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Axelsen TV, Olesen C, Khan D, Mohammadi A, Bouzinova EV, Nielsen CJF, Mele M, Hauerslev KR, Pedersen HL, Balling E, Vahl P, Tramm T, Christiansen PM, Boedtkjer E. Antibodies toward Na +,HCO 3--cotransporter NBCn1/SLC4A7 block net acid extrusion and cause pH-dependent growth inhibition and apoptosis in breast cancer. Br J Cancer 2024; 130:1206-1220. [PMID: 38310186 PMCID: PMC10991555 DOI: 10.1038/s41416-024-02591-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/09/2024] [Accepted: 01/17/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND Na+,HCO3--cotransporter NBCn1/Slc4a7 accelerates murine breast carcinogenesis. Lack of specific pharmacological tools previously restricted therapeutic targeting of NBCn1 and identification of NBCn1-dependent functions in human breast cancer. METHODS We develop extracellularly-targeted anti-NBCn1 antibodies, screen for functional activity on cells, and evaluate (a) mechanisms of intracellular pH regulation in human primary breast carcinomas, (b) proliferation, cell death, and tumor growth consequences of NBCn1 in triple-negative breast cancer, and (c) association of NBCn1-mediated Na+,HCO3--cotransport with human breast cancer metastasis. RESULTS We identify high-affinity (KD ≈ 0.14 nM) anti-NBCn1 antibodies that block human NBCn1-mediated Na+,HCO3--cotransport in cells, without cross-reactivity towards human NBCe1 or murine NBCn1. These anti-NBCn1 antibodies abolish Na+,HCO3--cotransport activity in freshly isolated primary organoids from human breast carcinomas and lower net acid extrusion effectively in primary breast cancer tissue from patients with macrometastases in axillary lymph nodes. Inhibitory anti-NBCn1 antibodies decelerate tumor growth in vivo by ~50% in a patient-derived xenograft model of triple-negative breast cancer and pH-dependently reduce colony formation, cause G2/M-phase cell cycle accumulation, and increase apoptosis of metastatic triple-negative breast cancer cells in vitro. CONCLUSIONS Inhibitory anti-NBCn1 antibodies block net acid extrusion in human breast cancer tissue, particularly from patients with disseminated disease, and pH-dependently limit triple-negative breast cancer growth.
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Affiliation(s)
- Trine V Axelsen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Claus Olesen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Danish Khan
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Ali Mohammadi
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | | | | | - Marco Mele
- Department of Surgery, Randers Regional Hospital, Randers, Denmark
| | - Katrine R Hauerslev
- Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Helene L Pedersen
- Department of Pathology, Randers Regional Hospital, Randers, Denmark
| | - Eva Balling
- Department of Surgery, Randers Regional Hospital, Randers, Denmark
| | - Pernille Vahl
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Trine Tramm
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Peer M Christiansen
- Department of Surgery, Randers Regional Hospital, Randers, Denmark
- Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ebbe Boedtkjer
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
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Lee S, Toft NJ, Axelsen TV, Espejo MS, Pedersen TM, Mele M, Pedersen HL, Balling E, Johansen T, Burton M, Thomassen M, Vahl P, Christiansen P, Boedtkjer E. Carbonic anhydrases reduce the acidity of the tumor microenvironment, promote immune infiltration, decelerate tumor growth, and improve survival in ErbB2/HER2-enriched breast cancer. Breast Cancer Res 2023; 25:46. [PMID: 37098526 PMCID: PMC10127511 DOI: 10.1186/s13058-023-01644-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/30/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Carbonic anhydrases catalyze CO2/HCO3- buffer reactions with implications for effective H+ mobility, pH dynamics, and cellular acid-base sensing. Yet, the integrated consequences of carbonic anhydrases for cancer and stromal cell functions, their interactions, and patient prognosis are not yet clear. METHODS We combine (a) bioinformatic analyses of human proteomic data and bulk and single-cell transcriptomic data coupled to clinicopathologic and prognostic information; (b) ex vivo experimental studies of gene expression in breast tissue based on quantitative reverse transcription and polymerase chain reactions, intracellular and extracellular pH recordings based on fluorescence confocal microscopy, and immunohistochemical protein identification in human and murine breast cancer biopsies; and (c) in vivo tumor size measurements, pH-sensitive microelectrode recordings, and microdialysis-based metabolite analyses in mice with experimentally induced breast carcinomas. RESULTS Carbonic anhydrases-particularly the extracellular isoforms CA4, CA6, CA9, CA12, and CA14-undergo potent expression changes during human and murine breast carcinogenesis. In patients with basal-like/triple-negative breast cancer, elevated expression of the extracellular carbonic anhydrases negatively predicts survival, whereas, surprisingly, the extracellular carbonic anhydrases positively predict patient survival in HER2/ErbB2-enriched breast cancer. Carbonic anhydrase inhibition attenuates cellular net acid extrusion and extracellular H+ elimination from diffusion-restricted to peripheral and well-perfused regions of human and murine breast cancer tissue. Supplied in vivo, the carbonic anhydrase inhibitor acetazolamide acidifies the microenvironment of ErbB2-induced murine breast carcinomas, limits tumor immune infiltration (CD3+ T cells, CD19+ B cells, F4/80+ macrophages), lowers inflammatory cytokine (Il1a, Il1b, Il6) and transcription factor (Nfkb1) expression, and accelerates tumor growth. Supporting the immunomodulatory influences of carbonic anhydrases, patient survival benefits associated with high extracellular carbonic anhydrase expression in HER2-enriched breast carcinomas depend on the tumor inflammatory profile. Acetazolamide lowers lactate levels in breast tissue and blood without influencing breast tumor perfusion, suggesting that carbonic anhydrase inhibition lowers fermentative glycolysis. CONCLUSIONS We conclude that carbonic anhydrases (a) elevate pH in breast carcinomas by accelerating net H+ elimination from cancer cells and across the interstitial space and (b) raise immune infiltration and inflammation in ErbB2/HER2-driven breast carcinomas, restricting tumor growth and improving patient survival.
