Cervical wear pathobiology by robot-simulated 3-year toothbrushing - New methodological approach

OBJECTIVES

An ex-vivo study was aimed at (i) programming clinically validated robot three-year random toothbrushing, (ii) evaluating cervical macro- and microwear patterns on all tooth groups of different functional age, (iii) documenting and codificating wear related morphological features at the cemento-enamel junction in young teeth and on roots in older teeth.

DESIGN

Following ethical approval random toothbrushing (44 strokes per tooth horizontally, rotating, vertically; 2x/d) with manual toothbrushes and low-abrasive dentifrice was performed in an artificial oral cavity with brushing-force 3.5 N on 14 extracted human teeth. Morphological features were examined by SEM at baseline and after simulated 3 years using the replication technique. 3D-SEM analyses were carried out with a four-quadrant back scattered electron detector. Wilcoxon-Mann-Whitney-test was used for statistical analyses.

RESULTS

3-year random toothbrushing with horizontal, rotating and vertical brushing movements revealed morphological features classified as four enamel patterns, one dentin pattern and three cervical patterns. Negative impacts were enamel, cementum and dentin loss. Positive impact on oral health was removing dental calculus and straightening cervical traumatic and iatrogenic damages. The volume loss varied from x̅=34.25nl to x̅=87.75nl. Wear extended apically from 100 to 1500 micrometres.

CONCLUSION

Robot simulated toothbrushing in an artificial oral cavity, with subsequent SEM and 3D-SEM assessment, elucidated both negative and oral health-contributing micromorphology patterns of cervical wear after simulated 3-year random toothbrushing. Cervical macro- and microwear of cementum revealed, for the first time, what we describe as overhanging enamel peninsulas and enamel islands on roots in young teeth, but no enamel islands on roots from older teeth after root cementum loss. In contrast, many older teeth exhibited enamel peninsulas.

Suppressor T helper type 17 cell responses in intestinal transplant recipients with allograft rejection

BACKGROUND

Intestinal transplant (ITx) rejection is associated with memory T helper type 17 cell (Th17) infiltration of grafted tissues. Modulation of Th17 effector cell response is facilitated by T regulatory (Treg) cells, but a phenotypic characterization of this process is lacking in the context of allograft rejection.

METHODS

Flow cytometry was performed to examine the expression of surface receptors, cytokines, and transcription factors in Th17 and Treg cells in ITx control (n = 34) and rejection patients (n = 23). To elucidate key pathways guiding the rejection biology, we utilized RNA sequencing (RNAseq) and assessed epigenetic stability through pyrosequencing of the Treg-specific demethylated region (TSDR).

RESULTS

We found that intestinal allograft rejection is characterized by Treg cellular infiltrates, which are polarized toward Th17-type chemokine receptor, ROR-γt transcription factor expression, and cytokine production. These Treg cell subsets have maintained epigenetic stability, as defined by FoxP3-TSDR methylation status, but displayed upregulation of functional Treg and purinergic signaling genes by RNAseq analysis such as CD39, in keeping with suppressor Th17 properties.

CONCLUSION

We show that ITx rejection is associated with increased polarized cells that express a Th17-like phenotype concurrent with regulatory purinergic markers.

Non-fatal outcomes of COVID-19 disease in pediatric organ transplantation associates with down-regulation of senescence pathways

This is a cross-sectional study examining kinetics and durability of immune response in children with solid organ transplants (SOTs) who had COVID-19 disease between November 2020 through June 2022, who were followed for 60-days at a single transplant center. Blood was collected between 1-14 (acute infection), and 15-60 days of a positive PCR (convalescence). SOT children with peripheral blood mononuclear cells (PBMC) cryopreserved before 2019 were non-infected controls (ctrls). PBMCs stimulated with 15-mer peptides from spike protein and anti-CD49d/anti-CD28. Testing done included mass cytometry, mi-RNA sequencing with confirmatory qPCR. 38 children formed the study cohort, 10 in the acute phase and 8 in the convalescence phase. 20 subjects were non-infected controls. Two subjects had severe disease. Subjects in the acute and convalescent phases were different subjects. The median age and tacrolimus level at blood draw was not significantly different. There was no death, and no subject was lost to follow-up. During acute infection CD57 expression was low in NKT, Th17 effector memory, memory Treg, CD4-CD8-, and γδT cells (p = 0.01, p = 0.04, p = 0.03, p = 0.03, p = 0.004 respectively). The frequencies of NK and Th2 effector memory cells increased (p = 0.01, p = 0.02) during acute infection. Non-switched memory B and CD8 central memory cell frequencies were decreased during acute infection (p = 0.02; p = 0.02), but the decrease in CD8 central memory cells did not persist. CD4-CD8- and CD14 monocyte frequencies increased during recovery (p = 0.03; p = 0.007). Our observations suggest down regulation of CD57 with absence of NK cell contraction protect against death from COVID-19 disease in children with SOTs.

Inhibition of discoidin domain receptor (DDR)-1 with nilotinib alters CSF miRNAs and is associated with reduced inflammation and vascular fibrosis in Alzheimer's disease

Discoidin Domain Receptor (DDR)-1 is activated by collagen. Nilotinib is a tyrosine kinase inhibitor that is FDA-approved for leukemia and potently inhibits DDR-1. Individuals diagnosed with mild-moderate Alzheimer's disease (AD) treated with nilotinib (versus placebo) for 12 months showed reduction of amyloid plaque and cerebrospinal fluid (CSF) amyloid, and attenuation of hippocampal volume loss. However, the mechanisms are unclear. Here, we explored unbiased next generation whole genome miRNA sequencing from AD patients CSF and miRNAs were matched with their corresponding mRNAs using gene ontology. Changes in CSF miRNAs were confirmed via measurement of CSF DDR1 activity and plasma levels of AD biomarkers. Approximately 1050 miRNAs are detected in the CSF but only 17 miRNAs are specifically altered between baseline and 12-month treatment with nilotinib versus placebo. Treatment with nilotinib significantly reduces collagen and DDR1 gene expression (upregulated in AD brain), in association with inhibition of CSF DDR1. Pro-inflammatory cytokines, including interleukins and chemokines are reduced along with caspase-3 gene expression. Specific genes that indicate vascular fibrosis, e.g., collagen, Transforming Growth Factors (TGFs) and Tissue Inhibitors of Metalloproteases (TIMPs) are altered by DDR1 inhibition with nilotinib. Specific changes in vesicular transport, including the neurotransmitters dopamine and acetylcholine, and autophagy genes, including ATGs, indicate facilitation of autophagic flux and cellular trafficking. Inhibition of DDR1 with nilotinib may be a safe and effective adjunct treatment strategy involving an oral drug that enters the CNS and adequately engages its target. DDR1 inhibition with nilotinib exhibits multi-modal effects not only on amyloid and tau clearance but also on anti-inflammatory markers that may reduce cerebrovascular fibrosis.

