Abstract 1295: SJP1901, a small molecule inhibitor targeting hippo pathway by directly inhibiting TEAD palmitoylation in hippo pathway-dependent cancer

The hippo pathway is a critical transcriptional regulator of cell growth, proliferation, and migration in cancer, furthermore,YAP-TEAD complexes act as a major role in the pathway. S-palmitoylation of cysteine residues in TEAD proteins is required for their stability and function in hippo pathway signaling. Recently, it has become manifested that the dysregulation of hippo pathway effectors (MST1/2 and LATS1/2) is involved in oncogenesis. These effectors inactivate translocation of YAP and TAZ into the nucleus. The translocation of YAP/TAZ is responsible for acting as transcriptional coactivators by binding to the transcription factor, TEADs resulting in the transcription of cancer-related genes that drive tumor growth. Since YAP/TAZ are considered to be natively unfolded and can be difficult to handle as a drug target, TEAD is regarded as an excellent therapeutic target for intervention of the hippo pathway. SJP1901 is a small molecule of TEAD inhibitor with potential as drug candidates in malignant mesothelioma and other types of cancer. Based on the results of structure-based drug design, hit compounds were synthesized and their efficacy was evaluated.The compounds effectively inhibited palmitoylation of TEAD proteins and showed remarkable efficacy in reporter gene assay using TEAD responsive element (TRE)-integrated MCF7 with nano molar IC50 concentrations. The excellent anti-tumor effect of SJP1901 was revealed via cell proliferation inhibition assay (nano molar IC50 concentrations) andanalysis of inhibited transcription activity for target genes (CTGF and CYR61) usingmalignant mesothelia cell lines (NCI-H226, NCI-H2052 and MSTO-211H) known to display hippo pathway-dependent cell growth. In addition, these compounds showed lower toxicities in normal cells such as Fa2N4, CCD-18co and WI38 (IC50>10 μM). In conclusion, we obtained potent small molecules which inactivate TEAD proteins by directly inhibiting their palmitoylation. SJP1901 showed outstanding anti-cancer effects through regulating hippo pathway-mediated target genes and lower toxicitiy in normal cells. In vivo efficacy study and research to expand the indications are currently ongoing.

Citation Format: Jihyun Um, Janghyun Lee, Kwangwoo Hwang, Sujin Park, Jooyoung Hyun, Dohyeong Lee, Jeongmin Lee, Li-Kyung Kim, Moon Jung Back, Seong Jun Park, Hwan Jung Lim, You-Keun Shin, Hei-Cheul Jeung, Jaewoong Lee, Hyun Tae Kim, Yongbin Park, Hoseok Kwon, Min-Hyo Ki. SJP1901, a small molecule inhibitor targeting hippo pathway by directly inhibiting TEAD palmitoylation in hippo pathway-dependent cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1295.

NFAT-Specific Inhibition by dNP2-VIVITAmeliorates Autoimmune Encephalomyelitisby Regulation of Th1 and Th17

Nuclear factor of activated T cells (NFATs) is an important transcription factor for T cell activation and proliferation. Recent studies have highlighted the role of NFATs in regulating the differentiation of effector CD4 T helper (Th) subsets including Th1 and Th17 cells. Because controlling the effector T cell function is important for the treatment of autoimmune diseases, regulation of NFAT functions in T cells would be an important strategy to control the pathogenesis of autoimmune diseases. Here, we demonstrated that an NFAT inhibitory peptide, VIVIT conjugated to dNP2 (dNP2-VIVIT), a blood-brain barrier-permeable peptide, ameliorated experimental autoimmune encephalomyelitis (EAE) by inhibiting Th1 and Th17 cells, but not regulatory T (T_reg) cells. dNP2-VIVIT negatively regulated spinal cord-infiltrating interleukin-17A (IL-17A) and interferon (IFN)-γ-producing CD4⁺ T cells without affecting the number of Foxp3⁺ CD4⁺ T_reg cells, whereas dNP2-VEET or 11R-VIVIT could not significantly inhibit EAE. In comparison with cyclosporin A (CsA), dNP2-VIVIT selectively inhibited Th1 and Th17 differentiation, whereas CsA inhibited the differentiation of all T cell subsets including that of Th2 and T_reg cells. Collectively, this study demonstrated the role of dNP2-VIVIT as a novel agent for the treatment of autoimmune diseases such as multiple sclerosis by regulating the functions of Th1 and Th17 cells.

