Induced pluripotent stem cells modulate the Wnt pathway in the bleomycin-induced model of idiopathic pulmonary fibrosis

BACKGROUND

The Wnt signaling pathway has been implicated in the pathogenesis of fibrotic disorders and malignancies. Hence, we aimed to assess the potential of the induced pluripotent stem cells (IPS) in modulating the expression of the cardinal genes of the Wnt pathway in a mouse model of idiopathic pulmonary fibrosis (IPF).

METHODS

C57Bl/6 mice were randomly divided into three groups of Control, Bleomycin (BLM), and BLM + IPS; the BLM mice received intratracheal instillation of bleomycin, BLM + IPS mice received tail vein injection of IPS cells 48 h post instillation of the BLM; The Control group received Phosphate-buffered saline instead. After 3 weeks, the mice were sacrificed and Histologic assessments including hydroxy proline assay, Hematoxylin and Eosin, and Masson-trichrome staining were performed. The expression of the genes for Wnt, β-Catenin, Lef, Dkk1, and Bmp4 was assessed utilizing specific primers and SYBR green master mix.

RESULTS

Histologic assessments revealed that the fibrotic lesions and inflammation were significantly alleviated in the BLM + IPS group. Besides, the gene expression analyses demonstrated the upregulation of Wnt, β-Catenin, and LEF along with the significant downregulation of the Bmp4 and DKK1 in response to bleomycin treatment; subsequently, it was found that the treatment of the IPF mice with IPS cells results in the downregulation of the Wnt, β-Catenin, and Lef, as well as upregulation of the Dkk1, but not the Bmp4 gene (P values < 0.05).

CONCLUSION

The current study highlights the therapeutic potential of the IPS cells on the IPF mouse model in terms of regulating the aberrant expression of the factors contributing to the Wnt signaling pathway.

Insights into Overlappings of Fibrosis and Cancer: Exploring the Tumor-related Cardinal Genes in Idiopathic Pulmonary Fibrosis

The pathogenesis of idiopathic pulmonary fibrosis (IPF) is quite similar to that of cancer pathogenesis, and several pathways appear to be involved in both disorders. The mammalian target of the rapamycin (mTOR) pathway harbors several established oncogenes and tumor suppressors. The same signaling molecules and growth factors, such as vascular endothelial growth factor (VEGF), contributing to cancer development and progression play a part in fibroblast proliferation, myofibroblast differentiation, and the production of extracellular matrix in IPF development as well. The expression of candidate genes acting upstream and downstream of mTORC1, as well as Vegf and low-density lipoprotein receptor related protein 1(Lrp1), was assessed using specific primers and quantitative polymerase chain reaction (qPCR) within the lung tissues of bleomycin (BLM)-induced IPF mouse models. Lung fibrosis was evaluated by histological examinations and hydroxyproline colorimetric assay. BLM-exposed mice developed lung injuries characterized by inflammatory manifestations and fibrotic features, along with higher levels of collagen and hydroxyproline. Gene expression analyses indicated a significant elevation of regulatory associated protein of mTOR (Raptor), Ras homolog enriched in brain (Rheb), S6 kinase 1, and Eukaryotic translation initiation factor 4E-binding protein 1 (4Ebp1), as well as a significant reduction of Vegfa, Tuberous sclerosis complex (Tsc2), and Lrp1; no changes were observed in the Tsc1 mRNA level. Our findings support the elevation of S6K1 and 4EBP1 in response to the TSC/RHEB/mTORC1 axis, which profoundly encourages the development and establishment of IPF and cancer. In addition, this study suggests a possible preventive role for VEGF-A and LRP1 in the development of IPF.

Plumbagin attenuates Bleomycin-induced lung fibrosis in mice

Background

Idiopathic pulmonary fibrosis (IPF) is a fatal fibrotic lung disease with limited treatment options. Plumbagin (PL) is an herbal extract with diverse pharmacological effects that have been recently used to treat various types of cancer. This study aims to explore the anti-fibrotic effect of PL and possible underlying mechanisms in IPF.