Morphometry of depth of interhemispheric fissure on Indian cadaveric brain specimens

Background

During neurosurgeries like resection of interhemispheric lipoma or cyst, surgeon needs to remain within the limits of interhemispheric fissure (IHF). Despite a massive literature search, data regarding the morphometry of IHF is meagre. Therefore, the present study was done to calculate the depth of IHF.

Materials and Methods

Twenty-five (fourteen male and eleven female) fresh human cadaveric brain specimens were used. The depth of IHF was measured from frontal pole; three points, anterior to coronal suture (A, B and C); four points, posterior to coronal suture (D, E, F and G) and from two points (via parieto-occipital sulcus and calcarine sulcus) on occipital pole. The measurements were taken from these points up to the floor of IHF. IHF is a midline groove and hence the measurements were taken from each point against both the left and the right cerebral hemispheres. At the end, not much bilateral asymmetry was found, hence the average of the reading for the same point against left and the right cerebral hemisphere was considered for calculation.

Result

Maximum depth was found to be 59.60 mm and minimum depth was found to be 19.66 mm among all the points which were considered for evaluation. No statistical difference was found in the depth of IHF among the male and the female groups as well as in the various age groups.

Conclusion

This data and knowledge about the depth of interhemispheric fissure will aid the neurosurgeons in order to perform the interhemispheric transcallosal approach as well as surgeries of interhemispheric fissure such as excision of lipoma, cyst, tumor of interhemispheric fissure through the shortest and the safest possible route.

132 GERIATRIC REHABILITATION IN THE COVID-19 ERA: SERVICE INNOVATION AND PATIENT OUTCOMES

Background

Methods

Results

Conclusion

Sesamol induces cytotoxicity via mitochondrial apoptosis in SCC-25 cells

Sesamol is the main constituent of sesame seed oil and is obtained from Sesamum indicum. Oral squamous cell carcinoma (OSCC) is one of the most common neoplasms affecting the oral cavity. In this study, we investigated the cytotoxic potentials of sesamol on human oral squamous carcinoma (SCC-25) cells. Human oral squamous carcinoma cells were treated with different concentrations (62.5, 125, and 250 μM/mL) of sesamol for 24 h. Cytotoxicity was analyzed by 3- (4, 5- dimethylthiazol -2- yl) -2, 5-diphenyltetrazolium bromide (MTT) assay. Intracellular reactive oxygen species (ROS) expression was investigated by dichloro-dihydro-fluorescein diacetate assay. Apoptosis-related morphology was analyzed by acridine orange/ethidium bromide staining. Caspase-9 expression was analyzed by confocal microscopic double immunofluorescence staining. Mitochondrial apoptosis-related markers are analyzed using qPCR. Sesamol treatment caused a significant cytotoxic effect in OSCC cells. Sesamol-induced cytotoxic effect was associated with intracellular ROS generation. Sesamol treatments induced a significant increase in the early and late apoptotic cells. This treatment also induced caspase-9 expression in OSCC cells. Sesamol treatments caused downregulation of Harvey rat sarcoma viral oncogene homolog (HRAS) expression at protein and gene levels. Sesamol treatment modulates intrinsic apoptotic marker gene expression in OSCC cells. Overall results confirm the anti-cancer potential of sesamol and it seems to be a promising candidate for OSCC.

Impact of Wearing Dentures on Dietary Intake, Nutritional Status, and Eating: A Systematic Review

INTRODUCTION

A key purpose of denture provision is to enable eating, yet the body of evidence pertaining to the impact of dentures on wide-ranging nutritional outcomes has not been systematically reviewed.

OBJECTIVES

To systematically review published evidence pertaining to the effect of wearing removable dental prosthesis on dietary intake, nutritional status, eating function, and eating related-quality of life (ERQoL).

METHODS

Eight questions relating to the impact of wearing dentures on nutritional outcomes were addressed. The target population was healthy adults aged ≥18 y. Data sources included Medline, Embase, CINAHL, and PubMed. Included were all human epidemiologic studies. The Newcastle-Ottawa score was used for appraisal of study quality. Harvest plots, vote counting, and accompanying narrative provided the basis for synthesis.

RESULTS

Of the 1,245 records identified, 134 were retrieved and eligibility assessed by 2 reviewers, and 41 studies were included in the synthesis (14 rated good quality, 20 fair, and 7 poor). The balance of data supported a positive impact of wearing full (5/7 studies) or partial (3/3 studies) dentures (vs. no dentures) on nutritional status, though no clear direction of effect was detected for the impact of dentures on dietary intake. The balance of data clearly showed that objective measures of eating function were compromised in full (14/15 studies) and partial (6/7 studies) denture wearers as compared with the dentate. Data showed that ERQoL was also compromised in denture wearers as compared with the dentate (3/3 studies). However, data showed a positive impact of wearing dentures on ERQoL (5/5 studies) as opposed to wearing no dentures.

CONCLUSION

The balance of evidence shows that despite no clear pattern on impact of wearing dentures on measured dietary intake, in those with tooth loss, wearing dentures can have a positive impact on nutritional status and enjoyment of eating.

KNOWLEDGE TRANSFER STATEMENT

The results of this systematic review can be used to advocate for health care services to address prosthodontic need to benefit nutritional outcomes. The findings will be of use in educating health care professionals on the impact of wearing dentures and not addressing prosthodontic need on nutritional outcomes.