Revisiting the Concept of Targeting NFAT to Control T Cell Immunity and Autoimmune Diseases

The nuclear factor of activated T cells (NFAT) family of transcription factors, which includes NFAT1, NFAT2, and NFAT4, are well-known to play important roles in T cell activation. Most of NFAT proteins are controlled by calcium influx upon T cell receptor and costimulatory signaling results increase of IL-2 and IL-2 receptor. NFAT3 however is not shown to be expressed in T cells and NFAT5 has not much highlighted in T cell functions yet. Recent studies demonstrate that the NFAT family proteins involve in function of lineage-specific transcription factors during differentiation of T helper 1 (Th1), Th2, Th17, regulatory T (Treg), and follicular helper T cells (Tfh). They have been studied to make physical interaction with the other transcription factors like GATA3 or Foxp3 and they also regulate Th cell signature gene expressions by direct binding on promotor region of target genes. From last decades, NFAT functions in T cells have been targeted to develop immune modulatory drugs for controlling T cell immunity in autoimmune diseases like cyclosporine A, FK506, etc. Due to their undesirable side defects, only limited application is available in human diseases. This review focuses on the recent advances in development of NFAT targeting drug as well as our understanding of each NFAT family protein in T cell biology. We also discuss updated detail molecular mechanism of NFAT functions in T cells, which would lead us to suggest an idea for developing specific NFAT inhibitors as a therapeutic drug for autoimmune diseases.

In-hospital infective endocarditis following transcatheter aortic valve replacement: a cross-sectional study of the National Inpatient Sample database in the USA

BACKGROUND

While the utilization of transcatheter aortic valve replacement (TAVR) for patients with severe aortic stenosis has been increasing, in-hospital infective endocarditis (IE) following TAVR has not been well described.

AIM

To identify in-hospital IE following TAVR.

METHODS

All patients who underwent TAVR between 2012 and 2014 were identified using the National Inpatient Sample database. Multi-variate logistic regression was performed to identify the predictors of in-hospital IE after TAVR.

FINDINGS

Of the 41,025 patients who received TAVR, 120 patients (0.3%) developed in-hospital IE. Viridans group streptococci (20.8%) was the most frequent causative organism for in-hospital IE, followed by Staphylococcus aureus (16.7%) and enterococci (8.3%). Patients who developed in-hospital IE after TAVR had significantly higher rates of death (20.8% vs 4.1%, P<0.001), septic shock (16.7% vs 0.8%, P<0.001), cardiogenic shock (12.5% vs 3.4%, P=0.02), acute kidney injury requiring haemodialysis (16.7% vs 1.6%, P<0.001), bleeding requiring transfusion (29.2% vs 11.3%, P=0.01), myocardial infarction (12.5% vs 2.1%, P<0.001) and permanent pacemaker removal (4.2% vs 0.05%, P<0.001) compared with patients without IE. Independent predictors of in-hospital IE after TAVR include younger age [odds ratio (OR) 0.92, 95% confidence interval (CI) 0.89-0.95], drug abuse (OR 48.9, 95% CI 6.9-347.3) and human immunodeficiency virus (HIV) infection (OR 7.8, 95% CI 1.4-44.4).

CONCLUSION

IE occurred in 0.3% of patients after TAVR during the same hospitalization, resulting in higher rates of adverse outcomes including mortality. Patients with younger age, a history of drug abuse or HIV infection are at greater risk of in-hospital IE following TAVR, and would benefit from vigilant preventive measures perioperatively.

Innovations in drug-eluting stents

Coronary artery disease affects patients worldwide and is a major cause of morbidity and mortality. Historically, the treatment approach for patients with coronary syndromes has been surgical. In the 1970s, percutaneous balloon angioplasty was introduced, leading to creation of a new field of interventional cardiology, which allowed a non-surgical minimally invasive approach to treat patients with coronary artery disease. However, the major limitations of balloon angioplasty were acute vessel closure and later restenosis. The introduction of bare metal stents and then drug-eluting stents (DES) revolutionized the practice of interventional cardiology and allowed for safe treatment of increasingly complex coronary artery lesions. Although drug-eluting coronary stents improve patient outcomes, they still have limitations. These limitations may arise from delayed endothelialization, local vessel hypersensitivity and endothelial dysfunction secondary to the drug elution, the durable polymer coating, or the stent scaffold. This comprehensive review will discuss the evolution of intracoronary stents from their introduction to current utilization of DES as well as future research on bioabsorbable stents and polymers.

