Adults' estimated prevalence of healthy behavior in society and self-reported oral health status and behaviors

OBJECTIVE

To assess Mashhad residents' self-perceived oral health level (OHL) and behaviors in relation to their perceptions of those of their fellow citizens.

METHODS

Cross-sectional telephone survey of 384 individuals recruited from communication centers. The interviews followed a validated Persian schedule with three main sections: 1) background information, 2) questions regarding self-reported OHL, and 3) questions regarding respondents' perceptions of the OHL of their fellow citizens.

RESULTS

Participants' mean self-rated OHL and tooth brushing frequency were higher than those of their fellow citizens. The correlation between self-reported and the estimated decayed and missing (DMT) was highest in the middle and lowest in the upper classes. Perceptions of the self- and others' OHL and DMT were positively correlated, with the latter being more so. Education level, age, and tooth brushing frequency affected self-perceived OHL and DMT.

CONCLUSION

Participants' perceived OHL could be explained by their estimation of the general population's oral health. These findings suggest that social norm interventions could nudge improving oral health behaviors.

Oxidative Phosphorylation Is a Metabolic Vulnerability in Chemotherapy-Resistant Triple-Negative Breast Cancer

Oxidative phosphorylation (OXPHOS) is an active metabolic pathway in many cancers. RNA from pretreatment biopsies from patients with triple-negative breast cancer (TNBC) who received neoadjuvant chemotherapy demonstrated that the top canonical pathway associated with worse outcome was higher expression of OXPHOS signature. IACS-10759, a novel inhibitor of OXPHOS, stabilized growth in multiple TNBC patient-derived xenografts (PDX). On gene expression profiling, all of the sensitive models displayed a basal-like 1 TNBC subtype. Expression of mitochondrial genes was significantly higher in sensitive PDXs. An in vivo functional genomics screen to identify synthetic lethal targets in tumors treated with IACS-10759 found several potential targets, including CDK4. We validated the antitumor efficacy of the combination of palbociclib, a CDK4/6 inhibitor, and IACS-10759 in vitro and in vivo. In addition, the combination of IACS-10759 and multikinase inhibitor cabozantinib had improved antitumor efficacy. Taken together, our data suggest that OXPHOS is a metabolic vulnerability in TNBC that may be leveraged with novel therapeutics in combination regimens. SIGNIFICANCE: These findings suggest that triple-negative breast cancer is highly reliant on OXPHOS and that inhibiting OXPHOS may be a novel approach to enhance efficacy of several targeted therapies.

Study of Mortality and Morbidity in Neonates with Congenital Diaphragmatic Hernia

Introduction: Congenital diaphragmatic hernia may either lead to death or cause several complications such as increased pulmonary artery pressure. Objective: The present study aimed to compare mortality and morbidity, vasopressor intake, and visceral hernia of CDH neonates with pulmonary hypertension and without pulmonary hypertension in Mahdieh and Mofid hospitals in Tehran. Methods: This cross-sectional analytical study included 56 neonates with congenital diaphragmatic hernia who were admitted to Mofid and Mahdieh Children's Hospitals from 2014 to 2018. The sample size included 56 people selected based on census method. We compared the pulmonary hypertension and non-pulmonary hypertension groups in variables, such as gender, gestational age, birth weight, place of birth, and type of delivery and we examined relationship between pulmonary hypertension and mortality and morbidity and relationship between mortality and vasopressor intake. Results: The OR value was calculated to be 1.106, which is significant at the level of 0.004 (p < 0.01). This finding indicated that the chance of death in the group of infants with severe pulmonary hypertension was increased by 1.106. Also, the relationship of visceral hernia (stomach, intestine, liver, kidney, and spleen) to thorax was examined by logistic regression. Only the OR value of liver hernia (9.42) was significant (p < 0.001), indicating that the chance of death was higher in infants with liver hernias. It also the OR value of dopamine, dobutamine, and milrinone was significant (p < 0.01). Conclusion: In general, the results obtained in our study indicated that the mortality rate in the group of infants with pulmonary hypertension was significantly higher than the group without pulmonary hypertension. Also, liver hernia to thorax was associated with the severity of pulmonary hypertension, and the patients needed medication had a higher chance of death.

The apoptotic effects of progesterone on breast cancer (MCF-7) and human osteosarcoma (MG-636) cells

Purpose

Progesterone has been reported to inhibit the proliferation of breast cancer and osteosarcoma cells; however, its inhibitory mechanism has not yet been clarified. The aim of the present study was to clarify the effects of progesterone on apoptosis in breast cancer (MCF-7) and human osteosarcoma (MG-63) cells.

Materials and methods

In this experimental study the cytotoxic effect of progesterone was measured in MCF-7 and MG-63 cells exposed to different concentrations of progesterone using MTT assay, and effective concentrations were identified. The expression levels of the Bax, P53 and Bcl-2 genes were evaluated by real-time PCR, and caspase-3, 8 and 9 activity levels were determined using a colorimetric method. Hoechst staining and flow cytometry were used to confirm apoptosis. The data were statistically analyzed using one-way analysis of variance (ANOVA) and independent-samples t-test.