Transcriptome of rhesus macaque (Macaca mulatta) exposed to total-body irradiation

The field of biodosimetry has seen a paradigm shift towards an increased use of molecular phenotyping technologies including omics and miRNA, in addition to conventional cytogenetic techniques. Here, we have used a nonhuman primate (NHP) model to study the impact of gamma-irradiation on alterations in blood-based gene expression. With a goal to delineate radiation induced changes in gene expression, we followed eight NHPs for 60 days after exposure to 6.5 Gy gamma-radiation for survival outcomes. Analysis of differential gene expression in response to radiation exposure yielded 26,944 dysregulated genes that were not significantly impacted by sex. Further analysis showed an increased association of several pathways including IL-3 signaling, ephrin receptor signaling, ErbB signaling, nitric oxide signaling in the cardiovascular system, Wnt/β-catenin signaling, and inflammasome pathway, which were associated with positive survival outcomes in NHPs after acute exposure to radiation. This study provides novel insights into major pathways and networks involved in radiation-induced injuries that may identify biomarkers for radiation injury.

Dysregulated metabolic pathways in age-related macular degeneration

Age-related macular degeneration is a major cause of vision impairment in the Western world among people of 55 years and older. Recently we have shown that autophagy is dysfunctional in the retinal pigment epithelium (RPE) of the AMD donor eyes (AMD RPE). We also showed increased reactive oxygen (ROS) production, increased cytoplasmic glycogen accumulation, mitochondrial dysfunction and disintegration, and enlarged and annular LAMP-1-positive organelles in AMD RPE. However, the underlying mechanisms inducing these abnormalities remain to be elucidated. Here, by performing a comprehensive study, we show increased PAPR2 expression, deceased NAD+, and SIRT1, increased PGC-1α acetylation (inactive form), lower AMPK activity, and overactive mTOR pathway in AMD RPE as compared to normal RPE. Metabolomics and lipidomics revealed dysregulated metabolites in AMD RPE as compared to normal RPE, including glycerophospholipid metabolism, involved in autophagy, lipid, and protein metabolisms, glutathione, guanosine, and L-glutamic acid, which are implicated in protection against oxidative stress and neurotoxicity, further supporting our observations. Our data show dysregulated metabolic pathways as important contributors to AMD pathophysiology, and facilitate the development of new treatment strategies for this debilitating disease of the visual system.

Optimizing the fermentation conditions and enhanced production of keratinase from Bacillus cereus isolated from halophilic environment

Keratinase degrading Bacillus cereus was isolated from the halophilic environment in Tamilnadu, India and keratinase production was optimized using wheat bran substrate. Of the screened bacterial isolates, four were found to have the ability to produce keratinolytic enzyme. The process parameters were optimized using one-variable-at-a-time approach and response surface methodology. Supplementation of 1% lactose supported more keratinase production (120 U/g). Among the selected nitrogen sources, addition of casein significantly enhanced maximum keratinase production (132.5 U/g). Among the ions, manganese chloride significantly enhanced keratinsase production (102.6 U/g), however addition of zinc sulphate and copper sulphate decreased keratinase production. The maximum keratinase production was obtained in the wheat bran medium containing 1% lactose, 0.5% manganese with 80% moisture (292 U/g). Statistics based contour plots were generated to explore the variations in the response surface and to find the relationship between the keratinase yield and the bioprocess conditions.

The mitochondrial citrate carrier, SLC25A1, drives stemness and therapy resistance in non-small cell lung cancer

Therapy resistance represents a clinical challenge for advanced non-small cell lung cancer (NSCLC), which still remains an incurable disease. There is growing evidence that cancer-initiating or cancer stem cells (CSCs) provide a reservoir of slow-growing dormant populations of cells with tumor-initiating and unlimited self-renewal ability that are left behind by conventional therapies reigniting post-therapy relapse and metastatic dissemination. The metabolic pathways required for the expansion of CSCs are incompletely defined, but their understanding will likely open new therapeutic opportunities. We show here that lung CSCs rely upon oxidative phosphorylation for energy production and survival through the activity of the mitochondrial citrate transporter, SLC25A1. We demonstrate that SLC25A1 plays a key role in maintaining the mitochondrial pool of citrate and redox balance in CSCs, whereas its inhibition leads to reactive oxygen species build-up thereby inhibiting the self-renewal capability of CSCs. Moreover, in different patient-derived tumors, resistance to cisplatin or to epidermal growth factor receptor (EGFR) inhibitor treatment is acquired through SLC25A1-mediated implementation of mitochondrial activity and induction of a stemness phenotype. Hence, a newly identified specific SLC25A1 inhibitor is synthetic lethal with cisplatin or with EGFR inhibitor co-treatment and restores antitumor responses to these agents in vitro and in animal models. These data have potential clinical implications in that they unravel a metabolic vulnerability of drug-resistant lung CSCs, identify a novel SLC25A1 inhibitor and, lastly, provide the first line of evidence that drugs, which block SLC25A1 activity, when employed in combination with selected conventional antitumor agents, lead to a therapeutic benefit.

Abstract 1716: Acquisition of estrogen independence induces TOB1-related mechanisms supporting breast cancer cell proliferation

Approximately 70% of newly diagnosed breast cancers express high levels of estrogen receptor alpha (ERα). However, de novo and acquired drug resistance to anti-estrogen agents limit the treatment of such patients, requiring the use of cytotoxic chemotherapy; many such patients have a poor prognosis. Therefore, resistance to therapies targeting the estrogen pathway remains a challenge in the treatment of estrogen-receptor positive breast cancer. To address this challenge, a system biological approach by screening a library of siRNAs targeting an estrogen receptor- and aromatase-centered network, was used and identified 46 genes that are dispensable in estrogen-dependent MCF7 cells, but are selectively required for the survival of estrogen-independent MCF7-derived cells, and multiple additional estrogen-independent breast cancer cell lines. Integration of this information identified a tumor suppressor gene TOB1 as a critical determinant of estrogen-independent estrogen-receptor positive breast cell survival. Depletion of TOB1 selectively promoted G1 phase arrest and sensitivity to AKT and mTOR inhibitors in estrogen-independent cells but not estrogen-dependent cells. Phosphoproteomic profiles (results from reverse phase protein array, RPPA) under basal conditions and following TOB1 depletion identified significant signaling network reprogramming by TOB1 that differed in estrogen-sensitive and estrogen-resistant cell lines. These data support a novel function for TOB1 in mediating survival of estrogen-independent breast cancers. The translational significance of this new molecular mechanism of estrogen independence in human breast cancer will be fully determined when TOB1 inhibitors are developed to enable in vivo validation studies. These studies also provide evidence for combining TOB1 inhibition and AKT/mTOR inhibition as a therapeutic strategy, which have potential translational significance for the management of patients with estrogen receptor-positive breast cancers.

