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Jones AN, Scheurlen KM, Macleod A, Simon HL, Galandiuk S. Obesity and Inflammatory Factors in the Progression of Early-Onset Colorectal Cancer. Cancers (Basel) 2024; 16:1403. [PMID: 38611081 PMCID: PMC11010915 DOI: 10.3390/cancers16071403] [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] [Received: 02/23/2024] [Revised: 03/27/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
Metabolic dysfunction associated with obesity leads to a chronic pro-inflammatory state with systemic effects, including the alteration of macrophage metabolism. Tumor-associated macrophages have been linked to the formation of cancer through the production of metabolites such as itaconate. Itaconate downregulates peroxisome proliferator-activated receptor gamma as a tumor-suppressing factor and upregulates anti-inflammatory cytokines in M2-like macrophages. Similarly, leptin and adiponectin also influence macrophage cytokine expression and contribute to the progression of colorectal cancer via changes in gene expression within the PI3K/AKT pathway. This pathway influences cell proliferation, differentiation, and tumorigenesis. This work provides a review of obesity-related hormones and inflammatory mechanisms leading to the development and progression of early-onset colorectal cancer (EOCRC). A literature search was performed using the PubMed and Cochrane databases to identify studies related to obesity and EOCRC, with keywords including 'EOCRC', 'obesity', 'obesity-related hormones', 'itaconate', 'adiponectin', 'leptin', 'M2a macrophage', and 'microbiome'. With this concept of pro-inflammatory markers contributing to EOCRC, increased use of chemo-preventative agents such as aspirin may have a protective effect. Elucidating this association between obesity-related, hormone/cytokine-driven inflammatory effects with EOCRC may help lead to new therapeutic targets in preventing and treating EOCRC.
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Affiliation(s)
- Alexandra N. Jones
- Price Institute of Surgical Research, University of Louisville, Louisville, KY 40202, USA; (A.N.J.); (A.M.); (H.L.S.)
| | - Katharina M. Scheurlen
- Price Institute of Surgical Research, University of Louisville, Louisville, KY 40202, USA; (A.N.J.); (A.M.); (H.L.S.)
| | - Anne Macleod
- Price Institute of Surgical Research, University of Louisville, Louisville, KY 40202, USA; (A.N.J.); (A.M.); (H.L.S.)
| | - Hillary L. Simon
- Price Institute of Surgical Research, University of Louisville, Louisville, KY 40202, USA; (A.N.J.); (A.M.); (H.L.S.)
- Division of Colon and Rectal Surgery, Hiram C. Polk Jr. MD Department of Surgery, University of Louisville, Louisville, KY 40202, USA
| | - Susan Galandiuk
- Price Institute of Surgical Research, University of Louisville, Louisville, KY 40202, USA; (A.N.J.); (A.M.); (H.L.S.)
- Division of Colon and Rectal Surgery, Hiram C. Polk Jr. MD Department of Surgery, University of Louisville, Louisville, KY 40202, USA
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Parks MA, Gaskins JT, Jin A, Galandiuk S, Kavalukas SL. You Want to be a Surgical Leader? Consider Training Elsewhere - An Observation of How Training Background May Impact Leadership Selection. J Surg Educ 2024; 81:564-569. [PMID: 38388306 DOI: 10.1016/j.jsurg.2023.12.012] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/15/2023] [Accepted: 12/22/2023] [Indexed: 02/24/2024]
Abstract
OBJECTIVE The significance of thought differences has always held importance in medicine, but it could be considered as increasingly acknowledged and valued to a greater extent in recent times as more emphasis is placed on diversity, equity, and inclusion. These unique perspectives have been examined according to race, gender, and ethnicity, but there is limited published data examining the prevalence of leadership roles within surgical departments in terms of training background. Our main objective is to identify trends in surgical leaders' education, and emphasize training diversity in surgical leadership. DESIGN A descriptive study of the training background of all surgical academic leaders. SETTING This internet search was performed at a tertiary care, academic medical center. PARTICIPANTS Academic chairpersons, division directors, and program directors. RESULTS 124 programs had pertinent information available. There was a mean of 7.6 leaders per institute examined: total 939 positions (119 chairs, 704 division directors, 116 program directors). 90/119 (76%) of the Chairs led at institutions outside of the places they completed their training. 4/119 (3%) did all their training at the same institution they chaired. 25/119 (21%) completed at least some but not all their training there, and later rose to the role of Chair. Among division directors, 217/704 (31%) did some training at that institution, and program directors were significantly more likely to have completed some training at their current institute (53/116, 46%; p = 0.001). There were no statistically significant differences when examined geographically. Women made up 18% of the leaders and were significantly more likely to lead as program director rather than a chair or division director (p < 0.001). CONCLUSION A majority of surgery chairs hold positions at institutions where they did not complete their medical training. This suggests that outside perspective could be a contributing factor when searching for this position.
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Affiliation(s)
- Mary Alex Parks
- University of Louisville, Department of Surgery, Louisville, Kentucky
| | - Jeremy T Gaskins
- University of Louisville, Department of Bioinformatics & Biostatistics, Louisville, Kentucky
| | - Allie Jin
- University of Louisville, Department of Surgery, Louisville, Kentucky
| | - Susan Galandiuk
- University of Louisville, Department of Surgery, Louisville, Kentucky
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Macleod A, Parks MA, Cook CN, Petras RE, Galandiuk S. Long-term behavior and functional outcomes of ileal-pouch anal anastomosis in inflammatory bowel disease with changing phenotype. Surgery 2024; 175:765-775. [PMID: 37802743 DOI: 10.1016/j.surg.2023.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 05/01/2023] [Revised: 06/24/2023] [Accepted: 07/08/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Ileal-pouch-anal anastomosis is the operation of choice after proctocolectomy for ulcerative colitis; some patients will develop Crohn's disease. We aim to determine long-term behavior and outcomes of inflammatory bowel disease-ileal-pouch-anal anastomosis after colectomy, where a specialist gastrointestinal pathologist re-evaluated the initial colectomy specimen. METHODS Patients with inflammatory bowel disease-ileal-pouch-anal anastomosis were identified from a single-surgeon prospective database containing 1,165 patients accrued from 1991 to 2017 and invited to complete pouch-function and quality-of-life assessments. Medical records were used to obtain clinical outcomes and subjective functional assessments for those unable to be contacted. Data were compared between patients with and without histological assessment disagreement and subsequent inflammatory bowel disease behavior subgroups. RESULTS For 138 patients included in the analysis, the median follow-up was 22.5 (range: 5-39) years. A total of 39.1% of patients had histologic diagnostic change after gastrointestinal pathologist review, and 19% and 39% developed Crohn's disease-like disease behavior at 10- and 20-year follow-ups. Pouch function and quality-of-life scores were similar across diagnostic change subgroups. Pouch failure was higher in Crohn's-like disease (31.1 vs 13.0%, P < .05). Intestinal continuity was maintained in 68.9% of Crohn's disease-like patients, 57.9% required biologics. Gastrointestinal pathologist review did not alter the time to new diagnosis (P = .419) or time to pouch failure (P = .320), mean: 11.0 and 11.41 years, respectively. CONCLUSION We describe equivocal patient-reported outcomes in patients with ileal-pouch-anal anastomosis and changing histologic and clinical diagnosis. Although pouch excision and biologic use rates are higher, many Crohn's disease-like patients maintain their pouch. Diagnostic change and pouch failure often occur >10 years after ileal-pouch-anal anastomosis creation. This supports the consideration of ileal-pouch-anal anastomosis after colectomy in carefully selected patients with inflammatory bowel disease, even those with ambiguous histology and the need for close long-term follow-up.
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Affiliation(s)
- Anne Macleod
- Price Institute of Surgical Research, University of Louisville, KY
| | - Mary Alex Parks
- Price Institute of Surgical Research, University of Louisville, KY
| | - Cheyenne N Cook
- Price Institute of Surgical Research, University of Louisville, KY
| | | | - Susan Galandiuk
- Price Institute of Surgical Research, University of Louisville, KY; Division of Colon & Rectal Surgery, Hiram C Polk Jr MD Department of Surgery, University of Louisville, KY.
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Galandiuk S. Making journals more relevant than ever. Surgery 2024; 175:552-553. [PMID: 37914571 DOI: 10.1016/j.surg.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/05/2023] [Indexed: 11/03/2023]
Affiliation(s)
- Susan Galandiuk
- University of Louisville School of Medicine, Department of Surgery, Louisville, KY.
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Galandiuk S. DCR : A World of Change and Strengthening Our Status. Dis Colon Rectum 2024; 67:1-2. [PMID: 37878466 DOI: 10.1097/dcr.0000000000003133] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
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Scheurlen KM, Snook DL, Littlefield AB, George JB, Parks MA, Beal RJ, MacLeod A, Riggs DW, Gaskins JT, Chariker J, Rouchka EC, Galandiuk S. Anti-inflammatory mechanisms in cancer research: Characterization of a distinct M2-like macrophage model derived from the THP-1 cell line. Cancer Med 2023; 12:21172-21187. [PMID: 38037545 PMCID: PMC10726891 DOI: 10.1002/cam4.6681] [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: 06/03/2023] [Revised: 10/12/2023] [Accepted: 10/25/2023] [Indexed: 12/02/2023] Open
Abstract
AIMS Macrophages play an essential role in cancer development. Tumor-associated macrophages (TAMs) have predominantly M2-like attributes that are associated with tumor progression and poor patient survival. Numerous methods have been reported for differentiating and polarizing macrophages in vitro, but there is no standardized and validated model for creating TAMs. Primary cells show varying cytokine responses depending on their origin and functional studies utilizing these cells may lack generalization and validity. A distinct cell line-derived TAM-like M2 subtype is required to investigate the mechanisms mediated by anti-inflammatory TAMs in vitro. Our previous work demonstrated a standardized protocol for creating an M2 subtype derived from a human THP-1 cell line. The cell expression profile, however, has not been validated. The aim of this study was to characterize and validate the TAM-like M2 subtype macrophage created based on our protocol to introduce them as a standardized model for cancer research. METHODS AND RESULTS Using qRT-PCR and ELISA, we demonstrated that proinflammatory, anti-inflammatory, and tumor-associated marker expression changed during THP-1-derived marcrophage development in vitro, mimicking a TAM-related profile (e.g., TNFα, IL-1β). The anti-inflammatory marker IL-8/CXCL8, however, is most highly expressed in young M0 macrophages. Flow cytometry showed increased expression of CD206 in the final TAM-like M2 macrophage. Single-cell RNA-sequencing analysis of primary human monocytes and colon cancer tissue macrophages demonstrated that cell line-derived M2 macrophages resembled a TAM-related gene profile. CONCLUSIONS The THP-1-derived M2 macrophage based on a standardized cell line model represents a distinct anti-inflammatory TAM-like phenotype with an M2a subtype profile. This model may provide a basis for in vitro investigation of functional mechanisms in a variety of anti-inflammatory settings, particularly colon cancer development.
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Affiliation(s)
- Katharina M Scheurlen
- Digestive Surgery Research Laboratory, Price Institute of Surgical Research, The Hiram C. Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Dylan L Snook
- Digestive Surgery Research Laboratory, Price Institute of Surgical Research, The Hiram C. Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Andrew B Littlefield
- Digestive Surgery Research Laboratory, Price Institute of Surgical Research, The Hiram C. Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Joan B George
- Digestive Surgery Research Laboratory, Price Institute of Surgical Research, The Hiram C. Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Mary A Parks
- Digestive Surgery Research Laboratory, Price Institute of Surgical Research, The Hiram C. Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Robert J Beal
- Digestive Surgery Research Laboratory, Price Institute of Surgical Research, The Hiram C. Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Anne MacLeod
- Digestive Surgery Research Laboratory, Price Institute of Surgical Research, The Hiram C. Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Daniel W Riggs
- Christina Lee Brown Envirome Institute, Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Jeremy T Gaskins
- Department of Bioinformatics & Biostatistics, University of Louisville, Louisville, Kentucky, USA
| | - Julia Chariker
- Kentucky IDeA Networks of Biomedical Research Excellence (KY INBRE), Bioinformatics Core, University of Louisville, Louisville, Kentucky, USA
| | - Eric C Rouchka
- Kentucky IDeA Networks of Biomedical Research Excellence (KY INBRE), Bioinformatics Core, University of Louisville, Louisville, Kentucky, USA
| | - Susan Galandiuk
- Digestive Surgery Research Laboratory, Price Institute of Surgical Research, The Hiram C. Polk, Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
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Macleod A, Scheurlen KM, Burton JF, Parks MA, Sumy MSA, Gaskins JT, Galandiuk S. Systemic adiponectin levels in colorectal cancer and adenoma: a systematic review and meta-analysis. Int J Obes (Lond) 2023; 47:911-921. [PMID: 37626126 DOI: 10.1038/s41366-023-01358-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/07/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Obesity is a well-established risk factor in the development of colorectal cancer; however, the mechanism mediating this relationship is not well understood. The adipokine, adiponectin, has an inverse relationship with obesity. Experimental studies have shown adiponectin to have dichotomous inflammatory and tumorigenic roles. Its role in the development of colorectal cancer, including the potential effect of its increase following bariatric surgery, is not yet clear. There are conflicting results from studies evaluating this relationship. This study sought to provide a systematic review and meta-analysis to examine the association between systemic adiponectin levels in patients with colorectal cancer and adenoma. METHODS An electronic literature search was performed using PubMed, EMBASE, Web of Science as well as gray literature. Articles were screened for inclusion criteria and assessed for quality using the Newcastle-Ottawa Scale. Pooled mean differences were calculated using a random effects model. Subgroup and meta-regression analyses were performed to identify potential sources of heterogeneity. RESULTS Thirty-two observational studies comparing systemic adiponectin in colorectal cancer vs healthy controls were included. Colorectal cancer cases had lower systemic adiponectin levels (overall pooled mean difference = -1.05 μg/ml [95% CI: -1.99; -0.12] p = 0.03); however, significant heterogeneity was present (I2 = 95% p < 0.01). Subgroup and meta- regression analyses results could not identify a source of the significant heterogeneity across the studies. CONCLUSIONS Studies suggest a trend towards lower systemic adiponectin levels in colorectal cancer patients, but the heterogeneity observed showed current evidence is not sufficient to definitively draw any conclusions. These data, however, suggest rising adiponectin is unlikely to account for the reported observation of increased CRC following bariatric surgery. Further studies with prospective age, race, and BMI-matched cohorts, and standardized adiponectin measurements may provide a better understanding of this relationship.
