Associations of CTCF and FOXA1 with androgen and IGF pathways in men with localized prostate cancer

AIMS

To examine associations between the transcription factors CCCTC-binding factor (CTCF) and forkhead box protein A1 (FOXA1) and the androgen receptor (AR) and their association with components of the insulin-like growth factor (IGF)-pathway in a cohort of men with localized prostate cancer.

METHODS

Using prostate tissue samples collected during the Prostate cancer: Evidence of Exercise and Nutrition Trial (PrEvENT) trial (N = 70 to 92, depending on section availability), we assessed the abundance of CTCF, FOXA1, AR, IGFIR, p-mTOR, PTEN and IGFBP-2 proteins using a modified version of the Allred scoring system. Validation studies were performed using large, publicly available datasets (TCGA) (N = 489).

RESULTS

We identified a strong correlation between CTCF and AR staining with benign prostate tissue. CTCF also strongly associated with the IGFIR, with PTEN and with phospho-mTOR. FOXA1 was also correlated with staining for the IGF-IR, with IGFBP-2 and with staining for activated phosphor-mTOR. The staining for the IGF-IR was strongly correlated with the AR.

CONCLUSION

Our findings emphasise the close and complex links between the endocrine controls, well known to play an important role in prostate cancer, and the transcription factors implicated by the recent genetic evidence.

Intravascular ultrasound for peri-procedural geometric orifice area measurement during transcatheter pulmonary valve replacement

Introduction

Large imaging filed intravascular ultrasound (IVUS) offering superior online tomographic perspective and visual accuracy could guide transcatheter pulmonary valve replacement (TPVR) for right ventricular outflow tract (RVOT) insufficiency. It is unknown whether geometric orifice area (GOA) measured by IVUS corresponds with effective orifice area (EOA) measure by transthoracic echocardiography (TTE) after successful TPVR.

Purpose

To compare minimal inner-leaflets cross-sectional area delineated in systole (min GOA) measured by IVUS versus EOA calculated = right ventricle stroke volume (measured in baseline cardiac magnetic resonance) / pulmonary valve velocity time integral (measured early post-procedure by Vivid e95).

Methods

After successful TPVR a 10MHz Vision PV 0.035" (60mm imaging field) IVUS catheter was slowly pulled from the distal pulmonary artery to the right ventricle with continuous imaging of RVOT. IVUS measurements included inner-valve dimension for several evenly spaced cross-sections along the entire length and perpendicular to RVOT long axis. Measured were outer-frame diameters (minimal and maximal) and its cross-sectional area, and cross-sectional area of the visual orifice (min GOA) identified exclusively at the coaptation site (Fig 1).

Results

There were 11 pts (median age 30 [25–36] yrs, 4 ♀, all but one with Tetralogy of Fallot) who had undergone prior corrective surgery (5 transannular patch, 2 bioprosthetic valve or 4 pulmonary homograft). Overall, 176 cross-sections were analyzed. Overall, min GOA measured 3.7±1.0cm2, and was 68%±9% of the valve-outer area (5.5±1.5cm2). It was substantially larger than calculated EOA (3.7±1.0cm2 vs 2.0±0.5cm2; p<0.001). The ratio of max/min GOA diameter was 1.11±0.11 signifying low eccentricity and was not related to EAO.

Conclusions

After successful balloon-expandable valve implantation to treat RVOT insufficiency, geometric orifice dimension was significantly smaller then outer valve frame dimension. Visual measure of geometric orifice area during the procedure using IVUS documented its circularity and indicated that it was larger than EOA calculated upon functional measure.

Funding Acknowledgement

Type of funding sources: Public hospital(s). Main funding source(s): This work was supported by the research grant (2.4/VI/18) founded by the National Institute of Cardiology in Warsaw (Poland). IVUS visualization of ES3.