Results

Compared to the control group, we observed a significant increase in the expression levels of the Bax and P53 genes and the activity levels of caspase-3 and 9, and a significant decrease in the expression level of the Bcl-2 gene in MCF-7 and MG-63 treated with effective concentration of progesterone. The caspase-8 activity level did not change significantly in treated MG-63 but increased in treated MCF-7 cells. Hoechst staining and flow cytometry results confirmed apoptosis in the cells exposed to effective concentration of progesterone.

Conclusions

The cytotoxic effect of progesterone on breast cancer and osteosarcoma cells was mediated by apoptotic pathways. In this context, progesterone triggers the extrinsic and intrinsic apoptotic pathways in MCF-7 cells and induces the intrinsic apoptotic pathway in MG-63 cells.

Abstract C016: Oxidative phosphorylation is a metabolic vulnerability in chemotherapy resistant triple negative breast cancer

There is a pressing need to identify improved therapies for triple negative breast cancers (TNBC) resistant to standard chemotherapy. To identify potential molecular targets, we performed RNA sequencing of pre-treatment biopsies from 43 patients with operable TNBC who received neoadjuvant anthracycline and taxane-based chemotherapy. Ingenuity pathway analysis demonstrated that the top canonical pathway associated with higher likelihood of recurrence was higher expression of oxidative phosphorylation (OXPHOS) signature. We therefore sought to determine the efficacy of IACS-10759, a potent inhibitor of OXPHOS, in 10 TNBC patient-derived xenografts (PDX), 8 generated from chemotherapy-resistant tumors. Partial response was observed in one PDX model and prolonged disease stabilization in 5 of 10 PDXs. PDXs with higher expression of protein coding mitochondrial genes were more sensitive to IACS-10759. AXL overexpression was associated with intrinsic and acquired IACS-10759 resistance. The combination of cabozantinib, a multi-kinase inhibitor targeting AXL, with IACS-10759 significantly improved responses in TNBC PDXs. In contrast, selective AXL inhibitor BGB324 or knockdown of AXL did not enhance IACS-10759 sensitivity. In addition, an in vivo synthetic lethality screen identified CDK4, PARP1 and PARP2 as potential combination targets for IACS-10759. Palbociclib as well as talazoparib enhanced growth inhibitory effect of OXPHOS inhibition in vitro and in vivo. Our data suggests that OXPHOS is a promising target in chemoresistant TNBC. IACS-10759 is currently in Phase 1 testing, including TNBC. Further work is needed to determine the optimal biomarker-driven combination partners.

Citation Format: Kurt Evans, Stacy Moulder, Erkan Yuca, Stephen Scott, Natalia Paez Arango, Maryam Shariati, Christopher P Vellano, Turcin Saridogan, Xiaofeng Zheng, Ana Maria Gonzalez-Angulo, Ming Zhao, Xiaoping Su, Coya Tapia, Ken Chen, Argun Akcakanat, Charles M Perou, Bora Lim, Debu Tripathy, Timothy A Yap, Maria E Di Francesco, Giulio Draetta, Philip Jones, Joe Marszalek, Funda Meric-Bernstam. Oxidative phosphorylation is a metabolic vulnerability in chemotherapy resistant triple negative breast cancer [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics; 2019 Oct 26-30; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2019;18(12 Suppl):Abstract nr C016. doi:10.1158/1535-7163.TARG-19-C016

Abstract B104: Combined inhibition of DDR1 and CDK4/6 induces synergistic effects in ER-positive, HER2-negative breast cancer with PIK3CA/AKT1 mutations

Molecular alterations in the PI3K/AKT/mTOR pathway occur frequently in estrogen receptor-positive (ER-positive) breast tumors. Patients with ER-positive, human epidermal growth factor receptor 2-negative (HER2-negative) advanced or metastatic breast cancer (MBC) are often treated with palbociclib, an FDA approved CDK4/6 inhibitor, in combination with endocrine therapy. In clinical studies (NCT01942135), the combination of fulvestrant plus palbociclib was associated with improved progression-free survival compared with fulvestrant plus placebo, irrespective of PIK3CA mutational status. The purpose of this study is to identify synthetic lethality partner that can be targeted in combination with palbociclib to improve its therapeutic response. We demonstrate that the in vitro efficacy of CDK4/6 inhibitor is reduced in the presence of PIK3CA/AKT1 mutations using ER-positive isogenic breast cancer cell lines. Utilizing a shRNA library screen targeting cancer related human kinases, we identified that genomic suppression of discoidin domain receptor 1 (DDR1), a tyrosine kinase active in various cancers, is synthetic lethal with palbociclib. Performing sulforhodamine B (SRB) proliferation assay, DDR1 knockdown by shRNA significantly reduced growth of PIK3CA/AKT1 mutant as well as wild type ER-positive cell lines. In addition, DDR1 pharmacological inhibitor, 7rh benzamide, activated the P53/P21 pathway and enhanced the sensitivity of PIK3CA/AKT1 mutant cells to palbociclib. Likewise, we found that combined treatment of palbociclib and 7rh further induced cell cycle arrest through decreasing G2-M phase population and reducing FoxM1 and Rb phosphorylation in mutant cell lines. Our data indicate that DDR1 inhibition can augment cell cycle suppressive effect of palbociclib and could be an effective rational strategy approach for targeted therapy of ER-positive, HER2-negative breast cancer harboring PIK3CA/AKT1 mutations.

