Pubertal exposure to dietary advanced glycation end products disrupts ductal morphogenesis and induces atypical hyperplasia in the mammary gland

BACKGROUND

Advanced glycation end products (AGEs) are reactive metabolites intrinsically linked with modern dietary patterns. Processed foods, and those high in sugar, protein and fat, often contain high levels of AGEs. Increased AGE levels are associated with increased breast cancer risk, however their significance has been largely overlooked due to a lack of direct cause-and-effect relationship.

METHODS

To address this knowledge gap, FVB/n mice were fed regular, low AGE, and high AGE diets from 3 weeks of age and mammary glands harvested during puberty (7 weeks) or adulthood (12 weeks and 7 months) to determine the effects upon mammary gland development. At endpoint mammary glands were harvested and assessed histologically (n ≥ 4). Immunohistochemistry and immunofluorescence were used to assess cellular proliferation and stromal fibroblast and macrophage recruitment. The Kruskal-Wallis test were used to compare continuous outcomes among groups. Mammary epithelial cell migration and invasion in response to AGE-mediated fibroblast activation was determined in two-compartment co-culture models. In vitro experiments were performed in triplicate. The nonparametric Wilcoxon rank sum test was used to compare differences between groups.

RESULTS

Histological analysis revealed the high AGE diet delayed ductal elongation, increased primary branching, as well as increased terminal end bud number and size. The high AGE diet also led to increased recruitment and proliferation of stromal cells to abnormal structures that persisted into adulthood. Atypical hyperplasia was observed in the high AGE fed mice. Ex vivo fibroblasts from mice fed dietary-AGEs retain an activated phenotype and promoted epithelial migration and invasion of non-transformed immortalized and tumor-derived mammary epithelial cells. Mechanistically, we found that the receptor for AGE (RAGE) is required for AGE-mediated increases in epithelial cell migration and invasion.

CONCLUSIONS

We observed a disruption in mammary gland development when mice were fed a diet high in AGEs. Further, both epithelial and stromal cell populations were impacted by the high AGE diet in the mammary gland. Educational, interventional, and pharmacological strategies to reduce AGEs associated with diet may be viewed as novel disease preventive and/or therapeutic initiatives during puberty.

MicroRNA-510 mediated negative regulation of Caveolin-1 in fibroblasts promotes aggressive tumor growth

Introduction

In the US, despite the recent decline in breast cancer deaths, a persistent mortality disparity exists between black and white women with breast cancer, with black women having a 41% higher death rate. Several studies are now reporting that racial disparities can exist independent of socioeconomic and standard of care issues, suggesting that biological factors may be involved. Caveolin-1 (Cav1) loss in the tumor stromal compartment is a novel clinical biomarker for predicting poor outcome in breast cancer including triple negative subtype, however the mechanism of Cav1 loss is unknown. We previously identified miR-510-5p as a novel oncomir and propose here that the high levels observed in patients is a novel mechanism leading to stromal Cav1 loss and worse outcomes.

Methods

Cav1 was identified as a direct target of miR-510-5p through luciferase, western blot and qPCR assays. Stromal cross talk between epithelial cells and fibroblasts was assessed in vitro using transwell co-culture assays and in vivo using xenograft assays.

Results

We found that Cav1 is a direct target of miR-510-5p and that expression in fibroblasts results in an 'activated' phenotype. We propose that this could be important in the context of cancer disparities as we also observed increased levels of circulating miR-510-5p and reduced levels of stromal Cav1 in black women compared to white women with breast cancer. Finally, we observed a significant increase in tumor growth when tumor cells were co-injected with miR-510-5p expressing cancer associated fibroblasts in vivo.

Conclusion

We propose that miR-510-5p mediated negative regulation of Cav1 in fibroblasts is a novel mechanism of aggressive tumor growth and may be a driver of breast cancer disparity.

Non-enzymatic glycoxidation linked with nutrition enhances the tumorigenic capacity of prostate cancer epithelia through AGE mediated activation of RAGE in cancer associated fibroblasts

The molecular implications of food consumption on cancer etiology are poorly defined. The rate of nutrition associated non-enzymatic glycoxidation, a reaction that occurs between reactive carbonyl groups on linear sugars and nucleophilic amino, lysyl and arginyl groups on fats and proteins, is rapidly increased by food cooking and manufacturing processes. In this study, we assign nutrition-associated glycoxidation with significant oncogenic potential, promoting prostate tumor growth, progression, and metastasis in vivo. Advanced glycation end products (AGEs) are the final irreversible product of non-enzymatic glycoxidation. Exogenous treatment of prostate tumor cells with a single AGE peptide replicated glycoxidation induced tumor growth in vivo. Mechanistically, receptor for AGE (RAGE) deficiency in the stroma inhibited AGE mediated tumor growth. Functionally, AGE treatment induced RAGE dimerization in activated fibroblasts which sustained and increased the migratory potential of tumor epithelial cells. These data identify a novel nutrition associated pathway that can promote a tissue microenvironment conducive for aggressive tumor growth. Targeted and/or interventional strategies aimed at reducing AGE bioavailability as a consequence of nutrition may be viewed as novel chemoprevention initiatives.

Abstract PO-053: South Carolina Cancer Disparities Research Center's (SC CADRE) culturally-sensitive, state-of-the-art treatment to eliminate cancer disparities conference

BACKGROUND: The South Carolina Cancer Disparities Research Center (SC CADRE) U54 conducted the Culturally-Sensitive, State-of-the-Art Treatment to Eliminate Cancer Disparities Conference in February of 2021. This virtual live webinar was a cancer-disparities-focused Continuing Medical Education (CME) Conference, held for health professionals and community stakeholders to improve the quality of cancer care in South Carolina and to bridge the gap in health care. PURPOSE: The course objective included identifying and/or implementing new cancer treatments to decrease cancer disparities rates in South Carolina, pertaining to rural cancer screening, advanced glycation end products (AGES), breast cancer, and prostate cancer. This conference was designated as a virtual live webinar; therefore, the format included lectures and question-and-answer segments. This conference also served as an enduring activity; therefore, this program was recorded and made available on the South Carolina Area Health Education Center (AHEC) Learning Platform for additional health professionals to attain CME credits. The Medical University of South Carolina designated this live and enduring activity for a maximum of 3.00 AMA PRA Category 1 Credit(s)TM. METHOD: The CME co-course director moderated the virtual conference in WebEx. The first presentation addressed the rural cancer disparities in the United States and in South Carolina. The second presentation addressed AGES, lifestyle, and disease. The third presentation addressed breast cancer incidence in the United States and in South Carolina. The fourth presentation addressed prostate cancer screening and treatment considerations. Conference participants placed their questions in the chat box for presenters to address. Conference participants were sent a program evaluation electronically, and it resulted in a 72% response rate. RESULTS: Fifty-three health care professionals participated in the conference. Seventy-seven percent of the conference attendees were women. The course/conference participants consisted of the following: medical physicians (7.5%), health administrators (13%), registered nurses (16%), nurse practitioners (5%), social workers (16%), retiree (1%), other health care providers (13%), public health providers (11%), Ph.D. Researcher (3%), clinical lab scientists (1%), student (1%), pediatrician (1%), health education specialists (1%), and physician assistants (1%). CONCLUSIONS: At completion of this course, health care professionals and community stakeholders are able to increase the awareness of the social determinants of health in relation to rural cancer disparities, define AGES, learn how AGES can damage the body, what to do to combat AGES, and interventions. In addition, course/conference participants would learn about existing disparities in breast cancer screening, and treatment and how minorities are affected by breast cancer. In conclusion, conference participants would learn about prostate cancer screening, diagnosis and treatment.

Citation Format: Latecia M. Abraham-Hilaire, Gayenell Magwood, David P Turner, Andrea Abbott, Stephen J. Savage, Judith Salley, Marvella E. Ford. South Carolina Cancer Disparities Research Center's (SC CADRE) culturally-sensitive, state-of-the-art treatment to eliminate cancer disparities conference [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-053.

Dietary Advanced Glycation End-Products and Mortality after Breast Cancer in the Women's Health Initiative

BACKGROUND

Advanced glycation end-products (AGE) are formed through nonenzymatic glycation of free amino groups in proteins or lipid. They are associated with inflammation and oxidative stress, and their accumulation in the body is implicated in chronic disease morbidity and mortality. We examined the association between postdiagnosis dietary Nε-carboxymethyl-lysine (CML)-AGE intake and mortality among women diagnosed with breast cancer.

METHODS

Postmenopausal women aged 50 to 79 years were enrolled in the Women's Health Initiative (WHI) between 1993 and 1998 and followed up until death or censoring through March 2018. We included 2,023 women diagnosed with first primary invasive breast cancer during follow-up who completed a food frequency questionnaire (FFQ) after diagnosis. Cox proportional hazards (PH) regression models estimated adjusted hazard ratios (HR) and 95% confidence intervals (CI) of association between tertiles of postdiagnosis CML-AGE intake and mortality risk from all causes, breast cancer, and cardiovascular disease.

RESULTS

After a median 15.1 years of follow-up, 630 deaths from all causes were reported (193 were breast cancer-related, and 129 were cardiovascular disease-related). Postdiagnosis CML-AGE intake was associated with all-cause (HRT3vsT1, 1.37; 95% CI, 1.09-1.74), breast cancer (HRT3vsT1, 1.49; 95% CI, 0.98-2.24), and cardiovascular disease (HRT3vsT1, 1.91; 95% CI, 1.09-3.32) mortality.

CONCLUSIONS

Higher intake of AGEs was associated with higher risk of major causes of mortality among postmenopausal women diagnosed with breast cancer.

IMPACT

Our findings suggest that dietary AGEs may contribute to the risk of mortality after breast cancer diagnosis. Further prospective studies examining dietary AGEs in breast cancer outcomes and intervention studies targeting dietary AGE reduction are needed to confirm our findings.

Examination of the Effectiveness of the Healthy Empowered Active Lifestyles (HEAL) Program on Advanced Glycation End Products

This pilot study investigated the effectiveness of the healthy empowered active lifestyles (HEAL) program to reduce circulatory levels of advanced glycation end products (AGEs) and assess its relationship to BMI, % body fat, fasting glucose, and A1C. The HEAL program was delivered at a local wellness center using a team-based approach and focused on physical activity and dietary education. A sample of twenty primarily European American (19 white, 1 black) participants (i.e., 10 males, 10 females) aged 26 to 71 (m = 48.75 ± 10.26) completed 12 weeks of the HEAL intervention. Pre to post changes in AGEs, BMI, % body fat, fasting glucose, and A1C were examined as primary outcomes. The findings showed participants had the following average reductions: AGEs 36.04 ± 18.48 ug/mL, BMI 2.0 ± 1.2 kg/m2, % body fat 3.18 ± 1.57%, fasting glucose 5.9 ± 17.21 mg/dL, and A1C 0.68 ± 1.11%. All twenty participants successfully completed the entire twelve weeks of the HEAL intervention. The results of this study show that the HEAL intervention provides beneficial reductions of AGEs, BMI, % body fat, fasting glucose, and A1C. In addition, the high adherence shows promise, and demonstrates the potential for HEAL as a behavioral intervention to improve pre-diabetic and other inflammatory related comorbidities. Further replication of results via additional randomized controlled trials is needed.