Alteration of Metabolic Conditions Impacts the Regulation of IGF-II/H19 Imprinting Status in Prostate Cancer

Prostate cancer is the second major cause of male cancer deaths. Obesity, type 2 diabetes, and cancer risk are linked. Insulin-like growth factor II (IGF-II) is involved in numerous cellular events, including proliferation and survival. The IGF-II gene shares its locus with the lncRNA, H19. IGF-II/H19 was the first gene to be identified as being "imprinted"-where the paternal copy is not transcribed-a silencing phenomenon lost in many cancer types. We disrupted imprinting behaviour in vitro by altering metabolic conditions and quantified it using RFLP, qPCR and pyrosequencing; changes to peptide were measured using RIA. Prostate tissue samples were analysed using ddPCR, pyrosequencing and IHC. We compared with in silico data, provided by TGCA on the cBIO Portal. We observed disruption of imprinting behaviour, in vitro, with a significant increase in IGF-II and a reciprocal decrease in H19 mRNA; the increased mRNA was not translated into peptides. In vivo, most specimens retained imprinting status apart from a small subset which showed reduced imprinting. A positive correlation was seen between IGF-II and H19 mRNA expression, which concurred with findings of larger Cancer Genome Atlas (TGCA) cohorts. This positive correlation did not affect IGF-II peptide. Our findings show that type 2 diabetes and/or obesity, can directly affect regulation growth factors involved in carcinogenesis, indirectly suggesting a modification of lifestyle habits may reduce cancer risk.

Intravascular ultrasound assessment of the actual transcatheter heart valve dimensions among patients treated for a right ventricular outflow tract insufficiency after surgical reconstruction

Introduction

Transcatheter heart valve (THV) deployment can be used to treat right ventricular outflow tract (RVOT) insufficiency, but it is unknown whether manufacturers' predicted THV dimensions correspond with actualy measured.

Purpose

To compare valve frame nominal dimensions predicted by the manufacturers' charts (Melody or Edwards SAPIEN [ES] 3) versus actual dimensions assessed using intravascular ultrasound (IVUS) with Visions PV.035 Digital Catheter (Philips) offering an imaging field of 60mm.

Methods

IVUS recordings were made post-THV deployment in 6 pts (median age 33 [20–44] yrs, 3 ♀, all with Tetralogy of Fallot) who had undergone prior corrective surgery (4 transannular patch, 1 bioprosthetic valve or 1 pulmonary homograft), but who presented with significant RVOT insufficiency. IVUS-visualized homograft cross-sections were perpendicular to its long axis. Offline volumetric measurements included the inner-THV dimension for a total of 16 evenly spaced cross-sections along the THV length. Assessed were THV inner-frame diameters (minimal and maximal), cross-sectional areas, and cross-sectional area of the visual orifice area identified at the coaptation site (Fig. 1). Each THV (1 Melody [Ø 22mm, 28mm nominal length] and 5 ES3 [1Ø 23mm, 18mm height; 4 Ø 29mm, 22.5mm height]) was implanted after pre-stenting using stents of 36, 39, or 48mm length, deployed on a 24mm (n=1) or 30mm (n=4) balloon-in-balloon catheter.

Results

Overall, 96 paired cross-sections were analyzed. Actual THV inner area was 95%±20% of that predicted. However, minimum THV inner diameter was smaller, but maximal inner diameter exceeded those predicted (Table 1). The ratios of measured-to-predicted minimal and maximal THV inner diameters were 97%±11% and 112%±13%, respectively, with a measured max/min inner THV frame diameter ratio of 1.16±0.13. However, the ratio of max/min lumen diameter measured at the coaptation site was of 1.11±0.11 signifying low eccentricity. Visual orifice area measured 364.3±87.6 mm2, and was 65%±8% of the measured inner THV area.

Conclusions

After balloon-expandable THV implantation to treat RVOT insufficiency, there are differences in dimensions between actually measured vs predicated by manufacturers' charts. IVUS allows online tomographic insight into the actual THV frame dimensions and the substantially smaller, but circular orifice area.