Citation Format: Maryam Shariati, Christopher A Bristow, Alessandro Carugo, Tim Heffernan, Xiaofeng Zheng, Michael D Peoples, Debu Tripathy, Funda Meric-Bernstam. Combined inhibition of DDR1 and CDK4/6 induces synergistic effects in ER-positive, HER2-negative breast cancer with PIK3CA/AKT1 mutations [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics; 2019 Oct 26-30; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2019;18(12 Suppl):Abstract nr B104. doi:10.1158/1535-7163.TARG-19-B104

Targeting AKT for cancer therapy

Introduction: Targeted therapies in cancer aim to inhibit specific molecular targets responsible for enhanced tumor growth. AKT/PKB (protein kinase B) is a serine threonine kinase involved in several critical cellular pathways, including survival, proliferation, invasion, apoptosis, and angiogenesis. Although phosphatidylinositol-3 kinase (PI3K) is the key regulator of AKT activation, numerous stimuli and kinases initiate pro-proliferative AKT signaling which results in the activation of AKT pathway to drive cellular growth and survival. Activating mutations and amplification of components of the AKT pathway are implicated in the pathogenesis of many cancers including breast and ovarian. Given its importance, AKT, it has been validated as a promising therapeutic target.Areas covered: This article summarizes AKT's biological function and different classes of AKT inhibitors as anticancer agents. We also explore the efficacy of AKT inhibitors as monotherapies and in combination with cytotoxic and other targeted therapies.Expert opinion: The complex mechanism following AKT inhibition requires the addition of other therapies to prevent resistance and improve clinical response. Further studies are necessary to determine additional rational combinations that can enhance efficacy of AKT inhibitors, potentially by targeting compensatory mechanisms, and/or enhancing apoptosis. The identification of biomarkers of response is essential for the development of successful therapeutics.

Treatment of normal hydrocarbons contaminated water by combined microalgae - Photocatalytic nanoparticles system

Two species of microalgae (Chlorella vulgaris and Dunaliella tertiolecta) as the biological agents along with ZnO nanoparticles as the photocatalyst were used to investigate the hydrocarbon removal efficiency from oily water samples. Firstly, the toxicities of the photocatalyst, normal paraffine hydrocarbons and their combination towards the microalgae were evaluated in terms of cell growth and chlorophyll content. The capability of algae to absorb the nanoparticles in the aqueous phase was confirmed by FT-IR spectroscopy. Then, the hydrocarbon removal efficiencies of the algae, photocatalyst and the combined photocatalyst-algae system were studied by measuring the residual hydrocarbon content of the samples. Results indicated that despite of the growth inhibitory effects of n-alkanes and nanoparticles on the examined algae, both of them could survive in the system. Dunaliella tertiolecta was more affected by normal paraffins while Chlorella vulgaris was more sensitive to ZnO nanoparticles. Both of the studied species were capable of hydrocarbon removal and the efficiency of Chlorella vulgaris was superior. The combination of algae and nanoparticles was also proved to have a synergistic effect on degradation of the hydrocarbon content of the medium. The obtained removal efficiencies for initial hydrocarbon concentrations of 0.05%, 0.1% and 0.5% (v/v) were 100%, 78% and 42% for Dunaliella tertiolecta-ZnO and 100%, 93% and 88% for Chlorella vulgaris- ZnO system, respectively. It can be concluded that the examined microalgae-nanoparticle system can be considered as a final polishing step in hydrocarbons removal from oily waters.

GSK3β regulates epithelial-mesenchymal transition and cancer stem cell properties in triple-negative breast cancer

Background

Triple-negative breast cancers (TNBCs), which lack receptors for estrogen, progesterone, and amplification of epidermal growth factor receptor 2, are highly aggressive. Consequently, patients diagnosed with TNBCs have reduced overall and disease-free survival rates compared to patients with other subtypes of breast cancer. TNBCs are characterized by the presence of cancer cells with mesenchymal properties, indicating that the epithelial to mesenchymal transition (EMT) plays a major role in the progression of this disease. The EMT program has also been implicated in chemoresistance, tumor recurrence, and induction of cancer stem cell (CSC) properties. Currently, there are no targeted therapies for TNBC, and hence, it is critical to identify the novel targets to treat TNBC.

Methods

A library of compounds was screened for their ability to inhibit EMT in cells with mesenchymal phenotype as assessed using the previously described Z-cad reporters. Of the several drugs tested, GSK3β inhibitors were identified as EMT inhibitors. The effects of GSK3β inhibitors on the properties of TNBC cells with a mesenchymal phenotype were assessed using qRT-PCR, flow cytometry, western blot, mammosphere, and migration and cell viability assays. Publicly available datasets also were analyzed to examine if the expression of GSK3β correlates with the overall survival of breast cancer patients.