Abstract PO-133: AGE:RAGE signaling pathway as a target in neuroendocrine prostate cancer

Advanced Glycation End products, or AGEs are non-enzymatically attached sugar metabolites that can contribute to prostate cancer development and progression. AGEs are formed when reducing sugars interact with amino acids, proteins, lipids or nucleic acids under physiological conditions, and are categorized as either endogenous (biological-AGEs) or exogeneous (dietary-AGEs). Dietary AGEs contribute to the body’s total AGE pool, and are responsible for increased AGE accumulation, that in turn facilitates interaction with the major AGE receptor, the Receptor for Advance Glycation End products, RAGE. RAGE is a transmembrane member of the Ig superfamily of cell surface molecules and is overexpressed in a variety of tumor types, including prostate cancer. Increased AGE accumulation upregulates RAGE expression, amplifying the signaling cascade with impacts on cytokinesis. This is especially relevant, as we have shown that both AGE and RAGE are significantly elevated in tumors from AA men when compared to EA men at the same stage. De novo neuroendocrine prostate cancer (NEPC) is rare constituting only 1% of all prostate cancer cases. However, recent studies have shown that individual cells within a prostate tumor can undergo a process termed neuroendocrine differentiation to become neuroendocrine-like. Studies have shown that androgen deprivation therapy (ADT) can drive neuroendocrine differentiation leading to the development of the castrate resistant prostate cancer phenotype. These latter cancers are referred to as neuroendocrine prostate cancer (NEPC) or aggressive variant prostate cancer (AVPC). Transformation to a neuroendocrine phenotype is one proposed mechanism of resistance to contemporary AR-targeted treatments, is associated with increased tumor progression, poor prognosis, and is thought to represent ~25% of lethal prostate cancers. Due to the increased application of ADT in prostate cancer patients, neuroendocrine prostate cancer is thought to be on the rise and therefore poses a significant health problem. Our studies show that AGEs can induce neuroendocrine differentiation in AR-positive prostate adenocarcinoma cells in vitro with a concomitant loss of the AR. In addition, we observe that AGEs promote more aggressive tumor growth in both syngeneic xenograft and spontaneous mouse models in vivo. Using shRNA and pharmacological inhibitors to RAGE, we show that AGE-mediated neuroendocrine differentiation is RAGE- dependent. Results from our studies could implicate RAGE inhibitors as therapeutic treatments to reduce the increased mortality observed in AA men with prostate cancer that disproportionately have increased levels of both AGE and RAGE.

Citation Format: Bradley A. Krisanits, Arabia Satterwhite, Lourdes M. Nogueira, Ashley Evans-Knowell, David P. Turner, Victoria J. Findlay, DeMarcus D. Woolfork. AGE:RAGE signaling pathway as a target in neuroendocrine prostate cancer [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-133.

Abstract A43: Dietary advanced glycation end-products (AGEs) and breast cancer in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO)

Introduction: Advanced glycation end-products (AGEs) are implicated in chronic diseases and cancer. AGEs are produced endogenously but can also be consumed in foods. AGE formation in food is accelerated during cooking at high temperatures. The objective of the study is to assign and quantify dietary AGE (dAGE) content in food and investigate the association between dAGE intake and breast cancer risk in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO).

Methods: The PLCO enrolled women aged 55 to 74 years into a randomized controlled trial examining various cancer screening modalities. In this prospective analysis, the study sample included only women enrolled in the intervention arm who were cancer-free at baseline and completed a baseline questionnaire and food frequency questionnaire (DQX) (n=28,127). dAGE values were assigned and quantified to foods in the DQX using a published AGE database. Descriptive analysis was used to obtain means and percentages while Pearson correlation was used to obtain correlation coefficient of dAGE intake with dietary factors linked to AGEs.

Results: After a median 11.6 years of follow-up, 1,642 women were diagnosed with breast cancer. The average dAGE consumption among all the women was 11,355 KU/day (SD: 6614 KU/day) and ranged between 715 and 87,129 KU/day. A higher proportion of overweight and obese women, African American women, and women who were diagnosed with breast cancer during follow-up were in the higher quintile of dAGE intake as compared to the lowest quintile. Significant positive correlations were observed between dAGE intake and dietary sources of animal protein (0.74), monounsaturated fatty acids (MUFA) (0.83), polyunsaturated fatty acid (PUFA) (0.70), and saturated fatty acids (SF) (0.83), while the correlations between dAGE and fructose (0.12), carbohydrates (0.39), and plant protein (0.40) were weaker.

Conclusion: A higher proportion of women who were diagnosed with breast cancer during follow-up were in the highest quintile of dAGE intake at baseline compared to the lowest quintile. The strong positive correlation observed between dAGE and fat and protein intake reflects the high AGE levels found in meats, especially those cooked at high temperatures. Further analyses using Cox proportional hazards will be conducted examining the association between dAGE intake and breast cancer risk.

Citation Format: Omonefe O. Omofuma, David P. Turner, Lindsay L. Peterson, Anwar T. Merchant, Jiajia Zhang, Susan E. Steck. Dietary advanced glycation end-products (AGEs) and breast cancer in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) [abstract]. In: Proceedings of the AACR Special Conference on Environmental Carcinogenesis: Potential Pathway to Cancer Prevention; 2019 Jun 22-24; Charlotte, NC. Philadelphia (PA): AACR; Can Prev Res 2020;13(7 Suppl): Abstract nr A43.

Abstract C031: Regular physical activity can prevent the oncogenic effects of lifestyle-associated advanced glycation end products

Advanced glycation end-products (AGEs), are reactive metabolites produced endogenously as a consequence of glucose metabolism. AGEs accumulate in tissues and organs as we grow older to promote multiple chronic disease phenotypes. AGE pathogenic effects are mediated through modification of protein function, genetic fidelity, stress responses and cellular signaling pathways. Critically, cancer disparity factors such as a sedentary lifestyle, obesity and an unhealthy diet are external influences that have been shown to contribute to the accumulation of AGEs. This research group examined circulating and tumor AGE levels in clinical specimens of prostate cancer and identified a race specific, tumor-dependent pattern of accumulation. AGE levels were highest in aggressive tumors, especially those from men with African ancestry. As our understanding of tumor biology advances, it is becoming increasingly clear that these lifestyle factors have distinct molecular consequences on the biologic make up of tumors, altering cell signaling events and gene expression profiles to contribute to cancer disparity outcomes such as earlier development or its progression to more aggressive disease. Increased AGE levels correlated with an up-regulation in the receptor for advanced glycation end products (RAGE) and activated NFkB. In a syngeneic sub-cutaneous prostate cancer mouse model, chronic consumption of AGE resulted in a 3-fold increase in tumor growth. Dietary-AGE mediated increases in tumor growth were accompanied by a cytoplasmic accumulation of AR, elevation in MYC, RAGE, and AGE as well as increased cell proliferation. Given the links between lifestyle and AGEs we examined the effects of regular physical activity on AGE induced tumor growth in our syngeneic sub-cutaneous dietary-AGE prostate cancer model. Mice exposed to physical activity for 1 hour, 5 days per week showed a significant decrease in AGE induced tumor growth. We also examined the effects of dietary-AGEs on tumor progression using the FVB-Tg(C3-1-TAg)cJeg/JegJ (C3-Tag) transgenic spontaneous prostate cancer mouse model. This model progresses to low grade prostate intraepithelial neoplasia (PIN) at 24 weeks. However, chronic consumption of AGE resulted in increased progression towards moderate to high grade PIN at this same time point. When regular physical activity was introduced, we observed delayed progression of PIN in both dietary groups, but most significantly in the high AGE fed mice. These studies support the concept that AGEs represent a biological consequence of the socioeconomic and environmental factors that promote cancer disparity, which may be at least in part reversed via physical activity. This may have the greatest impact for African American patients who tend to have poorer survival, and where a lack of physical activity, poor diet, and high obesity rates are more prevalent.

Citation Format: Bradley A Krisanits, Pamela M Woods, Dion Foster, Lourdes M Nogueira, Laura Spruill, Marvella E Ford, Victoria J Findlay, David P Turner. Regular physical activity can prevent the oncogenic effects of lifestyle-associated advanced glycation end products [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C031.

Abstract C024: Lifestyle-associated advanced glycation end products are elevated in ER+ positive breast cancer patients, alter response to therapy, and can be targeted by lifestyle intervention

Lifestyle factors associated with personal behavior can alter tumor-associated biologic pathways and thereby increase cancer risk, growth and disease recurrence. Advanced glycation end products (AGEs) are reactive metabolites produced endogenously as a byproduct of normal metabolism. A Western lifestyle consisting of high-fat, high-sugar and processed foods as well as little exercise can lead to a significant increase in AGE accumulation in the body and is also associated with driving cancer disparity. Increased AGE accumulation promotes disease phenotypes through modification of the genome, protein crosslinking and dysfunction, and aberrant cell signaling. We evaluated AGE levels in biospecimens from ER+ and ER- breast cancer patients, examined their role in therapy resistance, and assessed the ability of a lifestyle intervention to reduce circulating AGE levels in ER+ breast cancer survivors. A correlation between ER status and AGE levels was observed in tumor and serum samples. AGE treatment of ER+ breast cancer cells impacted pathways associated with ER regulation. We observed a significant increase in phosphorylation of ERalpha following AGE treatment when compared to untreated control with no change in total ERalpha levels. We also observed a significant increase in both AKT and ERK phosphorylation in ER+ cell lines in response to AGE treatment in a time-dependent manner. Inhibition of AKT with Ly294002 and inhibition of ERK with the MEK inhibitor U0126 significantly reduced ERalpha phosphorylation in the presence of AGE. Significantly, ER+ cells treated with AGEs no longer responded to hormonal therapy with tamoxifen. In a proof-of-concept study we examined the ability of a defined exercise and dietary intervention (i.e., cardiac rehabilitation) to reduce circulatory AGE levels in ER+ breast cancer survivors. A significant increase in average very active minutes and average calories burned was observed as a result of the intervention. This was accompanied by a significant reduction in dietary-AGE intake and also showed significant reductions in circulating AGE levels when fasting serum samples were analyzed by ELISA. An analysis of IL6 and CRP levels by ELISA in the same AGE assessed samples revealed no significant differences at any time point. There is a potential prognostic and therapeutic role for lifestyle-derived AGEs in cancer disparity. Given the potential benefits of lifestyle intervention on cancer incidence and mortality, opportunities exist for the development of community health and nutritional programs aimed at reducing AGE exposure in order to improve cancer prevention and treatment outcomes. Lifestyle interventions that lower AGE levels may then be utilized to reduce breast cancer incidence and improve prognosis in cancer disparity populations.

Citation Format: Katherine R. Walter, Ford E. Ford, Mathew J. Gregoski, Rita M. Kramer, Kendrea D. Knight, Laura Spruill, Lourdes M. Nogueira, Bradley A. Krisanits, Marian H. Taylor, Amanda C. La Rue, Michael B. Lilly, Stefan Ambs, King Chan, Tonya F. Turner, Heidi Varner, Shweta Singh, Jaime Uribarri, Elizabeth Garrett-Mayer, Kent E. Armeson, Ebony J. Hilton, Mark Clair, Victoria J. Findlay, Lindsay L. Peterson, Gayenell Magwood, David P. Turner. Lifestyle-associated advanced glycation end products are elevated in ER+ positive breast cancer patients, alter response to therapy, and can be targeted by lifestyle intervention [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C024.