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Affiliation(s)
- Anne Macleod
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | - Katharina M Scheurlen
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | - James F Burton
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | - Mary Alex Parks
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | - Mst Sharmin Akter Sumy
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA
| | - Jeremy T Gaskins
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA
| | - Susan Galandiuk
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
- Hiram C. Polk Jr. MD Department of Surgery, University of Louisville, Louisville, KY, USA.
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Galandiuk S. Sustainable Development Goals: Halfway There? Dis Colon Rectum 2023; 66:1143-1145. [PMID: 37578291 DOI: 10.1097/dcr.0000000000002995] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
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Scheurlen KM, Parks MA, Macleod A, Galandiuk S. Unmet Challenges in Patients with Crohn's Disease. J Clin Med 2023; 12:5595. [PMID: 37685662 PMCID: PMC10488639 DOI: 10.3390/jcm12175595] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 05/03/2023] [Revised: 08/08/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
Patients with Crohn's disease can present with a variety of clinical manifestations; treatment strategies should focus on long-term remission and improvement of quality of life. There is no standardized process of diagnosing, predicting prognosis, and treating the disease. This narrative review was based on a literature search using PubMed, Embase, and Science Direct. Data on unmet challenges in patients with Crohn's disease were extracted from identified manuscripts. The aim was to discuss present research on standardized processes in the management of patients with Crohn's disease and to identify the unmet needs in clinical evaluation and treatment approaches. There is no consensus on standardized diagnostic, treatment, and surveillance algorithms, particularly in assessing complications of Crohn's, such as stricturing disease, intestinal cancer risk, and cutaneous manifestations. Complications and treatment failure rates of conventional, interventional, and surgical therapy place emphasis on the need for standardized treatment algorithms, particularly in the case of acute complications of the disease. Research on standardized clinical approaches, reliable biomarkers for disease diagnosis and therapy monitoring, and new treatment agents is necessary to improve therapy and reduce complications in patients with Crohn's disease.
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Affiliation(s)
- Katharina M Scheurlen
- Price Institute of Surgical Research, Hiram C. Polk Jr. MD Department of Surgery, University of Louisville, Louisville, KY 40202, USA; (K.M.S.); (M.A.P.); (A.M.)
| | - Mary A Parks
- Price Institute of Surgical Research, Hiram C. Polk Jr. MD Department of Surgery, University of Louisville, Louisville, KY 40202, USA; (K.M.S.); (M.A.P.); (A.M.)
| | - Anne Macleod
- Price Institute of Surgical Research, Hiram C. Polk Jr. MD Department of Surgery, University of Louisville, Louisville, KY 40202, USA; (K.M.S.); (M.A.P.); (A.M.)
| | - Susan Galandiuk
- Price Institute of Surgical Research, Hiram C. Polk Jr. MD Department of Surgery, University of Louisville, Louisville, KY 40202, USA; (K.M.S.); (M.A.P.); (A.M.)
- Division of Colon and Rectal Surgery, Hiram C. Polk Jr. MD Department of Surgery, University of Louisville, Louisville, KY 40202, USA
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Scheurlen KM, MacLeod A, Kavalukas SL, Galandiuk S. State-of-the-art surgery for Crohn's disease: part III-perianal Crohn's disease. Langenbecks Arch Surg 2023; 408:132. [PMID: 36995518 DOI: 10.1007/s00423-023-02856-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/04/2023] [Indexed: 03/31/2023]
Abstract
PURPOSE Diagnosis and treatment of perianal Crohn's disease is challenging and requires its own domain of therapy. Different types of perianal disease require a spectrum of treatment strategies. Treatment options range from conservative therapy, including immunosuppressives, biologics, or stem cell therapy, to surgical treatment with specific indications depending on the underlying lesion. This is part III of the series "state-of-the-art surgery for Crohn's disease," focusing on the management of perianal disease. We discuss the definition and diagnosis of perianal Crohn's disease, the treatment of perianal lesions, and specific surgical indications and techniques. RESULTS AND CONCLUSION Pitfalls and complications play a substantial role in the treatment of perianal Crohn's disease, and surgical therapy may fail. Realistic treatment goals and an individual patient-oriented treatment approach are crucial in the treatment of perianal Crohn's disease.
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Affiliation(s)
- Katharina M Scheurlen
- Price Institute of Surgical Research, Hiram C. Polk Jr MD Department of Surgery, University of Louisville, Louisville, KY, 40202, USA
| | - Anne MacLeod
- Price Institute of Surgical Research, Hiram C. Polk Jr MD Department of Surgery, University of Louisville, Louisville, KY, 40202, USA
| | - Sandra L Kavalukas
- Price Institute of Surgical Research, Hiram C. Polk Jr MD Department of Surgery, University of Louisville, Louisville, KY, 40202, USA
- Division of Colon & Rectal Surgery, Hiram C Polk Jr MD Department of Surgery, University of Louisville, Louisville, KY, 40202, USA
| | - Susan Galandiuk
- Price Institute of Surgical Research, Hiram C. Polk Jr MD Department of Surgery, University of Louisville, Louisville, KY, 40202, USA.
- Division of Colon & Rectal Surgery, Hiram C Polk Jr MD Department of Surgery, University of Louisville, Louisville, KY, 40202, USA.
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O'brien SJ, Gaskins JT, Ellis CT, Martin BA, Mcdowell J, Gondim DD, Galandiuk S. Temporal increase in the incidence of anal squamous cell carcinoma in Kentucky and factors associated with adverse outcomes. Cancer Med 2023. [PMID: 36991580 DOI: 10.1002/cam4.5865] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Anal squamous cell cancer (ASCC) incidence in Kentucky is increasing at an alarming rate. In 2009, the incidence surpassed the US national average (2.66 vs. 1.77/100,000 people), and currently, Kentucky ranks second by state per capita. The reasons for this rise are unclear. We hypothesize individuals with ASCC in Kentucky have some unique risk factors associated with worse outcomes. METHODS Individuals with ASCC in a population-level state database (1995-2016), as well as those treated at two urban university-affiliated tertiary care centers (2011-2018), were included and analyzed separately. We evaluated patient-level factors including demographics, tobacco use, stage of disease, HIV-status, and HPV-type. We evaluated factors associated with treatment and survival using univariable and multivariable survival analyses. RESULTS There were 1698 individuals in state data and 101 in urban center data. In the urban cohort, 77% of patients were ever-smokers. Eighty-four percent of patients had positive HPV testing, and 58% were positive for HPV 16. Seventy-two percent of patients were positive for p16. Neither smoking, HPV, nor p16 status were associated with disease persistence, recurrence-free survival, or overall survival (all p > 0.05). Poorly controlled HIV (CD4 count <500) at time of ASCC diagnosis was associated disease persistence (p = 0.032). Stage III disease (adjusted HR = 5.25, p = 0.025) and local excision (relative to chemoradiation; aHR = 0.19, p = 0.017) were significantly associated with reduced recurrence-free survival. CONCLUSIONS The rate of ASCC in Kentucky has doubled over the last 10 years, which is outpacing anal SCC rates in the US with the most dramatic rates seen in Kentucky women. The underlying reasons for this are unclear and require further study. There may be other risk factors unique to Kentucky.
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Affiliation(s)
- Stephen J O'brien
- Price Institute of Surgical Research and Division of Colorectal Surgery, Hiram C. Polk Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Jeremy T Gaskins
- Department of Bioinformatics and Biostatistics, School of Public Health & Information Sciences, University of Louisville, Louisville, Kentucky, USA
| | - C Tyler Ellis
- Price Institute of Surgical Research and Division of Colorectal Surgery, Hiram C. Polk Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Brock A Martin
- Department of Bioinformatics and Biostatistics, School of Public Health & Information Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Jaclyn Mcdowell
- Department of Pathology and Laboratory Medicine, University of Louisville, Louisville, Kentucky, USA
- Markey Cancer Control Program, Kentucky Cancer Registry, Lexington, Kentucky, USA
| | - Dibson Dibe Gondim
- Department of Bioinformatics and Biostatistics, School of Public Health & Information Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Susan Galandiuk
- Price Institute of Surgical Research and Division of Colorectal Surgery, Hiram C. Polk Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
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Scheurlen KM, Snook DL, Alfieri T, Littlefield AB, George JB, Seraphine C, Cook CN, Rochet A, Gaskins JT, Galandiuk S. Obesity hormones and itaconate mediating inflammation in human colon cancer cells - Another lead to early-onset colon cancer? Heliyon 2023; 9:e13132. [PMID: 36825172 PMCID: PMC9941943 DOI: 10.1016/j.heliyon.2023.e13132] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/13/2022] [Revised: 01/09/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
Background Chronic inflammation is a key feature of obesity and a hallmark of colon cancer (CC). The obesity-related hormones leptin and adiponectin alter inflammatory gene profiles in cancer, but their specific role in CC is unclear. We have previously studied the effects of leptin and the macrophage-specific mediator itaconate on M2-like macrophages. This current study evaluates their effects on CC cells. Methods HT-29 CC cells (derived from a young patient, stage III CC) were treated with either leptin, adiponectin, 4-octyl itaconate (OI) or dimethyl itaconate (DI). Gene expression after treatment was analyzed at four time points (3, 6, 18, and 24 h). Results CCL22 was upregulated after treatment with adiponectin (at 18 h [FC 16.3, p < 0.001]). IL-8 expression increased following both adiponectin (at 3 h [FC 68.1, p < 0.001]) and leptin treatments (at 6 h [FC 7.3, p < 0.001]), while OI induced downregulation of IL-8 (at 24 h [FC -5.0, p < 0.001]). CXCL10 was upregulated after adiponectin treatment (at 6 h [FC 3.0, p = 0.025]) and downregulated by both OI and DI at 24 h, respectively (OI [FC -10.0, p < 0.001]; DI [FC -10.0, p < 0.001]). IL-1β was upregulated after adiponectin treatment (at 3 h [FC 10.6, p < 0.001]) and downregulated by DI (at 24 h [FC -5.0, p < 0.001]). TNF-α expression was induced following adiponectin (at 6 h [FC 110.7, p < 0.001]), leptin (at 18 h [FC 5.8, p = 0.027]) and OI (at 3 h [FC 91.1, p = 0.001]). PPARγ was affected by both OI (at 3 h [FC 10.1, p = 0.031], at 24 h [FC -10.0, p = 0.031]) and DI (at 18 h [FC -1.7, p = 0.033]). Conclusions Obesity hormones directly affect inflammatory gene expression in HT29 CC cells, potentially enhancing cancer progression. Itaconate affects the prognostic marker PPARγ in HT29 CC cells. Leptin, adiponectin and itaconate may represent a link between obesity and CC.
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Affiliation(s)
- Katharina M. Scheurlen
- Price Institute of Surgical Research, The Hiram C. Polk, Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
| | - Dylan L. Snook
- Price Institute of Surgical Research, The Hiram C. Polk, Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
| | - Toriana Alfieri
- Price Institute of Surgical Research, The Hiram C. Polk, Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
| | - Andrew B. Littlefield
- Price Institute of Surgical Research, The Hiram C. Polk, Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
| | - Joan B. George
- Price Institute of Surgical Research, The Hiram C. Polk, Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
| | - Caden Seraphine
- Price Institute of Surgical Research, The Hiram C. Polk, Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
| | - Cheyenne N. Cook
- Price Institute of Surgical Research, The Hiram C. Polk, Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
| | - Andre Rochet
- Price Institute of Surgical Research, The Hiram C. Polk, Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
| | - Jeremy T. Gaskins
- Department of Bioinformatics & Biostatistics, University of Louisville, 485 E. Gray Street, Louisville, KY, 40202, USA
| | - Susan Galandiuk
- Price Institute of Surgical Research, The Hiram C. Polk, Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA,Corresponding author. @UofLDeptofSurg
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Galandiuk S. Why Are Real Patient Outcomes Important? Dis Colon Rectum 2022; 65:1411-1412. [PMID: 36165562 DOI: 10.1097/dcr.0000000000002632] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Macleod A, Kavalukas SL, Scheurlen KM, Galandiuk S. State-of-the-art surgery for Crohn's disease: Part II-colonic Crohn's disease and associated neoplasms. Langenbecks Arch Surg 2022; 407:2595-2605. [PMID: 35729401 DOI: 10.1007/s00423-022-02572-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 05/25/2022] [Indexed: 12/11/2022]
Abstract
Despite advances in medical therapy, surgery continues to play a vital role in the management of Crohn's disease and its complications. Continuing from Part I of this series (small intestine/ileal disease), we focus next on colonic Crohn's disease and associated neoplasms. We will first review the surgical management of medical-refractory Crohn's colitis and its complications and then examine cancer risk, surveillance, and surgical management of Crohn's-associated colorectal dysplasia and malignancy. We conclude with a discussion of restoration of gastrointestinal continuity following colonic surgery for Crohn's disease.