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Affiliation(s)
- Soojung Lee
- Department of Biomedicine, Aarhus University, Hoegh-Guldbergs Gade 10, Building 1115, DK-8000, Aarhus C, Denmark
| | - Nicolai J Toft
- Department of Biomedicine, Aarhus University, Hoegh-Guldbergs Gade 10, Building 1115, DK-8000, Aarhus C, Denmark
| | - Trine V Axelsen
- Department of Biomedicine, Aarhus University, Hoegh-Guldbergs Gade 10, Building 1115, DK-8000, Aarhus C, Denmark
| | - Maria Sofia Espejo
- Department of Biomedicine, Aarhus University, Hoegh-Guldbergs Gade 10, Building 1115, DK-8000, Aarhus C, Denmark
| | - Tina M Pedersen
- Department of Biomedicine, Aarhus University, Hoegh-Guldbergs Gade 10, Building 1115, DK-8000, Aarhus C, Denmark
| | - Marco Mele
- Department of Surgery, Randers Regional Hospital, Randers, Denmark
| | - Helene L Pedersen
- Department of Pathology, Randers Regional Hospital, Randers, Denmark
| | - Eva Balling
- Department of Surgery, Randers Regional Hospital, Randers, Denmark
| | - Tonje Johansen
- Department of Pathology, Randers Regional Hospital, Randers, Denmark
| | - Mark Burton
- Department of Clinical Genetics, University of Southern Denmark, Odense, Denmark
- Clinical Genome Center, University and Region of Southern Denmark, Odense, Denmark
- Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark
| | - Mads Thomassen
- Department of Clinical Genetics, University of Southern Denmark, Odense, Denmark
- Clinical Genome Center, University and Region of Southern Denmark, Odense, Denmark
| | - Pernille Vahl
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Peer Christiansen
- Department of Surgery, Randers Regional Hospital, Randers, Denmark
- Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Ebbe Boedtkjer
- Department of Biomedicine, Aarhus University, Hoegh-Guldbergs Gade 10, Building 1115, DK-8000, Aarhus C, Denmark.
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Sloth RA, Axelsen TV, Espejo MS, Toft NJ, Voss NCS, Burton M, Thomassen M, Vahl P, Boedtkjer E. Loss of RPTPγ primes breast tissue for acid extrusion, promotes malignant transformation and results in early tumour recurrence and shortened survival. Br J Cancer 2022; 127:1226-1238. [PMID: 35821297 DOI: 10.1038/s41416-022-01911-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/22/2022] [Accepted: 06/29/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND While cellular metabolism and acidic waste handling accelerate during breast carcinogenesis, temporal patterns of acid-base regulation and underlying molecular mechanisms responding to the tumour microenvironment remain unclear. METHODS We explore data from human cohorts and experimentally investigate transgenic mice to evaluate the putative extracellular HCO3--sensor Receptor Protein Tyrosine Phosphatase (RPTP)γ during breast carcinogenesis. RESULTS RPTPγ expression declines during human breast carcinogenesis and particularly in high-malignancy grade breast cancer. Low RPTPγ expression associates with poor prognosis in women with Luminal A or Basal-like breast cancer. RPTPγ knockout in mice favours premalignant changes in macroscopically normal breast tissue, accelerates primary breast cancer development, promotes malignant breast cancer histopathologies, and shortens recurrence-free survival. In RPTPγ knockout mice, expression of Na+,HCO3--cotransporter NBCn1-a breast cancer susceptibility protein-is upregulated in normal breast tissue but, contrary to wild-type mice, shows no further increase during breast carcinogenesis. Associated augmentation of Na+,HCO3--cotransport in normal breast tissue from RPTPγ knockout mice elevates steady-state intracellular pH, which has known pro-proliferative effects. CONCLUSIONS Loss of RPTPγ accelerates cellular net acid extrusion and elevates NBCn1 expression in breast tissue. As these effects precede neoplastic manifestations in histopathology, we propose that RPTPγ-dependent enhancement of Na+,HCO3--cotransport primes breast tissue for cancer development.
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Affiliation(s)
- Rasmus A Sloth
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Trine V Axelsen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | | | - Nicolai J Toft
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Ninna C S Voss
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Mark Burton
- Department of Clinical Genetics, University of Southern Denmark, Odense, Denmark.,Clinical Genome Center, University and Region of Southern Denmark, Odense, Denmark.,Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark
| | - Mads Thomassen
- Department of Clinical Genetics, University of Southern Denmark, Odense, Denmark.,Clinical Genome Center, University and Region of Southern Denmark, Odense, Denmark
| | - Pernille Vahl
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Ebbe Boedtkjer
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
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Henningsen MB, McWhan K, Dam VS, Mele M, Hauerslev KR, Voss NCS, Dabir PD, Balling E, Pedersen HL, Vahl P, Johansen T, Tramm T, Christiansen PM, Boedtkjer E. Amplified Ca 2+ dynamics and accelerated cell proliferation in breast cancer tissue during purinergic stimulation. Int J Cancer 2022; 151:1150-1165. [PMID: 35657342 PMCID: PMC9544627 DOI: 10.1002/ijc.34147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022]
Abstract
Intracellular Ca2+ dynamics shape malignant behaviors of cancer cells. Whereas previous studies focused on cultured cancer cells, we here used breast organoids and colonic crypts freshly isolated from human and murine surgical biopsies. We performed fluorescence microscopy to evaluate intracellular Ca2+ concentrations in breast and colon cancer tissue with preferential focus on intracellular Ca2+ release in response to purinergic and cholinergic stimuli. Inhibition of the sarco‐/endoplasmic reticulum Ca2+ ATPase with cyclopiazonic acid elicited larger Ca2+ responses in breast cancer tissue, but not in colon cancer tissue, relative to respective normal tissue. The resting intracellular Ca2+ concentration was elevated, and ATP, UTP and acetylcholine induced strongly augmented intracellular Ca2+ responses in breast cancer tissue compared with normal breast tissue. In contrast, resting intracellular Ca2+ levels and acetylcholine‐induced increases in intracellular Ca2+ concentrations were unaffected and ATP‐ and UTP‐induced Ca2+ responses were smaller in colon cancer tissue compared with normal colon tissue. In accordance with the amplified Ca2+ responses, ATP and UTP substantially increased proliferative activity—evaluated by bromodeoxyuridine incorporation—in breast cancer tissue, whereas the effect was minimal in normal breast tissue. ATP caused cell death—identified with ethidium homodimer‐1 staining—in breast cancer tissue only at concentrations above the expected pathophysiological range. We conclude that intracellular Ca2+ responses are amplified in breast cancer tissue, but not in colon cancer tissue, and that nucleotide signaling stimulates breast cancer cell proliferation within the extracellular concentration range typical for solid cancer tissue.