Figure 1. IVUS visualization

Funding Acknowledgement

Type of funding source: None

Mechanism of transcatheter heart valve deployment for right ventricular outflow tract insufficiency after surgical reconstruction in childhood as assessed with intravascular ultrasound

Introduction

Transcatheter heart valve (THV) deployment can be used to treat right ventricular outflow tract (RVOT) insufficiency.

Purpose

To study deployment mechanism of a balloon expandable THV (Melody or Edwards SAPIEN [ES] 3) implanted for pulmonary homograft insufficiency using intravascular ultrasound (IVUS) with Visions PV.035 Digital Catheter (Philips) offering an imaging field of 60mm.

Methods

Sequential (baseline and post-THV) IVUS was performed in 6 pts (median age 33 [20–44] yrs, 3 ♀, all with Tetralogy of Fallot) who had undergone prior corrective surgery (4 transannular patch, 1 bioprosthetic valve or 1 pulmonary homograft), but who presented with significant RVOT insufficiency. IVUS-visualized homograft cross-sections were perpendicular to its long axis and were obtained along the entire homograft length (Fig. 1). Volumetric measurements included the native pulmonary homograft (inner lumen and outer dimension) and the corresponding inner-stent/inner-THV cross-sections post-THV for a total of 16 evenly spaced cross-sections per analyzed region. Each THV (1 Melody [Ø 22mm, 28mm nominal length] and 5 ES3 [Ø 23mm, 18mm height; 4 Ø 29mm, 22.5mm height]) was implanted after pre-stenting using stents of 36, 39, or 48mm length, deployed on a 24mm (n=1) or 30mm (n=4) balloon-in-balloon catheter.

Results

Overall, there were 96 paired cross-sections. There was significant increase in average lumen dimension after THV deployment (Δ of 97.5mm2) accompanied by the similar increase in outer pulmonary homograft dimensions (Δ of 84.0mm2) (Table 1). Whereas the maximal lumen diameter was unchanged, the minimal lumen diameter increased significantly resulting in substantial decrease in the ratio of max/min lumen diameter of 1.41±0.20 vs 1.16±0.13 (p<0.001) representing a reduction in lumen eccentricity.

Conclusions

During balloon-expandable THV implantation to treat RVOT insufficiency, there is a significant increase in baseline lumen dimensions accompanied by a substantial outer RVOT dimension increase to normalize lumen eccentricity.

Figure 1. IVUS intraprocedural visualisation

Funding Acknowledgement

Type of funding source: None

Obesity, Diabetes and COVID-19: An Infectious Disease Spreading From the East Collides With the Consequences of an Unhealthy Western Lifestyle

The pandemic of COVID-19, caused by the coronavirus, SARS-CoV-2, has had a global impact not seen for an infectious disease for over a century. This acute pandemic has spread from the East and has been overlaid onto a slow pandemic of metabolic diseases of obesity and diabetes consequent from the increasing adoption of a Western-lifestyle characterized by excess calorie consumption with limited physical activity. It has become clear that these conditions predispose individuals to a more severe COVID-19 with increased morbidity and mortality. There are many features of diabetes and obesity that may accentuate the clinical response to SARS-CoV-2 infection: including an impaired immune response, an atherothrombotic state, accumulation of advanced glycation end products and a chronic inflammatory state. These could prime an exaggerated cytokine response to viral infection, predisposing to the cytokine storm that triggers progression to septic shock, acute respiratory distress syndrome, and multi-organ failure. Infection leads to an inflammatory response and tissue damage resulting in increased metabolic activity and an associated increase in the mechanisms by which cells ingest and degrade tissue debris and foreign materials. It is becoming clear that viruses have acquired an ability to exploit these mechanisms to invade cells and facilitate their own life-cycle. In obesity and diabetes these mechanisms are chronically activated due to the deteriorating metabolic state and this may provide an increased opportunity for a more profound and sustained viral infection.