Results

We identified a GSK3β inhibitor, BIO, in a drug screen as one of the most potent inhibitors of EMT. BIO and two other GSK3β inhibitors, TWS119 and LiCl, also decreased the expression of mesenchymal markers in several different cell lines with a mesenchymal phenotype. Further, inhibition of GSK3β reduced EMT-related migratory properties of cells with mesenchymal properties. To determine if GSK3β inhibitors target mesenchymal-like cells by affecting the CSC population, we employed mammosphere assays and profiled the stem cell-related cell surface marker CD44+/24− in cells after exposure to GSK3β inhibitors. We found that GSK3β inhibitors indeed decreased the CSC properties of cell types with mesenchymal properties. We treated cells with epithelial and mesenchymal properties with GSK3β inhibitors and found that GSK3β inhibitors selectively kill cells with mesenchymal attributes while sparing cells with epithelial properties. We analyzed patient data to identify genes predictive of poor clinical outcome that could serve as novel therapeutic targets for TNBC. The Wnt signaling pathway is critical to EMT, but among the various factors known to be involved in Wnt signaling, only the higher expression of GSK3β correlated with poorer overall patient survival.

Conclusions

Taken together, our data demonstrate that GSK3β is a potential target for TNBCs and suggest that GSK3β inhibitors could serve as selective inhibitors of EMT and CSC properties for the treatment of a subset of aggressive TNBC. GSK3β inhibitors should be tested for use in combination with standard-of-care drugs in preclinical TNBC models.

Electronic supplementary material

The online version of this article (10.1186/s13058-019-1125-0) contains supplementary material, which is available to authorized users.

Abstract P6-18-13: Identification of optimal combination therapy partners for PI3K/Akt/mTOR pathway inhibitor in triple negative breast cancer

Triple-negative breast cancer (TNBC) is among the most aggressive subtypes, accounts for 10-15% of all breast cancer cases and is characterized by a lack of hormone receptors with a low overall survival rate. Due to the heterogeneity nature of this disease, the absence of validated molecular targets makes it unresponsive to conventional therapies. PI3K/Akt/mTOR pathway is aberrantly activated in TNBC, but single agent therapy is commonly subject to resistance. The goal of this study is to identify the genes that can be targeted to enhance the efficacy of mTOR inhibitor TAK228, an agent that is being investigated as a treatment for advanced solid tumors, in TNBC with PI3K pathway activation. We utilized an in vivo pooled barcoded shRNA library screening to determine the genes that have the potential to be used as TAK228 synthetic lethal partners. Using deep sequencing analysis of the shRNA profiles, we identified several genes whose loss of function conferred synthetic lethality in the presence of TAK228. We found that targeting the candidate genes (WEE1, BMX and MAPK15) with their inhibitors (AZD1775, Ibrutinib and Sunitinib) did not significantly affect the viability, however combination treatment of these agents with TAK228 induced a robust growth inhibition and demonstrated a significant synergy in MDA-MB-468 cell lines. Investigating the activation of relevant survival signaling pathways will further elucidate the mechanism of synthetic lethal interaction. These observations provide a promising rational strategy for the treatment of TNBC with PI3K pathway aberration.

Citation Format: Shariati M, Paez-Arango N, Bristow CA, Evans KW, Peoples MD, Carugo A, Heffernan TP, Meric-Bernstam F. Identification of optimal combination therapy partners for PI3K/Akt/mTOR pathway inhibitor in triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-18-13.

Survival Outcomes by TP53 Mutation Status in Metastatic Breast Cancer

Purpose

We sought to determine the significant genomic alterations in patients with metastatic breast cancer (MBC), and survival outcomes in common genotypes.

Patients and Methods

High-depth next generation sequencing was performed for 202 genes in tumor and normal DNA from 257 patients with MBC, including 165 patients with ER/PR+ HER2- (hormone receptor positive, HR+ positive), 32 patients with HER2+ and 60 patients with triple negative (ER/PR/HER2-) cancer. Kaplan Meier survival analysis was performed in our discovery set, in breast cancer patients analyzed in The Cancer Genome Atlas, and in a separate cohort of 98 patients with MBC who underwent clinical genomic testing.

Results

Significantly mutated genes (SMGs) varied by histology and tumor subtype, but TP53 was a SMG in all three subtypes. The most SMGs in HR+ patients included PIK3CA (32%), TP53 (29%), GATA3 (15%), CDH1 (8%), MAP3K1 (8%), PTEN (5%), TGFBR2 (4%), AKT1 (4%), and MAP2K4 (4%). TP53 mutations were associated with shorter recurrence-free survival (P=0.004), progression-free survival (P=0.00057) and overall survival (P=0.003). Further, TP53 status was prognostic among HR+ patients with PIK3CA mutations. TP53 mutations were also associated with poorer overall survival in the 442 HR+ breast cancer patients in the TCGA (P=0.042) and in an independent set of 96 HR+ MBC who underwent clinical sequencing (P=0.0004).

Conclusions

SMGs differ by tumor subtype but TP53 is significantly mutated in all three breast cancer subtypes. TP53 mutations are associated with poor prognosis in HR+ breast cancer. TP53 mutations should be considered in the design and interpretation of precision oncology trials.

