Characterization of unusual iAMP21 B-lymphoblastic leukemia (iAMP21-ALL) from the Mayo Clinic and Children's Oncology Group

Acute lymphoblastic leukemia (B-ALL) with intrachromosomal amplification of chromosome 21 (iAMP21-ALL) represents a recurrent high-risk cytogenetic abnormality and accurate identification is critical for appropriate clinical management. Identification of iAMP21-ALL has historically relied on fluorescence in situ hybridization (FISH) using a RUNX1 probe. Current classification requires ≥ five copies of RUNX1 per cell and ≥ three additional copies of RUNX1 on a single abnormal iAMP21-chromosome. We sought to evaluate the performance of the RUNX1 probe in the identification of iAMP21-ALL. This study was a retrospective evaluation of iAMP21-ALL in the Mayo Clinic and Children's Oncology Group cohorts. Of 207 cases of iAMP21-ALL, 188 (91%) were classified as "typical" iAMP21-ALL, while 19 (9%) cases were classified as "unusual" iAMP21-ALL. The "unusual" iAMP21 cases did not meet the current definition of iAMP21 by FISH but were confirmed to have iAMP21 by chromosomal microarray. Half of the "unusual" iAMP21-ALL cases had less than five RUNX1 signals, while the remainder had ≥ five RUNX1 signals with some located apart from the abnormal iAMP21-chromosome. Nine percent of iAMP21-ALL cases fail to meet the FISH definition of iAMP21-ALL demonstrating that laboratories are at risk of misidentification of iAMP21-ALL when relying only on the RUNX1 FISH probe. Incorporation of chromosomal microarray testing circumvents these risks.

Clinical utility of next generation sequencing to detect IGH/IL3 rearrangements [t(5;14)(q31.1;q32.1)] in B-lymphoblastic leukemia/lymphoma

The t(5;14)(q31.1;q32.1) associated with B-lymphoblastic leukemia/lymphoma (B-ALL/LBL) is a rare, recurrent genetic abnormality recognized as a distinct entity by the 2017 World Health Organization (WHO) classification. In these cases, the IGH enhancer region (14q32.1) is juxtaposed to the vicinity of the IL3 gene (5q31.1), resulting in increased production of interleukin-3 (IL3) and subsequently a characteristic reactive eosinophilia. B-ALL with t(5;14)(q31.1;q32.1) may have a low lymphoblast count that can complicate detection of t(5;14)(q31.1;q32.1) by conventional chromosome studies. We have identified four patients with IGH/IL3 rearrangements despite normal conventional chromosome studies in each case [one patient had a non-clonal t(5;14)(q31;q32) finding]. Fluorescence in situ hybridization utilizing a laboratory-developed IGH break-apart probe set identified IGH rearrangements in three of four cases, and a next generation sequencing (NGS) based assay, mate-pair sequencing (MPseq), was required to characterize the IGH/IL3 rearrangements in each case. Three patients demonstrated a balanced t(5;14)(q31.1;q32.1) while one patient had a cryptic insertion of the IL3 gene into the IGH region. These results demonstrate that NGS-based assays, such as MPseq, confer an advantage in the detection of IGH/IL3 rearrangements that are otherwise challenging to characterize by traditional cytogenetic methodologies.

Thrombin regulation of endothelin-1 gene in isolated human pulmonary endothelial cells

Endothelin (ET)-1 is a potent vasoconstrictor elicited from endothelial cells in response to a variety of stimuli and an important mediator for a variety of vascular diseases including pulmonary hypertension. In this paper, we describe the molecular regulation of the ET-1 gene in response to a vasoactive mediator, thrombin, in human pulmonary endothelial cells. Thrombin induces preproET-1 mRNA through a transcriptionally dependent mechanism, with a peak induction after 1 h of exposure. Analysis of chromatin structure identified several DNase I-hypersensitive regions under both basal and thrombin-stimulated conditions that reside in the 5'-promoter region, indicating that the ET-1 promoter is a constitutive promoter. Deletion analysis was employed as a functional assay to identify regions of the ET-1 promoter that are important in transcriptional regulation. We found that sites between -141 and -378 bp are essential for basal activity and that those between -378 and -484 bp are essential for thrombin-stimulated activity. However, full expression under both conditions required an element(s) within -952 bp.