Abstract C029: Consumption of dietary AGEs during puberty and increased breast cancer risk: A link between lifestyle and cancer disparity

Introduction. The focus of this study is on early lifestyle factors and their effect on mammary development during puberty and how they relate to increased breast cancer risk and disparities. At this time we do not understand what biological changes occur during pubertal mammary development which leads to a greater risk of developing cancer in later life. Identifying the molecular mechanisms that cause aberrant pubertal mammary development may lead to defined strategies to reduce breast cancer burden in later life. As our bodies use the sugars that we consume for energy they generate waste chemicals known as advanced glycation end products or AGEs for short. Significantly, low income, obesity and a sedentary lifestyle are established factors driving health disparity that also contribute to increased AGE accumulation levels in our bodies. In particular, AGE content in the Western Diet has consistently increased over the last 50 years due to increased consumption of sugar-laden and cheap processed/manufactured foods which are high in reactive AGE metabolites and can promote obesity. Methods. We use a dietary mouse model to assess impact of AGE on normal mammary development. Wild type FVB/n and RAGE null (RAGE-/-) mice are fed the respective diets from weaning until 7 (pubertal) or 12 (adult) weeks of age. Mammary glands are extracted for whole mounting and paraffin embedded for histology. Fibroblasts were isolated from mammary glands and cultured ex vivo. Transwell migration assays were performed with isolated fibroblasts and HC11 mouse mammary epithelial cells. qPCR was performed on the isolated fibroblasts to assess their activation status. Results. Early life exposures during mammary development influence the breast microenvironment to increase breast cancer risk. We show that due to an innate ability to influence the cellular matrix, dietary AGEs disrupt developmental programs during puberty and promote breast tumor growth. Through receptor for AGE (RAGE) dependent and independent mechanisms, chronic AGE consumption delayed ductal extension, increased ductal branching and caused aberrant terminal end bud (TEB) morphology. Dietary AGE activation of RAGE mediated a program of activated stroma leading to hyperplastic growth and the formation of pre-neoplastic lesions which persisted into adulthood. Importantly, AGE mediated effects remained even after diet intervention after puberty. In dietary-AGE breast tumor models, AGE mediated changes in tissue architecture and cell function were recapitulated and resulted in 3-fold increase in neoplastic growth. Through the perpetual activation of a reactive stroma, AGEs derived from diet represent a common early life exposure which can influence tumor behavior. Conclusions. A greater mechanistic understanding of the link between AGE intake during puberty and increased breast cancer risk may define novel potential strategies for lifestyle and pharmacological intervention aimed at reducing breast cancer risk and cancer disparities.

Citation Format: Callan C Frye, Bradley A Krisanits, Reid Schuster, Jaime Randise, Lourdes M Nogueira, Kristi Helke, Amanda C LaRue, David P Turner, Victoria J Findlay. Consumption of dietary AGEs during puberty and increased breast cancer risk: A link between lifestyle and cancer disparity [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C029.

Abstract B102: Body mass index, physical activity, and breast cancer subtype in European American, African American, and Sea Island breast cancer survivors

BACKGROUND: Breast cancer (BCa) is the second leading cause of cancer death among women in the United States and large racial/ethnic disparities are evident. Higher levels of body mass index (BMI), lower rates of physical activity (PA), and hormone receptor-negative BCa sub-type are associated with poorer BCa treatment outcomes. PURPOSE: To evaluate the prevalence of high BMI, low PA level, and BCa sub-type among three BCa survivor groups: European Americans (EAs), African Americans without Sea Island ancestry (AAs), and AAs with SI ancestry (SIs). METHODS: A state central cancer registry database was used to identify 137 (42 EAs, 66 AAs, and 29 SIs) women diagnosed with BCa between May 2012 and October 2013, who were within 6-21 months of diagnosis at the time of the study. RESULTS: Regardless of racial/ethnic group, most participants (82%) were overweight/obese (p=0.46). BMI was highest in younger AAs (p=0.02). The CDC PA guidelines (≥150 minutes/week) were met by only 28% of participants. In terms of BCa sub-type, among the 86 participants who provided saliva samples, the frequency of triple-negative BCa and estrogen-receptor-negative BCa was lower in EAs and SIs than in AAs (p< 0.05). CONCLUSIONS: This is the first study to identify differences in obesity rates, PA rates, and BCa sub-type in EAs, AAs, and SIs. Future research could explore dietary and PA behavioral interventions to reduce BCa recurrence risk, and could evaluate potential differential immune responses linked to the frequency of triple-negative BCa in AAs.

Citation Format: Marvella E Ford, Colleen E Bauza, Victoria J Findlay, David P Turner, Latecia M Abraham-Hilaire, Leslie A Moore, Gayenell Magwood, Anthony J Alberg, Kadeidre Gaymon, Kendrea D Knight, Ebony Hilton, Angela M Malek, Rita M Kramer, Lindsay L Peterson, Susan Bolick, Deborah Hurley, Catishia Mosley, Tonya R Hazelton, Dana R Burshell, Lourdes Nogueira, Franshawn Mack, Erika T Brown, Judith D Salley, Keith E Whitfield, Joan E Cunningham. Body mass index, physical activity, and breast cancer subtype in European American, African American, and Sea Island breast cancer survivors [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B102.

Abstract C083: Consumption of lifestyle-associated advanced glycation end products promotes prostate tumor growth by creating a tumor-enhancing stromal microenvironment

Our research has demonstrated that advanced glycation end products (AGEs) derived from the diet can directly impact neoplastic growth by creating a tumor-enhancing micro-environment. Most people are unaware of what AGEs are or the damage they can cause, but we are exposed to them every day through the lives we lead and the foods that we eat. The Western diet together with more sedentary habits means that lifestyle-associated AGEs are accumulating in our bodies at a faster rate than ever before. Changes in the AGE equilibrium due to lifestyle cause protein dysfunction, reduced genetic fidelity, and aberrant cell signaling activation which we believe contribute to cancer disparity outcomes. Disparity populations defined by AGE-associated risk factors such as diet, smoking, drinking and physical inactivity often bear a greater cancer burden when compared to the general population (reviewed by the PI, Cancer Research 2015). Lifestyle associated AGEs therefore may represent a unifying biological consequence of the social, demographic and environmental risk factors that contribute to the increased cancer incidence and mortality associated with cancer disparity. An important discovery from our work is that consumption of a diet high in AGEs accelerates prostate tumor growth in syngeneic xenograft prostate cancer (PCa) models as well as disease progression in spontaneous PCa models. Critically, dietary-AGE mediated effects on prostate tumor growth were dependent upon the stromal activation of RAGE. An activated stroma is a critical pathway impacting prostate cancer outcomes in African American men. Our studies show that dietary-AGE alters cytokine profiles, increases the activation of cancer associated fibroblasts (CAFs) and increases immune cell recruitment to the tumor microenvironment. Tumor associated immune cells adopt distinct metabolic patterns which function to maintain the energy requirements needed for cell differentiation and functionality. Pathway analysis of expression data from excised tumors shows that AGE consumption significantly impacts energy metabolism through the aberrant expression of MYC regulated transcriptional targets. Our studies also show that AGEs are highest in African American men with prostate cancer. Dietary-AGE mediated activation of tumor stroma therefore may align with the ancestry specific stromal and immune profiles observed in African American men with prostate cancer. Due to their links with lifestyle, both pharmacological and/or interventional strategies aimed at reducing the AGE accumulation pool may be viewed as universal cancer preventive and/or therapeutic initiatives. This may be an attractive option for populations where lifestyle change is not feasible due to poverty, inability, illness, treatment side effects, time, apathy and depression.

Citation Format: Bradley Krisanits, Callen Fry, Lourdes M Nogueira, Reid Schuster, Marvella El Ford, Mark T Hamann, Michaell B Lilly, Mahtabuddin Ahmed, Victoria J Findlay, David P Turner. Consumption of lifestyle-associated advanced glycation end products promotes prostate tumor growth by creating a tumor-enhancing stromal microenvironment [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C083.

Dietary advanced glycation end products (AGEs) and breast cancer mortality in the women’s health initiative (WHI)

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Background: Breast cancer (BrCa) is the second leading cause of cancer death and constitutes about 14% of total cancer deaths among US women. Advanced glycation end-products (AGEs) are implicated in chronic diseases including cancer and cardiovascular diseases (CVD). AGEs are naturally found in animal products and processed foods, and preparing food at high temperatures increases AGE formation. Our goal was to assess the association between post-diagnosis dietary NƐ-carboxymethyl-lysine (CML)-AGE intake, a common measure of AGE, and mortality from all-causes, BrCa and CVD among participants with invasive BrCa in the Women’s Health Initiative (WHI). Methods: The WHI enrolled postmenopausal women aged 50 to 79 years from 1993-1998 into randomized controlled trials and a prospective observational study to examine causes of morbidity and mortality. In this analysis, we included 2,073 women diagnosed with invasive BrCa during follow-up who completed a food frequency questionnaire (FFQ) after diagnosis, had energy intakes between ≥600 kcal/day and ≤5000 kcal/day, and had CML-AGE intake data available. Women were followed from BrCa diagnosis until death or censoring through March 2018. Cox proportional hazards regression models estimated the hazard ratios (HR) and 95% CIs of mortality risk from all-causes, BrCa and CVD by tertiles of dietary CML-AGE intake with adjustment for age, income, race/ethnicity, study arm, time from diagnosis to FFQ completion, education, physical activity, smoking, BMI, ER/PR status, diagnosis stage, postmenopausal hormone use, intake of energy, alcohol, fat, red and processed meats. Results: After a median 15.1 years of follow-up, 642 deaths were reported including 198 BrCa-specific and 129 CVD-specific deaths. The average time from BrCa diagnosis to FFQ completion was 1.5 years. Compared to the lowest tertile of CML-AGE intake, there was an increased risk in the highest tertile for all-cause mortality (HR: 1.51, 95% CI: 1.17-1.94), BrCa (HR: 1.86, 95% CI: 1.19-2.91) and CVD (HR: 2.14, 95% CI: 1.19-3.84) mortality. Conclusions: Higher dietary AGE intake after BrCa diagnosis in postmenopausal women was associated with increased risk of mortality from all-causes, BrCa and CVD. Exposure to AGEs could be modified through dietary counseling and evaluated in relation to reduced mortality risk after BrCa diagnosis.

Dietary Advanced Glycation End-products (AGE) and Risk of Breast Cancer in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO)

Advanced glycation end-products (AGEs) are implicated in the pathogenesis of several chronic diseases including cancer. AGEs are produced endogenously but can also be consumed from foods. AGE formation in food is accelerated during cooking at high temperatures. Certain high fat or highly processed foods have high AGE values. The objective of the study was to assign and quantify N^ϵ-carboxymethyl-lysine (CML)-AGE content in food and investigate the association between dietary AGE intake and breast cancer risk in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. The study included women enrolled in the intervention arm who were cancer-free at baseline and completed a baseline questionnaire and food frequency questionnaire (DQX). CML-AGE values were assigned and quantified to foods in the DQX using a published AGE database. Cox proportional hazards models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) of breast cancer among all women, and stratified by race/ethnicity, invasiveness of disease, and hormone receptor status. After a median 11.5 years of follow-up, 1,592 women were diagnosed with breast cancer. Higher CML-AGE intake was associated with increased risk of breast cancer among all women (HR_Q5VSQ1, 1.30; 95% CI, 1.04-1.62; P _trend = 0.04) and in non-Hispanic white women (HR_T3VST1, 1.21; 95% CI, 1.02-1.44). Increased CML-AGE intake was associated with increased risk of in situ (HR_T3VST1, 1.49; 95% CI, 1.11-2.01) and hormone receptor-positive (HR_T3VST1, 1.24; 95% CI, 1.01-1.53) breast cancers. In conclusion, high intake of dietary AGE may contribute to increased breast cancer.

Pubertal mammary development as a "susceptibility window" for breast cancer disparity

Factors such as socioeconomic status, age at menarche and childbearing patterns are components that have been shown to influence mammary gland development and establish breast cancer disparity. Pubertal mammary gland development is selected as the focus of this review, as it is identified as a "window of susceptibility" for breast cancer risk and disparity. Here we recognize non-Hispanic White, African American, and Asian American women as the focus of breast cancer disparity, in conjunction with diets associated with changes in breast cancer risk. Diets consisting of high fat, N-3 polyunsaturated fatty acids, N-6 polyunsaturated fatty acids, as well as obesity and the Western diet have shown to lead to changes in pubertal mammary gland development in mammalian models, therefore increasing the risk of breast cancer and breast cancer disparity. While limited intervention strategies are offered to adolescents to mitigate development changes and breast cancer risk, the prominent solution to closing the disparity among the selected population is to foster lifestyle changes that avoid the deleterious effects of unhealthy diets.

