inflammation was also tumor-specific, IL-6 and TNF-α mRNA increased with LLC tumors, and upregulation of NLRP3 mRNA was independent of tumor type. In summary, although both models caused muscle wasting, only the LP07 model displayed muscle weakness with reductions in ribosomal capacity. Intracellular signaling diverged at the mTOR level with similar reductions in RPS6 and 4E-BP1 phosphorylation regardless of tumor type. The increase in proinflammatory factors was more pronounced in the LLC model. Our results demonstrate novel divergent anabolic deficits and expression of proinflammatory effectors of muscle wasting in the LP07 and LLC preclinical models of lung cancer.NEW & NOTEWORTHY We provide novel data demonstrating significant divergence in anabolic deficits and the expression of proinflammatory effectors of muscle wasting consequent to different lung-derived tumors.

Hsp27 inhibits IKKbeta-induced NF-kappaB activity and skeletal muscle atrophy

Heat shock protein 25/27 (Hsp25/27) is a cytoprotective protein that is ubiquitously expressed in most cells, and is up-regulated in response to cellular stress. Previous work, in nonmuscle cells, has shown that Hsp27 inhibits TNF-alpha-induced NF-kappaB activation. During skeletal muscle disuse, Hsp25/27 levels are decreased and NF-kappaB activity increased, and this increase in NF-kappaB activity is required for disuse muscle atrophy. Therefore, the purpose of the current study was to determine whether electrotransfer of Hsp27 into the soleus muscle of rats, prior to skeletal muscle disuse, is sufficient to inhibit skeletal muscle disuse atrophy and NF-kappaB activation. The 35% disuse muscle-fiber atrophy observed in nontransfected fibers was attenuated by 50% in fibers transfected with Hsp27. Hsp27 also inhibited the disuse-induced increase in MuRF1 and atrogin-1 transcription by 82 and 40%, respectively. Furthermore, disuse- and IKKbeta-induced NF-kappaB transactivation were abolished by Hsp27. In contrast, Hsp27 had no effect on Foxo transactivation. In conclusion, Hsp27 is a negative regulator of NF-kappaB in skeletal muscle, in vivo, and is sufficient to inhibit MuRF1 and atrogin-1 and attenuate skeletal muscle disuse atrophy.

Hsp70 prevents disuse muscle atrophy in senescent rats

This study determined the effects of heat shock protein 70 (Hsp70) overexpression on disuse muscle atrophy in senescent rats. Solei of young and senescent rats were co-injected with Hsp70 plus a nuclear factor kappa B (NF-kappaBeta) reporter plasmid. After 4 days, the hind limbs of half the young and senescent rats were immobilized for 6 days with the remainder serving as weight bearing controls. Hsp70 protein levels and cross-sectional area decreased in both groups (~20%) after immobilization. Atrophy was prevented in those fibers overexpressing Hsp70. NF-kappaBeta activity increased in the soleus of both young (three-fold) and senescent (five-fold) animals after immobilization and was prevented by Hsp70 overexpression. Inhibitor of kappaBeta decreased in young (~30%) and senescent (~10%) animals with immobilization and returned to normal with Hsp70. Heat shock protein 70 overexpression prevents disuse atrophy in senescent rats, possibly through suppression of the NF-kappaB pathway.

Okuläre Beteiligung bei MuSK-Antikörper-positiver Myasthenia gravis

BACKGROUND

Antibodies (Ab) against the acetylcholine receptor (AChR) are found in 80 - 90 % of generalized myasthenia gravis (MG), but only in 50 % of pure ocular MG. Furthermore, Ab against the muscle-specific receptor tyrosine kinase (MuSK) were detected in 38 - 54 % of patients with AChR-Ab-negative ("seronegative") MG, but not in pure ocular MG.

METHODS

2 case reports have been analysed: two patients (42 years old and 61 years old) with primary ocular MG were studied. Both patients complained of fluctuating bilateral ptosis and double vision lasting for 2 to 3 months.