Vaccine misinformation - topic-based content analysis on Facebook

Background

Even though vaccinations are referred to as one of the greatest achievements of modern medicine, they are constantly associated with the mood present in part of society denying their sense and effectiveness. The development of technology has moved discussions about vaccinations to the space of the internet. The study aims to analyze the arguments of vaccine-deniers of children use in social media.

Methods

All public comments from the leading Facebook page of opponents of vaccination on Facebook were collected, which were available there between 01/05/2019 and 31/07/2019. Then the comments were stored on a Google spreadsheet and analyzed quantitatively in terms of the content according to the modified method developed by Kata (Kata, 2010).

Results

18685 comments were analyzed, of which 4042 contained content within the adopted criteria: 28.2% concerned conspiracy theories, 19.9% covered misinformation and based on unreliable premises, 14.0% related to the safety and effectiveness of vaccinations, 13.2% to non-compliance with civil rights, 10.9% own experience, 8.5% of morality, religion, and belief, and 5.4% of alternative medicine. There were also 1223 pro-vaccine comments, of which 15.2% were offensive, mocking or non-substantive.

Conclusions

A relatively large amount of content concentrated in terms of conspiracy theories and disinformation may indicate that this is a community characterized by a lack of trust in the scientific achievements of medicine. Surprisingly many comments related to one's own negative experiences with vaccinations, which contrasts with official statistics about side-effects. Vaccination promotion should refer to the arguments of vaccination opponents.

Key messages

The tendency of vaccine-hesitancy is strengthened by 'anti-vaccine' content in social media. To understand the individuals we need to understand what information he daily learns from the internet. It can be hard to maintain herd immunity, due to the prevailing misinformation on vaccination. To overcome this phenomenon, information campaigns must be dependent on the content in social media.

The role of insulin-like growth factors in the development of prostate cancer

INTRODUCTION

Preclinical, clinical, and population studies have provided robust evidence for an important role for the insulin-like growth factor (IGF) system in the development of prostate cancer.

AREAS COVERED

An overview of the IGF system is provided. The evidence implicating the IGF system in the development of prostate cancer is summarized. The compelling evidence culminated in a number of clinical trials of agents targeting the system; the reasons for the failure of these trials are discussed.

EXPERT OPINION

Clinical trials of agents targeting the IGF system in prostate cancer were terminated due to limited objective clinical responses and are unlikely to be resumed unless a convincing predictive biomarker is identified that would enable the selection of likely responders. The aging population and increased screening will lead to greater diagnosis of prostate cancer. Although the vast majority will be indolent disease, the epidemics of obesity and diabetes will increase the proportion that progress to clinical disease. The increased population of worried men will result in more trials aimed to reduce the risk of disease progression; actual clinical endpoints will be challenging and the IGFs remain the best intermediate biomarkers to indicate a response that could alter the course of disease.

IGF-1 and hyperglycaemia-induced FOXA1 and IGFBP-2 affect epithelial to mesenchymal transition in prostate epithelial cells

Localized prostate cancer (PCa) is a manageable disease but for most men with metastatic disease, it is often fatal. A western diet has been linked with PCa progression and hyperglycaemia has been associated with the risk of lethal and fatal prostate cancer. Using PCa cell lines, we examined the impact of IGF-I and glucose on markers of epithelial-to-mesenchymal transition (EMT), migration and invasion. We examined the underlying mechanisms using cell lines and tumour tissue samples. IGF-I had differential effects on the process of EMT: inhibiting in normal and promoting in cancer cells, whereas hyperglycamia alone had a stimulatory effect in both. These effects were independent of IGF and in both cases, hyperglycaemia induced an increase IGFBP-2(tumour promoter) and FOXA1. A positive correlation existed between levels of IGFBP-2 and FOXA1 in benign and cancerous prostate tissue samples and in vitro and in vivo data indicated that FOXA1 strongly interacted with the IGFBP-2 gene in normal prostate epithelial cells that was associated with a negative regulation of IGFBP-2, whereas in cancer cells the level of FOXA1 associating with the IGFBP-2 gene was minimal, suggesting loss of this negative regulation. IGF-I and hyperglycaemia-induced FOXA1/IGFBP-2 play important roles in EMT.