Dietary advanced glycation end products and the risk of postmenopausal breast cancer in the National Institutes of Health-AARP Diet and Health Study

BACKGROUND

Advanced glycation end products (AGEs) are reactive metabolites produced as a by-product of sugar metabolism and are consumed through the diet in high-fat and highly processed foods. They are associated with chronic inflammatory diseases, and evidence suggests that they play a role in carcinogenesis. The authors evaluated the association of dietary AGE intake and the risk of postmenopausal invasive breast cancer.

METHODS

This was a prospective cohort study of 183,548 postmenopausal women in the National Institutes of Health-AARP Diet and Health Study. The main outcome was incident invasive breast cancer. AGE intake was estimated from food-frequency questionnaires. Incident breast cancer cases were identified through state cancer registries. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals for developing breast cancer according to AGE intake quintiles. Multivariable regression models were adjusted for breast cancer risk factors.

RESULTS

The mean follow-up was 12.8 years, and 9851 breast cancers (1978 advanced stage) were identified. The median AGE daily intake was 5932 kilo units per 100 kilocalories (KU/1000 kcal). Women with higher intake tended to have lower education levels, higher body mass index, less physical activity, were current smokers, and had higher fat and meat intake. The highest quintile of AGE intake (compared with the lowest) was associated with an increased risk of breast cancer (HR, 1.09; 95% CI, 1.02-1.16; P = .03) after adjusting for breast cancer risk factors and particularly was associated with 37% of advanced-stage tumors (HR, 1.37; 95% CI, 1.09-1.74; P < .02) after adjusting for risk factors and fat and meat intake.

CONCLUSIONS

Dietary AGEs may play a role in the development of postmenopausal breast cancer.

Increased Preoperative Plasma Level of Microbial 16S rDNA Translocation Is Associated With Relapse After Prostatectomy in Prostate Cancer Patients

Background: The environmental factors for promoting prostate cancer (PCa) recurrence remain unknown. Methods: A retrospective cross-sectional study was conducted in healthy men (n = 12) and PCa patients undergoing prostatectomy (n = 27). Plasma preoperative level of total cell-free bacterial 16S rDNA, a marker of microbial translocation, was evaluated by qPCR. Plasma levels of prostate-specific antigen (PSA) were evaluated by ELISA. Results: Similar degrees of microbial translocation were found in healthy men and patients. However, the levels of microbial 16S rDNA were increased in patients with cancer relapse (n = 10) compared to patients without relapse (n = 17) after prostatectomy. Furthermore, the levels of microbial 16S rDNA were marginally increased in patients with pT3 or pT4 tumors compared to those with pT 2 or less. The levels of microbial 16S rDNA tended to increase in patients with higher pathologic tumor stage, Gleason score, and margin and lymph node involvements; but these differences did not reach significance. Conclusion: The plasma 16S rDNA levels increased in patients with PCa who have biochemical recurrence and 16S rDNA levels were higher in patients with higher-grade PCa.

Advanced glycation end products are elevated in estrogen receptor-positive breast cancer patients, alter response to therapy, and can be targeted by lifestyle intervention

Purpose

Lifestyle factors associated with personal behavior can alter tumor-associated biological pathways and thereby increase cancer risk, growth, and disease recurrence. Advanced glycation end products (AGEs) are reactive metabolites produced endogenously as a by-product of normal metabolism. A Western lifestyle also promotes AGE accumulation in the body which is associated with disease phenotypes through modification of the genome, protein crosslinking/dysfunction, and aberrant cell signaling. Given the links between lifestyle, AGEs, and disease, we examined the association between dietary-AGEs and breast cancer.

Methods

We evaluated AGE levels in bio-specimens from estrogen receptor-positive (ER+) and estrogen receptor-negative (ER−) breast cancer patients, examined their role in therapy resistance, and assessed the ability of lifestyle intervention to reduce circulating AGE levels in ER+ breast cancer survivors.

Results

An association between ER status and AGE levels was observed in tumor and serum samples. AGE treatment of ER+ breast cancer cells altered ERα phosphorylation and promoted resistance to tamoxifen therapy. In a proof of concept study, physical activity and dietary intervention was shown to be viable options for reducing circulating AGE levels in breast cancer survivors.

Conclusions

There is a potential prognostic and therapeutic role for lifestyle derived AGEs in breast cancer. Given the potential benefits of lifestyle intervention on incidence and mortality, opportunities exist for the development of community health and nutritional programs aimed at reducing AGE exposure in order to improve breast cancer prevention and treatment outcomes.

Electronic supplementary material

The online version of this article (10.1007/s10549-018-4992-7) contains supplementary material, which is available to authorized users.

Abstract 2234: Dietary-AGE ingestion during puberty modifies the breast microenvironment to alter mammary gland development: Linking diet, development and breast cancer risk

Evidence supports the notion that critical events during mammary development permanently alter developmentally regulated programs which influence the breast microenvironment to increase breast cancer risk. This is analogous to metabolic memory in diabetic patients where early metabolic events have been found to be remembered and affect disease severity later in life.

Advanced glycation end products (AGEs) are highly reactive metabolites that irreversibly accumulate in tissues as we age. AGE accumulation can contribute to pro-inflammatory and -oxidant phenotypes when signaling through the receptor for advanced glycation end products (RAGE). The pathogenic effects of AGE-RAGE signaling include tissue degeneration, protein dysfunction, aberrant cell signaling, and reduced genetic fidelity. AGEs form during normal metabolism but critically, lifestyle factors such as poor diet, a sedentary lifestyle and being obese also contribute to the AGE accumulation pool. The permanence of AGE adducts and their ability to mediate chronic and persistent inflammatory and oxidative stresses is particularly compatible to the concept of metabolic memory.

Our dietary studies in pubertal FVB/n mice fed a high AGE diet show a significant dysregulation of mammary gland development and hyperplastic lesion formation. We observe delayed mammary ductal extension, increased ductal branching and aberrant terminal end-bud (TEB) morphology. The basal myoepithelial cell layer surrounding mammary ducts and TEBs was irregular and epithelial cell proliferation was increased. Molecular characterization of these hyperplastic lesions were defined using DCIS progression markers by histopathological staining and qRT-PCR. Elevated AGE levels accompanied increased RAGE expression and increased macrophage and fibroblast infiltration around the TEBs. In attempt to reverse the effects caused by a high AGE diet, mice were fed a control diet after a pubertal high AGE diet. Hyperplastic lesions persisted despite diet intervention. Importantly, hyperplastic lesions were not observed in mice fed a control diet during puberty, then switched to a high AGE diet. These data indicate that exposure to AGE induced changes during puberty may leave a long-lasting imprint analogous to metabolic memory.

In conclusion, increased AGE consumption during pubertal growth results in significant disruption of normal mammary development and the appearance of hyperplastic lesions by adulthood. Consumption of a high AGE diet despite a control diet intervention, reveals hyperplastic lesions indicative of metabolic memory. We hypothesize that the high AGE diet may leave a metabolic imprint on the mammary gland microenvironment, increasing the risk of future breast cancer development.

Citation Format: Jaime F. Randise, Bradley A. Krisanits, Lourdes M. Nogueira, Kristi L. Helke, Taaliah Campbell, Victoria J. Findlay, David P. Turner. Dietary-AGE ingestion during puberty modifies the breast microenvironment to alter mammary gland development: Linking diet, development and breast cancer risk [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 2234.

Abstract A24: Triple-negative breast Cancer risk: Ancestry and immune response

Background: Blacks in the U.S. have the worst breast cancer survival outcomes of any racial/ethnic group in the nation. However, blacks are not a monolithic group but are comprised of several ethnic groups. One such group in particular is the Sea Island or Gullah population of coastal South Carolina, North Carolina, Georgia, and Florida, whose ancestors came from coastal rice-growing areas of Africa. Sea Islanders (SI) have the lowest rates of European (non-Hispanic white) genetic admixture of any U.S. blacks, and are thus a special population who provide a rare opportunity to investigate genetic contributions to the profound ancestrally linked disparities in BC.

Purpose: The purpose of this study was to identify, for the first time, frequencies of selected single nucleotide polymorphisms (SNPs) associated with triple-negative breast cancer (TNBC) in these three non-Hispanic population groups: whites, African Americans without Sea Island ancestry (AA), and African Americans with Sea Island ancestry (SI).

Methods: Saliva samples were obtained using a mailed kit from a sample of 90 women in SC who had been diagnosed with TNBC in the past 1.5 years, recruited from the three population groups (30 women per group). Four SNPs on the 19p13 locus of BRCA 1 (rs8170, rs4808611, rs2363956, and rs3745185) were evaluated.

Results: The percentage of TNBC cases was 6.7% among whites, 4.2% among SI blacks, and 22% among non-SI blacks. After controlling for TNBC status, similar allele frequencies for each SNP were seen in whites and SI blacks, compared to non-SI blacks (p&lt;0.01). The less genetically admixed groups (SI and whites) had a lower percentage of triple-negative breast cancer (AA vs. whites, p=0.02; AA vs. SI, p=0.03; whites vs SI: p=0.99)

Discussion: The prevalence of triple-negative breast cancer is significantly higher in African American women, and at younger ages, than in white women. Findings by Mukhtar et al. (2011) implicate immune function in the development of this aggressive breast cancer, as higher proliferating cellular nuclear antigen counts and tumor-associated macrophages were associated with hormone receptor-negative tumors and non-white ethnicity. Human populations differ in their transcriptional responses to immune challenges, and immune-responsive regulatory variants have participated in human adaptation by positive selection. Regulatory variants affecting steady-state gene expression and transcriptional responsiveness to immune challenges, particularly those that were viral related, may have been preferentially introduced into African genomes through admixture with Europeans, which may have conferred a natural selection disadvantage to modern blacks without SI ancestry. Such a natural selection disadvantage may mean that different immunologic therapeutic approaches are required for blacks with cancer than for whites with cancer, particularly for more aggressive disease.

Citation Format: Marvella E. Ford, Erika T. Brown, David P. Turner, Victoria J. Findlay, Nestor F. Esnaola, Anthony J. Alberg, Susan Bolick, Deborah Hurley, Rita Kramer, Judith D. Salley, Joan E. Cunningham. Triple-negative breast Cancer risk: Ancestry and immune response [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A24.

Use of pre-travel vaccine-preventable disease serology as a screening tool to identify patients in need of pre-travel vaccination: a retrospective audit

BACKGROUND

Vaccination is a safe and effective public health intervention that not only protects individual travellers from vaccine-preventable diseases (VPDs), but prevents them from becoming a source of disease in their destination and on their return. Obtaining an accurate vaccination history from travellers during a pre-travel review can be difficult; serology may be used to identify patients who are non-immune to specific diseases in order to guide vaccination requirements. Clinically relevant data about the usefulness of serology in this setting are lacking. We performed a retrospective audit of pre-travel VPD serology requested by practitioners of a busy community-based travel clinic.

METHODS

All serological results for measles, mumps, rubella, varicella zoster virus, hepatitis A and B requested over a 5-year period were extracted and analysed. Results were stratified by gender and year of birth and compared using Stata.

RESULTS

Four thousand four hundred and fifty-one serological assays from 1445 individual were assessed. Overall, 47% of patients tested had at least one negative serological result. High rates of seropositivity for measles, mumps and rubella were seen in those born prior to 1966 but >10% of travellers born after 1966 lacked serological evidence of protection against these diseases. Hepatitis A and B serological results revealed broadly lower rates of immunity in our community likely reflecting the absence of these vaccines from historical vaccine protocols.

CONCLUSIONS

Serology can be a useful tool in the identification of non-immune travellers to enable targeted vaccination prior to travel. We recommend that travel health clinicians assess patients' vaccination and infection histories, and strongly consider serology or vaccination where there is doubt about immunity. This will help protect the traveller and prevent importation of disease into destination or home communities.