Citation Format: Yong-Wei Zhang, Rochelle E. Nasto, Rency Varghese, Sandra A. Jablonski, Ilya G. Serebriiskii, Rishi Surana, Valerie S. Calvert, Ionut Bebu, Joseph Murray, Lu Jin, Michael Johnson, Rebecca Riggins, Habtom Ressom, Emmanuel Petricoin III, Robert Clarke, Erica A. Golemis, Louis M. Weiner. Acquisition of estrogen independence induces TOB1-related mechanisms supporting breast cancer cell proliferation. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 1716. doi:10.1158/1538-7445.AM2015-1716

Hepatitis C virus Genotype 1a core gene nucleotide patterns associated with hepatocellular carcinoma risk

Specific sequence changes in codons 70 and 91 of the hepatitis C virus genotype 1b (HCV GT1b) core gene have been associated with increased risk of hepatocellular carcinoma (HCC). Essentially all previous studies were conducted in Asian populations with a wide range of liver disease, and none were conducted specifically in GT1a-infected individuals. We conducted a pilot study in a multiethnic population in the USA with HCV-related cirrhosis to determine if this association extended to GT1a-infected individuals and to determine if other sequence changes in the HCV core gene were associated with HCC risk. HCV core gene sequences from sera of 90 GT1 HCV carriers with cirrhosis (42 with HCC) were analysed using standard RT-PCR-based procedures. Nucleotide sequence data were compared with reference sequences available from GenBank. The frequency of sequence changes in codon 91 was not statistically different between HCC (7/19) and non-HCC (11/22) GT1b carriers. In GT1a carriers, sequence changes in codon 91 were observed less often than in GT1b carriers but were not observed in non-HCC subjects (4/23 vs 0/26, P = 0.03, Fisher's exact test). Sequence changes in codon 70 were not distributed differently between HCC and non-HCC GT1a and 1b carriers. Most importantly, for GT1a carriers, a panel of specific nucleotide changes in other codons was collectively present in all subjects with HCC, but not in any of the non-HCC patients. The utility of this test panel for early detection of HCC in GT1a-infected individuals needs to be assessed in larger populations, including longitudinal studies.

Abstract 2492: Targeted quantitation of candidate metabolic biomarkers for hepatocellular carcinoma

The aim of this study is to compare metabolite levels in sera of hepatocellular carcinoma (HCC) patients versus cirrhotic controls. This is accomplished through targeted quantitative analysis of candidate metabolic biomarkers of HCC by using an ultra-performance liquid chromatography coupled to an electrospray ionization-quadrupole linear ion trap mass spectrometry (UPLC-ESI-QLIT MS). The targets were selected from our previous untargeted analysis, where we observed association of HCC to dysregulated levels of bile acids, lysophosphocholines (LPCs), lysophosphoethanolamines (LPEs), sphingophoslipid, long chain carnitines and amino acids. In this study, we performed quantitative analysis of three metabolites (glycodeoxycholic acid, 3beta 6beta-dihydroxy-5beta-cholan-24-oic acid, 3 sulfo-glycodeoxycholic acid) in sera of 199 participants from two cohorts (US and Egypt). The participants consist of 110 subjects (55 HCC cases and 55 cirrhotic controls) from the US and 89 subjects (40 HCC cases and 49 cirrhotic controls) from Egypt. Through a logistic regression model, we analyzed the quantitative results obtained by the UPLC-ESI-QLIT MS to evaluate the ability of the three candidate markers as a panel in distinguishing HCC cases from patients with liver cirrhosis. Receiver operating characteristic (ROC) curve obtained through the regression model yielded an area under the curve (AUC) of 0.754 in distinguishing the HCC cases from cirrhotic controls for the US cohort and an AUC of 0.709 for the Egyptian cohort. The model resulted in an AUC of 0.717 for the combined US and Egyptian cohort. We compared the diagnostic capability of these metabolites versus α-fetoprotein (AFP) in the US cohort, for which AFP measurements were available for both the HCC cases and cirrhotic controls. While AFP alone resulted in an AUC of 0.681, the combination of AFP with the three metabolites increased the AUC to 0.806. These results indicate the potential of these candidate biomarkers in combination with AFP for more accurate diagnosis of HCC in high risk population of cirrhotic patients.

Citation Format: Jun Feng Xiao, Yi Zhao, Rency Varghese, Bin Zhou, Cristina Di Poto, Lihua Zhang, Mahlet G. Tadesse, Dina Hazem Ziada, Kirti Shetty, Habtom W. Ressom. Targeted quantitation of candidate metabolic biomarkers for hepatocellular carcinoma. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2492. doi:10.1158/1538-7445.AM2013-2492

Note: This abstract was not presented at the AACR Annual Meeting 2013 because the presenter was unable to attend.

Integrated analysis of ATM mediated gene and protein expression impacting cellular metabolism

A major goal of systems biology is to decipher cellular responses to genetic perturbations or environmental changes. Network integration of high-throughput data sets such as transcriptomics, proteomics, and metabolomics ("3-omics") offers a powerful tool for understanding the regulation and organization of cellular functions and biological processes. Given that the ATM (the product of the ataxia-telangiectasia mutated) gene exhibits multifaceted functions involved in complex biological networks, we attempted to analyze "3-omics" data sets by utilizing a functional pathway analysis approach. ATM-mediated gene and protein expression and metabolite products were interrogated using a model system comprised of cells genetically similar but demonstrating ATM deficiency (AT5BIVA) or ATM proficiency (ATCL8). Here, we report an unprecedented finding from the results of this integrated analysis revealing that ATM dictates purine, pyrimidine, and urea cycle pathways through the regulation of adenosine monophosphate (AMP) activated protein kinase (AMPK), a major sensor and regulator of cellular energy homeostasis. Furthermore, our results support the feasibility of applying a systems approach for identification of specific cellular networks and understanding of pathway perturbations underlying the complex A-T clinical syndrome.