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Affiliation(s)
| | - Kezia McWhan
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Vibeke S Dam
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Marco Mele
- Department of Surgery, Randers Regional Hospital, Randers, Denmark
| | - Katrine R Hauerslev
- Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Ninna C S Voss
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.,Department of Surgery, Randers Regional Hospital, Randers, Denmark
| | - Parag D Dabir
- Department on Pathology, Randers Regional Hospital, Randers, Denmark
| | - Eva Balling
- Department of Surgery, Randers Regional Hospital, Randers, Denmark
| | - Helene L Pedersen
- Department on Pathology, Randers Regional Hospital, Randers, Denmark
| | - Pernille Vahl
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Tonje Johansen
- Department on Pathology, Randers Regional Hospital, Randers, Denmark
| | - Trine Tramm
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Peer M Christiansen
- Department of Surgery, Randers Regional Hospital, Randers, Denmark.,Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Ebbe Boedtkjer
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
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Tramm T, Vinter H, Vahl P, Özcan D, Alsner J, Overgaard J. Tumor-infiltrating lymphocytes predict improved overall survival after post-mastectomy radiotherapy: a study of the randomized DBCG82bc cohort. Acta Oncol 2022; 61:153-162. [PMID: 34705573 DOI: 10.1080/0284186x.2021.1989629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The predictive value of tumor-infiltrating lymphocytes (TILs) on the benefit from radiotherapy (RT) remains unclear. Our aim was to investigate the association between TILs and post-mastectomy RT (PMRT) regarding the risk of recurrence and survival in a randomized cohort. MATERIAL AND METHODS Stromal TILs were histologically estimated in 1011 tumors from high-risk breast cancer (BC) patients from the DBCG82bc trial. Patients were diagnosed between 1982 and 90, treated with total mastectomy and partial axillary lymph node dissection, randomized to ± PMRT followed by adjuvant systemic treatment. A competing risk model, Kaplan-Meier analysis and multivariate Cox regression analysis were used for correlating TILs and clinical outcome. RESULTS 106 of 1011 patients (10.5%) showed high TILs using a 30% cut-off. In multivariate regression analysis, a high level of TILs was an independent factor associated with lower risk of distant metastasis (DM) and improved overall survival (OS), but without association with loco-regional control. High TILs were associated with a significantly greater OS after PMRT at 20 years compared to low TILs (8% improvement for low TILs (23% to 31%) vs. 22% for high TILs (26% to 48%), interaction-test: p = 0.028). The association between TILs and PMRT was more pronounced among estrogen-receptor negative (ER-) tumors, and patients having ER-/low TILs tumors showed no OS benefit from PMRT at 20 years (-4% improvement for low TILs (28% to 24%) vs. 23% for high TILs (20% to 43%). A similar trend in the association between high TILs and reduced risk of DM after PMRT was seen. CONCLUSION High TILs predict improved OS from PMRT in BC patients, and the association appeared especially strong for ER- tumors. A trend in the association between high TILs and reduced risk of DM after PMRT was seen. These findings may indicate that RT triggers an immune response inducing a systemic effect outside the treatment field.
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Affiliation(s)
- Trine Tramm
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Hanne Vinter
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Pernille Vahl
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Demet Özcan
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Jan Alsner
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Overgaard
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
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6
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Sundelin EIO, Al-Suliman N, Vahl P, Vendelbo M, Munk OL, Jakobsen S, Pedersen SB, Frøkiær J, Gormsen LC, Jessen N. Metformin is distributed to tumor tissue in breast cancer patients in vivo: A 11C-metformin PET/CT study. Breast Cancer Res Treat 2020; 181:107-113. [PMID: 32240455 DOI: 10.1007/s10549-020-05621-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/27/2020] [Indexed: 01/11/2023]
Abstract
PURPOSE Epidemiological studies and randomized clinical trials suggest that the antidiabetic drug, metformin, may have anti-neoplastic effects. The mechanism that mediates these beneficial effects has been suggested to involve direct action on cancer cells, but this will require distribution of metformin in tumor tissue. The present study was designed to investigate metformin distribution in vivo in breast and liver tissue in breast cancer patients. METHODS Seven patients recently diagnosed with ductal carcinoma were recruited. Using PET/CT, tissue distribution of metformin was determined in vivo for 90 min after injection of a carbon-11-labeled metformin tracer. After surgery, tumor tissue was investigated for gene expression levels of metformin transporter proteins. RESULTS Tumor tissue displayed a distinct uptake of metformin compared to normal breast tissue AUC0-90 min (75.4 ± 5.5 vs 42.3 ± 6.3) g/ml*min (p = 0.01). Maximal concentration in tumor was at 1 min where it reached approximately 30% of the activity in the liver. The metformin transporter protein with the highest gene expression in tumor tissue was multidrug and toxin extrusion 1 (MATE 1) followed by plasma membrane monoamine transporter (PMAT). CONCLUSION This study confirms that metformin is transported into tumor tissue in women with breast cancer. This finding support that metformin may have direct anti-neoplastic effects on tumor cells in breast cancer patients. However, distribution of metformin in tumor tissue is markedly lower than in liver, an established metformin target tissue.