N-BLR, a primate-specific non-coding transcript leads to colorectal cancer invasion and migration

Background

Non-coding RNAs have been drawing increasing attention in recent years as functional data suggest that they play important roles in key cellular processes. N-BLR is a primate-specific long non-coding RNA that modulates the epithelial-to-mesenchymal transition, facilitates cell migration, and increases colorectal cancer invasion.

Results

We performed multivariate analyses of data from two independent cohorts of colorectal cancer patients and show that the abundance of N-BLR is associated with tumor stage, invasion potential, and overall patient survival. Through in vitro and in vivo experiments we found that N-BLR facilitates migration primarily via crosstalk with E-cadherin and ZEB1. We showed that this crosstalk is mediated by a pyknon, a short ~20 nucleotide-long DNA motif contained in the N-BLR transcript and is targeted by members of the miR-200 family. In light of these findings, we used a microarray to investigate the expression patterns of other pyknon-containing genomic loci. We found multiple such loci that are differentially transcribed between healthy and diseased tissues in colorectal cancer and chronic lymphocytic leukemia. Moreover, we identified several new loci whose expression correlates with the colorectal cancer patients’ overall survival.

Conclusions

The primate-specific N-BLR is a novel molecular contributor to the complex mechanisms that underlie metastasis in colorectal cancer and a potential novel biomarker for this disease. The presence of a functional pyknon within N-BLR and the related finding that many more pyknon-containing genomic loci in the human genome exhibit tissue-specific and disease-specific expression suggests the possibility of an alternative class of biomarkers and therapeutic targets that are primate-specific.

Electronic supplementary material

The online version of this article (doi:10.1186/s13059-017-1224-0) contains supplementary material, which is available to authorized users.

The Immunomodulatory Effect of Bone-Marrow Mesenchymal Stem Cells on Expression of TLR3 and TLR9 in Mice Dendritic Cells

BACKGROUND

Mesenchymal stem cells (MSCs) are multipotent cells with immunomodulatory effect on immune cells including dendritic cells (DCs). DCs are the most potent antigen-presenting cells (APC). MSCs have been found to modulate both differentiation and function of DCs. DCs express a broad range of Toll-like receptors (TLR), which play a critical role in DCs maturation and function.

OBJECTIVE

To evaluate expression level of TLR3 and TLR9 transcripts in DCs following treatment with MSCs supernatant.

METHODS

MSCs and DCs were derived from adult BALB/c mice bone marrow and spleen, respectively. MSCs supernatant was harvested following 24, 48, and 72 hours. Isolated DCs were treated with MSCs supernatant and incubated for 24 and 48 hours. TLR3 and TLR9 transcript levels were evaluated using real-time PCR.

RESULTS

The results showed that 48 and 72 hours MSCs supernatant significantly decreased the expression of TLR3 in DCs following 24 and 48 hours incubation in comparison with untreated cells (p<0.01). Moreover, 48 hours of treatment with 24, 48 and 72 hours MSCs supernatant significantly decreased TLR9 transcript level (p<0.05).

CONCLUSION

TLR3 and TLR9 mRNA expression decreases in DCs after incubation with MSCs culture supernatant. This confirms the immunomodulatory role of MSCs in cell-base therapy.

CCAT2, a novel noncoding RNA mapping to 8q24, underlies metastatic progression and chromosomal instability in colon cancer

The functional roles of SNPs within the 8q24 gene desert in the cancer phenotype are not yet well understood. Here, we report that CCAT2, a novel long noncoding RNA transcript (lncRNA) encompassing the rs6983267 SNP, is highly overexpressed in microsatellite-stable colorectal cancer and promotes tumor growth, metastasis, and chromosomal instability. We demonstrate that MYC, miR-17-5p, and miR-20a are up-regulated by CCAT2 through TCF7L2-mediated transcriptional regulation. We further identify the physical interaction between CCAT2 and TCF7L2 resulting in an enhancement of WNT signaling activity. We show that CCAT2 is itself a WNT downstream target, which suggests the existence of a feedback loop. Finally, we demonstrate that the SNP status affects CCAT2 expression and the risk allele G produces more CCAT2 transcript. Our results support a new mechanism of MYC and WNT regulation by the novel lncRNA CCAT2 in colorectal cancer pathogenesis, and provide an alternative explanation of the SNP-conferred cancer risk.

CCAT2, a novel noncoding RNA mapping to 8q24, underlies metastatic progression and chromosomal instability in colon cancer

The functional roles of SNPs within the 8q24 gene desert in the cancer phenotype are not yet well understood. Here, we report that CCAT2, a novel long noncoding RNA transcript (lncRNA) encompassing the rs6983267 SNP, is highly overexpressed in microsatellite-stable colorectal cancer and promotes tumor growth, metastasis, and chromosomal instability. We demonstrate that MYC, miR-17-5p, and miR-20a are up-regulated by CCAT2 through TCF7L2-mediated transcriptional regulation. We further identify the physical interaction between CCAT2 and TCF7L2 resulting in an enhancement of WNT signaling activity. We show that CCAT2 is itself a WNT downstream target, which suggests the existence of a feedback loop. Finally, we demonstrate that the SNP status affects CCAT2 expression and the risk allele G produces more CCAT2 transcript. Our results support a new mechanism of MYC and WNT regulation by the novel lncRNA CCAT2 in colorectal cancer pathogenesis, and provide an alternative explanation of the SNP-conferred cancer risk.