Human fibroblasts for large-scale "omics" investigations of ATM gene function

ATM (gene mutated in ataxia-telangiectasia) is a critical central component of the pleiotropic responses of cells to ionizing radiation-induced stress. To gain insight into molecular mechanisms and to enhance our understanding of ATM functions, we have advanced a human model cell system, derived from genetically defined immortal fibroblasts, and we have applied high-throughput genomic, proteomic and metabolomic technologies for a systems level analysis. The cellular characterizations reported here provide the background for application of a systems analysis to integrate transcription, post-translational modifications and metabolic activity induced by exposure of cells to ionizing radiation. We present here a summary of the derivation and characterization of cells comprising this model cell system and review applications of this model to systems analysis of ATM functions.

Positron-emission tomography/computed tomography (PET/CT) in the initial staging of primary rectal cancer

OBJECTIVE

The aim of this study was to assess the role of (18)flourodeoxyglucose positron-emission tomography/computed tomography (PET/CT) in the initial staging of primary rectal adenocarcinoma.

METHOD

A total of 20 patients with adenocarcinoma of the rectum were assessed with both PET/CT and conventional staging (CT chest/abdomen/pelvis, MRI rectum). Discordance with conventional imaging and incidental findings on PET were recorded and the patients presented to a colorectal cancer multidisciplinary team to assess management changes. Patients were followed up so that discordant or incidental findings could be verified by intra-operative examination, imaging or histology where possible.

RESULTS

Positron-emission tomography/computed tomography correctly identified the primary tumour in all 20 patients. Comparing PET/CT with conventional staging modalities, there were 11 discordant or incidental findings in nine patients (45%). This resulted in a potential change in stage in 30% (four patients downstaged and two upstaged). PET/CT suggested additional neoplastic pathology in three patients and excluded the same in two patients. The incidental neoplastic findings were of minor clinical significance and one was eventually deemed false positive. While PET/CT resulted in potential management changes in five patients (25%), no changes in surgical management occurred. When tumours were grouped according to conventional stage, PET/CT resulted in fewer changes in stage in stage I (0%), compared with stages II to IV (43%) (P = 0.08).

CONCLUSION

Positron-emission tomography/computed tomography provides additional information to conventional staging in primary rectal cancer. This information produced minor management changes in this study and did not effect surgical management. PET/CT may be most appropriately used selectively in more advanced stages and where indeterminate findings exist with conventional staging.

Abstract 5103: Analysis of the role of “ATM” through “omics” analysis

The human genetic disease, ataxia-telangiectasia (AT) is characterized by exquisite radiation sensitivity, neurological degeneration, immune deficiencies, genetic instability and predisposition to cancer. Furthermore, cells from patients with AT show disruption of the DNA damage response (DDR), a global signaling network that senses damage and coordinates cellular responses that include cell cycle regulation, transcription, DNA repair processes and apoptosis. Previously, AT5BIVA cells have been was established by SV40 immortalization of fibroblasts derived from an AT group D patient. We derived ATCL8 cells line was then derived by transfecting AT5BIVA with a vector carrying expressing the full- length wild type ATM. ATCL8 cells are and was found to be less sensitive to radiation resistant (D0=1.7 Gy) as compared tothan are the parental cell line AT5BIVA cells (D0=0.7 Gy).

We have used a systems approach to understand compare the baseline changes that occur at the genomics, proteomics and metabolomic levels in these two near isogenic cell lines and integrate the information to understand the correlation. The. mMicroarray analysies wereas carried performed out to compare investigate basal level changes in gene expression. between AT5BIVA and ATCL8. The p Proteomics analysies for the same system was donewere performed using a 2-D gels and mass spectrometry approach. Finally, metabolomic profilesing was performed were obtained using UPLC-ESI-TOF mass spectrometry followed by multivariate data analysis using (SIMCA-P and random forest) software. The mMetabolites which were found observed to be significantly different in ATCL8 as compared to AT5BIVA were then subjected to functional pathway analysies using the ingenuity software. The proteomics and the microarray data were then scored for the presence of proteins and genes which were a part of the predominant signaling pathways in the two cell lines as determined by metabolomic analysis.

The model system used in this study involves studyingof basal level changes in expression resulting from perturbations in a single gene and our results demonstrate the feasibility of such an the approach to correlate the changes found at all three levels of expression. The findings will be discussed in the context of the “AT” phenotype will be discussed.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5103.

Treatment of chronic hepatitis C genotype 4 with peginterferon alpha-2a plus ribavirin

BACKGROUND/AIM

Peginterferon plus ribavirin is the treatment of choice for chronic hepatitis C (HCV). HCV genotype 4 is considered difficult to treat and data regarding the efficacy of antiviral therapy for this genotype are scanty. The aim of the study was to asses the efficacy and tolerability of fixed dose peginterferon alpha 2a plus ribavirin for the treatment of HCV genotype 4.

METHODOLOGY

A prospective open label study was done on 30 middle eastern treatment naive chronic hepatitis C patients. They were treated with 180 mcg of peginterferon alpha 2a subcutaneous weekly plus oral ribavirin of 1200 mg daily if body weight > 75 kg. The treatment was continued for 48 weeks and patients were followed up for 24 weeks post-treatment. The early and sustained virological responses were were defined as the absence of HCV RNA from serum at 12 weeks and 72 weeks respectively. The data was analyzed on an intention to treat basis.

RESULTS

The early and sustained virological responses were 83.3% and 63.3% respectively. The EVR in patients with minimal or absent fibrosis (96.6%). The SVR in patients with BMI =/> 25 (81.8%) were not significantly different from those of patients with BMI < 25 (87.5%) even with the fixed dose peginterferon.

CONCLUSION

Peginterferon alpha 2a in combination with ribavirin is effective in the treatment of HCV genotype 4 and treatment response is intermediate between that of genotype 1 and genotype 2 or 3.