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Affiliation(s)
- Elias Immanuel Ordell Sundelin
- Research Laboratory for Biochemical Pathology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Nidal Al-Suliman
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Pernille Vahl
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Mikkel Vendelbo
- Department of Nuclear Medicine & PET Center, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Lajord Munk
- Department of Nuclear Medicine & PET Center, Aarhus University Hospital, Aarhus, Denmark
| | - Steen Jakobsen
- Department of Nuclear Medicine & PET Center, Aarhus University Hospital, Aarhus, Denmark
| | - Steen Bønløkke Pedersen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Jørgen Frøkiær
- Department of Nuclear Medicine & PET Center, Aarhus University Hospital, Aarhus, Denmark
| | - Lars C Gormsen
- Department of Nuclear Medicine & PET Center, Aarhus University Hospital, Aarhus, Denmark
| | - Niels Jessen
- Research Laboratory for Biochemical Pathology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
- Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Hedeager 3 2.sal, 8200, Aarhus N, Denmark.
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7
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Mele M, McWhan K, Henningsen M, Vahl P, Jensen V, Johansen T, Pedersen H, Christiansen P, Bødtkjer E. Abstract P5-05-03: Upregulated purinergic signaling enhances cell proliferation in human and murine breast carcinomas. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-05-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The composition of the extracellular tumor microenvironment differs from that of most other tissues and is thought to provide cancer cells with a growth and survival advantage compared to normal cells. In solid tumors, the extracellular concentration of ATP can be elevated to ~100 µm and extracellular pH can be as low as 6.5. In the current project, we investigate the consequences of purinergic signaling in human and murine breast carcinomas: we study intracellular Ca2+ signals and associated changes in cell proliferation during stimulation with extracellular nucleotides.
We employ biopsies of human and murine primary breast carcinomas and compare them with matched normal breast tissue. Human biopsies are obtained with written informed consent from patients undergoing breast conserving surgery at Aarhus University Hospital or Regional Hospital Randers in Denmark. Murine biopsies are from mice overexpressing unactivated ErbB2 specifically in the breast tissue. We isolate epithelial organoids (~150 µm diameter) from tissue biopsies by partial digestion with collagenase III. Organoids loaded with the Ca2+-sensitive fluorophore Fura-2 are studied by fluorescence microscopy. In separate experiments, cell proliferation is quantified by detecting newly synthesized DNA using immunofluorescence imaging of organoids incubated with the thymidine analogue bromodeoxyuridine (BrdU).
We find that intracellular Ca2+ responses during stimulation with extracellular ATP are elevated 2- to 10-fold in breast carcinomas from mice and humans, respectively, compared to matched normal breast tissue. We observe similar differences between breast cancer tissue and normal breast tissue in response to stimulation with the P2Y2/P2Y4-agonist UTP, whereas virtually no rise in the intracellular concentration of Ca2+ is observed in response to the P2X7-agonist 3'-O-(4-benzoyl)benzoyl-ATP. Application of cyclopiazonic acid – an inhibitor of the sarcoplasmic/endoplasmic reticulum Ca2+-ATPase – also cause exaggerated intracellular Ca2+ responses in breast cancer compared to normal breast tissue. Consistent with the elevated Ca2+ responses, stimulation with 100 µm ATP or 100 µm UTP increases the rate of cell proliferation (i.e., fraction of BrdU-positive cells) by ~2-fold in the breast cancer tissue.
In conclusion, we find that purinergic signaling is upregulated in human and murine breast carcinomas compared to normal breast tissue. Activation of purinergic receptors – most likely P2Y2 and/or P2Y4 – enhances cell proliferation in breast cancer tissue. We propose that the high ATP levels in the tumor microenvironment promote breast cancer development or progression and that the associated signaling pathways represent promising targets for therapy.
Citation Format: Mele M, McWhan K, Henningsen M, Vahl P, Jensen V, Johansen T, Pedersen H, Christiansen P, Bødtkjer E. Upregulated purinergic signaling enhances cell proliferation in human and murine breast carcinomas [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-05-03.
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Affiliation(s)
- M Mele
- Randers Regionshospitalet, Randers, Denmark; Aarhus University Hospital, Aarhus, Denmark
| | - K McWhan
- Randers Regionshospitalet, Randers, Denmark; Aarhus University Hospital, Aarhus, Denmark
| | - M Henningsen
- Randers Regionshospitalet, Randers, Denmark; Aarhus University Hospital, Aarhus, Denmark
| | - P Vahl
- Randers Regionshospitalet, Randers, Denmark; Aarhus University Hospital, Aarhus, Denmark
| | - V Jensen
- Randers Regionshospitalet, Randers, Denmark; Aarhus University Hospital, Aarhus, Denmark
| | - T Johansen
- Randers Regionshospitalet, Randers, Denmark; Aarhus University Hospital, Aarhus, Denmark
| | - H Pedersen
- Randers Regionshospitalet, Randers, Denmark; Aarhus University Hospital, Aarhus, Denmark
| | - P Christiansen
- Randers Regionshospitalet, Randers, Denmark; Aarhus University Hospital, Aarhus, Denmark
| | - E Bødtkjer
- Randers Regionshospitalet, Randers, Denmark; Aarhus University Hospital, Aarhus, Denmark
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8
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Boonmann C, Grisso T, Guy LS, Colins OF, Mulder EA, Vahl P, Jansen LMC, Doreleijers TAH, Vermeiren RRJM. Childhood traumatic experiences and mental health problems in sexually offending and non-sexually offending juveniles. Child Adolesc Psychiatry Ment Health 2016; 10:45. [PMID: 27822305 PMCID: PMC5093963 DOI: 10.1186/s13034-016-0127-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 10/12/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To examine the relationship between a history of childhood abuse and mental health problems in juveniles who sexually offended (JSOs) over and above general offending behavior. METHODS A sample of 44 JSOs incarcerated in two juvenile detention centers in the Netherlands between May 2008 and March 2014 were examined for childhood abuse history (Childhood Trauma Questionnaire-Short Form) and mental health problems (Massachusetts Youth Screening Instrument-Version 2). Furthermore, the connection between childhood abuse and mental health problems in JSOs was compared to a sample of 44 propensity score matched juveniles who offended non-sexually (non-JSOs). RESULTS In JSOs, sexual abuse was related to anger problems, suicidal ideation, and thought disturbance. These associations were significantly stronger in JSOs than in non-JSOs. CONCLUSIONS Our results suggest that the relationship between childhood abuse and both internalizing and externalizing mental health problems is of more salience for understanding sexual offending than non-sexual offending, and should, therefore, be an important focus in the assessment and treatment of JSOs.