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Affiliation(s)
- Anne Macleod
- Hiram C. Polk, Jr MD Department of Surgery, Price Institute of Surgical Research, University of Louisville, Louisville, KY, 40292, USA
| | - Sandra L Kavalukas
- Hiram C. Polk, Jr MD Department of Surgery, Price Institute of Surgical Research, University of Louisville, Louisville, KY, 40292, USA.,Division of Colon & Rectal Surgery, Hiram C. Polk Jr MD Department of Surgery, University of Louisville, 550 South Jackson St, Louisville, KY, 40202, USA
| | - Katharina M Scheurlen
- Hiram C. Polk, Jr MD Department of Surgery, Price Institute of Surgical Research, University of Louisville, Louisville, KY, 40292, USA
| | - Susan Galandiuk
- Hiram C. Polk, Jr MD Department of Surgery, Price Institute of Surgical Research, University of Louisville, Louisville, KY, 40292, USA. .,Division of Colon & Rectal Surgery, Hiram C. Polk Jr MD Department of Surgery, University of Louisville, 550 South Jackson St, Louisville, KY, 40202, USA.
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16
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Scheurlen KM, Chariker JH, Kanaan Z, Littlefield AB, George JB, Seraphine C, Rochet A, Rouchka EC, Galandiuk S. The NOTCH4-GATA4-IRG1 axis as a novel target in early-onset colorectal cancer. Cytokine Growth Factor Rev 2022; 67:25-34. [DOI: 10.1016/j.cytogfr.2022.06.002] [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] [Received: 06/18/2022] [Accepted: 06/27/2022] [Indexed: 11/24/2022]
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17
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Wise AK, Bhutiani N, Werthmann N, Kavalukas SL, Galandiuk S, Farmer RW. Early experience with focused telemedicine implementation in an academic colorectal surgery practice. Surgery 2022; 172:83-88. [DOI: 10.1016/j.surg.2022.01.033] [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] [Received: 09/15/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 10/19/2022]
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18
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Scheurlen KM, Snook DL, Walter MN, Cook CN, Fiechter CR, Pan J, Beal RJ, Galandiuk S. Itaconate and leptin affecting PPARγ in M2 macrophages: A potential link to early-onset colorectal cancer. Surgery 2022; 171:650-656. [PMID: 34876290 PMCID: PMC8885843 DOI: 10.1016/j.surg.2021.10.054] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 09/28/2021] [Accepted: 10/27/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Along with the rising incidence of obesity, there has been an increase in patients diagnosed with early-onset colorectal cancer (<50 years old). In colorectal cancer, worse patient survival is associated with certain cytokine expression and downregulation of peroxisome proliferator activated receptor gamma expression. The effects of the obesity hormone leptin and macrophage-specific metabolite itaconate on these mechanisms are poorly understood. We investigated their impact on peroxisome proliferator activated receptor gamma and macrophage cytokine expression in vitro. METHODS M2-like macrophages were treated with either leptin, 4-octyl itaconate, or dimethyl itaconate in a dose- and time-dependent manner. Gene expression after treatment with 4 doses (D1-4) of each compound was analyzed at 4 time points (3, 6, 18, and 24 hours). RESULTS Peroxisome proliferator activated receptor gamma was downregulated after 4-octyl itaconate treatment at 18 hours (FC -32.67, P ≤ .001). Interleukin-8 was upregulated after leptin and dimethyl itaconate treatment at 6 hours (FC 26.35 at D4, P ≤ .001, and FC 23.26 at D3, P = .006). Dimethyl itaconate upregulated IL-1β at 24 hours (FC 18.00 at D4, P ≤ .001). Tumor necrosis factor-α showed maximum downregulation after 4-octyl itaconate at 18 hours (FC -103.25 at D4, P ≤ .001). CONCLUSIONS Itaconate downregulates peroxisome proliferator activated receptor gamma as a tumor-suppressing factor and upregulates anti-inflammatory cytokines in M2-like macrophages. Itaconate provides a link between obesity and colorectal cancer and may be a key regulator in early-onset colorectal cancer.
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Affiliation(s)
- Katharina M Scheurlen
- Department of Surgery, Price Institute of Surgical Research, University of Louisville, Louisville, KY
| | - Dylan L Snook
- Department of Surgery, Price Institute of Surgical Research, University of Louisville, Louisville, KY
| | - Mary N Walter
- Department of Surgery, Price Institute of Surgical Research, University of Louisville, Louisville, KY
| | - Cheyenne N Cook
- Department of Surgery, Price Institute of Surgical Research, University of Louisville, Louisville, KY
| | - Casey R Fiechter
- Department of Surgery, Price Institute of Surgical Research, University of Louisville, Louisville, KY
| | - Jianmin Pan
- Biostatistics Shared Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, KY
| | - Robert J Beal
- Department of Surgery, Price Institute of Surgical Research, University of Louisville, Louisville, KY
| | - Susan Galandiuk
- Department of Surgery, Price Institute of Surgical Research, University of Louisville, Louisville, KY.
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Galandiuk S. Colorectal Surgeons and Climate Change? True, True and a Grain of Salt. Dis Colon Rectum 2021; 64:1159. [PMID: 34382601 DOI: 10.1097/dcr.0000000000002239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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20
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Galandiuk S. Invited Commentary. J Am Coll Surg 2021; 232:395-396. [PMID: 33771296 DOI: 10.1016/j.jamcollsurg.2020.12.027] [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] [Received: 12/02/2020] [Accepted: 12/02/2020] [Indexed: 10/21/2022]
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21
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O'Brien SJ, Kalbfleisch T, Srivastava S, Pan J, Rai S, Petras RE, Ronquillo N, Polk HC, Galandiuk S. Decreased Tumoral Expression of Colon-Specific Water Channel Aquaporin 8 Is Associated With Reduced Overall Survival in Colon Adenocarcinoma. Dis Colon Rectum 2021; 64:1083-1095. [PMID: 33990498 DOI: 10.1097/dcr.0000000000002071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Colon cancer survival is dependent on metastatic potential and treatment. Large RNA-sequencing data sets may assist in identifying colon cancer-specific biomarkers to improve patient outcomes. OBJECTIVE This study aimed to identify a highly specific biomarker for overall survival in colon adenocarcinoma by using an RNA-sequencing data set. DESIGN Raw RNA-sequencing and clinical data for patients with colon adenocarcinoma (n = 271) were downloaded from The Cancer Genome Atlas. A binomial regression model was used to calculate differential RNA expression between paired colon cancer and normal epithelium samples (n = 40). Highly differentially expressed RNAs were examined. SETTINGS This study was conducted at the University of Louisville using data acquired by The Cancer Genome Atlas. PATIENTS Patients from US accredited cancer centers between 1998 and 2013 were analyzed. MAIN OUTCOME MEASURES The primary outcome measures were recurrence-free and overall survival. RESULTS The median age was 66 years (147/271 men, 180/271 White patients). Thirty RNAs were differentially expressed in colon adenocarcinoma compared with paired normal epithelium, using a log-fold change cutoff of ±6. Using median expression as a cutoff, 4 RNAs were associated with worse overall survival: decreased ZG16 (log-rank = 0.023), aquaporin 8 (log-rank = 0.023), and SLC26A3 (log-rank = 0.098), and increased COL1A1 (log-rank = 0.105). On multivariable analysis, low aquaporin 8 expression (HR, 1.748; 95% CI, 1.016-3.008; p = 0.044) was a risk factor for worse overall survival. Our final aquaporin 8 model had an area under the curve of 0.85 for overall survival. On subgroup analysis, low aquaporin 8 was associated with worse overall survival in patients with high microsatellite instability and in patients with stage II disease. Low aquaporin 8 expression was associated with KRAS and BRAF mutations. Aquaporin 8 immunohistochemistry was optimized for clinical application. LIMITATIONS This was a retrospective study. CONCLUSION Aquaporin 8 is a water channel selectively expressed in normal colon tissue. Low aquaporin 8 expression is a risk factor for worse overall survival in patients who have colon cancer. Aquaporin 8 measurement may have a role as a colon-specific prognostic biomarker and help in patient risk stratification for increased surveillance. See Video Abstract at http://links.lww.com/DCR/B603. LA DISMINUCIN DE LA EXPRESIN TUMORAL DE LA ACUAPORINA DEL CANAL DE AGUA ESPECFICO DEL COLON SE ASOCIA CON UNA REDUCCIN DE LA SUPERVIVENCIA GENERAL EN EL ADENOCARCINOMA DE COLON ANTECEDENTES:La supervivencia del cáncer de colon depende del potencial metastásico y del tratamiento. Grandes conjuntos de datos de secuenciación de ARN pueden ayudar a identificar biomarcadores específicos del cáncer de colon para mejorar los resultados de los pacientes.OBJETIVO:Identificar un biomarcador altamente específico para la supervivencia general en el adenocarcinoma de colon utilizando un conjunto de datos de secuenciación de ARN.DISEÑO:La secuenciación de ARN sin procesar y los datos clínicos para pacientes con adenocarcinoma de colon (n = 271) se descargaron de The Cancer Genome Atlas. Se utilizó un modelo de regresión binomial para calcular la expresión diferencial de ARN entre muestras de cáncer de colon emparejadas y muestras de epitelio normal (n = 40). Se examinaron los ARN expresados de forma altamente diferencial.ENTORNO CLINICO:Este estudio se realizó en la Universidad de Louisville utilizando datos adquiridos por The Cancer Genome Atlas.PACIENTES:Se analizaron pacientes de centros oncológicos acreditados en Estados Unidos entre 1998-2013.PRINCIPALES MEDIDAS DE VALORACION:Las principales medidas de valoración fueron la supervivencia general y libre de recurrencia.RESULTADOS:La mediana de edad fue de 66 años (147/271 hombres, 180/271 caucásicos). Treinta ARN se expresaron diferencialmente en el adenocarcinoma de colon en comparación con el epitelio normal emparejado, utilizando un límite de cambio logarítmico de ± 6. Utilizando la expresión mediana como punto de corte, cuatro ARN se asociaron con una peor supervivencia general: disminución de ZG16 (rango logarítmico = 0,023), acuaporina8 (rango logarítmico = 0,023) y SLC26A3 (rango logarítmico = 0,098) y aumento de COL1A1 (log -rango = 0,105). En el análisis multivariable, la baja expresión de acuaporina8 (HR = 1,748, IC del 95%: 1,016-3,008, p = 0,044) fue un factor de riesgo para una peor supervivencia global. Nuestro modelo de aquaporin8 final tuvo un AUC de 0,85 para la supervivencia global. En el análisis de subgrupos, la acuaporina8 baja se asoció con una peor supervivencia general en pacientes con MSI-H y en pacientes en estadio II. La baja expresión de acuaporina8 se asoció con mutaciones de KRAS y BRAF. La inmunohistoquímica de aquaporina8 se optimizó para su aplicación clínica.LIMITACIONES:Este fue un estudio retrospectivo.CONCLUSIÓN:La acuaporina8 es un canal de agua expresado selectivamente en el tejido normal del colon. La baja expresión de AQP8 es un factor de riesgo de peor supervivencia global en pacientes con cáncer de colon. La medición de aquaporina8 puede tener un papel como un biomarcador de pronóstico específico del colon y ayudar en la estratificación del riesgo del paciente para una mayor vigilancia. Consulte Video Resumen en http://links.lww.com/DCR/B603.