Right ventricular diastolic function after repair of tetralogy of Fallot

The objective of this study was quantitate diastolic dysfunction in the postoperative phase of tetralogy of Fallot (TOF) and to correlate it with the type of surgical procedure and clinical parameters. Fifty consecutive patients (mean age, 5.0 years; mean weight, 13.5 kg), operated for TOF during the period November 2004 to May 2005, were prospectively studied [infundibular resection, 23; infundibular resection and transannular patch (TAP), 19; right ventricle --> pulmonary artery conduit, 8). Detailed echocardiography was done on postoperative days 3 and 9 with a focus on Doppler indices of right ventricular (RV) function, Antegrade late diastolic flow in the right ventricular outflow tract (RVOT) was taken as the marker of restrictive RV physiology. The previous parameters were correlated to the type of surgery and clinical indices of RV dysfunction. There was no mortality. Twenty-four patients showed restrictive RV physiology. This finding correlated with lower values of E/A ratio (0.98 +/- 0.17 vs 1.33 +/- 0.49, p < 0.002), tricuspid valve E-wave deceleration time (86.9 +/- 21.7 vs 151.4 +/- 152 msec, p < 0.05), index of myocardial performance (0.15 +/- 0.06 vs 0.26 +/- 0.09, p < 0.001), isovolumic relaxation time (19.4 +/- 17 vs 39+/-30 msec, p < 0.009), and a higher central venous pressure (15.1 +/- 1.5 vs 12.7 +/- 1.9, p < 0.001). Restrictive RV physiology correlated with prolonged intensive case unit (ICU) stay (5.1 +/- 3.7 vs 2.8 +/- 2 days, p < 0.015), longer duration of inotropic support (108.3 +/- 56.2 vs 55.5 +/- 28.3 hours, p < 0.02), and higher dosage of diuretics. RV diastolic dysfunction is demonstrable by Doppler echocardiography in the first week following surgery for TOF and tends to be worse with TAP. Restrictive physiology demonstrated by RVOT pulse Doppler predicts longer duration of inotropic support, prolonged ICU stay, and higher dosage of diuretics.

Morphological Responses of the Rabbit Testis to Ischemic/Reperfusion Injury due to Torsion

OBJECTIVE

To investigate the morphological effects of free radical injury on spermatogenic cells in both testes of the rabbit experimental model of testicular torsion.

MATERIALS AND METHODS

The left testes of 8 peripubertal NZW rabbits (3-6 months) were subjected to 0, 15, 30, 60, 90, 120, and 180 min of ischemia by applying a clamp to the spermatic cord, followed by reperfusion. Another set of 8 rabbits was subjected to 60 min of ischemia and administered antioxidants (acetylsalicylic acid, ascorbic acid, allopurinol, quercetin, superoxide dismutase) before reperfusion. Both testes of 4 animals per group were harvested at 24 h and the remaining 4 at 3 months. Johnsen scores for spermatogenic activity and other changes were assessed histologically and these were compared with testicular malondialdehyde (MDA), a measure of free radical damage, assayed on testicular homogenates using the thiobarbiturate method.

RESULTS

In the 24-hour reperfusion group, apoptotic bodies and giant cells were more prominent in the seminiferous tubules of the left testes compared to the right, and were maximal after 90 min. In the 3-month reperfusion group, giant cells were absent, and apoptotic bodies were reduced in both testes. Testicular MDA showed an increase only in the left testes in the 24-hour reperfusion group, while the 3-month group showed increased MDA levels in both testes, but more on the left. The Johnsen score fell only to 8.0 in the left testes in the 24-hour reperfusion group, but dropped to 2.3 in the 3-month reperfusion group. Only in the 3-month reperfusion group, did antioxidant-treated animals show a fall in Johnsen scores in the left testes, regardless of the type of antioxidant.

CONCLUSION

These findings confirm a role for reactive oxygen species (ROS) in damage to spermatogenic cells in both the ipsilateral and contralateral testes following torsion, with longer term effects in the torted testis. Currently available antioxidants do not provide any significant long-term protection against morphological damage to the testis by ROS generated in testicular torsion.

'Metachronous' adenocarcinoma of the small intestine

Adenocarcinoma of the small intestine accounts for less than 1% of primary gastrointestinal malignancies (1). Small intestine contains 75% of the length of the gastrointestinal tract with 90% of the surface mucosal area, and yet carcinoma is rare. Symptoms of small bowel adenocarcinoma are vague and non-specific, and this region is relatively inaccessible which together contributes to their late diagnosis and poor prognosis. The authors report a case of two primary adenocarcinomas of the small intestine in the same patient.

Putative role of serum insulin-like growth factor–1 (IGF-1) and IGF binding protein-3 (IGFBP-3) levels in the development of prostate cancer in Arab men

INTRODUCTION

The incidence of clinical prostate cancer in the Arab population is among the lowest in the world. High serum IGF-1 level has been implicated as a possible risk factor for the development of prostate cancer in Caucasians. The purpose of this study was to determine serum IGF-1 and IGFBP-3 levels in healthy Arab men and in Arab men with newly diagnosed benign prostatic hyperplasia (BPH) and prostate cancer, and to compare these values with values reported in Caucasians.

PATIENTS AND METHODS

Subjects were recruited in two groups: (a) indigenous, healthy Arab men aged 15-90 y (n = 383); (b) Arab men with newly diagnosed prostate cancer (n = 30) or BPH (n = 40). Blood was obtained from fasting patients and volunteers, between 8:00 a.m. and 12:00 noon. The serum concentrations of IGF-1 and IGFBP-3 were determined using Immunoradiometric assay (IRMA) kits.

RESULTS

As in Caucasians, serum IGF-1 and IGFBP-3 levels declined with age in Arab men. The mean +/- s.d. of serum IGF-1 levels in healthy Arab men in the age group 15-20, 51-60, 61-70 y were lower (376.2 +/- 153.2, 134.9 +/- 105.7 and 89.6 +/- 48.4 ng/ml, respectively), compared to values reported for similarly aged Caucasians. Arab men with newly diagnosed prostate cancer had significantly higher serum IGF-1 level (P < 0.01) and lower IGFBP-3 levels (P < 0.01) compared to age-matched Arabs without the disease.