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Affiliation(s)
- Cyril Boonmann
- Department of Child and Adolescent Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical, P.O. Box 303, 1115 ZG Duivendrecht, Amsterdam, The Netherlands ,Department of Forensic Child and Adolescent Psychiatry, Psychiatric University Hospitals Basel, Basel, Switzerland
| | - Thomas Grisso
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA USA
| | - Laura S. Guy
- Department of Psychology, Simon Fraser University, Burnaby, BC Canada
| | - Olivier F. Colins
- Curium-LUMC, Leiden University Medical Center and Academic Workplace Forensic Care for Youth, Leiden, The Netherlands
| | - Eva A. Mulder
- Curium-LUMC, Leiden University Medical Center and Academic Workplace Forensic Care for Youth, Leiden, The Netherlands
| | - P. Vahl
- Curium-LUMC, Leiden University Medical Center and Academic Workplace Forensic Care for Youth, Leiden, The Netherlands
| | - Lucres M. C. Jansen
- Department of Child and Adolescent Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical, P.O. Box 303, 1115 ZG Duivendrecht, Amsterdam, The Netherlands
| | - Theo A. H. Doreleijers
- Department of Child and Adolescent Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical, P.O. Box 303, 1115 ZG Duivendrecht, Amsterdam, The Netherlands
| | - Robert R. J. M. Vermeiren
- Department of Child and Adolescent Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical, P.O. Box 303, 1115 ZG Duivendrecht, Amsterdam, The Netherlands ,Curium-LUMC, Leiden University Medical Center and Academic Workplace Forensic Care for Youth, Leiden, The Netherlands
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Bodilsen A, Bjerre K, Offersen BV, Vahl P, Amby N, Dixon JM, Ejlertsen B, Overgaard J, Christiansen P. Importance of margin width in breast-conserving treatment of early breast cancer. J Surg Oncol 2016; 113:609-15. [DOI: 10.1002/jso.24224] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 02/28/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Anne Bodilsen
- Department of Breast and Endocrine Surgery; Aarhus University Hospital; Aarhus Denmark
| | - Karsten Bjerre
- Danish Breast Cancer Cooperative Group; Copenhagen Denmark
| | | | - Pernille Vahl
- Department of Pathology; Aarhus University Hospital; Aarhus Denmark
| | - Nikolaj Amby
- Department of Oncology; Aarhus University Hospital; Aarhus Denmark
| | - J. Michael Dixon
- Breakthrough Research Unit Edinburgh Breast Unit; Western General Hospital; Edinburgh United Kingdom
| | - Bent Ejlertsen
- Danish Breast Cancer Cooperative Group; Copenhagen Denmark
- Department of Oncology; Copenhagen University Hospital; Rigshospitalet Copenhagen Denmark
| | - Jens Overgaard
- Department of Experimental Clinical Oncology; Aarhus University Hospital; Aarhus Denmark
| | - Peer Christiansen
- Department of Surgery P, Breast Surgery Unit; Aarhus University Hospital/Randers Regional Hospital; Aarhus Denmark
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10
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Bodilsen A, Bjerre K, Offersen BV, Vahl P, Mele M, Dixon MJ, Ejlertsen B, Overgaard J, Christiansen P. Abstract S2-01: Importance of margin width and re-excision in breast conserving treatment of early breast cancer; a Danish breast cancer cooperative group study of 11,900 women. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-s2-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The majority of women with invasive breast cancer are treated surgically by breast conserving surgery (BCS). A significant proportion subsequently undergo re-excision to obtain clear margins. However what constitutes a sufficient negative margin continues to be subject of controversy. The purpose of the study was to investigate the association between margin width and ipsilateral breast tumour recurrence (IBTR) as well as identifying factors associated with residual disease after repeat surgery, and to determine the effect of re-excision on IBTR in a population-based nationwide cohort.
Method: 11,900 patients treated with breast conserving therapy for unilateral invasive cancer in Denmark between 2000 and 2009 were included. All patients received whole breast irradiation and were offered systemic adjuvant treatment according to the guidelines of the Danish Breast Cancer Cooperative Group.
Results: The median follow-up was 4.9 years. The cumulative incidence of IBTR at 5 and 9 year was 2.4% and 5.9%, respectively. No decrease in IBTR with a wider negative margin compared to a narrow but negative margin was seen in adjusted analysis (>0-1 mm vs. 2-4 mm vs. ≥5 mm (reference): HR 1.54 (CI 95% 0.81-2.93) vs 0.95 (CI 95% 0.56-1.62) vs. 1). A final positive margin did however increase the risk of IBTR (HR 2.51; 95% CI 1.02-6.23). Other factors associated with increased IBTR were young age (HR 3.10; 95% CI 1.89-5.10), more than 4 positive lymph nodes (HR 1.80; 95% CI 1.24-2.62), and re-excision (HR 1.53; 95% CI 1.16-2.02). Receiving chemotherapy (HR 0.45; 95% CI 0.33-0.61) or boost (HR 0.43; 95% CI 0.31-0.60) reduced risk of IBTR as did being oestrogen receptor positive treated with (HR 0.35; 95% CI 0.25-0.49) or without (HR 0.43; 95% CI 0.31-0.60) adjuvant endocrine therapy.
Within two months of initial BCS 1342 women (11%) had a re-excision. Residual disease was found in 20% of re-excisions. In adjusted analysis DCIS outside the invasive tumour (OR 2.69; 95% CI 1.99-3.63), positive initial margin (OR 2.26, 95% CI 1.70-2.99, p<0.001), and age <50 years (OR 1.53; 95% CI 1.00-2.31) was associated with increased risk of residual disease. Patients with residual disease after re-excision had in the adjusted analysis an increased risk of ipsilateral breast tumour recurrence (IBTR), regardless of whether residual findings were invasive carcinoma (HR 2.97, CI 95% 1.57-5.62) or DCIS (HR 2.58, CI 95% 1.50-4.45). However no difference was seen for overall survival comparing one procedure with repeat surgery with or without residual disease (p=0.96).