Methods

We used a bleomycin-induced experimental mouse model of lung fibrosis to assess the potential anti-fibrotic effect of PL. Histological analysis of lung tissue samples by H&E and Masson’s trichrome staining and hydroxyproline assay was performed to evaluate the fibrotic alterations. ELISA and real-time quantitative PCR were conducted to determine the amount of tumor necrosis factor-alpha (TNFα), tumor growth factor-beta (TGF-β), connective tissue growth factor (CTGF), and endothelin-1 (ET-1).

Results

Bleomycin exposure induced lung fibrosis, which was indicated by inflammation, collagen deposition, and structural damage. PL remarkably prevented bleomycin-induced lung fibrosis. Furthermore, PL significantly inhibited TNF-α and TGF-β production. PL also diminished the upregulated expression of CTGF and ET-1 induced by bleomycin.

Conclusion

Overall, our findings suggest PL as an anti-fibrotic agent acting via down-regulation of TGF-β/CTGF or ET-1 axis, as well as TNF-α, to improve lung fibrosis.

Induced Pluripotent Stem-cells Inhibit Experimental Bleomycin-induced Pulmonary Fibrosis through Regulation of the Insulin-like Growth Factor Signaling

Idiopathic pulmonary fibrosis (IPF) is among the illnesses with a high mortality rate, yet no specific cause has been identified; as a result, successful treatment has not been achieved. Among the novel approaches for treating such hard-to-cure diseases are induced pluripotent stem cells (IPSCs). Some studies have shown these cells' potential in treating IPF. Therefore, we aimed to investigate the impact of IPSCs on insulin-like growth factor (Igf) signaling as a major contributor to IPF pathogenesis.  C57BL/6 mice were intratracheally instilled with Bleomycin (BLM) or phosphate-buffered saline; the next day, half of the bleomycin group received IPSCs through tail vein injection. Hydroxyproline assay and histologic examinations have been performed to assess lung fibrosis. The gene expression was evaluated using specific primers for Igf-1, Igf-2, and insulin receptor substrate 1 (Irs-1) genes and SYBR green qPCR master mix. The data have been analyzed using the 2-ΔΔCT method. The mice that received Bleomycin showed histological characteristics of the fibrotic lung injury, which was significantly ameliorated after treatment with IPSCs comparable to the control group. Furthermore, gene expression analyses revealed that in the BLM group, Igf1, Igf2, and Irs1 genes were significantly upregulated, which were returned to near-normal levels after treatment with IPSCs. IPSCs could modulate the bleomycin-induced upregulation of Igf1, Igf2, and Irs1 genes. This finding reveals a new aspect of the therapeutic impact of the IPSCs on IPF, which could be translated into other fibrotic disorders.

Circulating CTRP5 in rheumatoid arthritis: an exploratory biomarker study

Background

Rheumatoid arthritis (RA) is an inflammatory disease that is characterized by the overproduction of cytokines. Among the newly discovered cytokines are the adipokines which are primarily produced by and released from the adipose tissue and some immune cells, as well as synovial cells. they are involved in various immune responses and inflammatory processes. However, there are controversial data regarding the pro-inflammatory or anti-inflammatory effects of adipokines in different conditions. C1q/TNF-related protein 5 (CTRP5) is a newly identified adipokine and adiponectin paralogous protein, which has been shown to be correlated with inflammatory diseases. Accordingly, the present study was designed to investigate the serum levels of CTRP5 in RA patients and evaluate any possible alterations in comparison to healthy individuals.

Methods

Serum CTRP-5 levels were measured in 46 patients and 22 healthy controls by ELISA. The demographic, laboratory, and clinical features of the patients were also evaluated in order to find any correlations.

Results

Serum levels of CTRP-5 were significantly (p < 0.0001) higher in patients with RA (14.88 ± 25.55) compared to healthy controls (4.262 ± 2.374). There was a significant correlation between serum CTRP-5 levels and triglyceride (TG) (r: − 0.3010, p: 0.0498), as well as erythrocyte sedimentation rate (ESR) (r: 0.3139, p: 0.0457), C-reactive protein (CRP) (r: 0.5140, p: 0.0008), and the number of white blood cells (WBC) (r: 0.3380, p: 0.0307), which are considered as the markers indicating the extent of inflammation. Moreover, CTRP-5 was found to be correlated with interstitial lung disease (ILD) (r: 0.3416, p: 0.0385), a comorbidity associated with RA disease.