CONCLUSIONS

Arab men have lower serum IGF-1 levels compared to Caucasians and this may be an important factor in the explanation of the low incidence of prostate cancer in the Arab population.

A network-informed approach to investigating a tuberculosis outbreak: implications for enhancing contact investigations

BACKGROUND

To elucidate networks of Mycobacterium tuberculosis transmission, it may be appropriate to characterize the types of relationships among tuberculosis (TB) cases and their contacts (with and without latent TB infection) in addition to relying on traditional efforts to distinguish 'close' from 'casual' contacts.

SETTING

A TB outbreak in a US low incidence state.

OBJECTIVE

To evaluate whether social network analysis can provide insights into transmission settings that might otherwise go unrecognized by routine practices.

DESIGN

All adult outbreak-associated cases (n = 19) and a convenience sample of their contacts with and without latent TB infection (LTBI) (n = 26) were re-interviewed in 2001 using a structured questionnaire. Network analysis software was used to create diagrams illustrating important persons within the outbreak network, as well as types of activities TB cases engaged in with their contacts.

RESULTS

Drug use and drug sharing were more commonly reported among cases and their infected contacts than among contacts without LTBI. TB cases central to the outbreak network used crack cocaine, uncovering the need to focus control efforts on specific sites and persons involved in illicit drug use.

CONCLUSION

Outbreaks occur even in areas with low TB incidence, frequently among groups whose drug use or other illegal activities complicate control efforts. TB programs should consider the use of network analysis as a supplement to routine contact investigations to identify unrecognized patterns of M. tuberculosis transmission.

De Vega's tricuspid annuloplasty for Ebstein's anomaly

A case of Ebstein's anomaly as demonstrated by echocardiography and electrophysiological studies is discussed. In view of deterioration in tricuspid regurgitation and right ventricular dysfunction, successful surgical repair employing De Vega's tricuspid annuloplasty along with plication of the atrialised portion of the right ventricle is described. Intraoperative transesophageal echocardiography following the procedure revealed satisfactory repair and a significant decrease in tricuspid regurgitation. This simple technique appears to be effective in patients having anterior leaflet sufficiently large area and motion. Adequate long-term follow-up in a large series of patients is essential to confirm that it is also beneficial and durable.

A new repair for anomalous left coronary artery

We report a new technique of left coronary artery implantation to the aorta with interposition of a tube created from the great arterial wall for anomalous left coronary artery from pulmonary artery. This technique was used in 3 patients, of which 2 patients survived. It achieves two coronary artery repair and avoids problems related to extensive mobilization of coronary artery for translocation. It is easily reproducible.

Dynamic regulation of mouse ovarian stanniocalcin expression during gestation and lactation

Stanniocalcin is a glycoprotein hormone that appears to play a paracine/autocrine role in several mammalian tissues. Recently studies have shown that stanniocalcin is highly expressed in the ovaries of mice and humans and we have investigated its expression in the mouse ovary during several physiological states to identify potential functional relationships. During postnatal development the pattern of stanniocalcin (STC) gene expression begins to become thecal-restricted as early as day 5 and achieves the adult pattern of expression by two weeks of age. During postnatal development the primary sites of STC protein localization are the theca and oocytes and after maturation it is also strongly concentrated in the corpora lutea. Over the estrous cycle the pattern of both STC gene expression and protein localization do not show dramatic changes though STC immunoreactivity (STCir) staining appears to be greatest during metestrus I. In the superovulation model, however, we observed a significant increase in STC messenger RNA (mRNA) levels after treatment with hCG implying regulation by LH. During gestation the expression of ovarian STC increases 15-fold and is localized to the theca-interstitial cells with lower expression also being found in the corpora lutea. STC also becomes detectable in the serum for the first time suggesting an endocrine role for STC during gestation. Interestingly, the presence of a nursing litter appears to up-regulate STC gene expression in lactating mice suggesting a role for ovarian STC in lactation. Also striking is the intense STCir staining found in oocytes as they are devoid of STC mRNA, thus implying a role for STC in oocyte maturation. Stanniocalcin, to our knowledge, is unique because no other secreted proteins produced by the ovarian thecal-interstitial compartment are significantly induced during mouse pregnancy. In summary, our data provide evidence for the active regulation of STC expression in the ovary during gestation and lactation and therefore implies that STC is a new regulator of the gestational and nursing state.

Molecular cloning and characterization of stanniocalcin-related protein

Stanniocalcin (STC) is a glycoprotein hormone first discovered in fish and recently identified in humans and mice. In this report we have described the cloning of an STC-like cDNA, designated here as STC related protein (STCrP). Human STCrP (hSTCrP) cDNAs were isolated as expressed sequence tags (ESTs) and predicted a polypeptide of 302 amino acids, with 58%, homology to human STC (hSTC). Ten of the eleven 1/2 cysteine residues that in STC allow for dimerization of monomeric subunits were conserved in hSTCrP. By Northern analysis, three hSTCrP mRNAs were detected and were most abundant in pancreas, spleen and kidney as well as a variety of different transformed cell lines. The high degree of sequence homology suggests that STC and STCrP may have been derived from a common ancestral gene.

Comparative analysis of mammalian stanniocalcin genes

The recent discovery of mammalian stanniocalcin (STC) prompted an investigation of its gene structure and expression pattern to study its function and regulation. We show that both the human and mouse genes are composed of four exons spanning about 13 kb, with 85% nucleotide sequence identity in coding regions. Remarkably high sequence conservation between species also exists in the approximately 3-kb 3'-untranslated region. Comparative analysis of the 5'-untranslated region and flanking DNA from the rat and human STC genes showed long stretches of CAG trinucleotide repeats and an additional (CA)25 dinucleotide repeat unique to the rat promoter. An analysis of STC expression in the mouse showed that ovary contained the highest level of messenger RNA, with lower, but detectable, levels in most tissues. In situ hybridization revealed strong, specific hybridization over the thecal-interstitial cells of the ovarian stroma, whereas immunohistochemical analysis indicated that STC was present not only in the stroma, but also in the corpora lutea and oocyte of the developing follicle. Consequently, STC may act as a signaling molecule between the thecal-interstitial cell compartment and the corpus luteum and oocyte, thereby regulating the activity of these structures in some way. These findings suggest that in addition to its role in mineral metabolism, STC has acquired an important function in reproduction during its evolution to mammals.