Effects of vasoactive and inflammatory mediators on endothelin-1 expression in pulmonary endothelial cells

Endothelin-1 (ET-1) is known to be involved in a variety of pathophysiologic conditions, especially of the pulmonary vasculature. The aim of this study was to investigate physiologic mediators potentially involved in the pathogenesis of pulmonary hypertension, for their effects on ET-1 gene expression at both the transcriptional and translational level. Rat microvascular and pulmonary artery endothelial cells grown in culture were exposed to vasoactive mediators (thrombin or an anoxic gas mixture) and inflammatory mediators (lipopolysaccharide, interleukin 1 alpha, interleukin 1 beta, or tumor necrosis factor alpha) for various time periods. The change in prepro-ET-1 (ppET-1) mRNA levels in these cells in response to stimuli was a time-dependent phenomenon. The inflammatory mediators caused an acute rise in ppET-1 mRNA levels whereby peak induction occurred after 1 h with a rapid decline to control levels by 4 h. The vasoactive mediators elicited a more sustained response whereby a significant elevation in ppET-1 mRNA expression occurred quickly and remained elevated through 4 h. The pattern of induction was more rapid for thrombin than for anoxic gas exposure. Radioimmunoassay analysis demonstrated a similar response for thrombin and the inflammatory mediators in ET-1 mature peptide release, whereas the effect of anoxic gas exposure was divergent. Significant elevations were noted after 6 h for thrombin as well as each of the inflammatory mediators except IL-1 alpha. In response to the anoxic gas exposure, however, a significant rise in ET-1 peptide release was not evident until after 24 h. To determine the level at which ppET-1 mRNA induction is regulated, cells were cotreated with each of the stimuli and actinomycin D or cycloheximide. Results indicate that the induction of ppET-1 mRNA levels is likely due to de novo transcription, as well as mRNA stabilization. In summary, inflammatory and vasoactive agents are important regulators of ET-1 gene expression in rat pulmonary endothelial cells; most important, we observed a differential response at the mRNA or peptide level depending on the mediator involved.

Strength after bouts of eccentric or concentric actions

This study examined the influence of an initial bout of eccentric or concentric actions and a subsequent bout of eccentric actions on muscular strength. Twenty-four healthy males, 24-45 yr old, were placed in three groups that performed eccentric actions in bouts 1 and 2 (ECC/ECC, N = 8), concentric actions in bout 1, and eccentric actions in bout 2 (CON/ECC, N = 8) or served as controls (N = 8). Bouts involved unilateral actions with the left and right quadriceps femoris. Ten sets of 10 repetitions with an initial resistance equal to 85% of the eccentric or concentric one repetition maximum (1 RM) were performed for each bout. Three minutes of rest were given between sets and 3 wk between bouts. Two weeks before bout 1 and 1, 4, 7, and 10 d after bouts 1 and 2, eccentric and concentric 1 RM were measured for the right quadriceps femoris and a speed-torque relation established for the left quadriceps femoris. Eccentric and concentric 1 RM decreased (P less than 0.05) 32% 1 d after bout 1 for group ECC/ECC. The speed-torque relation was down-shifted (P less than 0.05) 38%. Eccentric 1 RM and eccentric and isometric torque returned to normal 6 d later. Concentric 1 RM and torque at 3.14 rad.s-1 had not recovered on day 10 (-7% for both, P less than 0.05). Decreases in strength after bout 2 for group ECC/ECC only occurred on day (-9% for concentric 1 RM and 16% downshift of the speed-torque relation).(ABSTRACT TRUNCATED AT 250 WORDS)

Influence of eccentric actions on the metabolic cost of resistance exercise

Maintenance of a low energy expenditure during exercise in space is important because of the confined environment of the space craft. Resistance exercise is receiving increased attention as an exercise countermeasure, and we have shown that training with concentric (con) and eccentric (ecc) muscle actions induces greater increases in strength than training with only con actions. This study determined if performance of both actions markedly increased the metabolic cost of resistance exercise. Seventeen middle-age males performed each repetition of a "warm-up" and four sets of the leg press exercise with only con (Group CON, n = 8) or with con and ecc (Group CON/ECC, n = 9) actions. Sets were separated by 3 min of rest and each was performed to failure by selecting a resistance that allowed performance of the prescribed number of repetitions (7 to 10). The net energy cost of exercise was estimated from oxygen consumption data that were obtained at rest before exercise, during exercise, and for 20 min of recovery. The total work performed during the con actions was about 290 J.kg-1 body weight for both groups. The energy cost for this work was about 3 x 10(-3) cal.J-1. The requirement for the CON/ECC group to also lower the load increased (p less than 0.05) the energy cost 14%. These results indicate that con actions are mainly responsible for the metabolic cost of resistance exercise. Because ecc actions enhance the resistance training-induced increases in strength that are evident with only con actions with minimal additional energy cost, we suggest that they be considered in exercise prescriptions for use in space.