FOXC2 expression links epithelial-mesenchymal transition and stem cell properties in breast cancer

Resistance to chemotherapy and metastases are the major causes of breast cancer-related mortality. Moreover, cancer stem cells (CSC) play critical roles in cancer progression and treatment resistance. Previously, it was found that CSC-like cells can be generated by aberrant activation of epithelial-mesenchymal transition (EMT), thereby making anti-EMT strategies a novel therapeutic option for treatment of aggressive breast cancers. Here, we report that the transcription factor FOXC2 induced in response to multiple EMT signaling pathways as well as elevated in stem cell-enriched factions is a critical determinant of mesenchymal and stem cell properties, in cells induced to undergo EMT- and CSC-enriched breast cancer cell lines. More specifically, attenuation of FOXC2 expression using lentiviral short hairpin RNA led to inhibition of the mesenchymal phenotype and associated invasive and stem cell properties, which included reduced mammosphere-forming ability and tumor initiation. Whereas, overexpression of FOXC2 was sufficient to induce CSC properties and spontaneous metastasis in transformed human mammary epithelial cells. Furthermore, a FOXC2-induced gene expression signature was enriched in the claudin-low/basal B breast tumor subtype that contains EMT and CSC features. Having identified PDGFR-β to be regulated by FOXC2, we show that the U.S. Food and Drug Administration-approved PDGFR inhibitor, sunitinib, targets FOXC2-expressing tumor cells leading to reduced CSC and metastatic properties. Thus, FOXC2 or its associated gene expression program may provide an effective target for anti-EMT-based therapies for the treatment of claudin-low/basal B breast tumors or other EMT-/CSC-enriched tumors.

Visual impairment in the 40- to 64-year-old population of Shahroud, Iran

PURPOSE

To determine the prevalence of visual impairment by age and gender in Shahroud.

METHODS

Using random cluster sampling, 6311 Shahroud inhabitants who were between 40 and 64 years old were invited for ophthalmological examinations. Visual acuity worse than 0.5 LogMAR (20/60) and 1.3 LogMAR (20/400) in the better eye was regarded as low vision and blindness, respectively. The cause of blindness was determined by an ophthalmologist and in a person with more than one cause, the most correctable cause was regarded as the main cause.

RESULTS

This study was conducted on 5190 participants (response rate: 82.2%). On the basis of presenting visual acuity, the prevalence of low vision and blindness was found to be 1.8% (95% confidence interval (CI): 1.4-2.10) and 0.5% (95% CI: 0.3-0.7), respectively. Based on corrected vision, these values were 0.5% (95% CI: 0.3-0.7) and 0.3% (95% CI: 0.1-0.4), respectively. Visual impairment increased with age in women (P<0.001). Uncorrected refractive errors (63.9%), cataract (20.2%), and amblyopia (5.9%) were the most common causes of visual impairment based on presenting vision. Based on corrected vision, however, cataract (42.5%), amblyopia (12.5%), and retinitis pigmentosa (7.5%) were the most common causes of visual impairment.

CONCLUSION

Although the prevalence of visual impairment in the city of Shahroud was determined to be lower than two previous studies in the country, correction of refractive errors and cataract could minimize the rate of visual impairment in this population as they were shown to comprise 85% of the causes of visual impairment. The elderly women need to receive more attention.

In vitro Growth and Characterization of Stem Cells from Human Dental Pulp of Deciduous Versus Permanent Teeth

OBJECTIVE

By date investigations have indicated the presence of stem cells within the pulp tissue of both temporary and permanent human teeth. In the present study, these stem cells were compared in terms of their growth kinetics and culture requirements.

MATERIALS AND METHODS

Stem cells within the pulp of the human third molar (permanent tooth) and the deciduous incisor (temporary tooth) were isolated, culture-expanded and characterized. Then the proliferation potential of the cells was compared using multiple cell growth indices as PDT (Population doubling time), colonogenic activity and growth curve. Furthermore, the cultures of both cells were optimized for maximal proliferation.

RESULTS

Stem cells of either pulp tissue appeared as fibroblastic cells capable of differentiating into osteoblastic, odontoblastic, adipocytic and chondrocytic cell lineages. In contrast to molar stem cells, those from the incisor tooth expressed neurogenic markers of ßIII Tubulin and Tau. Based on in vitro growth data, the cells from third molar tended to have a lower PDT value (20.79, SD=2.8 versus 25.55, SD=2.9 hours), higher colonogenic activity and better growth curve than those from the deciduous incisor (P<0.05). Both cells exhibited high expansion rate when being plated in a medium with 20% phosphate buffer solution at a density of 100 cells/cm(2).

CONCLUSION

Given the high proliferation capacity, the stem cells from the human third molar would be an appropriate candidate for use in experimental, preclinical and even clinical setups.