Abstract P6-07-12: A physical activity and dietary counseling intervention in breast cancer survivors and changes in known and novel prognostic biomarkers

High rates of overweight/obesity are commonly seen in breast cancer (BC) survivors. Observational data show an association between post-treatment increased weight and lack of physical activity (PA) and risk of BC recurrence and death. Increases in prognostic inflammatory associated biomarkers (BM) such as interleukin-6 (IL6) and C-reactive protein (CRP), and their downstream effects, are linked to overweight/obesity and provide a potential mechanistic explanation for this increase in recurrence risk, but studies are mixed regarding the effect of lifestyle interventions on these BM. In addition, better BM may exist. The Getting on Board with an Active Lifestyle (GOAL) study tested the feasibility of a PA and dietary counseling (DC) intervention in BC survivors and included known BM (IL6 , CRP) as well as a novel BM (advanced glycation end-products [AGEs]). AGEs are reactive metabolites produced by an uncontrolled reaction between sugars and proteins and were selected because they are seen in chronic diseases including: diabetes, neuro-degenerative disorders, stroke, heart disease and more recently, BC. Further, dietary AGEs are consumed in high fat and highly processed foods that contribute to overweight/obesity.

Methods: Ten overweight/obese women (BMI≥25) within 36 months of BC diagnosis (stage I-III) participated in a 12-week supervised PA and DC intervention consisting of two supervised PA sessions per week and weekly DC sessions. Body mass index (BMI), resting heart rate (HR) and blood pressure (BP) and blood samples were collected at baseline, week 4, 8, 12, 24, 36, 52. IL-6, CRP and AGEs were assessed in serum using commercially available 96-well format ELISAs. Data through week 12 is presented here.

Results: Ten participants (four African American) completed the 12-week intervention. The age range of participants was 50-68 years (mean 56 years). The average number of daily active minutes increased significantly between baseline (45) and week 11 (71). There was a drop off at week 12 due to right-censoring of the data. Dietary AGE intake decreased in 8 of 10 participants from baseline to week 12 (average reduction 53%). Significant reductions in mean serum AGEs were seen (baseline=53 ug/ml, week 12=38ug/ml, p&lt;0.001). No correlating reductions in CRP or IL6 were found. Correlations were seen between AGE levels and AGE intake (r=0.24 at week 12). There were no significant correlations between AGE levels and IL6 or CRP. Decreases in BMI (average change -.54 kg/m2), resting HR and BP corroborated with AGE reductions.

Conclusions: The GOAL intervention has the potential to improve PA and dietary AGE intake among overweight/obese BC patients. Participants improved weight, resting HR, BP, and number of daily active minutes; which are important metrics for overall health. There were no changes in IL6 and CRP, but reductions in AGEs correlated with reductions in dietary AGE levels, indicating that serum AGEs may be reduced through diet and PA. Serum AGEs may represent a better BM than IL6 and CRP in BC survivors. Further investigation of AGEs in BC survivors is warranted.

Citation Format: Peterson LL, Ford ME, Gregoski MJ, Knight KD, Hilton EJ, Magwood G, Turner DP. A physical activity and dietary counseling intervention in breast cancer survivors and changes in known and novel prognostic biomarkers [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-07-12.

Abstract P4-05-01: Diet, development and predisposition to breast cancer: The impact of sugar derived metabolites (AGEs) on pubertal mammary gland development

The mammary gland is one of the few organs that continues to develop postnatally through stages including puberty, pregnancy, lactation, and involution. The gland is composed of epithelial and stromal cells that include fibroblasts, adipocytes, endothelial cells, nerve cells, and macrophages. Terminal end bud (TEB) structures are found exclusively in the pubertal developmental stage. The formation of TEBs and side branching drives mammary gland epithelial cell invasion into the mammary fat pad, continuing until the entire fat pad is filled. Pubertal mammary gland morphogenesis integrates a balance of epithelial cell proliferation, differentiation, and apoptosis. Several studies have shown that the interaction between mammary epithelial and stromal cells is crucial for the proper postnatal development of the mammary ductal tree. Interestingly, studies have shown that processes important in mammary gland development are often deregulated during breast cancer tumorigenesis. Thus, understanding the complex signaling network as well as the interactions between the different cell types during mammary gland development will be vital for elucidating the mechanisms underlying breast cancer progression and metastasis.

Glycation is the non-enzymatic glycosylation of sugar moieties to biological macromolecules such as protein and DNA which produces reactive metabolites known as advanced glycation end products (AGE's). AGE content in the Western Diet has consistently increased over the last 50 years due to increased consumption of sugar laden and cheap processed/manufactured foods which are high in reactive AGE metabolites. AGE containing food can lead to the accumulation of AGEs in the body overtime leading to pro-inflammatory and pro-oxidant effects when signaling through receptor for advanced glycation end products (RAGE). Leading too many complications associated with diseases including diabetes, Alzheimer's, heart disease and cancer. Preliminary data in our lab has shown that AGEs also have an effect on phosphorylation and signaling of estrogen receptor α (ERα), a key receptor and signaling pathway in the regulation of mammary gland development during puberty. This observation, together with the links between diet, mammary gland development and immune cell recruitment lead us to examine the biological effects of a diet high in AGEs on pubertal mammary gland development in mice. We observed a significant disruption of normal pubertal mammary gland development in mice fed a high AGE diet when compared to mice fed a control diet. Mice fed the high AGE diet showed increases in TEB number as well as width, length and area. We also observed an increase in ductal branching and a decrease in ductal extension. Future studies will assess the role of macrophage recruitment to the developing gland, specifically around the TEBs based on its reported role in normal TEB function. We also plan to assess ERa signaling in mice fed the high AGE diet based on the reported role of estrogen signaling in ductal elongation.

Citation Format: Krisanits BA, Nogueira LM, Findlay VJ, Turner DP. Diet, development and predisposition to breast cancer: The impact of sugar derived metabolites (AGEs) on pubertal mammary gland development [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-05-01.

Abstract C32: MicroRNA mediated megative regulation of caveolin 1 as a biological mechanism driving breast cancer disparities

In South Carolina, mortality differences between African American (AA) and non-Hispanic white (NHW) women breast cancer patients are amongst the highest in the country. Evidence suggests that the observed racial disparity exists independent of socioeconomic and standard of care issues, suggesting a potential biological factor may be involved. The loss of Caveolin-1 (Cav1) in the tumor stromal compartment has emerged as a novel biomarker for predicting poor clinical outcome in all of the most common subtypes of breast cancer, however the mechanism of Cav1 loss is unknown. We identified miR-510 as a novel oncomir and propose that its elevated expression in breast tumors results in stromal Cav1 loss and a subsequent worse outcome. In this study we used luciferase, western blot and quantitative PCR analysis to study Caveolin-1 as a direct target of miR-510. We used a co-culture system to assess crosstalk between epithelial and stromal compartments in vitro and a mouse model to assess this in vivo. Our research shows that Cav1 is a direct target of miR-510 and that overexpression of miR-510 leads to downregulation of Cav1 protein expression, specifically in the stromal compartment. This may be racially significant as our studies also show that miR-510 levels are elevated and Cav1 levels are reduced in AA breast cancer patients compared to their NHW counterparts. Data from our in vivo studies shows that cancer-associated fibroblasts (CAFs) isolated from miR-510 expressing epithelial derived tumors lead to more aggressive tumor growth when co-injected with breast tumor epithelial cells when compared to scrambled control CAF co-injections and breast tumor epithelial cells alone. Our results suggest that elevated miR-510 expression in breast epithelial cells leads to stromal Cav1 loss and is a mechanism driving racial disparity in breast cancer.

Citation Format: David P. Turner, Brooke King, Qi Guo, Bobbie Blake, Lourdes M. Nogueira, amanda c. larue, judith d. salley, marvella e. ford, ashley evans-knowell, Victoria J. Findlay. MicroRNA mediated megative regulation of caveolin 1 as a biological mechanism driving breast cancer disparities. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C32.

Disparities in Obesity, Physical Activity Rates, and Breast Cancer Survival

The significantly higher breast cancer (BCa) mortality rates of African-American (AA) women compared to non-Hispanic (NHW) white women constitute a major US health disparity. Investigations have primarily focused on biological differences in tumors to explain more aggressive forms of BCa in AA women. The biology of tumors cannot be modified, yet lifestyle changes can mitigate their progression and recurrence. AA communities have higher percentages of obesity than NHWs and exhibit inefficient access to care, low socioeconomic status, and reduced education levels. Such factors are associated with limited healthy food options and sedentary activity. AA women have the highest prevalence of obesity than any other racial/ethnic/gender group in the United States. The social ecological model (SEM) is a conceptual framework on which interventions could be developed to reduce obesity. The SEM includes intrapersonal factors, interpersonal factors, organizational relationships, and community/institutional policies that are more effective in behavior modification than isolation from the participants' environmental context. Implementation of SEM-based interventions in AA communities could positively modify lifestyle behaviors, which could also serve as a powerful tool in reducing risk of BCa, BCa progression, and BCa recurrence in populations of AA women.

The Role of Advanced Glycation End-Products in Cancer Disparity

While the socioeconomic and environmental factors associated with cancer disparity have been well documented, the contribution of biological factors is an emerging field of research. Established disparity factors such as low income, poor diet, drinking alcohol, smoking, and a sedentary lifestyle may have molecular effects on the inherent biological makeup of the tumor itself, possibly altering cell signaling events and gene expression profiles to profoundly alter tumor development and progression. Our understanding of the molecular and biological consequences of poor lifestyle is lacking, but such information may significantly change how we approach goals to reduce cancer incidence and mortality rates within minority populations. In this review, we will summarize the biological, socioeconomic, and environmental associations between a group of reactive metabolites known as advanced glycation end-products (AGEs) and cancer health disparity. Due to their links with lifestyle and the activation of disease-associated pathways, AGEs may represent both a biological consequence and a bio-behavioral indicator of poor lifestyle which may be targeted within specific populations to reduce disparities in cancer incidence and mortality.

Relation between handgrip strength, upper limb disability and handicap among elderly women

Age-related reductions in physical performance are important when thresholds required for independent activity are approached. Much rehabilitation aims to alleviate disability by improving physical performance (e.g. range of movement or strength), but information about the relation between impairments and disabilities and about the levels of relevant thresholds is very limited. This study aimed to examine the relation between impairment of handgrip strength, dexterity disability and handicap. Eighteen female day centre clients (mean age 78.9, SD 9.9 years) were assessed using the following measurements: a handgrip dynamometer, a standarized task of moving a saucepan of different weights, the Office of Population Censuses and Surveys' scale of severity of dexterity disability and self-perceived health status using the Nottingham Health Profile. Strong correlations were observed between impairment of handgrip force and dexterity ( r = —0.7251, P <0.001), but not between impairment/disability and handicap variables. A threshold effect was observed: four out of 18 subjects with a low handgrip strength per total forearm volume (<0.10 N/ml) were unable to perform a saucepan task and had low dexterity ability. The impact of a training regimen directed towards improving the handgrip force of those approaching the threshold required for independent activity should be evaluated.

Abstract C76: Mechanistic implications of advanced glycation end-products to prostate cancer and racial disparity

Poor diet, low income, obesity and a lack of exercise are established lifestyle factors that are known to increase cancer burden and are often more prevalent in African American communities. As our understanding of tumor biology advances, it is becoming increasingly clear that these inter-related lifestyle factors have distinct molecular consequences on the biological make-up of tumors, altering cell signaling events and gene expression profiles to contribute to cancer disparity outcomes such as its earlier development or its progression to more aggressive disease. Sparse information exists about the genetic and biological factors that contribute to differential cancer survival and mortality rates observed in minority populations. A greater understanding of the interplay between risk factors and the molecular mechanisms associated with cancer disparity will significantly impact minority health.