Conclusion

This study demonstrated the increased level of circulating CTRP-5 in RA patients, which correlated with some inflammation-associated parameters and RA-associated comorbidities. Our observations suggest CTRP-5 as a putative inflammatory biomarker in RA, which may be useful besides the other disease-related markers.

Myoepithelial Carcinoma ex Pleomorphic Adenoma: Rare Case Report with Clinicopathologic and Immunohistochemical Features

Introduction/Objective

Myoepithelial carcinoma is identified by nearly exclusive myoepithelial differentiation and evidence of malignancy. It may arise de novo or in preexisting benign tumors including pleomorphic adenoma and benign myoepithelioma. It occurs most commonly in the parotid gland followed by submandibular glands, minor salivary glands, and occasionally in the sublingual gland. Nasopharyngeal origin has been rarely reported.

Methods/Case Report

An afebrile 19-year-old female presented to the emergency department with persistent facial pressure, otalgia (right side greater than left side), rhinorrhea, and several episodes of epistaxis. One month before, she has been treated with Amoxicillin for three days with no relief, where Augmentin started for her for five days. About four days prior presentation, she was placed on Prednisone and Cefdinir. Over the next several days, she began having throat pain with difficulty swallowing. Routine blood work revealed a leukocytosis of 14.2 with normal differentiation. CT of the neck showed a large soft tissue mass centered at the right nasopharynx. Flexible nasal endoscopy performed bilaterally to reveal the nasopharynx is entirely obstructed with a lobulated mass filling the nasopharynx. On the right side, it extends into the posterior nasal passage filling the sphenoethmoid recess and the posterior floor of the nasal passage. Outpatient biopsy from nasopharynx mass is also performed.

Results (if a Case Study enter NA)

Mass biopsy reveals a mucinous and chondromyxoid background with mixed epithelial and myoepithelial differentiation. The is squamous metaplasia of myoepithelial cells and prominent mitotic activity and apoptotic activity. Immunohistochemistry was positive for CK5/6, calponin, BCL2, SMA, BerEp4, Sox10, and a proliferative index up to 40%. Based on this information Myoepithelial Carcinoma ex-pleomorphic adenoma of the nasopharynx is the diagnosis.

Conclusion

Carcinoma ex pleomorphic adenoma is usually a high-grade malignancy. It occurs most commonly in the parotid gland, followed by submandibular glands, minor salivary glands, and occasionally in the sublingual gland. Our case is one of the few cases of myoepithelial carcinoma arising in nasopharyngeal pleomorphic adenoma.

The role of hypoxia in the tumor microenvironment and development of cancer stem cell: a novel approach to developing treatment

Hypoxia is a common feature of solid tumors, and develops because of the rapid growth of the tumor that outstrips the oxygen supply, and impaired blood flow due to the formation of abnormal blood vessels supplying the tumor. It has been reported that tumor hypoxia can: activate angiogenesis, thereby enhancing invasiveness and risk of metastasis; increase survival of tumor, as well as suppress anti-tumor immunity and hamper the therapeutic response. Hypoxia mediates these effects by several potential mechanisms: altering gene expression, the activation of oncogenes, inactivation of suppressor genes, reducing genomic stability and clonal selection. We have reviewed the effects of hypoxia on tumor biology and the possible strategiesto manage the hypoxic tumor microenvironment (TME), highlighting the potential use of cancer stem cells in tumor treatment.

Gastric Carcinoma with Lymphoid Stroma: A Rare Case Report with EBV Negativity

Introduction/Objective

Gastric carcinoma with lymphoid stroma (GCLS) is a distinct and rare histologic subtype of gastric adenocarcinoma that is characterized by undifferentiated carcinoma mixed with prominent lymphoid cell infiltration. Around 80% of GCLS cases are associated with Epstein-Barr virus (EBV) infection. Here we report a case of EBV-negative GCLS.

Methods

The patient was a 79-year-old female with a recent history of abdominal distention, weight loss, and gastrointestinal bleeding who presented for evaluation. Endoscopy found a 4.6 mm lobulated lesion at the incisura of the stomach with endosonographic evidence of invasion through the submucosa. Biopsy was consistent with intramucosal diffuse neoplasm, favoring adenocarcinoma. The decision was made to do subtotal gastrectomy.