The Neglected Insulin: IGF-II, a Metabolic Regulator with Implications for Diabetes, Obesity, and Cancer

When originally discovered, one of the initial observations was that, when all of the insulin peptide was depleted from serum, the vast majority of the insulin activity remained and this was due to a single additional peptide, IGF-II. The IGF-II gene is adjacent to the insulin gene, which is a result of gene duplication, but has evolved to be considerably more complicated. It was one of the first genes recognised to be imprinted and expressed in a parent-of-origin specific manner. The gene codes for IGF-II mRNA, but, in addition, also codes for antisense RNA, long non-coding RNA, and several micro RNA. Recent evidence suggests that each of these have important independent roles in metabolic regulation. It has also become clear that an alternatively spliced form of the insulin receptor may be the principle IGF-II receptor. These recent discoveries have important implications for metabolic disorders and also for cancer, for which there is renewed acknowledgement of the importance of metabolic reprogramming.

Systemic Metabolism, Its Regulators, and Cancer: Past Mistakes and Future Potential

There has been a resurgence of interest in cancer metabolism; primarily in the resetting of metabolism within malignant cells. Metabolism within cells has always been a tightly regulated process; initially in protozoans due to metabolic enzymes, and the intracellular signaling pathways that regulate these, being directly sensitive to the availability of nutrients. With the evolution of metazoans many of these controls had been overlaid by extra-cellular regulators that ensured coordinated regulation of metabolism within the community of cells that comprised the organism. Central to these systemic regulators is the insulin/insulin-like growth factor (IGF) system that throughout evolution has integrated the control of tissue growth with metabolic status. Oncological interest in the main systemic metabolic regulators greatly subsided when pharmaceutical strategies designed to treat cancers failed in the clinic. During the same period, however the explosion of new information from genetics has revealed the complexity and heterogeneity of advanced cancers and helped explain the problems of managing cancer when it reaches such a stage. Evidence has also accumulated implying that the setting of the internal environment determines whether cancers progress to advanced disease and metabolic status is clearly an important component of this local ecology. We are in the midst of an epidemic of metabolic disorders and there is considerable research into strategies for controlling metabolism. Integrating these new streams of information suggests new possibilities for cancer prevention; both primary and secondary.

The improvement in neurocognitive functioning in anorexia nervosa adolescents throughout the integrative model of psychotherapy including cognitive remediation therapy

BACKGROUND

Patients with anorexia nervosa (AN) experience difficulties in neurocognitive functioning in the acute phase of illness which might be related to clinical presentation, but also in the apparently remitted state after weight recovery. Among the most commonly reported persistent deficits is cognitive inflexibility, which can be interpreted as a vulnerability trait or a "neuropsychological scar" reflecting the detrimental effect of prolonged semi-starvation in patients with a long duration of illness. Studies of adolescent samples with a relatively short clinical course may enable avoiding the effect of prolonged illness and help to determine whether neuropsychological deficits are trait or state dependent. The aim of this study is to assess cognitive functioning in adolescents with AN before and after the inpatient treatment programme, including cognitive remediation therapy (CRT).

METHODS

Forty-seven adolescent female inpatients with AN diagnosed according to DSM-5 and fifty healthy female adolescents matched for the education level and age were recruited. The patients underwent a multimodal treatment including a ten-week CRT. The standardized and cross-validated neuropsychological (Trail Making Test - TMT A and B, Color-Word Stroop Task - CWST, Ruff Figural Fluency Test - RFFT) and clinical measurements (Beck Depression Inventory - BDI, Eating Attitude Test - EAT-26, Yale-Brown Obsessive Compulsive Scale - Y-BOCS) were used to assess both clinical (in the acute phase and after partial weight recovery) and control subjects.