Conclusion: An overall low rate of IBTR was seen. While a final positive margin was associated with a more than two-fold risk of IBTR, no evidence of improved local control was found with wider negative margins compared to narrow. However the finding of residual disease at re-excision was associated with an increased risk of IBTR.
Citation Format: Bodilsen A, Bjerre K, Offersen BV, Vahl P, Mele M, Dixon MJ, Ejlertsen B, Overgaard J, Christiansen P. Importance of margin width and re-excision in breast conserving treatment of early breast cancer; a Danish breast cancer cooperative group study of 11,900 women. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr S2-01.
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Affiliation(s)
- A Bodilsen
- Aarhus University Hospital, Aarhus, Denmark; Danish Breast Cancer Cooperative Group, Copenhagen, Denmark; Breakthrough Research Unit Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - K Bjerre
- Aarhus University Hospital, Aarhus, Denmark; Danish Breast Cancer Cooperative Group, Copenhagen, Denmark; Breakthrough Research Unit Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - BV Offersen
- Aarhus University Hospital, Aarhus, Denmark; Danish Breast Cancer Cooperative Group, Copenhagen, Denmark; Breakthrough Research Unit Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - P Vahl
- Aarhus University Hospital, Aarhus, Denmark; Danish Breast Cancer Cooperative Group, Copenhagen, Denmark; Breakthrough Research Unit Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - M Mele
- Aarhus University Hospital, Aarhus, Denmark; Danish Breast Cancer Cooperative Group, Copenhagen, Denmark; Breakthrough Research Unit Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - MJ Dixon
- Aarhus University Hospital, Aarhus, Denmark; Danish Breast Cancer Cooperative Group, Copenhagen, Denmark; Breakthrough Research Unit Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - B Ejlertsen
- Aarhus University Hospital, Aarhus, Denmark; Danish Breast Cancer Cooperative Group, Copenhagen, Denmark; Breakthrough Research Unit Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - J Overgaard
- Aarhus University Hospital, Aarhus, Denmark; Danish Breast Cancer Cooperative Group, Copenhagen, Denmark; Breakthrough Research Unit Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - P Christiansen
- Aarhus University Hospital, Aarhus, Denmark; Danish Breast Cancer Cooperative Group, Copenhagen, Denmark; Breakthrough Research Unit Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
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11
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Bodilsen A, Bjerre K, Offersen BV, Vahl P, Ejlertsen B, Overgaard J, Christiansen P. The Influence of Repeat Surgery and Residual Disease on Recurrence After Breast-Conserving Surgery: A Danish Breast Cancer Cooperative Group Study. Ann Surg Oncol 2015; 22 Suppl 3:S476-85. [DOI: 10.1245/s10434-015-4707-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Indexed: 12/21/2022]
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12
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Mele M, Lee S, Vahl P, Christiansen P, Jensen V, Boedtkjer E. P069 Na+,HCO−3 cotransport mediates upregulated acid extrusion during human breast carcinogenesis. Breast 2015. [DOI: 10.1016/s0960-9776(15)70119-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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13
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Abstract
Carcinosarcoma of the breast is an extremely rare and highly aggressive breast tumor.It has two distinct malignant cell lines involving epithelial (carcinomatous) and mesenchymal (sarcomatous) components. The literature on the topic is sparse. We report a rare case of carcinosarcoma of the breast containing a small fraction of a pancytokeratin positive sarcomatous-appearing cell population i.e. a metaplastic cell population. The patient was treated with a multidisciplinary approach.
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Affiliation(s)
- Marco Mele
- Breast and Endocrinal Surgery Department, Aarhus University Hospital, Aarhus, Denmark
| | - Lisbeth L Jensen
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Pernille Vahl
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Jonas Amstrup Funder
- Breast and Endocrinal Surgery Department, Aarhus University Hospital, Aarhus, Denmark
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14
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Lee S, Mele M, Vahl P, Christiansen PM, Jensen VED, Boedtkjer E. Na+,HCO3- -cotransport is functionally upregulated during human breast carcinogenesis and required for the inverted pH gradient across the plasma membrane. Pflugers Arch 2014; 467:367-77. [PMID: 24788003 DOI: 10.1007/s00424-014-1524-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 04/14/2014] [Accepted: 04/16/2014] [Indexed: 12/21/2022]
Abstract
Metabolic and biochemical changes during breast carcinogenesis enhance cellular acid production. Extrusion of the acid load from the cancer cells raises intracellular pH, while it decreases extracellular pH creating an inverted pH gradient across the plasma membrane compared to normal cells and promoting cancer cell metabolism, proliferation, migration, and invasion. We investigated the effects of breast carcinogenesis on the mechanisms of cellular pH control using multicellular epithelial organoids freshly isolated from human primary breast carcinomas and matched normal breast tissue. Intracellular pH was measured by fluorescence microscopy, while protein expression was investigated by immunofluorescence imaging and immunoblotting. We found that cellular net acid extrusion increased during human breast carcinogenesis due to enhanced Na(+),HCO3 (-)-cotransport, which created an alkaline shift (~0.3 units of magnitude) in steady-state intracellular pH of human primary breast carcinomas compared to normal breast tissue. Na(+)/H(+)-exchange activity and steady-state intracellular pH in the absence of CO2/HCO3 (-) were practically unaffected by breast carcinogenesis. These effects were evident under both acidic (pH 6.8, representative of the tumor microenvironment) and physiological (pH 7.4) extracellular conditions. Protein expression of the Na(+),HCO3 (-)-cotransporter NBCn1 (SLC4A7), which has been linked to breast cancer susceptibility in multiple genome-wide association studies, was twofold higher in human breast carcinomas compared to matched normal breast tissue. Protein expression of the Na(+)/H(+)-exchanger NHE1 (SLC9A1) was markedly less affected. We propose that upregulated NBCn1 during human breast carcinogenesis contributes to the characteristic acid distribution within human breast carcinomas and thereby plays a pathophysiological role for breast cancer development and progression.