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Affiliation(s)
- Stephen J O'Brien
- Price Institute of Surgical Research, Hiram C. Polk, Jr. MD, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
| | - Theodore Kalbfleisch
- Department of Veterinary Science, Gluck Equine Research Center, University of Kentucky, Lexington, Kentucky
| | - Sudhir Srivastava
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky
- Centre for Agricultural Bioinformatics, ICAR-Indian Agricultural Statistics Research Institute, New Delhi, India
| | - Jianmin Pan
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky
| | - Shesh Rai
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky
| | - Robert E Petras
- Department of Pathology, Northeast Ohio Medical University, Rootstown, Ohio
| | | | - Hiram C Polk
- Price Institute of Surgical Research, Hiram C. Polk, Jr. MD, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
| | - Susan Galandiuk
- Price Institute of Surgical Research, Hiram C. Polk, Jr. MD, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
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Scheurlen KM, Snook DL, Gardner SA, Eichenberger MR, Galandiuk S. Macrophage Differentiation and Polarization into an M2-Like Phenotype using a Human Monocyte-Like THP-1 Leukemia Cell Line. J Vis Exp 2021. [PMID: 34398156 DOI: 10.3791/62652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Tumor-associated macrophages (TAM) can switch their expression and cytokine profile according to external stimuli. This remarkable plasticity enables TAM to adapt to ongoing changes within the tumor microenvironment. Macrophages can have either primarily pro-inflammatory (M1-like) or anti-inflammatory (M2-like) attributes and can continually switch between these two main states. M2-like macrophages within the tumor environment are associated with cancer progression and poor prognosis in several types of cancer. Many different methods for inducing differentiation and polarization of THP-1 cells are used to investigate cellular and intercellular mechanisms and the effects of TAM within the microenvironment of tumors. Currently, there is no established model for M2-like macrophage polarization using the THP-1 cell line, and the results of expression and cytokine profiles of macrophages due to certain in vitro stimuli vary between studies. This protocol serves as detailed guidance to differentiate THP-1 monocyte-like cells into M0 macrophages and to further polarize cells into an M2-like phenotype within 14 days. We demonstrate the morphological changes of THP-1 monocyte-like cells, differentiated macrophages, and polarized M2-like macrophages using light microscopy. This model is the basis for cell line models investigating the anti-inflammatory effects of TAM and their interactions with other cell populations of the tumor microenvironment.
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Affiliation(s)
- Katharina M Scheurlen
- Price Institute of Surgical Research, Department of Surgery, University of Louisville
| | - Dylan L Snook
- Price Institute of Surgical Research, Department of Surgery, University of Louisville
| | - Sarah A Gardner
- Price Institute of Surgical Research, Department of Surgery, University of Louisville
| | | | - Susan Galandiuk
- Price Institute of Surgical Research, Department of Surgery, University of Louisville;
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23
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Fiechter CR, Hallion JC, Schmidt MN, Galandiuk S, Polk HC. The Impact of Surgical Research on Career Success: A Forty-Year Follow-up of Undergraduate Experiences. Ann Surg 2021; 273:e100-e102. [PMID: 32740229 DOI: 10.1097/sla.0000000000004075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Casey R Fiechter
- Price Institute of Surgical Research, Department of Surgery, University of Louisville, Louisville, Kentucky
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O'Brien SJ, Netz U, Hallion J, Bishop C, Stephen V, Burton J, Paas M, Feagins K, Pan J, Rai SN, Galandiuk S. Circulating plasma microRNAs in colorectal neoplasia: A pilot study in assessing response to therapy. Transl Oncol 2020; 14:100962. [PMID: 33285367 PMCID: PMC7720092 DOI: 10.1016/j.tranon.2020.100962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/06/2020] [Revised: 10/17/2020] [Accepted: 11/16/2020] [Indexed: 12/31/2022] Open
Abstract
This pilot study examines a microRNA panel as a biomarker for response to surgical resection in colorectal cancer or colorectal advanced adenoma. A panel of 11 microRNAs was developed through screening and previous studies. Six miRNA are significantly increased following colorectal cancer resection. Three miRNA are significantly increased following colorectal advanced adenoma resection. The results of this study suggest that serum microRNA expression could be followed as a marker for response to therapy.
Introduction Current serological surveillance markers to monitor colorectal cancer (CRC) or colorectal advanced adenomas (CAA) are hampered by poor sensitivity and specificity. The aim of this study is to identify and validate a panel of plasma microRNAs which change in expression after resection of such lesions. Methods A prospectively maintained colorectal surgery database was queried for patients in whom both pre- and post-procedural serum samples had been obtained. An initial screening analysis of CRC and CAA patients (5 each) was conducted using screening cards for 380 miRNAs. Four identified miRNAs were combined with a previously described panel of 7 miRNAs that were diagnostically predictive of CRC and CAA. Differential miRNA expression was assessed using quantitative real-time polymerase chain reaction(qRT-PCR). Results Fifty patients were included (n = 27 CRC, n = 23 CAA). There was no difference in age, gender, or race profile of CRC patients compared to CAA patients. Six miRNA were significantly increased after CRC resection (miR-324, let7b, miR-454, miR-374a, miR-122, miR-19b, all p<0.05), while three miRNAs were significantly increased following CAA resection (miR-454, miR-374a, miR-122, all p<0.05). Three miRNA were increased in common for both (miR-454, miR-374a, miR-122). Discussion The expression of miRNAs associated with neoplasia (either CRC or CAA) was significantly increased following surgical resection or endoscopic removal of CRC or CAA. Future studies should focus on the evaluation of these miRNAs in CRC and CAA prognosis.
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Affiliation(s)
- Stephen J O'Brien
- Price Institute of Surgical Research, The Hiram C. Polk Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY 40292, USA
| | - Uri Netz
- Price Institute of Surgical Research, The Hiram C. Polk Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY 40292, USA; Department of Surgery, Soroka University Medical Center, Beer Sheva, Israel
| | - Jacob Hallion
- Price Institute of Surgical Research, The Hiram C. Polk Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY 40292, USA
| | - Campbell Bishop
- Price Institute of Surgical Research, The Hiram C. Polk Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY 40292, USA
| | - Vincent Stephen
- Price Institute of Surgical Research, The Hiram C. Polk Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY 40292, USA
| | - James Burton
- Price Institute of Surgical Research, The Hiram C. Polk Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY 40292, USA
| | - Mason Paas
- Price Institute of Surgical Research, The Hiram C. Polk Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY 40292, USA
| | - Kayla Feagins
- Price Institute of Surgical Research, The Hiram C. Polk Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY 40292, USA
| | - Jianmin Pan
- Department of Bioinformatics and Biostatistics, University of Louisville School of Medicine, Louisville, KY 40292, USA
| | - Shesh N Rai
- Department of Bioinformatics and Biostatistics, University of Louisville School of Medicine, Louisville, KY 40292, USA
| | - Susan Galandiuk
- Price Institute of Surgical Research, The Hiram C. Polk Jr. MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY 40292, USA.
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O'Brien SJ, Ellis CT, McDowell J, Galandiuk S, Polk HC. Anal squamous cell carcinoma incidentally found at hemorrhoidectomy. Surgery 2020; 169:610-616. [PMID: 33004218 DOI: 10.1016/j.surg.2020.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/24/2020] [Accepted: 08/18/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Anal squamous cell carcinoma incidence is increasing nationally and, more so, in Kentucky. Squamous cell carcinoma of the anus unexpectedly identified at hemorrhoidectomy pathologic evaluation is not uncommon. We hypothesized this is occurring more frequently and sought to evaluate its impact on outcomes. METHODS The Kentucky Cancer Registry, a premier population database, was queried for all squamous cell carcinoma of the anus cases between 2007 and 2016. Hemorrhoidal squamous cell carcinoma of the anus patients were compared with nonhemorrhoidal squamous cell carcinomas of the anus. Patient demographics, treatments, and outcomes were analyzed. RESULTS Of the 722 squamous cell carcinoma of the anus cases identified, 3.05% (n = 22) were within hemorrhoidectomy specimens. Demographics were similar between hemorrhoidal squamous cell carcinoma of the anus versus nonhemorrhoidal squamous cell carcinoma of the anus. Chemoradiation was the most common treatment strategy among all patients, and there were similar rates of disease, persistence, recurrence, and survival between hemorrhoidal and nonhemorrhoidal squamous cell carcinoma. Stage I disease was more common in the hemorrhoid group compared with the nonhemorrhoid group (63% vs 27%, P < .01). CONCLUSION Hemorrhoidal squamous cell carcinoma of the anus comprised 3.05% of our population-based cohort. Hemorrhoidal squamous cell carcinomas of the anus were more likely to receive chemoradiation compared with local excision, but there were similar oncologic outcomes. We postulate that some individuals may receive overtreatment with chemoradiation owing to imprecise labeling of hemorrhoid specimens. For this reason, we advocate for separate submission of each hemorrhoid specimen.
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Affiliation(s)
- Stephen J O'Brien
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY
| | - C Tyler Ellis
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY
| | - Jaclyn McDowell
- Markey Cancer Control Program, Kentucky Cancer Registry, Lexington, KY
| | - Susan Galandiuk
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY
| | - Hiram C Polk
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY.
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States V, O'Brien S, Rai JP, Roberts HL, Paas M, Feagins K, Pierce EJ, Baumgartner RN, Galandiuk S. Pyoderma Gangrenosum in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis. Dig Dis Sci 2020; 65:2675-2685. [PMID: 31925675 DOI: 10.1007/s10620-019-05999-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 12/05/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Pyoderma gangrenosum (PG) is an uncommon but severe extra-intestinal manifestation (EIM) of inflammatory bowel disease (IBD). The incidence and risk factors for PG are disputed. AIMS To assess the incidence of PG and identify factors associated with PG in IBD patients. METHODS A search of electronic databases (Ovid and PubMed) was conducted between 1966 and 2019. Studies that calculated the incidence of PG in IBD patient cohorts were included. Patient demographics, IBD subtype, and EIM presence were recorded. A review of our institutional database of 1057 IBD patients was conducted. A multivariate regression model and meta-analysis were conducted to identify risk factors for PG. A random effects model was used to combine the data of included studies. RESULTS Fourteen studies were included in addition to 1057 IBD patients and 26 PG cases from the Louisville cohort. In total, there were 379 cases of PG in the cumulative cohort of 61,695 IBD patients. The PG incidence in individual studies ranged from 0.4 to 2.6%. In the institutional cohort, ocular EIMs and a permanent stoma were significant risk factors for PG. In the meta-analysis, PG was associated with female gender (RR = 1.328, 95% CI 1.161-1.520), Crohn's disease (RR = 1.193, 95% CI 1.001-1.422), erythema nodosum (RR = 9.281, 95% CI 6.081-14.164), and ocular EIM (RR = 4.55, 95% CI 3.04-6.81). There was study heterogeneity when assessing IBD subtype, ocular, and joint EIMs. CONCLUSIONS There are conflicting data on the incidence and risk factors for PG. This meta-analysis confirms an association between PG and female gender, Crohn's disease, erythema nodosum, and ocular EIM that have been described in smaller studies.
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Affiliation(s)
- Vanessa States
- Price Institute of Surgical Research, The Hiram C. Polk Jr., MD Department of Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY, 40202, USA
| | - Stephen O'Brien
- Price Institute of Surgical Research, The Hiram C. Polk Jr., MD Department of Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY, 40202, USA
| | - Jayesh P Rai
- Department of Cardiology, University of Louisville, Louisville, KY, USA
| | - Henry L Roberts
- Price Institute of Surgical Research, The Hiram C. Polk Jr., MD Department of Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY, 40202, USA
| | - Mason Paas
- Price Institute of Surgical Research, The Hiram C. Polk Jr., MD Department of Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY, 40202, USA
| | - Kayla Feagins
- Price Institute of Surgical Research, The Hiram C. Polk Jr., MD Department of Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY, 40202, USA
| | | | | | - Susan Galandiuk
- Price Institute of Surgical Research, The Hiram C. Polk Jr., MD Department of Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY, 40202, USA.
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Galbraith NJ, Walker SP, Gardner SA, Bishop C, Galandiuk S, Polk HC. Interferon-gamma increases monocyte PD-L1 but does not diminish T-cell activation. Cell Immunol 2020; 357:104197. [PMID: 32891037 DOI: 10.1016/j.cellimm.2020.104197] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/06/2020] [Accepted: 08/12/2020] [Indexed: 01/16/2023]
Abstract
Immune dysfunction can occur during sepsis or following major trauma. Decreased monocyte HLA-DR expression and cytokine responses are associated with mortality. Recent studies have shown that adaptive immune system defects can also occur in such patients, characterised by increased PD-L1 expression and associated T-cell anergy. The aim of this study was to determine the effects of an immune adjuvant, interferon-gamma, on monocyte PD-L1 expression and T-cell activation in an ex-vivo human whole blood model of infection. We found that with interferon-gamma treatment, monocytes had increased HLA-DR expression and augmented TNF-α production in response to LPS stimulation, with a decrease in IL-10 levels. Both LPS and interferon-gamma increased the level of monocyte PD-L1 expression, and that a combination of both agents synergistically stimulated a further increase in PD-L1 levels as measured by flow cytometry. However, despite elevated PD-L1 expression, both CD4 and CD8 T-cell activation was not diminished by the addition of interferon-gamma treatment. These findings suggest that PD-L1 may not be a reliable marker for T-cell anergy, and that interferon-gamma remains an adjuvant of interest that can improve the monocyte inflammatory response while preserving T-cell activation.