RESULTS

Initially, AN patients performed significantly worse compared to the controls, but afterwards, inpatient treatment improvement was noted on all examined measures. In a few subtests (TMT, CWST) performance of AN patients after the programme was still significantly poorer than in HC.

CONCLUSIONS

Cognitive inflexibility in adolescent AN patients, as measured with TMT, CWST, and RFFT tends to improve after therapy. Nevertheless, a few neuropsychological subtests which did not show complete normalization may warrant attention in subsequent studies. Further research including control intervention is needed to conclude whether CRT intervention affects the outcome.

Gonadotropin-releasing hormone and kisseptin-10 regulate nuclear receptor subfamily 5 group a member 1/catenin beta 1/ nuclear receptor subfamily 0 group B member 1 activity in female rat anterior pituitary gland

In this study, we tested the hypothesis that modulation of endogenous gonadotropin-releasing hormone (Gnrh) neuronal network activity alters the mRNA expression of nuclear receptor subfamily 5 group A member 1 (Nr5a1), through one of the component of Wnt pathway signaling - catenin beta 1 (Ctnnb1) (its co-activator), and its co-repressor nuclear receptor subfamily 0, group B member 1 (Nr0b1) in the female rat pituitary gland in vivo. Adult ovariectomized rats were given a serial infusion of Gnrh, kisspeptin-10, Gnrh + Gnrh antagonist (Antide), or kisspeptin-10 + kisspeptin antagonist (kisspeptin-234) into the third ventricle of the brain. The anterior pituitary and blood was used to mRNA and protein expression analysis. We demonstrated that Gnrh up-regulates Nr5a1 mRNA expression in the anterior pituitary and induces NR5A1 depletion in gonadotropes. Gnrh administration increased both Ctnnb1 mRNA expression and protein synthesis, and induced activation of cellular Ctnnb1 via translocation from the gonadotropes cytoplasm to nucleus. After kisspeptin-10 treatment, up-regulation of Nr0b1 mRNA and protein expression in the anterior pituitary was observed. These data indicate that Gnrh-neuron-mediated network activity alters Nr5a1 gene transcription and translation in gonadotrope cells and this effect may result from the changes induced in the Ctnnb1 and Nr0b1 gene/protein expression balance.

Post-diagnosis serum insulin-like growth factors in relation to dietary and lifestyle changes in the Prostate testing for cancer and Treatment (ProtecT) trial

PURPOSE

The insulin-like growth factor (IGF) system is modifiable by diet and lifestyle, and has been linked to prostate cancer development and progression.

METHODS

We conducted a prospective cohort study of 621 men diagnosed with localized prostate cancer to investigate the associations of dietary and lifestyle changes with post-diagnosis circulating levels of IGF-I and IGFBP-3. We used analysis of covariance to estimate the associations, controlling for baseline IGF-I or IGFBP-3, respectively.

RESULTS

Mean IGF-I levels were 6.5% (95% CI -12.8, -0.3%, p = 0.04) lower in men who decreased their protein intake after diagnosis compared to men who did not change. Men who changed their fruit and vegetable intake had lower IGF-I levels compared to non-changers [Decreased intake: -10.1%, 95% CI -18.4, -1.8%, p = 0.02; Increased intake: -12.0%, 95% CI -18.4, -1.8%, p = 0.002]. IGFBP-3 was 14.6% (95% CI -24.5, -4.8%, p = 0.004) lower in men who achieved a healthy body mass index after diagnosis. Men who became inactive had 9.5% higher average IGF-I levels (95% CI 0.1, 18.9%, p = 0.05).

CONCLUSIONS

Decreased protein intake and body mass index, and increased physical activity and fruit and vegetable intake, following a prostate cancer diagnosis were associated with reduced post-diagnosis serum IGF-I and IGFBP-3. Counterintuitively, reduced fruit and vegetable intake was also associated with reduced IGF-I, but with weak statistical support, possibly implicating chance. If confirmed in other studies, our findings may inform potential lifestyle interventions in prostate cancer. ProtecT was registered at International Standard Randomised Controlled Trial Registry, http://isrctn.org as ISRCTN20141297.