Sirenomelia (mermaid syndrome): an infant from parents who used a special form of snuff

We report the first case of a fetus with sirenomelia or mermaid syndrome, whose Afghanian parents were heavy user of a special form of snuff. The case was diagnosed as a mermaid syndrome but some of the features were common to both symmelia dipus and symmelia apus, for example, the single lower extremity had the normal femur, tibia and fibula, but the single foot was rotated medially. The digestive tube ended to a massive closed saclike structure and the anus was absence. The external genital organs were rudiment and the normal testes were undescended. Aorta was divided to branches, such that the external iliac arteries were very small in comparison to the internal iliac arteries. Inferior Vena cava was placed on to the left side of the aorta and unlike the majority of reported mermaid syndrome, the bladder was present. So, the researchers believe that the present case is a rare variant of the mermaid syndrome.

Efficiency of alternative MCMC strategies illustrated using the reaction norm model

The Markov chain Monte Carlo (MCMC) strategy provides remarkable flexibility for fitting complex hierarchical models. However, when parameters are highly correlated in their posterior distributions and their number is large, a particular MCMC algorithm may perform poorly and the resulting inferences may be affected. The objective of this study was to compare the efficiency (in terms of the asymptotic variance of features of posterior distributions of chosen parameters, and in terms of computing cost) of six MCMC strategies to sample parameters using simulated data generated with a reaction norm model with unknown covariates as an example. The six strategies are single-site Gibbs updates (SG), single-site Gibbs sampler for updating transformed (a priori independent) additive genetic values (TSG), pairwise Gibbs updates (PG), blocked (all location parameters are updated jointly) Gibbs updates (BG), Langevin-Hastings (LH) proposals, and finally Langevin-Hastings proposals for updating transformed additive genetic values (TLH). The ranking of the methods in terms of asymptotic variance is affected by the degree of the correlation structure of the data and by the true values of the parameters, and no method comes out as an overall winner across all parameters. TSG and BG show very good performance in terms of asymptotic variance especially when the posterior correlation between genetic effects is high. In terms of computing cost, TSG performs best except for dispersion parameters in the low correlation scenario where SG was the best strategy. The two LH proposals could not compete with any of the Gibbs sampling algorithms. In this study it was not possible to find an MCMC strategy that performs optimally across the range of target distributions and across all possible values of parameters. However, when the posterior correlation between parameters is high, TSG, BG and even PG show better mixing than SG.

Effect of a new phenanthroline derivative on testicular tissue and serum testosterone concentration and its contraceptive affects on adult Balb/C mouse strain

In this research, the effect of 2, 6-diaminopyridinum as a new phenanthroline derivative was studied on the hypophysis-gonad axis, testicular tissue and sperm production in male Balb/C mice. Fifty adult male Balb/C mice were divided in five groups. First group was considered as untreated control. Saline was injected to second group and the remaining three groups received intraperitoneal injection of 15, 20 and 25 mg kg(-1) of 2, 6-diaminopyridinum every other day for 20 days. The LD50 was determined to be 35 mg kg(-1) body weight. The testicular tissues were studied morphologically and the serum concentration of FSH, LH and testosterone were measured. The results showed that 25 mg kg(-1) diaminopyridinum decreased the number of germ cells significantly and serum testosterone level with no change on FSH and LH levels. This study indicates that 25 mg kg(-1) of phenanthroline may directly affect testicular tissue causing a lower testosterone level and spermatogenesis in mice.

Prevalence of subjective poor health symptoms associated with exposure to electromagnetic fields among university students

The number of people complaining about different symptoms that may be associated with exposure to electromagnetic fields (EMF) has increased rapidly during past years. Students use both mobile phones and video display terminals frequently. The purpose of this study was to investigate the association of mobile phone use and EMF health hazards. Basic demographic data and self-reported symptoms were sought using a questionnaire administered to all apparently healthy students at Rafsanjan University of Medical Sciences (RUMS) and Vali-e-Asr University (VAU). Questions about some major confounding factors such as age, gender, amount of video display terminal work were also included. Exact Fischer Test was used for data analysis. Among self-reported symptoms, headache (53.5%), fatigue (35.6%), difficulties in concentration (32.5%), vertigo/dizziness (30.4%), attention disorders (28.8%), nervousness (28.1%), palpitation (14.7%), low back pain (14.3%), myalgia (12.4%), and tinnitus (9.9%) were the main self-reported symptoms. No significant differences in the prevalence of these symptoms were found between CRT users and those who did not use CRTs. A significant association was found between cordless phone use and difficulties in concentration (P < .05) or attention disorders (P < .05). However, after correction of the gender role, these differences were not significant. No association was found between mobile phone use and the above-mentioned symptoms. No significantly higher prevalence of self-reported symptoms was found in individuals who had used mobile phones, video display terminals or cordless phones more frequently than others. Mass-media's lack of interest in the possible hazards of exposure to EMF in developing countries can explain the difference observed between the results of this study and those of other researchers in some developed countries who have shown an association between EMF exposure and the prevalence of self-reported subjective symptoms. This finding can confirm the results obtained in provocative studies which indicated the role of psychological factors in electromagnetic hypersensitivity. More research is needed to clarify whether daily environmental EMF may cause health problems.