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Affiliation(s)
- Soojung Lee
- Department of Biomedicine, Aarhus University, Ole Worms Allé 3, Building 1170, 8000, Aarhus C, Denmark
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15
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Abstract
A carcinoma arising in a fibroadenoma is a rare event, which often entails a diagnostic challenge. The most common type is the lobular carcinoma and secondary a ductal carcinoma. We present an extremely rare case of malignant development of an invasive apocrine carcinoma in a complex fibroadenoma and underline the importance for clinicians to recognize the possibility of benign and malignant co-existence especially in older women.
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Affiliation(s)
- Marco Mele
- Department of Breast and Endocrinal Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Pernille Vahl
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Jonas Amstrup Funder
- Department of Breast and Endocrinal Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Anne Schmidt Sorensen
- Department of Breast and Endocrinal Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Vibeke Jensen
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
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16
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Mele M, Lee S, Moreira J, Vahl P, Wielenga V, Jensen V, Pedersen S, Christiansen P, Aalkjær C, Boedtkjer E. Abstract P3-03-02: Na+,HCO3--cotransport is the major mechanism of cellular acid extrusion in human and murine breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-03-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
High metabolism and insufficient blood supply are characteristics of cancer tissue, which in combination with biochemical changes favor glycolytic metabolism and result in prominent intracellular acid production. Although extracellular pH at the core of malignant tumors is as low as one unit below normal, intracellular pH (pHi) in tumor cells is typically normal or even slightly alkaline. Thus, cancer cells must possess efficient mechanisms of acid extrusion to eliminate the excess acid load.
We investigated the role of the Na+,HCO3–cotransporter NBCn1 (SLC4A7), which in recent genome-wide association studies has been linked to human breast cancer. Based on immunohistochemistry of tumor slices and immunoblotting of enzymatically isolated epithelial organoids, we found that NBCn1 expression is upregulated in human and murine primary breast carcinomas and metastases compared to normal breast tissue. The upregulation of NBCn1 was of similar or greater magnitude than that observed for the Na+/H+-exchanger NHE1, which has previously been implicated in cell migration, proliferation and malignancy. Measurements of pHi from slices of human and murine breast cancers and from malignant and normal breast epithelial organoids showed that Na+,HCO3–cotransport is the major mechanism of acid extrusion in the near-physiological pHi range. Na+/H+-exchange was important for acid extrusion only at very low pHi values. We furthermore found that Na+,HCO3–cotransport activity was substantially greater in malignant compared to normal breast epithelial organoids of both human and murine origin, while no apparent difference in Na+/H+-exchange activity was detected between cancer and normal breast tissue. Steady-state pHi was higher in the breast cancer tissue compared to normal breast epithelium in the presence of CO2/HCO3- but not in its nominal absence.
We propose that NBCn1 plays a major role for cellular acid extrusion and pHi regulation in human and murine breast cancer. The upregulated expression of NBCn1 and the functional importance of Na+,HCO3–cotransport for pHi regulation support a causative role for NBCn1 in breast cancer development or progression.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-03-02.
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Affiliation(s)
- M Mele
- Aarhus University Hospital, Aarhus C, Jutland, Denmark; Copenhagen University Hospital, Copenhagen, Zeeland, Denmark; Danish Cancer Society Research Center, Frederiksberg C, Zeeland, Denmark; Aarhus University, Aarhus C, Jutland, Denmark
| | - S Lee
- Aarhus University Hospital, Aarhus C, Jutland, Denmark; Copenhagen University Hospital, Copenhagen, Zeeland, Denmark; Danish Cancer Society Research Center, Frederiksberg C, Zeeland, Denmark; Aarhus University, Aarhus C, Jutland, Denmark
| | - J Moreira
- Aarhus University Hospital, Aarhus C, Jutland, Denmark; Copenhagen University Hospital, Copenhagen, Zeeland, Denmark; Danish Cancer Society Research Center, Frederiksberg C, Zeeland, Denmark; Aarhus University, Aarhus C, Jutland, Denmark
| | - P Vahl
- Aarhus University Hospital, Aarhus C, Jutland, Denmark; Copenhagen University Hospital, Copenhagen, Zeeland, Denmark; Danish Cancer Society Research Center, Frederiksberg C, Zeeland, Denmark; Aarhus University, Aarhus C, Jutland, Denmark
| | - V Wielenga
- Aarhus University Hospital, Aarhus C, Jutland, Denmark; Copenhagen University Hospital, Copenhagen, Zeeland, Denmark; Danish Cancer Society Research Center, Frederiksberg C, Zeeland, Denmark; Aarhus University, Aarhus C, Jutland, Denmark
| | - V Jensen
- Aarhus University Hospital, Aarhus C, Jutland, Denmark; Copenhagen University Hospital, Copenhagen, Zeeland, Denmark; Danish Cancer Society Research Center, Frederiksberg C, Zeeland, Denmark; Aarhus University, Aarhus C, Jutland, Denmark
| | - S Pedersen
- Aarhus University Hospital, Aarhus C, Jutland, Denmark; Copenhagen University Hospital, Copenhagen, Zeeland, Denmark; Danish Cancer Society Research Center, Frederiksberg C, Zeeland, Denmark; Aarhus University, Aarhus C, Jutland, Denmark
| | - P Christiansen
- Aarhus University Hospital, Aarhus C, Jutland, Denmark; Copenhagen University Hospital, Copenhagen, Zeeland, Denmark; Danish Cancer Society Research Center, Frederiksberg C, Zeeland, Denmark; Aarhus University, Aarhus C, Jutland, Denmark
| | - C Aalkjær
- Aarhus University Hospital, Aarhus C, Jutland, Denmark; Copenhagen University Hospital, Copenhagen, Zeeland, Denmark; Danish Cancer Society Research Center, Frederiksberg C, Zeeland, Denmark; Aarhus University, Aarhus C, Jutland, Denmark
| | - E Boedtkjer
- Aarhus University Hospital, Aarhus C, Jutland, Denmark; Copenhagen University Hospital, Copenhagen, Zeeland, Denmark; Danish Cancer Society Research Center, Frederiksberg C, Zeeland, Denmark; Aarhus University, Aarhus C, Jutland, Denmark