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Affiliation(s)
- Norman J Galbraith
- Department of General Surgery, Royal Alexandra Hospital, Paisley, Glasgow, Scotland, UK.
| | - Samuel P Walker
- University of Kentucky School of Medicine, University of Kentucky, Lexington, KY, USA
| | - Sarah A Gardner
- Price Institute of Surgical Research, Hiram C. Polk, Jr. M.D. Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | - Campbell Bishop
- Price Institute of Surgical Research, Hiram C. Polk, Jr. M.D. Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | - Susan Galandiuk
- Price Institute of Surgical Research, Hiram C. Polk, Jr. M.D. Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | - Hiram C Polk
- Price Institute of Surgical Research, Hiram C. Polk, Jr. M.D. Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA
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28
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O'Brien SJ, Bishop C, Hallion J, Fiechter C, Scheurlen K, Paas M, Burton J, Galandiuk S. Long non-coding RNA (lncRNA) and epithelial-mesenchymal transition (EMT) in colorectal cancer: a systematic review. Cancer Biol Ther 2020; 21:769-781. [PMID: 32730165 PMCID: PMC7515495 DOI: 10.1080/15384047.2020.1794239] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is a leading cause of cancer-related death. Epithelial-mesenchymal transition (EMT) is a major process in tumor metastasis development. This systematic review aims to describe the role of long non-coding RNA (lncRNA) in EMT in CRC. METHODS The electronic databases, PubMed, Cochrane, and EMBASE, were searched from January1990 to June 2019 to identify studies examining lncRNA and their role in mediating EMT in CRC. Studies examining clinical specimens and/or in vitro experiments were included. RESULTS In 61 identified studies, 54 lncRNAs were increased in CRC compared to normal colorectal epithelium. Increased lncRNA expression was frequently associated with worse survival. Many lncRNAs mediate their effect through competitive endogenous RNA or transcription factor regulation. The ZEB1, 2/E-cadherin, Wnt/β-catenin signaling, and chromatin remodeling pathways are discussed in particular. CONCLUSIONS lncRNAs are major regulators of EMT and predictor adverse outcome in CRC patients. Future research must focus on delineating lncRNA function prior to potential clinical use.
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Affiliation(s)
- Stephen J O'Brien
- Price Institute of Surgical Research, Department of Surgery, University of Louisville , Louisville, KY, USA
| | - Campbell Bishop
- Price Institute of Surgical Research, Department of Surgery, University of Louisville , Louisville, KY, USA
| | - Jacob Hallion
- Price Institute of Surgical Research, Department of Surgery, University of Louisville , Louisville, KY, USA
| | - Casey Fiechter
- Price Institute of Surgical Research, Department of Surgery, University of Louisville , Louisville, KY, USA
| | - Katharina Scheurlen
- Price Institute of Surgical Research, Department of Surgery, University of Louisville , Louisville, KY, USA
| | - Mason Paas
- Price Institute of Surgical Research, Department of Surgery, University of Louisville , Louisville, KY, USA
| | - James Burton
- Price Institute of Surgical Research, Department of Surgery, University of Louisville , Louisville, KY, USA
| | - Susan Galandiuk
- Price Institute of Surgical Research, Department of Surgery, University of Louisville , Louisville, KY, USA
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29
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Scheurlen KM, Billeter AT, O'Brien SJ, Galandiuk S. Metabolic dysfunction and early-onset colorectal cancer - how macrophages build the bridge. Cancer Med 2020; 9:6679-6693. [PMID: 33624450 PMCID: PMC7520341 DOI: 10.1002/cam4.3315] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 06/08/2020] [Accepted: 06/26/2020] [Indexed: 12/12/2022] Open
Abstract
Background The incidence of colorectal cancer (CRC) among patients <50 years of age has increased dramatically over the last decades. At the same time, the growing proportion of obese children and adolescents and the increasing proportion of young and obese patients with CRC suggests an association between metabolic dysfunction and carcinogenesis. Tumor‐associated macrophages (TAMs) are able to orchestrate tumor promoting and suppressing mechanisms in CRC. The aim of this review was to discuss the different roles of TAMs in CRC and their phenotype‐specific metabolic pathways to identify potential new targets for CRC treatment. Methods A literature search was performed using PubMed, Cochrane and Embase to identify studies on TAMs and their metabolism in CRC. The following search terms were used in various combinations: (obesity OR adiposity OR obese) AND (macrophage OR polarization OR macrophage metabolism) AND ((colon cancer*) OR (colon carcinoma) OR (colonic tumor*) OR (colonic neoplasm[MeSH]) OR (rectal cancer*) OR (rectal carcinoma) OR (rectal tumor*) OR (rectal neoplasm[MeSH]) OR (colorectal cancer*) OR (colorectal carcinoma) OR (colorectal tumor*) OR (colorectal neoplasm[MeSH])). Studies including data on the phenotype and metabolism of TAMs in CRC were analyzed. Results Evidence for the prognostic utility of macrophage markers in CRC is currently evolving, with a particular role of stage‐dependent cellular metabolism profiles of TAMs. Itaconate is one of the metabolites produced by proinflammatory subtypes of TAMs and it is known to have tumor promoting effects. Metabolic pathways that are involved in macrophage activation and reprogramming play a role in a chronic inflammatory setting, consequently affecting the onset and development of CRC. Conclusions Tumor‐promoting metabolites, such as itaconate, are directly regulating these mechanisms, thereby triggering carcinogenesis. Metabolic reprogramming in TAMs can build a bridge between metabolic dysfunction and the onset and progression of CRC through inflammatory pathways, particularly in younger patients with early‐onset CRC.
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Affiliation(s)
- Katharina M Scheurlen
- Price Institute of Surgical Research, Department of Surgery, University of Louisville, Louisville, KY, USA
| | - Adrian T Billeter
- Department of General, Visceral, and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany
| | - Stephen J O'Brien
- Price Institute of Surgical Research, Department of Surgery, University of Louisville, Louisville, KY, USA
| | - Susan Galandiuk
- Price Institute of Surgical Research, Department of Surgery, University of Louisville, Louisville, KY, USA
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Galbraith NJ, Gardner SA, Walker SP, Trainor P, Carter JV, Bishop C, Sarojini H, O'Brien SJ, Bhatnagar A, Polk HC, Galandiuk S. The role and function of IκKα/β in monocyte impairment. Sci Rep 2020; 10:12222. [PMID: 32699255 PMCID: PMC7376008 DOI: 10.1038/s41598-020-68018-x] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 05/27/2020] [Indexed: 11/16/2022] Open
Abstract
Following major trauma, sepsis or surgery, some patients exhibit an impaired monocyte inflammatory response that is characterized by a decreased response to a subsequent bacterial challenge. To investigate this poorly understood phenomenon, we adopted an in-vitro model of endotoxin tolerance utilising primary human CD14 + monocytes to focus on the effect of impairment on IκKα/β, a critical part of the NFκB pathway. Impaired monocytes had decreased IκKα mRNA and protein expression and decreased phosphorylation of the IκKα/β complex. The impaired monocyte secretome demonstrated a distinct cytokine/chemokine footprint from the naïve monocyte, and that TNF-α was the most sensitive cytokine or chemokine in this setting of impairment. Inhibition of IκKα/β with a novel selective inhibitor reproduced the impaired monocyte phenotype with decreased production of TNF-α, IL-6, IL-12p70, IL-10, GM-CSF, VEGF, MIP-1β, TNF-β, IFN-α2 and IL-7 in response to an LPS challenge. Surgical patients with infection also exhibited an impaired monocyte phenotype and had decreased SITPEC, TAK1 and MEKK gene expression, which are important for IκKα/β activation. Our results emphasize that impaired monocyte function is, at least in part, related to dysregulated IκKα/β activation, and that IκKα/β is likely involved in mounting a sufficient monocyte inflammatory response. Future studies may wish to focus on adjuvant therapies that augment IκKα/β function to restore monocyte function in this clinically important problem.
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Affiliation(s)
- Norman J Galbraith
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
| | - Sarah A Gardner
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
| | - Samuel P Walker
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
| | - Patrick Trainor
- Diabetes and Obesity Center, Institute of Molecular Cardiology, University of Louisville School of Medicine, Louisville, KY, USA
| | - Jane V Carter
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
| | - Campbell Bishop
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
| | - Harshini Sarojini
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
| | - Stephen J O'Brien
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
| | - Aruni Bhatnagar
- Diabetes and Obesity Center, Institute of Molecular Cardiology, University of Louisville School of Medicine, Louisville, KY, USA
| | - Hiram C Polk
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA.
| | - Susan Galandiuk
- Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, 40292, USA
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31
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Rai SN, Qian C, Pan J, McClain M, Eichenberger MR, McClain CJ, Galandiuk S. Statistical Issues and Group Classification in Plasma MicroRNA Studies With Data Application. Evol Bioinform Online 2020; 16:1176934320913338. [PMID: 32313420 PMCID: PMC7157974 DOI: 10.1177/1176934320913338] [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: 12/23/2019] [Accepted: 02/18/2020] [Indexed: 11/16/2022] Open
Abstract
The analysis of plasma microRNAs (miRNAs) has been widely used as a method for finding potential biomarkers for human diseases, especially those with a link to cancer. Methods of analyzing plasma miRNA have been thoroughly discussed from sample extraction to data modeling. However, some issues exist within the process that have rarely been talked about. Rice et al. discussed some issues in plasma miRNA studies, such as the lack of standard methodology including the use of different cycle threshold, time to plasma extraction, among others. These issues can lead to inconsistent data, and thus impact the result and assay reproducibility. Other external issues, such as batch effect and operator effect, may also indirectly impact the statistical analysis. Here, we discuss issues in plasma miRNA studies from a statistical point of view. The interaction effect of different ways of calculating fold-change, the choice of housekeeping genes, and methods of normalization are among the issues we discuss, with data demonstrations. P values are calculated and compared to determine the effect of those issues on statistical conclusions. Statistical methods such as analysis of variance and analysis of covariance are crucial in the analysis of miRNA but investigators are often confused about them; therefore, a brief explanation of these statistical methods is also included. In addition, 3-group classification is discussed, as it is often challenging, compared with 2-group classification.
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Affiliation(s)
- Shesh N Rai
- Biostatistics and Bioinformatics Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA.,Department of Bioinformatics & Biostatistics, University of Louisville, Louisville, KY, USA.,Alcohol Research Center, University of Louisville, Louisville, KY, USA.,Hepatobiology & Toxicology COBRE Center, University of Louisville, Louisville, KY, USA
| | - Chen Qian
- Biostatistics and Bioinformatics Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA.,Department of Bioinformatics & Biostatistics, University of Louisville, Louisville, KY, USA
| | - Jianmin Pan
- Biostatistics and Bioinformatics Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Marion McClain
- Alcohol Research Center, University of Louisville, Louisville, KY, USA.,Hepatobiology & Toxicology COBRE Center, University of Louisville, Louisville, KY, USA.,Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Maurice R Eichenberger
- Price Institute of Surgical Research, Hiram C. Polk Jr. M.D. Department of Surgery, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Craig J McClain
- Alcohol Research Center, University of Louisville, Louisville, KY, USA.,Hepatobiology & Toxicology COBRE Center, University of Louisville, Louisville, KY, USA.,Department of Medicine, University of Louisville, Louisville, KY, USA.,Gastroenterology, Robley Rex Louisville VA Medical Center, Louisville, KY, USA
| | - Susan Galandiuk
- Price Institute of Surgical Research, Hiram C. Polk Jr. M.D. Department of Surgery, School of Medicine, University of Louisville, Louisville, KY, USA
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32
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Royal JM, Oh YJ, Grey MJ, Lencer WI, Ronquillo N, Galandiuk S, Matoba N. A modified cholera toxin B subunit containing an ER retention motif enhances colon epithelial repair via an unfolded protein response. FASEB J 2019; 33:13527-13545. [PMID: 31560862 DOI: 10.1096/fj.201901255r] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 12/13/2022]
Abstract
Cholera toxin B subunit (CTB) exhibits broad-spectrum biologic activity upon mucosal administration. Here, we found that a recombinant CTB containing an endoplasmic reticulum (ER) retention motif (CTB-KDEL) induces colon epithelial wound healing in colitis via the activation of an unfolded protein response (UPR) in colon epithelial cells. In a Caco2 cell wound healing model, CTB-KDEL, but not CTB or CTB-KDE, facilitated cell migration via interaction with the KDEL receptor, localization in the ER, UPR activation, and subsequent TGF-β signaling. Inhibition of the inositol-requiring enzyme 1/X-box binding protein 1 arm of UPR abolished the cell migration effect of CTB-KDEL, indicating that the pathway is indispensable for the activity. CTB-KDEL's capacity to induce UPR and epithelial restitution or wound healing was corroborated in a dextran sodium sulfate-induced acute colitis mouse model. Furthermore, CTB-KDEL induced a UPR, up-regulated wound healing pathways, and maintained viable crypts in colon explants from patients with inflammatory bowel disease (IBD). In summary, CTB-KDEL exhibits unique wound healing effects in the colon that are mediated by its localization to the ER and subsequent activation of UPR in epithelial cells. The results provide implications for a novel therapeutic approach for mucosal healing, a significant unmet need in IBD treatment.-Royal, J. M., Oh, Y. J., Grey, M. J., Lencer, W. I., Ronquillo, N., Galandiuk, S., Matoba, N. A modified cholera toxin B subunit containing an ER retention motif enhances colon epithelial repair via an unfolded protein response.