High resolution fluoride profiles of artificial in vitro lesions treated with fluoride dentifrices and mouthrinses during pH cycling conditions

A pH cycling model which incorporated a severe demineralization component was used to evaluate fluoride uptake and lesion progression for each of a NaF-based dentifrice, NaF-based mouthrinse and a monofluorophosphate (MFP)-based dentifrice. Simultaneous transverse fluoride and calcium profiles across the resulting artificial lesions were obtained using a proton microprobe technique with a resolution of approximately 10 microns. Longitudinal microhardness testing and proton microprobe calcium profiles were used to determine the extent of lesion progression (delta Z) with respect to untreated controls. Under the pH cycling conditions of the present study, the NaF dentifrice and mouthwash were observed to have a considerably higher uptake of fluoride in the lesion than the MFP dentifrice. Although the mineral content profiles of the lesions differed for treatments with each of the fluoride products, the differences were not significantly different in this model.

Use of an intra-oral model to evaluate 0.05% sodium fluoride mouthrinse in radiation-induced hyposalivation

The present study was undertaken to evaluate the effect of a twice-daily topical application of a 0.05% NaF mouthrinse on de- and remineralization in the oral cavities of subjects suffering from radiation-induced hyposalivation. Six subjects each wore a bonded intra-oral appliance containing a sound and a demineralized human enamel slab for four weeks. During that period, the subjects used 0.05% NaF rinses, twice daily, instead of the 1.1% NaF gel that had previously been a part of their preventive regimen. Salivary flow rates, plaque pH profiles following a 10% sucrose rinse, S. mutans and lactobacillus counts, fluoride clearance, and enamel microhardness were determined during the study. Sound enamel samples displayed no evidence of demineralization, and the previously demineralized enamel showed remineralization in the outer 50 microns in three of the six subjects. The results suggest that a twice-daily oral rinse with 0.05% NaF can prevent demineralization and enhance remineralization in subjects with radiation-induced hyposalivation.

Dependence of in vitro demineralization of apatite and remineralization of dental enamel on fluoride concentration

The anti-caries activity of fluoride is contributed to in several ways. Two major aspects of fluoride action are (i) the inhibition of demineralization at the crystal surfaces within the tooth, and (ii) the enhancement of subsurface remineralization resulting in arrestment or reversal of caries lesions. Fluoride present in the aqueous phase at the apatite crystal surface may play a determining role in the inhibition of enamel or dentin demineralization. In one part of the present study, the initial dissolution rate of synthetic carbonated-apatite in acetate buffers was measured with fluoride present in the buffer in the 0-2.6 mmol/L (0-50 ppm) range. Inhibition of demineralization was shown to be a logarithmic function of the fluoride concentration in solution. In the second part of the present study, an in vitro pH-cycling model was used for determination of the effect on net de/remineralization of enamel by treatment solutions containing fluoride in the 0-26 mmol/L (0-500 ppm) range. The net mineral loss was shown to be negatively related to the logarithm of the fluoride concentration. These studies have demonstrated an exponential quantitative relationship between fluoride concentration and inhibition of apatite demineralization or enhancement of remineralization. The clinical implications are (i) that simply increasing fluoride concentration may not necessarily give increased cariostatic benefit, and (ii) that improving the means of delivery of relatively low fluoride concentrations for longer times should be more appropriate for enhancing clinical efficacy.

Fluoride uptake into demineralized primary enamel from fluoride-impregnated dental floss in vitro

Fluoridated mouthrinses are not advised for preschool children who may swallow much of the agent. An alternate method of delivering topical fluoride to the interproximal tooth surfaces in these young patients may be fluoridated dental floss. The purpose of this study was to determine the fluoride levels of demineralized primary enamel both before and after the use of a commercially available dental floss impregnated with commercially available fluoride-containing products. The results showed that demineralized primary tooth surfaces treated with fluoride-impregnated dental floss exhibited significantly higher fluoride levels than those surfaces treated by immersion in a fluoridated mouthrinse or deionized water.

Effect of an anticalculus dentifrice on lesion progression under pH cycling conditions in vitro

The aim of the present study was to examine a sodium fluoride anticalculus dentifrice product containing soluble pyrophosphate for its ability to promote remineralization and/or inhibit demineralization of dental enamel in a pH cycling model in vitro. Enamel crowns with windows were subjected to 14 days of alternating demineralization and remineralization periods at 37 degrees C. Teeth were immersed 5 min daily in one of the test dentifrice systems (1:3 slurry in deionized water) between the demineralization and remineralization cycles. Test dentifrices included (1) sodium fluoride (NaF; 1,100 ppm F)/silica abrasive (Crest) and (2) NaF (1,100 ppm F) with 3.3% soluble pyrophosphate/silica abrasive (Crest Tartar Control). Controls included a placebo dentifrice (silica abrasive) with no added fluoride and a group which received no treatment at all, i.e., demineralization/remineralization only. Overall, both of the NaF dentifrices were very effective in limiting in vitro caries progression and were not significantly different from each other. Inclusion of pyrophosphate in the NaF dentifrice did not affect the net outcome of the cycling demineralization/remineralization processes which is in agreement with recent clinical and in situ studies of these products.