RESULTS

AChR-Ab were negative but MuSK-Ab were clearly positive. In spite of treatment with pyridostigmine and prednisolone, the symptoms in patient 1 generalized within 4 weeks causing dysphagia, limb muscle weakness and respiratory crisis. Symptoms immediately responded to plasmapheresis. Patient 2 clearly improved under treatment with pyridostigmine, methylprednisone, and azathioprine. There was no generalization within a course of 12 months.

CONCLUSIONS

Both cases clearly indicate that MuSK-Ab can be found in primary isolated ocular MG lasting for 2 to 3 months. In a primary ocular manifestation of MG the detection of MuSK might indicate the risk for subsequent generalization and might have implications for immunosuppressive therapy. Therefore, seronegative MG requires testing for MuSK-Ab.

?Seronegative? Myasthenie mit Antik�rpern gegen die muskelspezifische Tyrosin-Kinase

About 10-20% of patients with generalized myasthenia gravis do not have acetylcholin receptor (AChR) antibodies and are referred to as having "seronegative" myasthenia. Recently, antibodies to muscle-specific kinase (MuSK), which mediates aggregation of AChR, were detected in half of these patients. We investigated six patients with seronegative myasthenia and identified two characteristic cases with MuSK antibodies. A 56-year-old woman developed ptosis and double vision followed by bulbar symptoms and respiratory insufficiency. She showed moderate response to treatment with pyridostigmine and no response to prednisolone, azathioprine, or intravenous immunoglobulin but good response to several plasma exchanges. A 46-year-old man with exercise-induced weakness of the upper limbs and mild bulbar and respiratory symptoms had a milder course for 9 years. These cases highlight the clinical spectrum of MuSK-positive myasthenia and the differences to AChR-positive myasthenia with predominant bulbar symptoms and often severe symptoms with respiratory insufficiency. Finally, they illustrate the therapeutic difficulties with less response to pyridostigmine and immunosuppressive drugs.

K-ras mutations in the bile of patients with primary sclerosing cholangitis

BACKGROUND AND AIMS

The development of cholangiocarcinoma (CCC) is a complication of primary sclerosing cholangitis (PSC). To date, no reliable factors have been described which can define those PSC patients at high risk for the development of CCC and the clinical diagnosis of CCC in PSC patients is difficult. Therefore, molecular markers of cholangiocarcinogenesis, such as K-ras mutations, may improve the early diagnosis of CCC or the timing of liver transplantation.

METHODS

K-ras mutations were analysed by enriched polymerase chain reaction/restriction fragment length polymorphism in the bile fluid of 56 PSC patients and 20 patients with other cholestatic diseases. To assess the value of K-ras mutations as a risk factor for cholangiocarcinogenesis, patients were prospectively investigated over a mean period of 31.5 months.

RESULTS

In contrast with the control group, 17 (30%) patients with PSC revealed K-ras mutations in bile fluid. The mean Mayo score was not significantly different between PSC patients with (mean score 0.70) and without (mean score 0.13; p=0.2) K-ras mutations. In contrast with the group of PSC patients without K-ras mutations, four CCCs and two dysplasia were diagnosed in the group of patients with K-ras mutations during the follow up investigation (p<0.001).

CONCLUSIONS

Our results indicate that K-ras mutations in bile fluid of PSC patients represent frequent early events during cholangiocarcinogenesis. However, most of the PSC patients with K-ras mutations remained tumour free after a long follow up investigation which is in agreement with the fact that these mutations are not specific for malignancy but may also occur in normal bile duct mucosa or in dysplasias. Therefore, analysis of K-ras mutations in bile should not be used for diagnosis of CCC in PSC patients. However, the results of our prospective follow up investigation indicate that K-ras mutations in bile fluid of PSC patients have to be considered as risk factors for the development of CCC which may have implications for the timing of liver transplantation.

[Clinical aspects and diagnosis of the occlusion of upper mesenteric arteries]

Acute mesenteric vascular occlusion is associated with an extremely high mortality. Only the early diagnosis may be helpful in this condition. A directed anamnesis and close observation of clinical signs and symptoms associated with metabolic acidosis, significant base deficit, elevated white blood count, and arteriography could shorten the time period between vascular occlusion and operation. This is the way, which possibly leads to more gratifying results.