Circulation of Porcine Parvovirus Types 1 through 6 in Serum Samples Obtained from Six Commercial Polish Pig Farms

Porcine parvoviruses are small non-enveloped DNA viruses, very resistant to inactivation, and ubiquitous in the global pig population. Porcine parvovirus type 1 (PPV1) has been known since the 1960s and is a major causative agent of reproductive failure in breeding herds. During the last decade, several new parvoviruses have been identified in pigs by molecular methods and have been consecutively designated as PPV2 through PPV6. Epidemiology data for these viruses are limited, and the impact of these newly recognized parvoviruses on pigs is largely unknown. To further generate knowledge on the distribution of PPVs in pigs, a total of 247 serum samples were collected from six commercial Polish pig farms during 2013-2015 and tested by PCR assays and ELISAs. The pigs ranged from two to 18 weeks of age at sample collection. Breeding herds supplying the investigated farms were routinely vaccinated against PPV1. While all growing pig samples were negative for PPV1 DNA, young pigs were frequently negative for PPV1 antibodies and seroconversion to PPV1 was commonly seen at 9-10 weeks of age. The PPV2 antibody detection was highest in young pigs (2-6-week-old) and decreased in older pigs indicating passively acquired antibodies. The DNA prevalence rates in the serum samples analysed were 19% for PPV2, 7.7% for PPV3, 2.4% for PPV4, 4.0% for PPV5 and 6.1% for PPV6. Most PPV DNA-positive samples were identified in 9- to 18-week-old pigs with no obvious association with disease on the farm. All recently emerging PPV genotypes were detected in Polish farms. Similar to previous reports in other pig populations, PPV2 was the most frequent PPV genotype circulating in Poland.

Outbreak of extended spectrum beta-lactamase producing E. coli in a nursing home in Ireland, May 2006

In May 2006, a consultant microbiologist noted two isolates of extended spectrum beta-lactamase (ESBL)-producing Escherichia coli associated with urinary tract infections in a single week in two residents in a nursing home in Ireland

Microbial conversion of methyl- and methoxy- substituted derivatives of 5H-indolo[2,3-b]quinoline as a method of developing novel cytotoxic agents

In furtherance of our structure-activity relationship studies on the antitumor activity of indolo[2,3-b]quinolines, novel cytotoxic derivatives bearing methyl groups at N-5, C-11, C-2 and/or C-9, as well as methoxy-groups at C-2 and/or C-9, were synthesized by the modified Graebe-Ullmann reaction. To elucidate the metabolic pathways of these compounds, zygomycete fungus Cunninghamella elegans ATCC 9245 (which is known to produce drug metabolites that are also formed in mammals) was used as a mimetic organism. Simultaneously, biotransformation of the same substrates was carried out with a microsomal fraction of rat liver. Three forms of microbial conversion were observed: hydroxylation of the aromatic ring or hydroxylation of the methyl group, and O-demethylation. The reaction proceeded regioselectively, and only positions C-2 and C-9 were affected in the indolo[2,3-b]quinoline system. The products formed were found to be identical with the metabolites generated by rat liver microsomes. The metabolites obtained displayed a cytotoxic activity in vitro against colon adenocarcinoma SW-707 and lung carcinoma A-549 (ID50 in the range 0.27-3.04 microM), which was as strong as that of the substrates. In the course of the further metabolic pathway study of indolo[2,3-b]quinolines we found that metabolites with a hydroxyl group in the aromatic system were transformed to non-cytotoxic polymeric products by multicopper oxidases: human ceruloplasmin or fungal laccase (used as mimetic enzyme), whereas metabolites with a hydroxymethyl group did not undergo such bioconversion. The last mentioned compounds can be regarded as a novel type of cytotoxic indolo[2,3-b]quinoline derivatives formed in metabolic processes.