Circulating antioxidants in ulcerative colitis and their relationship to disease severity and activity

Oxygen free radicals produced by neutrophils are important in the pathogenesis of mucosal damage in ulcerative colitis. Vitamin A, vitamin E and cysteine in the plasma can scavenge free radicals. In the present study, plasma levels of vitamin A, vitamin E, cysteine, cystine and protein-bound cysteine were measured in active ulcerative colitis before and immediately after treatment of the active disease, and correlated with disease severity, extent and activity. Plasma vitamin A and cysteine were significantly reduced in active ulcerative colitis compared with controls. Levels of vitamin E, cystine and protein-bound cysteine were not significantly altered in active ulcerative colitis. Vitamin A and cysteine concentrations returned to normal levels (P < 0.05) within 2 weeks of treating active colitis. There were significant negative correlations between clinical severity and the plasma concentrations of vitamin A and cysteine. Plasma cysteine levels also correlated inversely to disease extent. Depletion of the circulating antioxidants, vitamin A and cysteine, in active ulcerative colitis is likely to be important in the pathophysiology of the disease.

Oculocutaneous malignancies in xeroderma pigmentosum

Xeroderma pigmentosum is a rare autosomal recessive genodermatosis characterized by markedly increased sensitivity to sunlight, and the early development of skin tumours. Four cases of XP with malignancy have been described with a brief review of the literature. The cases have been documented with a view to study the evolution of the disease process and the development of malignancy during the follow up period.

Microfilariae in cytologic smears: a report of six cases

BACKGROUND

Filariasis is a major public health problem in tropical countries, including India. Despite this high incidence, it is unusual to find microfilariae in fine needle aspiration cytology. (FNAC) smears and body fluids. Six cases of filariasis diagnosed by FNAC are reported.

CASES

In case 1, a thyroid aspirate from a 23-year-old female showed a microfilaria with colloid and thyroid follicular cells. In case 2, pericardial fluid from a 50-year-old male with breathlessness and chest pain showed clusters of malignant cells and many microfilariae. In case 3, a bronchial aspirate from a 55-year-old male with fever and chest pain showed aggregates of acute inflammatory cells and a microfilaria. Cases 4 and 5 were lymph node aspirates from a 29-year-old male and 3-year-old female. Both smears showed microfilariae in a background of reactive lymphoid cells. In case 6, FNAC from a 21-year-old female with a cystic swelling in the breast showed clusters of microfilariae, lymphocytes and granular debris.

CONCLUSION

In three of the six cases microfilariae were the cause of symptoms, whereas in the other three cases, microfilariae were associated with other diseases, including malignancy. Thus, careful screening of FNAC smears might be helpful in detecting microfilariae, even in asymptomatic patients.

Carcinomatous meningitis: clinical manifestations and management

Carcinomatous meningitis (CM) is a cause of significant morbidity and mortality in patients with cancer. During the past 15 years, diffuse leptomeningeal metastases of extracranial malignant tumors have been increasingly reported [Wasserstrom et al. 1982, Theodore and Gendelman 1981, Little et al. 1974, Olson et al. 1974, Yaphey et al. 1978, Sorensen et al. 1984], CM is increasing in frequency because of improved survival of patients with systemic anti neoplastic therapies and increased awareness of this problem among physicians. In this review, we will be discussing the epidemiology, etiology, pathology, pathophysiology, clinical manifestations, diagnosis and management of carcinomatous meningitis, as well as the status of recent basic and clinical investigations.

Positive response to oral divalproex sodium (Depakote) in patients with spasticity and pain

Divalproex sodium (DVS; Depakote) is a commonly used antiepileptic agent that increases the levels of gamma aminobutyric acid. Spasticity from different causes may be due to a deficiency of inhibitory transmitters like gamma aminobutyric acid or an excess of excitatory neurotransmitters. Spasticity also may be accompanied by pain. The authors administered DVS orally for pain and spasticity in three patients with a history of spinal cord injury and one patient with a history of head injury. Three patients had marked improvement in spasticity and pain. One patient, who had some symptomatic improvement in spasticity, could not tolerate DVS because of gastric irritation. In contrast to the side effects of sedation and increased motor weakness associated with antispasticity drugs commonly used, no such side effects were detected with DVS. It is suggested that a possible enhancement by DVS of gamma aminobutyric acid-ergic postsynaptic inhibition of motor reflex arc in the spinal cord may represent a new nonsedating, management approach for spasticity as a result of traumatic spinal cord and head injuries.

Children's emotional associations with colors

In this study children's emotional associations with colors were investigated. Sixty children (30 girls, 30 boys), equally divided into groups of 5-year-olds and 6 1/2-year-olds, were asked their favorite color and were then shown nine different colors, one at a time and in a random order. For each color, children were asked, "How does (the color) make you feel?" All children were able to verbally express an emotional response to each color, and 69% of children's emotional responses were positive (e.g., happiness, excitement). Responses also demonstrated distinct color-emotion associations. Children had positive reactions to bright colors (e.g., pink, blue, red) and negative emotions for dark colors (e.g., brown, black, gray). Children's emotional reactions to bright colors became increasingly positive with age, and girls in particular showed a preference for brighter colors and a dislike for darker colors. Boys were more likely than girls were to have positive emotional associations with dark colors. Potential sources for children's color-emotion concepts, such as gender-related and idiosyncratic experiences, are discussed.

Neuroimaging studies of cerebral "visceral larva migrans" syndrome

"Visceral larva migrans" syndrome is a zoonotic disease caused by the migration or presence in human tissue of nematode larva from lower-order animals. This syndrome includes generalized illness, eosinophilia, and symptoms arising from larval invasions of different organs including the liver, lungs, eyes, and central nervous system. There has been only one case report of the computed tomographic (CT) and magnetic resonance imaging (MRI) appearances of cerebral toxocaral disease. Described here is a patient with cerebral toxocaral disease with a high eosinophil count and toxocaral titer in the serum and abnormal CT and MRI findings who had spontaneous recovery of the clinical symptoms.