Advanced glycation end products (AGEs) are reactive metabolites produced as a by-product of sugar metabolism. Failure to remove these highly reactive metabolites can lead to protein damage, aberrant cell signaling, increased stress responses, and decreased genetic fidelity. Critically, AGE accumulation is also directly affected by our lifestyle choices such as poor diet, low income, obesity and a lack of exercise. We recently reported a potential mechanistic link between AGEs and prostate cancer which may provide a molecular consequence of our lifestyle choices that can directly impact tumor biology and contribute to cancer disparity. We examined circulating and intra-tumoral AGE metabolite levels in clinical specimens and identified a race specific, tumor dependent pattern of accumulation in prostate cancer serum and tumor.

Further mechanistic studies in immortalized prostate cancer cell lines show that AGE treatment increases the expression of the receptor for AGEs (RAGE) to activate cancer-associated signaling cascades. Loss of function studies show that AGE mediated increases in cancer associated processes was dependent upon RAGE expression. Significantly, we show that AGEs are secreted into the tumor microenvironment by cancer cells and may function as signaling molecules to promote immune cell recruitment.

These data implicate the AGE-RAGE signaling axis as a potential biological mechanism promoting prostate cancer and may represent a biological mechanism promoting prostate cancer disparity. AGE metabolites may have high potential impact as prognostic/diagnostic markers and/or as a novel area of potential therapeutic intervention to reduce cancer disparity.

Citation Format: Danzell M. Smith, Dion Foster, Van Phan, Victoria J. Findlay, Lourdes M. Nogueira, Laura Spruill, Mahtabuddin Ahmed, Judith D. Salley, Marvella E. Ford, David P. Turner. Mechanistic implications of advanced glycation end-products to prostate cancer and racial disparity. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr C76.

Abstract B08: Highlighting the maturation of the MSI/NCI P20 South Carolina Cancer Disparities Research Center Partnership

The South Carolina Cancer Disparities Research Center (SC CaDRe), funded by the NIH/NCI Center to Reduce Cancer Health Disparities (CRCHD) in 2011, is a formal collaboration between the Medical University of South Carolina (MUSC) and South Carolina State University (SCSU, an historically black university). The SC CaDRe focuses on biological mechanisms of disparity in hormone-related cancers (breast and prostate cancer). The Sea Island population plays a prominent role in the three SC CaDRe research projects. The Sea Islanders are an African American ethnic group indigenous to the coastal southeast, with low rates of European American genetic admixture; as such they are ideal for inclusion in biomedical research. Each SC CaDRe research project includes Multiple PIs from MUSC and SCSU. The first research project is titled Biological Implications of DNA Glycation in Prostate Cancer Disparities; the second is titled MicroRNA Mediated Negative Regulation of Caveolin 1 as a Biological Mechanism Driving Breast Cancer Disparities; and the third is titled Feasibility Study of Breast Cancer Candidate Genes in Three Population Groups in South Carolina. The design and results of each project will be presented. The P20 SC CaDRe has led to two funded NIH R21 grants, an R01 grant, an R25E grant, and a DOD research training grant. Three undergraduate students from SCSU and four graduate students from MUSC have participated in SC CaDRe cancer research training, resulting in peer-reviewed publications and presentations at national scientific meetings. As a next step, the SC CaDRe investigators plan to submit an NIH/NCI CRCHD U54 grant application in 2016.

Citation Format: Marvella E. Ford, Dennis K. Watson, James Stukes, Mahtabuddin Ahmed, David P. Turner, Ashley Evans Knowell, Victoria J. Findlay, Anita L. Harrison, Kendrea D. Knight, Heidi Varner, Kimberly Cannady, Judith D. Salley. Highlighting the maturation of the MSI/NCI P20 South Carolina Cancer Disparities Research Center Partnership. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B08.

Abstract C65: Defining the implications of sugar derived metabolites (AGEs) to tamoxifen resistance and breast cancer disparity: Is it a question of lifestyle?

Tamoxifen is the most widely prescribed adjuvant therapy for estrogen receptor positive (ER+) breast cancer which comprises around 70% of all breast cancer cases. While many patients respond positively to tamoxifen treatment around 50% have de-novo resistance and approximately 30% of responsive tumors recur due to acquired drug resistance. Compared to European American women, African-American women with ER+ breast cancer, have worse progression-free and overall survival which coincides with increased resistance to anti-cancer therapies such as tamoxifen. Poor diet, low income, obesity and a lack of exercise are established lifestyle factors that are known to increase cancer burden and are often more prevalent in African American communities. Our research has identified a potential mechanistic link between sugar derived metabolites and estrogen receptor (ER) phosphorylation which provides a biological consequence of these established lifestyle factors which may directly impact tamoxifen therapy and minority health.

Glycation is the non-enzymatic glycosylation of sugar moieties to biological macromolecules such as protein and DNA which produces reactive metabolites known as advanced glycation end products (AGE's). AGE's accumulate in our tissues as we grow older and drive many of the complications associated with diseases displaying health disparity including diabetes, metabolic syndrome, Alzheimer's and heart disease. Significantly, low income, obesity and an inactive lifestyle are established factors driving health disparity that also contribute to increased AGE accumulation levels in our bodies. In particular, AGE content in the Western Diet has consistently increased over the last 50 years due to increased consumption of sugar laden and cheap processed/manufactured foods which are high in reactive AGE metabolites and promote obesity.

Due to the established links with lifestyle and cancer disparity we examined the biological effects of AGEs on tamoxifen therapy and found that elevated AGE levels can directly affect the response to tamoxifen treatment and promote tamoxifen resistance. AGE treatment in ER+ breast cancer cell models promoted tamoxifen resistance via the activation of the MAPK and AKT pathways leading to resistance associated changes in ERα phosphorylation. We also observed greater levels of AGE and its cognate receptor for AGE (RAGE) within breast cancer tumor and serum samples and showed a correlation between tumor progression and intra-tumoral AGE concentration.

Strategies to eliminate or delay the occurrence of tamoxifen resistance would contribute to increasing overall survival in minority populations. By associating lifestyle-derived AGEs with tamoxifen resistance, opportunities exist for impacting cancer treatment initiatives arising through health and nutritional education and community outreach programs driven by basic, translational, epidemiological and cancer prevention research initiatives.

Citation Format: Katherine R. Walter, Danzell M. Smith, Van Phan, Laura spruill, Marvella E. Ford, Victoria J. Findlay, David P. Turner. Defining the implications of sugar derived metabolites (AGEs) to tamoxifen resistance and breast cancer disparity: Is it a question of lifestyle? [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr C65.

Abstract B07: Design and preliminary outcomes of a study to reduce cancer-associated reactive metabolite levels in breast cancer survivors – The RCAM Study

Breast cancer (BCa) is the 2nd leading cause of cancer death in women in the US. African American (AA) women have higher BCa mortality rates and higher obesity rates compared to other women. It is well known that exercise and a healthier diet can improve prognosis among BCa survivors but little is known about their positive effects on common biological pathways involved in BCa recurrence. The RCAM Study is a 1-year study designed to identify bio-behavioral pathways that may impact BCa recurrence. The study evaluates the effect of the intervention on a novel biomarker associated with cancer recurrence advanced glycation end products (AGEs). The intervention, adapted from the highly successful Diabetes Prevention Program (DPP), consists of a 12-week physical activity and dietary counseling program. The supervised physical activity component is conducted twice a week at a local health system's cardiopulmonary rehabilitation center; the individualized dietary counseling component is conducted weekly at the health system's weight management center. The study participants consist of overweight or obese women who received surgery for invasive BCa and who are within 36 months of diagnosis. In addition, adjuvant therapy must have been received at least four weeks prior to study enrollment. To date, 10 participants have completed the 12-week intervention and will be followed for 1 year. Preliminary ELISA data from blood samples collected pre- and post-12 week intervention show significant post-intervention reductions in inflammatory biomarker levels. Commensurate decreases in body mass, resting heart rate, and blood pressure were also seen. The average pre-/post-intervention decrease in AGE levels was not as dramatic for the AA participants, most of whom were morbidly obese at enrollment, as for the European American (EA) women, most of whom were overweight at enrollment. These data demonstrate the high potential of the RCAM intervention in improving prognosis among BCa survivors and show the need to tailor the intervention to meet the specific needs of AA women.

Citation Format: Marvella E. Ford, David P. Turner, Mathew J. Gregoski, Lindsay L. Peterson, Kendrea D. Knight, Ebony J. Hilton, Gayenell Magwood. Design and preliminary outcomes of a study to reduce cancer-associated reactive metabolite levels in breast cancer survivors – The RCAM Study. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B07.

Effects of harvest, fire, and pest/pathogen disturbances on the West Cascades ecoregion carbon balance

BACKGROUND

Disturbance is a key influence on forest carbon dynamics, but the complexity of spatial and temporal patterns in forest disturbance makes it difficult to quantify their impacts on carbon flux over broad spatial domains. Here we used a time series of Landsat remote sensing images and a climate-driven carbon cycle process model to evaluate carbon fluxes at the ecoregion scale in western Oregon.

RESULTS

Thirteen percent of total forest area in the West Cascades ecoregion was disturbed during the reference interval (1991-2010). The disturbance regime was dominated by harvesting (59 % of all area disturbed), with lower levels of fire (23 %), and pest/pathogen mortality (18 %). Ecoregion total Net Ecosystem Production was positive (a carbon sink) in all years, with greater carbon uptake in relatively cool years. Localized carbon source areas were associated with recent harvests and fire. Net Ecosystem Exchange (including direct fire emissions) showed greater interannual variation and became negative (a source) in the highest fire years. Net Ecosystem Carbon Balance (i.e. change in carbon stocks) was more positive on public that private forestland, because of a lower disturbance rate, and more positive in the decade of the 1990s than in the warmer and drier 2000s because of lower net ecosystem production and higher direct fire emissions in the 2000s.

CONCLUSION

Despite recurrent disturbances, the West Cascades ecoregion has maintained a positive carbon balance in recent decades. The high degree of spatial and temporal resolution in these simulations permits improved attribution of regional carbon sources and sinks.

Abstract B13: Hematopoietic stem cell-derived cancer-associated fibroblasts are novel contributors to the pro-tumorigenic microenvironment

Targeting the tumor microenvironment is critical towards improving the effectiveness of current cancer therapeutics. Cancer-associated fibroblasts (CAFs) are one of the most abundant cell types of the tumor microenvironment, playing an important role in tumor progression and angiogenesis. Multiple origins for CAFs have been proposed including resident fibroblasts, adipocytes, and bone marrow. Our laboratory previously identified a novel hematopoietic stem cell (HSC) origin for CAFs; however, the functional roles of HSC-derived CAFs (HSC-CAFs) in tumor progression have not yet been examined. Thus, to test the hypothesis that HSC-CAFs promote tumor progression via contribution to extracellular matrix (ECM) and through paracrine production of pro-angiogenic factors, we developed a method to isolate HSC-CAFs. HSC-CAFs were profiled based on their expression of hematopoietic and fibroblastic markers in two murine tumor models, Lewis lung carcinoma (LLC) and E0771 breast cancer. Findings revealed HSC-CAF production of factors associated with both ECM deposition and remodeling. Functional in vivo studies showed that co-injection of HSC-CAFs with tumor cells resulted in increased tumor growth rate and significantly larger tumors than injection of tumor cells alone. Immunohistochemical studies revealed increased blood vessel density with co-injection, demonstrating a role for HSC-CAFs in tumor progression through promotion of tumor vascularization in vivo. Mechanistic in vitro studies indicated a role for HSC-CAF produced vascular endothelial growth factor (VEGF-A) and transforming growth factor-beta-1 (TGFβ-1) in endothelial tube formation and vascular patterning. These in vitro and in vivo findings suggest that HSC-CAFs are a critical component of the tumor microenvironment contributing to ECM production, ECM remodeling, and tumor vascularization. Given their role in multiple components of tumor progression, targeting the novel HSC-CAF may be a promising therapeutic strategy alone or in combination with existing anti-angiogenesis therapies.