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Boedtkjer E, Moreira JMA, Mele M, Vahl P, Wielenga VT, Christiansen PM, Jensen VED, Pedersen SF, Aalkjaer C. Contribution of Na+,HCO3(-)-cotransport to cellular pH control in human breast cancer: a role for the breast cancer susceptibility locus NBCn1 (SLC4A7). Int J Cancer 2012; 132:1288-99. [PMID: 22907202 DOI: 10.1002/ijc.27782] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 07/31/2012] [Indexed: 12/16/2022]
Abstract
Genome-wide association studies recently linked the locus for Na(+),HCO(3)(-)-cotransporter NBCn1 (SLC4A7) to breast cancer susceptibility, yet functional insights have been lacking. To determine whether NBCn1, by transporting HCO(3)(-) into cells, may dispose of acid produced during high metabolic activity, we studied the expression of NBCn1 and the functional impact of Na(+),HCO(3)(-)-cotransport in human breast cancer. We found that the plasmalemmal density of NBCn1 was 20-30% higher in primary breast carcinomas and metastases compared to matched normal breast tissue. The increase in NBCn1 density was similar in magnitude to that observed for Na(+)/H(+)-exchanger NHE1 (SLC9A1), a transporter previously implicated in cell migration, proliferation and malignancy. In primary breast carcinomas, the apparent molecular weight for NBCn1 was increased compared to normal tissue. Using pH-sensitive fluorophores, we showed that Na(+),HCO(3)(-)-cotransport is the predominant mechanism of acid extrusion and is inhibited 34 ± 9% by 200 μM 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid in human primary breast carcinomas. At intracellular pH (pH(i) ) levels >6.6, CO(2)/HCO(3)(-)-dependent mechanisms accounted for >90% of total net acid extrusion. Na(+)/H(+)-exchange activity was prominent only at lower pH(i) -values. Furthermore, steady-state pH(i) was 0.35 ± 0.06 units lower in the absence than in the presence of CO(2)/HCO(3)(-). In conclusion, expression of NBCn1 is upregulated in human primary breast carcinomas and metastases compared to normal breast tissue. Na(+),HCO(3)(-)-cotransport is a major determinant of pH(i) in breast cancer and the modest DIDS-sensitivity is consistent with NBCn1 being predominantly responsible. Hence, our results suggest a major pathophysiological role for NBCn1 that may be clinically relevant.
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18
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Boedtkjer E, Moreira J, Mele M, Vahl P, Jespersen M, Christiansen P, Jensen V, Pedersen SF, Aalkjaer C. Na
+
,HCO
3
−
‐cotransport is crucial for intracellular pH control in human breast cancer. FASEB J 2012. [DOI: 10.1096/fasebj.26.1_supplement.882.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ebbe Boedtkjer
- Department of BiomedicineAarhus UniversityAarhus CDenmark
| | - José Moreira
- Danish Centre for Translational Breast Cancer Research and Department of Proteomics in CancerDanish Cancer SocietyCopenhagenDenmark
| | - Marco Mele
- Surgical Department PAarhus University HospitalAarhus CDenmark
| | - Pernille Vahl
- Department of PathologyAarhus University HospitalAarhus CDenmark
| | - Marie Jespersen
- Department of PathologyAarhus University HospitalAarhus CDenmark
| | | | - Vibeke Jensen
- Department of PathologyAarhus University HospitalAarhus CDenmark
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Colins O, Vermeiren R, Vahl P, Markus M, Broekaert E, Doreleijers T. Parent-reported attention-deficit hyperactivity disorder and subtypes of conduct disorder as risk factor of recidivism in detained male adolescents. Eur Psychiatry 2011; 27:329-34. [PMID: 21420836 DOI: 10.1016/j.eurpsy.2011.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 12/17/2010] [Accepted: 01/03/2011] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Parents are considered to be crucial informants in child psychiatry, particularly for disorders in which age of onset is included in the diagnostic criteria. In detained adolescents, however, parents all too often are difficult to reach or reluctant to cooperate. The clinical relevance of gathering parental information in this context should therefore be demonstrated. This study examines if parent reports of attention-deficit-hyperactivity disorder (ADHD) and age of onset subtypes of conduct disorder (CD) predict official criminal recidivism. METHOD Participants were 110 detained male adolescents from all three Youth Detention Centers in Flanders. Between January 2005 and February 2007, both youth and a parent were interviewed with the Diagnostic Interview Schedule for Children Version IV. Two to 4 years later, information on criminal recidivism was retrieved. RESULTS Youth self-reported ADHD and CD (subtypes) were not related with recidivism. Parent-reported ADHD, CD and childhood-onset CD predicted serious property recidivism, while parent-reported adolescent-onset CD predicted future violent arrests. In reverse, childhood-onset CD as reported by parents was negatively associated with violent recidivism. CONCLUSION Obtaining parental diagnostic information in delinquent adolescents is crucial for predicting recidivism. This finding emphasizes the need of including parents when studying mental disorder in detained adolescents.
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Affiliation(s)
- O Colins
- Curium, Leiden University Medical Center, Oegstgeest, The Netherlands.
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20
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Vahl P, Herrmann C, Zuhrt R, Barthel J, Blumenthal-Barby CC. [Physiological and psychological specifics of the stomatological care in patients suffering from connatal troubles of the haemodynamics]. Stomatol DDR 1989; 39:708-11. [PMID: 2636476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Four groups of patients are subdivided related to the degree of severity of the trouble of haemodynamics. Main reasons for the decreased loadability are the lack in oxygen in the capillary range, increased infections of the respiratory systems and an altered situation of defense. The multitude of patients of the groups I and II can be treated in child's stomatology. The endangering of the patient acc. to its loadability, the application of local anaesthetics without supplement of means affecting the circulation and a protection by antibiotics with all the surgical interventions are prerequisites.
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