Reperfusion therapy in ST-elevation myocardial infarction: guidelines, strategies, pharmacology, and stent selection

Treatment of acute ST-elevation myocardial infarction (STEMI) has rapidly evolved with many advances made in the past decade. Percutaneous coronary intervention is the preferred strategy when available, although there remains a role for thrombolytic therapy, with prompt reperfusion as the primary goal. With regards to antithrombotic therapy, bivalirudin now has a significant role in STEMI care with improved outcomes over unfractionated heparin plus GP IIb/IIIa inhibitors. Dual antiplatelet therapy has become a mainstay of treatment with combination of aspirin and clopidogrel, as well as an expanding role of more potent novel agents, prasugrel and ticagrelor. In primary PCI in STEMI, coronary stents are now being used routinely, although short-term and long-term outcomes of drug-eluting stents (DES) versus bare metal stents (BMS) continue to be studied. Recent meta-analyses have examined the trade-off of lower rates of in-stent restenosis and need for target vessel revascularization with DES versus the potential increase in the risk of stent thrombosis and need for longer course of dual antiplatelet therapy. This review will discuss the current STEMI guidelines and strategies, recent advances in pharmacotherapy, and data on stent selection.

Methylation of the ribosyl moiety at position 34 of selenocysteine tRNA[Ser]Sec is governed by both primary and tertiary structure

The selenocysteine (Sec) tRNA[Ser]Sec population in higher vertebrates consists of two major isoacceptors that differ from each other by a single nucleoside modification in the wobble position of the anticodon (position 34). One isoacceptor contains 5-methylcarboxymethyluridine (mcmU) in this position, whereas the other contains 5-methylcarboxymethyluridine-2'-O-methylribose (mcmUm). The other modifications in these tRNAs are N6-isopentenyladenosine (i6A), pseudouridine (psi), and 1-methyladenosine (m1A) at positions 37, 55, and 58, respectively. As methylation of the ribose at position 34 is influenced by the intracellular selenium status and the presence of this methyl group dramatically alters tertiary structure, we investigated the effect of the modifications at other positions as well as tertiary structure on its formation. Mutations were introduced within a synthetic gene encoded in an expression vector, transcripts generated and microinjected into Xenopus oocytes, and the resulting tRNA products analyzed for the presence of modified bases. The results suggest that efficient methylation of mcmU to yield mcmUm requires the prior formation of each modified base and an intact tertiary structure, whereas formation of modified bases at other positions, including mcmU, is not as stringently connected to precise primary and tertiary structure. These results, along with the observations that methylation of mcmU is enhanced in the presence of selenium and that this methyl group affects tertiary structure, further suggest that the mcmUm isoacceptor must have a role in selenoprotein synthesis different from that of the mcmU isoacceptor.

Analysis of selenocysteine (Sec) tRNA([Ser]Sec) genes in Chinese hamsters

Several recent observations have indicated that the primary structure of the Chinese hamster selenocysteine tRNA([Ser]sec) is different than those of other mammalian species. These reports prompted us to investigate the gene sequence for this tRNA in Chinese hamsters. Southern blotting of Chinese hamster ovary (CHO) genomic DNA derived from cultured cells with a tRNA([Ser]sec) probe indicated several hybridizing bands, and each of the corresponding genetic loci was isolated from a recombinant CHO library by molecular cloning. Sequence analysis of these regions indicated three likely pseudogenes and a single functional gene whose sequence differed from those of other mammals. Of these, only one pseudogene and the putative functional gene are actively transcribed following their microinjection into Xenopus oocytes. The possibility that the functional CHO tRNA([Ser]sec) evolved from an edited transcript is discussed.

The zebrafish genome contains two distinct selenocysteine tRNA[Ser]sec genes

The zebrafish is widely used as a model system for studying mammalian developmental genetics and more recently, as a model system for carcinogenesis. Since there is mounting evidence that selenium can prevent cancer in mammals, including humans, we characterized the selenocysteine tRNA[Ser]sec gene and its product in zebrafish. Two genes for this tRNA were isolated and sequenced and were found to map at different loci within the zebrafish genome. The encoding sequences of both are identical and their flanking sequences are highly homologous for several hundred bases in both directions. The two genes likely arose from gene duplication which is a common phenomenon among many genes in this species. In addition, zebrafish tRNA[Ser]sec was isolated from the total tRNA population and shown to decode UGA in a ribosomal binding assay.