Citation Format: Lindsay T. McDonald, Dayvia A. Laws, Ryan R. Kelly, Ying Xiong, Anjan Motamarry, Risha K. Patel, Jeffrey A. Jones, Patricia M. Watson, David P. Turner, Dennis K. Watson, Adam C. Soloff, Victoria J. Findlay, Amanda C. LaRue. Hematopoietic stem cell-derived cancer-associated fibroblasts are novel contributors to the pro-tumorigenic microenvironment. [abstract]. In: Proceedings of the AACR Special Conference: Tumor Angiogenesis and Vascular Normalization: Bench to Bedside to Biomarkers; Mar 5-8, 2015; Orlando, FL. Philadelphia (PA): AACR; Mol Cancer Ther 2015;14(12 Suppl):Abstract nr B13.

The potential repertoire of the innate immune system in the bladder: expression of pattern recognition receptors in the rat bladder and a rat urothelial cell line (MYP3 cells)

PURPOSE

The urothelium is a frontline sensor of the lower urinary tract, sampling the bladder lumen and stimulating an immune response to infectious and noxious agents. Pattern recognition receptors (PRRs) recognize such agents and coordinate the innate response, often by forming inflammasomes that activate caspase-1 and the release of interleukin-1. We have shown the presence of one PRR (NLRP3) in the urothelia and its central role in the inflammatory response to cyclophosphamide. The purpose of this study was to (1) assess the likely range of the PPR response by assessing the repertoire present in the rat bladder and (2) determine the utility of the MYP3 rat urothelia cell line for in vitro studies by assessing its PPR repertoire and functional responsiveness.

METHODS

Immunohistochemistry was performed for seven PPRs (NLRP1, NLRP3, NLRP6, NLRP7, NLRP12, NLRC4 and AIM2) on bladder sections and MYP3 cells. For functionality, MYP3 cells were challenged with the quintessential NLRP3 activator ATP and assessed for caspase-1 activation.

RESULTS

All PPRs examined were expressed in the bladder and localized to the urothelial layer with several also in the detrusor (none in the interstitia). MYP3 cells also expressed all PRRs with a variable intracellular location. ATP-stimulated caspase-1 activity in MYP3 cells in a dose-dependent manner was reduced by knockdown of NLRP3 expression.

CONCLUSION

The results suggest that the bladder possesses the capacity to initiate an innate immune response to a wide array of uropathological agents and the MYP3 cells will provide an excellent investigational tool for this field.

Advanced glycation end-products: a biological consequence of lifestyle contributing to cancer disparity

Low income, poor diet, obesity, and a lack of exercise are interrelated lifestyle factors that can profoundly alter our biologic make up to increase cancer risk, growth, and development. We recently reported a potential mechanistic link between carbohydrate-derived metabolites and cancer, which may provide a biologic consequence of lifestyle that can directly affect tumor biology. Advanced glycation end-products (AGE) are reactive metabolites produced as a by-product of sugar metabolism. Failure to remove these highly reactive metabolites can lead to protein damage, aberrant cell signaling, increased stress responses, and decreased genetic fidelity. Critically, AGE accumulation is also directly affected by our lifestyle choices and shows a race-specific, tumor-dependent pattern of accumulation in cancer patients. This review will discuss the contribution of AGEs to the cancer phenotype, with a particular emphasis on their biologic links with the socioeconomic and environmental risk factors that drive cancer disparity. Given the potential benefits of lifestyle changes and the potential biologic role of AGEs in promoting cancer, opportunities exist for collaborations affecting basic, translational, epidemiologic, and cancer prevention initiatives.

Abstract A47: MicroRNA-510 as a predictive marker for response to platinum-based chemotherapy in triple negative breast cancer

Breast cancer is a heterogeneous disease with multiple subtypes, which are clinically classified based on the expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). Associated with the poorest prognosis of all subtypes, triple negative breast cancer (TNBC) is defined as ER-/PR-/HER2-; without these molecular targets, these cancers are insensitive to highly effective targeted therapies and systemic chemotherapy remains the mainstay of treatment for these women. Resent research has shown that platinum chemotherapy agents are particularly active in TNBC, including a clinical trial that demonstrated single agent cisplatin alone can induce response in a subset of TNBC patients. The identification of biomarkers to predict response is required to distinguish patients most likely to benefit from this agent from resistant ones, whom may respond better from other forms of chemotherapy. We have published studies examining the role of miR-510 in breast cancer and observed that miR-510 expression is elevated in tumors when compared to matched non-tumor samples. Drug cytotoxicity assays indicate miR-510 positively correlates with sensitivity to cisplatin in vitro. Furthermore, inhibition of miR-510 causes sensitive breast cancer cell lines to be more resistant in vitro, while overexpression of miR-510 restores sensitivity to cisplatin in resistant breast cancer cell lines both in vitro and in vivo. Recent mechanistic studies have revealed that cisplatin activates the ΔNp63/TAp73 apoptotic pathway specifically in in TNBC with p53 mutations (∼60% of all TNBCs). We have validated peroxiredoxin 1 (Prdx1) as a direct target of miR-510 and studies have also indicated that Prdx1 is a negative regulator of the ΔNp63/Tap73 pathway, suggesting that miR-510 may mediate sensitivity to cisplatin through the negative regulation of Prdx1. We demonstrate an increase in the activation of this pathway in TNBC cells expressing miR-510 upon cisplatin treatment. Based on these data we propose that elevated levels of miR-510 mediates cisplatin sensitivity and that it may serve as a non-invasive biomarker to predict response to cisplatin in TNBC patients. To this end, we have shown by qPCR that miR-510 levels are detectable in serum samples from a subset of human breast cancer patients, and further studies will assess positive correlations between miR-510 expression and cisplatin sensitivity.

Citation Format: Qi Jin Guo, Jamie N. Miils, Natalie Mason, Savannah G. Bandurraga, Lourdes M. Nogueira, Rita Kramer, David P. Turner, Victoria J. Findlay. MicroRNA-510 as a predictive marker for response to platinum-based chemotherapy in triple negative breast cancer. [abstract]. In: Proceedings of the AACR Precision Medicine Series: Drug Sensitivity and Resistance: Improving Cancer Therapy; Jun 18-21, 2014; Orlando, FL. Philadelphia (PA): AACR; Clin Cancer Res 2015;21(4 Suppl): Abstract nr A47.

MicroRNA-510 promotes cell and tumor growth by targeting peroxiredoxin1 in breast cancer

Introduction

MicroRNAs are small non-coding RNAs that are involved in the post-transcriptional negative regulation of mRNAs. MicroRNA 510 (miR-510) was initially shown to have a potential oncogenic role in breast cancer by the observation of its elevated levels in human breast tumor samples when compared to matched non-tumor samples. Few targets have been identified for miR-510. However, as microRNAs function through the negative regulation of their direct targets, the identification of those targets is critical for the understanding of their functional role in breast cancer.

Methods

Breast cancer cell lines were transfected with pre-miR-510 or antisense miR-510 and western blotting and quantitative real time PCR were performed. Functional assays performed included cell growth, migration, invasion, colony formation, cytotoxicity and in vivo tumor growth. We performed a PCR assay to identify novel direct targets of miR-510. The study focused on peroxiredoxin 1 (PRDX1) as it was identified through our screen and was bioinformatically predicted to contain a miR-510 seed site in its 3' untranslated region (3'UTR). Luciferase reporter assays and site-directed mutagenesis were performed to confirm PRDX1 as a direct target. The Student's two-sided, paired t-test was used and a P-value less than 0.05 was considered significant.

Results

We show that miR-510 overexpression in non-transformed and breast cancer cells can increase their cell growth, migration, invasion and colony formation in vitro. We also observed increased tumor growth when miR-510 was overexpressed in vivo. We identified PRDX1 through a novel PCR screen and confirmed it as a direct target using luciferase reporter assays. The reintroduction of PRDX1 into breast cancer cell lines without its regulatory 3'UTR confirmed that miR-510 was mediating its migratory phenotype at least in part through the negative regulation of PRDX1. Furthermore, the PI3K/Akt pathway was identified as a positive regulator of miR-510 both in vitro and in vivo.

Conclusions

In this study, we provide evidence to support a role for miR-510 as a novel oncomir. We show that miR-510 directly binds to the 3'UTR of PRDX1 and blocks its protein expression, thereby suppressing migration of human breast cancer cells. Taken together, these data support a pivotal role for miR-510 in breast cancer progression and suggest it as a potential therapeutic target in breast cancer patients.

Abstract PR10: Advanced glycation end-products are increased in prostate cancer and may promote racial disparity

African American cancer patients are more likely to die of their disease than their European counterparts. Our research has identified a potential mechanistic link between carbohydrate derived metabolites and cancer associated pathways which may provide a biological consequence of the socioeconomic and environmental factors that are known to drive cancer health disparity.

Glycation is the non-enzymatic glycosylation of sugar moieties to biological macromolecules such as protein and DNA which produces reactive metabolites known as advanced glycation end products (AGE's). AGE's accumulate in our tissues as we grow older and drive many of the complications associated with diseases displaying health disparity including diabetes, metabolic syndrome, Alzheimer's and heart disease. Low income, obesity and an inactive/sedentary lifestyle are established factors driving cancer health disparity. Apart from their production during normal metabolism, AGE's are also formed through the ingestion of food and by external environmental factors such as lack of exercise. AGE content in the Western Diet has consistently increased over the last 50 years due to increased consumption of sugar laden and cheap processed/manufactured foods which are high in reactive AGE metabolites and can promote obesity.

We therefore examined circulating and intra-tumoral AGE metabolite levels in clinical specimens and identified a race specific, tumor dependent pattern of accumulation in prostate cancer serum and tumor. In mouse xenograft models, AGE accumulation was highest in the more aggressive tumors. One way AGE's mediate their deleterious effects is by functioning as ligand for the trans-membrane receptor for AGE (RAGE). In diabetes and other diseases, the AGE-RAGE signaling axis is a pro-inflammatory pathway leading to the upregulation of pro-inflammtory cytokines through increased NFkB activation. Higher AGE levels in prostate tumors corresponded with higher RAGE expression and increased NFkB transcriptional activity. In immortalized prostate cancer cell lines AGE treatment increased cancer associated processes and RAGE expression levels. Loss of function studies show that AGE mediated increases in cancer associated processes was dependent upon RAGE expression.

These data implicate the AGE-RAGE signaling axis as a potential biological mechanism promoting prostate cancer and indicate that increased AGE accumulation may represent a biological mechanism promoting prostate cancer disparity.

This abstract is also presented as Poster C62.

Citation Format: David P. Turner, Victoria J. Findlay, Lourdes M. Nogueira, Sadia Robinson, Emily Kistner-Griffin, Laura Spruill, Ryan Y. Turner, Mahtabuddin Ahmed, Judith D. Salley, Marvella E. Ford. Advanced glycation end-products are increased in prostate cancer and may promote racial disparity. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr PR10. doi:10.1158/1538-7755.DISP13-PR10

AGE metabolites: a biomarker linked to cancer disparity?

Socioeconomic and environmental influences are established factors promoting cancer disparity, but the contribution of biologic factors is not clear. We report a mechanistic link between carbohydrate-derived metabolites and cancer that may provide a biologic consequence of established factors of cancer disparity. Glycation is the nonenzymatic glycosylation of carbohydrates to macromolecules, which produces reactive metabolites called advanced glycation end products (AGE). A sedentary lifestyle and poor diet all promote disease and the AGE accumulation pool in our bodies and also increase cancer risk. We examined AGE metabolites in clinical specimens of African American and European American patients with prostate cancer and found a higher AGE concentration in these specimens among African American patients when compared with European American patients. Elevated AGE levels corresponded with expression of the receptor for AGE (RAGE or AGER). We show that AGE-mediated increases in cancer-associated processes are dependent upon RAGE. Aberrant AGE accumulation may represent a metabolic susceptibility difference that contributes to cancer disparity.