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Affiliation(s)
- Joshua M Royal
- Department of Pharmacology and Toxicology, James Graham Brown Cancer Center, Center for Predictive Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Young Jun Oh
- Department of Pharmacology and Toxicology, James Graham Brown Cancer Center, Center for Predictive Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Michael J Grey
- Division of Gastroenterology, Nutrition, and Hepatology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Digestive Disease Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Wayne I Lencer
- Division of Gastroenterology, Nutrition, and Hepatology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Digestive Disease Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Nemencio Ronquillo
- Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Susan Galandiuk
- The Hiram C. Polk Jr., M.D. Department of Surgery, Price Institute of Surgical Research, University of Louisville, Louisville, Kentucky, USA
| | - Nobuyuki Matoba
- Department of Pharmacology and Toxicology, James Graham Brown Cancer Center, Center for Predictive Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
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33
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Carter JV, O'Brien SJ, Burton JF, Oxford BG, Stephen V, Hallion J, Bishop C, Galbraith NJ, Eichenberger MR, Sarojini H, Hattab E, Galandiuk S. The microRNA-200 family acts as an oncogene in colorectal cancer by inhibiting the tumor suppressor RASSF2. Oncol Lett 2019; 18:3994-4007. [PMID: 31565080 PMCID: PMC6759516 DOI: 10.3892/ol.2019.10753] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 10/15/2018] [Accepted: 04/03/2019] [Indexed: 12/17/2022] Open
Abstract
This study aimed to determine whether manipulation of the microRNA-200 (miR-200) family could influence colon adenocarcinoma cell behavior. The miR-200 family has a significant role in tumor suppression and functions as an oncogene. In vitro studies on gain and loss of function with small interfering RNA demonstrated that the miR-200 family could regulate RASSF2 expression. Knockdown of the miR-200 family in the HT-29 colon cancer cell line increased KRAS expression but decreased signaling in the MAPK/ERK signaling pathway through reduced ERK phosphorylation. Increased expression of the miR-200 family in the CCD-841 colon epithelium cell line increased KRAS expression and led to increased signaling in the MAPK/ERK signaling pathway but increased ERK phosphorylation. Functionally, knockdown of the miR-200 family led to decreased cell proliferation in the HT-29 cells; therefore, increased miR-200 family expression could increase cell proliferation in the CCD-841 cell line. The present study included a large paired miR array dataset (n=632), in which the miR-200 family was significantly found to be increased in colon cancer when compared with normal adjacent colon epithelium. In a miR-seq dataset (n=199), the study found that miR-200 family expression was increased in localized colon cancer compared with metastatic disease. Decreased expression was associated with poorer overall survival. The miR-200 family directly targeted RASSF2 and was inversely correlated with RASSF2 expression (n=199, all P<0.001). Despite the well-defined role of the miR-200 family in tumor suppression, the present findings demonstrated a novel function of the miR-200 family in tumor proliferation.
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Affiliation(s)
- Jane V Carter
- Price Institute of Surgical Research, University of Louisville School of Medicine, Louisville, KY 40202, USA.,Department of Surgery, North Cumbria University Hospitals NHS Trust, Carlisle, Cumbria CA2 7HY, UK
| | - Stephen J O'Brien
- Price Institute of Surgical Research, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - James F Burton
- Price Institute of Surgical Research, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Brent G Oxford
- Price Institute of Surgical Research, University of Louisville School of Medicine, Louisville, KY 40202, USA.,School of Medicine, University of Louisville School of Medicine, Louisville, KY 40292, USA
| | - Vince Stephen
- Price Institute of Surgical Research, University of Louisville School of Medicine, Louisville, KY 40202, USA.,School of Medicine, University of Louisville School of Medicine, Louisville, KY 40292, USA
| | - Jake Hallion
- Price Institute of Surgical Research, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Campbell Bishop
- Price Institute of Surgical Research, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Norman J Galbraith
- Price Institute of Surgical Research, University of Louisville School of Medicine, Louisville, KY 40202, USA.,Department of Surgery, University Hospital Wishaw, Wishaw, North Lanarkshire ML2 0DP, UK
| | - Maurice R Eichenberger
- Price Institute of Surgical Research, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Harshini Sarojini
- Price Institute of Surgical Research, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Eyas Hattab
- Department of Pathology and Laboratory Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Susan Galandiuk
- Price Institute of Surgical Research, University of Louisville School of Medicine, Louisville, KY 40202, USA
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34
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O'Brien SJ, Galandiuk S. Reply to: Atomic bomb and CRISPR gene editing technology. Surgery 2019; 166:956. [PMID: 31331684 DOI: 10.1016/j.surg.2019.05.052] [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] [Received: 05/24/2019] [Accepted: 05/30/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Stephen J O'Brien
- Price Institute of Surgical Research, The Hiram C. Polk Jr., MD Department of Surgery, University of Louisville, KY, USA
| | - Susan Galandiuk
- Price Institute of Surgical Research, The Hiram C. Polk Jr., MD Department of Surgery, University of Louisville, KY, USA.
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35
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O'Brien SJ, Kalbfleisch T, Srivastava S, Rai S, Galandiuk S. Abstract 1817: Differential expression of long non-coding RNA in colon adenocarcinoma RNA-sequence data set. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-1817] [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
Introduction: Colon cancer is the fourth most common cancer in the United States and the third leading cause of cancer-related death. High throughput genomic sequencing has led to a number of significant advances in tumor biology and in identifying novel signaling molecules such as long non-coding RNA (lncRNA). The aim of this study was to identify differentially expressed lncRNA in colon cancer from a large RNA-sequencing (RNA-seq) data set.
Methods: The raw RNA-seq files of 398 patients with colon cancer were downloaded from The Cancer Genome Atlas (TCGA). Sequencing files were aligned using STAR (Spliced Transcripts Alignment to a Reference) to the most recent genome annotation. Using a subset of patients with paired colon cancer and normal colon epithelium RNA-seq data (n=40), an exploratory binomial regression model was used to calculate differential RNA expression. The most differentially expressed lncRNA were identified from the exploratory analysis and verified by comparing the larger colon cancer RNA-seq data set (n=358) with the normal colon epithelium RNA-seq data set (n=40).
Results: 33,514 genes were identified from the comparative analysis, and using differential expression cut off values of > +1.5 or < -1.5 log fold change and a false discovery rate of <0.05; 543 were upregulated and 1822 were downregulated. Within this dysregulated group, 60 lncRNAs were identified. Using the larger data set (n=358 vs n=40), 41/60 lncRNA remained differentially expressed, of which 15 were downregulated and 26 were upregulated. Twenty-four of these lncRNAs have not previously been described in colon cancer, 12 of which are upregulated and 12 of which are downregulated (Table 1).
Conclusions: This analysis of RNA-seq data from TCGA has identified dysregulated lncRNAs which have not previously been described in human colon cancer. These lncRNAs may have significant roles in colon cancer tumor signaling.
Table 1.Differential expression of lncRNA not described in colon cancerlncRNALog Fold ChangeP-valueDescription in other cancersKRT16P14.1041.36E-21Increased in lung squamous cell carcinomaBOK-AS13.7784.98E-09Increased in oral squamous cell carcinomaCELP3.1151.30E-09Not availableCLDN10-AS12.3944.61E-12Not availablePOU6F2-AS12.2678.25E-09Not availableSLC7A11-AS12.1931.60E-13Decreased in gastric adenocarcinomaCSAG42.1083.59E-10Not availableLUCAT12.0224.21E-11Increased in Ovarian cancer, renal clear cell carcinoma, head and neck squamous cell carcinoma, Non-small cell cancer, glioma, osteosarcoma, esophageal squamous cell carcinomaVPS9D1-AS11.9795.27E-21Decreased in gastric adenocarcinoma, Increased in non-small cell lung cancerLEF1-AS11.8464.48E-13Increased in glioblastomaCASC81.6485.64E-06Single nucleotide polymorphisms in colorectal adenocarcinomaLINC004911.5903.11E-04Not availableLINC00648-1.5021.02E-15Not availableLINC00163-1.6751.03E-22Not availableSATB2-AS1-1.8074.18E-09Increased in osteosarcomaLINC00702-2.1424.81E-18Not availableTRHDE-AS1-2.2623.44E-24Not availableLINC00908-2.3082.76E-103Not availableLINC00483-2.4012.87E-39Increased in gastric adenocarcinomaLINC00461-2.4401.42E-41Increased in glioma, multiple myelomaFENDRR-2.6872.12E-58Decreased in breast cancer, prostate cancer, osteosarcoma, gastric adenocarcinoma,ARHGEF26-AS1-2.7148.55E-32Not availableADAMTS9-AS2-2.9041.78E-74Increased in lung cancer salivary adenoid cystic carcinoma, Decreased in glioma, gastric adenocarcinomaMT1JP-4.4601.08E-114Decreased in retinoblastoma, Decreased in gastric adenocarcinoma
Citation Format: Stephen J. O'Brien, Theodore Kalbfleisch, Sudhir Srivastava, Shesh Rai, Susan Galandiuk. Differential expression of long non-coding RNA in colon adenocarcinoma RNA-sequence data set [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1817.
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Affiliation(s)
- Stephen J. O'Brien
- 1Price Institute of Surgical Research, University of Louisville, Louisville, KY
| | | | | | - Shesh Rai
- 2University of Louisville, Louisville, KY
| | - Susan Galandiuk
- 1Price Institute of Surgical Research, University of Louisville, Louisville, KY
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36
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O'Brien SJ, Ekman MB, Manek S, Galandiuk S. CRISPR-mediated gene editing for the surgeon scientist. Surgery 2019; 166:129-137. [PMID: 30922545 DOI: 10.1016/j.surg.2019.01.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/16/2019] [Accepted: 01/23/2019] [Indexed: 12/19/2022]
Abstract
Tremendous advances have occurred in gene editing during the past 20 years with the development of a number of systems. The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-associated protein 9 (Cas9) system represents an exciting area of research. This review examines both the relevant studies pertaining to the history, current status, and modifications of this system, in comparison with other gene-editing systems and future applications, and limitations of the CRISPR-Cas9 gene-editing system, with a focus on applications of relevance to the surgeon scientist. The CRISPR-Cas9 system was described initially in 2012 for gene editing in bacteria and then in human cells, and since then, a number of modifications have improved the efficiency and specificity of gene editing. Clinical studies have been limited because further research is required to verify its safety in patients. Some clinical trials in oncology have opened, and early studies have shown that gene editing may have a particular role in the field of organ transplantation and in the care of trauma patients. Gene editing is likely to play an important role in future research in many aspects of the surgery arena.
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Affiliation(s)
- Stephen J O'Brien
- Price Institute of Surgical Research, The Hiram C. Polk Jr MD Department of Surgery, University of Louisville, Louisville, KY
| | - Matthew B Ekman
- Price Institute of Surgical Research, The Hiram C. Polk Jr MD Department of Surgery, University of Louisville, Louisville, KY
| | - Stephen Manek
- Price Institute of Surgical Research, The Hiram C. Polk Jr MD Department of Surgery, University of Louisville, Louisville, KY
| | - Susan Galandiuk
- Price Institute of Surgical Research, The Hiram C. Polk Jr MD Department of Surgery, University of Louisville, Louisville, KY.
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Wise A, Galandiuk S. Ileal pouch anal anastomosis in women of childbearing age: The impact of surgery upon sexual function, fertility, pregnancy, and mode of delivery. Seminars in Colon and Rectal Surgery 2019. [DOI: 10.1053/j.scrs.2019.01.010] [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: 11/11/2022]
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Al-Eryani L, Jenkins SF, States VA, Pan J, Malone JC, Rai SN, Galandiuk S, Giri AK, States JC. miRNA expression profiles of premalignant and malignant arsenic-induced skin lesions. PLoS One 2018; 13:e0202579. [PMID: 30114287 PMCID: PMC6095593 DOI: 10.1371/journal.pone.0202579] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 08/06/2018] [Indexed: 12/21/2022] Open
Abstract
Arsenic, a naturally occurring element, contaminates the drinking water of over 200 million people globally. Chronic arsenic exposure causes multiple cancers including those originating from skin, lung and bladder, and is associated with liver, kidney, and prostate cancers. Skin is the primary target organ for arsenic toxicity; chronic toxicity initially manifests as non-malignant hyperkeratoses (HK) and subsequently advances to malignant lesions, including squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). In this study, we evaluate the miRNA expression profiles of premalignant (3 HK) and malignant (3 BCC and 3 SCC) skin lesions from individuals chronically exposed to high levels of arsenic (59–172 ppb) in their drinking water in West Bengal, India. The lesions were histologically complex requiring histopathologic identification of keratinocytes to be isolated for RNA analyses. Keratinocytes were harvested using Laser Capture Microdissection and miRNA expression profiles were determined using TaqMan® Array Human MiRNA A Card v2.0. Thirty-five miRNAs were differentially expressed among the three lesion types analyzed. Two miRNAs (miR-425-5p and miR-433) were induced in both BCC and SCC relative to HK indicating their association with malignancy. Two other miRNAs (miR-184 and miR-576-3p) were induced in SCC relative to both BCC and HK suggesting selective induction in tumors capable of metastasis. Six miRNAs (miR-29c, miR-381, miR-452, miR-487b, miR-494 and miR-590-5p) were selectively suppressed in BCC relative to both SCC and HK. In conclusion, the differential miRNA expression was both phenotype- and stage-related. These miRNAs are potential biomarkers and may serve as therapy targets for arsenic-induced internal tumors.