Results

The patient underwent distal gastrectomy with Billroth 2 reconstruction. Gross examination of the stomach revealed a firm 1.4 cm nodule in the background of diffuse mucosal granularity in the adjacent stomach.

Microscopically, the tumor invaded the submucosa without lymph nodes involvement.

Staining showed the tumor diffusely positive for CAM5.2, focally and weakly positive for pancytokeratin and CK7, while negative for CK20. Mismatch repair (MMR) proteins staining demonstrated a loss of nuclear expression of MLH1 and PMS2. Her2/Neu FISH was non-amplified. The tumor was found to be EBV negative by EBER ISH while PD-L1 was expressed. The histopathological findings confirmed the final diagnosis of gastric carcinoma with lymphoid stroma (GCLS).

Conclusion

We report a case of GCLS that was EBV negative with non-amplified HER2, while MMR-deficient, and PD-L1 positive. These results suggest that this tumor subtype may be less responsive to targeted therapy, but show susceptibility to immune checkpoint inhibitors.

Differential Response of Neural Cells to Trauma-Induced Swelling In Vitro

Brain edema and the associated increase in intracranial pressure are major consequences of traumatic brain injury (TBI) that accounts for most early deaths after TBI. We recently showed that acute severe trauma to cultured astrocytes results in cell swelling. We further examined whether trauma induces cell swelling in neurons and microglia. We found that severe trauma also caused cell swelling in cultured neurons, whereas no swelling was observed in microglia. While severe trauma caused cell swelling in both astrocytes and neurons, mild trauma to astrocytes, neurons, and microglia failed to cell swelling. Since extracellular levels of glutamate are increased in brain post-TBI and microglia are known to release cytokine, and direct exposure of astrocytes to these molecules are known to stimulate cell swelling, we examined whether glutamate or cytokines have any additive effect on trauma-induced cell swelling. Exposure of cultured astrocytes to trauma caused cell swelling, and such swelling was potentiated by the exposure of traumatized astrocytes to glutamate and cytokines. Conditioned medium (CM) from traumatized astrocytes had no effect on neuronal swelling post-trauma, while CM from traumatized neurons and microglia potentiated the effect of trauma on astrocyte swelling. Further, trauma significantly increased the Na-K-Cl co-transporter (NKCC) activity in neurons, and that inhibition of NKCC activity diminished the trauma-induced neuronal swelling. Our results indicate that a differential sensitivity to trauma-induced cell swelling exists in neural cells and that neurons and microglia are likely to be involved in the potentiation of the astrocyte swelling post-trauma.

The role of interleukin-23 in stability of in vitro T helper-17 cells

Interleukin (IL)-17-producing T helper (Th)-17 cells have recently been explained as a distinct population of CD4+ T cells which play an important role in immunity against infectious agents. Establishment of persistent phenotype of Th17 cells and recognition of lineage-deviating factors are of most attractive goals in modern researches in immunology. Although IL-6 and TGF-β are frequently used to differentiate naive T cells to Th17 phenotype in mouse models, the application of IL-23 and its importance in preventing cells from plasticity needs to be more investigated. Our main objective was to evaluate the role of IL-23 in Th17 to Th1 plasticity. In this research project, we generated in vitro Myelin oligodendrocyte glycoprotein (MOG)-specific Th17 cells in the presence of TGF-β, IL-6, IL-23 and peptide MOG35-55. Th17 development was confirmed by assessment of relevant transcription factors and secreted cytokines by flowcytometry and ELISA, respectively. Th17 to Th1 plasticity was monitored by consecutive samplings in different time points without any extra supplementation of IL-23. Cell culture supernatant was evaluated for Interferon (IFN)-γ secretion and cells were evaluated for intracellular expression of this cytokine. Our results showed that the employed method was relatively convenient in developing antigen-specific Th17 cells. We also showed that IL-23 deprivation which happens by prolongation of culture period, can convert IL-17 producing cells to IFN-γ secreting Th1 phenotype. IL-23 can be considered as a Th17 phenotype stabilizing factor for in-vitro developed lineages.