Understanding the role of ETS-mediated gene regulation in complex biological processes

Ets factors are members of one of the largest families of evolutionarily conserved transcription factors, regulating critical functions in normal cell homeostasis, which when perturbed contribute to tumor progression. The well-documented alterations in ETS factor expression and function during cancer progression result in pleiotropic effects manifested by the downstream effect on their target genes. Multiple ETS factors bind to the same regulatory sites present on target genes, suggesting redundant or competitive functions. The anti- and prometastatic signatures obtained by examining specific ETS regulatory networks will significantly improve our ability to accurately predict tumor progression and advance our understanding of gene regulation in cancer. Coordination of multiple ETS gene functions also mediates interactions between tumor and stromal cells and thus contributes to the cancer phenotype. As such, these new insights may provide a novel view of the ETS gene family as well as a focal point for studying the complex biological control involved in tumor progression. One of the goals of molecular biology is to elucidate the mechanisms that contribute to the development and progression of cancer. Such an understanding of the molecular basis of cancer will provide new possibilities for: (1) earlier detection, as well as better diagnosis and staging of disease; (2) detection of minimal residual disease recurrences and evaluation of response to therapy; (3) prevention; and (4) novel treatment strategies. Increased understanding of ETS-regulated biological pathways will directly impact these areas.

Abstract P4-07-02: MicroRNA 204 mediated negative regulation of the IGF2R promotes breast cancer progression and is a potential mechanism driving breast cancer disparity

Breast cancer (BC) is a worldwide health issue as it represents the leading cause of cancer in women and the second leading cause of cancer-related mortality in women, with an increasing incidence. In the US, African American (AA) women have a significantly higher rate of mortality due to BC compared to Caucasian American (CA) women. It is becoming increasingly apparent that racial disparity in cancer exists due to molecular differences in tumor biology as well as, or in addition to, socioeconomic and standard of care issues. Sparse information exists regarding the molecular mechanisms that promote BC health disparity therefore, a greater understanding of the risk factors and biological links associated with BC, will significantly impact AA women. Our studies have identified a race specific mechanistic link between microRNA-204 (miR-204) and the Insulin-like Growth Factor-2 Receptor. MicroRNAs are small non-coding RNAs that function to inhibit gene expression through translational repression. Our published studies identified miR-204 as a novel oncomir and we recently identified IGF2R as a direct target. The IGF2R has been proposed to be a tumor suppressor gene in several cancers including breast cancer. We show that over-expression of miR-204 results in a decrease in IGF2R protein levels. We propose that the inhibition of IGF2R allows IGF-2 to bind the IGF1R leading to hyperactivation of this pathway which results in increased proliferation, migration and invasion, processes that are required for tumor progression. Indeed, we show that miR-204 expression results in the activation of the IGF1R/IRS-1/ERK pathway together with an increase in proliferation, migration and invasion. Published studies have shown that exogenous expression of activated IGF1R increases migration in non-transformed breast cells. We have shown that exogenous expression of miR-204 also increases migration in these cells. However, when miR-204 and IGF1R are both exogenously expressed no additional increase in migration was observed, suggesting that mIR-204 mediated increase in migration is through activation of the IGF1R pathway. Reduced IGF2R expression correlates with poor patient prognosis in BC patients and a recent study showed significantly higher levels of IGF2R in CA compared to AA tumor samples, suggesting that decreased IGF2R expression may contribute to BC disparity. We examined serum from BC patients and found elevated levels of miR-204 in AA compared to CA women. Circulating miRNAs can serve as accessible biomarkers for diagnosis & prognosis and may define a novel area of potential therapeutic intervention to reduce BC disparity. Our data also suggest that miR-204 mediated inhibition of IGF2R could be a potential biological mechanism driving BC disparity. A major hurdle to the identification of biological mechanisms conferring cancer health disparity is a lack of suitable experimental models with which to investigate race specific differences in tumor biology. We have developed a unique inducible miR-204 transgenic mouse model to define in vivo the oncogenic potential of miR-204 and the mechanism and functional consequences of IGF2R loss.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-07-02.

A large proportion of North American net ecosystem production is offset by emissions from harvested products, river/stream evasion, and biomass burning

Diagnostic carbon cycle models produce estimates of net ecosystem production (NEP, the balance of net primary production and heterotrophic respiration) by integrating information from (i) satellite-based observations of land surface vegetation characteristics; (ii) distributed meteorological data; and (iii) eddy covariance flux tower observations of net ecosystem exchange (NEE) (used in model parameterization). However, a full bottom-up accounting of NEE (the vertical carbon flux) that is suitable for integration with atmosphere-based inversion modeling also includes emissions from decomposition/respiration of harvested forest and agricultural products, CO2 evasion from streams and rivers, and biomass burning. Here, we produce a daily time step NEE for North America for the year 2004 that includes NEP as well as the additional emissions. This NEE product was run in the forward mode through the CarbonTracker inversion setup to evaluate its consistency with CO2 concentration observations. The year 2004 was climatologically favorable for NEP over North America and the continental total was estimated at 1730 ± 370 TgC yr(-1) (a carbon sink). Harvested product emissions (316 ± 80 TgC yr(-1) ), river/stream evasion (158 ± 50 TgC yr(-1) ), and fire emissions (142 ± 45 TgC yr(-1) ) counteracted a large proportion (35%) of the NEP sink. Geographic areas with strong carbon sinks included Midwest US croplands, and forested regions of the Northeast, Southeast, and Pacific Northwest. The forward mode run with CarbonTracker produced good agreement between observed and simulated wintertime CO2 concentrations aggregated over eight measurement sites around North America, but overestimates of summertime concentrations that suggested an underestimation of summertime carbon uptake. As terrestrial NEP is the dominant offset to fossil fuel emission over North America, a good understanding of its spatial and temporal variation - as well as the fate of the carbon it sequesters ─ is needed for a comprehensive view of the carbon cycle.

ETS1 transcriptional activity is increased in advanced prostate cancer and promotes the castrate-resistant phenotype

Advanced disease accounts for the majority of prostate cancer-related deaths and androgen deprivation therapy (ADT) is the standard of care for these patients. Many patients undergoing ADT become resistant to its effects and progress to castrate-resistant prostate cancer (CRPC). Current therapies for CRPC patients are inadequate, with progression-free survival rates as low as 2 months. The molecular events that promote CRPC are poorly understood. ETS (v-ets erythroblastosis virus E26 oncogene) transcription factors are regulators of carcinogenesis. Protein levels of the archetypical ETS factor, ETS1, are increased in clinical and latent prostate cancer relative to benign prostatic hyperplasia and normal prostate to promote multiple cancer-associated processes, such as energy metabolism, matrix degradation, survival, angiogenesis, migration and invasion. Our studies have found that ETS1 expression is highest in high-grade prostate cancer (Gleason 7 and above). Increased ETS1 expression and transcriptional activity promotes an aggressive and castrate-resistant phenotype in immortalized prostate cancer cells. Elevated AKT (v-akt murine thymoma viral oncogene homolog) activity was demonstrated to increase ETS1 protein levels specifically in castrate-resistant cells and exogenous ETS1 expression was sufficient to rescue invasive potential decreased by inhibition of AKT activity. Significantly, targeted androgen receptor activity altered ETS1 expression, which in turn altered the castrate-resistant phenotype. These data suggest a role for oncogenic ETS1 transcriptional activity in promoting aggressive prostate cancer and the castrate-resistant phenotype.

Mechanisms and functional consequences of PDEF protein expression loss during prostate cancer progression

BACKGROUND

Ets is a large family of transcriptional regulators with functions in most biological processes. While the Ets family gene, prostate-derived epithelial factor (PDEF), is expressed in epithelial tissues, PDEF protein expression has been found to be reduced or lost during cancer progression. The goal of this study was to examine the mechanism for and biologic impact of altered PDEF expression in prostate cancer.

METHODS

PDEF protein expression of prostate specimens was examined by immunohistochemistry. RNA and protein expression in cell lines were measured by q-PCR and Western blot, respectively. Cellular growth was determined by quantifying viable and apoptotic cells over time. Cell cycle was measured by flow cytometry. Migration and invasion were determined by transwell assays. PDEF promoter occupancy was determined by chromatin immunoprecipitation (ChIP).

RESULTS

While normal prostate epithelium expresses PDEF mRNA and protein, tumors show no or decreased PDEF protein expression. Re-expression of PDEF in prostate cancer cells inhibits cell growth. PDEF expression is inversely correlated with survivin, urokinase plasminogen activator (uPA) and slug expression and ChIP studies identify survivin and uPA as direct transcriptional targets of PDEF. This study also shows that PDEF expression is regulated via a functional microRNA-204 (miR-204) binding site within the 3'UTR. Furthermore, we demonstrate the biologic significance of miR-204 expression and that miR-204 is over-expressed in human prostate cancer specimens.

CONCLUSIONS

Collectively, the reported studies demonstrate that PDEF is a negative regulator of tumor progression and that the miR-204-PDEF regulatory axis contributes to PDEF protein loss and resultant cancer progression.

Prostate-Derived ETS Factor Regulates Epithelial-to-Mesenchymal Transition through Both SLUG-Dependent and Independent Mechanisms

The 5-year survival rate is very low when breast cancer becomes metastatic. The metastatic process is governed by a network of molecules of which SLUG is known to play a major role as a regulator of epithelial-to-mesenchymal transition (EMT). Prostate-derived ETS factor (PDEF) has been proposed as a tumor suppressor, possibly through inhibition of invasion and metastasis; therefore, understanding the mechanism of PDEF regulation may help to better understand its role in breast cancer progression. This study shows for the first time that the transcription factor SLUG is a direct target of PDEF in breast cancer. We show that the expression of PDEF is able to suppress/dampen EMT through the negative regulation of SLUG. In addition, we show that PDEF is also able to regulate downstream targets of SLUG, namely E-cadherin, in both SLUG-dependent and -independent manners, suggesting a critical role for PDEF in regulating EMT.

Abstract 470: Role of Fli1 in hematopoietic stem cell-derived fibroblast promotion of tumor cell migration and invasion

Cells and paracrine factors of the tumor microenvironment play a central role in tumor angiogenesis, invasion, migration and proliferation, making the tumor microenvironment an exciting therapeutic target. Among the most prominent cell types in the tumor stroma are fibroblasts, termed carcinoma-associated fibroblasts (CAFs). We have identified a novel population of CAFs and CAF precursors (circulating fibroblast precursors, CFPs) that are of hematopoietic stem cell (HSC) origin. These cells preferentially migrate and differentiate in response to tumor and their inhibition results in decreased tumor size. While these studies have identified a novel HSC-derived CAF population, the mechanisms by which these cells promote tumorigenesis are unknown. Previous studies have indicated a critical role for Fli1, an Ets family transcription factor, in regulation of HSCs and differentiation/maturation of hematopoietic lineages. Additionally, loss of Fli1 has been associated with cancer progression. Based on these findings, we hypothesize that HSC-derived CFPs/CAFs directly affect tumor cell migration and invasion and that loss of Fli1 in CFPs/CAFs enhances these effects. To address this hypothesis, we examined the ability of HSC-derived fibroblast populations to affect tumor cell migration and invasion in vitro. Fibroblasts were established from peripheral blood and bone marrow of normal mice and mutant Fli1 mice expressing a truncated Fli1 protein (Fli1ΔCTA) lacking the carboxy-terminal regulatory (CTA) domain. The effects of conditioned media from these fibroblast populations on tumor cell migration and invasion were examined in chemotactic transwell migration assays and matrigel-based invasion assays, respectively. Data show that conditioned media from all HSC-derived fibroblast populations promoted migration and invasion of tumor cells versus control, and that this effect was significantly enhanced using conditioned media from fibroblasts derived from Fli1ΔCTA/Fli1ΔCTA mice. Ongoing studies are directed at identifying the mechanisms by which Fli1 target genes affect HSC-derived fibroblast modulation of tumor cell migration and invasion.

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 470. doi:10.1158/1538-7445.AM2011-470