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Affiliation(s)
- Laila Al-Eryani
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY, United States of America
| | - Samantha F. Jenkins
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY, United States of America
| | - Vanessa A. States
- Price Institute of Surgical Research, University of Louisville, Louisville, KY, United States of America
| | - Jianmin Pan
- Biostatistics Shared Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, United States of America
| | - Janine C. Malone
- Department of Medicine, University of Louisville, Louisville, KY, United States of America
| | - Shesh N. Rai
- Biostatistics Shared Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, United States of America
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, United States of America
| | - Susan Galandiuk
- Price Institute of Surgical Research, University of Louisville, Louisville, KY, United States of America
| | - Ashok K. Giri
- Molecular Genetics Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - J. Christopher States
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY, United States of America
- * E-mail:
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Netz U, Galbraith NJ, O'Brien S, Carter J, Manek S, Petras RE, Galandiuk S. Long-term outcomes following ileal pouch-anal anastomosis in patients with indeterminate colitis. Surgery 2018; 163:535-541. [DOI: 10.1016/j.surg.2017.11.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/10/2017] [Accepted: 11/16/2017] [Indexed: 02/07/2023]
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O'Brien SJ, Carter JV, Burton JF, Oxford BG, Schmidt MN, Hallion JC, Galandiuk S. The role of the miR-200 family in epithelial-mesenchymal transition in colorectal cancer: a systematic review. Int J Cancer 2018; 142:2501-2511. [DOI: 10.1002/ijc.31282] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/16/2018] [Accepted: 01/23/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Stephen J. O'Brien
- Price Institute of Surgical Research, The Hiram C. Polk Jr., M.D. Department of Surgery, University of Louisville; Louisville KY
| | - Jane V. Carter
- Price Institute of Surgical Research, The Hiram C. Polk Jr., M.D. Department of Surgery, University of Louisville; Louisville KY
- Department of Surgery; North Cumbria University Hospitals NHS Trust; Whitehaven Cumbria United Kingdom
| | - James F. Burton
- Price Institute of Surgical Research, The Hiram C. Polk Jr., M.D. Department of Surgery, University of Louisville; Louisville KY
| | - Brent G. Oxford
- Price Institute of Surgical Research, The Hiram C. Polk Jr., M.D. Department of Surgery, University of Louisville; Louisville KY
| | - Miranda N. Schmidt
- Price Institute of Surgical Research, The Hiram C. Polk Jr., M.D. Department of Surgery, University of Louisville; Louisville KY
| | - Jacob C. Hallion
- Price Institute of Surgical Research, The Hiram C. Polk Jr., M.D. Department of Surgery, University of Louisville; Louisville KY
| | - Susan Galandiuk
- Price Institute of Surgical Research, The Hiram C. Polk Jr., M.D. Department of Surgery, University of Louisville; Louisville KY
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Chiodini RJ, Dowd SE, Barron JN, Galandiuk S, Davis B, Glassing A. Transitional and temporal changes in the mucosal and submucosal intestinal microbiota in advanced Crohn's disease of the terminal ileum. J Med Microbiol 2018; 67:549-559. [PMID: 29458679 DOI: 10.1099/jmm.0.000690] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 01/09/2023] Open
Abstract
PURPOSE Crohn's disease is a chronic debilitating intestinal syndrome of unknown aetiology that is thought to result in part from an imbalance (dysbiosis) of the intestinal microbial populations, known as the microbiota. In this study we sought to compare the microbiota at the mucosal and submucosal levels at the resection margin in Crohn's disease to those in other intestinal dysbiotic disease controls to determine the level of bacterial translocation. METHODOLOGY 16S microbiota sequencing was performed on DNA extracted from mucosal and submucosal samples from resected intestinal tissues from Crohn's disease and controls. RESULTS Grossly normal appearing tissue at the resection margin showed early signs, suggesting bacterial translocation, with two bacterial families having penetrated the mucosal surfaces. In contrast, 4 and 13 bacterial families were present within submucosal tissues at the disease centre and disease margin, respectively. Although there was no significant difference in biodiversity, there was increased bacterial richness in the Crohn's disease group as compared to non-IBD controls. CONCLUSION The presence and/or absence of certain bacteria suggested disease-specific ecological or micro-environmental pressures driving or excluding certain organisms in Crohn's disease. The data suggest that several of the dysbiotic conditions previously reported for Crohn's disease are not unique but common to general dysbiosis. The examination of multiple intestinal sites in advanced disease may provide a spectrum of disease from early onset at the resection margin to active disease at the disease margin and late-stage fibrostenotic disease at the centre of the lesion, and a unique etiopathogenic view of Crohn's disease.
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Affiliation(s)
- Rodrick J Chiodini
- Department of Biological and Physical Sciences, Montana State University-Billings, Billings, MT, USA.,St Vincent Healthcare, Sisters of Charity of Leavenworth Health System, Billings, MT, USA
| | - Scot E Dowd
- Molecular Research (Mr DNA), Shallowater, TX, USA
| | - James N Barron
- Department of Biological and Physical Sciences, Montana State University-Billings, Billings, MT, USA
| | - Susan Galandiuk
- Department of Surgery, University of Louisville, Louisville, KY, USA
| | - Brian Davis
- Department of Surgery, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Angela Glassing
- Department of Biological and Physical Sciences, Montana State University-Billings, Billings, MT, USA
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Abstract
Inflammatory bowel diseases (IBDs) affecting the colon [Crohn's disease (CD) and ulcerative colitis (UC)] are associated with an increased risk of colorectal cancer (CRC). Our previous work using oligonucleotide array data indicated that SMAD2 was significantly underexpressed in UC dysplastic tissue compared to benign UC. The aim of this current study was to determine whether single nucleotide polymorphisms (SNPs) within the SMAD2 gene are associated with IBD dysplasia/cancer. We performed an SNP haplotype-based case-control association study. Leukocyte DNA was obtained from 489 unrelated Caucasians (158 UC, 175 CD, 71 CRC, 85 controls). Eleven SNPs were genotyped. All 11 SNPs were in Hardy-Weinberg equilibrium in the control population. Strong linkage disequilibrium was observed among nearly all SMAD2 SNPs. There were no significant associations between SMAD2 allele or haplotype frequencies. Power calculations indicated good power for single-marker analysis (>0.8) and reasonably good power against effects of 0.1–0.15 for haplotype analysis. SMAD2 SNPs were not associated with the development of IBD dysplasia/cancer. This incongruity between our previous microarray data and the findings from this genotype study may be attributed to mechanisms such as alternative splicing of pre-mRNA SMAD2 and/or cross talk with other cellular pathways.
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Affiliation(s)
- S.S. Mahid
- Price Institute of Surgical Research and the Section of Colorectal Surgery, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
| | - K.S. Minor
- Price Institute of Surgical Research and the Section of Colorectal Surgery, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
| | - B.C. Brangers
- Price Institute of Surgical Research and the Section of Colorectal Surgery, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
| | - G.A. Cobbs
- Department of Biology, University of Louisville, Kentucky - USA
| | - S. Galandiuk
- Price Institute of Surgical Research and the Section of Colorectal Surgery, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
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Netz U, Carter J, Eichenberger MR, Feagins K, Galbraith NJ, Dryden GW, Pan J, Rai SN, Galandiuk S. Plasma microRNA Profile Differentiates Crohn's Colitis From Ulcerative Colitis. Inflamm Bowel Dis 2018; 24:159-165. [PMID: 29272478 PMCID: PMC5858028 DOI: 10.1093/ibd/izx009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is commonly divided into 2 entities: Crohn's disease (CD) and ulcerative colitis (UC). Differentiating between these entities when dealing with IBD confined to the colon is important, especially when planning surgical treatment. Due to ambiguous histological or endoscopic findings, accurate diagnosis is not possible in up to 15% of cases. The aim of this study was to determine whether plasma microRNAs (miRNAs) can help differentiate Crohn's colitis (CC) from ulcerative colitis. METHODS Patients with isolated CC and with UC were enrolled in our study from January 2010 to May 2016. Peripheral blood was collected, and total RNA was isolated from plasma. Screening was performed for 380 common miRNAs. miRNAs that were differentially expressed between these 2 groups were chosen, and their differential expression was confirmed using single miRNA assays in a larger sample size. A predictive model was generated using these data. Significantly differentially expressed miRNAs were then validated utilizing the predictive model to assess blinded data from the single assays. RESULTS Screening was performed on 8 patients from each group. Seven differentially expressed miRNAs were chosen for single assay confirmation. Two miRNAs (miR-598, miR-642) were consistently different between the patient groups (P = 0.013, P = 0.005). Using blinded data, these 2 miRNAs were validated using the predictive model, achieving an overall accuracy of 75% (95% confidence interval, 40.7-92.9). CONCLUSIONS We identified 2 plasma miRNAs that differentiated CC from UC. Our data indicate the promise and feasibility of a plasma miRNA-based assay to distinguish between these 2 conditions.
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Affiliation(s)
- Uri Netz
- Price Institute of Surgical Research, The Hiram C. Polk Jr., MD Department of
Surgery, University of Louisville, Louisville, Kentucky,Department of Surgery A, Soroka University Medical Center, Beer Sheva,
Israel,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva,
Israel
| | - Jane Carter
- Price Institute of Surgical Research, The Hiram C. Polk Jr., MD Department of
Surgery, University of Louisville, Louisville, Kentucky
| | - M Robert Eichenberger
- Price Institute of Surgical Research, The Hiram C. Polk Jr., MD Department of
Surgery, University of Louisville, Louisville, Kentucky
| | - Kayla Feagins
- Price Institute of Surgical Research, The Hiram C. Polk Jr., MD Department of
Surgery, University of Louisville, Louisville, Kentucky
| | - Norman J Galbraith
- Price Institute of Surgical Research, The Hiram C. Polk Jr., MD Department of
Surgery, University of Louisville, Louisville, Kentucky
| | - Gerald W Dryden
- Department of Medicine, Division of Gastroenterology, Hepatology, and
Nutrition University of Louisville School of Medicine Louisville, Kentucky
| | - Jianmin Pan
- Department of Bioinformatics and Biostatistics, University of Louisville
School of Public Health and Information Sciences, Louisville, Kentucky
| | - Shesh N Rai
- Department of Bioinformatics and Biostatistics, University of Louisville
School of Public Health and Information Sciences, Louisville, Kentucky
| | - Susan Galandiuk
- Price Institute of Surgical Research, The Hiram C. Polk Jr., MD Department of
Surgery, University of Louisville, Louisville, Kentucky,Address correspondence to: Susan Galandiuk, MD, FACG, AGAF, The Hiram C.
Polk Jr, MD Department of Surgery, 550 South Jackson Street, Louisville, KY 40202 (e-mail:
)
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Netz U, Carter JV, Eichenberger MR, Dryden GW, Pan J, Rai SN, Galandiuk S. Genetic polymorphisms predict response to anti-tumor necrosis factor treatment in Crohn’s disease. World J Gastroenterol 2017; 23:4958-4967. [PMID: 28785150 PMCID: PMC5526766 DOI: 10.3748/wjg.v23.i27.4958] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 04/05/2017] [Accepted: 05/04/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate genetic factors that might help define which Crohn’s disease (CD) patients are likely to benefit from anti-tumor necrosis factor (TNF) therapy.
METHODS This was a prospective cohort study. Patients were recruited from a university digestive disease practice database. We included CD patients who received anti-TNF therapy, had available medical records (with information on treatment duration and efficacy) and who consented to participation. Patients with allergic reactions were excluded. Patients were grouped as ever-responders or non-responders. Genomic DNA was extracted from peripheral blood, and 7 single nucleotide polymorphisms (SNPs) were assessed. The main outcome measure (following exposure to the drug) was response to therapy. The patient genotypes were assessed as the predictors of outcome. Possible confounders and effect modifiers included age, gender, race, and socioeconomic status disease, as well as disease characteristics (such as Montreal criteria).
RESULTS 121 patients were included. Twenty-one were non-responders, and 100 were ever-responders. Fas ligand SNP (rs763110) genotype frequencies, TNF gene -308 SNP (rs1800629) genotype frequencies, and their combination, were significantly different between groups on multivariable analysis controlling for Montreal disease behavior and perianal disease. The odds of a patient with a Fas ligand CC genotype being a non-responder were four-fold higher as compared to a TC or TT genotype (P = 0.009, OR = 4.30, 95%CI: 1.45-12.80). The presence of the A (minor) TNF gene -308 allele correlated with three-fold higher odds of being a non-responder (P = 0.049, OR = 2.88, 95%CI: 1.01-8.22). Patients with the combination of the Fas ligand CC genotype and the TNF -308 A allele had nearly five-fold higher odds of being a non-responder (P = 0.015, OR = 4.76, 95%CI: 1.35-16.77). No difference was seen for the remaining SNPs.
CONCLUSION The Fas-ligand SNP and TNF gene -308 SNP are associated with anti-TNF treatment response in CD and may help select patients likely to benefit from therapy.
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Carter JV, Galbraith NJ, Kim W, Galandiuk S. Comment on: Patient autonomy-centered self-care checklist reduces hospital readmissions after ileostomy creation. Surgery 2017; 162:693-694. [PMID: 28666683 DOI: 10.1016/j.surg.2017.05.014] [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] [Received: 05/19/2017] [Accepted: 05/23/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Jane V Carter
- Price Institute of Surgical Research, The Hiram C. Polk Jr. MD, Department of Surgery, Louisville, KY
| | - Norman J Galbraith
- Price Institute of Surgical Research, The Hiram C. Polk Jr. MD, Department of Surgery, Louisville, KY
| | - Woihwan Kim
- University of Louisville School of Medicine, University of Louisville, Louisville, KY
| | - Susan Galandiuk
- Price Institute of Surgical Research, The Hiram C. Polk Jr. MD, Department of Surgery, Louisville, KY.
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Bhutiani N, Grizzle W, Galandiuk S, Otali D, Dryden G, Egilmez N, Mcnally LR. Abstract 1863: Non-invasive imaging of colitis using multispectral optoacoustic tomography. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-1863] [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
Background: Currently, several non-invasive modalities, including MRI and PET, are being investigated to identify early intestinal inflammation, longitudinally monitor disease status, or detect dysplastic changes in patients with inflammatory bowel disease (IBD). Currently, multispectral optoacoustic tomography (MSOT; often in combination with ultrasound) has been used to effectively image tumor xenografts as well as several orthotopic tumor models, including pancreatic adenocarcinoma, but not to specifically assess inflammatory or dysplastic changes in the bowel in murine models. Here, we assess the applicability and utility of (MSOT) in evaluating the presence and severity of colitis.
Methods: Nine 6-7 week old C57B/6 mice underwent antibiotic depletion of gastrointestinal flora before inoculation with enterotoxic Bacteroides fragilis to induce colitis. Mice were then anesthetized, depilated, imaged from their superior thorax to inferior pelvis using MSOT. Mice were evaluated prior to bacterial inoculation, 2 days after inoculation, and 7 days after inoculation. MSOT values for oxygenated and deoxygenated hemoglobin were determined using MSOT imaging software and compared using linear regression. At each timepoint, three mice underwent colonoscopy prior to euthanasia and colon processing for histology.
Results: Mice with bacterially-induced colitis demonstrated a temporally-associated increase in mesenteric and colonic vascularity, with an increase in mean signal intensity of oxygenated hemoglobin (1.150 vs. 2.716 MSOT a.u. compared to controls; p=0.004) by MSOT two days after inoculation. These findings were significantly more prominent 7 days after inoculation, with increased mean signal intensity of oxygenated hemoglobin (1.150 vs. 2.716 vs. 3.422 MSOT a.u. for controls vs. 2 days post-ETBF vs. 7 days post-ETBF, p=0.0002) and the development of punctate vascular lesions on the colonic surface. Compared to untreated controls, mice at 2 days and 7 days post ETBF inoculation demonstrated an increased colitis score on colonoscopy (1.5 vs. 2.5 vs. 5.5), which correlated well with MSOT findings of mean oxygenated hemoglobin signal intensity (r=0.82, p=0.013). These findings were also associated with inflammatory changes observed on histologic analysis.
Conclusions: MSOT represents a non-invasive diagnostic modality that effectively identifies colitis in a murine model. With improvements in depth of tissue penetration, MSOT may hold potential as a sensitive, accurate, non-invasive imaging tool in evaluation of both disease status and early detection of malignancy in patients with IBD.
Citation Format: Neal Bhutiani, William Grizzle, Susan Galandiuk, Dennis Otali, Gerald Dryden, Nejat Egilmez, Lacey R. Mcnally. Non-invasive imaging of colitis using multispectral optoacoustic tomography [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 1863. doi:10.1158/1538-7445.AM2017-1863
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Affiliation(s)
- Neal Bhutiani
- 1Univ. of Louisville Brown Cancer Ctr., Louisville, KY
| | | | | | | | - Gerald Dryden
- 1Univ. of Louisville Brown Cancer Ctr., Louisville, KY
| | - Nejat Egilmez
- 1Univ. of Louisville Brown Cancer Ctr., Louisville, KY
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Bhutiani N, Grizzle WE, Galandiuk S, Otali D, Dryden GW, Egilmez NK, McNally LR. Noninvasive Imaging of Colitis Using Multispectral Optoacoustic Tomography. J Nucl Med 2016; 58:1009-1012. [PMID: 27908970 DOI: 10.2967/jnumed.116.184705] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 11/17/2016] [Indexed: 12/20/2022] Open
Abstract
Currently, several noninvasive modalities, including MRI and PET, are being investigated to identify early intestinal inflammation, longitudinally monitor disease status, or detect dysplastic changes in patients with inflammatory bowel disease. Here, we assess the applicability and utility of multispectral optoacoustic tomography (MSOT) in evaluating the presence and severity of colitis. Methods: C57B/6 mice were untreated or treated with Bacteroides fragilis and antibiotic-mediated depletion of intestinal flora to initiate colitis. Mice were imaged using MSOT to detect intestinal inflammation. Intestinal inflammation identified with MSOT was also confirmed using both colonoscopy and histology. Results: Mice with bacterial colitis demonstrated a temporally associated increase in mesenteric and colonic vascularity with an increase in mean signal intensity of oxygenated hemoglobin (P = 0.004) by MSOT 2 d after inoculation. These findings were significantly more prominent 7 d after inoculation, with increased mean signal intensity of oxygenated hemoglobin (P = 0.0002) and the development of punctate vascular lesions on the colonic surface, which corresponded to changes observed on colonoscopy as well as histology. Conclusion: With improvements in depth of tissue penetration, MSOT may hold potential as a sensitive, accurate, noninvasive imaging tool in the evaluation of patients with inflammatory bowel disease.
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Affiliation(s)
- Neal Bhutiani
- Department of Surgery, University of Louisville, Louisville, Kentucky
| | - William E Grizzle
- Department of Pathology, University of Alabama Birmingham, Birmingham, Alabama
| | - Susan Galandiuk
- Department of Surgery, University of Louisville, Louisville, Kentucky
| | - Denis Otali
- Department of Pathology, University of Alabama Birmingham, Birmingham, Alabama
| | - Gerald W Dryden
- Department of Surgery, University of Louisville, Louisville, Kentucky
| | - Nejat K Egilmez
- Department of Microbiology and Immunology, University of Louisville, Louisville, Kentucky; and
| | - Lacey R McNally
- Department of Cancer Biology, Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina
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Abstract
Rosai-Dorfman disease (RDD) is a rare, acquired disease of unknown etiology that affects primarily children and young adults. It is characterized by a proliferation of distinctive histiocytes in the lymph nodes and/or extranodal sites. Involvement of the gastrointestinal tract is rare. We report a case of RDD in a 60-year-old woman who presented with hematochezia and was found to have RDD of the rectum presenting as a rectal mass. This report highlights the current pathogenetic mechanisms, immunohistochemical markers, and the gastrointestinal manifestations of RDD.
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Affiliation(s)
- Houda Alatassi
- Department of Pathology, University of Louisville Hospital, Louisville, KY 40202, USA
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Chiodini RJ, Dowd SE, Galandiuk S, Davis B, Glassing A. The predominant site of bacterial translocation across the intestinal mucosal barrier occurs at the advancing disease margin in Crohn's disease. Microbiology (Reading) 2016; 162:1608-1619. [PMID: 27418066 DOI: 10.1099/mic.0.000336] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Crohn's disease is characterized by increased permeability of the intestinal mucosal barriers and an abnormal or dysregulated immune response to specific and/or commensal bacteria arising from the intestinal lumen. To determine the types of bacteria that are transgressing the mucosal barrier and colonizing the intestinal submucosal tissues, we performed 16S rRNA gene microbiota sequencing of the submucosal and mucosal tissues at the advancing disease margin in ileal Crohn's disease. Microbial populations were compared between mucosa and submucosa and non-inflammatory bowel disease (non-IBD) controls, as well as to microbial populations previously found at the centre of the disease lesion. There was no significant increase in bacteria within the submucosa of non-IBD controls at any taxonomic level when compared to the corresponding superjacent mucosa, indicating an effective mucosal barrier within the non-IBD population. In contrast, there was a statistically significant increase in 13 bacterial families and 16 bacterial genera within the submucosa at the advancing disease margin in Crohn's disease when compared to the superjacent mucosa. Major increases within the submucosa included bacteria of the Families Sphingomonadaceae, Alicyclobacillaceae, Methylobacteriaceae, Pseudomonadaceae and Prevotellaceae. Data suggest that the primary site of bacterial translocation across the mucosal barrier occurs at the margin between diseased and normal tissue, the advancing disease margin. The heterogeneity of the bacterial populations penetrating the mucosal barrier and colonizing the submucosal intestinal tissues and, therefore, contributing to the inflammatory processes, suggests that bacterial translocation is secondary to a primary event leading to a breakdown of the mucosal barrier.
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Affiliation(s)
- Rodrick J Chiodini
- St Vincent Healthcare, Sisters of Charity of Leavenworth Health System, Billings, MT, USA.,Department of Biological and Physical Sciences, Montana State University-Billings, Billings, MT, USA
| | - Scot E Dowd
- Molecular Research (Mr. DNA), Shallowater, TX, USA
| | - Susan Galandiuk
- Hiram C. Polk, Jr. MD, Department of Surgery, University of Louisville, Louisville, KY, USA
| | - Brian Davis
- Department of Surgery, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Angela Glassing
- Department of Biological and Physical Sciences, Montana State University-Billings, Billings, MT, USA
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Carter J, States V, Netz U, Pan J, Rai S, Galandiuk S. Abstract B32: Longitudinal changes in plasma miRNA in patients with benign and malignant colorectal neoplasia. Cancer Res 2016. [DOI: 10.1158/1538-7445.nonrna15-b32] [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
Introduction: The adenoma-carcinoma sequence is well-recognized as a stepwise pattern of mutational activation of oncogenes and inactivation of tumor suppressor genes resulting in sporadic colorectal cancer (CRC) development from colorectal adenomas (CRA) within the chromosomal instability pathway. MicroRNAs (miRNA) play an important role in oncogenesis by regulating gene expression and are known to be actively released from cells. They are found in body fluids such as plasma, saliva, feces and urine. We have previously demonstrated differential expression of plasma miRNAs in patients with CRC as compared to that of controls.
Methods: Plasma was isolated from 10 patients: 5 patients with advanced colorectal adenoma (>0.6cm diameter) and 5 patients with stage II or III colorectal cancer prior to treatment and 4-6 weeks following endoscopic removal or surgical resection, respectively. RNA was extracted from plasma (Qiagen® miRNeasy), RT-PCR performed and 768 miRNAs were screened using microfluidic array technology (Applied BioSystems®) in pre- and post-treatment samples for each patient. Data were analyzed using paired t-tests after normalizing raw cycle threshold data to endogenous RNU6 for pre- and post-treatment samples. In addition, miRNA expression data from both pre- and post-treatment CRA and CRC samples were compared to that of plasma from 10 individuals without neoplasia (controls) (ANOVA).
Results: Significant differential expression of plasma miRNAs was observed between pre- and post-treatment samples in both CRA and CRC groups. Interestingly, there was generalized miRNA upregulation in CRA when comparing pre-treatment samples to post-treatment samples. Conversely there was miRNA down-regulation in pre-treatment CRC plasma as compared to post-resection samples. Utilizing significantly dysregulated miRNAs, as well as p-values, AUC, fold-change and biological significance, miRNA panels were selected to facilitate detection of CRA recurrence (following complex polypectomy for large polyps) or for detection of recurrent CRC following resection. The resulting panel was able to differentiate between pre- and post-treatment samples for CRA (miR-186 and miR-623) with AUC 0.94 (95% CI 0.76 – 1.00) and for CRC (miR-324-5p, miR-30d and miR-766) with AUC 0.88 (95% CI 0.63 – 1.00). In addition, while miRNA expression of pre-treatment CRA and CRC samples differed significantly from controls, post-treatment CRA and CRC samples did not.
Conclusion: Comparison of pre- and post-treatment plasma samples reveals differing patterns of changes in miRNA expression in benign colorectal neoplasms (CRA) as opposed to invasive neoplasia (CRC). The observed miRNA down-regulation prior to surgical resection of CRC might indicate decreased expression of miRNAs inhibiting oncogenes prior to cancer treatment, while the miRNA upregulation seen in pre-treatment CRA plasma could indicate inhibition of tumor suppressors. Such observations will perhaps elucidate the role of miRNA in carcinogenesis and may provide for a relatively non-invasive method of detecting such lesions. Further validation is needed to develop a miRNA panel that will allow monitoring for evidence of recurrent disease.
Citation Format: Jane Carter, Vanessa States, Uri Netz, Jianmin Pan, Shesh Rai, Susan Galandiuk. Longitudinal changes in plasma miRNA in patients with benign and malignant colorectal neoplasia. [abstract]. In: Proceedings of the AACR Special Conference on Noncoding RNAs and Cancer: Mechanisms to Medicines ; 2015 Dec 4-7; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2016;76(6 Suppl):Abstract nr B32.
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Affiliation(s)
| | | | - Uri Netz
- University of Louisville, Louisville, KY
| | | | - Shesh Rai
- University of Louisville, Louisville, KY
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